It's been almost 18 months since the grit hit the fan at Algoma Public Health.
First, there was the disclosure by SooToday that the health unit had hired an interim chief financial officer with a serious criminal background.
Then, the resignation of Dr. Kim Barker as APH's medical officer of health and chief executive officer, followed by the scathing provincial assessment of the local board of health, the subsequent resignations of Board Chair Marchy Bruni and three other board members, the related collapses of the Canal Village development and Amit Sofer's medicinal marijuana grow-op venture, then the multimillon-dollar lawsuits against APH and the city.
Today, aftereffects continue to be felt from what the Association of Local Public Health Agencies refers to as Algoma Public Health's "perfect storm."
SooToday's 15-month freedom-of-information battle to access KPMG's forensic review of APH is now spilling over into Ontario's appellate courts, while bureaucrats try to winnow governance and administrative lessons from the chaff of the local scandal.
Brian Beamish, the province's information and privacy commissioner, has twice ordered the KPMG document be turned over to SooToday in its entirety .
Ontario Minister of Health and Long-Term Care Dr. Eric Hoskins, MPP David Orazietti, Mayor Christian Provenzano and the new APH board all want the report made public.
The secret document is known to contain a significant amount of new information that was not included in the public version of Provincial Assessor Graham Scott's report on APH's finances and governance released one year ago.
It's also known to contain sensitive personal information about two individuals, one of whom has fought since last year to keep the document out of SooToday's hands.
This week, she succeeded again in blocking a scheduled handoff of the KPMG report to our newsroom.
This time, the woman, whose identity has never been revealed to us, advised Commissioner Beamish that she's appealing his decision to the Divisional Court, causing him to again order that the planned release to SooToday be delayed.
The unidentified woman argues that the document should remain confidential because it contains deeply sensitive personal information and will expose her to civil liability.
Meanwhile, the Algoma Public Health fiasco is being studied by other health authorities as a cautionary tale.
APH's Interim Chief Executive Officer Tony Hanlon, its Chief Financial Officer Justin Pino and Provincial Assessor Graham Scott conducted a detailed post-mortem of the case at a risk management workshop organized by alPHa, Ontario's Association of Local Public Health Agencies.
To understand good governance, it’s helpful to know what bad governance looks like, Scott told the Toronto gathering, attended by senior health unit staff and board members from 24 boards of health.
Risk management involves identifying, assessing, understanding, acting on, and communicating risk issues, defined as anything that might affect the achievement of organizational goals.
The biggest risk any organization faces is failing to have or to follow good governance practices, Scott told the meeting, as reported on the alPHa website.
"Dr. Hanlon and Mr. Pino explained how poor governance, inexperience and a near-complete lack of due diligence on the part of the Algoma Board of Health laid the foundation for the crisis," the meeting report said.
The analysis of APH traced governance issues back several years before the hiring of Dr. Barker and her interim chief financial officer, who was found to have done a good job with no missing funds.
"It was also these factors that gave rise to the former business administrator [Jeffrey Holmes] committing fraud over time from 2006 to 2013," the alPHa report said.
Asked how such a large amount of money could go missing from 2006 to 2013 without an auditor taking notice, Scott suggested a checklist might help ensure selection of competent help, because not all auditors do quality work.
Based on the Algoma Public Health experience, workshop participants were told that health boards should have:
- employee engagement processes
- arrangement to hire an executive coach or mentor for new medical officers of health and chief executive officers
- professional development plan for medical officers of health and CEOs
- internal and external communications plans
- extraordinary front-line staff
- a skills-based membership with professional expertise in fields including finance and law
- an orientation process for new members of health boards
- a professional development program designed specifically for board members
- a risk management orientation
- an effective board performance evaluation
- board sub-committees (such as governance, audit & risk, finance)
- board procedures and policies
- regular rotation of board chair
- operational policies (including human resources and finance)