Funding & Finances

 

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Access the current Funding Agreement.

Learn more about the funding system that enables midwives to provide midwifery services, including: the role of the transfer payment agency (TPA) and the Ontario Midwifery Program (OMP); and the TPA-MPG contract, which outlines how funds are applied for and disbursed to MPGs.

 

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Effectively planning and managing the finances of midwives and their practice group (MPG) is essential to their success. An understanding of the funding model, the establishment of practice systems, responsibilities within contracts, maintenance of records, and timely consultation with specialists will build a healthy foundation for midwives and ongoing security for the practice. Many of these elements will also be relevant to Aboriginal Midwives working in practice groups or midwives working under alternative funding arrangements, but some elements may not be applicable because the funding models vary.

  • TPA-MPG Budget: Understanding the TPA-MPG budget, which implements the Funding Agreement, is key to managing caseload, grants and disbursements.
  • Internal Budget: Understanding the various sources of income and expenses will assist MPGs in making accurate projections that will support a healthy financial practice.
  • Banking and finances: MPGs need to open a business bank account, manage their daily banking while employing financial controls to prevent fraud, and ensure they have adequate cash flow to pay for ongoing expenses while awaiting payment from billings.
  • Accounting & record keeping: Operating an effective business requires developing robust accounting systems to track and report on expenditures. Practice groups are also required to retain and present these records in the event of a financial audit.
  • Fraud prevention: Highly effective fraud prevention controls are necessary to deter fraud and ensure the practice group’s finances are not compromised.  
  • Purchasing: Developing purchasing procedures based on best practices is important to maintaining an accurate budget and financial controls.
  • Taxes: Understanding the tax reporting requirements of individual midwives as independent contractors (including individual deductions and record-keeping) and of practice groups is essential to managing personal taxes and operating a business. Be aware of when a practice would be required to collect and remit HST.
  • Interpractice Care Agreement (ICA): The ICA consists of a guide, templates, and detailed instructions. The template is a tool that calculates how much compensation each midwife and practice group should receive when a client in midwifery care transfers to another midwifery practice.  
  • Signing contracts: All contracts carry a degree of risk and liability and should be entered into with some understanding of the elements of a good contract. Legal counsel can identify problematic clauses in contracts, suggest alternate wording, and if needed assist in the negotiations of a contract; HIROC has also developed a risk note on important clauses in contracts. Practices may wish to develop a policy on contract signing, which addresses clauses to watch out for and signing authority.
  • AOM’s template agreements, which consist of partnership agreement, employee agreement and independent contractor agreement (for midwives and second attendants) can be modified to reflect the MPG’s needs and implemented to establish an understanding of the business relationships between the MPG and its members.