Board of Public Health calls for careful consultation, phase in period prior to full blown restructuring by province

The main office of Hastings-Prince Edward Public Health in Belleville, ON. (Google Images/Dave Dodgson/HPEPU staff)



The Board of Hastings Prince Edward Public Health is recommending the province and Premier Doug Ford consult with Boards of Health and municipalities further and institute any changes that modernize public health in Ontario in a carefully timed and phased manner.

The Board responded to the 2019 Provincial Budget, released in April, and the corresponding plans to modernize public health across Ontario at its regular monthly meeting Wednesday and approved a communique directed to Ford.

Medical Officer of Health and HPEPH CEO Dr. Piotr Oglaza told the Gazette the request came as a result of discussion around the board table and a feeling there should be further examination and consultation with regional health agencies.

“We want to ensure the pace at which this is planned to happen does not jeopardize the health and safety of the community,” Oglaza said.

Provincial plans for public health include replacing 35 existing public health units with 10 regional entities and reviewing the municipal/provincial cost sharing formula which is currently set locally at 75 per cent provincial and 25 per cent municipal for HPEPH mandatory programs. 

In addition, several related programs are currently funded 100 per cent by the province. 

Communication from the Ministry of Health and Long Term Care confirmed the province intends to decrease their contribution in varying amounts depending on the size of receiving regions and that municipalities are expected to fund the difference. 

The province is proposing these changes be implemented retroactively to April 1, 2019 and for HPEPH, this means that participating municipalities will be required to contribute 30 per cent for both mandatory and related programs – amounting to over $500,000 and representing a 15 per cent increase in municipal funding to HPEPH for 2019.

The levies directed to the various municipalities served by HPEPH had been set long before the provincial budget was dropped and a drastic rejigging of the funding formula that pushed a portion of Health Unit costs back on municipal tax payer was announced.

According to a press release issued after Wednesday’s monthly board  meeting, the Board of Health recognized the need to implement a sustainable public health system in Ontario and the Board intends to work with the Ministry collaboratively and proactively to ensure HPEPH can respond to local needs as any changes are applied. 

However, it was recognized that options will need to be considered to mitigate the immediate impacts of these unexpected changes in structure and funding 

In efforts to mitigate these impacts, the Board approved the use of the current operational reserve to absorb the cost of the funding formula change. 

“(HPEPH) has been able to reach into its reserves in order to balance our budget and has that option available while we await further instruction and response from the Ministry of Health and Longterm Care,” Oglaza added.

Recognizing that relying on accumulated surplus is a short-term solution, the Board also approved communication to Premier Doug Ford recommending that the province:

  • Consult with Boards of Health and the municipalities they serve prior to implementing any changes
  • Implement any changes in a carefully timed and phased manner that does not jeopardize the health and safety of our communities
  • Postpone any changes to the funding formula until after the implementation of a new regional model, to ensure that public health services are not put at risk
  • Provide additional information regarding regional boundaries, service expectations, and funding to facilitate proactive planning

The communication also reinforces programs and services will need to be delivered in a different way in order to adapt to a new structure and funding model and that HPEPH is willing to work with the Ministry to ensure that any changes are implemented in a manner that minimizes disruption in service.

“We are very hopeful that we can collaborate and develop some mitigation strategies with the (MOHLTC). I know that all of the public health agencies across Ontario are dealing with the same issues and have the same concerns we do,” Oglaza said.

Oglaza added the  work of public health continues to be essential to the long-term sustainability of the health care system by protecting the health of the population and preventing disease and injury before it occurs.

“Maintaining a strong investment in public health programs and services will help reduce cost and strain on the health care system for years to come,” he added.