SUDBURY—One of the main reasons the board of health for Public Health Sudbury and Districts approving an overall budget increase at a meeting last week is due to increased costs of operating and continuing to provide services, all without much in the way of provincial funding.
Rene Lapierre, chair of the local board of health told The Expositor the 2024 operating budget amounts to $30,073,079, an increase of $1,396,294 over the 2023 budget.
“The biggest reason for the increased costs of operations is we have not received an increase in funding from the province for a long time,” Mr. Lapierre said. He explained PHSD received a provincial funding increase of one percent this year—the first in several years—but this doesn’t meet staff 2.25 percent salary increases this year, nor the benefits package increases. “And the operational costs to provide the services we do have increased.”
“The budget includes minimal costs associated with a significantly downsized COVID-19 program that now must be funded within the cost-shared base budget, and otherwise includes only fixed cost increases and incorporates operational reductions in addition to unfunded budget pressures,” the board of health said in a release.
At its meeting last week, the board of health set its sights on the future of public health for the area and “marked a clear path forward to ensure strong, stable and locally responsive public health capacity,” the press release stated.
As part of the province’s public health system, boards of health are required by law to deliver provincially mandated public health programs and services to promote and protect the health of individuals in their service areas. This public health system is expected to fundamentally change with the sweeping Strengthening Public Health plan announced by the Ministry of Health in August. The ministry’s plan included mergers of existing public health units and a review of local public health roles and responsibilities, both by 2025, and a new approach to funding by 2026.
“With these rapid paced and transformative changes, the board of health and our skilled staff need to have the capacity to fully engage in creating the future of Ontario’s public health system while ensuring we continue to be accountable, transparent and responsive to local needs,” said Mr. Lapierre. “Today (November 16) the board approved the 2024-2028 strategic plan, the budget for 2024 and our first steps in exploring mergers with other local public health units. These decisions mean we will have the strategic direction, resources and roadmap to see public health through 2024 and ensure we emerge as a strong and effective new local public health agency.”
“At our meeting the board passed a motion to support a request for funding from the province to hire a consultant to have a feasibility study done to see if the Algoma Public Health Unit and (PHSD) could amalgamate,” said Mr. Lapierre. “The Algoma board will be looking at this same motion this week and as long as they give their approval, the medical officers of health for both will make a request to the ministry to fund this study,” said Mr. Lapierre. He pointed out in 2015-2016, Algoma Public Health faced losses of their medical officer of health and chief executive officer and the positions were filled with the PHSD representatives running the operations for a year and a half.
“When this took place our MOH and CEO discovered that many of the things Algoma Health does are similar to what PHSD does in terms of services and processes,” continued Mr. Lapierre. He pointed out the closest public health board to Algoma is in Thunder Bay, but this is too large a gap geographically.
In meetings with Algoma health and PHSD, “we all felt that looking into the amalgamation of our two would be the right decision,” said Mr. Lapierre. “If as a board we said no, we will not comply with amalgamation, digging in our heels would not be looked on favourably by the province.”
The province is requesting that board amalgamations take in areas with a total population of at least 500,000. “If our two health units merge, we would have a total population of about 340,000-350,000,” said Mr. Lapierre. “This is a little further than the ask from the province, but our pitch to them will be the geographic factors (going into additional areas further would make it difficult to provide the services the health unit does now). And there maybe efficiencies in services like IT with our proposal.”
Requests for funding for the amalgamation feasibility study need to be in by March, and if a recommendation comes from the province for a proposed merger, this will take place in 2025.
The 2024-2028 board of health strategic plan builds on past successes and sets the direction for local public health. “Our values of humility, trust and respect will continue to underpin our four strategic priorities: equal opportunities for health, impactful relationships, excellence in public health practice and a healthy and resilient workforce.”
“We have counted on our public health team to protect and promote our health, to be there for us, through difficult times, and I am reassured to know that our service will be maintained as we embark on this significant system change,” said Ms. Lapierre.
Under the Health Protection and Promotion Act, there are currently 34 boards of health in Ontario, each with a responsibility to deliver programs and services set out in the Ontario Public Health Standards. These programs and services must consider local contexts and needs, with the goal of improving health for all and with a special focus on those at greater risk of poor health outcomes.
