Toronto Public Health (TPH) is raising concerns that potential provincial changes to its funding formula could have a dramatic impact on some of the services it provides.
In a presentation to TPH’s Budget Committee this week, staff said a number of programs would be at risk if the province follows an earlier plan to cut its share of funding for public health units.
By 2018, the province shared costs with Ontario’s public health units at a 75-25 percent split.
The proposed funding model for public health units in the 2019 budget reduced the provincial share to 70 percent, with the aim of further reducing it to 60-40 in the next year and 50-50 the year after that.
However, due to the COVID-19 pandemic, the province maintained its share at 70 percent over the past few years and provided “mitigation funding” which kept support at 2018 levels.
However, it is not clear if this will continue as the province emerges from the pandemic, raising the prospect that public health funding could be cut dramatically.
The health unit said on Monday it could be short by $ 49 million next year if the province proceeds with a new funding formula.
If that happens, the programs with the highest risk of cuts include the harm reduction program with housing, support and Housing, which is fully funded by the city, as well as a safe injection program for people trying to get off opioids and various capital projects.
But various other programs paid for through provincial mitigation funding would also be at risk.
At a Toronto Board of Public Health meeting earlier this month, Finance and Administration director Althea Hutchinson said “there would be some very difficult decisions that would have to be made” if the funding model changes.
“I would characterize it as more than devastating,” Hutchinson said when asked about the impact if the province proceeds with the original plan, which would eventually see an estimate of $ 100 million in provincial funding cut from TPH’s budget.
In an email to him CP24.com on Thursday, a spokesman for Health Minister Sylvia Jones said there was no plan to change the formula, but did not clarify how long the policy would last.
“There are no plans to change cost-sharing ratios, and the dollar amount flowing to public health units reflects a 75-25 cost-sharing ratio,” the email read.
“Yesterday the minister met with the Association of local public health agencies (ALPHA), including (Toronto Medical Health Officer) Dr. eileen de Villa. At that meeting the minister provided ALPHA and Dr. De Villa will have no changes in the cost sharing ratio and that our government will continue to invest in public health.”
Toronto’s Public Health Department said CP24.com in an email Thursday that they have not received any communication confirming the funding formula for 2024 so far.
In an interview with Coun. Chris Moise, who chairs TPH’s board, said the comments from Jones ‘ office give him “little to no confidence” in terms of what will happen to funding the health unit next year.
In fact, the city has not yet received confirmation of the provincial funding formula for 2023, although staff do not expect any dramatic changes for this year.
“We’re in what month, July? It’s just nuts, ” said Moise
Jones ‘ office did not clarify when asked explicitly whether the formula would remain unchanged for 2024.
Moise said the programs affected would be wide-ranging, and because TPH is primarily a service-based organization, funding cuts would amount to downloads.
“I think it’s important to really zone out what this is all about; we’re talking about cutting staff, frontline staff in public health doing the heavy lifting every day. There will be fewer of them,” he said.
He also noted that Ontario recently received billions of dollars in additional federal funding through a new health agreement with the provinces.
Speaking on Jan. 5 TPH Board Meeting, de Villa said it is important to recognize public health as an “investment” in the health of the population.
“It’s an investment in prevention that actually saves money on the streets, especially, Yes, in health care. But savings aren’t just about health. We see them in practically every sector of society,” De Villa said. “The challenge of course with prevention is it’s really hard to explain the value of what didn’t happen, right? And that, I think, is the challenge that has always existed for us as public health; very difficult to sell the value of what didn’t happen.”
During the pandemic, TPH was highly visible as one of the main agencies monitoring the outbreak, providing advice to the public and facilitating a widespread vaccination campaign. However, the day-to-day work of the agency includes dental programs, sexual health programs, food safety, and the Prevention of chronic diseases and injuries.
TPH’s Budget Committee voted Monday to recommend that the board ask the province to “provide sufficient and sustainable funding for Toronto Public Health to meet the health needs of Toronto’s population, taking into account things like inflationary pressures and demands resulting from the COVID-19 pandemic” as well as the impact of the pandemic on other issues like immunization and mental health.
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