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Ontario public health units press province for more stable funding

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Ontario's public health units are calling on the government to stop using one-time funding to bridge a gap it created four years ago, and to provide them with a predictable source of money as they address a backlog of services built up over the COVID-19 pandemic.

Premier Doug Ford's government announced in 2019 it was cutting the provincial share of public health funding. It moved from a 75-25 cost-sharing formula with municipalities to 70 per cent from the province and 30 per cent from municipalities.

Following an outcry, Ford backed down on in-year retroactive cuts and offered mitigation funding to help local governments transition to the new formula. That mitigation funding was considered temporary, but has continued through 2023.

Now, the Association of Local Public Health Agencies is asking the government to permanently revert to the original funding level in its upcoming budget.

"There is an overreliance on mitigation and one-time funding to underwrite ongoing and predictable costs," the association wrote in its budget submission.

"It creates unnecessary uncertainty in the budget planning process and carries significant enough financial risk that it can result in the curtailment of important services. The absence of sufficient, predictable, and timely funding of public health through multi-year budgets and a consistent funding formula is a long-standing issue that can and should be easily resolved."

A spokesperson for Health Minister Sylvia Jones noted in a statement that the money flowing to public health units still reflects a 75 per cent contribution from the province.

"Our government will continue to invest in public health," Hannah Jensen wrote.

The public health units are asking the government to boost their overall funding by $145 million so they can meet provincially mandated standards, handle inflationary costs, and catch up on services backlogged due to the pandemic.

Dr. Charles Gardner, the medical officer of health for Simcoe Muskoka and vice-president of the public health association, said through most of the pandemic, health units had to dedicate the majority of their resources to COVID-19.

Recently, staff at his health unit have been able to get back to more regular services, and COVID-response funding from the province has helped, but more will be needed in order to address the backlog that accumulated over the past three years, he said.

"Simply getting our staff back to general programming wouldn't be enough for us to immediately be back to the optimal level of program delivery that we had before the pandemic," Gardner said.

Priority areas include immunizations for children and youth, the response to substance use and opioids, in-school programs to address the oral health of children, mental health promotion and catching up with food safety inspections, he said.

Ottawa Public Health said it needs more funding to support drop-in clinics for parents, accelerate the rollout of outbreak management tools for communicable diseases, improve mental health and addiction supports and childhood vaccinations.

The pandemic has resulted in a growing number of children not being vaccinated against measles, mumps and rubella, Catherine Kitts, the chair of the Ottawa Board of Health recently told a legislative committee.

"Eight-month-old babies are showing up in hospital emergency departments without having received one dose of vaccine against highly infectious diseases," she said.

"These vaccines would normally be provided at two, four and six months of age. Unless coverage rates improve, the risk of outbreaks will grow over time. Diseases such as measles, which was eliminated in Canada in 1998, could see a resurgence."

Part of the public health units' funding request is for a $12.5-million boost for the Healthy Babies Healthy Children program, a home visitation for families at risk with newborns that's funded by the Ministry of Children, Community and Social Services.

A spokesperson for the ministry said the government will "continue working with our partners to explore ways to improve program delivery."

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