Public Health During COVID-19 and Beyond
Municipal Implications
Public health units have been, and continue to be, on the front lines of Ontario’s COVID-19 pandemic response. Staff has been working hard over the last two years to keep us all safe in the face of immense pressures in the health care sector at large. They have been able to pivot quickly and effectively as new COVID science continually emerges to put the most appropriate local public health measures in place.
Public health units are municipally co-funded operations either governed by their own autonomous boards of directors or are within municipalities. They have been providing essential services, such as: vaccine clinics, contact tracing, COVID testing, supporting the long-term care sector, and advising and training for safe child care re-openings, among many other responsibilities.
Prior to the COVID-19 pandemic, AMO provided written submissions to the provincial government’s Public Health and Emergency Health Services Modernization consultations. The emergency situation paused the consultation in March 2020. AMO is asking for consultations to resume with a COVID lens, once the COVID waves have subsided. The pandemic exposed both strengths and areas of improvement locally and provincially. This learning needs to be considered as part of any future modernization and restructuring of public health.
As of 2020, public health funding is split 70% provincial and 30% municipal. The key difference between this and the former funding split of 75/25, is that the new cost-sharing covers everything. Previously, there was 100% provincial funding for some programs such as oral health, with cost-sharing only for mandatory Ontario Public Health Standards’ programs.
Appropriate cost-sharing needs to be protected, by enshrining the formula in the Health Promotion and Protection Act. Municipal governments are 100% responsible for all public health costs due to provincial legislation from the late 1990s whereas the province provides funding as a policy choice.
The province provided additional funding in 2020 to mitigate the impact of the new funding changes on municipalities. AMO, municipal, and public health leaders sought to have it extended into 2022 along with provincial funds to address program backlogs due to COVID. With the pandemic ongoing, now is not the time to reduce funding.
Municipal governments cannot be expected to make up for provincial funding reductions, nor can they bear the costs of potential future provincial restructuring. As Ontario recovers from the COVID-19 emergency, it has become clear that sustained, reliable funding to public health is now more important than ever.
Background
There are 34 public health units that provide population health services to Ontarians across the province. Working with municipal governments, public health units focus on the overall health and well-being of a community by preventing disease and making interventions aimed at keeping people healthy and outside of the health care system. Municipal governments play a major role in the delivery of public health services, both as an employer (when in a municipality) and funding partner.
