SUDBURY – The Board of Health for Public Health Sudbury and Districts (PHSD) has approved a near-zero increase for its 2020 operating budget. The approved budget aims to maintain important public health programs for local communities despite major provincial funding reductions, increases in fixed costs, and heightened health needs. The budget also includes a 10 percent increase to PHSD municipalities in this year’s budget.
“Local public health interventions are highly cost saving,” said Rene Lapierre, chair of the PHSD board of health, in a release. “But more importantly, they are health-enhancing. The work of local public health is critical to preventing patients from entering the healthcare system in the first place, which is essential for ending hallway healthcare.”
“Our commitment is that residents, communities and partners can continue to depend on public health as a foundation in the health system, working for all to improve health opportunities,” said Dr. Penny Sutcliffe, PHSD medical officer of health and chief executive officer. “Achieving this commitment with a near-zero budget increase has been very difficult and is the result of deliberate planning and hard decisions, which included organizational realignment and staffing reductions, to preserve our ability to promote and protect health, and prevent disease.”
Dr. Sutcliffe noted that preparing the 2020 budget has been difficult and, after this year, things may get a lot more difficult in terms of continued sustainability of programs and services provided.
“We’ve seen a lot of changes in provincial policy and I have talked about it being a winding road over the past year and trying to maintain programs and services,” Dr. Sutcliffe told the Recorder. “That’s because there has been a change in provincial funding. Some of the programs that historically have been funded 100 percent by the province have now been changed to being cost shared with municipalities. And a lot of programs that were funded at 75 percent previously are now being funded at 70 percent. Another piece of the pie is that we have seen a reduction of $1.17 million in our base funding; and the expectation is for us to pick up more of these costs.”
The 2020 operating budget for PHSD is $26,623,396, which represents an increase of less than one percent ($200,000 or 0.76 percent) when compared to 2019.
For all boards of health starting January 2020, the provincial government will no longer fully fund certain public health programs that it has historically covered at 100 percent. It also is reducing its funding share for all programs to a maximum of 70 percent.
The Ministry of Health communicated in August the expectation that all municipalities will be protected in 2020 from any cost increases resulting from this funding change that exceed 10 percent of their existing costs. Incorporating all these changes, the 2020 operating budget includes over $500,000 in cost reductions related to organizational realignment and staffing reductions; a one-time provincial grant of $600,000 and an increase in municipal funding of $4.47 per person per year, or almost a $735,000 total increase (up 10 percent as compared with 2019).
While there is a 10 percent increase to municipalities in this budget, it is not larger because of the one-time funding provided by the province, said Dr. Sutcliffe.
However, “we had to cut expenditures by over $520,000, which has meant a reduction in five staff members; full-time equivalent staff positions, that will be covered through attrition and restructuring the organization,” continued Dr. Sutcliffe. “And we don’t know what will happen in 2021. If there is not an injection in funding from the province we will lose $1.4 million in funding in 2021, and $1.8 million in 2022 which is not sustainable.”
Dr. Sutcliffe said earlier in the year the province had indicated that the 35 public health agencies in the province would be disbanded and centralized into 10 regional public health entities. “We have been working with all our partners in the Northeast getting ready for this,” she said. However, “we have now been told the ministry has pushed the reset button on its plans, and will first consult municipalities and local health officials on reforming the system (by April 2020). This will also include a reset on emergency medical service reforms.
“We have been working on this since April,” she said, noting, “all of this is up in the air now. Jim Pine, who has been named as co-ordinator for the restructuring, will begin consultations shortly with public health and emergency health services.”
“These are difficult times. In 2019, we had to put in place a hiring freeze in addition to many spending restraints,” said Mr. Lapierre, in a release. “We continue to have hard work ahead of us. Our communities’ needs are increasing while at the same time projections estimate a shortfall of over $1.2 million for 2021. We are very active in the Ministry of Health’s public health modernization initiative so that we can give our best advice on how to protect a resilient and responsive local public health system for years to come.”