The unit that makes some of Hamilton's major front-line health decisions will likely be merged with similar health units Niagara, Brant and Haldimand-Norfolk.

Dr. Elizabeth Richardson, Hamilton's medical officer of health, was on a conference call with the province last week. She said Monday that the province's plan to merge 32 public health units into 10 will mean Hamilton being in a unit with those neighbouring areas.

The province is open to opinions, Richardson said. And it's still not known if that area would have just one medical officer of health.

But whatever happens, she said, Hamilton is merging with someone.

"What we've heard from the province is the change from a funding standpoint is not going away," said Richardson after a board of health meeting. "It's something that's going to happen."

Each area in the draft boundaries has its unique challenges, Richardson said. Each needs that attention to detail. Niagara has more cross-border public health issues. Hamilton has big-city health care issues and some surrounding rural areas. Brant, Haldimand and Norfolk have sparser populations and some deep health care challenges.

Public health units handle a variety of tasks, including smoking enforcement, restaurant inspections, parenting programs, communicable disease, low-income dental programs and overdose prevention sites. Flexibility is important, Richardson said.

"All public health happens at a local level."

How much of that exists remains to be seen. Right now, each area is governed by its own board of health, and in Hamilton, that's all of city council. The new unit will have a regional board, Richardson said, and no one knows yet how seats will be allocated.

"Those are the sorts of things we don't know yet," Richardson said.

The Doug Ford government announced the merger in the spring budget, saying only that public health services would be realigned, and 32 units would be merged into 10.

The province has changed how public health will be funded, which means municipalities will pay 30 per cent of the cost instead of 25. That means Hamilton will have to pay about $2.4 million more.

Hamilton city councillors aren't happy with the city losing its board of health.

"I've got a serious problem with that," said Tom Jackson, Ward 6 (east Mountain) councillor. "I've got grave concerns and I definitely want to have commentary down the road."

Mayor Fred Eisenberger said Hamilton will definitely speak up. Announcing a number before talking to cities, he said, is "wrought for inefficiency and disaster."

"Quality care generally comes with local contact and local decision making."