OTTAWA – Mayors, councillors, reeves, and wardens from Ontario’s 444 municipalities are in Ottawa this week, along with MPPs and cabinet minister, to discuss and learn about the issues facing towns and cities. This year’s annual meeting of the Association of Municipalities of Ontario’s features all the usual topics of conversation — rural economic development, infrastructure spending, planning matters — but there’s a new one this year that reflects the concerns of local officials.

It involves the D-word. Not death. Not even deficits. They want to talk about downloading.

On Monday morning, the Canadian Press reported that the Progressive Conservative government, led by Premier Doug Ford, was moving ahead with changes to public-health funding that will mean that municipalities will eventually have to contribute 30 per cent of program costs.

The move is more restrained than the government’s initial proposal earlier this year, which would have seen Toronto compelled to pay for 50 per cent of its public-health funding. That proposal — originally scheduled to take effect retroactively after the 2019 fiscal year had begun — was one of the least popular elements of the spring budget and was reversed after weeks of protest from local officials, including Toronto mayor John Tory. Additionally, the government says that no municipality will see its public-health funding shrink by more than 10 per cent per year, giving them time to adjust.

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During an address Ford delivered to the AMO conference on Monday, the premier emphasized that the government has no plan to make cuts to land-ambulance funding or to the Ontario Municipal Partnership Fund, one of the primary transfers from the province to smaller municipalities.

Even so, the move to force municipalities to take on a larger share of public-health funding has brought back memories of the last PC government in Ontario, led by premiers Mike Harris and Ernie Eves, which downloaded large costs — highways, police, social services — to municipalities. That downloading was only partly reversed under 15 years of Liberal government. One person who played a key role in that reversal, Jim Watson, now mayor of Ottawa, told attendees Monday that the provincial government shouldn't download costs and must respect the municipal budget cycle.

“We worked very hard to create an upload agreement that was based on principles,” Watson told TVO.org after his speech. “Things like social services and public-health and ambulance costs shouldn’t be borne by the property taxpayer. They should be funded by the province … it’s going to set us back.”

Watson also noted that public-health units across the province overwhelmingly have their costs dictated by provincial requirements, which limits their ability to find “efficiencies” or otherwise save money.

But large and pricey parts of the Harris-era downloading were never reversed. And that raises fears that today’s “cost-sharing” announcement from the Tories — which was billed as a deficit-fighting measure — could become simply a permanent part of municipal policy in Ontario.

“I think it’s all too easy to just shift the burden to another level of government than to tackle the tough issues,” Barrie mayor Jeff Lehman told TVO.org. “I support the government’s efforts to reform health care: that’s where they’re going to find real savings.”

Lehman and Watson both warned that cuts to public health could end up increasing health-care costs in the long run.

“If you cut the services that keep people out of the hospital in the first place, you’re going to drive up your costs elsewhere,” Lehman said.

Steve Clark, the minister of municipal affairs and housing, told TVO.org that the government is listening to municipalities and denied any claims that the Tories are simply using them to balance the books.

“The opportunity the premier gave our sector when he pressed the pause button in May was a chance for us to sit down and have these conversations [with municipalities],” Clark said. “I’m encouraged, and the fact that nobody will see less than a 10 per cent reduction in funding gives people the opportunity to work with us and provide an exemplary level of service.”

Before Ford’s speech, Marcus Ryan, the mayor of Zorra Township, in Oxford County, told TVO.org that the possibility of cuts to ambulance services — which appear to be off the table for now — was particularly frightening for his constituents.

“We know in rural Ontario that you’re giving up some things; it’s going to take longer for the police or fire or ambulance to come to your house. But you still expect a certain minimum level of service,” Ryan says. “In Oxford County, in particular, we’ve invested our own money to decrease that difference between urban and rural response times, and now there’s a question about whether we keep doing that.”

Jamie McGarvey, AMO’s president and the mayor of Parry Sound, said in his speech introducing Ford to the conference that “if the goal is saving money, improving services for people, and showing greater respect for taxpayers, we wouldn’t start with public health or paramedic services.”

Speaking with TVO.org later on Monday, after a speech from health minister Christine Elliott during which she pledged more consultation with municipalities as the province restructures the health-care system, McGarvey was more conciliatory.

“After everything I’ve seen this morning, I am seeing a new path forward. We’re going to be looking at further collaborations, consultation, and discussion, and I’m looking very positively at this new road,” McGarvey said. “I appreciate the fact that the government is willing to work with us.”