A move by the province to cap the annual funding grant to municipalities for ambulance service has left Middlesex County staring down a $745,000 budget hole.

In a letter sent to the county this week, the health ministry said its funding grant for local ambulance service this year won't increase from the $17.4 million it received the previous year.

The province typically funds about half the cost of ambulance service, which cost about $35.4 million in 2018. The rest is covered by the county and member municipalities, with the City of London picking up just under $15 million of the tab in 2018.

And although the province's letter made a point of saying the grant wouldn't be reduced, Thames Centre Deputy Mayor Kelly Elliott, who also sits on county council, said a growing demand for ambulance service means the province's move amounts to a funding cut.

"It leaves a lot of unknowns," said Elliott. "We need to have a frank discussion about how we're going to fill this gap in our budget."

A report coming to Tuesday's meeting of Middlesex council says the funding cap creates an immediate shortfall of $745,638 for this fiscal year.

Municipalities made to be 'bad guys'

Elliott says council will have to find ways to fill this gap and added that maintaining service levels will require higher contributions from county municipalities or tax increases.

Meanwhile, she said the ambulance service continues to deal with long off-loading times at emergency rooms and other challenges of meeting the service needs of a growing and aging local population.

"We have all of these strains that are already happening on our system," said Elliott. "So to add a funding gap on top of that is huge for us."

Elliott says because the 2018 funding grant is based on levels set the previous year, the funding model is essentially two years behind current service level.

"If service cuts aren't an option for us then we are going to have to look at going back to the municipalities, and going to the city of London and making up that $745,000."

Elliott also said that by capping the ambulance funding, the province is leaving it up to the county to find ways to cover the shortfall and deal with the political fallout of any tax increases.

There is no doubt that <a href="https://twitter.com/hashtag/Middlesex?src=hash&ref_src=twsrc%5Etfw">#Middlesex</a> County is going to have to re-open our <a href="https://twitter.com/hashtag/budget?src=hash&ref_src=twsrc%5Etfw">#budget</a> due to the many <a href="https://twitter.com/hashtag/onpoli?src=hash&ref_src=twsrc%5Etfw">#onpoli</a> announcements coming out that are impacting our budgets. <a href="https://twitter.com/hashtag/PCPO?src=hash&ref_src=twsrc%5Etfw">#PCPO</a> hasn’t called it downloading, but that’s exactly what’s happening here - and <a href="https://twitter.com/hashtag/munipoli?src=hash&ref_src=twsrc%5Etfw">#munipoli</a> will be the bad guys. <a href="https://t.co/GZ3TlqzPx5">https://t.co/GZ3TlqzPx5</a> —@kellyelliottmcm

"The province isn't coming out and saying they're downloading these programs onto municipalities but that's exactly what's happening," she said. "They're essentially making the municipalities the bad guys."

The province's letter says the county must find ways to trim costs.

"The County of Middlesex should identify operation and administrative efficiencies associated with non-direct programs and services while ensuring the on-going provision of frontline services that patients rely on every day."

Read the report that the Middlesex County council will discuss at their Tuesday meeting below.