Ontario’s Association of Local Public Health Agencies is imploring the Ford government to put their modernization review of public health and emergency health services on the back-burner — and reverse changes to the public health funding model — as health workers endeavour to contain COVID-19.

In a letter to Health Minister Christine Elliott dated March 6, association president Carmen McGregor labelled the global outbreak as a moment to “take a collective step back.” As of Jan. 1, municipalities in Ontario were made responsible for 30 per cent of public health funding; for the first year, the Ford government pledged to give extra money to public health units experiencing more than a 10 per cent increase of their current costs.

“The capacity for most public health units has been steadily eroding over the years largely due to the ministry putting caps on annual budget increases,” McGregor said, noting constraints on new program delivery, annual CPI increases and collective agreement requirements. “This erosion will be significantly and immediately compounded by the province’s abrupt and unjustified decision to immediately shift five per cent of the cost-shared and 30 per cent of previously 100 per cent provincially funded public-health programs to municipalities.”

McGregor’s association, at the time of their last annual report, represented 35 different members — including public health units in Ottawa, Thunder Bay, Toronto, Waterloo and Niagara regions.

McGregor asked that the funding revert to the old model until the COVID-19 situation was over.

While she said her association was keen to assist Elliott on her quest for a co-ordinated, “nimble, resilient, efficient and responsive” public-health sector, McGregor also requested an “official direction” from Elliott that paused their modernization consultations — led by Jim Pine — until the outbreak was over.

Face-to-face consultations have already been postponed, McGregor noted in the letter. The deadline for written submissions and feedback in the process has also been extended until March 31.

She lauded Ontario as having “one of the world’s strongest foundations” for day-to-day health promotion, disease prevention and health-related surveillance, but said COVID-19 had revealed issues. “The chronic inadequacy of resources to meet our daily obligations is regrettably brought into stark relief when they need to be diverted to emergency response duties,” McGregor wrote.

Loretta Ryan, Executive Director of the Association of Local Public Health Agencies, said in an email on Monday afternoon that they had not yet heard back from Elliott on their correspondence. The health minister’s office confirmed that it had received the letter.

NDP Leader Andrea Horwath needled Elliott about the letter during Monday’s question period, asking for a commitment to heed the association’s requests. Elliott replied that Pine’s consultations were being “stepped back,” and maintained that the government was responding to the concerns. Elliott said that individual public health units across the province understood “any changes that were made last year will be mitigated financially by this government.”

While speaking to reporters, Elliott reiterated that Pine and his team’s consultations on public health in Ontario will continue amid work containing COVID-19 — albeit, more gradually. “As things stand now, Mr. Pine is very well aware of the priorities for the public health units, and so we are taking our cue from them. They are telling us what they are able to do and what they would rather have paused,” she said.

In advance of the provincial budget, which the government plans to release on March 25, Finance Minister Rod Phillips was asked on Monday whether there would be any changes to public health’s funding formula in the new fiscal plan. Phillips demurred to reporters, saying he’d leave discussions about that file to Elliott.

Governments across Canada, including the provinces, are dealing with virus-related uncertainties as they deliver their budgets this spring. (Quebec is due to introduce its 2020 fiscal plan tomorrow.) Phillips noted to reporters on Monday that, in a call with the other finance ministers across Canada last week, several of them were commenting on how the economic forecasts they’d used as a basis for this year’s budgets were now more than a month old.

“We are in a very dynamic environment,” Phillips said.

Phillips said the government had to remain in contact, for now, with businesses, regulators, finance ministers and mayors to understand the full impacts of COVID-19. The question now facing economists, he said, was to determine how long the economic repercussions will last. “We’re going to deal with the economy that’s in front of us. We’re going to follow the facts,” he said.

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In terms of resources — financial, human and otherwise — at the provincial public health level, Ontario’s Chief Medical Officer of Health David Williams told reporters on Monday that such issues would be probed by the province’s new COVID-19 “command table” — which Williams is a part of, and which reports to Elliott.

Their role is to assess wider issues, Williams said, and take a pulse on the response across the province — including modelling out the resources that would be needed in various hypothetical scenarios.