'A little bit of shock': The latest on an Algoma Public Health merger review

Algoma Public Health has a lot to think about in the foreseeable future.

In August, APH received notice from the provincial government regarding the funding and structure of local public health agencies that will take place from 2024 to 2026.

The government announced a one per cent or $88,000 increase to base funding for public health units for each year - in 2024, 2025 and 2026.

It also announced that it wants public health units, including APH, to look into ‘voluntary mergers’ with other health units.

“I think for the most part we’re all in a little bit of shock. This will be a topic of conversation in future board meetings,” said APH board chair Sally Hagman at the public health unit’s most recent board meeting held on Wednesday.

“Our expenses are going way beyond one per cent per year,” APH board member Jody Wildman said regarding government funding.

“We should participate in the reviews but if we’re trying to get an idea of their vision for public health, it’s (the provincial government) saving money. It’s simply that,” Wildman said.

“The board takes this very, very seriously,” Hagman said.

A written report to the board states “the announced one per cent growth to base funding in 2024 is insufficient to meet ongoing inflationary pressures.”

“Of note, from 2019 to 2021, there has not been any provincial increases to public health base funding. A one per cent increase was provided to public health base funding in 2022 and 2023. According to the Bank of Canada, the average annual rate of inflation from 2019 to 2023 was 3.78 per cent, and a basket of goods and services that cost $100 in 2019 would cost $116 in 2023, a 16 per cent increase in cost,” wrote Dr. Jennifer Loo, APH medical officer of health and CEO in an email to SooToday.

In response, the APH board approved a motion stating that Loo and Hagman will discuss funding concerns with the government.

As for the province encouraging public health units such as APH to voluntarily merge with other health units, Loo reminded the board that this is not the first time mergers have come up for discussion.

“The history is all there. Those of us in the northeast in particular have had conversations about this in the past,” Loo said. 

It was announced by the province in 2019 that it wanted APH to be grouped with health units in Nipissing, Muskoka, North Bay, Parry Sound, Sudbury, Timiskaming and Porcupine into a northeastern Ontario mega-public health unit.

“In 2017 there was talk of us being integrated with the LHINs. There were conversations underway around functional mergers, how we could share services and improve efficiency. In 2019 we were faced with the possibility of becoming 10 public health unit regions across Ontario,” Loo recalled.

The APH board resolved that the health unit “engage with northeastern Ontario counterparts for further exploratory dialogue about voluntary mergers in light of recent provincial announcements.”

“Listening and engaging with the Ministry is probably the best way to go," Loo told the board.

Details of what such mergers would involve are scarce at this point. 

“Beyond what was announced by the province, we do not have specific details as to what criteria the province will be putting forward that would make a health unit be one that would consider a voluntary merger,” Loo wrote in reply to SooToday.

The province has historically considered mergers as a way to “optimize capacity, stability and sustainability in the public health sector.”

“The health of Algoma communities, the effectiveness of APH programs and services, and a strong public health workforce continue to be the key strategic priorities of Algoma Public Health; any dialogue and consideration of public health system change in our region would take these priorities into account. It is positive that, at this point in time, the province has been very clear that these mergers are voluntary, and are not a cost-saving exercise; the province intends that any savings from mergers would be reinvested to local public health operations and that frontline jobs and local public health programs and services would be retained and strengthened,” Loo wrote.

Since 1998, the number of public health units in Ontario, through mergers in various parts of the province, has been reduced from 42 to 33.

The most recent intentional merger plan, between Porcupine and Timiskaming Health Units, was announced this year.