Algoma Public Health board votes against merger with Sudbury health unit (update)

There will be no voluntary merger of Algoma Public Health with Public Health Sudbury and Districts.

APH board of health members voted unanimously not to further explore a voluntary merger at an APH meeting held Tuesday.

“We’ve seen this play out before where northeast services have been pooled in the larger of the two regions, Sudbury in this case, and we didn’t want to see public health decisions in Sudbury made by folks living in Sudbury that could affect differing circumstances that we’ve got here in Sault Ste. Marie,” said Sault Mayor Matthew Shoemaker, an APH board member.

The Ontario government planned to merge some public health units into larger regional entities beginning in 2019 but those plans were put on hold when the COVID-19 pandemic struck.

The province has increased funding for public health units by one per cent annually to help them plan for potential mergers.

However, both Dr. Jennifer Loo, APH medical officer of health/CEO and Sally Hagman, APH board chair, noted at Tuesday’s meeting that the voluntary merger would result in big startup expenses.

“There was a huge monetary cost associated with the transition,” Hagman said.

“In terms of costs, there were significant transition costs associated with the process of bringing the two organizations together and the other thing that we found was that there were going to be ongoing increased costs once the entity was merged beyond that transitional one-time funding that we could apply for,” Loo said.

Concern was expressed that fewer board members would represent a larger geographical area in a merged APH/Sudbury health unit.

“The two boards, if we had simply merged them together, would have had 22 members which we felt was unworkable and also the maximum allowed by provincial legislation was 13 members,” said Don McConnell, the APH board’s 2nd Vice-Chair.

“We looked at how can we expand our area, how can we have fair representation based on population, how can we continue to have fair representation based on geographical distribution and we even had some suggestions as to adding special interest members which also had some merit. The difficulty is you can’t do that if you have only 13 board members.”

“It’s difficult to see an improvement in service,” McConnell said.

APH’s decision came after the boards of the two health units chose to look into the benefits and drawbacks of a merger in November.

Sault Ste. Marie City Council and the Township of Wawa opposed a merger.

“The concerns that I had about the relocation of services or the relocation of decision-making power to Sudbury were never really allayed and therefore confirmed my hunch to oppose the merger from the get-go,” Mayor Shoemaker said.

“We were told that there would not be any loss of positions by the Ministry,” Hagman said when asked if a merger would have led to cuts in staff at APH.   

“There were huge costs associated with information technology. That would probably be our biggest cost,” Hagman said.

“Certainly our board would be shrinking by 50 per cent and then you’re not representing all of the municipalities within Algoma or within the greater district of Sudbury. Missing out on that type of input would be huge to the overall picture. This is like a well-oiled machine and it works well because of the people that run it.” 

In November, Loo told the board that “there is a risk, certainly, of future provincial directions to engage in non-voluntary restructuring.” 

It is not known what next steps the Ontario government may take after APH’s unanimous rejection of a voluntary merger. 

“We don’t have a crystal ball. We don’t know how this will all work out in the end but we do know that we have a very strong health unit and it’s as strong as the people who work for it and I hope that they will be there for us for many years to come,” Hagman said.

In contrast, Public Health Sudbury and Districts board members voted unanimously on Tuesday in favour of developing a joint business case for a merger with APH.

Proposing a potential merger to the Ministry of Health required agreement from both boards of health but after APH’s Tuesday vote a voluntary merger between APH and PHSD will not take place.

“On behalf of Board members, I would like to extend our gratitude for the thoughtful and extensive work by both boards of health, the Medical Officers of Health, and staff from both public health units over the last few months to gather the information necessary to make an informed decision,” said René Lapierre, Public Health Sudbury & Districts Board of Health chair in a release.

“While our respective boards have decided differently, the diversity of perspectives shared during this exploration has enriched our relationships and mutual understanding,” Lapierre said.

“Although the Board of Health has voted not to merge with PHSD, the journey both organizations have taken together through this feasibility study has been a valuable learning opportunity, and the rich history of collaboration between APH and PHSD will continue into the future,” APH stated in its own release.

“I’d like to thank the Sudbury District for their amazing cooperation and collaboration with us. We hope our relationships continue growing further,” APH board chair Hagman said.

The APH resolution follows:

WHEREAS the Boards of Health for the District of Algoma Health Unit (APH) and the Sudbury and District Health Unit (PHSD) each passed resolutions in November 2023 to direct their Medical Officers of Health/Chief Executive Officers (MOH/CEOs) to seek provincial funding to study the potential benefits and drawbacks of a voluntary merger of APH and PHSD and report back to their respective Boards for discussion and direction;

WHEREAS the MOH/CEOs for APH and PHSD have since undertaken a process of negotiation and joint engagement to pursue this study, resulting in the confidential Impact Assessment document dated February 9, 2024 (IAD), delivered to the APH and PHSD Boards of Health;

The APH Board of Health therefore resolves:

1.  THAT it does not intend to merge APH with PHSD,

2.  THAT the APH MOH/CEO be directed to:

      a.  not to further negotiate with PHSD to complete a Voluntary Merger Business Case for submission to the Ministry; and

     b.  communicate this resolution to key stakeholders including the Ministry and the PHSD Board Chair.

3. THAT the APH Board Chair ensure timely reporting back to the Board on this matter at future meetings to enable subsequent Board engagement and direction, as the Board may deem appropriate.