Public Health Sudbury and Districts (PHSD) was able to win approval for its $28-million public health budget Thursday despite an effort by some board of health members who tried to shave the budget to save money for municipal taxpayers in Sudbury. A budget cut likely would have threatened jobs at the health unit, the board was told.
The budget that was eventually approved represents an overall increase of 2.02 per cent in spending for 2022 over the spending in 2021. The funding for the health unit comes mainly from the Ontario government ($18.9 million) and partly from 18 area municipalities that each pay a share of just over $9 million.
Because there is a per capita funding formula, Greater Sudbury's share of the funding for the coming year is an increase of seven per cent. It means Sudbury with a population of 141,290, will be paying a levy of $7.8 million compared, for example, to Espanola with a population of 4,362 paying a public health levy of $241,028.
The budget concerns arose just as the board chair René Lapierre presented the motion to approve the document.
Board member Ken Noland opened the discussion.
"I do have a problem with the seven-per-cent increase at the municipal level. I know the last two years, we talked about when we're having increases to the municipal level that maybe we needed to start doing some cuts or something to help control that," he said.
Board member Randy Hazlett said he too had a concern about the seven per cent. Hazlett said he had previously proposed limiting the PHSD budget to three per cent, but a resolution for that was defeated by the board. Hazlett suggested that a review of the health unit's spending processes and procedures might be in order so that seven-per-cent increases wouldn't happen in the future.
At that point, chair Lapierre made a point to inform the meeting that the actual spending increase for the PHSD operating budget is two per cent, not seven per cent. The seven per cent figure is the increase of Sudbury's share of the annual levy.
Lapierre told the meeting that any member of the board can propose changes to the budget to find savings, but he said if that were to take place, it would likely mean cuts to the public health programs and that could force the board into conducting a program review. The problem with that, said Lapierre, is that the health unit has a lot of health programs that it is mandated to provide and such programs cannot be cut.
Board member Robert Kirwan inquired whether the health unit budget increase could be refused at the city council level. Kirwan said he assumed that the municipalities must accept the levy and cannot send it back to the board of health, saying, "No we don't want this. Go back and sharpen your pencils."
Lapierre said as far as he is aware of the Ontario Health Promotion Act, municipalities must pay the levy they are given.
Board member Claire Gignac said she was concerned about the seven per cent levy and wondered if the board could find some "wiggle room" such as lowering the levy to six per cent. She said it was not a large amount and by cutting the levy, it might mean less resistance at the city council level.
Lapierre thanked her and reminded the board that even with the seven per cent levy, PHSD staff is still trying to find an additional $50,000 to balance up the budget.
"So anything that the board members would like to propose as a reduction means we have to find that much more somewhere else," said Lapierre.
Board member Bill Leduc commented that if the board of health keeps asking the municipality for increased funding, it sends the wrong message to the province. Leduc said if the province sees the municipality continually picking up the tab for increasing health costs, then there is no reason for the province to step in when there is a funding shortfall.
Lapierre asked medical officer of health Dr. Penny Sutcliffe to respond.
"As the medical officer of health, I would say that now is absolutely not the time to be cutting back on public health programs and services," said Sutcliffe.
She said the pandemic is a public health emergency and at the same time, there is a backlog of public health services and programs that PHSD has not been able to respond to as staff has directed so much attention to dealing with the pandemic.
Leduc noted that Sudbury Public Health has not sounded the alarm over the homelessness crisis or the opioid crisis in the city. He said if the city declared an emergency over those issues it would "send a strong message" to the province and would likely result in extra provincial funding for Sudbury.
"So why wouldn't we sound that alarm now to access some of these extra funds? That would then help offset the municipality portion?" Leduc asked.
Sutcliffe responded that it was an urgent situation in Sudbury and across the North and all northern health units are working together to get as much support as possible.
"But declaring the crisis here in Sudbury is something that I think needs to be addressed now," said Leduc. "Which is then going to trigger the rest of Northern Ontario to follow suit. So why wouldn't we do that because it would automatically get funding, extra funding that would help offset costs?"
Lapierre jumped into the discussion to say just by declaring an emergency, there is no guarantee for extra funding. He added that even if extra funding was provided, it wouldn't necessarily solve the budget concern because any extra funds would have to go to emergency programs for opioids or the homeless.
As the meeting progressed, Hazlett tabled a motion asking the board to approve a levy for six per cent, instead of the seven per cent. As Lapierre wrote up the motion, Sutcliffe was asked what the dollar value would be by reducing the levy to six per cent.
She answered it would be in the range of $140,000 to $150,000. A bit later in the meeting, Sutcliffe said such cuts would have an impact on staffing.
As it turned out, the motion was defeated.
Later in the meeting, the original motion for a seven per cent health unit levy was presented. That vote was passed seven to four.
