Public Health in Simcoe Muskoka District of Muskoka

Public Health in Simcoe Muskoka District of Muskoka Council Meeting Charles Gardner, Medical Officer of Health

Our Mission With our communities, we prevent disease and injury, and promote and protect health for all in Simcoe Muskoka.

The 2019 Board of Health • Anita Dubeau, Chair, County of Simcoe • Michael Mc. Cann, City of Barrie • Ralph Cipolla, Vice Chair, City of Orillia • Larry Oehm, Provincial Appointee • Sandy Cairns, District of Muskoka • Lynn Dollin, County of Simcoe • Gary Harvey, City of Barrie • Peter Koetsier, District of Muskoka • Steve Kinsella, Provincial Appointee • Rick Milne, County of Simcoe • Floyd Pinto, County of Simcoe • Peter Preager, Provincial Appointee • Scott Warnock, Provincial Appointee • Peter Willmott, Provincial Appointee

Public Health Modernization • April 11, 2019 Provincial budget included the following: • Establish 10 regional public health entities (from the 35 health units that presently exist) • Reduction of provincial funding of $200 million by 2021– 22

Public Health Modernization • Through discussion with MOHLTC staff we learned: • New autonomous Boards of Health to commence April 1, 2020 • Provincial recommendation that Muskoka join NE regional public health entity – 70: 30 funding ratio in 2020 and beyond • Recommend Simcoe join a regional public health entity to also serve the population of York Region – funding ratio 70: 30 in 2020, and 60: 40 in 2021 and beyond • SMDHU Board of Health advocating that Simcoe Muskoka remain together and join with York - May 15 th letter

Reasons for Muskoka and Simcoe to Stay Together • • Only two health units were proposed to be split Public health in Simcoe Muskoka came together at the direction of the province in 2005 We have worked hard to maintain excellence in public health in the District of Muskoka and Simcoe County Division of Muskoka and Simcoe would disrupt these services Muskoka would join an area of 400, 000 kilometers with the NE health units – very challenging land area to service Health service patterns tend to refer south of Muskoka The Muskoka – Simcoe division would greatly increase the complexity of merging with the other areas Levy costs for Muskoka are projected to be higher if it joins the northeast than if it stays with Simcoe (joining York)

Estimated District of Muskoka levy Comparison * 2020 Budget Year assumes SMDHU operates independently with a 30% Municipal Levy increase over 2019. The existing allocation formula (1: 1 ratio of population and population assessment) was used with 2018 MPAC values. Assumptions: (1) Levy is allocated entirely based on population in years 2021 and 2022. (2) Includes 60: 40 Provincial Funding for Simcoe-York and 70: 30 Provincial Funding for NE Ontario in 2021 (3) Assumes 2% budget increase year-over-year.

Board of Health Motion, May 15 th • IT IS RECOMMENDED THAT the Board of Health communicate with the Ontario Minister of Health, recommending that the full territory of the Simcoe Muskoka District Health Unit remain intact and join with York Region to form a new regional public health entity on April 1, 2020; • AND FURTHERMORE THAT the municipalities, the MPPs and Local Health Integration Networks of Simcoe Muskoka, as well as the Boards of Health for York Region, Sudbury, North Bay, Parry Sound, Algoma, Porcupine, Timiskaming, and Renfrew, the Association of Local Public Health Agency and the Chief Medical Officer of Health receive a copy of this communication.

Advocacy from other Boards of Health • • The Boards of Health for the northeastern health units have advocated in support of the SMDHU Board’s position The Board of Health for York Region (Committee of Council) has advocated that York Region continue to provide public health services for the Region (and not merge with Simcoe)

Public Health Modernization • Letter from the Minister of Health, Aug 20 • Increase in municipal portion of funding to 30% in 2020 (no citation of changes in 2021) • Transition funding in 2020 to limit levy increase to 10% • Memo from Helen Angus, DM MOH, October 10 • Appointment of Jim Pine (presently CAO, Hastings County; formerly with MMAH) to facilitate discussion between MOH, the municipalities and the administrative leads in Public Health and EMS. Discussion paper to the Minister of Health.

Final Thoughts • The SMDHU Board is committed to working with our communities for excellence in public health services. • Public Health is undergoing a transition in its funding and boundaries – present uncertainty regarding details of direction and timeline • The SMDHU Board of Health advocates for public health service in Muskoka and Simcoe to remain together through this transition