Simcoe Muskoka District Health Unit Barrie Office
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Public Health Modernization

Updated January 2020

The modernization of public health in Ontario was announced as part of the provincial government’s budget on April 11, 2019. At that time the province indicated that it would reduce the number of public health units to 10 from 35 by April 1, 2020 and that 10 new autonomous boards of health would be created with strong regional and local representation. We were also informed that the funding formula for public health entities would change, with the municipal portion increasing and the provincial portion decreasing, depending on the size of the population served by the new public health entities.

The province also proposed that SMDHU be split, with public health services for the District of Muskoka provided by a regional public health entity that would include Sudbury, North Bay, Parry Sound, Algoma, Porcupine, Timiskaming, and the northern portion of Renfrew. Public health services for Simcoe County would be provided by a regional public health entity that would also provide service to the population of York Region. These changes were also to take effect April 1, 2020, although the Ministry of Health did indicate that the province was willing to receive and consider feedback from boards of health, municipalities and other stakeholders on the proposed boundary changes.

Since then representatives from the Ministry of Health have indicated that aspects of the original direction provided to health units have been paused.  Current Boards of Health will continue to exist beyond April 1, 2020 (for an unknown duration) and the April 1, 2020 deadline for change is no longer applicable. For the 2020 budget year, there has been a shift of funding from 75% provincial/25% municipal to 70% provincial/30% municipal resulting in reduced funding overall from the province for this health unit.

In October the province announced that Jim Pine, Chief Administrative Officer of the County of Hastings and former member of the Board of Directors of the Association of Municipalities of Ontario, will serve as advisor for renewed consultations on strengthening and modernizing public health and emergency health services. Pine will play a key role in facilitating productive discussions between the Ministry of Health and public health, emergency health and municipal stakeholders.

Based on communications from the provincial government, the following outcomes are being sought in the modernization of the public health system:

• Better consistency and equity of service delivery across the province;

• Improved clarity and alignment of roles and responsibilities between the province, Public Health Ontario (PHO) and local public health;

• Better and deeper relationships with primary care and the broader health care system to support the goal of ending hallway health care through improved health promotion and disease prevention, and, improved public health delivery and sustainability of the system.

Pine’s work includes soliciting input from partners on designing a public health system that is nimble, resilient, efficient and responsive to emerging issues. There is an online survey available until February 10, 2020 that is seeking feedback from the public, public health agencies, and any stakeholders. Additionally, on January 28, an in-person consultation session on Public Health and Emergency Health Services Modernization is being held at York Region Council Chambers with the province and its representatives. Senior leadership from SMDHU will be presenting at that meeting.


The SMDHU Board of Health has responded to these announcements through several letters to the Minister of Health and Long-Term Care Christine Elliott:

Letter re: Public Health Modernization (November 20, 2019)

Letter re: Levy increase in 2020 for the obligated municipalities of the Simcoe Muskoka District Health Unit (October 17, 2019)

Letter re: Impact of provincially directed change in the funding of public health units on the municipal levies anticipated for 2020 (July 17, 2019)

Letter re: Northeast Public Health entities boundaries (July 18, 2019)

Letter re: Public Health Modernization mandate and funding (June 27, 2019)

Letter to partners/clients re: Public Health Modernization (May 23, 2019)

Letter re: Public Health Boundaries (May 15, 2019)

Letter re: Public Health System and the 2019 Ontario Provincial Budget (April 18, 2019)

We have also sent letters to our community partners and clients in Simcoe Muskoka telling them about these changes:

There has been a great deal of media coverage about the proposed changes and cuts to public health. Opposition to the changes has come from a variety of sources, including the following:

We will continue to update this page as new information becomes available.
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