THUNDER BAY – A combination of increased program requirements without a corresponding provincial funding increase could lead to budgetary pressure on the district health unit.
The Thunder Bay District Board of Health on Wednesday ratified its $12.8 million mandatory and core budget for 2019, which includes 118 full-time equivalent positions.
The fiscal plan includes a three per cent increase to the municipal levy, which is paid by district municipalities based on their population. The increase, the first since 2015, is projected to result in Thunder Bay paying an additional $82,000 in 2019.
“We’re not expecting an increase from the provincial government. We’ve been advised by them not to plan for any increase,” DeMille said.
“The board did approve an increase to the municipal portion of the budget but it’s actually a very small portion of the overall health unit budget. I do anticipate we will experience significant challenges in the next year and coming years.”
Through the Ontario Public Health Standards, the province has imposed an updated and enhanced mandate on public health units, though DeMille said there has not been a funding increase to help pay for new requirements.
DeMille said administration will be taking a critical look at all programming, reallocating to align resources and monitoring effectiveness.
“There will be some tough choices, absolutely,” DeMille said. “There will be consequences of all this that we will have to deal with. We’ll have to work with the management team, with the board, with our staff to look at what we need to do, what we need to keep, what maybe we can do less of.”
Beginning next year, the health unit will be ending its administration of the Fair Start program, which provides developmental screening for children from 18 months until school age. DeMille said a number of community partners have been involved in the program and it’s possible one of them could pick it up.
Health unit funds that had gone to the Fair Start program will now be allocated to a visual health program, which has been required by the province, and expected to begin next year.
“We’re going to be exploring how to implement the requirements over the next six months to a year and looking at what we’re going to need in an ongoing way,” DeMille said. “It’s a visual health screening program for children in (senior kindergarten). There are particular screens that will be done in school settings and then referrals for those children who need it.”
As well, the legalization of cannabis and the Progressive Conservative provincial government’s decision to allow it to be used anywhere smoking tobacco is permitted has made health units responsible for enforcing places of use, DeMille said.
“We have tobacco enforcement officers that actually enforce the Smoke Free Ontario Act and that’s related to smoking and vaping,” DeMille said. “It’s been updated to include cannabis and we were informed we have to do the cannabis enforcement as well. That just adds another layer of challenge and implications for us.”
DeMille said any major disease outbreak, such as this year’s tuberculosis outbreak that primarily hit some members of the city’s under housed and marginalized population, can also put budgetary pressure on the health unit.
Calling it a gamechanger, DeMille commended the public health nurses for their hard work to get outbreak under control, but said tuberculosis can reappear.
We do have to work with our partners and maintain a heightened vigilance and not let our guard down,” DeMille said, adding it is a challenging and horrible disease. “Even if we might declare the outbreak over, we can get future cases six months down the road, one year down the road or two years down the road.”
