Public Health Merger – A Done Deal?

Jeff Green | Mar 27, 2024

The merger of three Public Health Units in Southeastern Ontario may not be a done deal, but at a presentation to Frontenac County Council last week, public health officials indicated that barring any hiccups it will come about very soon, within 9 short months in fact.

Kingston Frontenac Lennox and Addington Public Health (KFLAPH) Board Chair Wes Garrod, KFLAPH Medical Officer of Health and Chief Executive Officer Dr. Piotr Oglaza, and Loyalist Township Councillor and merger committee member Nathan Townend tag-teamed a PowerPoint presentation at the meeting, pointing out most of the potential benefits of the merger, lending an air of inevitability to the process.

The pieces of the puzzle that remain to be completed are a formal approval of the merger plan by all three boards - KFLAPH, Prince Edward Hastings Public Health, and Leeds Grenville and Lanark District Health Unit - and there is the matter of provincial money.

The reason the long-discussed merger is taking place now, after a relatively short exploration period which only commenced last fall, is that a financial incentive for voluntary public health mergers is available from the Province of Ontario.

The provincial government put forward a three pronged strategy for public health last spring, Dr. Oglaza explained to Council, including a review of public health standards, a review of the funding model, and the promotion of voluntary mergers among the 34 Public Health Units in the province.

The province put incentive funding in place for units that merged, which, Oglaza said, “is over and above operating funding”.

Once the merger proposals are submitted, and the deadline for submission is in early April, those that are approved by the province will receive the funding and the mergers will proceed from there. Governance and the makeup of the new board, as well as the amount each municipality will pay to support the new health unit, are still to be determined.

The benefits of amalgamation include falling in line with provincial goals that public health units will serve at least 500,000 people. This will provide for increased capacity by combining resources, improve long term sustainability, provide more equitable outcomes throughout the entire region, including in rural communities, and will maintain front line jobs.

“The province has been clear that any savings that we realise by combining our resources, will be reinvested locally in public health services, it is not about saving money for the province,” said Dr. Oglaza.

The three units involved in the proposed merger have worked together for a number of years on joint projects and service delivery.

One potential advantage of the merger for residents in the north end of Lanark, Frontenac, Lennox and Addington and Hastings County, is for services to flow east-west along the Hwy. 7 corridor, instead from south to north as they do now.

“For a community like Sharbot Lake, for example, which is oriented to Perth as much as to Kingston, we will be able to send the outreach team more frequently, as the need arises,” said Dr. Oglaza.

Nathan Townend added that making sure there are the municipal and rural components of the makeup of the new board have been part of the discussions.

He said “I cannot speak to the specifics of governance because it has to go to the various boards first, but I can tell you that maintaining the links with our municipal partners and ensuring rural representation has been a key part of the governance discussion ... we do absolutely expect for rural folks that we will be able to punch above our weight, certainly compared to where we are now.”

While the work to develop a model and a business case for an amalgamation of the three Public Health Units has proceeded with lightning speed, certainly when compared to other aspects of health care reform in Ontario, the idea of making such a change has a longer history.

Under the former Liberal government headed by Premier Kathleen Wynne, the province asked the three health units to consider combining forces, and at that time the three of them all agreed that they were better off on their own, with commitments to cooperate.

In the early days of the Doug Ford government, the province announced that the 34 Public Health Units would be combined so that only 10 remained, and that all of Eastern Ontario would be served by the City of Ottawa, where Public Health is integrated with the municipal government.

In response to this, the boards of the three Health Units in this region decided that combining forces with each other was a good idea after, and proposed that as an alternative to the City of Ottawa plan.

The onset of the COVID pandemic put the entire matter on hold and raised the profile of Public Health at the same time.

So, when the voluntary process, with incentives, was announced last spring, the three boards were primed to respond, and the process has now progressed to the decision stage.

While Frontenac County Council does not have a direct say in the decision, one member of its council, Frontenac Islands Mayor Judy Greenwood-Speers, is a voting member of the KFLAPH Board of Directors representing the residents of the county.