Public Health Funding and Infrastructure

Position:

Resolutions	Recent Developments
A10-9 - Local Public Health and Local Health Integration Networks THAT the Association of Local Public Health Agencies (alPHa) strongly promote that Public Health Agencies in Ontario remain as independent and separate entities from Local Health Integration Networks (LHINs) and that this position be communicated to the Minister of Health and Long-Term Care	August 19 2010 alPHa has sent a letter to the Minister of Health and Long-Term Care introducing this and four other 2010 Resolutions. Please click here to read.
A10-3 Governance by Autonomous Boards that the Government of Ontario continue, in consultation with alPHa and its members, to implement the governance recommendations of the Capacity Review Committee to ensure that all Ontarians are served by Boards of Health that are autonomous, skills based, with a balance between municipal and local citizen representatives, and whose resources and decisions are dedicated solely to public health in their communities	August 19 2010 alPHa has sent a letter to the Minister of Health and Long-Term Care introducing this and four other 2010 Resolutions. Please click here to read.
#A05-10, SARS Commission THAT aIPHa urge the Government of Ontario to act immediately to establish a consultation process to review and advance the recommendations of the second interim report of the SARS Commission that are not being addressed by Operation Health Protection	December 15, 2005 alPHa has sent a letter to the Minister of Health and Long-Term Care introducing the Resolutions passed at the 2005 Annual General Meeting for follow-up and action by his Ministry. Please click here to view the letter.
#A05-16, Local Public Health Funding THAT the Association of Local Public Health Agencies (alPHa) petition the federal and provincial governments to ensure that municipalities have additional means of revenue generation to ensure the availability of resources adequate to meet local public health needs	Fall 2006 AMO, the City of Toronto and the Ontario Government have entered into discussions under the Provincial-Municipal Fiscal and Service Delivery Review, to include the financing and funding relationship, as well as service delivery and service governance. Report and recommendations are due in the Spring of 2008. http://www.mah.gov.on.ca/userfiles/HTML/nts_1_28110_1.html February 15, 2006 Letter sent to provincial and federal finance ministers introducing this resolution. Please click here to read.
#A04-9, Public Health Impact Statement Requirements  THAT the Government of Ontario immediately require that public health impact analysis statements be a component of Cabinet Submissions prepared by any Ministry of Government	May 9, 2006 Minister of Health Promotion has replied to alPHa's February 1 letter. Please click here to read. February 1, 2006 alPHa has written to Minister of Health Promotion Jim Watson (in his capacity as Chair of the Interministerial Committee on Healthy Living) to introduce Resolutions A03-1 and A04-9 for the Committee's consideration. Please click here to read. March 3, 2005 alPHa has written to Finance Minister Greg Sorbara to introduce resolution A04-9 in the context of his eventual receipt of the report of the Ontario Beverage Alcohol System Review. Please click here to read. September 10, 2004 Response received from the Ministry to the letter described below. Please click here to read. The response to A04-4 and 5 is on pages 2 & 3. The reponse to A04-9 is on page 4. July 21, 2004 Letter sent to Minister of Health George Smitherman, copied to CMOH Sheela Basrur and Premier Dalton McGuinty introducing Resolutions # A04-4, 5 and 9 and others for their attention. Please click here to read.
#A04-3, National Advisory Committee on SARS and Public Health  THAT the Association of Local Public Health Agencies (alPHa) urge the Government of Canada to implement all of the National Advisory Committee's recommendations; AND FURTHER that alPHa urges the Government of Canada to strike a Ministerial Advisory Committee, including representation from alPHa and its Council of Ontario Medical Officers of Health, to oversee and guide the implementation of these recommendations; AND FURTHER that alPHa urges the Government of Canada to direct the Minister of State for Public Health to report to parliament at least annually on the progress of the implementation	July 21, 2004 Letter sent to Federal Minister of Health Ujjal Dosanjh and Minister of State (Public Health) Carolyn Benett introducing Resolution #A04-3 for their attention. Please click here to read. July 18, 2004 alPHa received a letter from Dr. Carolyn Bennett, Minister of State (Public Health) thanking us for our input into this spring's stakeholder roundtables. It gives a brief synopsis of progress made so far in the planning of the new agency.  Please click here to read.
#A03-1, Establishment of Health Goals and Objectives for Ontario THAT the Association of Local Public Health Agencies petition the government of Ontario to review the current process for development and adoption of Mandatory Health Programs and Services Guidelines within the Health Protection and Promotion Act and replace it with a process to establish health goals and objectives for the province of Ontario and subsequently set requirements and standards for all government ministries and government-funded agencies that are comprehensive, complementary and effective in promoting the health of Ontario residents in light of the provincial goals and objectives	May 9, 2006 Minister of Health Promotion has replied to alPHa's February 1 letter. Please click here to read. February 1, 2006 alPHa has written to Minister of Health Promotion Jim Watson (in his capacity as Chair of the Interministerial Committee on Healthy Living) to introduce Resolutions A03-1 and A04-9 for the Committee's consideration. Please click here to read. March 23, 2004 The call for the establishment of Provincial Health Goals is reiterated in alPHa's Position Paper, Creating a Sustainable Public Health System in Ontario, released on March 22 November 26th, 2003 Received a letter from the Ministry of Health and Long Term Care in response to this and three other resolutions. Click here to view the letter. September 8th, 2003 alPHa staff sent its annual letter to the Minister of Health and Long-Term Care, introducing this and other Resolutions for consideration and action. Please click here to read the letter
#A02-2, Adequate Funding for Public Health Programs and Services THAT alPHa urge the Government of Ontario to ensure that all boards of health receive adequate municipal and provincial funding such that all boards of health are able to fully comply with the Mandatory Health Programs and Services Guidelines AND FURTHER that alPHa urge the Government of Ontario to recognize and affirm that an unwillingness to adequately fund public health programs and services results in further erosion of these essential programs and services which will adversely affect the health of all Ontarians and will lead to many preventable hospitalizations and deaths occurring resulting in substantial additional costs to the health care system and the overall economy	October 2006 alPHa has compiled feedback from the survey described below and shared the results with members. On October 31st, a letter was sent to Minister Smitherman on the impact of the provincial cap, focused on the inability of many health units to proceed with previously approved program expansions. Please click here to read the letter.  June 8, 2006 alPHa has sent a letter to the CMOH and all MPPs describing the expected impacts of the announced 5% cap on growth of public health funding at the provincial level. Includes the results of a survey of all health units, to which 33 of 36 responded. Please click here to read. January, 2006 alPHa has created and implemented a communication plan designed to inform ministers and critics of the funding pressures faced by health units in 2006. June 2005 alPHa surveyed health departments on their 2005 budget process to deterimine the level of support that had been achieved for alPHa's position that the absolute municipal contribution to health unit funding should not be reduced as the provincial portion rises to 55%  May 28, 2004 Province announced it will increase its share of public health funding from 50% to 75% by 2007 to strengthen public health programs and services. The government also announced that it would be investing $273 million in public health in 2004/05, growing to $469 million by 2007/08. Click here to read the press release. March 22, 2004 alPHa releases its Position Paper,  Creating a Sustainable Public Health System in Ontario, January 26, 2004 Minister of Health and Long-Term Care announced plans to put unprecedented resources into the province's public health system. View the report in the Globe and Mail. February 17, 2003 alPHa wrote letter to thank Health Minister Tony Clement for supporting public health strongly in the dispute over budget increases between the board of health of Hastings and Prince Edward Counties Health Unit and the area's mayors.  Clement firmly told the mayors that municipalities must comply with their obligated duties in the HPPA to provide/pay for public health programs. December 11, 2002 alPHa received a letter from Geoff Kettel, Public Health Branch (written on behalf of Minister Tony Clement) indicating the province cost-shares public health funding with municipalities "subject to the availability of financial resources" and has increased mandatory program funding by 17% over the last 2 years (Safe Water and West Nile virus).  The letter also outlines the Ministry's new 100% funded programs (e.g. FOCUS, Asthma Strategy, Universal Influenza Immunization). November 4, 2002 Received a letter from Premier Ernie Eves indicating he received the information. November 1, 2002 alPHa wrote a position statement on adequate provincial funding for public health programs and services, and posted it on its web site. Click here to read.
CLOSED RESOLUTIONS	REASON FOR CLOSURE
#A05-17, Board of Health Budgets, 2006 Resolution urging all Ontario Boards of Health to approve 2006 budgets that will allow them to fully comply with the delivery of all mandated public health programs and services, while also urging the province to keep its promise to pay 65% of that total.	December 11 2006 alPHa Advocacy Committee recommends that this resolution be closed, as the budget process for 2006 is completed. alPHa has an existing, more general Resolution calling for sufficient financial commitments from funders to allow 100% compliance with Mandatory Programs (A02-2, Adequate Funding for Public Health Programs and Services).
#A04-5, Continual Revision of General and Program Standards alPHa urges the Government of Ontario to establish an inclusive, rapid process for continually reviewing, revising, approving and modernizing the general and program standards of the Mandatory Health Programs and Services Guidelines	February 19 2007 Ontario Public Health Standards Consultation Draft released. In place of the former General Standards, there is a Foundational Standard, which requires Boards of Health to continuously monitor health status and adapt local services in a system of continuous quality improvement. Once finalized, alPHa`s advocacy committee will be asked to consider
#A04-4, Mandatory Health Programs and Services Guidelines alPHa urges the Government of Ontario, as an interim step, to finalize the revised chronic disease prevention, early detection of cancer, injury prevention and substance abuse prevention, reproductive health, child health and safe water program standards.	December 11 2006 alPHa Advocacy Committee recommends closure of resolution A04-4, as The current Review and Renewal of the Mandatory Health Programs and Services Guidelines process supersedes the recommendations made by the technical review committees in 2002
#A04-2, Ontario Expert Panel on SARS and Infectious Diseases THAT alPHa urges the Government of Ontario to strike an Expert Advisory Group, including representation from alPHa and its Council of Medical Officers of Health, to oversee and guide the implementation of these recommendations; AND FURTHER alPHa urges the Government of Ontario to direct the Minister ofHealth and Long-Term Care to report to the legislature at least annually on the progress of the implementation	December 11 alPHa Advocacy Committee recommends closure of Resolution A04-2 as the establishment of the Capacity Review Committee, the Agency Implementation Task Force, and the Mandatory Program Review and Renewal process would appear to satisfy the operative clause
#A01-2, Provincial Accountability Framework and Mandatory Program Compliance/Funding THAT the Public Health Branch assure that the provincial Accountability Framework, as it applies to the roles and functions of boards of health, is fully discussed with boards of health and health unit senior management, such that the purposes, structure and impacts of Framework are fully understood by these groups; and AND FURTHER that no reduction of provincial funding result from non-compliance with Mandatory Program requirements and standards.	December 11, 2006 alPHa Advocacy Committee recommends closure of this resolution as it refers to a Provincial Accountability Framework, which was an initiative of the Progressive Conservative government of the time. The issue appears to be concerns that failure to comply with the MHPSG would be used as leverage to reduce provincial contributions, a scenario not borne out in the intervening years (the province has significantly increased its funding to boards of health). alPHa’s resolution on adequate funding for full compliance with Mandatory Programs remains active (A02-2).
#A00-1, Federal Funding for Public Health  THAT the Association of Local Public Health Agencies (alPHa) calls on the Federal Government to establish a national program for Disease Prevention and Health Promotion, establish national standards and provide 50% funding to Provinces for all new and expanded programs and services meeting such standards;   AND FURTHER that the Association of Local Public Health Agencies (alPHa) calls on the Province of Ontario to immediately invest 1% of the projected added treatment cost of $9.5 B to provide an additional $95 M for the funding of public health agencies as the provincial share of new funding for public health activities;   AND FURTHER that the Association of Local Public Health Agencies (alPHa) and all Ontario Boards of Health contact the Federal and Provincial Governments to support the enhancement of preventive services	December 11 2006 alPHa Advocacy Committee recommends closure of Resolution A00-1 as 1) the federal government has since created the Public Health Agency of Canada (satisfies the “establish a national program for disease prevention and health promotion” clause); 2) TheFederal/Provincial/Territorial Ministers of Health agreed upon Health Goals for Canada in October 2005 (satisfies the “establish national standards” clause); 3) Operation Health Protection investments, the creation of the Ministry of Health Promotion and the increase to the  provincial share of public health funding more than satisfies the call for  $95M in new provincial money; 4)The call on the federal government to provide 50% funding for the costs of new and expanded programs and services to meet these goals is unrealistic as worded – such funding would be part of the Canada Health Transfer, which does not itemize types of health – related spending.