Medical Officer of Health explains investigation into ‘voluntary’ merger of three local boards of health

County councillors were updated Tuesday night on investigation into a “voluntary” merger of three local boards of health.

Dr. Ethan Toumishey

Dr. Ethan Toumishey, Medical Officer of Health and CEO for Hastings Prince Edward Public Health, (HPEPH) presented an update on the ongoing work of the Tri-Board Voluntary Committee.

The committee is exploring the feasibility of a voluntary merger of HPEPH with Kingston, Frontenac, Lennox & Addington Public Health and Leeds, Grenville and Lanark District Health.

The consulting firm of the Sense and Nous has been hired to draft a business case that will demonstrate if and how the proposed merger meets the province’s objectives for public health mergers.

Toumishey states the primary “focus of the merger is not reducing cost, but rather improving public health capacity and the province has indicated that any cost savings from a merger would be retained by the new health unit. Maintaining, or even improving, service delivery especially in the rural areas is the vision for a merged organization.”

Desired outcomes, he stated, include a public health system that can optimize performance, meet unexpected surges in demand, and have staff to fully deliver core services in a system that aligns with community partners to improve population health, while reducing inequities.

A minimum population base of 500,000 in needed. The Ontario Ministry of Health announced mergers in August 2023 to “strengthen the public health sector” and supports agencies that decide to voluntarily merge, indicating any cost efficiencies realized by a merger would be retained by Local Public Health Agencies (LPHA) to support their programs and services.

Following a question from councillor Bill Roberts on whether the changes are actually “voluntary”, Toumishey noted talks about public health units have come a long way.

The Ontario provincial budget 2019 saw the province looking to restructure public health into 10 regional entities. There are currently 34 public health units. This and other proposed changes were interrupted by the COVID-19 pandemic.

Through consultation in the ensuring years, this “voluntary” program has surfaced, Toumishey said, adding that a few public health units have merged, while others found it was not beneficial.

Roberts and councillor Phil St.-Jean are the County representatives on the health board. St.-Jean expressed concern that a merger could reduce the amount of local representation, and feared programming changes for rural areas like the County.

Toumishey stated the cost of mergers including transitional costs, consulting services and wage harmonization for any new local public health agency are expected to be funded by the province until 2027.

Once completed, the business case would be reviewed by each of the three boards of health and if approved, would be submitted to the ministry on April 2 for consideration.

Committee members include Jan O’Neill, board chair; Quinte West councillor Michael Kotsovos, vice-chair, Dr. Jeffrey Allin, provincial appointee to the board; board members Sean Kelly, Belleville councillor and Bill Roberts (alternate), Prince Edward County councillor; and Toumishey (non-voting member).