Ottawa Public Health says it expects its funding shortfall to more than triple over the next decade, and it's pointing to shrinking provincial contributions as a key driver.
In a report released ahead of Monday's Board of Health meeting, the health unit projects its shortfall will grow from $4.5 million in 2027 to $14.7 million by 2036. Medical Officer of Health Dr. Trevor Arnason says the unit is facing a widening structural gap between what programs cost and what funding comes in.
Costs rising faster than revenues
According to the report, OPH's operating costs are expected to rise by roughly $3.4 million each year over the coming decade, while revenues grow by only about $2.2 million annually — a structural shortfall growing by about $1.2 million a year.
"Without deliberate action by the Board of Health, the Province, and the City of Ottawa, this imbalance will continue to widen through the coming decade," the report said.
The health unit stresses the projection isn't a worst-case scenario, describing it in the report as "a projection of current conditions sustained forward in time." It warns demand will only increase, citing population growth, an aging population, widening health inequities and infectious disease activity.
Province falling short of 75 per cent commitment
Cost-shared programs — ones intended to be split between the Ministry of Health and the City of Ottawa — represent 83 per cent of OPH's operating costs. Under provincial policy, Queen's Park is supposed to cover 75 per cent of those programs, with the city picking up the remaining 25 per cent.
According to the report, the province is currently covering only 58 per cent. OPH says the province funded about 65 per cent of the cost-shared budget in 2023, but contributions have declined since. The report notes the 75/25 ratio is a policy commitment, not a legal obligation, and doesn't apply to programs that are fully provincially or municipally funded.
Ontario's Ministry of Health sees it differently. Lily Barnes, a spokesperson for the minister, said the province has delivered a nearly 27 per cent funding increase to Ottawa Public Health since 2018.
We restored the 75 per cent provincial, 25 per cent municipal cost-share ratio for public health funding and have provided PHUs, including Ottawa Public Health, with annual increases to base funding each year since 2023.
"This funding and additional investments were made in direct response to feedback from public health units across the province, including Ottawa Public Health," Barnes said in a statement to CBC News.
Efficiencies and staff shortages
OPH says it found $9 million in internal efficiencies following reviews in 2022 and 2023. Current cost-saving moves include relocating an immunization clinic to cut rent, consolidating vaccine storage, and redesigning dental service delivery.
The health unit is also running with a 4.7 per cent staff shortage — about $3.4 million in unspent salaries — which the report calls a trend that is "not sustainable over time."
The report recommends having OPH staff complete a targeted service review by 2027 to identify what could be minimized or cut if deficits persist and no new funding arrives. It also recommends the Board of Health chair write to the health minister asking the province to increase OPH's base funding to meet its 75 per cent commitment.
