Ottawa Public Health (OPH) says it expects its funding shortfall to more than triple from $4.5 million in 2027 to $14.7 million by 2036, and it says dwindling contributions from the province aren’t helping.

In a report released ahead of Monday’s Board of Health meeting, Ottawa’s Medical Officer of Health Dr. Trevor Arnason said the health unit is facing a growing structural funding gap.

“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 report shows that over the next decade, the public health unit’s operating costs are expected to increase by around $3.4 million annually, while revenues are expected to grow by about $2.2 million annually, resulting in a “structural shortfall growing by roughly $1.2 million each year.”

“This is not a projection of worst-case outcomes; it is a projection of current conditions sustained forward in time,” OPH said.

The report warns that demands on the current funding base will only increase, citing population growth, an aging population, widening health inequities and infectious disease activity.

The report recommends directing OPH staff to complete a “targeted service review” to present in 2027, to find what else can be minimized or cut if cost–revenue deficits persist and additional funding is not secured.

OPH also says it’s operating with a 4.7 per cent staff shortage, equivalent to around $3.4 million in unspent salaries — a trend that it says is “not sustainable over time.”

The health unit was able to find $9 million in “internal efficiencies” following reviews in 2022 and 2023, the report noted.

Some current cost-saving initiatives OPH has implemented include relocating an immunization clinic to lower rent costs, consolidating vaccine storage to cut rental costs, redesigning dental service delivery and optimizing other programs.

Unmet provincial commitments

The Ontario Ministry of Health has committed to supporting 75 per cent of municipalities’ shared- cost programs, with the city supporting the remaining 25 per cent.

According to OPH’s report, however, the province is currently covering only 58 per cent of the cost of those programs.

“Cost-shared programs represent 83% of OPH’s operating costs,” the report says. “These are programs whose costs are intended to be shared between the Ministry of Health and the City of Ottawa, with the province committing under policy to cover 75%.”

The report claims the province funded around 65 per cent of OPH’s cost-shared budget in 2023, but its contributions have declined since.

Ontario’s Ministry of Health painted a different picture. Lily Barnes, a spokesperson for the Minister of Health, said the province made a nearly “27% increase in funding 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,” Barnes said in a statement to CBC News.

“This funding and additional investments were made in direct response to feedback from public health units across the province, including Ottawa Public Health.”

OPH’s report explains that the 75/25 ratio is a provincial policy commitment — not a legal obligation.

“It does not extend to programs designated as 100% provincially funded, nor to programs funded entirely by the City,” the report says.

The city has also received “project specific” and one-time funding over the years, however OPH said many of these cannot be applied to offset budget pressures from core programs.

The OPH report recommends that the chair of the Board of Health writes to the minister to request that the province increase OPH’s base funding to meet its 75 per cent commitment.