The Independence of Ontario's Public Health Units: Does Governing Structure Matter?

Lyons, Joseph

In short, the MLHU kept its municipal levy stable between 2003 and 2014 in order to take advantage of the increase in provincial funding. However, this strategy really only brought three years of significant increases for the MLHU: 2005 MLHU: , 2006 MLHU: and 2007 Interviewees from both the MLHU and the City of London explained that the City initially agreed to this strategy, but grew frustrated by the pace at which the transition to the 75/25 funding split was taking place. The MLHU' s autonomy allowed it to ignore the City' s requests for a levy reduction for quite some time, but provincial expenditure caps began to cut into the annual increases anyway. For the entire period, the MLHU' s annual levy increase was much lower than the City' s overall expenditure increases. Its cost-shared program funding increases, on the other hand, did exceed municipal expenditure increases, but not by much. These results lend some support to the hypothesis that autonomous health units would be better positioned to take advantage of the increase in provincial funding. The MLHU was able to capture more fully the provincial increases by keeping municipal contributions frozen, rather than reducing them. When the City wanted its contribution reduced, it was unable to bring the health unit immediately under control.