Crunching the Toronto Public Health funding numbers

The Ford government and the City of Toronto are in a war of numbers over the size of the funding cut on the way to public health.

Toronto fired the first shot with a startling claim that the cut will amount to $1 billion over the coming decade.

The province is trying to downplay the size of the cut by describing it as just one third of one per cent of the city’s entire budget.

In both cases, each level of government can be accused of playing with the numbers to suit its political purposes.

But even when you strip away the spin, and focus only on the facts about the next couple of years, there remains a fundamental disagreement about the size of the cut.

The city puts the figure at about $65 million for the coming year and $84 million in 2020-21. The province puts the figure at $25 million for the coming year and $33 million in 2020-21.

Why the big difference?

In short, the two sides are doing the math differently.

The province assumes the total amount of the city’s program spending will not shrink, and that, in fact, the city will increase its funding by the same amount to make up the difference as the province reduces its contribution.

But the city assumes it will not increase its funding to Toronto Public Health, and assumes that the province will calculate its own contribution based on that.

CBC News has looked through how both levels of government arrived at these amounts.

The cost-sharing formula

The bulk of the programs delivered by Toronto Public Health (about $173-million worth) are funded on a cost-sharing basis of 75 per cent by the province and 25 per cent by the city.

Some programs — including infectious disease control, enforcement of the Smoke-Free Ontario strategy, and dental services for children through the Healthy Smiles Program — are delivered by Toronto Public Health but are currently 100 per cent funded by the province. These total about $19 million a year.

The province is proposing to shift all of its funding to a 60-40 the cost-sharing model for the next two years, down to 50-50, effective in 2021.

The math comparisons are made slightly complicated by the fact that the city fiscal year starts in January and the province’s in April, and the lower contribution would start taking effect partway through the city’s fiscal year. So for the sake of clarity, the calculations below are for 2020, a full year at which the province’s contribution would be lower

City of Toronto math

Of the $173 million in cost-shared programs, the City of Toronto currently contributes $43 million (for its 25 per cent share) and the province contributes $130 million. The city assumes it will not increase its own allocation to the programs, so its contribution will stay at $43 million.

So, when cost-sharing shifts to a 60-40 ratio, the city calculates that the province would then kick in only $65 million. That would amount to a $65-million cut in the provincial funding.

The city also assumes the province will contribute zero in the future towards the programs that are currently 100 per cent provincially funded. That would be an additional $19-million cut.

Add those two figures together, the city comes up with an $84-million funding cut.

The province, however, makes different assumptions when it calculates the funding cut.

Ministry of Health math

The health ministry puts the total funding for Toronto Public Health’s provincially-funded programs at $190 million, which is slightly, but not significantly different from the city’s figures. The province puts its total contributions at $147 million, and the city’s at $43 million.

The province argues that a 60-40 split of this amount in the future would mean it provides 60 per cent of the $190 million total cost, which would be $114 million.

Do that math, and reducing its contribution from $147 million to $114 million would mean a $33 million cut from the province.

This would mean the province is expecting the city to find $33 million to replace that lost provincial funding, something that will be tricky to do. The city passed this year’s budget months ago, and city officials say the only way to make up the funding in the future would be to raise taxes — most likely in the form of property taxes — or take the money from other municipal programs.

However, the province is now dangling the possibility of one-time funding to help with the transition.

The essence of the dispute

The province calculates the funding cut by assuming the city will increase its contribution. The city assumes it will not increase its contribution. Each side is standing by their numbers.

“Traditionally, the province only contributes its share if the city provides its share,” said Toronto’s medical officer of health Eileen de Villa in an interview with CBC News.

An official with the Ministry of Health, providing a background briefing to CBC News, said the city’s numbers are based on incorrect assumptions.

The official said it is incorrect for the city to assume the province will provide zero funding for programs that it currently funds at a 100 per cent rate.

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