In the first issue of the Ontario Health Promotion Email Bulletin, on May 2nd 1997, we featured an 'editorial' on "Why the Province must continue full funding for Sexual Health". That original message was posted on the Citizens for Local Democracy web-site in the Health Services restructuring area. You can find it at:
Now, 8 months later, on January 2nd 1998, we are taking a look at what some of the impacts have been, and could be, as a result of the transfer of financial responsibilities from Province to municipalities [downloading] of social and health services. To begin this feature, we return to the Sexual Health Network of Ontario [SHNO] for an update. The backgrounders for the SHNO can be found on the Internet at: http://www.web.net/~stirling/SHNO2BCK.htm
Following this article, there are several short pieces summarized and excerpted from a series of documents prepared by the Social Planning Council of Metro Toronto, and posted on the Citizens for Local Democracy List Archives. The SPC can be reached at
Note that the upcoming event by the Alliance for Health Promotion of Eastern Ontario, announced in the previous message of the Ontario Health Promotion Email Bulletin, is also related to this topic. Given the short-time period after the holidays, it was not possible to compile a number of the many valuable resources related to the impact of downloading. For example a number of resources have been referred to in recent discussions on CLICK4HP list-serv and on other lists, such as C4LD-L. We welcome additional articles, opinions, resources, reviews and more related to this subject and others. YOUR contributions, comments and suggestions are always welcome! Please send to:
A. The Sexual Health Network Of Ontario
Update on the Sexual Health & AIDS -- lobby to maintain 100% provincial funding
Part of the transfer of financial responsibilities from the province to municipalities is public health. Within the downloaded public health budget are the sexual health and AIDS programs, which have been 100% provincially funded since their creation. (This is in contrast to most of public health which has been cost-shared by the province and muncipalities.)
The Sexual Health Network of Ontario, a province-wide network made up of agencies, health units and individuals interested in sexual health and AIDS issues, undertook to lobby the Province to maintain 100% funding for sexual health and AIDS programs. Sexual Health Network memebers met as constituents with local MPPs, including numerous members of Cabinet and Planning & Priorities Committee. Meetings were held with political staff within the Health Minister's and Premier's offices. Strong support was obtained from opposition critics, who wrote government and raised the issue in the house. The Association of Local Health Agencies (ALPHA) and the Ontario Medical Association also urged the government to maintain 100% funding for these programs. Numerous letters and petititions were sent to the Health Minister and Premier Harris. Academic support is growing.
To date, the government has adopted a wait and see attitude. The downloading of Public Health was established in law with passage of Bill 152. The Province made a small concession -- it will continue to
fund the Sex Information Education Council of Canada and Planned Parenthood of Ontario's Facts of Life Line for some months. Both of these programs offer provincial-level service that can not be incorporated into definitions of municipal service. Details have not yet been released.
The provincial sexual health program costs roughly 27.5 million -- approximately 1/10th of one percent of the provincial health care budget. The Sexual Health Network of Ontario is continuing its lobby effort in the belief that this level of budget adjustment can still be made. Media attention, which was difficult to draw last spring, picked up in December and continues.
For background information on the efforts of the Sexual Health Network of Ontario as posted on the Internet go to:
To contact SHNO - P.O. BOX 602 POSTAL STATION Q TORONTO ONT. M4T 2N4
Tel.: Carolyn Egan at Birth Control & VD Info Centre. 416-789-4541.
[submitted by Connie Clement]
B. The Impact Of Downloading
a series of documents prepared by the Social Planning Council of Metro Toronto. The SPC can be reached at
Excerpts printed here - for full copies contact the SPC or see the C4LD-L Archives at http://hypermail.community.web.net/archives/c4ldemoc/ and look for the December 16th postings by Liz Rykert on Downloading
Social Planning Council of Metropolitan Toronto October 1997
1. SPC Who Does What to Whom - Context
Recently, the provincially appointed Toronto Transition Team stated that a 15% cut was required to ensure "downloading" did not increase property taxes. This is another way of saying that with "downloading" a 15% tax increase is necessary to retain the services we already have.
The new pressures on the municipal budget mean that service levels in the new city of Toronto will be difficult to maintain. People will have to pay more or expect less, maybe both. Cuts to services by the federal and provincial governments have already being felt at the local level. Pools and rinks, schools and libraries, social housing, public transit and roads, garbage collection, community programs, welfare systems, police and many other services may now all be drawn into making difficult choices about what to cut.
Who defines the public good?
Downloading transforms public policy without public input. It focuses us on short-term principles like whether or not downloading is revenue neutral. This series asks us to think about the longer term. Does downloading affect: how fairly we treat all members of our society? the quality of the services we all use? our quality of life? how we spend money as individuals and communities?
The real questions behind downloading:
Long Term Care
For more information contact Armine Yalnizan at the Social Planning Council- 416-351-0095
2. Downloading Social Assistance
The welfare cuts of 1995 were the first phase of what is about to become a massive overhaul of the welfare system. The province is "downloading" more social assistance costs onto municipalities and is changing the legal framework for those most in need.
Municipalities currently pay 10% to 20% of benefits and half the administration costs for General Welfare, which was designed to provide emergency short-term assistance. Family Benefits, which covers longer term assistance for single parents and the disabled, is currently 100% provincially funded and administered.
The new system will have municipalities pay 20% of all social assistance benefits and 50% of all administrative costs. The combination of downloading and new legislation means more costs for municipalities and less say.
Why is the Province Downloading?
In exchange for downloading social programs, the Province will pick up more of the costs of education. Both the downloading and cuts to education are being used to finance the provincial government's income tax cut.
Downloading draws municipalities into the cutting agenda. They will be pressured to further cut benefits and limit access to social assistance by tightening eligibility.
These pressures will trigger a race to the bottom, with different benefits and conditions for people in different parts of the province.
Downloading doesn't deal with the root problem: who is working, and who isn't. Simply offloading the problem from senior to local governments means taking the pressure off senior governments to do something about unemployment.
3. Downloading Longterm Care
In January 1997, Ontario's Conservative Government proposed to "download" the responsibilities and costs of long term care for seniors onto municipalities. Widespread opposition from health care groups and municipalities forced the province to back off from this initial proposal.
Since then the province has closed hospital beds and has eliminated regulations governing the hours of care long-term patients must receive. Knowing that the population of elderly among us will grow dramatically over the next 10 years, there are real concerns that the long-term care needs of seniors will be offloaded onto families and aging spouses. And what will happen to those without family supports or money?
Who does what to whom?
Long-term care (LTC) is the range of services and facilties that support seniors and help them to live reasonably healthy active lives. These include public homes for the aged, private nursing homes, and a range of home support and homecare services. This Sound Bite focuses on long-term care outside the home.
Ontario only has 40 long-term care beds for every 1,000 seniors. That's the lowest ratio of LTC beds to seniors in Canada! In Metro the situation is worse, with only 35 LTC beds per 1,000 seniors. Today, almost 16,000 Ontario residents are waiting for a LTC bed. In Metro the waiting list is 4,400 people long and growing.
Three major factors mean the future is closer than we think: a rapidly aging population; hospital and health care cuts; and the inability of property taxes to fill in the gaps for long-term care.
Even though the province retracted its position on downloading long-term care, the gaps in service that will arise over the next few years are obvious, especially for low-income seniors.
Any expectation that municipalities will be able assist the growing number who are unable to afford steadily mounting user fees is wishful thinking.The downloading of other services will put increasing pressures on the property tax system for properly financed universal services. Property taxes are simply not designed to pay for programs for those most in need or specific types of need.
Contact these organizations to learn more about long-term care:
Metro Consumers for Community-Based Long-Term Care - Ethel Meade - Tel: 416 423 4674
Ontario Health Coalition - Lynn Simmons -
Tel: 416 441 2502
Ontario Coalition of Senor Citizen Organizations - Bea Levis -
Tel: 416 979 7057
4. Downloading Social Housing - The Big Risk
As the municipal elections unfolded, homelessness and property taxes became central themes. These issues are central to downloading. Of all the services to be downloaded to municipalities, social housing will land on local finances with the biggest crash.
Despite opposition from municipal leaders, community groups and even their own advisors, the province intends to download 100% of its responsibilities for social housing.
The Big Squeeze
Metro Toronto currently has 36% of the province's social housing units. Downloading this responsibility is estimated to cost Metro residents an additional $365 million a year ($269 million if the costs are pooled across the Greater Toronto Area). However, that does not include the other big ticket items involved in downloading social housing: interest rate increases in mortgages; the costs of repairing an aging housing stock; and meeting new demands.
The Pressure Point
With all the other downloaded costs, local budgets are unlikely to be able to keep up with the cost of repairing of units let alone build new ones. Despite more need, cities will be less able to act.
Municipalities will be left with unpleasant options: give less in rent subsidies to those in need; build fewer or no new units; let the backlog of repairs grow; or all three. Any combination of these mean more hardship for those on the edge.
As rents consume more of the household budget, there will be more people using food banks, more living in overcrowded conditions, more evictions, and more homelessness. For far too many people, downloading represents a downward spiral.
In January 1998 the province will start billing municipalities for social housing costs. But local governments won't fully run the system until 2001. In the meantime, the only real option may be for municipal politicans and community leaders to push senior governments into rebuilding, not downloading, the future of our communities.
These excerpts come from a series of "Downloading Sound Bites" produced in October 1997 by the Social Planning Council of Metropolitan Toronto. For fuller details please contact
Andy Mitchell at email@example.com or
Armine Yalnizan Tel: 416-351-0095