Education, Children and Youth
Public health units
A public health unit is an official health agency that, unlike community health centres, is established by a municipality or a group of municipalities to provide public health services.
There are 36 public health units in Ontario. They administer health promotion and disease prevention programs. They also provide information about immunization, screening and other services.
Under the Health Protection and Promotion Act, each health unit is governed by an autonomous board of health with various governance models, largely made up of elected representatives from municipal councils.
Status, funding, and application of the French Language Services Act
The status of the public health units is a longstanding issue for the Commissioner’s Office, which recommended in its 2009-2010 annual report that the Ministry of Health and Long-Term Care require public health units to apply the French Language Services Act, and followed up on the recommendation in its 2010-2011 annual report.
The issue arises from the fact that according to the Ministry, public health units are not government agencies within the meaning of the French Language Services Act, but local boards as defined in the Municipal Affairs Act. Consequently, they are exempt from the obligations that government agencies have under the FLSA.
The question we have to ask ourselves, then, is this: Where does the funding for public health units come from?
Funding for public health units has undergone a number of changes since the units were established.In 1998, they were funded entirely by municipalities.Ten years later, the government increased the province’s share from 50 to 75 percent, and that funding came from the Ministry of Health and Long-Term Care.
In addition to the fact that a large portion of the funding is provided by the province, a clause in the legislation reinforces the idea that public health units are government agencies. Section 4 of the Health Protection and Promotion Act, which defines the duties of the boards of health – i.e., the public health units – states that these agencies must perform such other functions as are required by or under any other Act, such as the French Language Services Act!
Thus, the Ministry of Health and Long-Term Care has the authority to regulate the provision of French-language services by public health units. That is why the Commissioner recommended in 2009-2010 that the Ministry require public health units to implement the French Language Services Act.
Recommendation to the Ministry of Health and Long-Term Care
Since the province provides most of the funding for public health units, the Commissioner recommended in his 2009-2010 annual report that, when all or part of their funding comes from the province, the Ministry of Health and Long-Term Care require them to implement the Act.
While the recommendation was not acted on, the Ministry set up an interministerial committee to develop strategies to improve the delivery of French-language services in the field.The Ministry also developed various useful tools, such as a guidance document and an inventory of French-language resources, for use by the public health units.
Although these initiatives are commendable, the Commissioner was dissatisfied with the government’s response to his recommendation and revisited the issue the following year. In his 2010-2011 report, he again urged the Ministry to require public health units to implement the French Language Services Act. As long as these health care providers are not subject to the FLSA, the Commissioner remains concerned that public health units will be under no legal obligation to provide service in French on a regular basis.
Unilingual materials
The Commissioner’s Office has received a variety of complaints about public health units. Most of them, however, are about the lack of French-language materials for distribution to the public, service providers and teachers in schools.Specifically, complainants reported that English-only notices concerning an oral health screening program were distributed in French-language schools. Not surprisingly, the Commissioner was very unhappy about this situation and made his criticisms known in his 2010-2011 annual report.
Ontario’s public health units were also under the gun in 2009, when members of the public reported deficiencies in French-language services relating to the influenza A (H1N1) pandemic. In some cases, Francophones said that they did not have access to information about these health services and that there was no public awareness campaign for them in their municipality. The Commissioner discussed this issue at length in his Special Report on French Language Health Services Planning.
In response, the Ministry of Health and Long-Term Care produced a guide to help the 36 public health units plan and deliver services in French. However, this is left to the health units’ discretion.
Dialogue with the Ministry
The Commissioner’s Office wants to make it clear that the Ministry recognizes the need to encourage public health units to provide service in French. In its Guide to Providing French Language Public Health Programs and Services to French-speaking Ontarians, the Ministry emphasizes the importance of providing French-language services, especially for target groups such as unilingual Francophones, and programs intended for French-language schools and daycare centres.
This is a step in the right direction. Moreover, on the basis of its conversations with Ministry officials, the Commissioner’s Office can confirm that they are determined to make the delivery of public health services to Ontario’s Francophones equitable.
Demonstrated progress
In a 2013 blog post, the Commissioner saluted the establishment of a Public Health French Language Services Community of Practice in Eastern Ontario.
Ottawa Public Health (OPH) and the Eastern Ontario Health Unit (EOHU) received one-time funding from the Ministry of Health and Long-Term Care for the development of the community of practice. The aim was to provide a central resource for the province’s 36 public health units. This central resource provides support for the local planning, delivery and evaluation of French-language programs and services for the units’ clients.
In addition to increasing awareness of and access to existing French-language services, the community of practice aims to consolidate effort, share best practices and accelerate the development of French-language services, as the Commissioner has noted.