This is how the cost of health care is being dumped on local governments | iNFOnews | Thompson-Okanagan's News Source
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Kelowna News

This is how the cost of health care is being dumped on local governments

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The City of Kelowna just got a $622,000 federal grant to create a program to battle stigma for indigenous people dealing with addictions.

While that sounds like a good thing there’s a catch to it – once the program is established who pays to keep it going?

The money comes from Health Canada's Substance Use and Addictions Program that has granted millions to cities across the country. Kelowna is the only Thompson-Okanagan city to get grants so far. This is their second.

The federal program is an example of what it, and provincial governments, have been doing for decades – subtly, and not so subtly, downloading senior government responsibilities and costs to municipalities.

“How downloading occurs is, first the government creates a vacuum then encourages local governments to fill the vacuum with grants,” Columbian Institute associate Gaetan Royer told iNFOnews.ca. “Cities are kind of forced, by their sense of responsibility to their citizens, to fill that gap.”

Royer is co-author of a 2014 report from the institute called ‘Who is Picking Up the Tab? Federal and Provincial Downloading onto Local Governments.’

READ MORE: Decades of downloading on cities led to homelessness in Kamloops, Okanagan today: report

Before that, in 2007, he published the book ‘Time for Cities’ which includes a chapter called Downloading for Dummies.

“Downloading is always made to appear to be in the public interest by the governments who have decided to get rid of an inconvenient function,” he wrote in that chapter.

“Municipal officials who resist downloading always end up fighting what seems like a good idea to their constituents. For the layperson, the fact that ‘my city is being asked to promote disease prevention’ always appears to be in the public interest, simply because health is in the public interest.”

Health care is a provincial responsibility with large financial contributions from the federal government and not the responsibility of cities.

But, given the opioid overdose crisis in B.C. along with increasing homelessness and mental health issues, local governments are taking on more and more responsibility.

The Kelowna grant is one of dozens listed on the federal government website, many of them going to Victoria and Vancouver.

It provides two years of funding but there’s nothing in a report going to city council on Monday about who will pay to keep that program going if it’s deemed worthy.

It’s a common ploy by senior governments to offer grants or fund pilot projects in many different areas, Royer wrote.

Once they’re up and running and the public likes them, cities are pressured to pay to keep them going once the funding runs out.

It’s far more than health care that has been downloaded.

In the 1950s and 1960s federal funds paid for things like water and sewer systems. Now, local governments have to compete for grants to replace them or pay for them on their own.

Once they’re built, it’s up to the local ratepayers to keep them going.

“Cutbacks in services implemented by provincial and federal governments inevitably create new demands for municipalities,” Royer wrote in Downloading for Dummies. “For example, most cities now have to cope with increased demand on their fire department resources responding to an increasing number of medical calls because of reduced availability of provincially funded ambulance services.”

Some cities actually invite downloading.

The most recent example of that is the newly elected City of Vancouver mayor and council who are hiring 100 nurses.

Not only is the city not equipped to be running nursing services, it also doesn’t get funding from senior governments to do so, Royer said.

“What choice is there for municipalities other than looking after people?” he said. “That’s the dilemma.”

In 2021, the City of Kelowna got $3.2 million from the Strengthening Communities’ Services Program, funded by both senior governments, for a number of initiatives to cope with homelessness.

That included 18 months of funding to maintain its overnight camping area for the homeless but, as a one-time grant, the cost of doing that falls on the city once it runs out.

READ MORE: Here’s how $3.2 million will be spent on 'outdoor sheltering' in Kelowna

That site is currently overflowing so the city can’t just shut it down. Now, the cost of housing the homeless – or, at least, providing a safe space for them to camp – falls on local taxpayers.

It's not always taxpayers as a whole who take the hit.

Because the federal government deliberately got out of providing affordable housing in the 1980s, many Lower Mainland cities have taken over that task by now requiring 15% of new housing units to be affordable, Royer said.

“Instead of having our collective taxes paying for affordable housing to be built, now the buyers of new condo complex are going to be paying for 10% or 15% of the new units to be below market,” he said.

No one seems to have followed up on the 2014 research on downloading paper and no one seems to be documenting just how big that impact has been, not only for health and housing but numerous other formerly provincial responsibilities that have now fallen to local governments.

Another example Royer gives in Downloading for Dummies are regulations to restrict or ban the use of pesticides.

That should be done on a provincial or national scale, he argues. Instead, it was left to local governments to take the time and money to draft and enforce regulations and pay legal fees if they’re challenged.

The only way to stop the ongoing trend to downloading onto the local taxpayer is for citizens and local governments to push back.

“It would take making it an issue that rises above all the other issues,” Royer said.

That's a tough thing to do when affordable housing, crime and homelessness were top of mind for voters in the Oct. 15 municipal election.

At the annual Union of B.C. Municipalities conventions there are resolutions made and passed regularly about downloading.

This year, for example, there was one calling for provincial funding for Lower Mainland dikes. The responsibility for the dikes was handed over to local governments in 2003. Now, in the face of climate change, many have to be raised and repaired.

Another resolution, from Kaslo, says flood mitigation has been downloaded but control over what happens upstream is still in the hands of the province.

“It comes down to who is best equipped to deliver what service,” Royer said.

Once that’s determined, of course, the funding has to follow.


To contact a reporter for this story, email Rob Munro or call 250-808-0143 or email the editor. You can also submit photos, videos or news tips to the newsroom and be entered to win a monthly prize draw.

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