Boards of Health (Public Health) are required in Ontario

A board of health is an autonomous corporation that governs the local Public Health Unit under the Health Protection and Promotion Act.

It is a provincially-mandated external agency and local board responsible for ensuring its Public Health Unit meets the Ontario Public Health Standards, which set out the minimum requirements for fundamental public health programs and services for boards of health.

It oversees the provision of public health programs and services in the public’s interest, including fiscal and administrative oversight. The Board is also responsible for approving policies developed by Public Health staff and advising municipal council on public health issues.

Boards of health include:

(a)  the regional municipalities of Durham, Halton, Niagara, Peel, Waterloo and York,

(b)  a single-tier municipality that, under the Act establishing or continuing it, has the powers, rights and duties of a local board of health or a board of health established under this Act, and

(c)  an agency, board or organization prescribed by regulation; (“conseil de santé”)

Section 1 of the Health Protection and Promotion Act

Governance

The Board of Health must have 3 to 13 members:

There shall be not fewer than three and not more than thirteen municipal members of each board of health. 

The Lieutenant Governor in Council may appoint one or more persons as members of a board of health, but the number of members so appointed shall be less than the number of municipal members of the board of health. 

Section 49 of the

The recruitment process for public Board of Health members is conducted by the Municipal Clerk following a municipal election (i.e. the end of term of Council). Municipal council approves all appointments to the Board of Health. Appointments are for the “Term of Council” (4 years).

Meetings must be open to the public (as with all municipal committee meetings), with some exceptions.

Mandatory health programs and services

Every board of health,

• (a)  shall superintend, provide or ensure the provision of the health programs and services required by this Act and the regulations to the persons who reside in the health unit served by the board; and
• (b)  shall perform such other functions as are required by or under this or any other Act. 

Section 4 of the Health Protection and Promotion Act

They are required to provide the following services and programs:

Every board of health shall superintend, provide or ensure the provision of health programs and services in the following areas:

• 1.  Community sanitation, to ensure the maintenance of sanitary conditions and the prevention or elimination of health hazards.
• 1.1  The provision of safe drinking water by small drinking water systems.
• 2.  Control of infectious diseases and diseases of public health significance, including provision of immunization services to children and adults.
• 3.  Health promotion, health protection and disease and injury prevention, including the prevention and control of cardiovascular disease, cancer, AIDS and other diseases.
• 4.  Family health, including,
  • i.  counselling services,
  • ii.  family planning services,
  • iii.  health services to infants, pregnant women in high risk health categories and the elderly,
  • iv.  preschool and school health services, including dental services,
  • v.  screening programs to reduce the morbidity and mortality of disease,
  • vi.  tobacco use prevention programs, and
  • vii.  nutrition services.
• 4.1  Collection and analysis of epidemiological data.
• 4.2  Such additional health programs and services as are prescribed by the regulations.

Section 5 of the Health Protection and Promotion Act

Optional health programs and services

A board of health may provide any other health program or service in any area in the health unit served by the board of health if,

(a)  the board of health is of the opinion that the health program or service is necessary or desirable, having regard to the needs of persons in the area; and

(b)  the councils of the municipalities in the area approve of the provision of the health program or service.

Section 9 of the Health Protection and Promotion Act

Budget

Public Health funding is cost-shared between the Ontario provincial government (75%) and municipal governments (25%).

The federal government may provide some minor funding and expenditure recovery for specific programs and services such as:

• Contraceptive sales
• Food handler course registrations
• Menactra Vaccine
• HPV Vaccine
• Flu Vaccine
• Seniors Dental Program

Example: Hastings Prince Edward Public Health (HPEPH)

In 2025, HPEPH’s budget included:

• $18.7M in total revenues and total expenses ($0 surplus/deficit)
  • $13.7M from the Ontario government
  • $240K from the federal government
  • $4M from member municipalities’ property taxes
  • $700K from member municipalities’ reserve funds

The municipal portion of the Public Health Unit funding is split between the member municipalities’ operating budgets based on their share of the population according to the last Statistics Canada census:

Regulations

• Health Protection and Promotion Act
• Ontario Public Health Standards

Examples

Public Health Unit locations

• Algoma Public Health
• Huron Perth Public Health
• Ottawa Board of Health
• South East Health Unit (Kingston, Frontenac and Lennox & Addington Public Health, Hastings Prince Edward Public Health and Leeds, Grenville and Lanark District Health Unit)