Summary of Delegations for the Rural Ontario Municipalities Association - Issue Report

Report To:                         Manitoulin-Sudbury District Services Board

From:                                     Donna Stewart, CAO

Date:                                       November 20, 2025

RE:                                           Summary of Delegations for the Rural Ontario Municipalities Association - Issue Report

Strategic Plan Goal:  2. Transform How We Work
Objective:                          2.4. Strengthen our presence by improving communication, advocacy, and awareness of our services and impact

Purpose

Delegation meetings with Cabinet Ministers are a key feature of the Rural Ontario Municipalities Association (ROMA) Conference. These meetings are a unique opportunity for our board to engage with Ministers, Parliamentary Assistants and senior Ontario Government officials on local matters that impact the Manitoulin-Sudbury District Services Board.

The Manitoulin-Sudbury DSB will submit various delegations to request meetings with the provincial government. The deadline for submitting our delegation requests was November 18, 2025.

Summary of Delegations

1. Ministry of Education and Ministry of Colleges, Universities, Research Excellence and Security

Issue:
Admission Cap to Primary Care Paramedic Programs in Northern Ontario

Issue Summary:
The four Provincial Colleges in Northern Ontario provide Primary care Paramedic recruits to the organizations responsible for provision of paramedic services to this vast geography. In 2025, only 68 students were graduated from these schools, while they experienced a nearly 60% attrition rate from the program.

Issue Background:
There are a total of 19 provincial colleges in Ontario delivering the Primary Care Paramedic Diploma Program. In Northern Ontario, there are only 4 provincial colleges to provide graduate recruitment to the 13 Northern Ontario paramedic services. The 2025 admission rate into the four northern colleges is 196, while the second year return rate is 110. Likely 2026 graduation rates will be 60 to 70. The first year admission cap for College Boreal increased by 6 students while the other caps remained static. The result will be a significant shortfall of recruits through 2027. During the same period, the Provincial Colleges across Southern Ontario significantly increased admission caps.

2. Ministry of Health

Issue ONE:
Full Funding of Non-Urgent Patient Transfer System

Issue Summary:
The Manitoulin-Sudbury District Services Board (DSB), in partnership with local hospitals, has operated a non-urgent patient transportation program for over a decade to prevent 9-1-1 Paramedic Service degradation by transferring medically stable patients through alternate means. This program effectively preserves emergency response capacity, particularly in rural and remote areas impacted by Ontario’s regionalized health care model.

While similar programs elsewhere are fully funded by the Ministry of Health (MOH), the Manitoulin-Sudbury model receives only 50% provincial funding, requiring hospitals and the DSB to fund the remainder. This partial funding arrangement has been identified by all partners as unsustainable, placing the ongoing success and viability of the program at significant risk.

Issue Background:
Paramedic Services have evolved in recent years to address broader health and social needs while continuing to face rising 9-1-1 call volumes. Since 2015, urgent and emergent calls account for 93.4% of the DSB’s workload, creating strain on emergency resources.

The non-urgent transportation program was introduced to alleviate this pressure by handling interfacility transfers of medically stable patients, shifting approximately 1,800 calls annually away from Paramedic Services. The program is innovative in that it leverages Personal Support Workers (PSWs) to escort patients, reducing reliance on hospital medical staff and improving operational efficiency.

Despite its demonstrated success, the program’s partial funding model continues to limit its sustainability. Without full MOH support comparable to other jurisdictions, the DSB and hospital partners face growing challenges in maintaining this vital service.

Issue TWO:
Supportive Housing Funding

Issue Summary:
It has been determined that supportive housing is essential to effectively address and ultimately end homelessness.

Issue Background:
Funding for supportive housing capital funds from the Ministry of Municipal Affairs and Housing does not include a commitment to support operations, particularly supports for Mental Health and Substance use needs. Community partners struggle to meet demand for services.

3. Ministry of Education

Issue ONE:
Workforce Stability and Funding Flexibility

Issue Summary:
Inconsistent wage support and rigid funding rules are creating workforce instability across the early years and child care system.

Issue Background:
Recruitment and retention challenges persist due to the absence of a provincial wage grid and inequities in workforce funding. EarlyON programs must employ RECEs but receive no workforce compensation. Additionally, restrictions on Workforce Compensation funding for 6–12 programs prevent service system managers from reinvesting unused funds to address local needs. Greater flexibility and consistent wage supports are required to stabilize the workforce, sustain operations, and ensure equitable access across all program types.

Issue TWO:
Utilization Targets and Rural Equity

Issue Summary:
Provincial utilization targets of 90% (2025) and 95% (2026) are unrealistic for rural and northern communities.

Issue Background:
Low population density limits demand, and rigid utilization requirements force providers to accept only full-time families, reducing access for lower-income or part-time users. Flexibility is needed to ensure equitable access and sustainable operations in low-density areas.

Issue THREE:
Flexibility in Rural Child Care Infrastructure Funding

Issue Summary:
Current capital funding rules limit rural and northern expansion by restricting funds.

Issue Background:
Many rural and northern communities have little or no existing child care infrastructure. Providing flexibility to use funding for school-based spaces where possible, or additional funding to reflect higher costs in northern communities, would help address access gaps and long waitlists while promoting equity, access, and sustainability.

4. Ministry of Labour, Immigration, Training and Skills Development

Issue ONE:
Employment System Integration

Issue Summary:
Improved communication and integration between the Ministry of Children, Community and Social Services and Ministry of Labour, Immigration, Training and Skills Development is necessary as it relates to verification documentation. Both ministries require employment verification however, there is no automated mechanism in place to share this data. This creates an administrative burden for staff and affects employment provider performance targets.

Issue Background:
Employment verification is challenging for providers to obtain after an individual is employed as there is no incentive to provide the information. Employment verification is required from both ministries and as we are working within an Integrated Employment System, it is crucial that the technology become integrated which would reduce the burden on staff, clients and allow employment providers to meet their checkpoints more efficiently.

Issue TWO:
Inconsistent Learn and Stay Grant terms hinder northern paramedic retention

Issue Summary:
Under the current Learn and Stay Grant structure, students in provincially funded college paramedic programs are required to provide only one year of service in exchange for full tuition forgiveness. By comparison, students in the Community Training Solutions (CTS) one-year paramedic program are required to provide only six months of service, despite their course costing roughly the same as the two-year provincial programs. This creates a disparity in return-on-investment for the province and weakens retention in the North.

Additionally, Learn and Stay students are permitted to complete their final semester placement (4th semester) outside of Northern Ontario. This policy allows participants to spend only three semesters in the North before potentially relocating, further undermining the intent of the program to address paramedic shortages in rural and northern communities.

Issue Background:
The Learn and Stay Grant was introduced to attract and retain healthcare professionals, including paramedics, in underserviced areas of Ontario by providing tuition forgiveness in exchange for local service commitments. While the intent of the program is positive, its current design inadvertently reduces the retention incentive for northern graduates.

Paramedic recruitment and retention continue to be a major challenge in Northern Ontario, with high turnover and limited applicant pools impacting emergency response capacity. Allowing grant recipients to fulfill their obligation after only one year (or six months in the case of CTS programs), and to complete their final placements outside the region, undermines the program’s long-term effectiveness.

If the province’s objective is to genuinely improve paramedic retention in Northern Ontario, a minimum two-year service requirement for all Learn and Stay Grant recipients, regardless of program type, should be implemented, along with a requirement to complete all placements within Northern Ontario.

5. Ministry of Municipal Affairs and Housing

Issue ONE:
Homelessness Prevention Program (HPP) Funding

Issue Summary:
Planning over a 3-year period along with the creation and maintenance of our by-name list has helped us establish the right mix of HPP supports. More families are experiencing food insecurity, utility and rental arrears. A multi-year HPP allocation with funding for both operating and supportive housing capital would support improved planning.

Issue Background:
There may not be visible encampments in our small communities, homelessness is very much present. Many people are living in precarious, unsafe and unsuitable situations often located off grid far from any services or support. We are seeing increased numbers of families experiencing food insecurity, utility and rental arrears and the need for emergency supports.

Issue TWO:
COCHI-OPHI Funding

Issue Summary:
The allocated COCHI-OPHI funding impacts our ability to plan, increased sustainable funding is needed. Funding through the COCHI-OPHI programs is not enough to address the needs of aging buildings, the non-profits and urban native providers we are in partnership with as well as support rejuvenation, affordability and new construction.

Issue Background:
In 2025-26 our total allocation for COCHI-OPHI was $650,400, the 2026 DSB Community Housing budget is $3,889,187. Community Housing is a direct hit on the municipal tax levy to maintain our existing stock. We are trying to address all the needs we have and juggling those has become next to impossible without an increase in the tax levy.

Conclusion

Staff have submitted the above ROMA delegations to the Association as the deadline was November 18th, 2025.