Ontario Introduces Plan to Reform Home and Community Care Services
Date: February 27, 2020
On February 25, 2020, the Ontario government tabled Bill 175, Connecting People to Home and Community Care Act, 2020. The legislation is intended to improve funding and access to home and community care for patients.
If passed, the legislation would give rise to significant changes in this sector through amendments to the Connecting Care Act, 2019 (CCA), the Ministry of Health and Long-Term Care Act (MHLCA), and the repeal of the Home Care and Community Services Act, 1994 (HCCSA).
Changes to the CCA and Introduction of Ontario Health Teams
Bill 175, if passed, would introduce a number of significant amendments to the CCA.
By way of background, in 2019 the CCA established a framework for a connected health care system. A key component of the CCA was the establishment and oversight of Integrated Care Delivery Systems and the establishment of a government agency – Ontario Health – to fund and oversee health system services.
Key amendments to the CCA would include:
- replacing all references to Integrated Care Delivery Systems with “Ontario Health Teams” (OHTs)
- authorizing Ontario Health to provide funding to a health service provider (HSP) or OHT, which in turn would provide funding to or on behalf of an individual to purchase home and community care services. HSPs and OHTs would be prohibited from charging for these home and community care services
- requiring HSPs and OHTs that provide home and community care services to establish a process for reviewing complaints regarding their services
- providing authority to the Minister of Health and Long-Term Care to appoint a supervisor to exercise all powers of an HSP or OHT when the Minister considers it in the public interest to do so
- expanding investigative powers that were introduced in the CCA to:
- include investigations with respect to home and community care services
- grant investigators broad powers to enter a dwelling without a warrant
- provide for enforcement and penalty provisions with respect to obstructing, interfering with, or failing to provide information to an investigator appointed under the CCA
- prohibiting individuals from making “related employer” applications under the Labour Relations Act, 1995 (LRA) with respect to the appointment of a supervisor
- specifying that a supervisor appointed to a HSP or OHT that provides home and community care services is not a “sale of a business” for the purposes of the LRA, the Employment Standards Act, 2000 or the Pay Equity Act, and that the supervisor and OHT/HSP are not to be treated as one employer.
Other Statutes Affected
1. Ministry of Health and Long-Term Care Act
Bill 175 would maintain the Minister’s power, currently under the HCCSA, to enter into agreements with Indigenous organizations to provide for home and community care services for Indigenous communities.
Bill 175 would also continue the Minister’s right of subrogation regarding costs incurred for home and community care services and long-term care services.
2. Home Care and Community Services Act, 1994
Bill 175 would repeal the HCCSA and provide consequential amendments to a number of statutes to provide for the repeal, replacing references to the HCCSA with terms and references applicable to the CCA.
The Ministry is seeking feedback on proposed regulations it has posted under Bill 175.
Among other things, the Ministry’s proposed regulations would:
- modify the existing regulations made under the CCA to adjust how groups of services are referred to in the regulation, to include residential accommodation services as a home and community care service
- add four new community care services that LHINs currently provide but are not captured under the current CCA framework
- require HSPs to ensure coordination of care for patients who may be eligible for home and community care services
- eliminate the service maximums found in O. Reg. 386/99 under the HCCSA.
The Ministry is also seeking feedback on proposed regulations to the Excellent Care for All Act, 2010 and the MHLCA. It proposes consequential amendments to regulations under other statutes to account for the repeal of the HCCSA and other legislation to support the home and community care program in Ontario.
Parties can provide feedback on the proposed regulations until April 14, 2020.
Bill 175 was introduced and passed first reading on February 25, 2020.
We will continue to monitor its progress and will report back on any notable changes or developments.
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