Regulation - LGIC

Amendments to Ontario Regulation 386/99 under the Home Care and Community Services Act, 1994 and Ontario Regulation 201/96 under the Ontario Drug Benefit Act to Enable Access to End-of-Life Care for Out-of-Province Patients Moving to Ontario

Regulation Number(s):
386/99
201/96
Bill or Act:
Home Care and Community Services Act, 1994, Ontario Drug Benefit Act
Summary of Proposal:
The Home Care and Community Services Act, 1994 (HCCSA) and its regulations govern the provision of community services to eligible Ontarians. Community services include professional services, personal support services, homemaking services, and community support services.

Currently, in order to be eligible for home care services (professional services, personal support services and homemaking services), a patient must be an insured person under the Health Insurance Act (HIA) and meet other eligibility criteria. There are no eligibility criteria for community support services in Regulation 386/99.

The ministry is proposing to amend Regulation 386/99 to remove the requirement to be an insured person under the HIA in the Regulation for professional services, personal support services, and homemaking services to persons who meet the following criteria:

• They were residents of another Canadian province or territory where they have public health insurance coverage.
• They move directly to Ontario from the other province or territory for the purposes of receiving end-of-life care in the community.
• They meet the other eligibility criteria in Regulation 386/99 for the professional services, personal support services and/or homemaking services they are seeking.

The ministry also proposes to make consequential amendments to Ontario Regulation 201/96 under the Ontario Drug Benefit Act (ODBA) to ensure that recipients of certain professional services under HCCSA who do not have OHIP coverage (as described in the above bullet) are eligible for the ODB Program like other recipients of certain professional services who do have OHIP coverage.

The ministry is simultaneously amending the Assistive Devices Program policy to remove the requirement to have Ontario Health Insurance Plan coverage in order to receive home oxygen therapy for palliative care for the same cohort of patients. No regulatory amendment is required for this change in policy. These patients would still have access to physician and hospital services funded by their home provinces or territories. They would be responsible for the costs of any other services, such as laboratory services and ambulance services, which are not included in this proposal.
Analysis of Regulatory Impact:
An amendment to Ontario Regulation 386/99 under the Home Care and Community Services Act is required to change the eligibility for professional services, personal support services, and homemaking services related to the requirement to be an insured person under the Health Insurance Act (i.e. have Ontario Health Insurance Plan (OHIP) coverage).

An amendment to Ontario Regulation 201/96 under the Ontario Drug Benefit Act is also required to change the eligibility criteria for the Ontario Drug Benefit Program. Currently, most patients must be insured persons under the Health Insurance Act and meet other eligibility criteria to be eligible for these services/benefits. New and returning residents to Ontario from another province/territory of Canada, in general, have an interprovincial waiting period of up to three months before their OHIP coverage begins.
Further Information:
Proposal Number:
19-HLTC036
Posting Date:
November 4, 2019
Comments Due Date:
December 20, 2019
Contact Address:
10th Floor, 1075 Bay Street
Toronto, Ontario
M5S 2B1
Comment on this proposal via email