Modernizing the Legislative Framework for Home and Community Care

Regulation Number(s):
Instrument Type:
Bill or Act:
Connecting People to Home and Community Care Act, 2020
Summary of Decision:

made under the


Made: March 10, 2022
Filed: March 11, 2022
Published on e-Laws: March 11, 2022
Printed in The Ontario Gazette: March 26, 2022

Analysis of Regulatory Impact:
In compliance with requirements set out in the MOPBA, which came into force January 1, 2021 the Ministry has performed a preliminary analysis of the regulatory impact and anticipates that there will be both costs and benefits (or cost savings) to home and community care sector stakeholders.

Stakeholders include approved home and community care agencies, community support service agencies, and service provider organizations. The preliminary estimate accounts for costs at the organization and staff level - including care coordinators, nurses, personal support workers, allied health and management staff involved in delivery of services.

Key costs associated with new requirements set out in the regulatory framework include:
• Staff education and training on the application of the new regulations in the context of their jobs (including for care coordinators, nurses, PSWs, and management), which is estimated to require between half-a-day to a full-day's time per year.
• Administrative/compliance costs for home and community care provider organizations of complying with the new requirements (e.g., investigating and responding to alleged abuse, harm, or risk of harm within 10 days; executing and overseeing contracts with service provider organizations; legal services fees) which is estimated to require between half-an-hour to up to 4 hours per incident.

The combined total estimated cost for these requirements for all home and community care stakeholders over 10-year period is approximately $2.2 million. Estimated annual costs will be approximately $212, 875.

Benefits of a new regulatory framework include:
• A more integrated care delivery system for patients that will support better outcomes.
• Health system cost avoidance opportunities resulting from more efficient use of heath care resources (e.g., more care in the community rather than in costly hospital/institutional alternatives).
• An important step forward that will embed provisions regarding the funding and delivery of home and community care in the Connecting Care Act, 2019, (CCA) signaling that modernizing home and community care as part of an integrated, connected health care system centred around the needs of patients
• enabling Ontario Health Teams and Health Service Providers to assume responsibility for the delivery of home and community care within an integrated, connected health care system centred around the needs of patients.
• Cost-saving from reducing duplication of services including assessments, and integration of services that meet the needs of the population while improving patient/client safety.
Further Information:
Proposal Number:
Posting Date:
February 25, 2020
Summary of Proposal:
The Home Care and Community Services Act, 1994 and its regulations govern the provision of publicly funded home and community care services in Ontario. This framework was developed twenty-six years ago to address inconsistent access to care, variability of care and patient experience, and to manage demand for services. While the current model has made progress on these issues, feedback from the public and system partners indicates that delivery can be rigid and siloed, creating barriers to modernizing and connecting care.

In 2019, the Connecting Care Act, 2019 established a framework for a connected health care system. The Act also identified criteria for the establishment and oversight of Ontario Health Teams and established an agency of the government - Ontario Health - to fund and oversee health system services.

Through the Connecting People to Home and Community Care Act, 2020, if passed by the Ontario legislature, the ministry is proposing to leverage existing authorities in the Connecting Care Act, 2019 to govern the funding and oversight of home and community care. This approach recognizes that home and community care is part of an integrated system and is not a stand-alone service. It would embed home and community care in broader health system legislation, creating a single framework for integrated care. Eventually, with a strong regulatory framework in place to ensure quality, consistency and accountability, with ongoing patient rights and complaint mechanisms, the Home Care and Community Services Act, 1994 and its regulations, would be repealed.

Similar to other Canadian jurisdictions, detailed parameters for the delivery of home and community care would be outlined in regulation and policy, rather than legislation. The ministry is planning to maintain the core elements of the home and community care program, while introducing flexibility for Ontario Health Teams and other providers to implement integrated, effective and accountable models of care that respond to local needs.

The ministry would maintain the ability to fund Indigenous communities directly by amending the Ministry of Health and Long-Term Care Act (MOHLTC Act). This would maintain the government-to-government relationship with Indigenous communities in the delivery of home and community care services. The MOHLTC Act would also be amended to maintain the Minister's right of subrogation and cost recovery currently found in the Home Care and Community Services Act, 1994 and the Ministry is proposing regulations under the MOHLTC Act with respect to these rights.

The two appendices attached provide a summary of the ministry's proposed regulations under the Connecting Care Act, 2019 and other legislation to support the home and community care program in Ontario. The ministry is seeking feedback on these proposed regulations.
Contact Address:
1075 Bay Street West
10th Floor
Toronto ON M5S 2B1
Royal Assent Date:
March 11, 2022