Convenient Care at Home Act, 2023
Bill or Act:
Convenient Care at Home Act, 2023
Summary of Proposal:
The Convenient Care at Home Act, 2023 (CCHA) would amend the Connecting Care Act (CCA) to consolidate the 14 Local Health Integration Networks (LHINs) into a new service organization named Ontario Health atHome. LHINs would no longer exist, and the Local Health System Integration Act, 2006 (LHSIA), would be repealed. Ontario Health atHome would assume all staff, service contracts with Service Provider Organizations (SPOs), and assets, liabilities, rights, and obligations of the LHINs.
Ontario Health (OH) would be responsible for funding and overseeing Ontario Health atHome, and Ontario Health atHome would be a Crown agency, a subsidiary of Ontario Health and a health service provider (HSP) under the CCA.
The Bill would also amend the Public Sector Labour Relations Transition Act, 1997 to make the LHIN amalgamation an occurrence to which that Act applies. Ontario Health atHome would be designated as a successor employer for the purposes of that Act.
Initially, Ontario Health atHome would provide the same services that LHINs provide.
It is proposed that as Ontario Health Teams (OHTs) mature, responsibility for providing home care would be transitioned to designated OHTs (and/or HSPs working within designated OHTs) and Ontario Health atHome's role would shift to providing designated OHTs and/or HSPs ('client providers') with back-office and care coordination supports, including by assigning care coordinators to work under the direction of client providers. It is anticipated client providers would enter into service contracts with Ontario Health atHome to purchase these operational supports. The CCHA would also authorize Ontario Health atHome to receive payments from client providers as consideration for operational supports provided.
The CCHA would amend s.29 of the CCA to enhance and clarify the legislative framework for OHT designations. The Lieutenant Governor in Council (LGIC) would maintain their authority to make regulations setting out criteria that OHTs must meet to be considered by the Minister of Health for designation, with specificity that regulations may be made pertaining to the types of services an OHT must provide. The amendments would specify that the Minister may impose additional terms and conditions on a designation and that designations may be amended or revoked.
The CCHA would amend the CCA to expand the Minister's power to issue orders to transfer staff, assets, liabilities, rights and obligations from OH into the SO, an HSP or an OHT; or to transfer the aforementioned from the SO into OH, an HSP, or an OHT. It would also clarify that the LGIC can make a regulation to prescribe that a program or a division be the subject of a Minister's transfer order under s.40 of the CCA.
The CCHA would clarify MOH's authority to collect and use personal health information and personal information to monitor and evaluate home and community care services and monitor the health, safety and well-being of persons applying for or receiving those services.
Other minor technical and housekeeping amendments are also proposed.
Analysis of Regulatory Impact:
Feedback was provided by 18 home and community care stakeholders, including service provider organizations, client and provider associations, and individuals.
Stakeholders identified areas of potential direct costs and impacts to government and non-government organizations, including in relation to:
- Providers educating their staff on the system changes that would be made through the Convenient Care at Home Act,
- The transfer of contracts (by operation of law) from the Local Health Integration Networks to Ontario Health atHome,
- Time spent by Ontario Health atHome to define or redefine the scope of care coordinator roles and responsibilities, and
- Time spent by Ontario Health atHome to develop new service delivery standards and guidelines.
Specific dollar amounts were not identified.
No indirect costs were identified.
Stakeholders also provided comments about home and community care more broadly that do not directly relate to the contents of the Convenient Care at Home Act. Comments included the need to address staffing shortages, funding levels, and equitable access to home and community care.
Stakeholders also communicated that they are interested in being involved in upcoming work on home care modernization.
February 16, 2024
Comments Due Date:
November 11, 2023
Home and Community Care Branch, Strategic Partnerships Division, Ministry of Health
9th Floor, 56 Wellesley St W, Toronto, ON M5S 2S3
The Convenient Care at Home Act, 2023 received royal assent and is awaiting proclamation.