RNAO's recommendations focus on four urgent health issues:

1. Health system reform
2. Primary care
3. Long-term care
4. Opioid overdose crisis. 

In the view of nurses, these are public investments that will keep Ontarians healthy.

The full submission is available here, or at the bottom of this document.

Summary of recommendations

1. Health System Reform

• Commit to adding 2,500 RN Full-Time Equivalents per year, to begin catching up with the rest of the country’s RN to patient ratios.

2. Primary Care

• Transfer funding as appropriate to ensure that the 4,500 RNs currently working as care coordinators in LHINs are transitioned to primary care and other community-based organizations, with their contracts intact and no loss in compensation, benefits or seniority. 
• Invest funding to allow NP-led clinics to open in communities where there is or will be insufficient access to primary care services. 

3. Long-Term Care

• Release the funding committed for the remaining 15 Attending NP positions in long-term care of the 75 positions that were to be released in the current budget year. 
• Commit funding to add 50 Attending NPs in long-term care positions per year in order to move towards appropriate staffing levels. 
• Review and transform funding models in LTC to account for both complexity of resident care needs and quality outcomes. LTC homes that decrease acuity (CMI) due to evidence-based care should retain all funding to reinvest in staffing and/or programs for residents. 
• Increase direct care per resident day in LTC to four hours, as per Ontario’s Action Plan for Seniors. 
• Mandate by 2025 a nursing and personal care staffing skill mix of at least 20 per cent RNs, inclusive of NPs and Clinical Nurse Specialists, and 25 per cent RPNs (and no more than 55 per cent personal support workers (PSW)).

4. Consumption and Treatment Services (CTS)

• Commit to approval and funding for CTS sites in communities where there is a need and where organizations are able and willing to create the sites. 
  • In the interim, commit funding for the five of the 21 CTS sites that have been allowed for (above the 16 currently operating), and streamline and expedite the CTS application process to ensure that all 21 sites are open as soon as possible.
  • Increase funding for all existing CTS sites to deliver the staffing levels essential to meeting demand for services.
     

Thank you for the opportunity to provide feedback on the proposed regulatory amendments to Ontario Regulation 275/94 under the Nursing Act, 1991 to enable the initiation of psychotherapy by registered nurses (RN). The Registered Nurses' Association of Ontario (RNAO) is the professional association representing RNs, nurse practitioners (NP), and nursing students in all roles and sectors across Ontario, including those working in mental health. We strongly support these regulatory amendments to RN scope of practice.*

The Registered Nurses' Association of Ontario (RNAO) is the professional association in Ontario representing registered nurses (RNs), nurse practitioners (NPs), and nursing students in all roles and sectors, including correctional nursing. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses' contributions to shaping the health system, and influenced decisions that affect nurses and the public they serve.

RNAO appreciates the opportunity to provide feedback to the Standing Committee on Social Policy on Bill 74, An Act concerning the provision of health care, continuing Ontario Health and making consequential and related amendments and repeals, known in its short title as, The People's Health Care Act, 2019.

Each day across the province, many Ontarians receive life-saving and wellness-enhancing health services thanks to Canada's Medicare – a universal, single-payer health insurance system cherished by its citizenry. The support and care of a person's chosen family aligned with the knowledge, skill, and judgment of dedicated health professionals has allowed many Ontarians to have a high-quality life and a peaceful death. While acknowledging these strengths, there is much left to do. For many years RNAO has been urging the provincial government to recalibrate the balance between life-saving and wellness-enhancing services (strengthening the later), and address flaws that result in barriers to access with inequitable health outcomes, hallway health care, and other detrimental experiences.

RNAO supports a health system transformation that will enable a person-centred, seamless health system that will promote health, prevent disease, and provide personalized wrap-around services to manage acute, chronic, and palliative care needs. In order to realize this objective, RNAO is pleased to offer the following pragmatic, solution-focused recommendations: