Policy and Political Action

Policy & Political Action

Home Care Guarantee for the People of Ontario - RNAO’s Response to Bill 175: Submission to the Standing Committee on the Legislative Assembly

RNAO welcomes the opportunity to provide feedback to the Standing Committee on the Legislative Assembly on Minister Elliott’s Bill 175, an Act to amend and repeal various Acts respecting home care and community services, known in its short title as, Connecting People to Home and Community Care Act, 2020.

RNAO offers 16 recommendations and related commentary on Bill 175 that will also speak to the draft regulatory proposals that were simultaneously posted in February 2020 as part of the government’s proposed legislative framework for home and community care modernization.

Summary of RNAO recommendations:

An integrated and coordinated health system that delivers person-centred high-quality care

  • Ensure all amendments and additions to the Connecting Care Act, 2019 are consistent with the expansion of the Ontario Health Teams (OHT) as part of advancing the broader health transformation agenda to serve all Ontarians and achieve the Quadruple Aim in our health system.
  • Eliminate the current home care delivery business models that are transactional and fee-for-service. Instead, implement models that ensure care and caregiver continuity and emphasize expert clinical and relational care. For this to succeed, build a stable workforce by ensuring 70 per cent of staff are employed full-time and are compensated in a way that matches the hospital sector.
  • Immediately transfer the 4,500 RNs currently working as care coordinators in LHINs with the related funding – inclusive of compensation – to primary care and other community-based organizations, maintaining their contracts with compensation, benefits, and seniority intact.1
  • Broaden the list of care-coordination functions in new regulation under the Connecting Care Act, 2019 to include: (a) connecting patients to necessary social supports and services, and (b) reaching out to non-traditional settings (i.e. shelters, streets, and correctional facilities) accounting fully for the impact of social determinants of health on the lives of persons in local communities.
  • Award contracts for home-care providers that can deliver a broad range of nursing and support care services 24/7 to avoid fragmented care.
  • Award contracts with a preference for home-care agencies that are Best Practice Spotlight Organizations, as they have proven to deliver better health, clinical and satisfaction outcomes for Ontarians.

Improved and equitable access to home and community care services

  • Increase the public funding to home care services by 20 per cent to enable increased access to home care.
  • RNAO’s Submission on Bill 175: Connecting People to Home and Community Care Act, 2020
  • In keeping with the Ontario Health Teams framework, ensure any dollars saved from increased integration, care coordination and better outcomes are re-invested into additional access to home care services for Ontarians and not to profit-making.
  • Guarantee an expanded publicly-funded basic basket of home and community services with qualifying criteria to ensure improved and equitable access for all Ontarians, regardless of geographic location. For this, engage in full consultation on the types and definitions of “home and community care services” to be included (i.e., nursing, personal support, homemaking, etc.)
  • Ensure OHTs and health-service providers are accountable to needs-based funding that follows Ontarians in an efficient and person-centred manner.
  • Expand technology in the home care environment—including virtual care that is safe and secure—by developing a robust set of quality standards that guides the use of technology and outlines virtual care as an adjunct to in-person care and not as a replacement.

Transparent oversight and public accountability

  • Engage in comprehensive public consultation on the proposed oversight model for any new care settings (including residential congregate care) to ensure definition, criteria and standards are deliberated with the safety of Ontarians prioritized.
  • Develop a transparent, detailed and phased plan for the dissolution of LHINs to limit interruption to vital home and community care services for persons in Ontario that is communicated to the public and implemented immediately.
  • Embed the Patients’ Bill of Rights in legislation—not in regulation as proposed—and allow a minimum of 60 days for the public and stakeholders to comment on the draft proposal for the new Patients’ Bill of Rights.
  • Strengthen a clear accountability system in home and community care and maintain the minister’s oversight over compliance of the Patients’ Bill of Rights in legislation, with the ability to approve, deny, or terminate home care agencies based on their assessment.
  • Add the same complaints and appeals processes under the existing Home Care and Community Services Act, 1994 legislation to the Connecting Care Act, 2019 and halt plans to shift these processes to regulation.

Read our full submission in the PDF below.

RNAO_Bill_175_Written_Submisssion_2020-06-17.pdf663.95 KB
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