Policy and Political Action

Policy & Political Action

RNAO's ECCO Report: Enhancing Community Care for Ontarians – A Three Year Plan

Ontario’s nurses call on government and stakeholders to collectively strengthen our publicly-funded, not-for-profit health system and make it more responsive to the public’s needs, easier to navigate and more efficient and cost-effective. To make this happen, the health system must be anchored within primary care to advance primary health care for all through: health promotion, disease prevention, chronic disease management/prevention and mental health care. Equally important are addressing social/environment determinants of health and changes that enable nurses and all other regulated health professionals to work to their full scope of practice, a commitment to reducing structural duplication, and advancing system integration and alignment.


This white paper presents a model that advances a robust foundation for community care and improves integration between all health sectors through a single health system planner and funder – the LHINs as maturing system structure – and anchoring the health system in primary care. Specifically, the paper provides an overview of the ECCO model to inform and evolve strategies to ensure timely access to Ontario’s health system, improve client experience and outcomes, and deliver comprehensive services in a cost-effective and seamless manner.

ECCO Report(s)

What is the ECCO model?

The ECCO model integrates the current functions and roles of the CCACs into existing structures, organizes primary care entities and stimulates overall system integration and co-ordination through the LHINs.

The model is a long overdue innovative solution to facilitating health system integration, improving client outcomes and health system effectiveness. Now is the time for ECCO, a model that provides a path to transform Ontario’s health system.

ECCO Model
Resource Type Resources

Enhancing Community Care for Ontarians – RNAO’s ECCO Model. Home Health Care/Support Services Webcast (January 17, 2013)

Enhancing Community Care for Ontarians - RNAO's ECCO Model. LTC Placement/Discharge Co-ordination Webcast (December 4, 2012)

Enhancing Community Care for Ontarians - RNAO's ECCO Model. Care Co-ordination/Health System Navigation Webcast (October 30, 2012)


Phase out CCACs to get improved access and system integration: ECCO report. (October 11, 2012)

Dubbs, Katie. "Registered Nurses’ Association calls for an end to Community Care Access Centres". The Toronto Star, (October 4, 2012).

Mulligan, Carol. "Dissolve CCACs: Nurses association". Sudbury Star, (October 6, 2012).

Ulrichsen, Heidi. Northern Life article, Northern Life.ca (Oct. 17, 2012).

Canada Health Newsweekly, "Report urges abolition of Ontario’s CCACs". HealthEdition.com, (October 19, 2012).

Grinspun, Dr. Doris. "Commentary: Re: Commentary: Re: Ontario nurses support Community Care Access Centres Northumberland View Friday, October 19, 2012". Northhumberlandview.ca, (October 22, 2012).

Herpburn, Bob. "Searching for the truth in health spending: Hepburn". The Toronto Star, (October 16, 2013)

Herpburn, Bob. "Kathleen Wynne fails to act on growing health-care mess: Hepburn" The Toronto Star, (January 7, 2014)


External Commentary Kodner, Dr. Dennis. "ECCO - A Disruptive Health-Care Innovation Whose Time Has Come". Commentary - International Visiting Fellow, The Kings Fund, London, UK. (October 22, 2012).
Position Statement Primary Care Council Joint Position Statement on Location of Care Co-ordination Within Health System (October 2014) .

Supportive Quotes for ECCO

"Case management is a vital and dynamic strategy for the health-care system across Canada as we all age, as we all live with chronic illness, and as we survive catastrophic injuries. Primary care is the sector where the process and role of the case management provider will have the biggest impact in the future." Joan Park, President - National Case Management Network of Canada

"The Registered Nurses' Association of Ontario' is right on track in its prescription that care co-ordination and system navigation should be handled by interprofessional primary health organizations. Our association's 73 Community Health Centres, 10 Aboriginal Health Access Centres, four Nurse-Practitioner- led clinics and 15 Community Health Teams look forward to actively supporting the transition from Community Care Access Centres to primary health care." Adrianna Tetley, Executive Director, Association of Ontario Health Centres (AOHC)

"The Ontario Community Support Association commends the RNAO for proactively examining the structure of the province's publicly-funded, not-for-profit health system. We are particularly encouraged that the report considers issues of efficiency and duplication in our health care system and calls for greater access to home care and community support services for Ontarians. In the coming weeks, we look forward to working with RNAO, other stakeholders and the Ontario Government in designing a more integrated, client-centred health system." Deborah Simon, Chief Executive Officer - Ontario Community Support Association (OCSA)

"For too long, Ontario's home care system has placed profit ahead of people, failing to meet the needs of those requiring care. The work that RNAO has done on developing models to revive the home care system, increase timely access to care, and strengthen interdisciplinary, collaborative primary care in Ontario is impressive. All Ontarians want a health care system that is centred around the needs of patients. Today, we are presented with a report that lays out a concrete vision for change and Ontario's New Democrats are looking closely at these ideas." France Gélinas, Health Critic for the New Democratic Party of Ontario

"I support the values of the RNAO plan as its ultimate goal is to reduce bureaucracy in the system. This is exactly what our Paths to Prosperity: Patient-Centred Health Care white paper seeks to accomplish: to place patients, not bureaucrats, at the centre of all decisions concerning the patient's health and wellness. This includes a bold proposal to eliminate middle management, like the CCACs, and instead use this money for home care and frontline patient care." Bill Walker, PC deputy health critic and MPP for Bruce-Grey-Owen Sound

"Ontarians receiving care in their home are increasingly benefiting from the quality care provided by Ontario nurses and other health care workers. Our government is increasing our investment in community care so that, with the help of nurses, 90,000 more seniors will get the care they need at home. Part of Ontario's Action Plan for Health Care is a new Seniors Care Strategy, led by Dr. Samir Sinha, that will help us do an even better job of caring for seniors and supporting their independence. I welcome the advice of the RNAO, as well as many other partners, as we work together to gain the greatest value for the unprecedented investment we are making in community care." Deb Matthews, Minister of Health and Long-Term Care

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