Policy and Political Action

Policy & Political Action

RNAO's Response to Bill 74: The People's Health Care Act, 2019

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:

Summary of RNAO Recommendations
  1. Prohibit Ontario Health (OH) from involvement in direct service delivery and management.
  2. Ensure that primary care is the anchor for an integrated health system.
  3. Amend Part IV, Integration, 29 (2) (a) to require each Ontario Health Team (OHT) to include primary care as a mandatory service.
  4. Amend Part IV, Integration, 29(2) (a) to require each OHT to include home care and mental health and addiction as mandatory services.
  5. Enable primary care to lead at a minimum 30 OHTs.
  6. Amend Part V, Transfers, 40(2) to move the Primary Care branch currently situated within the MOHLTC to OH.
  7. Amend Part V, Transfers, 40(2) to move Public Health Ontario into OH.
  8. Immediately transfer the care co-ordination function and the 4,500 RN care co-ordinators working in the LHINs into interprofessional primary care teams, with their salary and benefits intact.
  9. Immediately transfer the Mental Health and Addiction Nurses (MHANs) from the LHINs into interprofessional primary care teams and local child and youth mental health (CYMH) agencies, with their salary and benefits intact.
  10. Ensure that wait times for children's mental health services are less than 30 days.
  11. Immediately transfer the Rapid Response Nurses (RRN) from the LHINs into interprofessional primary care teams, with their salary and benefits intact.
  12. Immediately transfer NPs providing integrated palliative care from the LHINs into interprofessional primary care teams, with their salary and benefits intact.
  13. Provide hospitals with funding earmarked to immediately post and fill 10,000 RN vacancies.
  14. Ensure the implementation of independent RN prescribing in all sectors, inclusive of diagnostic testing by 2019, and integrate RN prescribing into the baccalaureate nursing curriculum by 2020.
  15. Ensure regulation is in place by January 2020 authorizing RNs to continue to initiate and perform the controlled act of psychotherapy.
  16. Dedicate additional funds to ensure new and existing NPs are compensated fairly and equally across all sectors.
  17. Release the funding for the 30 outstanding Attending NP positions in long term care (LTC). And, ensure equity of access to NPs by funding and allocating one NP for 120 residents across all LTC homes in Ontario – to be hired in accordance with the MOHLTC role description and funding policy (full-time position on-site).
  18. Remove legislative, regulatory, and practice environment barriers to NP scope of practice, as follows:
    1. Authorize NPs to perform point-of-care testing.
    2. Authorize NPs to order additional forms of energy (e.g. CT, MRI, nuclear medicine procedures, non-invasive EEGs, and ECGs in all situations).
    3. Authorize NPs to apply specified forms of energy (e.g. defibrillation).
    4. Expand NPs' authority to certify a death.
    5. Authorize NPs to complete Forms 1, 2, 3, 4, 5, 14, and 28 for mental health services.
    6. Ensure NPs are enabled to act as most responsible providers in hospital.
  19. Add to the preamble:
  20. The people of Ontario and their government:

    Believe that everyone living in Ontario should have a fair opportunity to attain their full health potential and that no one should be disadvantaged from achieving this potential.

    Acknowledge that health promotion and prevention are key to sustainable health systems.

  21. Add to Part 1.1, Interpretation:

    Health is the highest attainable state of physical, mental and social well-being, including the ability to adapt and self-manage in the face of social, physical, and emotional challenge; it is not merely the absence of disease or infirmity;

    Health promotion is the process of enabling people to increase control over, and to improve, their health.

    Specific outcomes for diverse communities is the avoidable, unfair, or remediable differences in health outcomes and health access among individuals or groups of people, whether they are defined socially, economically, demographically or geographically or by other means of stratification.

  22. Add to Part 2.6, Objects of the Agency:

    (b) (ix) the development and implementation of strategies and accountability and reporting mechanisms for health promotion and prevention;

    (b) (x) the development and implementation of strategies and accountability and reporting mechanisms to reduce the avoidable and remediable differences in health outcomes and health access between groups of people in Ontario;

    (h) to respect the diversity of communities, including but not limited to Indigenous and Francophone populations, in the planning, design, delivery and evaluation of services;

  23. Add to Part VII, Regulations:

    Section 48 (g) requiring a health service provider, integrated care delivery system, or other person or entity that receives funding from the Agenda under section 21 to institute a system for collecting socio-demographic and race-based data in order to be able to report on progress toward specific outcomes for the diverse communities in Ontario.

    Section 48 (h) requiring a health service provider, integrated care delivery system, or other person or entity that receives funding from the Agenda under section 21 to institute an accountability and quality improvement plan for health promotion and the prevention of chronic disease and injury.

  24. Require not-for-profit entities to be the foundation of the People's Health Care Act, 2019

 

PreviewAttachmentSize
RNAO Submission Bill 741.03 MB
Resource Type: 
Submission