Home and Community Service Regulations

When Ontario’s government passed Bill 175 (Connecting People to Home and Community Care Act, 2020), it set a process in motion.

First, it moved home and community care to the new legislation. Next will come the regulations, which set structures to guide the policies, programmes, and services that affect Ontario’s residents. The June update on the regulations outlined government’s proposed approach and invited comments. In July, Care Watch submitted its feedback. We shared ideas and drafts with the Alzheimer Society of Ontario and the Ontario Community Support Association – organizations with goals similar to ours.

We were pleased that government acted on some of the earlier feedback it received. We note that: 1) the definition of abuse is broadened; 2) official service maximums are removed; 3) social determinants of health are part of care planning; and 4) the appeals process under the Bill of Rights is stronger.

We also had some questions and concerns.

• How will home and community service providers – within and outside of Ontario Health Teams – be funded?
• How will services be allocated both to individuals and across geographical areas?
• Who will be eligible to coordinate care? How will they be accountable?
• How and when can for-profit organizations deliver services, and which services can they deliver?
• How will clients coming from the community, and not from a hospital, access home and community services?

In our feedback, Care Watch recommended that Ontario:

• Consider existing not-for-profit agencies first when service providers are being selected in a community.
• Set eligibility criteria and assessments provincially.
• Make Ontario Health Teams responsible for care coordination, with specialized input as needed.
• Define a pathway for clients to access home and community supports directly from the community.
• Treat the Bill of Rights as a contract, with consequences for failing to uphold clients’ rights. Further strengthen appeals and include a dispute resolution process.
• Formalize the rights of staff and other workers to work safely and be free from abuse.
• Hold all providers – whether for-profit or non-profit – to the same standards (clean inspection records, compliance with the Bill of Rights, and community participation in governance).
• Set clear expectations for Ontario Health Teams and health services providers about how they will involve existing home and community care agencies in planning and delivering services.

What can you do?

Government says it is “modernizing” home and community care. Keep a close watch to be sure this is really happening. Elections are coming soon. Don’t be afraid to ask questions. You can ask:

• How will you and your party see that services are available to the people who need them?
• What will you and your party do to force organizations who provide services to stick to standards and respect the rights of clients and workers?

These questions are only a beginning. As government makes further announcements, and as the regulations evolve, we will suggest others. Think about what is important to you and ask for the answers you need.