Ontario Budget 2018 Makes Significant Commitments to Health Care

On March 28, 2018, Finance Minister, Charles Sousa introduced Budget 2018, A Plan for Care and Opportunity. An overview of investment commitments of interest to occupational therapists follows. The budget proposes commitments over a 4 year period and is generally considered a blueprint for the Liberal Party's election platform for June's election.  In light of the coming election, the ability to deliver upon these commitments will, to some extent, be dependent upon the outcome of the election and ongoing commitment to the policy directions these investments espouse.  Commitments for the 2018 – 19 fiscal year will be realized.

According to the government, the top 10 highlights of the 2018 Budget include: 

  1. Free Prescription Drugs for Everyone 65 and Over through OHIP+ 
  2. More Child Care, More Choice (free child care for 2.5 year olds to JK) 
  3. New Ontario Drug & Dental Program 
  4. Seniors’ Healthy Home Program
  5. Stronger Hospitals, Better Care 
  6. Mental Health Matters 
  7. Home Care for Seniors 
  8. Removing Barriers for Individuals with Developmental Disabilities 
  9. Supporting Student Success with Free Tuition 
  10. Boosting the Minimum Wage and Creating Good Jobs

Investment in health care is a major theme of the budget with significant investment across a variety of sectors.  Overall annual spending is forecasted over the budget’s 4 year period.

  • 2017/18 $58.3B 
  • 2018/19 $61.3B (5.1% year over year increase) 
  • 2019/20 $64.2B (4.7%) 
  • 2020/21 $66.6B (3.7%) Average of 4.7% annual growth 2017/18 – 2020/21
Major investments include:

Hospitals 

  • An additional $822M investment in Ontario hospitals in 2018/19 -- an increase of 4.6 per cent; first announced by Premier Wynne on March 22. 
    • $305M for hospitals in high growth areas or with special needs (paediatrics, etc.) 
    • $187M for more hospital beds 
    • $95M to open new patient care spaces 
    • $54M to expand access to specialized services like bariatrics, organ transplants 
    • $48M for 26,000 more MRI hours and 14,000 new surgical and medical procedures 
    • $40M for more cancer surgeries, endoscopies, chemotherapy treatments, etc. 
    • $25M for more cardiac procedures
    • $5M for more critical care beds 
    • $4M for stroke care 
  • Committing $19B over 10 years for capital funding to build and renovate hospitals. 
  • $10M for a Centre of Excellence in Health Care Artificial Intelligence with St Joe’s Hamilton, Niagara Health System, McMaster and the Vector Institute.

Mental Health & Addictions 

  • $2.1B over four years for additional investment in mental health and addictions (first announced March 21 by Premier Wynne). Funding includes: 
    • Increasing access to publicly funded structured psychotherapy in primary settings and through mental health and addictions community agencies. 
    • Providing standardized training to primary care teams and community mental health and addictions agencies so they can provide high-quality structured psychotherapy services. 
    • Also boosting the Mental Health and Addictions Strategy through an investment of $570M over four years to improve community services across Ontario.
    • Investment of $175M over four years to expand school-based supports for mental health and addictions services.

Long-Term Care Homes

  • 30,000 new LTC beds over next decade; 5,000 new beds by 2022 (first announced November 2017). 
  • $300M over three years in new funding, starting with $50M in 2018/19 to hire a RN for every home and reach average of four hours of care by 2022. 
  • Every home will have staff with specialized training in behavioural supports and in palliative and end of life care.

Home Care 

  • $650M for home care over three years.
    • $180M for new volume – 2.8M more hours of personal support & caregiver respite, 284,000 more nursing visits, 58,000 more therapy visits. Half of this funding is to address demographic changes; half is to provide more service to more complex clients (Maple 4/5).
    • $5M for improved digital information and connection. 
    • $45M for rate increases for nursing and PSW services (2 per cent for nursing, 1 per cent for PSW). 

Supporting PSWs 

  • $23M over three years to add 5,500 PSWs in under-served areas. Money will support new models (F/T pay for PSWs), and enhanced grants for individuals interested in entering PSW workforce. 
  • $38M over three years in new funding to support PSW training and education. 
  • $65M over three years for an investment in PSW retirement security. Government will provide initial contribution and matching of up to 2.5 per cent of income through a TFSA retirement plan.

Support for Caregivers 

  • Launching new caregiver organization in spring 2018.
  • $75M over three years to support palliative and end-of-life care. 
  • Easier system navigation for caregivers

Primary Health Care

  • $102 million over three years to support the expansion of interprofessional primary care teams, focusing on areas that have the greatest need, so that people living in all regions of the province have access to team-based primary care. This investment will result in 19 new or expanded teams that will recruit nearly 100 new health professionals such as nurse practitioners, registered nurses, social workers, psychologists, chiropractors, physiotherapists and pharmacists to provide direct primary care services to patients who can benefit most from team-based primary care. 
  • $330 million over three years to support the recruitment and retention of health care professionals for primary care teams across the province. This includes professionals working in Aboriginal Health Access Centres, community health centres, Nurse Practitioner-Led Clinics and on family health teams, as well as other settings that collectively serve four million patients across Ontario. 

Palliative care 

  • Investing an additional $15M in 2018-19 to improve access to community-based palliative care. 
  • Improving access to community-based end-of-life services by completing the government’s goal of opening 20 new residential hospices across Ontario. 
  • Palliative care training for health service providers working in First Nation and urban Indigenous communities. 
  • More non-medical supports to patients and caregivers in the community through an additional investment to providers of visiting hospice volunteer services. 

Auto Insurance

  • The government remains committed to transforming the auto insurance system to prioritize care for accident victims. Initial steps taken by the government include implementing standard treatment plans for the most common auto collision injuries and reducing disputes that can ultimately hurt victims instead of helping them. As a next step, the government will be investing in the development of Pathways of Care that will support catastrophically injured persons through the Ontario Neurotrauma Foundation (ONF). The ONF, in partnership with Spinal Cord Injury Ontario, will work with insurers, legal professionals and people with lived experience to develop standards of care that reflect scientific evidence, existing research and best practices, to support the government’s goal of an overarching system of care that supports all people injured in auto collisions.

Other Commitments: 

  • New Seniors’ Healthy Home Program - Provides benefit of up to $750 annually for eligible households led by seniors 75 and over to help them live independently and offset the costs of their home maintenance (such as snow shoveling, lawn care, etc.). 
  • Rowan’s Law: Concussion prevention - A commitment of $5M over three years to support implementation of the recently-passed concussion safety legislation. 
  • Ontario’s Strategy to Combat the Opioid Crisis - An investment of more than $222M in the implementation of the Strategy to Prevent Opioid Addiction and Overdose. 
  • Starting in August 2019, OHIP+ will be expanded to seniors, eliminating the annual deductible and co-payment for seniors under the ODB program — saving the average senior approximately $240 annually. Seniors’ prescription medications funded through the ODB program will be free-of-charge, regardless of income. This represents an investment of about $575 million per year by 2020–21. 
  • $2.2 billion over three years to increase access to child care and affordability for more Ontario families by introducing free preschool starting in September 2020. This investment also includes about $1 billion over three years to support reduced fees and more subsidized spaces for infants and toddlers. 
  • $100 million over three years in the Province’s Dementia Strategy, including $34.5 million to expand community dementia programs and respite care services to improve the lives of people living with the disease and their families. These programs offer activities such as art, music and exercise, which can provide meaningful social and recreational engagement and lead to enhanced well-being. 
  • $6 million over three years for expanded access to house calls for seniors, including visits by professional care providers such as social workers, therapists and nurses. 
  • $1.4 billion since 2014 to expand developmental services.
  • $62 million in the Ontario Autism Program in 2018–19 to expand current system capacity so that more children and youth can be served through increased behavioural intervention, family supports and training. 
  • $250 million in new funding over three years to address the current waitlists for special education assessments and improve access to special education programs and services in schools. 
  • multi-year plan also includes action to improve the rates and supports available to people accessing social assistance, such as:
    • Increasing Ontario Works and Ontario Disability Support Program (ODSP) rates by three per cent annually for the next three years, starting in fall 2018; and
    • Other benefits and allowances, including the Personal Needs Allowance and Comfort Allowance, which are available to those residing in institutions, longterm care homes and emergency shelters, and will be increased by two per cent annually for the next three years, starting in fall 2018. 
Implications for Occupational Therapists​

A quick scan of key investments gives ready evidence of the potential for significant commitments in many areas in which occupational therapists work.  OSOT's advocacy strategies, both at a provincial and local level will be informed by these funding priorities.  Members are encouraged to monitor news of investments as they are talked about at the LHIN and organizational level.  Talk to your employers or funders!  Consider how you can position OT services within these funding opportunities!  OSOT Sector Teams are terrific resources to forward queries and suggestions.  Want to link with others who work in similar practice to discuss implications/opportunities?  Why not use OSOT's Find-a-Colleague online tool.  Watch your monthly updates for news of how policies are rolling out.


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