Government Announces Transformation of Ontario’s Health Care System

On February 26, 2019, the Ontario government introduced Bill 74 ,The People's Health Care Act,  which when passed will enact legislation that enables significant transformation of the province’s public health care system.  If passed, the legislation would create a central agency (Ontario Health) to oversee Ontario's healthcare system intended to, among other things, remove duplication. In addition, the changes contemplated by the Bill are intended to create a healthcare system that will:

  • direct public funding to frontline services to continuously improve the patent experience; 
  • build a sustainable, digitally-enabled, publically funded healthcare system;
  • establish a new model of integrated public health care delivery which will put patients at the centre of a connected care system anchored in the community;
  • empower providers to work directly with one another to offer co-ordinated care; and
  • recognize diversity within Ontario's communities.

View the Minister of Health’s February 26, 2019 announcement and vision for change.

It is anticipated that fulsome realization of the vision of change will take some time.  Government is committed to a phased, thoughtful approach that protects continuity of patient care.  However, movement is already afoot with the appointment of the Board of Directors of Ontario Health who were announced on March 8th.  These Directors have effectively become the Directors of each of the 14 LHINs and the 6 agencies named to be rolled into Ontario Health – Cancer Care Ontario, Health Quality Ontario, eHealth Ontario, Trillium Gift of Life Network, Shared Services Ontario and HealthForce Ontario Marketing and Recruitment Agency.  The Ministry has identified a priority for establishing the basis of Ontario Health by Summer 2019. 

What will Ontario’s new health system look like?

There is much that is unknown at this time.  Information is emerging regularly and will likely become clearer when the legislation is passed and Ontario’s provincial budget is released on April 11th.  

  • At the provincial level, Ontario Health (the Agency) is proposed to oversee health care delivery and improve clinical guidance & provide support for providers to enable better quality care for patients.  

  • At the local level, it is proposed that local/regional teams called Ontario Health Teams will develop amongst local health care providers (organizations) who will work together to provide coordinated, integrated care or, to address a specific patient population or focus of care, across the continuum of care.  This will enable providers to work as a coordinated Team as one unit, breaking down siloed boundaries and delivering “connected care” that best manages transitions in a patient’s health care journey. An Ontario Health Team might, for example, comprise a hospital, a home care provider agency, and a long-term care home,  or... 4 Family Health Teams, a CHC, and a not-for-profit that provides community mental health and addiction services.  Teams will be funded as a whole, not as siloed components. It is expected that Ontario Health Teams will look different and do things differently to maximize local/regional resources and address local/regional priorities.

    Learn more about the proposed structure of a transformed health system in a series of webcasts provided by the Ministry of Health.  View these here.
Engaging Ontario Health Teams

Under Ontario Health Teams, the health care providers (including hospitals, doctors and home and community care providers) will work as one coordinated team – no matter where they provide care. These teams will support patient care where and when they need it, and help them transition from one health care provider to another seamlessly.    On April 3, 2019 the MOHLTC opened a call for self assessments for early adopters.  Regional health service providers are invited to consider how they might partner to address health population needs and to submit self assessments by May 15th.  Thereafter, the Ministry will select groups to advance to a full application for mid July with a goal to be able to announce early adopter Ontario Health Teams in fall 2019.  See details and resources health services providers have been provided.

What might this mean for occupational therapists?
  • OSOT and occupational therapists have long advocated for better integrated care across siloed systems (primary care, hospitals, home care, long-term care, etc.).  A truly integrated system without funding silos would more effectively enable professions/professionals to work across transitions…..a space where OTs have a great deal to offer!
  • We believe the proposed new structure will provide incentive and opportunity for occupational therapists to think about the journey of their patients across the system and to think about how  occupational therapists could/should support them throughout that journey
  • Hospitals, home care providers, long-term care homes, etc. in which OTs are engaged may already be mobilizing to complete self assessments with a goal to proposing partnerships.  OTs should engage with their organization administration to ascertain any plans.  Being aware can support opportunities for input, engagement and promoting the important roles that occupational therapists can play across a system of care.
  • This will be a time of real transition and innovative thinking – opportunity to consider new ways of delivering service, proposing new program models, etc.

5 things every OT working in the public health care system should do…..
  1. Familiarize yourself with information about Ontario Health and proposed Ontario Health Teams – OSOT can help!  View the Ministry webcasts, sign up to receive ongoing MOHLTC updates.  Watch for OSOT updates in emails and on the website.  We can all participate best and contribute to a change agenda when we are well informed!

  2. Talk to your program leads, managers, PPLs, administrators to learn about how your organization is reacting/organizing around this system restructuring - what might be the opportunities for Ontario Health Teams in your region for your organization?  Keeping apprised of your organization's strategic direction and interests enables you and your OT colleagues to best position OT services to complement desired directions.

  3. Think outside the box – chat with colleagues….how could OT services contribute to best management of your clients’ needs across a more integrated system.  This can help you be ready, inspired… to contribute to discussions/proposal development, etc in your organization.  Have fun thinking about what you or the profession could do if not fettered by the walls of existing organizational structures.  How can OT contribute to the Ministry's vision for "Connected Care"?

  4. Look to the evidence…are  you aware of initiatives in other jurisdictions that are impacting outcomes, efficiencies, etc. – let us know your questions, we’ll share what we have!

  5. Promote Occupational Therapy!  This is a terrific time to be underlining the tremendous value an OT can bring to managing transitions across components of the health system.  What better time to have your organization and the stakeholders who may become Ontario Health Team partners understand what OT is and the value we can bring to the clients you serve!  This is our opportunity!  Need resources?  Check out the professional promotion resources on website.

How about one more thing?!  Send your questions and updates of issues and developments in your region to OSOT….understanding what you are hearing, not hearing, being asked to address, etc. helps OSOT to better support you and OTs across the province.

What will OSOT be doing?
  • Monitoring legislative development and passage of Bill 74.
  • Contributing feedback to the Premier’s Council on Hallway Medicine 
  • Continuing to meet with our government contacts….who have had little information to share in recent months….but further to the budget will likely be in a more open/informed position 
  • As transformation evolves….we’ll work to establish relationship with Ontario Health and build an understanding of how best to interact with this agency on issues of relevance to OTs in Ontario 
  • Continue to disseminate research/evidence that we have that supports OT services…..watch our social media pages
  • Respond to your questions and issues…..
  • Share information to help keep you informed.
  • Support you through this massive change agenda…..and support and encourage you to be an active participant in change for the better!  Together let's advocate for our patients/clients and our profession!