Points of Relevance for OTs from Ontario's Fall Economic Statement

On November 4, 2021, Ontario's Finance Minister presented the Fall Economic Outlook and Fiscal Review: Build Ontario. The plan lays out how the government will build the foundation for Ontario's recovery and prosperity by "getting shovels in the ground on critical infrastructure, attracting increased investment, and restoring leadership in auto manufacturing and other industries. The plan also aims to protect Ontario's progress agains the COVID-19 pandemic.

View Build Ontario, Ontario's fall economic outlook and fiscal review.

The following content from Build Ontario have been highlighted as of particular relevance to occupational therapists. Members are encouraged to consider implications for practice opportunities, to watch for investments that will serve these goals/objectives and to consider how access to OT services may be impacted/enabled in your local area.

A Plan to Safely Reopen Ontario and Manage COVID 19 for the Long Term

In consultation with the Chief Medical Officer of Health, the Ontario government has released a plan that outlines the Province’s gradual approach to lifting remaining public health and workplace safety measures by March 2022. The plan will be guided by the ongoing assessment of key public health and health care indicators and supported by local or regional tailored responses to COVID 19.

In the absence of concerning trends, Ontario will slowly and incrementally lift all remaining public health and workplace safety measures, including the provincial requirement for proof of vaccination and wearing of face coverings in indoor public settings, over the next six months. This phased approach will be guided by the ongoing assessment and monitoring of key public health and health care indicators, such as the identification of any new COVID 19 variants, increases in hospitalizations and ICU occupancy and rapid increases in transmission to ensure that public health and workplace safety measures are lifted safely.

To manage COVID 19 over the long term, local and regional responses by public health units will be deployed based on local context and conditions. Public health measures that may be applied locally could include reintroducing capacity limits and/or physical distancing, reducing gathering limits and adding settings where proof of vaccination is required, among others. Public health measures would be implemented provincially in exceptional circumstances, such as when the province’s health system capacity is at risk of becoming overwhelmed or if a vaccine resistant COVID 19 variant is identified in the province.

Expanding Education Support for Nursing and Other Health Care Providers

The Nursing Graduate Guarantee Program provides over 600 new nursing graduates in Ontario with temporary full-time employment to support the transition from practice to full-time employment. By the end of 2021–22, an additional 400 new graduates will be working in acute care settings to support Ontario’s surgical recovery plan and staffing needs in the long-term care sector.
The Enhanced Extern Program offers students with training opportunities to work as unregulated health care providers in hospitals as they continue their education. In 2021–22, Ontario is adding over 7,000 spots in the Enhanced Extern Program to allow students in nursing, respiratory therapy, medicine, paramedicine, occupational therapy and physiotherapy to participate. The program is now also open to allow internationally educated nurses to participate.These additional nurses, personal support workers and other health care providers create much needed capacity in Ontario’s health care system and are part of the government’s commitment to providing the best possible care to the people of Ontario.

Support to Hospitals

To ensure hospitals can continue to provide high-quality patient care, the government is providing hospitals with over $1.8 billion in 2021–22 to support 3,100 new and additional beds, reduce surgical and diagnostic imaging backlogs and to help hospitals keep pace with patient needs and increase access to high‐quality care.

Expanding Home Care for COVID 19 Response and Recovery

Home and community care keeps people healthy and at home, where they want to be, and plays an important role in the lives of approximately 700,000 families annually. It prevents unnecessary hospital and long-term care admissions and shortens hospital stays — protecting hospitals and long-term care homes for those who need them the most.
This is why the government is investing an additional $548.5 million over three years in the home and community care sector. The investment will expand home care services, support additional staff including personal support workers and connect patients to the services they need.

The funding would support up to an estimated 28,000 post-acute surgical patients and up to an estimated 21,000 patients with complex health conditions every year by providing:

739,000 nursing visits;
157,000 nursing shift hours;
117,000 therapy visits including physiotherapy, occupational therapy and speech language pathology;
2,118,000 hours of personal support services; and
236,000 other types of home care visits.

These investments will allow patients to return home to recover after their surgeries or receive home care when they have complex health conditions. This investment also helps to ensure that hospital beds are available for those who need them the most.

Helping Seniors Stay Safely in Their Homes

Most seniors would prefer to age in their own homes, surrounded by memories and loved ones. This is why the government introduced the temporary Seniors’ Home Safety Tax Credit for the 2021 tax year in the 2021 Budget.

In recognition that some seniors may undertake more renovations to make their homes safer as they age or may not have used the credit in 2021 (e.g., due to concerns related to the pandemic), the government proposes to extend the credit to the 2022 tax year.
The Seniors’ Home Safety Tax Credit would be worth 25 per cent of up to $10,000 in eligible expenses for a senior’s principal residence in Ontario in 2022. The maximum credit would be $2,500 for the year.

Examples of eligible expenses would include renovations to permit a first-floor occupancy or secondary suite for a senior; grab bars and related reinforcements around the toilet, tub and shower; wheelchair ramps, stair/wheelchair lifts and elevators; and non-slip flooring.

The 2022 credit extension would provide an estimated $35 million in support to about 32,000 people, or $1,100, on average, up to a maximum benefit of $2,500.
See Annex: Details of Tax Measures and Other Legislative Initiatives for further information.

Building on Mental Health and Addictions Investments

Mental health is health. People dealing with mental health challenges deserve access to the treatment and care they need. COVID 19 has intensified the need for mental health supports and services, and is another reason why the government is making a historic investment of $3.8 billion over 10 years to ensure people can access the care they need.

One example highlighted in the pandemic is that too many communities and families across Ontario have experienced the pain of opioid addiction firsthand. This is why the government has invested $32.7 million towards targeted addictions services and supports, including treatment for opioid addictions. This funding will help to enhance access to addictions services and address urgent gaps in needed supports across the continuum of care.

Another example is the impact the COVID 19 pandemic has had on school-age children. This is why the Province is providing over $80 million to support student mental health for the 2021–22 school year. This funding will support hiring more than 1,000 mental health workers.

Supporting Health Care Workers’ Mental Health

The COVID 19 pandemic has had a significant impact on frontline health care workers’ mental health. In fact, the majority of health care workers reported that their mental health has worsened since the start of the COVID 19 pandemic. They need support now more than ever.

This is why the government is investing $12.4 million over two years starting in 2021–22 to continue rapid access to existing and expanded mental health and addictions supports for health and long-term care workers across the province. These treatment options include one-to-one psychotherapy and workshops provided by partners including the Canadian Mental Health Association — Ontario, the Ontario Psychological Association, and five hospitals. This funding will also support needs assessments, online peer support, workplace mental health training and intervention services at select hospitals to help frontline workers whose mental health has been impacted by workplace and occupational stress.

Through these measures, the government is taking action to address the recommendations included in Ontario’s Long-Term Care COVID 19 Commission Report to ensure long-term care staff receive the mental health supports they need.
These investments will support the workforce of the health and long-term care sector to continue providing high-quality care and service to patients and long-term care residents.

Supporting Postsecondary Students’ Mental Health

The COVID 19 pandemic has increased the pressures on postsecondary mental health services. Building on the government’s record investments to address mental health and addictions challenges from the 2021 Budget, the government is investing an additional $8.7 million, for a total of $27.9 million in 2021–22 to increase mental health supports at Ontario postsecondary institutions. This funding will address the increased need across all Ontario postsecondary institutions, and also includes new funding for Indigenous Institutes, Université de l’Ontario français and the Northern Ontario School of Medicine.

Supporting the Mental Health and Well-Being of Children and Youth with Eating Disorders

During the COVID 19 pandemic, hospitals across Ontario have seen a surge in severe eating disorders among children and youth due to increased isolation, school disruption, social media exposure and stress-fueled unhealthy eating and exercise habits.

This is why the government is investing $8.1 million in 2021–22 to address increased demand for services to support specialized care for children and youth with eating disorders. In addition, as part of the Province’s Roadmap to Wellness: A Plan to Build Ontario’s Mental Health and Addictions System, the 2021 Budget committed $175 million in 2021–22 to expand and enhance mental health and addictions services. This includes $11 million for eating disorder services and supports that span the continuum of care, from intensive services through to community, outpatient and early intervention services.

Securing Necessary Support for Health Care

The COVID 19 pandemic has intensified pre-existing pressures on provincial and territorial health care systems, demonstrating the need for increased financial support from the federal government. Ontario recognizes the federal commitment to work with provinces and territories to support priorities like long-term care, mental health and addictions, and the establishment of vaccine verification systems. Strengthening health care now is more important than ever.

Ontario maintains that the best way for the federal government to support provinces and territories as they improve health care systems, including long-term care and mental health and addictions, is through the Canada Health Transfer (CHT).

In 2021–22, the Ontario government is projected to spend $69.9 billion on base health sector expenditures and a further $5.2 billion on dedicated COVID 19 health response — approximately 40 per cent of the provincial Budget. Federal supports through the Canada Health Transfer are projected to be $16.7 billion in 2021–22 or approximately 22 per cent of these costs. When Medicare started, initial costs were shared between provinces and the federal government on a 50/50 basis. There is a need to rebalance health care funding in Canada, renewing this original vision to reflect the demands of today. The effects of COVID 19 have further underscored the need for urgent federal action to address increasing pressures on the provincial health care system.

The federal share of total provincial and territorial health spending is projected to decline from 22 per cent in 2021–22 to less than 18 per cent by 2040. If the federal government does not increase its share of health funding and maintain this level over time with a minimum annual escalator of five per cent, it would severely impact Ontario’s ability to respond to the pressures in its health care system.

To address this inequity, Ontario, along with the Premiers of all other provinces and territories, through the Council of the Federation, has called on the federal government to immediately increase the Canada Health Transfer to cover at least 35 per cent of provincial and territorial health care costs. This funding would allow Ontario to continue supporting critical health needs such as hospitals, physician services, long-term care, home and community care, mental health and addictions, as well as addressing surgical backlogs that have accumulated during the pandemic, without taking resources away from other key provincial responsibilities.