On June 6, 2019, the Connecting Care Act (CCA) was proclaimed into force. It brings into effect a number of key structural changes that will create the framework for health system transformation in Ontario.
Not all of the changes have immediate effect. What does this mean for health industry clients? We discuss some of the key changes below.
Establishment of Ontario Health
The new province-wide central agency (Ontario Health in English and Santé Ontario in French) has been established as a non-share capital corporation. Although the new entity has been created, Ontario Health will not be fully operational until the transfer and consolidation of the 14 Local Health Integration Networks (LHINs) and 6 provincial health agencies, such as Cancer Care Ontario, eHealth Ontario and Health Shared Services Ontario. This will be achieved by way of transfer order as set out by the CCA. The transfers may be staggered over time.
The objects of Ontario Health are broad and incorporate many of the powers and authorities of the LHINs and objects relating to the specific mandates of the provincial health agencies. There is the ability to identify new objects. As set out in a previous Health Communiqué, the province has already introduced legislation that would enable the objects of Ontario Health to be amended to support the development of a provincial mental health and addictions strategy and Mental Health and Addictions Centre of Excellence within Ontario Health.
The CCA enables the Minister of Health and Long-Term Care (the Minister) to transfer the assets, liabilities, rights, obligations or employees of the LHINs and provincial health agencies to Ontario Health (or other entities). There are a number of procedural requirements set by statute. Before a transfer order is made, the Minister is required to provide notice to Ontario Health and each affected transferor or transfer recipient. The transfer order will specify the assets, liabilities, rights, obligations and employees that are to be transferred and the date on which the transfer takes effect. The order may specify the process by which any issues arising out of the interpretation of the order are to be resolved.
There are a number of provisions under the CCA relating to the treatment of the parties and the allocation of risk and liability resulting from a transfer order. There are special rules, for example, as it relates to the transfer of employees.
Ontario Health Teams
The CCA provides for the creation of integrated care delivery systems, referred to as Ontario Health Teams (OHTs). Under the CCA, the Minister may designate a person or entity or a group of persons or entities as an OHT, provided that they have the ability to deliver in an integrated and coordinated manner at least three of the following types of services:
- hospital services,
- primary care services,
- mental health or addictions services,
- home care or community services,
- long-term care home services,
- palliative care services, and
- any other prescribed health care service or non-health service that supports the provision of health care services.
According to the Ministry, it has received over 150 self-assessment submissions from health service providers and organizations who want to become an OHT. The deadline to submit self-assessments was May 15, 2019. Those teams that demonstrate a higher degree of readiness to become an OHT will be invited to prepare and submit a full application in early July 2019.
The deadline to submit a full application will be in September 2019.
In the fall of 2019, OHT candidates will be announced.
The date for the next call for self-assessments will be some time in fall 2019. The Ministry intends to announce the exact date in the coming weeks.