Patients First Act, 2016
On June 2, 2016, the government of Ontario introduced Bill 210, containing the Patients First Act, 2016. It is anticipated that the Bill 210 will pass sometime in the fall of 2016.
As indicated in the Patients First proposal, legislative changes will be required to provide LHINs with the authority to plan and implement better integration of primary care, home and community care services and to better incorporate population and public health planning into local health planning. The discussion paper (Patients First – A Proposal to Strengthen Patient-Centred Health Care in Ontario) also proposed “to move all CCAC functions into the LHINs.” In order to achieve these structural changes, a number of legislative changes have been proposed in the bill containing the Patients First Act, 2016.
Bill 210, proposes amendments to the Local Health System Integration Act, 2006 ( LHSIA) and the Home Care Community Services Act, 1994 (HCCSA) to expand the mandate and role for the LHINs. If passed the bill will affect the following statutes:
- The Community Care Access Corporations Act (CCAC Act) would be repealed once the transfer of functions from the CCACs to the LHINs is complete.
- LHSIA would be amended to expand the LHIN mandate and oversight powers and establish sub-regions.
- The Home Care and Community Services Act, 1994 (HCCSA) would be amended to allow the Minister to approve LHINs to provide home and community services directly or through contracts with service providers.
- The Community Care Access Corporations Act (CCAC Act) would be amended to repeal the Act to reflect the wind down of the CCACs
- The Health Protection and Promotion Act (HPPA) would be amended in order to establish engagement requirements for LHINs and local boards of health
- The Excellent Care for All Acts, 2010 (ECFAA) would also be amended in order to support the establishment of an integrated clinical care council.
Outlined below is a brief summary of some of the proposed amendments. If the bill is passed, the proposed amendments would:
- Recognize LHINs expanded mandate, including authority to deliver home care services currently provided by the CCACs and to coordinate community services.
- Require LHINs to establish sub-regions as the focal point for local planning and performance monitoring and managed.
- Expand LHIN board membership from nine (9) to twelve (12) members to reflect the expanded mandate.
- Change the length of time a person may be Board Chair (e.g., may exceed a maximum of six (6) years when a person is appointed as a Board Chair after having served at least three (3) years as a member.
- Require each LHIN to have one or more Patient and Family Advisory Committees to support community engagement.
- Give the Minister the authority to order the transfer of CCAC staff and assets to LHINs
- Following a Minister’s order, LHINs would assume responsibility for the management and delivery of home and community care (directly or through contracts with service providers), including the placement of patients into long-term care homes.
- LHINs would become successor employers under collective agreements.
- LHINs would establish an integrated management structure.
- Dissolve CCACs by Minister’s order after CCAC staff and assets have been transferred to the LHINs.
- Allow for an integrated clinical care council to be established within Health Quality Ontario to develop and make recommendations to the Minister on clinical standards in priority areas (e.g., home care, primary care).
- Give the Patient Ombudsman oversight of complaints regarding home and community care and related health services functions provided or arranged by the LHINs. The Provincial Ombudsman would retain oversight over LHINs in their services planning and other functions not related to health services delivery.
It is still anticipated that the transition dates for the dissolution of the CCACs into the LHINs will be 2017.
Bill 210, Patients First Act, 2016, is available for viewing here.