My question is to the Premier. I am very concerned about this government’s plan to further privatize home and community care services. In Thunder Bay and across the province we have seen the devastating consequences of turning over critical services to private corporations: missed appointments, staffing shortages and, ultimately, worse outcomes for Ontarians.

To the Premier: Will you ensure there is publicly available home and community care for all Ontarians?

To the Premier: Will you listen to home and community care workers and clients and stop the privatization of essential services for seniors and people with disabilities?

To the member opposite: You did mention earlier, and you are correct—our government is investing $1 billion over three years to expand and improve home care services. This is going to be across the province. That’s $100 million for community service. I will note that was part of our 2022 budget, which the member opposite voted against.

Also, budget 2023 accelerated investments to bring home care funding in 2023-24 up to $569 million, which, again, the member opposite voted against.

My question to the member opposite: Can you see how making the delivery system more streamlined, which this bill is going to do, will assist in delivering programs?

Home care services in Ontario address the needs of people of all ages, including children and youth with medically complex needs, the frail elderly and other seniors, people with physical disabilities, people with chronic diseases, and people who require health care services on a short- or long-term basis to live safely in their home and community.

With an aging population that is living longer, home and community care is going to be an increasingly important component of our health care system. It is critical that our system has the most effective structure, policies and approaches in place to ensure Ontarians have access to better and more convenient home and community care.

As outlined by the Deputy Premier and Minister of Health, the gradual transition of home care into Ontario health teams is a fundamental part of the work to improve the home care experience for patients and families, and improve how providers collaborate to provide care.

Alors que notre gouvernement continue de moderniser les services de soins à domicile et en milieu communautaire, y compris la planification de la transition des services de soins à domicile vers les équipes santé Ontario, nous avons écouté attentivement et avons travaillé en étroite collaboration avec les organismes prestataires de services, le personnel des services de soins à domicile, les patients et leurs familles, ainsi qu’avec d’autres partenaires du système afin de garantir l’existence d’une base solide de soin plus étroitement intégrée aux autres composantes du système de santé et qui est fondée sur le principe central des soins axés sur le patient. Une partie essentielle du travail continu en vue d’une approche moderne et centrée sur le patient des services de soins à domicile est la continuité des soins aux patients tout au long de ce processus. Il est essentiel d’éviter toute interruption pour les patients et leurs familles.

Ontario health teams are already transforming how people access care in their communities. And the province has engaged in thoughtful planning and preparation to ensure stable home care delivery is maintained while improvements to care are made and the gradual transition to Ontario health teams takes place—because the only thing better than having care close to home is having care in your home.

The proposed Convenient Care at Home Act is the latest legislation designed to improve home care. Significant progress has already been made to modernize the home care sector to achieve better patient outcomes through system integration and help ensure the sustainability of our publicly funded health care system for future generations.

In 2020, our government introduced the Connecting People to Home and Community Care Act, which established a new framework for home and community care under the Connecting Care Act. This new legislative framework, complete with the accompanying home and community care regulations, took effect in 2022. This legislative framework was an initial step designed to facilitate the delivery of home care by Ontario health teams and enable new models of care, including changes to care coordination.

The Connecting People to Home and Community Care Act ushered in a new, flexible and modern framework for home and community care. This new framework enables the provision of home care services by Ontario health teams, as well as more flexible, efficient and responsive care coordination and service delivery by contracted service provider organizations.

Le nouveau cadre législatif et réglementaire des soins à domicile et en milieu communautaire établi par la loi sur les soins de santé a jeté les bases de service de soins à domicile intégrés, réactifs et innovants—qui sera maintenant davantage développé par la proposition de la Loi sur la prestation commode de soins à domicile.

L’une des premières étapes en vertu de la législation proposée consisterait à regrouper les 14 organismes de soutien aux soins à domicile en une seule organisation, appelée Santé à domicile Ontario, qui serait chargée de coordonner l’ensemble des services de soins à domicile dans la province au moyen des équipes santé Ontario, relevant de Santé Ontario. Santé à domicile Ontario serait un guichet unique qui fournirait aux personnes des plans de soins à domicile faciles à comprendre, leur permettant de connaître les soins qu’elles recevront et quand, avant de rentrer chez elles depuis l’hôpital.

La création d’une organisation unique permettrait de relever les défis systématiques liés à la prestation des soins à domicile. Au lieu de politiques et de processus différents, ou de systèmes de technologie de l’information distincts, une organisation unique pourrait réduire les fonctions et l’administration redondantes et soutiendrait l’efficacité du système et permettrait de généraliser les meilleures pratiques.

Ontario Health would fund and oversee both the new organization and Ontario health teams, helping to ensure strategic direction is aligned. Ontario Health would also be able to align funding and oversight of home and community care with other health system organizations and sectors.

Ontario Health has significant experience with integrating our health care system. Ontario Health has already integrated 22 former health agencies and organizations, such as Cancer Care Ontario, eHealth Ontario, Health Quality Ontario and others into a single organization, bringing together the expertise and experience of these former agencies to support a more connected, high-quality health care system. Ontario Health has worked with the Ministry of Health to achieve more than $300 million in ongoing, annualized savings to reinvest back into direct patient care.

Ontario Health is also implementing the province’s Digital First for Health Strategy, which provides employment for and administrative support of the Office of the Patient Ombudsman; supports the Mental Health and Addictions Centre of Excellence, which is helping to implement the Roadmap to Wellness, the province’s mental health and addictions strategy; and continues to support the government’s supply chain centralization efforts.

Ontario Health is enabling supply chain excellence across the health sector, including supporting home care by making significant progress in leading new provincial procurements for home care medical equipment and supplies and related services which are critical to delivering patient care. For years, there has been significant variation across the province, and this was identified as an opportunity for improvement.

Ontario Health and the Home and Community Care Support Services organizations have worked closely together to plan for implementation of these new contracts for medical equipment and supplies. This work will bring significant value for Ontario, improve the provider experience, and simplify and standardize key processes that focus on patient care.

Ontario Health has also enhanced the provincial formulary for advanced wound care products and developed the first-ever provincial formulary for home care products, which will be made available to all patients irrespective of where they are in the province, improving the quality and equity of patient care.

Le ministère a écouté attentivement et a travaillé en étroite collaboration avec les organismes prestataires de services, le personnel des soins à domicile et en milieu communautaire et d’autres partenaires du système, ainsi que les patients et leurs familles, et continuera à collaborer avec les partenaires du système tout au long de ce processus.

Au fur et à mesure de la transition vers les équipes santé Ontario, les patients et les aidants continueront à accéder aux services de soins à domicile et en milieu communautaire de la même manière et par l’intermédiaire des mêmes contacts qu’ils ont appris à connaître et en qui ils ont confiance.

Speaker, Ontario’s Home and Community Care Support Services organizations, which would transition to a single agency under Ontario Health, have also been engaging in collaborative efforts to support more connected home care, including supporting Ontario health teams. For example, Home and Community Care Support Services Central East is supporting the Durham Ontario Health Team leading project, which will deliver an integrated system of care for the residents of the downtown Oshawa neighbourhood. The residents of this area have higher rates of chronic conditions and a higher utilization of emergency, community and social services when compared to the regional average. Through the downtown Oshawa neighbourhood integrated model of care, patients will be able to access care from various providers on-site at a mid-rise apartment building that is also home to a significant amount of seniors facing socio-economic challenges.

Providers on-site will include care coordinators, community paramedicine providers, Lakeridge Health mental health services, Community Care Durham, and contracted service provider organizations. Care may also be accessed through self-referrals and primary care referrals, and the patient pathway is based on the principle of “no wrong door” to services.

In Central East, a multidisciplinary mobile emergency diversion team has also been established, composed of rapid response nurses, occupational therapists, physiotherapists, nurse practitioners and community paramedicine providers. The team assists with immediate patient care needs such as IV medication administration, wound care, and home safety assessments until contracted home care services can be secured. This temporary and urgent hands-on care is allowing patients to be discharged from the hospital, and it also prevents a return trip to the emergency department. The multidisciplinary mobile emergency diversion team was first piloted in the Peterborough area and helped to divert 92 emergency department visits within 120 days.

In North Simcoe Muskoka, a stroke care coordinator role has been developed to improve the transition from hospital to home and provide ongoing care for people who have experienced a stroke. Based out of the Royal Victoria Regional Health Centre and supported by the Central East Stroke Network, the program has helped increase the number of stroke patients admitted to the home and community care support services stroke pathway and supported admissions to the pathway from all area hospitals. Benefits include warm hand-offs of patients who are transitioned from hospital to the community, a reduction in hospital readmissions for stroke patients, and improved integration between home care and outpatient programs.

In Central West, the hospital-to-home direct nursing service supports palliative patients through regular check-ins and symptom monitoring from a dedicated team of nurses. These nurses assess patients and can provide appropriate patient care, which helps to avoid an emergency or acute-care intervention. The hospital-to-home nurse completes weekly clinical assessments of the patient, their symptoms and the situation in the home, and provides education and resources to support the patient and their family so the patient can remain safely in their own home.

Home and Community Care Support Services South West has also implemented palliative care initiatives such as providing specialized education in palliative care, which is enabling patients to have access to nurses with more specialized skills in palliative care and supporting more patient- and family-centred end-of-life care in their place of choice: their home.

To address gaps in home care, the ministry engages extensively with key partners to expand more equitable access to services. The ministry provides up to $14.8 million in funding directly to First Nations communities to deliver front-line home care services such as nursing, personal support and therapy. An additional investment of $4.2 million is provided to urban Indigenous organizations to deliver culturally appropriate home care to Indigenous people in urban areas throughout Ontario.

To be more inclusive of all Indigenous patients, communities and organizations, a new category of Indigenous services has been added to the suite of services that comprise home and community care. Traditional healing services and Indigenous cultural support services fall under this category of services. These broader, more inclusive services will support more equitable access to culturally appropriate services for all Indigenous patients.

Already, new models of home care delivery are being implemented to enable a more integrated experience for clients and their families. The Children’s Hospital of Eastern Ontario is now responsible for home care delivery, building stronger links between home care and the people who care for children at the hospital. Through a model of care called @home, a number of hospitals and health care partners are working together to provide eligible patients and their families with an integrated approach to transitioning patients home from the hospital.

Most patients enrolled in @home programs have been seniors at significant risk for re-hospitalization. Patients receive care for up to 16 weeks, after which many transition to home and community care support services for ongoing health care and personal supports. Care coordinators from home and community care support services central have already supported the safe transition of hundreds of patients through recently established at-home programs from five hospitals: Humber River, Mackenzie Health, Markham-Stouffville, North York General and Southlake.

Once patients are safely at home, home care providers continue to work together to meet the individual patient’s needs, often with one or more services such as nursing, personal support, restorative and rehabilitation services, and medical equipment and supplies. This connected patient-centred model of care has optimized patient recovery while also helping to support hospital capacity by ensuring the hospital beds are available for those who need them the most.

On top of all of this, last year we announced over $1 billion to expand access to home care services over the next three years, which will benefit nearly 700,000 families who rely on home care by expanding home care services while recruiting and training more home care workers. In addition, the government announced an additional $548.5 million investment in home care over three years that is in addition to the $1-billion investment previously mentioned. This will help prevent unnecessary hospital and long-term-care admissions and shorten hospital stays. Most importantly, it will provide Ontarians with the choice to stay in their home longer, close to loved ones.

We are seeing more and more examples of the benefits of connected and integrated care, including through the province’s community paramedicine initiative, where providers who are trained as paramedics work alongside home care and primary care providers to give people living with chronic health conditions additional support to live at home more independently. Speaker, home care is an important connector in our health care system, enabling—

I want to congratulate the member from Newmarket–Aurora for obviously having excellent mastery of the subject matter. My question for her is, in the riding of Essex sometimes we get telephone calls from people who are trying to set up home care for their family members and sometimes they find it difficult to navigate the system. So we have to help them navigate the system. My question to the member from Newmarket–Aurora is, how is this proposed legislation and Ontario Health atHome going to make it easier for people in Essex county and across the province of Ontario to access the home care services they need?

I want to thank my colleague for a very impassioned speech about home care and about the disparity of services that northern Ontario is experiencing. You can always tell when he’s really passionate, because his voice goes up three or four octaves, and it makes it entertaining for some of us.

However, the question on this voting thing—I’m going to go there—because once again, the government has brought forward a piece of legislation which does not solve the problem. They always say to us, “Why are you not voting with us?” We’re going to vote against legislation which does not address the needs of the people of this province, and that includes northern Ontario, to my colleague.

So when my colleague finds out that seniors who are not getting dignity in home care are now looking to medical assistance in dying—they’re looking to the MAID system, because they have no dignity—what can he tell the House about the level of desperation, based on this bill?

Écoute, j’apprécie ta question en français, premièrement, mais à nulle part dans ce projet de loi est-ce que ça parle des services en français non plus. Ce qu’on sait dans la province de l’Ontario : il y a une grosse pénurie de services en français. Je suis certain que tu ne peux pas le dénier parce qu’on le vit constamment. On n’a qu’à penser à, encore, que vous venez d’annoncer notre université que vous avez cancellée—je ne comprends pas la justification.

Mais quand ça vient à des services de santé, un des gros dossiers de l’AFO, madame la Présidente, c’est le manque de services en santé francophones. En étant critique francophone, puis qu’on voit qu’ils n’adressent pas ces services en français dans un projet de loi qui dit « Convenient Care at Home »—what about the French part of it? Because right now, in this bill, it doesn’t address nothing about services in French, which are lacking a lot in Ontario.

My question is for the member from Mushkegowuk–James Bay. I spent many years working in your community—Moose Factory, Moosonee and all of those James Bay communities. I struggle to understand how home care services will improve by centralizing them in a single monolithic institution. Does that make any sense to you?

Now, we’re moving from 14 organizations to a single-organization model, and this is going to provide a strong and centralized foundation to support the stability of the home care services now and into the future.

The Ontario Health Teams—they’re going to be taking on the responsibility. The organization would provide ongoing operational supports and care coordination to those teams. This is not a layer, but a support partner for OHTs, and planning and delivery.

This being said, in the past, the opposition has voted against our government’s proposals to make health care delivery quicker and more reliable now for constituents in your community.

So I ask the member from Hamilton—

In my riding, in Essex, we have lots of people entering the career of PSW because of the steps taken by this government, and the member opposite made reference to the number of PSWs available in the marketplace and available to deliver the services required. I can tell you that I went to Anderson College and talked to the trainees there and they were very happy to have received free tuition and free books from this government to get their training, to get more PSWs. I know that that program is being taken up very well by the people in the riding of Essex.

My question to the member is, is she aware of how many people in her riding are benefiting from the remarkable program introduced by this government to pay the tuition and pay the books for PSWs entering that profession?