An Update on The People’s Health Care Act, 2019
On February 26th, the Minister of Health and Long-Term Care, Christine Elliott, announced the government’s plans for health system transformation by tabling the proposed legislation, Bill 74, The People’s Health Care Act, 2019. While some matters are still unknown with regards to the implementation of the legislation, there are two parts of the Act that may have impact for our members and are being highlighted.
Ontario Health (previously known as the ‘Super Agency’)
This new agency would deliver health care province-wide through the consolidation of 20 current Crown organizations including:
- Cancer Care Ontario
- Health Quality Ontario
- eHealth Ontario
- Trillium Gift of Life Network
- Health Shared Services Ontario
- HealthForce Ontario Marketing and Recruitment Agency
- 14 Local Health Integration Networks
Ontario Health would be an agency under the Broader Public Service Accountability Act and would be governed by a 15-person Board of Directors that will be appointed by Cabinet. A CEO search is underway, with a focus on people with a business background.
Ontario Health Teams (previously known as ‘MyCare Groups’)
Ontario Health Teams (OHTs) will be responsible for delivery of patient care in a defined geography with the intent to deliver, in an integrated and coordinated manner, at least three types of health services including:
- Hospital care
- Primary care
- Mental health and addictions care
- Long-term care
- Home and community care
- Palliative care
Although there appears to be 30 unsolicited proposals already submitted to the Ministry, all proposals will need to undergo a formal Expression of Interest (EOI) and a readiness assessment, which will also include a site visit that would include speaking to all partners identified in the proposal. At full maturation, it’s anticipated there will be 30 to 50 OHTs across the province, each serving between 50,000 to 500,000 people with an average of around 300,000.
How does this all impact team-based primary care?
*NOTE: this is speculative and would need to be verified once more information is known on the roll out of the new agency
Ontario Health:
- The legislation defines that FHTs and NPLCs will now be defined as ‘health service providers’ which means at some point, all contracts will move over to the agency BUT at the moment things will be status quo until they sort out contract management – it appears that current FHT contracts will probably stay in effect for some time and the NPLC contract will need to be opened up to allow for an assignment clause to Ontario Health. This could all take some time.
- The LHINs may be in existence for a while with the function of managing home and community care until they are transferred, possibly to the OHTs (ensuring continuity of patient care).
- Five regional entities will be established under the agency to provide more oversight of health service delivery.
- It’s not well understood if family physicians can be defined as an HSP but the legislation allows ‘any other person or entity or class of persons or entities that is prescribed’.
Ontario Health Teams:
- Primary care can apply to lead the development of an OHT in their community, especially if the size of the population that they serve are over 50,000.
- Governance structures will remain but there would be one budget that the lead would be accountable for – the focus right now is on collaborative governance, with a focus on seamless transitions of care for patients.
- There will be a readiness assessment with the early adopters and site visits – if a proposal indicates that partners are going to participate, they’ll visit and see what that means if there was true collaboration in developing the proposal.
- OHTs will have supports from the government and will also be a conduit to identify legislative and regulatory barriers to success, barriers to integration, sharing or best practices, tools for digital health and communications and change management assistance.
Overall – there aren’t many answers yet and more information will follow as the Ministry starts working on its implementation plan. AFHTO looks forward to working with stakeholders including OCFP, Section on General and Family Practice, NPAO, and others to ensure that primary care’s foundational role in health system transformation is recognized.
Next Steps:
- AFHTO will be setting up a webinar with H&K to walk through the Act and to explain the EOIs when they come out – anticipated date for roll out is mid to late March so stay tuned for more details.
- Sign up for the Ministry e-newsletter which will send you updates as they become available: https://mailchi.mp/ontario/connectedcareupdates
- As this rolls out there will be a lot of questions so please let us know at info@afhto.ca – we will be having ongoing conversations with the Ministry during the implementation of the Act and would like to let them know about concerns/questions from the field.
- If you or your team is interested in leading and/or participating in the EOI when they become available, please let us know at info@afhto.ca so that we can ensure the decision makers in the Ministry are also aware.
Reference Documents:
- Detailed memo on The People’s Health Care Act, 2019 from H&K (February 28, 2019)
- Concise memo on The People’s Health Care Act, 2019 from H&K (February 28, 2019)
- Flash Update on the Minister of Health and Long-Term Care Announcement of The People’s Health Care Act, 2019 (February 26, 2019)
- Government Transformation of the Health Care System including backgrounder of the announcement and other documents
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