Ministry Reports

Choosing Quality, Rewarding Excellence  :

Ontario's Response to the Caplan Report on Home Care

May 1, 2006


Ontarians tell us that they prefer to receive care at home - rather than in a hospital or other institution. New technologies and advances in drug treatments are making it possible for the health care system to provide more services at home. Care that was once only available in hospital, such as dialysis, intravenous therapy and chemotherapy, can now be delivered safely at home.

Home care is providing a much wider range of services than in the past, including post-operative care, rehabilitation services, end-of-life care, ongoing nursing and personal support services for people with chronic illnesses, and community support services such as meals and help with homemaking for people who are frail or disabled.

Ontario's Goal
A health system that helps people stay healthy, delivers good care when people need it, and will be there for our children and grandchildren.

Approximately 500,000 people receive home care services in Ontario every year. By 2007/08, enhancements in funding will mean that over 100,000 more people receive acute and end-of-life care at home. Home care is available to people at all stages of life, but most services are used by people over age 65. Between 2001 and 2031, the number of people over age 65 in Ontario will double, and the demand for home care will grow.

Home care is a cornerstone of the government's plan to transform health care. Providing more skilled care in the community allows Ontarians to leave hospital sooner or even avoid hospitalization, which reduces wait times for hospital services. Ontario is committed to providing high quality home care. That is why the government asked the Honourable Elinor Caplan to lead an independent review of the competitive bidding process used by Community Care Access Centres (CCACs), the agencies that arrange for and coordinate home care services to provide nursing, personal support and homemaking services, physiotherapy, occupational therapy, social work, speech-language pathology, and dietetics services, and medical supplies and equipment to clients eligible for home care.

The purpose of the review was to:

  • assess the impact of the procurement process on the quality and cost of care
  • identify ways to improve the quality and continuity of home care services
  • identify ways to increase stability in the workforce
  • identify ways to improve the procurement process.

The May 2005 report, Realizing the Potential of Home Care: Competing for Excellence by Rewarding Results, made 70 recommendations designed to enhance the quality of home care services, strengthen the home care workforce, and improve the procurement process. Over the past few months, the Ministry of Health and Long-Term Care (the ministry) has worked closely with Community Care Access Centres, the Ontario Association of Community Care Access Centres (OACCAC), the Ontario Community Support Association, the Ontario Home Care Association, the Alliance of Professional Associations for Community-based Therapy Services, the Ontario Association of Children's Rehabilitation Services, the Community Care Health Providers Network Inc., and other provider organizations, in reviewing the Caplan Report and developing plans for implementation. The ministry has accepted the Honourable Elinor Caplan's recommendations with the exception of all but two of the recommendations:

  • Allow CCACs to reallocate up to five per cent of their budget annually
  • Consider cross-appointments between CCAC and Local Health Integration Network (LHIN) boards.

While the ministry recognizes the benefit of more flexible approaches to funding, allowing CCACs to allocate a portion of their budget to a reserve fund would not be consistent with the newly enacted Local Health System Integration Act, 2005 or with funding practices for transfer payment agencies as set out in the Management Board of Cabinet Transfer Payment Accountability Directive.

Furthermore, in the ministry's view, cross-appointments between CCACs and LHIN could result in a conflict of interest with the LHIN' role as the funder. To avoid this conflict, the decision to not proceed with this recommendation was made.

In fact, the ministry, the OACCAC and CCACs have already acted on many of the recommendations, such as establishing working groups to revise current Request for Proposal (RFP) documents and tools.

The following pages list the recommendations from the Caplan Report, and describe the ministry's response under three key goals:

  1. Sustaining client-focused, quality home care services
  2. Stabilizing the home care workforce
  3. Improving procurement practices.

The full report is available for download in PDF format, below :

Document Download

Full Report
Choosing Quality, Rewarding Excellence: Ontario's Response to the Caplan Report on Home Care
37 pages | 343 kb | PDF format

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