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Summary of Amendments to Regulations to Strengthen Home Care Services in Ontario

A.  Community Care Access Corporations Act, 2001 (CCAC Act)

The amendments to Ontario Regulation 554/06 under the CCAC Act expand the case management role of Community Care Access Centres (CCACs). The list of charitable corporate objects in section 5 of the CCAC Act has been expanded to allow CCACs to manage the placement of persons into adult day programs provided under the Long-Term Care Act, 1994, supportive housing programs funded by the Ministry or a Local Health Integration Network (LHIN), and chronic care and rehabilitation beds in public hospitals.

CCACs are currently authorized to place clients into long-term care homes.  This change enables CCACs to expand their role as a systems navigator, leveraging their expertise in case management to improve both client service and health system efficiency.  The  regulatory amendments will enable innovation at the local level by LHINs, CCACs and health service providers.

B. Long-Term Care Act, 1994 (LTCA)

The regulations relating to the provision of home care services have been consolidated under the LTCA and updated. New provisions have been added to allow CCACs to provide additional services and service choices to their clients. The amendments to O. Reg. 386/99 will allow home care clients to access:

• New venues for service. The amendments provide CCACs with a new venue for delivering professional services to clients: a congregate or group setting. The following services could be offered in this new venue: nursing, occupational therapy, speech-language pathology, dietetics, social work, social service work, respiratory therapy, training, diagnostic and laboratory services, and medical supplies and equipment. Physiotherapy services could also be provided in a congregate or group setting provided the client satisfies certain eligibility criteria.
• New specialized services.   The amendments enable CCACs to provide their clients with three new professional services.  Specific eligibility criteria are listed for respiratory therapy services and pharmacy services.
  1. Respiratory therapy services – for eligible clients in their home, in a congregate or group setting, or in a long-term care home.
  2. Pharmacy services – for eligible clients in their home.
  3. Social service work services – for home care clients in their home, or in a congregate or group setting.  

The amendments to O. Reg. 386/99 also enable CCACs to provide:

• New services to long-term care home clients.  The amendments to O. Reg. 386/99 of the LTCA authorize CCACs to provide additional professional services in long-term care homes.  CCACs could provide residents of long-term care homes with:
  • Nursing services in the context of the Ministry’s Nurse-Led Long-Term Care Outreach Team initiative. 
  • Training to provide nursing services
  • Respiratory therapy services – if the resident satisfies the eligibility criteria for receipt of this service. 
  These new services complement the physiotherapy, occupational therapy, and speech-language pathology services already provided to residents of long-term care homes through CCACs.

To update and modernize the regulatory framework for this sector, a number of additional changes have been made to O. Reg. 386/99 under the LTCA.  The amendments:

• expand the list of Community Support Services in the Act to reflect those already being funded by the Ministry. Eleven new services have been added, seven of which are defined in the regulation.
• update the eligibility criteria for receipt of homemaking services, personal support services, and professional services.
• update the eligibility criteria for receipt of professional services in a long-term care home.
• add new health and safety eligibility criteria for receipt of home care services (professional, personal support, and homemaking). These provisions are consistent with the health and safety eligibility criteria that apply to the provision of school health support services.
• set out the plan of service requirements for CCACs and approved community service agencies when placing clients into adult day programs, supportive housing, and chronic care and rehabilitation beds in public hospitals.
• clarify that services provided by CCACs to school aged children/youth in schools or children/youth being home-schooled are “health services”.
• add a new provision that requires professional service providers to ensure that plans of care are developed, evaluated and revised by a regulated health professional. This new requirement applies when services are being provided by a regulated health professional, or an assistant.

C.  Health Insurance Act (HIA)

Section 13 of Regulation 552 under the HIA has been revoked. This section included the eligibility criteria for professional services. The provisions relating to professional services have been updated and incorporated into O. Reg. 386/99 under the LTCA. As a result, all of the regulatory provisions relating to professional home care services have been consolidated in O. Reg. 386/99 under the LTCA.

An additional amendment was made to clause 15(6)(h) of Regulation 552 under the HIA to ensure that persons receiving professional services provided by or arranged by a CCAC continue to be exempt from the requirement to pay a co-payment fee for insured ambulance services.

D.  Ontario Drug Benefit Act (ODBA)

An amendment was made to paragraph 1 of subsection 2(1) of Regulation 201/96 under the ODBA to ensure that persons receiving professional services provided by or arranged by a CCAC continue to be eligible for drug benefits.