The July 1997 Metropolitan Toronto Health Services Restructuring Report contained preliminary decisions (Notices of Intention to Issue Directions or "Notices") regarding rehabilitation, long-term care and sub-acute care. The major changes in today’s directions are:

• Total capital renovation estimate rises by $83 million to $266 million from the previous estimate of $183 million
• Total reinvestment in home care, long-term care and sub-acute care increases to $263 million from the previous estimate of $157 million
• The home care annual reinvestment rises to $43 million from $28 million
• A total increase of 11,000 long-term care beds and long-term home care places. This represents an additional 1,609 long-term care places than in the July 1997 report. This includes:
• 427 more nursing home and home for the aged beds to a total of 5,634
• 1,182 more places in non-institutional services such as supportive housing, long-term home care, attendant care and adult day care for a total of 5,363
• The reinvestment in sub-acute care increases to $33 million for 432 beds. The original estimate was up to $32 million for 493 beds. Sub-acute care is a new level of service for patients who do not require acute care but need skilled therapy or nursing care on a short term basis to regain function and return home. The HSRC has concluded that sub-acute beds should be located in acute care hospitals
• An increase of 184 rehabilitation beds for Toronto to a total of 905 from the 721 planned in the July 1997 report

The initial decisions for siting and governance of complex continuing care and rehabilitation services was confirmed. This plan calls for the transfer of services at the Austin Terrace site (Hillcrest) of the Rehabilitation Institute of Toronto; Riverdale Hospital; Runnymede Chronic Care Hospital; Salvation Army Toronto Grace Hospital and St. Bernard’s Hospital. Once their services are transferred to other hospital sites, they will no longer be hospitals. The Commission is also advising the Minister of Health to withdraw the licence of the Dewson Hospital, a private chronic care hsopital.

A change in today’s announcement from the July 1997 announcement is in the rehabilitation services. Specifically, the Baycrest Centre for Geriatric Care and Providence Centre will keep rehabilitation services that were originally planned to be transferred.

The HSRC is today also releasing Notices of Intention to Issue Directions to Toronto and GTA/905 hospitals for a consistent approach to medical human resources planning in hospitals that are consolidating services. The goal is to ensure that a fair approach is used that grants all physicians with appointments now, with appointments to hospitals receiving other hospitals’ programs through the transition period.

After granting appointments to all potentially affected physicians, hospitals will be required to develop a human resources plan to meet the medical needs of each hospital over the long term.

The deadline for submissions from interested parties is May 11, 1998. After review of feedback, the HSRC will issue directions on this matter.

The HSRC is a group of individuals appointed by the Ontario government to redesign the Ontario health system. It is an independent agency of doctors, health care educators, hospital administrators, former hospital board members and other experts.

Highlights of the HSRC’s recommendation to date include the call for:

• over $1.4 billion in hospital building upgrades
• over $700 million reinvested annually in new services in the areas of:
• rehabilitation
• mental health
• sub-acute care
• long-term care
• home care
• increased capacity to treat 19% more emergency and ambulatory patients at hospitals by 2003.

The public can obtain information a copy of this report by visiting the HSRC internet web site at http:\\www.hsrc-crss.org

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Contact: Paul Kilbertus (416) 327-5504