Home Care Reform and The Patients First Act, 2016

Understanding the key issues

Dr. Eric Hoskins, Minister of Health and Long-Term Care (MOHLTC), has proposed significant reforms to Ontario’s health care system, with a particular focus on home and community care.  The proposed changes will significantly affect access to services as well as the services we may expect to receive as we age in our homes, communities or institutions. Care Watch believes that we need to think carefully about the changes that are being proposed. This is a once in a decade or more opportunity, since governments tend to be reluctant to make visible, large-scale, structural changes to public services, especially our very popular publicly-funded health system.

The restructuring process is outlined in a series of government proposals published under the Patients First brand.  Many individuals and organizations, including Care Watch, have provided input to these proposals via government consultation processes and the public media.  Lots of statements are being made both for and against the proposals.

In December 2016, Minister Hoskins tabled draft legislation, called The Patients First Act, 2016 (Bill 210), which aims to amend several other pieces of legislation to implement the government’s proposal for restructuring. Care Watch will analyse the proposals from our perspective as senior citizens and taxpayers. Care Watch will also publish a series of fact sheets or commentaries on issues that arise from the proposed restructuring.

This series of educational backgrounders and fact sheets analyze the complexities of the restructuring process and presents Care Watch’s views on issues such as the scope of home and community care services, the definition of primary care, and the capacity of the Local Health Integration Units (LHINs) to deliver home and community care.

We hope you will use these materials to generate conversations in your community.  We welcome your feedback on any of these materials: contact us.

Backgrounders and fact sheets:

NEW Self-Directed Personal Support Services Ontario (SDPSSO)

Care Watch has received updated information regarding the development and implementation of the new provincial Self-Directed Care Organization (SDCO), which will employ PSWs on behalf of eligible home care clients participating in the self-directed care funding programme.  This backgrounder shares the updated information; it also articulates CW’s concerns about the initiative and the potential impact on the HCC system in general.

Self-Directed Personal Support Services Ontario: Update on Commentary

January 5, 2018

A new provincial crown agency called the Self-Directed Personal Support Services Ontario (SDPSSO) is scheduled to be implemented in 2018. Care Watch acknowledges its value, but has several questions. The information may become relevant in CW’s election strategy.

Self-Directed Personal Support Services Ontario: A Commentary

November 12, 2017

Levels of Care Framework

A report entitled Thriving at Home: A Levels of Care Framework to Improve the Quality and Consistency of Home and Community Care for Ontarians was released by the Ministry of Health and Long-Term are on June 1, 2017.  Care Watch made submissions to the Ministry respecting the development of a “levels of care framework” (LOCF), as well as contributed to two stakeholder workshops.

CW is posting this information to update readers on significant discussions in the home and community care sector, which will affect the ability of seniors to choose to age at home. Information may also be used to question candidates running for election in June 2018.

Levels of Care Update – Thriving at Home Report

November 5, 2017

Earlier Materials:

For Ontario’s seniors, “Patients First” mistakenly emphasizes clinical solutions to community IssuesJanuary 12, 2016

This is a backgrounder in response to the MOHLTC’s Discussion Paper Patients First: Proposal to Strengthen Patient-Centred Health Care in Ontario.


“Privatization” in health services, and its implications for home and community care, is a complex matter. Several groups are calling for increased privatization, while others believe that increased privatization will breach the social contract that we as Canadians have fought so hard to establish and maintain.  We hope this fact sheet will bring some clarity to the issue to better understand what to look for in our home and community care system.

Examining Privatization in Health Care

May 14, 2016

Primary Care

In recent documents and in media stories covering planned changes, there has been repeated reference to primary care, without a clear definition of what primary care is. In addition, the stories tend to bundle hospital care with primary care services, which alters the make-up and focus of the primary care system.

In this fact sheet, Care Watch attempts to describe primary care to ensure that we can agree on what we are likely to be getting in a restructured system.

Health System Restructuring and Primary Care

July 14, 2016


Ontario’s health care system, and particularly our home and community care services, is undergoing significant change.  Both provincial and federal governments have started processes to restructure and redefine home and community services that are supposed to support and keep ageing Ontarians in their own homes for as long as possible. However, remarkably little attention is paid to changing the model of health care and ways of financing it.

How can we ensure equitable access to home and community care services? Read more to find out.

Home and Community Care Funding – The Elephant in the Room

September 18, 2016

Read our submissions to government on home care restructuring, the Levels of Care Framework, and the Patients First Act