Summary#

Bill 135, the Convenient Care at Home Act, 2023, amends Ontario’s Connecting Care Act, 2019 and several other Acts. It provides for 14 local health integration networks to be amalgamated into Ontario Health atHome, a corporation without share capital that is a subsidiary of Ontario Health and an agent of the Crown unless regulations provide otherwise. Its stated goal is to address home and community care services and health governance; the Act does not guarantee particular service results.

• Ontario Health atHome’s objects include providing home and community care, care co-ordination, placement management, public information and referrals, and operational supports to funded health service providers and Ontario Health Teams. The bill does not require it to provide every listed service in every case.
• The Agency may issue directives to Ontario Health atHome, which must comply, and may require it to disclose service-contract information, including confidential pricing and volume details.
• The Minister may collect personal information to monitor and evaluate services and assess the health, safety and well-being of people applying for or receiving home and community care.
• Employees of the 14 predecessor corporations transfer to Ontario Health atHome with continuous employment. Employees assigned to a client provider for care co-ordination remain employees of Ontario Health atHome.
• The Act limits lawsuits and other proceedings over specified acts and the amalgamation. It preserves judicial review and proceedings brought by the Crown or the Agency.
• The Act received Royal Assent, but several main provisions—including the amalgamation provisions—were set to start on a date named by proclamation. No proclamation date is included in the supplied material.

What it means for you#

• Patients and people seeking home or community care: The Minister may collect personal information for the stated monitoring and assessment purposes. The bill does not set out a general application or service-entitlement process.
• Health service providers and Ontario Health Teams: If funded to provide home and community care, they may disclose personal health information to the Minister for the purposes set out in the Act. The bill also allows Ontario Health atHome to provide them operational supports under service contracts.
• Employees of the former networks: The amalgamation transfers their employment to Ontario Health atHome without ending or severing employment. Assigned care co-ordination employees remain employed by Ontario Health atHome while working under a client provider’s direction.
• Taxpayers and the public: The Service Organization is subject to annual audits by the Auditor General. The Minister may also review or audit its operations. The Minister of Finance must pay an unpaid judgment against it from public funds only after it has made all reasonable efforts to pay, including liquidating assets.
• People considering a lawsuit: The Act bars specified claims and proceedings, including many claims for damages. Judicial review and proceedings brought by the Crown or Agency are exceptions.

Money#

No cost estimate is available in the supplied material.

• The Service Organization must appoint a chief executive officer and may appoint employees. The bill gives no staffing or cost estimate.
• Its board members are entitled to remuneration and reasonable expense reimbursement set by the Lieutenant Governor in Council.
• It must have annual audits. Additional audits or reviews may be ordered.
• The Service Organization may not operate for profit. Some financial actions, including borrowing, lending and investing, require Cabinet approval; other actions, including fundraising, require the Minister’s approval.
• Public money may be used to pay a judgment against the Service Organization if it remains unpaid after reasonable efforts to pay.

What is unclear#

• The supplied material does not say when the delayed provisions were proclaimed to start.
• The bill allows regulations to define or clarify key terms, set service standards, and govern service contracts and operational supports. Those rules are not included.
• The bill does not set out detailed privacy safeguards or explain how collected personal information will be stored, retained or shared beyond the stated purposes.
• It does not specify the Service Organization’s budget, staffing levels, service coverage, or how it will coordinate with existing programs.
• The parent Act’s current text was not supplied, so the full change from current law could not be verified.

Case for#

• Bringing the 14 predecessor corporations together could make it easier to coordinate home and community care and shared supports across Ontario.
• Giving Ontario Health atHome defined roles in care co-ordination, placement management and support for providers could help organize work that crosses multiple health services.
• Agency oversight, required compliance with directives, and annual Auditor General audits could provide tools to monitor the organization.

Case against#

• The bill gives the Agency binding directive powers and allows it to require confidential service-contract information, but does not itself set out detailed limits on those powers.
• The Minister’s personal-information collection powers cover service monitoring and assessment of applicants’ and recipients’ health, safety and well-being. The supplied text does not explain the practical privacy safeguards.
• The limits on legal claims could restrict remedies for people affected by specified acts or the amalgamation, even though judicial review remains available.
• The bill creates new governance and staffing duties but gives no cost estimate or staffing plan.