The Changing Landscape

Current Information Needs

As noted in the overview, caregiver and provider surveys were conducted, as well as consultation sessions with self-advocates (persons with Developmental Disabilities). Some common priorities including access, funding, decision-making, planning, and education and support were identified.

In particular, all who attended were eager for more information, and easier access to the information. Everyone wanted to increase their knowledge and awareness of resources, dementia supports/services, tools, planning, and to have a list of current resources/information/links.

Traditionally, access to information and services has been through a variety of providers including physicians, family health teams, Home & Community Care coordinators, the former Local Health Integration Networks (LHINs), hospitals, community support service agencies, etc.

However, it should be noted that in the health and community sectors, there is no one resource that lists all supports and services, and no single coordinated access to all supports and services.

The development of the new Guide has been an opportunity to identify and bring together some of the best information sources and practices to support persons with a developmental disability.

In the last year, the ability to coordinate access to such information and services in the immediate future is made even more complex as a result of new provincial directions in delivering health and social services.

This new delivery model/system being established by the province is described below. The model closely aligns with what we have been striving to achieve in developing the Guide, identifying best information and practices using collaborative partnerships to support persons with a developmental disability.

Changes in the delivery of healthcare services

Profound changes have taken place in the delivery of healthcare services in the province. On April 19, 2019, the Ontario government passed Bill 74, The People’s Health Care Act, 2019. The purpose of the Act is to manage the health system more effectively through coordinating the work of existing provincial health agencies and programs. This model of integrated health care delivery will enable patients and service providers to work together to achieve a connected system designed around patient needs.

There is now one single health agency – “Ontario Health” – to oversee healthcare delivery, improve clinical guidance and provide support for providers to ensure better quality care. Across the province, Ontario Health Teams (OHTs) are being established. Each team will be responsible for a specific geographical location based on a population size of 300,000, and will manage all care in the region. Services will still include acute care provided by hospitals, primary care, rehabilitation services, home care, community support services, palliative care, diagnostic services, transitional care, long-term residential care, etc.

In November 2019, the 14 LHINs were clustered into five regional structures, to plan for the transition of certain LHIN functions and responsibilities into Ontario Health. Ontario is overseeing the operational reorganization of the 14 LHINs into five interim and transitional geographical regions (west, central, Toronto, east, and north) based on the existing 14 LHIN geographic boundaries.

The 14 LHINs still exist, but the 14 CEOs have been replaced with 5 “Interim Transitional Regional Leads” who now report to the Board of Ontario Health, which remains as the Board for the LHINs. The five Transitional Regional Leads will be responsible for the management of the LHIN operations in their regions, including the continued coordination of patient access to home and community care and long-term care placement. The province has rebranded and refocused the LHINs (with the same regional identifiers) on a transitional basis, and the LHINs have become known as “Home and Community Care Support Services”.

A new Digital Health Strategy was also launched in November 2019.

The goals of the strategy are to provide:

1. More virtual care options e.g., video visits
2. Expanded access to online appointment booking
3. Greater data access for patients to review their secure health records online and make informed choices about their care.
4. Better, more connected tools for providers to access patient records stored across multiple health service providers to provide better, faster care.
5. Data integration and predictive analytics: Providers will face fewer barriers to integrating and using secure health information to manage health resources and improve patient care.

There will be a regulatory amendment to the Home Care and Community Services Act, 1994 to permit delivery of virtual care/digital visits in home and community settings.

The government is also making regulatory amendments to various regulations made under the Personal Health Information and Protection Act, 2004, Excellent Care for All Act, 2010, and the Connecting Care Act, 2019 to ensure that the work of agencies being transferred can continue without interruption under Ontario Health. This includes ensuring that the privacy of a patient’s personal health information remains protected during and after transition.

• You can find out more information about the Ontario Health strategy on their website.
• You can find more information on the digital health strategy, (or cut and paste https://news.ontario.ca/en/release/54594/ontario-expanding-digital-and-virtual-health-care).

And these aren’t the only changes.

The Ministry of Health and Long-Term Care has now become two ministries:

• The Ministry of Health and
• the Ministry of Long-Term Care.

The Ministry of Health will focus on helping people stay healthy, delivering high-quality care, and protecting the health system for future generations. The Ministry of Long-Term Care will work to end hallway medicine, reduce waitlists and ensure that the long-term care sector can handle the growing elderly population. The Ministry of Community and Social Services has now become the Ministry of Children, Community and Support Services. The focus for the expanded Ministry will be to help improve outcomes for children, youth, families and individuals who need support, advance the interests of women across Ontario, and help new immigrants settle and integrate.

Further information can be found on the website of Ontario Ministries.

What do all these changes mean for you as a person with a developmental disability, or as a caregiver?

Don’t panic. We just want you to be aware of these changes, which will take place in phases over a period of time. For the time being, you will access services as before.

For example, the LHIN functions that involve delivering home and community care remain unchanged but have moved to local OHTs.

The Ontario Health plan remains to integrate and fund local health care and to improve access and patient experience. To find a contact in your area, go to the Ontario Health Teams website which has a list of regions and the local agencies.

If you access services through the Developmental Services Agency (DSO), go to the DSO website for service and contact information.