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Budget 2021: Ontario’s Plan to Protect People’s Health and the Economy

The Government of Ontario released its 2021 recovery budget as Ontarians and the health system continue to cope with COVID-19. The historic budget, which includes the largest spending in Ontario’s history at $173 billion, focuses on protecting lives and protecting livelihoods.

The budget, titled Ontario’s Action Plan: Protecting People’s Health and Our Economy, emphasizes the $16.3 billion allocated to protect people’s health, focusing on capital investments for hospitals, infection prevention and control measures, investments into long-term care, and support for vulnerable people and communities. The budget also aims to stimulate the economy with $23.8 billion in COVID-19 relief, including direct support to families and businesses.

The budget, which comes only five months after the release of the 2020 budget, emphasizes the need for the federal government to increase transfers to the province. The document demonstrates the widening gap between the status quo and a “fair federal share” which is needed to ensure the stability of Ontario’s health care system; a common theme at most of the Federal-Provincial-Territorial Premier’s meetings.

It is important to note that, while this level of new health care spending is unprecedented, several of the investments in this budget have been committed to previously, and many are re-announcements from the past several months.

Long-term care investments

Hands-on care and staffing

The province has committed $4.9 billion over four years to increase hands-on care to four hours per day for all residents by 2024-25. This investment will include the creation of more than 27,000 new positions including personal support workers (PSWs) and nurses. This funding will also support a 20% increase of direct care by health professionals such as physiotherapists and social workers.

To meet the target of four hours of hands-on care, the province has committed $121 million to support the accelerated training of 9,000 PSWs. The accelerated PSW training program is a publicly funded, tuition‐free opportunity for 6,000 new students and is expected to take six months to complete, rather than the typical eight months.

The government has committed to extend the wage enhancement for 147,000 workers who deliver personal support services. The wage enhancement will be available until June 30, 2021 and will then be reviewed.

New beds and capacity

As announced previously, the government has committed an additional $933 million in 80 new long-term care projects to build 9,478 new beds and upgrade 5,212 existing beds. This sets the government on track to build 30,000 new long-term care beds for a total investment of $2.6 billion in infrastructure projects.

Addressing the COVID-19 pandemic

The province will also boost spending to protect residents from COVID-19 with an additional $650 million in 2021-2022 in resources to long-term care. This is in addition to the $1.4 billion invested since the start of the pandemic.

$246 million has been committed over the next four years to improve living conditions in homes including ensuring all homes have air conditioning and new ventilation to improve infection prevention and control.

And finally, the Long-Term Care COVID-19 Commission will provide its final report to the Minister of Long-Term Care by April 30, 2021. The province has committed to address the long-standing and systemic challenges in the sector and improve care for residents in long-term care. A resident quality of care framework will be established which will outline performance measures to guide oversight and quality improvement in long-term care based on the recommendations of the Commission.

Stimulating staffing in retirement homes

Ontario is investing $2 million over two years to attract PSWs and nurses to work in retirement homes. PSWs will receive a financial grant of $5,000 for a six-month commitment and nurses will receive $10,000 for a one-year commitment.

Seniors benefits

Ontario has committed $160 million over three years to support the community paramedicine program in over 30 communities across the province. This resident-centred program allows seniors to stay in their homes longer.

The Seniors’ Home Safety Tax Credit will provide $30 million to support approximately 27,000 seniors and people who live with senior relatives. This credit was previously announced in the 2020 Budget.

Supporting hospital capacity

$30.2 billion will be invested over the next 10 years, including an additional $3 billion since the 2020 Budget, in hospital infrastructure. This spending will support new investments in major hospital projects, including investing in major hospital development and in the Region of Peel and surrounding areas through collaboration with Trillium Health Partners and William Osler Health System.

Ontario will continue to invest in the hospital sector, with an additional $1.8 billion in 2021–22 bringing the total additional investment in hospitals since the start of the pandemic to over $5.1 billion. Building on the $3.4 billion provided in 2020–21, this additional $1.8 billion investment in 2021–22 includes:

  • $760 million to support more than 3,100 hospital beds to help the sector continue to provide care for COVID‐19 patients as well as other patients;
  • $300 million to reduce surgical backlogs from delayed or cancelled surgeries and procedures due to the COVID‐19 pandemic. Funding will help hospitals keep operating rooms open late in the evening to complete up to 52,000 surgical hours of elective surgeries and will address the MRI/CT backlog. This investment will also be used to create a centralized provincial surgical waitlist program to help reduce delays in scheduling and help match patients to surgeons with shorter wait times; and
  • $778 million to support hospitals to keep pace with patient needs and to increase access to high‐quality care.

As announced earlier this week, Ontario has committed $1.2 billion to help Ontario’s public hospitals recover from financial pressures created and worsened by COVID-19. More specifically:

  • $696.6 million will be allocated to help cover historic working funds deficits for qualifying public hospitals with a focus on small, medium as well as specialty and rehabilitation hospitals.
  • $572.3 million will reimburse hospitals for the loss of revenue streams such as co-payments for private rooms and the reduction of retail services.

Mental health and addictions

The government will provide an additional $175 million in 2021-2022 for mental health and addictions support, which is part of the $3.8 billion Roadmap to Wellness plan to which spans over 10 years.

To support individuals living in remote, rural and underserved communities, the government will create four new mobile mental health clinics across the province. The mobile clinics will begin operating across Ontario in summer 2021.

The government is also providing additional funding of $183 million over three years to support the projected cost increases in mental health and addiction services.

Other health related investments

Ontario is investing an additional $234.9 million over three years to ensure access to vital blood products, used in specialized treatments for a variety of conditions including burns, bleeding disorders, liver diseases and many types of cancer. Ontario is planning to open an additional six dedicated plasma collection sites to sustain the demand for these vital blood products.

The government is also investing an additional $602.2 million in 2021–22 in the Ontario Public Drug Program to support greater utilization, higher drug costs and the increase in the number of eligible recipients.

What is missing?

Investing in digital offerings that make services more accessible and advanced for all Ontarians has been a priority for this government. However, this budget only remarked on the 34 million+ patient visits conducted virtually since April 2020 as a result of COVID-19 (10 times the amount from the previous year) with no further mention of virtual care expansion or digital health initiatives.

Also missing from the budget are any new investments for Public Health, which did not see any increase in funding or mention in the 2020 budget either.

Looking forward

The province awaits the final report from the COVID-19 Long-Term Care Commission which will further direct where gaps need to be filled in order to improve long-term care across the province.

Premiers from across the country will also continue to put pressure on the federal government to ensure they are contributing fairly to the Canada Health Transfer. With the first federal budget being released on April 19, the provinces will continue to press Prime Minister Justin Trudeau and Deputy Prime Minister Chrystia Freeland to transfer their fair share to the provinces for health care needs.

If you have any questions about this budget or the upcoming release of the COVID-19 Long-Term Care Commission report, contact your Santis Health Lead.

Additional reading

Read the budget here.

Read the Ministry of Finance’s press release here.