The Ford Government released its 2020 budget as it plans for economic recovery amidst the second wave of the COVID-19 pandemic. The budget, titled Ontario’s Action Plan: Protect, Support, Recover, outlines a three-year action plan and fiscal outlook focused on three pillars:
- Protect — Urgent COVID-19 response;
- Support — Support for People and Jobs; and
- Recover — Creating the Conditions for Growth.
Building on the first phase of Ontario’s Action Plan released in March 2020, this budget serves as the next phase in Ontario’s COVID-19 response.
The government’s direction for health care
Over the course of the last nine months, the Ford Government has continued to announce investments to long-term care, mental health and addictions, and COVID-19 testing (both increases to testing capacity and rapid testing). In today’s budget, the government has committed $7.5 billion in new health care spending, with an overall health care investment of $15.2 billion over 3 years ($4 billion will be available in the 2021-2022 fiscal year with $2 billion in 2022-2023).
It is important to note that, while this level of new health care spending is unprecedented, many investments in this budget have been committed to previously, and are re-announcements from the past several months.
The government is committing $783 million to the long-term care sector. The province, to date, has invested $243 million in the sector for emergency capacity and COVID-19 containment measures. The additional $540 million announced today will be invested in protecting residents, caregivers and staff from future surges and spread.
Long-term care investments include:
- $405 million to help homes continue with infection prevention and control measures relating to COVID-19 including enhanced screening, staffing supports and purchasing additional supplies and personal protective equipment (PPE).
- $61.4 million for minor capital repairs and renovations in homes to improve infection prevention and control.
- $40 million to help stabilize the homes as they transition to lower occupancy rooms.
- $30 million to allow long-term care homes to hire more infection prevention and control staff and train new and existing staff.
- $2.8 million to extend the High Wage Transition Fund to ensure that gaps in long-term care staffing can continue to be addressed during COVID-19.
$1.75 billion, which was committed earlier in the summer, will increase capacity and access for residents by building 30,000 long-term care beds. The Ford Government also announced the Accelerated Build Pilot program to enable the faster construction of four new long-term care homes. The new Construction Funding Subsidy also aims to help operators with costs associated with location (homes in large urban centres receive an additional $5.75 per bed compared to $2.75 for rural areas).
Temporary wage increases were announced in October 2020 totalling $461 million for direct caregivers and personal support workers. The budget signals that temporary wage enhancements will be reviewed and could be extended through March 31, 2021. $52.2 million has also been invested to recruit, retain and support 3,700 more nurses and personal support workers to meet demand.
In retirement homes, $10.9 million has been made available in addition to the $20 million already given to the sector, to ensure they have access to PPE and critical supplies to protect residents and staff.
Compared to 2019-2020, the province will invest an additional $2.5 billion into the hospital sector with the focus on an additional 2,250 hospital beds (as announced last week). The government is also creating capacity by investing $18 billion in capital grants over 10 years, with $175 million this year dedicated to 129 hospitals across the province.
Premier Ford, having promised to ‘end hallway medicine’ upon his election in June 2018, will address capacity challenges as a result of Ontario’s growing population, and is looking to reduce the use of unconventional beds in hospitals. New funding will go towards “providing additional across‐the‐board increases for all public hospitals, including small, medium, large community, teaching, specialty psychiatric and specialty children’s hospitals.”
Exacerbated by the COVID-19 pandemic, the province is investing $283.7 million to address the surgical backlog while ensuring hospitals have the capacity to manage COVID-19 and the flu season. The Ford Government believes this investment will address wait times in hospitals and Independent Health Facilities (IHFs) by “performing over 60,000 surgeries including cancer, cardiac, orthopedics and cataract surgery.”
Seniors and their families will be eligible for the proposed Seniors’ Home Safety Tax credit to help keep seniors in their homes longer, by retrofitting homes to be safer and more accessible for up to $10,000. The government is committing $3.1 million to senior active living centres which will help with remote and virtual programming to connect seniors at home and provide safe in-person programming.
The Ontario Community Support Program will receive $16 million over two years to connect people with disabilities, older adults and others with underlying medical conditions who are self-isolating, with meals, medicines and other essentials while they stay at home.
Mental health and addictions
As announced earlier in 2020, the Ford Government is investing $3.8 billion over 10 years for its Mental Health and Addictions (MHA) Roadmap to Wellness. This includes $176 million in 2020–2021 to help expand access for critical mental health and addictions support and to reduce wait times for critical services.
A new program outlined in the budget will invest an additional $3.25 million (totalling $19.25 million) in 2021-2022 for mental health supports for postsecondary students. “This funding will help students by strengthening community partnerships and increasing the number of mental health workers and programs at colleges, universities and Indigenous Institutes.”
Other mental health supports include:
- Expanded community supports offered in both French and English.
- Expanded access for MHA supports to reduce wait times.
- Walk-in clinics, counseling and therapy, day treatment and live-in treatment supports for children and youth.
- Virtual supports including internet-based cognitive behavioural therapy, virtual addiction services, and Kids Help Phone.
- More rent supplements to support emergency short-term rentals.
- Enhanced supports for interprofessional primary care teams, frontline health care workers, indigenous communities as well as seniors, those with disabilities, first responders and vulnerable populations.
- As part of Ontario’s back-to-school plan, an investment of $42.5 million to support students with special needs and provide student mental health supports.
- $3 million annual investment to enhance mobile crisis intervention teams to support the de-escalation and stabilization of situations involving persons in crisis in partnership with mental health crisis workers and police services.
Ontario’s immediate COVID-19 health response offered patients enhanced access to virtual care with the creation of temporary fee schedule codes. Practitioners across the province have been able to conduct virtual care visits with their patients using digital channels, including home and community care and community paramedicine. Frontline care workers have also been able to access a patient’s health records efficiently and securely with new and improved digital health solutions.
The province has also allowed for virtual check-ins through community-based service providers for vulnerable home care clients, virtual nursing and rehab home care services for patients, as well as virtual care supports for mental health and addictions.
The budget indicated that in the next two years, 70% of the services Ontarians use most, including enhanced virtual health care, will be available digitally. However, no new funding has been tied to this goal.
COVID-19 emergency support
The government already committed $1.4 billion to expand COVID-19 testing and ramp up case and contact management.
An additional $4 billion for 2021-2022 and $2 billion for 2022-2023 has been provided for flexible funding to help the health care sector address its changing needs as part of the response to the pandemic.
Procurement was a challenge for many governments as they faced the first wave of the COVID-19 pandemic. Challenges with securing enough PPE have helped create change in the current procurement system in Ontario. Moving forward, Ontario will centralize procurement to “accelerate the work to transform and modernize how the government purchases goods and services so the people of Ontario can have the supplies they need when they need them.”
Other recovery tools
The government is committing $13.5 billion in the “Support” pillar and $4.8 billion in the “Recover” pillar of the plan.
Support ($13.5 billion total, $2.4 billion new spending)
- $380 million to parents for the Support Learners initiative.
- Up to $30 million for the Seniors’ Home Safety Tax Credit.
- $60 million over three years starting in 2020-2021 in the Black Youth Action Plan to extend the current program and create new economic empowerment.
- $100 million over two years for the Community Building Fund to support community tourism, cultural and sports organizations that are experiencing significant financial pressures.
- $25 million one-time funding for Ontario’s arts institutions.
- $1.8 billion in support for the People and Jobs Fund over the next two years to respond to emerging needs in various sectors.
Recover ($4.8 billion all new spending)
- $680 million over the next four years in broadband infrastructure.
- Electricity bill savings for medium and larger industrial and commercial employers which equals $1.3 billion in savings over three years.
- $385 million for municipal and provincial property tax relief.
- Permanent exemption for employers with revenues less than $5 million for the Employer Health Tax (EHT).
- Up to 20% support for eligible Ontario tourism expenses for 2021.
- $500 million over four years to make government services more reliable, convenient and accessible.
What is missing?
Notably missing from the budget are any new investments for Public Health, with the government continuing to tout the $270 million already announced for “Public Health, home and community care supports and virtual care and Telehealth initiatives.”
With the debt-to-GDP ratio in Ontario hovering around 47%, compounded by the growing federal debt which is likely to increase substantially due to ongoing COVID-19 relief spending, Ontario, like all provinces, will struggle to introduce new spending into subsequent budgets. Provinces and their budgets will grapple with the long-term effects of COVID-19 for years to come. Governments across the country will rely on the current low interest rates to support their spending mechanisms, which could become problematic if interest rates start to rise.
The government is already looking forward to the 2021 Ontario Budget. Details of virtual and in-person consultations have not been released at this point in time. The government, however, is encouraging Ontarians to share written submissions for the 2021 Budget by mail, by email (email@example.com) or online at Ontario.ca/BudgetConsultations.
If you have any questions about this budget or the upcoming consultation process, contact your Santis Health Lead.
Read the budget here.
Read the Ministry of Finance’s news release here.