23 January 2023

Ontario Announces Expansion Of Services Available At Independent Health Facilities



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On Monday, January 16, 2023, the Ontario government announced its intention to expand the delivery of certain insured surgical and diagnostic imaging services available in the community.
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On Monday, January 16, 2023, the Ontario government announced its intention to expand the delivery of certain insured surgical and diagnostic imaging services available in the community. The changes intended to combat the backlog of patients waiting for low-risk minimally invasive services, will permit more services to be offered in independent health facilities ("IHFs") and private hospitals. These procedures are to be funded by the Ontario Health Insurance Plan.

There are currently two private hospitals in Ontario that provide surgical services.

IHFs are privately-owned health facilities that perform procedures typically performed in public hospitals, including diagnostic imaging, surgical and therapeutic procedures. IHFs are licensed under the regulatory regime of the Independent Health Facilities Act (the "IHFA"). This announcement represents a significant change in provincial healthcare policy, as no new licenses have been issued under the IHFA in nearly two decades.

The announcement detailed a three-step plan:

  1. Cataracts: The Ontario government has formed new partnerships with IHFs in Windsor, Kitchener, Waterloo and Ottawa to perform cataract surgeries and will be increasing funding to existing IHFs that perform such surgeries.
  2. Expansion of scope: The Ontario government intends to expand the scope of services performed in community surgical and diagnostic centres, with a continued focus on cataract surgeries as well as MRI and CT imaging and colonoscopy and endoscopy procedures (to start in 2023).
  3. New legislation, new surgeries: The Ontario government plans to introduce new legislation in February 2023 which, if passed, will allow for more varied surgeries to be performed in the community, such as hip and knee replacement as well as foot surgeries and additional diagnostic imaging (to start in 2024).

While details of the process to licence new providers are still largely unknown, the government announced that the application process will require detailed staffing plans and a number of physicians at the centres to have active privileges at their local hospital.

It is not yet known what other quality assurance standards will be required. The most recent call for applications1 to licence IHFs for cataract surgeries was issued in 2020. It required facilities to obtain a pre-licensing inspection with the College of Physicians and Surgeons of Ontario. An alternative licensing regime is proposed by the Oversight of Health Facilities and Devices Act, 2017 (the "OHFDA"), which would permit the Lieutenant Governor in Council to designate inspecting bodies of community health facilities. The OHFDA received Royal Assent on December 12, 2017 but has not been enacted. If enacted, IHF licences would be replaced with community health facility licences and the IHFA would be repealed.

Other requirements from the 2020 IHF call for applications, which may be relevant to this process, include:

  • facilities were required to meet certain health and safety requirements, design standards and spatial requirements;
  • facilities were to be prepared to provide service immediately upon issuance of an IHF licence;
  • applicants were required to provide information about how the facility would address surgical backlogs and wait times; and
  • applicants were required to provide information about the number of surgeries to be provided at the facility annually.

The full text of the provincial government's announcement can be found here:

This is an area of policy and law that is undergoing significant change.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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