On August 26, 2024, the Ontario government announced a call for applications to consider new licenses under the Integrated Community Health Services Act, 2023 (formerly Bill 60) (the “Act”) for gastrointestinal (“GI”) endoscopy procedures. This call builds on the call for applications for MRI and CT services launched this past June. The call for applications is open until November 4, 2024.
KEY HIGHLIGHTS
- Increased GI Endoscopy Procedures: New licences are expected to be issued starting in Winter 2025. The aim is to increase the number of GI endoscopy procedures and shorten wait times from when the order or requisition is received to when the procedure is performed.
- Call for Applications: Applications for new licences opened on August 26, 2024. The call for applications is open until November 4, 2024. Per the Ministry guideline, questions regarding the application process must be received by September 9, 2024.
- Future Calls for Applications: A third call for applications to expand access to orthopedic surgeries is planned for Fall 2024.
ABOUT COMMUNITY SURGICAL AND DIAGNOSTIC CENTRES
As set out in our previous communique regarding the call for applications for MRI and CT services, the Act repealed the Independent Health Facilities Act and established “integrated community health services centres,” which are health facilities “in which one or more members of the public receive services for or in respect of which facility costs are charged or paid.” This includes a community surgical and diagnostic centre (“Centre”). In summary:
- The Act provides for the charging of “facility costs,” which are fees or payments for or in respect of a service or operating cost that supports the provision of insured services. There is a Schedule of Facility Costs that sets out the fees covered by OHIP, or they may be prescribed by regulation.
- There are prohibitions on charging individuals for insured services, for preferential access to services, or for refusing to provide insured services to individuals who choose not to purchase uninsured services.
- A licence is required in order to establish or operate a Centre. The issuance of a licence is at the discretion of the Director. A licence may be issued or renewed for a term of up to five years.
- Licensing is contingent upon the issuance of a “call for applications” for the establishment and operation of one or more Centres. The Director may do this by sending a call for applications to one or more specified persons, or by publishing a call for applications, as in this case. The call for applications must set out the service or services to be provided.
- There are detailed requirements for licence applications, including but not limited to:
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- description of the services to be provided and how the Centre will provide “connected and convenient care,” including: (i) capacity to improve patient wait times, (ii) plans to improve patient experiences and access to care, and (iii) plans to integrate with the health system;
- details of quality assurance and continuous quality improvement programming;
- detailed staffing model for the proposed Centre and evidence of the sustainability of this model, including: (i) staff classification with rates/ranges of compensation, (ii) the number of staff required for each position, (iii) the model for staffing anaesthesia delivery, and (iv) information regarding the hospital privileges of physicians who provide services at the Centre, if applicable;
- description of how the proposed Centre has consulted with health system partners in the development of the application, including any endorsement of the application by health system partners;
- description of any uninsured services that are being provided or will be provided, including any charges for the uninsured services and the processes for providing information and obtaining patient consent in connection with any uninsured services; and
- description of current linkages with health system partners and how the Centre will maintain and improve those linkages to promote optimal patient care.
- The Minister and the Director have wide discretion, powers, and authority as it relates to the licensing and operation of Centres. There are several oversight mechanisms, including compliance orders, Minister directions, revocation, suspension, refusal to renew or amendments to licences.
- All Centres will be under the oversight of Accreditation Canada’s quality assurance program. Accreditation Canada has released Program Standards and Core Requirements that must be met.
INTEGRATION WITH PUBLIC HEALTH SYSTEM
As noted above, Centres must be integrated with the broader public health system. New facilities are required to provide detailed staffing plans that protect staffing resources, report into the province’s wait times information system, and participate in regional central intakes, when available, to ensure timely patient care. For Centres that provide GI endoscopy services, the Ministry plans to provide facility cost funding based on a set rate for individual procedures and a separate set rate for combined procedures.
Applicants have a limited timeframe of 10 weeks to respond to the call for applications.
Miller Thomson’s Health Industry group is pleased to assist health industry organizations with the application process and to address any questions relating to community surgical and diagnostic centres, health system integration, and requirements.
