Published plans and annual reports 2023–2024: Ministry of Health

Ministry of Health overview

Ministry’s vision

The Ministry of Health is creating a health system where Ontarians will be connected to health care when and where they need it, through Your Health: A Plan for Connected and Convenient Care. Your Health is built on 3 pillars: The Right Care in the Right Place, Faster Access to Care, and Hiring More Health Care Workers. These 3 pillars are designed to work together to help people stay healthy and protect the health system for future generations.

The ministry is strengthening Ontario’s publicly funded health care system by building more integrated, patient-focused care, including:

• enhancing access to primary care providers, supporting health care infrastructure, and growing the health care workforce
• bringing down wait times for services and ending hallway health care
• reducing unnecessary emergency room visits, avoidable readmissions to hospitals and the rate of Alternate Levels of Care
• delivering better coordinated care in the community and in the home, including improving transitions and wait times between hospital and home care
• improving access to mental health and addictions services, including individuals in crisis
• improving access to online / digital services
• providing people with more connected care through Ontario Health Teams

The ministry provides overall direction and leadership to the health sector, planning and allocating funding, guiding resources, and developing legislation and policies to deliver timely, quality care. The ministry also manages key provincial programs including the Ontario Health Insurance Program, Drug Programs, Emergency Health Services, Independent Health Facilities and Laboratory Services.

Ministry programs and activities

Hospital operations

A responsive, resilient, and stable hospital system is a key component of the province’s health care system. Ministry investments in Ontario’s publicly funded hospitals continue to enable hospitals to provide high-quality care and enhance access to key health services at current and future levels of demand. These investments are supporting the continuation of over 3,500 acute, post-acute and critical care beds opened since the start of the pandemic, increasing hospitals’ operational funding, addressing surgical and diagnostic imaging recovery, and supporting health human resources. If hospitals experience fiscal and operational challenges, the ministry also works with them to ensure that patients continue to have access to quality care when they need it.

The ministry is also focused on improving connections across the health care system, which can support reducing avoidable hospital readmissions and address hallway health care. Readmission rates are indicators of quality of care as well as how integration is taking place across the acute care and community care sectors. Reducing avoidable readmission decreases pressures on the health care system including emergency departments, and decreases wait times. The ministry is also working with Ontario Health and hospitals to address the Alternate Levels of Care rate, which is the number of days when acute care is no longer required but a patient is waiting in hospital for transfer/discharge to another setting. The ministry continues to support the development of innovative solutions across the continuum of care while ensuring the long-term sustainability of the hospital system.

Health capital

To support growing demands on the health care system, Ontario’s investments over the next 10 years will lead to $48 billion in health infrastructure across the province. These investments will increase capacity in hospitals, build new health care facilities and renew existing hospitals and community health centres. Essential improvements and expansions include emergency rooms, surgical facilities, and patient spaces across the province.

The government’s plan for hospital expansion, includes supporting more than 50 major hospital projects that would add 3,000 new beds over 10 years. As of March 2023, 30 hospital projects and 10 community projects were under construction, with many more in the procurement or planning phase. Approved capital funding for hospital projects and other health capital related programs was more than $1.75 billion during 2022–23.

The province is also continuing to invest in infrastructure renewal, to support vital repairs, maintenance, and upgrades, to ensure existing health facilities across the province are properly maintained. Health capital investments are critical to ending hallway health care and support improvements to the Facility Condition Index Score.

Health Human Resources

The Ministry of Health supports a range of initiatives to ensure Ontario maintains a high-quality health care workforce, now and in the future. Ontario continues to make progress in increasing the number of health workers available to provide patients with care and support with more than 14,800 added since Winter 2020 through Ontario’s Health Human Resources programs. Your Health: A Plan for Connected and Convenient Care focuses on improving the health care experiences of Ontarians and growing the health care workforce, to improve the quality of health care delivery across the province for years to come.

Since 2018, over 60,000 new nurses and nearly 8,000 new physicians have registered to work in Ontario, with thousands more personal support workers now providing care in Ontario. 2022 was a record-breaking year for new nurses in Ontario with over 12,000 new nurses registered and ready to work and another 30,000 nursing students were studying at a college or university. The ministry continues to look at how investments in nursing education, recruitment and retention programs can improve support for nurses and workforce stability.

Additional programs include initiatives to support the Ontario Learn and Stay Grant (funded via the Ministry of Colleges and Universities), which supports a dedicated approach to recruiting and retaining health care workers in priority communities that are in small, rural and remote communities facing human health resources challenges. The Enhanced Extern Program has provided hospitals with over 5,600 externs since 2021, providing hospitals with additional health care students and graduates from different fields to support patient care. As of March 2023, the Supervised Practice Experience Partnership has provided more than 2,300 internationally educated nurses with workplace experience in Ontario’s hospitals, long-term care homes and home and community care organizations. The ministry is also working to maximize the expertise of regulated health care professionals, to work to the full extent of their training and expertise, by expanding their scope of practice

In Fall 2022, the ministry began developing an Integrated Capacity and Health Human Resources Plan for Ontario. The ministry is analyzing current gaps in the system, anticipating needs over the next 10 years, and determining solutions to address growing health care demands. The plan will focus on how to meet this demand through investments, health human resources and innovative solutions. This ministry is building on this work and shifting focus to working directly with leaders in the health care system on a workforce plan that includes where to prioritize current and future resources, addressing and minimizing system gaps and building a strong health system for the long term.

The ministry is focused on ensuring there is a greater understanding of each community and their needs and that there is a plan to recruit and retain the health care workers needed, including family physicians, nurses, specialists, and other health providers. The province will prioritize areas most in need, like rural and remote communities, where gaps already exist.

Emergency health services

The ministry is making the important changes needed to build a more responsive, resilient, and connected emergency health system in Ontario. To achieve this, we are working with our valued paramedic services, Ornge, Central Ambulance Communications Centres, base hospitals, and other sector stakeholders to implement new and innovative initiatives.

Building on the proven success of 9-1-1 Patient Care Models (PCM), the ministry continues to expand the patient groups eligible to be treated on scene by paramedics or referred and discharged to supports in the community. In addition to ongoing models for mental health and addictions and palliative patients, more PCM initiatives for patients with epilepsy and diabetes are being implemented across Ontario. The ministry is also reviewing innovative proposals for emerging models with the goal of providing more 9-1-1 patients with timely and appropriate care in the community, while protecting hospital capacity for those who need it most.

To help connect people with the right care and reduce wait times, the government is investing an additional $51 million over 3 years to expand the Dedicated Offload Nurses Program to support timely 9-1-1 responses in Ontario communities. The program provides funding to hire health care providers focused exclusively on transferring ambulance patients to hospital care, thereby freeing paramedics to respond to other 9-1-1 emergency calls.

Industry-leading technology upgrades are being made to modernize Ontario’s ambulance dispatch system. Following the recent launch of the Medical Priority Dispatch System — the international standard for call triaging — at the Mississauga Central Ambulance Communications Centre (CACC), progress is being made to implement this technology at additional CACCs. Computer Aided Dispatch upgrades also continue to roll out at remaining sites across the province.

To expand health human resource capacity in the emergency health sector, the ministry is working closely with colleges and paramedic services to explore strategies to increase enrollment, as well as promoting paramedic retention in northern, remote, and First Nations communities through the Ontario Learn and Stay Grant.

Home and community care

Home and community care services play an important role in helping a wide range of Ontarians, including seniors and people with medically complex needs, disabilities, and acquired brain injuries, live safely and independently at home or in the community, as well as enabling Ontarians to return home safely from hospital and completing their recovery from surgery or other treatment in hospital. Home and community care services reduce pressures on hospitals, helping efforts to eliminate hallway health care and reduce the number of hospital patients designated as Alternate Level of Care because they should be receiving their care at home or in another community setting. 

Additional investments in home and community care are improving quality of care and helping Ontarians to stay in their homes longer. The province is investing $1 billion over three years in home care, starting in 2022–23, and $100 million in community care over 3 years, starting in 2022–23. The ministry continues to work at reducing wait times from a patient’s hospital discharge to their first home care service.

The ministry has also taken significant steps to modernize home and community care, including introducing and expanding new integrated models of care that address long-standing barriers that have separated home and community care from other parts of the health care system, enabling more seamless coordination of services for patients and connections with primary care and other providers in the community, while maintaining and strengthening oversight and accountability measures. Ontario Health Teams are being established as a new model of integrated care delivery that will include the delivery of home and community care over the coming years and ensure that these services are better linked with primary care and other parts of the health system.

The Assistive Devices Program also plays an important role in allowing people with physical disabilities to live independently in their homes. In 2022–23, the program is expected to provide $532 million in funding for wheelchairs, prosthetic limbs, real-time continuous glucose monitors and other devices.

Ontario drug programs

Ontario’s publicly funded drug programs provides millions of eligible Ontarians with benefits related to thousands of drug products. In 2022–23, the ministry is expected to provide $5.7 billion to support Ontario drug programs. The ministry continues to focus on ensuring that drug funding decisions are based on best available evidence and are sustainable for current and future Ontarians.

The ministry also recognizes the unique challenges faced by patients with rare diseases, and their families and caregivers, and funds 42 drugs for rare diseases with eight others under active negotiation or consideration at the pan-Canadian Pharmaceutical Alliance. In addition, there are over 1,000 drugs that may be covered by the ministry’s Exceptional Access Program if a patient’s individual clinical criteria are met. Ontario continues to expand the use of biosimilars, which ensure patients continue to receive the same high-quality treatment while allowing the government to fund more new drug therapies and bring innovation to the health care system.

Ontario Health Insurance Plan

The Ontario Health Insurance Plan (OHIP) is the province’s health care plan that pays for many of the health services Ontarians need. OHIP covers part or all of medically necessary services provided by doctors or other primary care providers, visits to the hospital, laboratory testing in community labs or hospitals and a number of other health services. In 2022–23, the province is expected to provide $18 billion for OHIP-funded services.

In 2022–23, to ensure patients continue to access the heath care they need as the Ontario health care system continues to recover from the COVID‑19 pandemic, the ministry extended many of the temporary physician-based initiatives previously introduced.

For physicians on the frontlines, a temporary hospital-based funding framework, to facilitate the recruitment and flexible deployment of physicians during COVID‑19 patient surges, was extended until the end of March 2023. Physician premiums to help reduce the surgical backlog and the temporary sessional fee codes established for physicians working in COVID‑19 assessment centres, long-term care homes, congregate care settings, and vaccination clinics, continued to be available and remained in place during 2022–23.

The COVID‑19 vaccination fee code enabled the physician vaccine administration channel to ramp up vaccination delivery in primary care settings and community locations in support of Ontario’s vaccination strategy. This fee code remains available until at least March 31, 2024.

In addition to extending COVID‑19 physician funding initiatives, the ministry also implemented a new virtual care funding framework in 2022–23. The ministry and Ontario Medical Association (OMA) agreed to introduce the new framework under the 2021 Physician Services Agreement, and the new model was implemented and replaced the temporary COVID‑19 virtual care fee codes on December 1, 2022. Under the new framework, all medically necessary physician services rendered by video and telephone remain insured under OHIP and patients continue to have access to virtual care where clinically appropriate. The new framework also supports continued patient access to in-person care where clinically required or requested by the patient.

Mental Health and Addictions

Supporting the mental health and wellbeing of all Ontarians is a key priority for the Ontario government. The ministry continues to move forward with implementing Roadmap to Wellness — Ontario’s comprehensive plan to build a world-class mental health and addictions system that provides safe, evidence-based care. Supported by a commitment to invest $3.8 billion over 10 years, Roadmap to Wellness is adding capacity to meet demand and is bridging gaps in the care continuum. This plan is also creating provincial infrastructure for a continuum of mental health and addictions care that connects community, primary, and acute care to better wrap around the needs of Ontarians.

Since 2019–20, the government has flowed $525 million in new base funding for mental health and addictions services and supports, and the province is on track to meet its Roadmap funding commitment. This funding is supporting a range of services, including child and youth mental health, addictions services, supportive housing, for individuals involved in the criminal justice system, and Indigenous mental health and addictions services. In 2022–23, an additional $204 million in one-time funding was approved to continue building on the progress achieved through Roadmap to Wellness.

The ministry continues to work at improving timely access to care for clients with mental health or substance use challenges, including connecting them to community mental health and addictions services, which is intended to reduce the frequency and rate of repeat emergency department visits for these conditions. The ministry is also improving access to mental health supports through innovative programs such as Ontario Structured Psychotherapy, an evidence-based, publicly funded psychotherapy program for Ontarians coping with depression, anxiety, and anxiety-related conditions. More than 8,300 Ontarians enrolled in the program from April 2022 to November 2022.

Other innovative programs include mobile mental health and addictions clinics to support rural and underserved regions; and youth wellness hubs offer Ontarians aged 12 to 25 access to mental health, addictions, and primary care alongside a range of recreational, wellness and social services. The government also provided funding for Breaking Free Online, a virtual addictions program for Ontarians 16 and older, with over 6,300 clients enrolled and actively engaged since it launched in June 2021. For children and youth across the province, “One Stop Talk” (launched as a pilot in November 2022), offers convenient, low barrier ways to talk to a clinician by phone, video conference, text, and chat without an appointment.

Public Health

Strengthening Ontario’s public health sector continues to be a priority for the Ministry of Health. The ministry continues to make significant investments to support the sector, with public health units receiving approximately $828.8 million in 2022 to support the delivery of public health programs and services, excluding COVID‑19 related investments which have totalled an additional $1.6 billion since 2020. Provincial funding to public health units for public health programs and services has also increased by approximately $100 million or 14%, since 2018.

One of the ministry’s key public health initiatives is the Ontario Seniors Dental Care Program, which has an annual investment of approximately $90 million. This program helps reduce unnecessary trips to the hospital, prevent chronic disease and increase quality of life for seniors from low-income households. In 2022, almost 90,000 seniors were enrolled in the program. The province is expanding the program to provide care to more seniors in need, including 103 new dental infrastructure projects in underserviced areas, including mobile dental buses and an increased number of dental suites in Public Health Units.

Additionally, the ministry continues to work towards providing help to those who use drugs through its support of the Consumption and Treatment Services program, which help save lives by providing supervised drug consumption and wrap-around health services. This is in addition to investments made through Public Health Units for substance use initiatives such as needle exchange and harm reduction programming.

The ministry is committed to working with public health and municipal partners to monitor capacity and funding requirements to ensure critical public health services are maintained and delivered to protect and promote the health and well-being of Ontarians.

Digital health and information management

The Ministry of Health has been delivering on its commitment to provide better and more connected digital services for Ontario’s front-line providers and patients. The ministry’s digital health initiatives are focusing on more virtual care options, expanded online appointment booking, greater data access for patients such as reviewing their secure health record online, better connected access to patient records for frontline providers and more data integration and predictive analysis to improve patient care.

As of March 2023, over 266,000 frontline providers can access provincially held patient health records, leading to more integrated care and better decision making. In 2022–23, approximately 72% of all Ontarians had a virtual visit and the continued use of virtual care as an adjunct to traditional in-person care, highlights patient and provider expectations about the use of digital tools in all aspects of their health care journey. Ontario is continuing to support medically appropriate virtual care services to improve patient access to care while ensuring quality of care, accountability, and value for money.

Digital and data tools also play a key role to enabling Ontario Health Teams. As of March 2023, over $106 million in funding has been allocated to digital and virtual care projects for Ontario Health Teams and other health care providers, with over 600 approved projects, benefitting over 2.8 million patients. This includes funding related to virtual home and community care, integrated virtual care, remote care management and surgical transitions, virtual urgent care services, online appointment bookings, patient portals, virtual primary care, clinical system renewal and tests of change.

Ministry 2023–24 strategic plan

Through Your Health: A Plan for Connected and Convenient Care, the province is taking action to strengthen all aspects of health care, particularly where Ontarians access it most frequently — in hospital emergency rooms, in community settings like pharmacies and doctors’ offices, in long-term care homes and through care delivered right in their own homes. This long-term plan is built on 3 pillars: The Right Care in the Right Place, Faster Access to Care, and Hiring More Health Care Workers. By focusing on improving the health care experiences of Ontarians and growing our health care workforce, we will improve the quality of health care delivery across the province for years to come.

Through the 2023 Budget, the Ontario government is continuing to build on and enhance Your Health in many ways. Ontario’s health sector investments are increasing by an additional $15.3 billion over 3 years starting in 2023–24.

Pillar One: The Right Care in the Right Place

When people have health care available in their communities, and in ways that are convenient for them, they are more likely to seek and receive the treatment they need when they need it and stay healthier.

Delivering convenient care to people in their communities will help keep Ontario healthier by diagnosing illnesses earlier, starting treatment as soon as possible, and keeping emergency room wait times down for individuals who need urgent care.

Starting in Fall 2023, the program to allow pharmacists to prescribe over-the-counter medication will be expanded for more common ailments, including mild to moderate acne, canker sores, diaper dermatitis, yeast infection, pinworms and threadworms, and nausea and vomiting in pregnancy.

Ontario is accelerating investments to bring funding for home and community care in 2023–24 up to $569 million, including supporting contract rate increases to stabilize the home and community care workforce. This funding will also expand home care services and improve the quality of care, making it easier and faster for people to connect to care.

In 2023–24, Ontario is building on the Roadmap to Wellness commitment to invest $3.8 billion over 10 years by allocating an additional $425 million over 3 years to connect more people to mental health and addictions services. This funding will support children and youth, including those suffering from eating disorders, maintain supportive housing services and work with Indigenous partners and communities to support Indigenous people’s access to high-quality, culturally appropriate care. This funding will also include a 5% increase in the base funding of community-based mental health and addictions services providers funded by the Ministry of Health.

Pillar Two: Faster Access to Care

The sooner patients have access to the care they need, the better the outcomes. Long wait times take a toll on people’s physical and mental health, creating more anxiety and stress.

As part of the most ambitious capital plan in Ontario’s history, over $48 billion in hospital infrastructure spending will take place over the next 10 years including over $32 billion in hospital capital grants. This will support more than 50 hospital projects that would add 3,000 new beds over 10 years.

The Ontario government is reducing wait times by investing an additional $72 million in 2023–24 to make more surgeries available at community surgical and diagnostic centres to connect people to care faster. This investment will allow hospitals to focus their time and efforts on more complex and high-risk surgeries, ease pressure on emergency departments and reduce surgical waitlists.

Pillar Three: Hiring More Health Care Workers

Hiring more health care professionals is the most effective step to ensure families are able to see a health care provider where and when they need to. Well-trained and well-supported doctors, nurses, personal support workers and more, are the people that Ontarians can rely on when they need care.

The province is further building the health care workforce by investing $200 million in 2023–24 to extend supports through the Enhanced Extern Program and the Supervised Practice Experience Partnership Program to address immediate health care staffing shortages. $80 million is being invested over 3 years to expand nursing education in universities and colleges by increasing enrolment by 1,000 registered nurses, 500 registered practical nurses and 150 nurse practitioner seats. A $22 million investment will hire up to 200 hospital preceptors to provide mentorship, supervision, and training to newly graduated nurses, with $15 million to keep 100 mid-to-late career nurses in the workforce and $4.3 million to help at least 50 internationally trained physicians get licensed in Ontario.

The province is also helping more Ontario students to become doctors by investing an additional $33 million over 3 years to add 100 undergraduate seats beginning in 2023, as well as 154 postgraduate medical training seats to prioritize Ontario residents trained at home and abroad beginning in 2024 and going forward. Ontario residents will also continue to be prioritized for undergraduate spots at medical schools in the province.

The province is also supporting a full continuum of care for first responders experiencing Post-Traumatic Stress Injury and other concurrent mental health disorders at Runnymede Healthcare Centre’s First Responders Wellness and Rehabilitation Centre. The dual-site project, with sites in Toronto and Peel Region, is advancing towards construction, with the government making an additional investment of $9.6 million to accelerate the project’s development towards its next round of approval.

Ministry financial information

Table 1: Ministry planned expenditures 2023–24 ($)

Table 2: Total operating and capital summary by vote 

Operating and Capital Summary by Vote

Historic Trend Table

Agencies, Boards and Commissions (ABCs)

Ministry of Health organization chart

April 11, 2023

• Sylvia Jones, Minister
  • Michael Tibollo, Associate Minister, Mental Health and Addictions
  • Robin Martin, Parliamentary Assistant
  • Dawn Gallagher Murphy, Parliamentary Assistant
• Dr. Catherine Zahn, Deputy Minister
  • Peter Spencer, Director, Legal Services
  • Valerie Hopper, Director, Communications
  • Dane Nelson, Director, Policy and Delivery
  • Dr. Kieran Moore, Chief Medical Officer of Health, Office of Chief Medical Officer of Health, Public Health, & Assistant Deputy Minister, Public Health
    • Elizabeth Walker, Executive Lead, Public Health
      • Brent Feeney, Director, Accountability and Liaison
      • Colleen Kiel, Director, Public Health Strategic Policy, Planning and Communications
      • Jodi Melnychuk, Director, Health Protection, Policy and Partnerships
      • Heather Schramm, Director, Health Promotion and Prevention Policy and Programs
      • Robert Lerch, Vaccine Policy and Programs
      • Justine Hartley, Director, Health System Emergency Management
  • Dr. Karima Velji, Chief of Nursing and Professional Practice & Assistant Deputy Minister, Nursing and Professional Practice
    • David Lamb, Director, Capacity and Health Workforce Planning
    • Allison Henry, Director, Health Workforce Regulatory Oversight
    • Dr. Nathalie Boudreau, Director, Nursing and Health Professionals
    • Robert Crawford, Project Director, Health System Integrated Capacity Plan
  • Angela Copeland, Chief Information Officer, Health Services I&IT Cluster
    • Arden Tansey, Head, Drugs & Assistive Devices I&IT Solutions
    • Kenny Liang, Head, Public Health I&IT Solutions
    • Tanya Bobechko, Head, Payment & Registration I&IT Solutions
    • Swetlana Signarowski, Head, Corporate I&IT Solutions & Integration Management
    • Louise Doyon, Head, Long-Term Care and Community Administration I&IT Solutions
    • Heather Berios, Head, Emergency Health I&IT Solutions & Technology Management
  • Susan Flanagan, Assistant Deputy Minister & Chief Administrative Officer, Corporate Services
    • Cherrie Lethbridge, Director, HR Strategic Business Unit
    • Jeffrey Graham, Director, Fiscal Oversight and Performance
    • Shelley Gibson, Director, Business Services
    • Jim Yuill, Director, Financial Management
    • John Amodeo, Director, Corporate Management
  • Greig Hein, Assistant Deputy Minister, Strategic Policy Planning and French Language Services
    • Robert Francis, Director, Strategic Policy
    • Jovan Matic, Director, Supply Chain Modernization
    • Jillian Paul, Director, Research, Analysis and Evaluation
    • Hanna Ziada, Director, Indigenous, French Language and Priority Populations
  • Michael Hillmer, Assistant Deputy Minister, Digital and Analytics Strategy
    • Kamil Malikov, Director, Health Data Science
    • Aileen Chan, Director, Health Data
    • Jennifer Bridge, Director, Health Analytics and Insights
    • Evan Mills, Director, Digital Health Program
    • Christine Sham, Director, Information Management Strategy and Policy
  • Peter Kaftarian, Associate Deputy Minister, Clinical Care and Delivery
    • Patrick Dicerni, Assistant Deputy Minister, Health Programs and Delivery, General Manager of OHIP, and Executive Officer of Drugs
      • Angie Wong, Director, Drug Programs Policy and Strategy
      • David Schachow, Director, Delivery and Eligibility Review
      • Rob Acheson, Director, Claims Services
      • Laura Pinkney, Director, Health Insurance
      • Neeta Sarta, Director, Laboratories and Diagnostics
    • Teresa Buchanan, Assistant Deputy Minister, Physician and Provider Services
      • Nicole Williams, Director, Negotiations
      • Nadia Surani, Director, Primary Health Care
      • Julie Ingo, Director, Provider Services
    • Melanie Kohn, Assistant Deputy Minister, Hospitals and Capital
      • Sherif Kaldas, Director, Health Sector Models
      • Lilly Whitham, Director, Hospitals
      • James Stewart, Director, Health Capital Investment
      • Kristin Taylor, Director, Provincial Programs
  • Alison Blair, Associate Deputy Minister, Health Integration and Partnerships
    • Rhonda McMichael, Assistant Deputy Minister, Strategic Partnerships
      • Amy Olmstead, Director, Home and Community Care
      • Taryn Pimento, Director, Project Management Office
      • Allison Costello, Director, Ontario Health Teams Policy and Operations
      • Renee Mahalanobis, Director, Ontario Health Oversight
    • Susan Picarello, Assistant Deputy Minister, Emergency Health Services
      • Stuart Mooney, Director, Emergency Health Program Management and Delivery
      • Rumana Chowdhury, Director, Emergency Health Regulatory and Accountability
    • Kyle MacIntyre, Assistant Deputy Minister, Mental Health and Addictions
      • Rachel Robins, Director, Mental Health and Addictions Policy, Accountability and Provincial Partnership
      • Mary Mannella, Director, Mental Health and Addiction Programs

Appendix

Annual Report

In 2022–23, the Ministry of Health (the ministry) continued to support the government’s priority to build a stronger, stable, and modernized health system that provides more connected and convenient care for patients and helps keep the province open.

The ministry put plans in place to support numerous investments and initiatives across the health care system, including adding new hospital and long-term care beds and thousands of more nurses and personal support workers to care for patients. The ministry worked with regulatory colleges to ensure more qualified newcomers to Ontario and internationally trained health care professionals could start caring for patients faster and significantly expanded and supported medical school enrollment. Additional ministry investments enabled the expansion of home and community care and building more capacity for mental health and addictions services and supports.

These investments helped to support the province’s health care system through the unprecedent challenges of the COVID‑19 pandemic, and the ministry continued to work collaboratively with many health partners and providers to address pressures facing the health care system.

In 2022–23, the ministry also continued to play a critical role in managing COVID‑19, including continuing to lead the successful vaccination rollout across the province. In addition to achieving one of the highest vaccination rates in the world, the ministry supported the rollout of antiviral medications and free rapid antigen tests, which are additional tools that helped protect Ontarians’ health and keep them out of hospitals.

The ministry continued to support modernization and innovation in the health care system to better meet the needs of patients. This included the ongoing implementation of more integrated models of care, such as Ontario Health Teams, supporting more digital and virtual care options and innovative programs such as the High Priority Communities Strategy, and safely expanding scopes of practice so qualified professionals could do more to help patients, while also alleviating pressures in other parts of the health care system.

Your Health: A Plan for Connected and Convenient Care

In February 2023, the Ontario government released Your Health: A Plan for Connected and Convenient Care. The plan laid out a broad series of initiatives under 3 pillars: The Right Care in the Right Place, Faster Access to Care and Hiring More Health Care Workers. These pillars will work together to deliver connected and convenient care in hospital emergency rooms, in community settings like pharmacies and community organizations and doctors’ offices, in long-term care homes and through care delivered at home.

The government also introduced new legislation, the Your Health Act, 2023, which if passed, would support the province’s plan to connect people to convenient care closer to home. This includes:

• Supporting efforts to reduce wait times for publicly funded surgeries and diagnostics.
• Enable “As of Right” rules that allow health care workers registered in other provinces and territories to immediately start working and caring for people in Ontario without having to first register with one of Ontario’s health regulatory colleges. These changes would mark the first step towards a pan-Canadian portable registration model, the first of its kind for health care professionals in Canada.
• Strengthen protections for personal health information and data, as the province puts in place new models to integrate data that will better inform policy and program planning to improve services.

Reducing wait times for surgeries and procedures

As part of Your Health, the Ontario government has established a three-step plan that makes it easier and faster for people to access the publicly-funded surgeries and procedures they need by further leveraging community surgical and diagnostic centres to reduce wait times and increase the availability of surgeries.

In Step One, the province is urgently tackling the existing backlog for cataract surgeries, which has one of the longest waits for procedures. New partnerships with community surgical and diagnostic centres in Windsor, Kitchener-Waterloo and Ottawa will add 14,000 additional cataract surgeries that will be performed each year. This number represents up to 25% of the province’s current cataract waitlist, and accounts for the estimated COVID‑19 related backlog of cataract surgeries. These centres will perform the 14,000 additional surgeries with existing health human resources.

Ontario is also investing more than $18 million in existing centres to cover care for thousands of patients, including more than 49,000 MRI and CT operational hours, 4,800 cataract surgeries, 900 other ophthalmic surgeries, 1,000 minimally invasive gynecological surgeries and 2,845 plastic surgeries such as hand soft tissue repair.

In Step Two, the ministry is working to further reduce wait times by expanding the scope of community surgical and diagnostic centres to address regional needs with a continued focus on cataracts, as well as MRI and CT imaging and colonoscopy and endoscopy procedures. To start as early as 2023, these procedures will be non-urgent, low-risk and minimally invasive and, in addition to shortening wait times, will allow hospitals to focus their efforts and resources on more complex and high-risk surgeries.

Step Three has seen the government introduce legislation in February 2023 that would support more integrated service delivery, such as MRI and CT scanning in existing community diagnostic centres. Starting in 2024, this next step will also expand surgeries for hip and knee replacements. Legislative changes would also strengthen oversight of community surgical settings, and include community surgical and diagnostic centres under the Ontario Patient Ombudsman’s jurisdiction in regard to patient complaints. As the province expands the role of community surgical and diagnostic centres, Ontario Health and the Ministry of Health will continue to work with system partners and clinical experts to put in place the highest standards for quality and safety.

Expanding care at local pharmacies

Under the Your Health plan, pharmacists are able to prescribe medications for 13 common ailments to patients across Ontario. These medications treat everyday health concerns like rashes, pink eye, insect bites and urinary tract infections. Visiting a pharmacist to assess and treat these common medical conditions can save a trip to the doctor, and give family doctors more time for appointments with patients who need more specialized care for more serious concerns. As of the end of March 31, 2023, just over 135,000 assessments have been completed through this initiative.

As with visiting a family physician or walk-in clinic, there is no extra cost to Ontarians for receiving a prescription from a pharmacist for common ailments when showing an Ontario health card. This new service is in addition to pharmacists being able to renew prescriptions for most medications, such as blood pressure, diabetes, and asthma medication.

Plan To Stay Open: Health System Stability and Recovery

Building on the government’s Plan to Stay Open that was released in late March 2022, the province introduced the second phase of its plan to support the health system in August 2022 with its Plan to Stay Open: Health System Stability and Recovery.

This plan addressed immediate actions to stabilize and build up the health care system and focused on providing the best care possible to patients and ensuring the resources and supports were in place to keep the province and economy open. The plan further bolstered Ontario’s health care workforce, expanded innovative models of care, and ensured hospital beds are there for patients when they need them. It provided the health system with support to address urgent pressures while preparing for a potential winter surge.

Health Human Resources

Permanent wage enhancement for personal support workers and direct support workers

The passing of the Pandemic and Emergency Preparedness Act, 2022, which was a key part of the province’s Plan to Stay Open, bolstered Ontario’s health workforce by giving publicly-funded personal support workers (PSWs) and direct support workers (DSWs) a permanent raise. This permanent wage enhancement includes an additional $3 per hour for approximately 50,000 eligible workers in long-term care, $3 per hour for approximately 50,000 workers in the home and community care sector and $2 per hour for 7,300 workers in public hospitals. These changes will benefit over 158,000 PSWs and DSWs who deliver publicly funded services in home and community care, long-term care, public hospitals, and social services.

Recruiting and retaining health care workers

Another cornerstone of the Plan to Stay Open and the Pandemic and Emergency Preparedness Act, 2022, were innovative measures to recruit and retain more doctors, nurses and PSWs to the province’s health care system, which included:

• making it easier and quicker for foreign-credentialled health workers to begin practicing in Ontario by reducing barriers to registering with and being recognized by health regulatory colleges
• investing $142 million to launch the new “Learn and Stay” grant
• training more doctors through the largest expansion of medical school education in over 10 years
• investing an additional $41.4 million annually to support the clinical education component in Ontario’s nursing education programs to further support the next generation of health care workers

Breaking down barriers to expand the health workforce

The Ontario government made additional changes to break down barriers so that more health professionals can work in Ontario. These changes make it faster and easier for health care professionals trained in Ontario, other provinces and internationally to register and practice in Ontario. Changes include:

• allowing internationally educated nurses to register in a temporary class and begin working sooner while they work towards full registration
• making it easier for non-practicing or retired nurses to return to the field by introducing flexibility to the requirement that they need to have practiced nursing within a certain period of time before applying for reinstatement
• creating a new temporary independent practice registration class for physicians from other provinces and territories, making it easier for them to work for up to 90 days in Ontario
• requiring health regulatory colleges to comply with time limits to make registration decisions
• prohibiting health regulatory colleges from requiring Canadian work experience for the purpose of registration, with some exceptions such as when equivalent international experience is accepted
• accepting language tests approved under the Immigration and Refugee Protection Act (Canada) to reduce duplicate language proficiency testing for immigrants to Canada

Learn and stay expansion

In January 2023, the province proceeded to expand the Learn and Stay grant to include paramedic and medical laboratory technologist programs in priority communities. This will help connect over a dozen underserved and growing communities with more health care workers. Eligible students in these programs will receive full, upfront funding for tuition, books, and other direct educational costs in return for working and caring for people in the region where they studied for a term of service after they graduate.

Upskilling nurses

The province invested over $4.6 million in the Michener Institute to remove financial barriers for nurses wanting to upskill to work in critical care areas of hospitals. The funding provides free tuition for students and all college and hospital costs, including backfilling their current roles to ensure continuity of care, and allows nurses to train to work in critical care areas of hospitals. By Spring 2023, close to 600 registered nurses will have completed their upskilling education and will be ready to support critical care in hospitals across Ontario. In addition to the Michener Institute, the government is also investing more than $9.4 million to support accelerated critical care nursing at Centennial College, Conestoga College, George Brown College, Laurentian University, Mohawk College, and St. Lawrence College.

Hospitals & health infrastructure

Increasing hospital capacity

Ontario invested an additional $3.3 billion in 2022–23, bringing the total additional investment in hospitals to $8.8 billion since 2018–19. This investment includes $1.5 billion to support the continuation of over 3,500 acute, post-acute and critical care beds, increasing access to high quality care, surgical and diagnostic imaging recovery, and health human resources. It also ensures that all publicly funded hospitals receive a minimum 2% increase to their budgets. This investment will assist all publicly funded hospitals across the province to continue providing high-quality care and enhance access to key health services at current and future levels, while helping to build a stronger, more resilient health care system.

Expanding access to MRI services

In 2022–23, the Ontario government improved people’s access to diagnostic imaging services while reducing wait times by investing over $20 million in operating funding to support the addition of 27 new magnetic resonance imaging (MRI) machines in hospitals across Ontario. This funding will provide hospitals in all regions of the province with annual operational funding for new MRI machines.

With this investment, some small and rural community hospitals will now be able to operate their very first MRI machine. For people in these communities, this means they will have more convenient access to diagnostic imaging and no longer need to travel to receive an MRI scan. This funding will also support additional MRI machines in hospitals in high-population growth areas with increased demand for MRI services. With more MRI services throughout the province, patients can be diagnosed faster and if needed, begin treatment and follow-up care even sooner.

Health Infrastructure Renewal Fund

Ontario is providing $175 million to hospitals through the Health Infrastructure Renewal Fund to address urgent infrastructure renewal needs such as upgrades or replacements of roofs, windows, security systems, fire alarms and back-up generators. These are essential improvements that will in return deliver excellent care to patients on the frontline in a safe and comfortable environment. In 2022–23 upgrades and repairs at 131 hospitals were supported through this program.

Centre de santé communautaire de Timmins

Ontario invested over $10 million to build a new health care facility for the Centre de santé communautaire de Timmins (CSC Timmins). This new, dedicated site will bring together comprehensive health services under one roof to improve access to quality care for Francophone patients and families in Timmins and the surrounding area.

CSC Timmins currently provides programs and services such as primary health, mental health and addictions and chronic disease services in 2 temporary locations. This investment will enable the team to operate in 1 new, modern facility and expand services to include childhood education, physiotherapy, and psychology services. Once complete, the new CSC Timmins will accommodate about 18,000 visits and 20,000 group attendances for health care services each year. The facility will also mean medical students will be able to receive hands-on practical training onsite under the supervision of a family physician.

Guelph General Hospital

The Ontario government committed over $15 million to redevelop the emergency department at Guelph General Hospital. This redevelopment will expand emergency services, including emergency mental health services, to improve access to high-quality care for patients and families in Guelph, Wellington, and surrounding communities.

Hamilton Health Sciences

Ontario committed over $20 million to Hamilton Health Sciences to support planning for the redevelopment of Juravinski Hospital and Cancer Centre and the expansion of Hamilton General Hospital’s emergency department. The redevelopment is planned to include a new patient care tower that will significantly increase inpatient services and add over 100 new inpatient beds at the Juravinski site. Expanding the emergency department at Hamilton General Hospital will help relieve space and volume pressures, provide additional space for ambulance off-loading and improve wait times for patients. This funding will improve access to services for the growing region around Hamilton, West Niagara, and south-central Ontario.

Hillcrest Reactivation Centre

The province provided up to $12.1 million to support the University Health Network Hillcrest Reactivation Centre. The centre operates 75 transitional care beds to provide care to patients who are waiting to move from a hospital to home, community or long-term care. This funding will support key renovations and improve existing infrastructure to ensure patients can continue to receive high-quality care in a comfortable environment.

Muskoka Algonquin Health Care

The Ontario government invested an additional $14 million to modernize and expand Muskoka Algonquin Healthcare to support planning for the phased redevelopment of its 2 hospital sites, Huntsville District Memorial Hospital and South Muskoka Memorial Hospital. As part of the redevelopment, more than 60 new beds are planned to be added across the 2 hospitals, bringing the total number of beds at Muskoka Algonquin Healthcare to more than 150. Much needed health care services are also planned to be enhanced, including chronic disease management, mental health and addictions services and emergency health care services. These new beds and enhanced services will ensure families in Muskoka, East Parry Sound and surrounding communities continue to have access to the care they need.

North of Superior Health Group

The province invested $1 million to modernize and expand North of Superior Healthcare Group’s McCausland Hospital site. This funding will support early planning for the hospital redevelopment, which will enhance emergency services and upgrade aging infrastructure to better support collaboration with health care partners and integrating health services and programs. This will improve access to care for patients and their families in Terrace Bay, Schreiber, Rossport, Jackfish and Pays Plat.

Oak Valley Health

The Ontario government is investing an additional $2.5 million to expand and build a new, modernized hospital at Oak Valley Health’s (formerly known as Markham Stouffville Hospital) Uxbridge Hospital site. This will support planning of an interconnected hospital campus that will bring health care and community health providers together in three facilities, including a new hospital, a long-term care home and an ambulatory care building, to enhance the patient experience and improve access to integrated, high-quality care. The redeveloped hospital will also expand key services, including diagnostic imaging, cardiorespiratory services, and laboratory and pharmacy services.

Princess Margaret Cancer Care

Ontario invested $5.3 million to plan multiple expansions at the Princess Margaret Cancer Centre. This included a new 14-bed inpatient unit for their stem cell transplant program, expanding the Malignant Hematology Day Unit to provide outpatient care, and expanding the ambulatory Malignant Hematology clinics to create dedicated nurse-led initiatives such as telephone triage, drop-in assessments, and high-quality virtual care. These new beds and expansion of services will ensure that more patients have access to lifesaving cancer treatment.

Proton beam therapy facility

Ontario invested up to $5 million in the University Health Network (UHN), to support the planning for Canada’s first-ever hospital-based proton beam therapy facility, which will provide innovative lifesaving cancer treatment to patients closer to home. The proton beam therapy facility would include up to 5 treatment suites to support approximately 1,500 paediatric and adult patients annually.

Ontario is working with the Proton Therapy Planning Group, a collaboration between Ontario Health-Cancer Care Ontario, the Pediatric Oncology Group of Ontario, The Hospital for Sick Children, and the Princess Margaret Cancer Centre — University Health Network, on further planning to help address the health care needs of patients and families.

Scarborough Health Network

The Ontario government’s $1 billion investment will support several major redevelopment and expansion projects for the Scarborough Health Network. This includes an additional $3 million to plan a new Birchmount Hospital, which in the first phase, will see a new, state-of-the-art inpatient tower built with more than 200 new beds, 14 new operating rooms and additional space to support future growth. Once completed, Birchmount Hospital is planned to have over 450 beds, nearly doubling the current capacity. Health care services at the hospital are also planned to be expanded as part of the redevelopment, including medicine, surgery, critical and emergency care, mental health and addictions care, and stroke and rehabilitation care.

The province is also investing over $20 million in renovations at Scarborough General Hospital that will expand diagnostic imaging services and modernize one of the operating rooms. Ontario continued to support the redevelopment of the emergency department and fracture clinic at Centenary Hospital. In addition, the government is supporting the planning and construction of a new chronic kidney disease facility that will be located in the new Bridletowne Neighbourhood Centre community hub. The new facility will expand the network’s hemodialysis and chronic kidney disease programs and bring services together under one roof to make it easier and more convenient for patients to access lifesaving treatment.

Southlake Regional Health Centre

Ontario invested $5 million to expand Southlake Regional Health Centre, supporting the planning to build a new state-of-the-art hospital and redevelop the existing site to improve access to high-quality health care for residents of York Region and Simcoe County. Over 100 new inpatient beds are planned to be added to Southlake, bringing the total number of beds to over 600. Planning for the new hospital will also include expanded acute and post-acute care, critical care and emergency care, diagnostic imaging, surgery, and mental health care. Southlake’s expansion will also transform the current Davis Drive site into a modern ambulatory care centre.

The ministry also made an investment of up to $4.6 million in Southlake’s health human resources, to strengthen their health workforce. This investment in the Enhanced Extern and Clinical Preceptor Programs, and the Supervised Practice Experience Partnership, helps support valuable hands-on clinical experience for nursing and allied health students, and supports internationally trained nurses.

St. Joseph’s Healthcare Hamilton

The Ontario government committed over $5 million to redevelop St. Joseph’s Healthcare Hamilton’s psychiatric emergency services. This redevelopment will help increase mental health and addictions emergency services at the hospital and ensure that patients and families in Hamilton and the surrounding region have access to high-quality care in a comfortable and compassionate space. The space next to the current emergency mental health department will be redeveloped into 2 patient care areas. One area will be for patients experiencing more severe mental health and addictions crises who need to be cared for in a more specialized environment, and the other will be for those who would benefit from other medical care and mental health supports.

St. Thomas Elgin General Hospital

Ontario invested $235,000 to support critical infrastructure upgrades at St. Thomas Elgin General Hospital to enhance the delivery of mental health and addictions services in Elgin County. This funding will enhance three psychiatric intensive care unit rooms, providing individuals who are experiencing more severe mental health and addictions crises and require more specialized care, a safe place to receive it in their own community. In addition, a second seclusion room in the hospital’s Mental Health Care Inpatient Unit will be added. 

Stevenson Memorial Hospital

The province invested an additional $6 million to modernize and expand Stevenson Memorial Hospital in New Tecumseh. This funding will support the planning of the first phase of the hospital’s redevelopment, including a new addition and a modern emergency department that will be triple its current size, which will improve access to high-quality care for families in Simcoe County.

Sunnybrook Health Sciences Centre

Ontario invested $5 million to support the planning to expand and redevelop Sunnybrook Health Sciences Centre, for a new, state-of-the-art critical care tower that will add more beds and expand much-needed health care services. Sunnybrook’s new critical care tower will bring the hospital’s critical care units together under one roof.

Based on early planning, the hospital intends to add over 100 new beds so that the new tower will have a total of approximately 260 patient beds. This is planned to include over 100 critical care beds and over 100 medical and surgical beds to make it easier and more convenient for families to access high-quality, integrated care when they need it. The hospital is also planning to modernize its existing infrastructure and enhance health services, including expanding its complex malignant hematology program to add stem cell transplant services and increasing radiation therapy so that more patients have access to lifesaving cancer treatment.

Toronto Western Hospital

The Ontario government provided a $34 million planning grant for a new state-of-the-art patient tower at Toronto Western Hospital. This expansion will add 20 new operating rooms, including 3 new image-guided operation rooms for complex neurosurgical and spinal procedures. With these new rooms, the University Health Network will be able to increase its surgical capacity by over 20% in the next 10 years to provide high-quality care to more patients in the Greater Toronto Area and surrounding communities. The tower will also include several new units and departments, including a pre-operative care unit, post-anaesthetic care unit, medical device reprocessing department and pharmacy, and enhance the mental health program to provide even better integrated care.

Unity Health Toronto’s St. Joseph’s Health Centre

Through a more than $1 billion investment, Ontario is supporting the redevelopment and expansion of Unity Health Toronto’s St. Joseph’s Health Centre. This funding will deliver a new state-of-the-art patient care tower with an expanded emergency department and new spaces for operating rooms, critical care, and medical, surgical, and mental health inpatient programs. Over 100 new beds are planned to be added to St. Joseph’s Health Centre, for a total of over 400 beds. The investment will also support renovations to the existing hospital to expand much-needed health care services and improve access to high-quality care for the residents of Toronto and surrounding communities.

Waterloo region

The province invested $5 million to modernize and expand Grand River Hospital and St. Mary’s General Hospital in the Region of Waterloo. The investment will support planning to redevelop the hospitals, add more patient beds and expand much-needed clinical care programs and services, such as cancer care, cardiac care, the chest and thoracic program, surgery, and medical imaging. In addition, ambulatory services such as outpatient surgery, urgent care, clinics, and diagnostic imaging will be enhanced. The project will enable the hospitals to seamlessly work together to create a more integrated and patient-centered health care system in the region.

To further support high-quality care in the region, the government is investing $1 million in a study at Grand River Hospital to evaluate the use of intraoperative surgical technology that could improve outcomes for patients who require hip replacement surgery. This innovative technology was developed in Ontario and is intended to increase the accuracy of the placement of implants, which could lead to faster patient healing times and the decreased likelihood of hip dislocations post-surgery.

William Osler Health System

The Ontario government invested up to $21 million to expand William Osler Health System. This funding will help plan for the transformation of Peel Memorial into a new hospital with 24/7 emergency services and expanded services including seniors care, mental health and addictions, rehabilitation and complex continuing care for patients and their families.

As part of this transformation, William Osler Health System is planning to provide post-acute care at Peel Memorial Hospital for patients recovering from an acute care stay before they safely return home. Over 250 new inpatient beds are planned to be added to William Osler Health System, which will significantly increase capacity. 

The Ontario government has also invested up to $3 million to support planning to expand cancer care services at Brampton Civic Hospital; to add new services and capacity for 6 medical linear accelerators to provide radiation treatment. This will make it easier for patients to access lifesaving treatment and high-quality cancer care closer to home.

Windsor Regional Hospital

With the Ontario government accelerating the timeline to build the new Windsor Regional Hospital, it has committed over $30 million in capital funding for the current hospital to connect people with improved treatments for patients with cancer and cardiovascular disease. The hospital will use this investment to renovate and expand its cardiac catheterization lab, which is where patients receive angiograms, angioplasties and other minimally invasive cardiac tests and procedures. In addition, this investment will enable the hospital to expand its cancer centre to accommodate a new linear accelerator, which provides cancer patients with necessary radiation therapy treatment.

Supply chain

The Ministry of Health is working with patients, providers and partners across government and the health sector to create an integrated, patient-focused supply chain for health care products and services. It is expected that hospitals will benefit significantly, with access to better tools, expertise, performance data and supports.

In response to global supply chain disruptions resulting from the pandemic, the ministry, in partnership with Ontario Health and supply chain organizations, launched the Health Supply Shortages Program to ensure hospital access to critical medical and surgical supplies needed to deliver high-quality, equitable patient care across the province. The Ministry of Health also continues to work closely with the Treasury Board Secretariat, Ministry of Public and Business Service Delivery and Supply Ontario on ways to modernize the province’s procurement system and deliver enhanced value and outcomes for patients, caregivers, and the health care system.

Emergency Health Services

Emergency Department Peer to Peer Program

The ministry, working with Ontario Health, established the Emergency Department Peer to Peer Program to assist with supporting patients. The program supports rural and remote Emergency Department physicians through access to immediate, on-demand, and real-time coaching and support via virtual channels from experienced peers. The program is currently providing support to 27 rural and remote hospitals across the province and is expected to expand in 2023–24.

Dedicated Offload Nurses Program

The province provided an increase of $7 million in 2022–23 to support the Dedicated Offload Nurses Program. This investment provided additional support to 20 municipalities that were already participating in this program, while also expanding the program to 7 new municipalities. This program provides funding for health care professionals dedicated to transferring (or offloading) ambulance patients to hospital care, which then releases paramedics to respond to 9-1-1 calls faster and increases ambulance availability. To address health human resource challenges, eligibility for Dedicated Offload Nurses Program funding was also expanded in 2022 to include paramedics, respiratory therapists, physician assistants, and nurses.

Land ambulance funding

For 2022–23, the Ontario government provided nearly $764 million in funding to assist municipalities with the cost of land ambulance operations. This represents an average increase of 5% provincially compared to 2021–22 funding levels.

9-1-1 Patient Care Models

The ministry has been working with its valued partners, including the Ontario Association of Paramedic Chiefs and Ontario Base Hospital Group Medical Advisory Committee, to expand patient care models that provide paramedics with the flexibility to treat patients on scene and refer or discharge them to supports in the community, to help avoid unnecessary emergency department visits.

To date, the ministry has approved successful mental health and addictions and palliative patient care models initiatives in 41 Ontario communities. The ministry has also expanded these initiatives to serve additional patient groups, such as those with epilepsy and diabetes.

Renewing Ornge Air Ambulance

Ontario is renewing Ornge Air Ambulance’s fixed wing fleet with new of state-of-the-art aircraft. This investment in the future of Ornge will ensure it can continue to provide safe and consistent air ambulance services to all Ontarians, especially in rural and remote areas of the province.

Dispatch modernization

The ministry has worked with sector partners to modernize the ambulance dispatch system with what is widely considered the standard-of-care for ambulance communication centres around the world through the rollout of Computer Aided Dispatch upgrades at 13 Central Ambulance Communications Centre (CACC) and the launch of the Medical Priority Dispatch System at the Mississauga CACC. 

Home and community care

Expanding home care

Home care is the provision of personal support services and nursing and other professional services to seniors and people of all ages who need care to stay at home or recover from a hospital stay, or to enable children and youth to participate in school. Starting in 2022–23, Ontario is investing $1 billion more over three years to stabilize and further expand home care, which will benefit the nearly 700,000 families who rely on home care annually, including by helping them avoid unnecessary hospital visits and long-term care home admissions and shortening hospital stays. This new funding will support expanded home care services and retaining, recruiting, and training more home care workers.

Expanding community services

Starting in 2022–23, the government is investing $100 million over 3 years to stabilize and expand community services — which includes Community Support Services, Acquired Brain Injury Services, and Assisted Living Services. These services include meals, transportation, respite as well as personal support services

Modernizing the delivery of services

In May 2022, the Home Care and Community Services Act, 1994 and its regulations were repealed and the Connecting People to Home and Community Care Act, 2020 and new home and community care regulations were proclaimed into force. The new legislation and regulations provide a modernized framework for the delivery of home and community care services, with Ontario Health Teams helping to guide the expansion and modernization of home and community care within an integrated health care system. The province is working with Ontario Health Teams and home and community care providers to implement new and innovative programs for people wanting to connect to care at home, including more virtual care options and connecting home care services with other care providers such as a family doctor.

Community paramedicine

With the help of paramedics working alongside home care and primary care providers, people living with chronic health conditions are getting additional support to live at home more independently and avoid regular visits to the hospital emergency room. The Ministry of Health’s expanded community paramedicine program is in place in 55 communities and has connected more than 30,000 people to 24/7 non-emergency support at home or in the community. The initiative allows paramedics to use their training and expertise to provide home visits for a range of services, including making sure medication is taken as prescribed, educating people on how to properly manage their chronic conditions, and providing assessments and referrals to local community care services, such as home care.

Palliative care and hospice expansion

In 2022–23, the Ontario government invested an additional $13.7 million in operational funding this year for eligible hospices across the province to support clinical costs for end-of-life services. The province also invested $4 million to expand Hospice Niagara by adding 2 new Hospice Palliative Care Centres of Excellence in Welland and Fort Erie. This investment will support the planning and construction of the two centres that will add 20 new hospice beds, for a total of 30 hospice beds operated by Hospice Niagara. Once open, the province will provide an additional $2.1 million annually in operational funding to further support end-of-life care services for more than 500 people per year at the 2 new centres.   

Ontario also committed to add an additional 23 new hospice beds across 10 sites in the province. These new beds are located in Vaughan, Mississauga, Durham, Hastings County, Northumberland County, Parry Sound, Kenora, Hamilton, Windsor, and Waterloo. These 23 beds are in addition to the 500 beds already available across the province that connect Ontarians with comfortable and dignified end-of-life care near their communities and loved ones.

Assistive Devices Program

The Ontario government implemented funding for real-time continuous glucose monitors (rtCGMs) for eligible Ontarians. Funding rtCGMs and the related supplies will help the most vulnerable Ontarians with type 1 diabetes, and who are the most at risk of a severe hypoglycemic event or cannot recognize or communicate the symptoms of hypoglycemia, to manage their condition.

Ontario Health Teams

Ontario Health Teams (OHTs) are a model of integrated, population-health based care delivery, where health and community care providers work together as 1 team for their population, even if they are not in the same organization or physical location. Ontario Health Teams bring together health care providers from across health and community sectors, including primary care, hospitals, home and community care, mental health and addictions services, and long-term care, as 1 collaborative team to better coordinate care and share resources.

An Ontario Health Team is responsible for delivering care for their patients, understanding their health care history, easing their transition from one provider to another, directly connecting them to different types of care, and providing 24/7 help in navigating the health care system.

The Ontario government, in partnership with Ontario Health, approved 3 new Ontario Health Teams in Northern Ontario that will break down barriers in people’s health care to provide connected and more convenient care. The new Ontario Health Teams are:

• Maamwesying Ontario Health Team, serving Indigenous communities in Northeastern Ontario, including the urban Indigenous population in Sault Ste. Marie
• City & District of Thunder Bay Ontario Health Team, serving Thunder Bay and the surrounding region
• Kiiwetinoong Healing Waters Ontario Health Team, serving Dryden, Red Lake and Sioux Lookout

With these new teams, there are now 54 Ontario Health Teams. The Ministry of Health also invited four new potential teams to complete full applications to become approved Ontario Health Teams. Once approved, these remaining teams would result in the province achieving its goal of full provincial coverage, ensuring everyone has the support of an Ontario Health Team. These 4 remaining teams are:

• Équipe Ontario Cochrane District Team
• Équipe Sudbury Espanola Manitoulin Elliot Lake Team
• Équipe des régions du Temiskaming Area Team
• West Parry Sound Team

To ensure that Ontario Health Teams are built to last and positioned to deliver better patient care, the province introduced new direction for OHTs through The Path Forward. This document sets out new direction for common OHT structures, decision-making, operational capacity, communications, and clinical pathways. The ministry and Ontario Health are engaging with OHTs and system partners to implement this direction.

Public health

Responding to COVID‑19

In April 2022, the Ontario government, in consultation with the Chief Medical Officer of Health, expanded eligibility for fourth doses of the COVID‑19 vaccine to individuals aged 60 and over as well as First Nation, Inuit and Métis individuals and their non-Indigenous household members aged 18 and over. Starting in September 2022, eligibility for COVID‑19 first booster doses was expanded to children aged 5 to 11, to provide an extra layer of protection to those who need it ahead of the new school year.

Later in September 2022, based on guidance from Health Canada and the National Advisory Committee on Immunization (NACI), the province began offering the bivalent COVID‑19 booster dose to all Ontarians aged 18 and over, beginning with the most vulnerable populations, followed by everyone aged 12 and over if they had completed their primary COVID‑19 vaccine series. A new paediatric Pfizer COVID‑19 vaccine was also made available for children aged between 6 months to under 5 years old. 

For patients at higher-risk of hospitalization and serious illness, antiviral treatments, including Paxlovid (nirmatrelvir and ritonavir) and Veklury (remdesivir), were made easier to access and available through multiple channels. Prescriptions for Paxlovid were made available for free to eligible individuals from pharmacists, physicians, nurse practitioners and Clinical Assessment Centres.

To further improve access to this effective treatment option, Ontario provided updated guidance on polymerase chain reaction (PCR) testing, which is used to determine who should receive Paxlovid. Ontario pharmacies participating in the publicly funded PCR testing program provide convenient access for testing to eligible individuals. Free PCR tests were offered at any provincial testing location and rapid antigen tests continued to be available at no charge in over 3,000 retail locations in the province.

With the province’s high vaccination rates, expansion of booster doses, as well as the availability of antivirals, Ontario has the tools necessary to manage the impact of the virus. The Chief Medical Officer of Health and the province continued to monitor key indicators and the COVID‑19 situation across Ontario.

Public health funding

Ontario invested an additional $19 million in 2022–23, bringing the total additional investment for public health units to $100 million (or 14% increase) since 2018–19 (excluding COVID‑19 investments). This investment included 1% growth funding to address increased costs associated with direct service delivery, including pandemic recovery, funding to support the delivery of the Ontario Seniors Dental Care Program which provides comprehensive dental care to eligible seniors from low-income households, and funding to help retain nurses across the public health sector.

The Ontario government has also helped expand the capacity of public health units to prevent, monitor, detect, and contain COVID‑19 in the province. Since 2020–21, Ontario invested approximately $1.6 billion in additional funding for public health units to support and enhance COVID‑19 monitoring, case and contact management, and delivery of the COVID‑19 vaccine program at the local level.

Ontario remains committed to working with public health and municipal sector partners to monitor capacity and funding requirements for the COVID‑19 response and ensure critical public health services are maintained and delivered to protect the health and well-being of Ontarians.

Flu shots

Starting in November 2022, free flu shots were made available to Ontarians 6 months of age and older. Ontarians were able to receive their flu shot at doctor and nurse practitioner offices, as well as some public health units and participating pharmacies. To protect the most vulnerable, Ontario’s initial supply of flu vaccines in September 2022 was prioritized for long-term care homes and hospitals, followed by retirement homes, health care provider offices and participating pharmacies for seniors and individuals in the community who are at higher risk of complications from the flu. Keeping up to date on vaccines continues to be the best way for people to stay healthy during the flu and respiratory illness season.

Community health care

Interprofessional primary care teams

The province is providing additional funding to create more interprofessional primary care teams, which include team members from 2 or more professions such as nurses, doctors, social workers, and others. This investment of $30 million will create up to 18 new or expanded teams and help bridge the gap in accessing interprofessional primary care for vulnerable, marginalized, and unattached patients to ensure they are able to connect to care where and when they need it. In addition, this expansion will support primary care integration within Ontario Health Teams and sustain direct service delivery in existing interprofessional primary care teams that are experiencing increased operating costs.

Community Infrastructure Renewal Fund

The ministry invested over $7.6 million to support critical upgrades and repairs at 65 community health care facilities across the province through the Community Infrastructure Renewal Fund. This funding will support health care system partners to address urgent infrastructure renewal needs.

Community health facilities are publicly funded and provide a range of programs to patients across the province, including primary care, community mental health and addictions services, allied health care such as physical therapy and respiratory therapy, and programs and services delivered by a public health unit.

New Community Post-Stroke Rehabilitation Program

The ministry invested up to $5 million to develop recommendations for establishing a comprehensive community post-stroke rehabilitation program for adult stroke patients, and to fund front-line services. This year’s initial investment may be followed by ongoing investments in the future to ensure that all Ontarians have access to high-quality post-stroke care in their community once they leave a hospital. A province-wide community post-stroke rehabilitation program will ensure consistent access to these important therapies for all adults regardless of their age or where they live.

As a first step to developing the new community post-stroke rehabilitation program, the government has asked Ontario Health to assess the current state of community stroke rehabilitation services and map access points to these services. This will help identify immediate opportunities to improve access to coordinated post-stroke care by leveraging existing resources developed in collaboration with sector partners. Ontario Health will also work closely with the province on a standardized provincial data collection approach to capture the total number of stroke patients who access outpatient rehabilitation services.

Mental health and addictions 

In 2022–23, an additional $204 million in one-time funding was provided to the mental health and addictions sector to sustain and enhance capacity through investments such as training, equipment and supplies, enhancing service delivery spaces, and software licenses. This investment builds on Roadmap to Wellness, a provincial strategy to address long-standing mental health and addictions needs, with a historic investment of $3.8 billion over 10 years.

One Stop Talk for children and youth

The Ontario government invested $4.75 million in 2022–23 to expand the “One Stop Talk” virtual “walk-in” counselling program to connect children, youth, and their families with more convenient and timely ways to access mental health counselling no matter where they live. The “One Stop Talk” service offers convenient ways to talk to a clinician by phone, video conference, text, and chat without an appointment. The program began as a pilot in November 2022 with 6 participating mental health organizations and is being expanded to additional organizations and their waitlisted patients.

Youth Wellness Hubs

The province expanded the number of Youth Wellness Hubs across the province to make it faster and easier for young people to connect to mental health and substance use support, primary care, social services, education, and more. Through the Addictions Recovery Fund, the government is adding 8 new youth wellness hubs to the 14 that were created since 2020, bringing the total to 22 across the province. The 8 new Youth Wellness Hubs will be in Algoma Region, Kingston Frontenac Lennox and Addington, London-Middlesex, Sagamok Anishnabek First Nation, Sarnia-Lambton, Sudbury, Thorncliffe Park, and West Toronto.

Mental health supports for health care workers

Ontario invested over $12.4 million over 2 years since 2021–22 to provide existing and expanded mental health and addictions supports for all frontline health care workers across the province. As of February 28, 2023, over 5,100 health care workers accessed individual psychotherapy support with a clinician at one of the 5 partner hospitals or through the Ontario Psychological Association, and nearly 2,000 health care workers have participated in the ECHO peer support program. Organization-focused mental wellness training sessions were also offered by the Canadian Mental Health Association — Ontario Division through their dedicated Your Health Space program and as of mid-March 2023, over 11,800 health care leaders and staff attended a session. Also, over 17,000 health care workers enrolled in internet-based Cognitive Behavioural Therapy (iCBT) when it was available as a pandemic response initiative from May 2020 to September 2022.

Children and youth eating disorders intensive supports for hospitals

Ontario invested over $21 million in one-time funding over 2 years since 2021–22, to immediately address the increased demand for specialized intensive care for children and youth diagnosed with an eating disorder. The Ontario government provided funding to support eating disorder services at the Hospital for Sick Children, McMaster Children’s Hospital at Hamilton Health Sciences, the Children’s Hospital of Eastern Ontario (CHEO) and the Children’s Hospital at London Health Sciences Centre. This funding supported up to 11 inpatient surge beds as well as additional partial hospitalization and day treatment spaces, to help patients with eating disorders more successfully transition from inpatient care to community care, ensuring that children and youth receive high-quality care in the right settings.

Addictions Recovery Fund

An additional $90 million was approved through the Addictions Recovery Fund, which included over $41 million for 2022–23 to increase access to bed-based addictions treatment, with approximately 210 of the planned beds operationalized to date. In addition to new treatment beds, funding was committed starting in 2022–23, to support non-bed-based services and supports across the province including Indigenous land-based healing services, mobile mental health clinics and youth wellness hubs with the aim to improve access to additional types of treatments.

Drug programs

Trikafta

Through its publicly-funded drug program, the Ontario government expanded coverage for Trikafta, the latest treatment option for cystic fibrosis, to include all Ontarians aged 6 and over. The province also removed the patients’ lung function as a part of the eligibility criteria in order to further reduce barriers to accessing lifechanging treatments for cystic fibrosis patients. Ontario is now the first province to expand access to youth aged 6 to 11.

Luxturna

Ontario provided $2.9 million to establish a provincial gene therapy program to fight against blindness for those suffering from a rare and debilitating genetic eye disease, Inherited Retinal Disease. Luxturna is the first Health Canada approved gene therapy for Inherited Retinal Disease. Prior to Luxturna, there was no effective treatment for children and adults living with this inherited form of vision loss that can lead to blindness. This critical public funding will cover the one-time treatment, which slows the progression of vision loss and in some cases improves vision. It will also cover associated drug and patient treatment costs.

Biosimilars

Ontario joined several other provinces and territories by expanding the use of biosimilar drug treatments for Ontarians. Ontario Drug Benefit (ODB) recipients who are on an originator biologic will begin to transition to a Health Canada approved biosimilar version of the drug at no cost. Patients and health care providers can be confident that the quality, safety, and patient benefits of the biosimilar are highly similar to the biologic drug. Biosimilars undergo the same robust and rigorous approval process by Health Canada and to be approved in Canada, a biosimilar must be proven to be highly similar, with no clinically meaningful differences in terms of safety and efficacy. The ministry will continue to work with partners, including physicians, pharmacists, and manufacturers, to ensure a smooth and successful transition. This switch will allow Ontario to invest more in new and innovative drug treatments and continue to grow the roster of publicly funded life saving drugs.

Provincial laboratory services

Genomic sequencing in Ontario

The province continued to invest in genomic sequencing for rare disease diagnostics in Ontario. With the successful completion of the “Genome-wide Sequencing Ontario (GSO)” pilot project at SickKids Hospital in Toronto and the Children’s Hospital of Eastern Ontario in Ottawa, this testing will continue to be a provincially funded clinical service in Ontario, so Ontarians living with rare diseases can access the lifechanging, innovative diagnostics they need closer to home.

With this investment, Ontario is able to offer testing to individuals whose test samples would have previously been sent out-of-country. Better access to this testing means more patients living with rare diseases will be able to get to the right treatments and care they need faster. This innovative pilot project was a first of its kind in Canada, and Ontario continues to be at the forefront of genomic medicine nationally and among leading jurisdictions internationally.

Digital / virtual health

Health811

The Ontario government and Ontario Health launched Health811 (previously known as Health Connect Ontario), a new tool that lets Ontarians call or chat online with a registered nurse and find the health care services and information they need all in one, easy-to-use website. Health811 has replaced the former Telehealth Ontario, adding enhanced online tools and allowing individuals to call 811 or visit the website 24 hours a day, 7 days a week to get health advice, help navigating health services and find information. This service helps Ontarians avoid unnecessary visits to emergency departments and unneeded delays in accessing care. Health811 advisors and clinical staff currently provide supported services to Ontarians through over 80,000 monthly calls and chats, with a wait time of less than 60 seconds, 98% of the time. 

Surgical waitlist HUB

The province funded the implementation of a new, innovative software across hospitals in Eastern Ontario that will help reduce surgical backlogs in the region. This innovative first-in-Ontario surgical waitlist HUB, built by Novari Health, consolidates patients waiting for surgery into a real-time regional wait list system using interactive mapping and analytics tools. The HUB will improve the coordination of surgical services between hospitals in Eastern Ontario. The software, in collaboration with hospitals across the region and will integrate with existing hospital IT systems to gain an overall picture of backlogs, speed up wait times and help identify bottlenecks at various stages of the surgical process.

French language services

To better serve the Francophone community, Ontario is now offering the option of French language characters, such as accents (ç, è, é, ê, ë, for example), on Ontario health cards. This is another step forward in the province’s plan to make French characters available on all Ontario government identification. Ontarians with French names may visit a Service Ontario location with the required supporting identification documents to request a free replacement health card displaying their name with French language characters, including accents.

Ontario provides virtual care as another tool to connect French-speaking patients across the province with health care services in their preferred language. Whether living in a French-speaking community, a rural and remote setting, or in an urban area, patients can connect with a health care provider and receive care in French through real-time video. A French language services locator map also provides information about services available in French, including access to virtual health care. Details are available at otn.ca/patients/French-language-services.

Key performance indicators

The Ministry of Health is committed to delivering Ontario’s plan to end hallway health care and build more capacity for a connected and integrated health care system centered around the needs of patients. A key part of this plan is measuring the province’s progress on 15 ministry-level key performance indicators as well as a diverse set of program-level measures. These KPIs are related to government-directed and ministry-identified priorities. Listed below are 5 examples of KPIs that the ministry is tracking annually and the most recent performance results of each measure. The 5 illustrative ministry-level KPIs listed below enables tracking of progress towards strategic ministry outcomes and priorities, such as ending hallway health care, access to virtual care, Alternate Level of Care (ALC) rate, etc.

Outcome measure #1 — Daily average number of inpatients receiving care in hallway health care beds

The ministry is working to end hallway healthcare, and to ensure that all patients receive timely access to high-quality health care. There was a daily average of 1,374 inpatients receiving care in hallway healthcare beds as of December 2022. The target is to have 0 inpatients receiving hallway health care and the plan to achieve the target includes managing better patient flow within the hospitals, creating additional bedded capacity, and ensuring patients receive care in the right setting at the right time.

Outcome measure #2 — Percentage of Ontarians who had a virtual visit

The ministry is setting expectations through the Ontario Health Team model and modernizing virtual care billing frameworks to remove outdated barriers to virtual care. A survey conducted in the period of November 2021 to February 2022 had indicated that 73.2% of Ontarians had a virtual visit in the last 12 months, far exceeding the target of 30% by 2022–23. The impact of COVID‑19 on service/care patterns has accelerated the achievement of the target.

Outcome measure #3 — Alternate Level of Care (ALC) rate

The ministry is working with Ontario Health and hospitals to address capacity and ALC challenges (creating capacity across the continuum, supporting growing demand for hospital services, and ensuring appropriate patients’ transition). As of November 2022, the ALC rate was 15.2%, which was higher than the average rate in fiscal year 2021–22. The increase may be related to staffing shortages across the health sector preventing discharge of patients to next destination and the end of Emergency Orders supporting an influx of patients creating high volumes of patient flow.

Outcome measure #4 — Percentage of Ontario population served by an Ontario Health Team (OHT) at maturity

With 3 new OHTs being approved in October 2022, Ontario currently has a total of 54 OHTs which serves 97% of the Ontario population at maturity. The ultimate goal is that the approved OHTs serves 100% of the Ontario population by January 1, 2025. The target value will be achieved when all communities in Ontario have an operational OHT.

Outcome measure #5 — Number of seniors served as part of Ontario Seniors Dental Care Program

As of August 31, 2022, the number of program applications received to date was 140,055 and the number of enrolled seniors as of August 31, 2022 was 77,044, 36.6% increase compared to the enrolment as of October 1, 2021. Due to the pandemic, non-essential dental and construction services were suspended, which impacted the staged implementation timing. The target is to have 100,000 seniors access services annually by March 31, 2024, when the program is fully implemented.

In addition to the 15 government-directed and ministry-identified KPIs, the Ministry of Health tracks outcomes and outputs measures at the program level and reports on them through quarterly report backs and other in-year submissions to support evidence-based decision making.

Table 3: Ministry Interim Actual Expenditures 2022–2023