Today, the Ontario government announced its highly anticipated call for applications to consider new licences under the Integrated Community Health Services Act, 2023 (the Act) (formerly, Bill 60) for Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) services. The call for applications is open until August 12, 2024.
Key Highlights
- Increased MRI and CT Scans: New licences are expected to be issued starting in Fall 2024 to add nearly 100,000 MRI and CT scans each year. The aim is to reduce wait times for these diagnostic services to 28 days from the date of the order/ requisition.
- Call for Applications: Applications for new licences open today (June 3, 2024). The call for applications is open until August 12, 2024. Questions regarding the application process must be received by June 17, 2024.
- Future Calls for Applications: Two further calls for applications are planned to expand GI endoscopy procedures and orthopedic surgeries in the Summer and Fall 2024.
About Community Surgical Diagnostic Centres
Although Bill 60 received Royal Assent on May 18, 2023, the Act was not proclaimed into force until September 25, 2023, pending the development of Ontario Regulation 215/23. The Act repealed and replaced the Independent Health Facilities Act, 1990. In summary,
- An “integrated community health services centre” (“Centre”) means among other things “a health facility, including a community surgical and diagnostic centre, in which one or more members of the public receive services for or in respect of which facility costs are charged or paid”.
- The Act provides for the charging of “facility costs” which are fees or payment for or in respect of a service or operating cost that supports the provision of insured services. There is a Schedule of Facility Costs that sets out the fees that are covered by OHIP or they may be prescribed by regulation.
- There are prohibitions on charging a person for insured services, for preferential access to services or for refusing to provide insured services to individuals who choose not to purchase uninsured services.
- A licence is required in order to establish or operate a Centre. The issuance of a licence is at the discretion of the Director. A licence may be issued or renewed for a term of up to five years.
- Licensing is contingent upon the issuance of a “call for applications” for the establishment and operation of one or more Centres. The Director may do this by sending a call for applications to one or more specified persons, or by publishing a call for applications in any manner the Director considers appropriate. The call for applications must set out the service or services to be provided.
- There are detailed requirements for licence applications, including but not limited to:
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- description of the services to be provided and how the Centre will provide “connected and convenient care”, including: (i) capacity to improve patient wait times, (ii) plans to improve patient experiences and access to care, and (iii) plans to integrate with the health system
- details of quality assurance and continuous quality improvement programming
- detailed staffing model for the proposed Centre and evidence of the sustainability of this model, including, (i) staff classification with rates/ranges of compensation, (ii) the number of staff required for each position, (iii) the model for staffing anaesthesia delivery, and (iv) information regarding the hospital privileges of physicians who provide services at the Centre, if applicable
- description of how the proposed Centre has consulted with health system partners in the development of the application, including any endorsement of the application by health system partners
- description of any uninsured services that are being provided or will be provided, including, any charges for the uninsured services, and the processes for providing information and obtaining patient consent in connection with any uninsured services
- description of current linkages with health system partners and how the Centre will maintain and improve those linkages to promote optimal patient care
- The Minister and the Director have wide discretion, powers and authority as it relates to the licensing and operation of Centres. There are a number of oversight mechanisms, including compliance orders, Minister directions, revocation, suspension, refusal to renew or amendments to licences.
Integration with Public Health System
All Centres will be under Accreditation Canada’s quality assurance program, with routine inspections starting in October 2024.
As stated above, Centres must be integrated with the broader public health system, requiring detailed staffing plans to protect staffing resources, reporting into the province’s wait times information system, and participating in regional central intakes to maintain timely patient care. For Centres that provide licensed MRI or CT services, the Ministry intends to provide facility cost funding under an hourly payment model.
There is only a short window (10 weeks) for applicants to respond to the call for applications.
Miller Thomson’s Health Industry group is pleased to assist health industry organizations with the application process and to address any questions relating to community surgical diagnostic centres, health system integration and requirements.
