Ontario Introduces a Plan to Stay OpenPublished on March 30, 2022
Government attracting more health care workers through new “Learn and Stay” grant and by recognizing foreign-credentialed professionals
TORONTO — Ontario is introducing A Plan to Stay Open, which includes legislation that, if passed, will expand on policies and measures already in place to ensure the province is able to stay open by building a stronger, more resilient health care system that is better able to respond to crisis.
The COVID-19 pandemic revealed that historically, Ontario had not done enough to protect and prepare the province for a crisis. Stockpiles of personal protective equipment (PPE) were depleted or expired, emergency protocols were under-developed and out-of-date and the province’s health care system was chronically underfunded and understaffed. A Plan to Stay Open, which includes the Pandemic and Emergency Preparedness Act, 2022, will, if passed, recruit and retain more doctors, nurses and personal support workers, further expand domestic production of critical supplies like masks and vaccines and will continue building health care infrastructure so hospitals have the capacity to delver high-quality care to treat more patients.
“We can never go back to previous governments’ chronic underfunding of health care and inadequate emergency preparedness that brought our health care system to the brink and caused so much disruption in our daily lives,” said Prabmeet Sarkaria, President of the Treasury Board. “Our hardworking families, dedicated health care workers and job-creating businesses deserve a plan that will keep Ontario open, safe and prepared.”
Expanding Ontario’s Health Workforce
The cornerstone of the province’s Plan to Stay Open are innovative measures to recruit more doctors, nurses and personal support workers to the province’s health system. To build on the 8,600 health care workers added to the system since March 2020 through wage enhancements and financial incentives, the Plan, and legislation, if passed, will:
- Invest $142 million to launch the new “Learn and Stay” grant. The program will start with $81 million over the next two years to expand the Community Commitment Program for Nurses for up to 1,500 nurse graduates each year to receive full tuition reimbursement in exchange for committing to practice for two years in an underserved community. Starting in Spring 2023, applications will open for up to 2,500 eligible students each year who commit to stay in their region working in an underserved community for up to two years after graduating. Students will be eligible to receive full, upfront funding for tuition, books and other direct educational costs.
- Make 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. The legislation would prohibit regulatory colleges from requiring Canadian work experience as a qualification for registration, subject to any exemptions provided for in accompanying regulation. Proposed legislative amendments would also require regulatory colleges to certify potential applicants in a timely manner so that internationally trained health care workers can start work as soon as possible.
- Make the temporary wage enhancement for personal support (PSWs) and direct support workers (DSWs) permanent. Since October 1, 2020, over 158,000 PSWs and DSWs providing publicly funded services in hospitals, long-term care, home and community care and social services have been receiving a wage enhancement of $3/hour or $2/hour. The permanent wage enhancement will help to stabilize, attract and retain the workforce needed to provide a high level of care during the COVID-19 pandemic and to continue these important supports in the long-term recovery from the pandemic.
- Train more doctors through the largest expansion of medical school education in over 10 years. Ontario is adding 160 undergraduate seats and 295 postgraduate positions over the next five years, including at the Ryerson School of Medicine in Brampton, the first new medical school to be created in the province since the Northern Ontario School of Medicine was established in 2005.
- To further support the next generation of health care workers, the government is also investing an additional $41.4 million annually to support the clinical education component in Ontario’s nursing education programs. This investment will enable publicly assisted colleges and universities to expand laboratory capacity supports and hands-on learning for students, providing opportunities for learners to demonstrate their knowledge of theories and principles in actual practical settings.
“Now more than ever, we must train the health care work force of tomorrow to ensure we are prepared to meet the needs of the people of Ontario, especially during times of crisis,” said Jill Dunlop, Minister of Colleges and Universities. “Creating more opportunities for health care professionals to complete their training and successfully transition to employment means that all Ontarians will have access to the quality of care they expect and deserve, regardless of location.”
Shoring-up Domestic Production of Critical Supplies
At the onset of the pandemic, all of the province’s personal PPE was purchased from international sources, which caused enormous disruption due to lockdowns and border restrictions such as when the U.S. barred shipments of N95 respirators from entering Canada. By promoting and supporting Ontario manufacturing and innovation, the province is now producing a wide variety of PPE and critical supplies and equipment (CSE), including N95 respirators at a newly-expanded 3M facility in Brockville, with 93 per cent of the forecasted PPE spend for the next 18 months with Ontario or Canadian sources.
In addition to these measures, and as the province continues to invest in PPE and CSE, the Plan and legislation, if passed, will:
- Launch a life sciences strategy that will support early-stage companies, attract new investment and encourage early adoption of Ontario-made innovations in our hospitals and health system.
- Leverage the province’s extensive manufacturing capability wherever possible to maintain a healthy stockpile of quality PPE and CSE, which could help strengthen PPE and CSE supply chains and ensure the preparedness and the safety and security of Ontarians in non-emergency times and in time of crisis.
- Ensure a safe and stable food supply by requiring regular reports on the province’s security of food supply and contingency planning, including surge capacity for food inspection in an emergency. The changes would also allow for the creation of a temporary location(s) for part or all of the Ontario Food Terminal operations during an emergency.
- Prohibit the offer to sell or the sale of government-provided PPE and CSE that has been provided without charge or payment of a fee, preventing hoarding and protecting consumers from bad actors.
Building More Hospital Beds
Since the outset of the pandemic, the government has added nearly 1,000 more intensive-care unit hospital beds with the capacity to now handle 2,915 critical care patients. The Plan to Stay Open will do more by implementing a capital plan expansion with more than 50 major projects that would add 3,000 new beds over 10 years and invest to support the continuation of over 3,100 acute and post-acute beds in hospitals and alternate health care facilities, and hundreds of new adult, paediatric and neonatal critical care beds.
In addition, Ontario now has 26,090 new and 21,880 upgraded long-term care beds in development, under construction or completed — which means close to 87 percent of the beds committed to as part of the government’s $4.6 billion investment to build more than 30,000 net new beds by 2028 and 28,000 upgraded long-term care beds across the province are in the development pipeline.
“While the pandemic is not over, we are now in a place where we can use the lessons learned over the past two years and take actions to ensure our health system is even better, stronger and more resilient in the face of any future challenge,” said Christine Elliott, Deputy Premier and Minister of Health. “Our government is making investments to keep Ontario open, support growing demands and address longstanding challenges in patient care to ensure Ontarians continue to have access to safe, high-quality health care now and in the future.”
Additionally, the Pandemic and Emergency Preparedness Act, if passed, will strengthen emergency oversight and coordination by:
- Establishing clear accountability and governance frameworks for emergencies;
- Requiring the development of a provincial emergency management plan that is publicly available, reviewed and revised at least every five years, with an annual public report on progress of the plan; and
- Enhancing identification, assessment and planning requirements for potential emergency threats.
- The Community Commitment Program for Nurses was first launched in January 2021 to mitigate the impact of COVID-19 on pre-existing nursing shortages in Ontario by attracting registered nurses, registered practical nurses and nurse practitioners to work in high-need hospitals, long-term care homes and home and community care agencies.
- Through the enhanced Community Commitment Program for Nurses, up to 1,500 nurses will be placed with employers in 2022-23 and up to an additional 1,500 next year (2023-24). A total of 1,500 nurses, (up to 750 a year), will be dedicated to services in a rural or northern community.
- The government will consult with key stakeholders and partners this summer to identify target programs and communities where there are critical gaps in the workforce that can be addressed with the support of the Ontario Learn and Stay Grant. Health human resources will be the initial focus, but this will change each year.
- Since 2006, Ontario has provided additional support for clinical education through the clinical education grant. In 2021-22, the grant provided approximately $20.6 million to support the clinical education component of health science programs at publicly assisted colleges and universities.
"These are phenomenal investments into nursing education and the future of Ontario’s health-care workforce. These programs will strengthen the quality of care throughout Ontario, particularly in communities where there is a great demand for more health-care professionals."
- Linda Franklin
President and CEO of Colleges Ontario
"Ontario’s universities welcome these timely investments in strengthening Ontario’s health-care system and our highly skilled workforce. The supports announced today will help increase access to critical training and hands-on learning for students, while helping improve access to quality care and high demand talent in communities throughout our province."
- Steve Orsini
President and CEO, Council of Ontario Universities
"A strong and resilient health care system is essential for everyone, including businesses. This plan is a great step in bolstering pandemic preparedness and addresses several of our members' concerns, including labour shortages in the health care sector, access to PPE, and increased capacity in our health system."
- Rocco Rossi
President & CEO, Ontario Chamber of Commerce
"COVID-19 has shown us how crippling a public health crisis can be for our economy and our society. One of the key lessons we learned is the importance of pandemic planning and readiness. Ontario’s doctors are eager to work with government to implement these changes and ensure we are ready."
- Dr. Adam Kassam
President of the Ontario Medical Association
"Today’s announcement that the 3,100 temporary hospital beds created during the pandemic are to be made permanent represents the largest one-time increase in Ontario hospital capacity since the late-1990s. Ontario’s hospitals are very proud of their high levels of efficiency, but Ontario had the same number of hospital beds at the start of the pandemic as it did 20 years ago – with a population that has grown by 2.8 million people. The Ontario Hospital Association thanks the Government of Ontario for this investment as it provides hospitals across Ontario with additional funded beds to better meet the needs of patients in their communities. In the time ahead, we must build off the momentum of this investment with long-term health services capacity planning. Let’s also ensure that hospitals and the wider health care system are supported with the financial resources to meet the needs of Ontario’s rapidly growing and aging population and that, working together, we ensure Ontario has enough health care professionals and workers to provide care in hospitals and other settings. Hospitals will always focus on making the best use of taxpayer dollars but after a two-decade-long focus on efficiency and the punishing experience of the ongoing pandemic, it’s clear that Ontario’s hospitals need to grow again."
- Anthony Dale
President and CEO, Ontario Hospital Association
"The expansion of the Community Commitment Program for Nurses and the new Ontario Learn and Stay Grant will support the attraction and retention of skilled health care professionals in rural and northern Ontario and ensure better access to quality health care services in rural and remote communities."
- Mayor Robin Jones
Chair, Rural Ontario Municipal Association (ROMA)
"These proactive and creative measures, particularly with a focus on underserved communities, are needed and most welcomed. Our teams have been through a lot during the pandemic, and are providing care to an aging population. The availability and retention of qualified health human resources is definitely top of mind for health and long-term care organizations, as well as for frontline healthcare workers."
- Dominic Giroux
President and CEO, Health Sciences North
"RNAO welcomes the expansion of nursing programs to attract and retain nurses in remote and underserved communities. Nursing is central to the health of Ontarians and our health system. RNAO will continue to do all we can to ensure a robust nursing workforce with expertise and safe workloads so people across the province have timely access to quality nursing care, in all settings and sectors. "
- Dr. Doris Grinspun
"WeRPN supports the introduction of this bill as a start to laying the groundwork for preparing Ontario for future pandemics and other threats to our healthcare system. We look forward to working with this government on the next steps needed to ensure Ontario has access to an adequate supply of RPNs to meet future health system crises."
- Dianne Martin