Introduction
COVID‑19 is a once-in-a-generation challenge. Through it all, the people of Ontario have come together and done what is necessary to protect communities, hospitals and Ontario’s most vulnerable citizens. Now, the light is at the end of the tunnel and hope is on the horizon.
From the very beginning of the pandemic, the government took extraordinary measures to slow the spread of the COVID‑19 virus and made every resource available to protect people and jobs. On December 14, 2020, Ontario administered its first vaccine to a personal support worker named Anita Quidangen. Like so many others on the front lines, Anita Quidangen is a true Ontario hero. Throughout the worst of the pandemic, Anita took on extra shifts at her long-term care home, working all hours to care for her frail and elderly residents. She did not hesitate to lead by example by receiving her first dose of the vaccine, and millions of people across the province have followed.
The government has worked in unprecedented cooperation with municipal leaders, public health officials, frontline health care workers and the federal government to achieve one of the highest rates of vaccine protection in the world. As of October 18, 2021, over 10 million or 83 per cent of eligible individuals are fully vaccinated with both doses of their COVID‑19 vaccine. Vaccinations remain the most valuable tool to slowing the spread of COVID‑19 and reducing the risk of admissions to hospitals and intensive care units (ICUs). The job is not done. But hope is on the horizon.
Protecting People’s Health
The Team Ontario Vaccine Campaign
The key to defeating COVID‑19 is for everyone who is eligible for a vaccine to get vaccinated as soon as possible. This is why, through the 2021 Budget, the government provided investments of more than $1 billion to support the rollout of Ontario’s COVID‑19 Vaccination Plan.
During the peak of the COVID‑19 vaccine rollout, eligible individuals were able to book an appointment at one of the 3,150 locations across the province, including more than 2,500 pharmacies and more than 650 mass immunization clinics, hospitals, primary care settings as well as pop-up and mobile clinics.
The efforts of the people of Ontario have paid off. Ontario has one of the highest vaccination rates in the world with more than 22 million doses administered. As of October 18, 2021, more than 87 per cent of eligible people aged 12 and above (over 11 million individuals) have received one dose of the vaccine and more than 83 per cent (over 10 million individuals) have received both doses and are fully vaccinated. But the job is not done.
This is why the Province is continuing its last mile strategy to reach eligible individuals who have yet to receive first or second doses. This includes mobile and drive-through clinics, community-based pop-ups, dedicated clinic days for people with disabilities and their families, townhall meetings in multiple languages and translation services. All of these measures reach communities with new and accessible options for people to receive their COVID‑19 vaccine.
Ontario’s COVID‑19 Testing Strategy
Since the beginning of the COVID‑19 pandemic, Ontario has committed $3.7 billion to support COVID‑19 testing and contact tracing, including a $2.3 billion investment made through the 2021 Budget. Ontario will use every tool and resource available to continue testing, especially in priority areas.
Expanding the Use of Rapid Testing
To keep workers and customers safe, and help businesses stay open, the government continues to provide rapid antigen tests as a screening tool to essential industries and small and medium-sized businesses through the Provincial Antigen Screening Program. To date, more than 28.1 million tests have been distributed for use in over 30,000 sites.
Maintaining the COVID‑19 Collection and Testing Network
Accessible COVID‑19 testing is a critical component of the government’s pandemic response and Ontario continues to lead Canada in the number of tests administered. The ongoing testing effort enables the people of Ontario to access a COVID‑19 test at one of more than 420 assessment centres, participating community laboratories or participating pharmacies across the province. The provincial testing network has the capacity to process more than 100,000 tests per day. The network’s robust capacity ensures that 97 per cent of individuals who have been tested received their results within two days.
Supporting Hospitals Through the Pandemic
Hospital and ICU capacity is critical to protecting the health of the people of Ontario and for avoiding future lockdowns. This is why the Province has created more than 3,100 new and additional beds to ensure that the people of Ontario have access to the health care services they need.
The government is investing an additional $1.8 billion in 2021–22 in hospitals, bringing total new investment to hospitals to $5.1 billion since the start of the pandemic. This additional funding in 2021–22 includes:
- Ongoing supports for critical care capacity in the health care system in response to a potential rise in COVID‑19-related hospitalizations and ICU admissions;
- $778 million to help hospitals keep pace with patient needs and to increase access to high-quality care;
- $760 million to support hospitals with more than 3,100 beds, which is the equivalent of six large community hospitals; and
- $300 million to reduce surgical and diagnostic imaging backlogs.
As the COVID‑19 pandemic evolves, Ontario continues to ensure its health care system is prepared to respond to any scenario to protect the health and well-being of the people of Ontario.
Reducing the Surgical Backlog and Supporting Surgical Recovery in Hospitals
As announced in the 2021 Budget, Ontario is investing $300 million in 2021–22 to support surgical recovery in hospitals from delayed or deferred surgeries and procedures due to the COVID‑19 pandemic. This brings the total investment for surgical recovery in hospitals to more than $580 million since the start of the pandemic. This additional investment in 2021–22 will reduce wait times and improve access to care by supporting up to 67,000 surgeries and procedures, as well as up to 135,000 more diagnostic imaging hours.
As part of this investment, Ontario launched a Surgical Innovation Fund in 2021–22 to support 104 projects that will provide Ontario hospitals with the flexibility they need to perform more surgeries and procedures in their communities. Funding expands hospital capacity to address the local and unique barriers for surgical outputs across the province. Projects include:
- Greater Toronto Area (GTA): Developing a new training program for in-hospital training of registered nurses and registered practical nurses attaining their operating room certifications;
- Western Region: Leveraging an existing surgical procedure training program to train registered nurses and registered practical nurses across multiple hospitals in the area;
- Eastern Region: Purchasing operating room equipment, including an ultrasound unit and a surgical table to support additional procedures; and
- Northern Region: Coordinating purchases for surgical equipment, such as ultrasound units, to support greater flexibility and optimization of regional surgical sites across the North.
Building Up the Health Sector Workforce
The contribution made by the province’s nurses and personal support workers has been critical in the fight against COVID‑19. Nurses and personal support workers have given their all during the pandemic, and Ontario owes them gratitude and support.
The pandemic has taken its toll and highlighted the need for more staff on the health care front lines.
This is why Ontario is investing $342 million to strengthen the nursing workforce by adding over 5,000 new and upskilled registered nurses and registered practical nurses as well as 8,000 personal support workers to critical areas of the health care system through a variety of programs.
Supporting Specialization for 500 Registered Nurses
Specialized acute care nurses are a critical resource for COVID‑19 response and health care system recovery. The Province is providing 500 registered nurses with specialized acute care training to support critical care areas, including intensive care units, surgical services and emergency departments.
This will help provide additional ICU capacity to support a response to the fourth wave of COVID‑19 and a ramp up of surgeries to address backlogs.
Increasing Capacity through the Community Commitment Program for Nurses
Through the Community Commitment Program for Nurses, Ontario is adding 420 registered nurses to work in hospitals, long-term care homes, and home and community care agencies in the greatest need across the province.
Creating Opportunities to Upskill through the WeRPN Bridging Program
Ontario is adding 900 registered nurses and 700 registered practical nurses through the WeRPN Bridging Program. This program will add more nursing capacity to the home and community care sector, by upskilling personal support workers to registered practical nurses, and registered practical nurses to registered nurses.
Expanding Nursing Enrolment
Ontario is expanding nursing education in universities and colleges by increasing enrolment by 1,000 registered nurses and 1,500 registered practical nurses. These nurses are to graduate by 2026, which will help support and sustain the health care system in the future.
Recruiting and Training Additional Personal Support Workers
The Province is also adding and recruiting additional personal support workers to the health care sector. Ontario is providing funding to train 8,000 personal support workers by 2022–23 in response to the personal support workforce shortage. The government also launched the personal support worker Return of Service program in September 2020, by providing $10 million in one-time funding to recruit an additional 2,000 personal support workers to long-term care homes, and home and community care agencies. Ontario is providing a $5,000 incentive to recent personal support worker graduates in exchange for a six-month commitment to an eligible long-term care, or home and community care employer.
These investments build on existing initiatives to ensure that people in Ontario have access to high-quality health care services.
Expanding Education Support for Nursing and Other Health Care Providers
The Nursing Graduate Guarantee Program provides over 600 new nursing graduates in Ontario with temporary full-time employment to support the transition from practice to full-time employment. By the end of 2021–22, an additional 400 new graduates will be working in acute care settings to support Ontario’s surgical recovery plan and staffing needs in the long-term care sector.
The Enhanced Extern Program offers students with training opportunities to work as unregulated health care providers in hospitals as they continue their education. In 2021–22, Ontario is adding over 7,000 spots in the Enhanced Extern Program to allow students in nursing, respiratory therapy, medicine, paramedicine, occupational therapy and physiotherapy to participate. The program is now also open to allow internationally educated nurses to participate.
These additional nurses, personal support workers and other health care providers create much needed capacity in Ontario’s health care system and are part of the government’s commitment to providing the best possible care to the people of Ontario.
Hiring More Nurse Practitioners for Long-Term Care Homes
As part of the Province’s Long-Term Care Staffing Plan, Ontario is improving quality of care in the long-term care sector. As announced in the 2021 Budget, Ontario is investing $4.9 billion over four years to increase the average direct daily care to four hours per resident in long-term care and hiring more than 27,000 staff, including personal support workers and nurses, to ensure loved ones receive the best quality care in Canada.
The Province is acting on the recommendations of the Long-Term Care COVID‑19 Commission by increasing the quality of resident care by expanding the workforce. Ontario is investing an additional $57.6 million, beginning in 2022–23, to hire 225 nurse practitioners in the long-term care sector, including specialized incentives to help retain nurse practitioners. Nurse practitioners are highly trained and experienced health professionals, who combine advanced nursing knowledge and a deep understanding of health management, health promotion, and disease treatment. Ontario’s new investment will increase the number of nurse practitioners and help to ensure loved ones are supported by safe, high-quality care.
Increasing the number of nurse practitioners is a key part of the government’s Long-Term Care Staffing Plan commitment towards building a qualified workforce and improving the quality of care and leadership within the sector.
Expanding Home Care for COVID‑19 Response and Recovery
Home and community care keeps people healthy and at home, where they want to be, and plays an important role in the lives of approximately 700,000 families annually. It prevents unnecessary hospital and long-term care admissions and shortens hospital stays — protecting hospitals and long-term care homes for those who need them the most.
This is why the government is investing an additional $548.5 million over three years in the home and community care sector. The investment will expand home care services, support additional staff including personal support workers and connect patients to the services they need.
The funding would support up to an estimated 28,000 post-acute surgical patients and up to an estimated 21,000 patients with complex health conditions every year by providing:
- 739,000 nursing visits;
- 157,000 nursing shift hours;
- 117,000 therapy visits including physiotherapy, occupational therapy and speech language pathology;
- 2,118,000 hours of personal support services; and
- 236,000 other types of home care visits.
These investments will allow patients to return home to recover after their surgeries or receive home care when they have complex health conditions. This investment also helps to ensure that hospital beds are available for those who need them the most.
Protecting Seniors
Fixing Long-Term Care
For years, previous governments have neglected long-term care. The pandemic highlighted vulnerabilities for residents, their families, caregivers and staff. The Province is fixing long-term care so that every resident experiences the best possible quality of life.
The Province’s plan to fix long-term care includes three priorities:
- Improving staffing and care: With training opportunities for thousands of new personal support workers and funding to hire nurses, nurse practitioners and personal support workers.
- Protecting residents through better accountability, enforcement and transparency: With investments of $72.3 million over three years to increase enforcement capacity and double the number of inspectors by 2022–23.
- Building modern, safe, comfortable homes for seniors: With significant progress made towards the commitment to build 30,000 net new long-term care beds by 2028 as well as upgrades to about 28,000 existing beds to modern design standards through an additional planned investment of $3.7 billion, beginning in 2024–25.
Improving Quality and Accountability in Long-Term Care Homes
Ontario is taking necessary and timely steps to protect residents in long-term care homes across the province. These include investments and continued improvements in staffing and accountability to help ensure every resident experiences the best possible quality of life, supported by safe, high-quality care. These measures address some of the recommendations of the independent Long-Term Care COVID‑19 Commission by ensuring greater accountability, enhanced enforcement and greater public transparency.
Improving Information Sharing to Transition between Long-Term Care and Hospitals
Historically, health data and information between the long-term care and hospital sectors have been siloed, leading to costly re-admission procedures when patients are transferred between the two.
The government is investing $22 million over three years to implement an Ontario-made technology that will integrate the clinical information between hospitals and the long-term care sector to streamline re-admissions, share information with families, and ensure vulnerable seniors get the highest quality care possible. This initiative responds to the recommendations made in Ontario’s Long-Term Care COVID‑19 Commission Report to ensure a coordinated continuum of care that includes all long-term care homes.
Improving Access to Dental Services
Low-income seniors deserve access to quality dental care. The Ontario Seniors Dental Care Program was announced in the 2019 Budget, with approximately $90 million in annual funding to provide high-quality dental care to seniors.
Eligible seniors are aged 65 and older with an annual net income of $22,200 or less or a couple with a combined annual net income of $37,100 or less, and who do not have existing dental benefits. These seniors can access dental services provided by public health units and participating community health centres and Aboriginal Health Access Centres.
In addition to pre-existing barriers such as geographical challenges, the COVID‑19 pandemic has reduced timely access to dental services for seniors, causing longer wait times for non-emergency procedures in some areas. As a next step to expanding this service, the government is investing an additional $17 million over two years to increase access to dental services for eligible seniors across Ontario. This investment will serve up to an additional 35,000 eligible seniors. Funding would support new and renovated dental clinics and the procurement of additional mobile dental buses for seniors enrolled in the Ontario Seniors Dental Care Program.
Protecting People
Building on Mental Health and Addictions Investments
Mental health is health. People dealing with mental health challenges deserve access to the treatment and care they need. COVID‑19 has intensified the need for mental health supports and services, and is another reason why the government is making a historic investment of $3.8 billion over 10 years to ensure people can access the care they need.
One example highlighted in the pandemic is that too many communities and families across Ontario have experienced the pain of opioid addiction firsthand. This is why the government has invested $32.7 million towards targeted addictions services and supports, including treatment for opioid addictions. This funding will help to enhance access to addictions services and address urgent gaps in needed supports across the continuum of care.
Another example is the impact the COVID‑19 pandemic has had on school-age children. This is why the Province is providing over $80 million to support student mental health for the 2021–22 school year. This funding will support hiring more than 1,000 mental health workers.
Supporting Health Care Workers’ Mental Health
The COVID‑19 pandemic has had a significant impact on frontline health care workers’ mental health. In fact, the majority of health care workers reported that their mental health has worsened since the start of the COVID‑19 pandemic. They need support now more than ever.
This is why the government is investing $12.4 million over two years starting in 2021–22 to continue rapid access to existing and expanded mental health and addictions supports for health and long-term care workers across the province. These treatment options include one-to-one psychotherapy and workshops provided by partners including the Canadian Mental Health Association — Ontario, the Ontario Psychological Association, and five hospitals. This funding will also support needs assessments, online peer support, workplace mental health training and intervention services at select hospitals to help frontline workers whose mental health has been impacted by workplace and occupational stress.
Through these measures, the government is taking action to address the recommendations included in Ontario’s Long-Term Care COVID‑19 Commission Report to ensure long-term care staff receive the mental health supports they need.
These investments will support the workforce of the health and long-term care sector to continue providing high-quality care and service to patients and long-term care residents.
Supporting Postsecondary Students’ Mental Health
The COVID‑19 pandemic has increased the pressures on postsecondary mental health services. Building on the government’s record investments to address mental health and addictions challenges from the 2021 Budget, the government is investing an additional $8.7 million, for a total of $27.9 million in 2021–22 to increase mental health supports at Ontario postsecondary institutions. This funding will address the increased need across all Ontario postsecondary institutions, and also includes new funding for Indigenous Institutes, Université de l’Ontario français and the Northern Ontario School of Medicine.
Supporting the Mental Health and Well-Being of Children and Youth with Eating Disorders
During the COVID‑19 pandemic, hospitals across Ontario have seen a surge in severe eating disorders among children and youth due to increased isolation, school disruption, social media exposure and stress-fueled unhealthy eating and exercise habits.
This is why the government is investing $8.1 million in 2021–22 to address increased demand for services to support specialized care for children and youth with eating disorders. In addition, as part of the Province’s Roadmap to Wellness: A Plan to Build Ontario’s Mental Health and Addictions System, the 2021 Budget committed $175 million in 2021–22 to expand and enhance mental health and addictions services. This includes $11 million for eating disorder services and supports that span the continuum of care, from intensive services through to community, outpatient and early intervention services.
Providing Additional Support to Retirement Homes
Staff in Ontario’s licensed retirement homes have worked tirelessly to stop the spread of COVID‑19 and keep 65,000 residents who live in these homes safe.
To ensure these residents have a safe and welcoming place to live, Ontario has invested more than $153 million since the beginning of the COVID‑19 pandemic. This includes funding for staffing retention and recruitment, Infection Prevention and Control, and other COVID‑19 emergency measures.
Building on this investment, Ontario is investing an additional $11 million in 2021–22 to help residents stay safe through the pandemic. This includes $8 million to ensure homes have the staffing needed to support residents during any outbreaks, and $3 million for on-site and mobile support teams to help strengthen retirement homes’ capacity to contain any COVID‑19 outbreaks.
Keeping Schools Safe
Ontario is investing more than $1.6 billion in resources for this school year to protect students and staff from COVID‑19.
These investments include providing up to $450 million in personal protective equipment and critical supplies and equipment, $86 million towards school-focused nurses in public health units and testing, and $66 million for enhanced cleaning protocols and other health and safety measures in student transportation. In addition, the Province is allocating $59 million towards continued special education, mental health, well-being and equity supports, as well as $35 million towards additional technology funding, including devices for students and connectivity supports for remote learning technology. Other resources being made available total up to $941 million, including funding for temporary staffing, school operations, learning recovery and renewal, and increased access to school board reserves.
Ontario has also allocated over $600 million to improve ventilation and filtration in schools, with $450 million funded through the COVID‑19 Resilience Infrastructure stream of the Investing in Canada Infrastructure Program. These investments have resulted in the installation of over 70,000 standalone HEPA filter units and other ventilation devices. Other improved measures in Ontario schools include running ventilation systems for longer periods and using higher grade filters.
The Province is continuing to invest $1.4 billion in the 2021–22 school year to maintain and renew school facilities, including heating, ventilation and air-conditioning (HVAC) systems and windows. With these continued investments in school infrastructure, the government is keeping students and staff safe in classrooms across Ontario.
Protecting the Most Vulnerable Populations from COVID‑19
As the province continues to respond to the COVID‑19 pandemic, the government is taking further action to protect Ontario’s most vulnerable populations and ensure the safety of those in congregate care settings including homes for adults with developmental disabilities, shelters, children’s residential settings, youth justice facilities and Indigenous residential programs.
Building on previous investments of $131 million, the Ontario government is investing an additional $8.9 million in 2021–22 for COVID‑19 supports in congregate care settings to ensure the province’s most vulnerable and those who care for them are safe. This funding will help to provide supports such as personal protective equipment, Infection Prevention and Control measures, and HEPA filters to improve ventilation. These supports will help reduce transmission of the virus and allow residents and staff to be better protected against COVID‑19.
Supporting People through the Social Services Relief Fund
Ontario’s Social Services Relief Fund helps protect the health and safety of the province’s most vulnerable people during the COVID‑19 pandemic. Since 2020–21, the government has provided over $1 billion in support for municipal service managers and Indigenous program partners to immediately respond to rising COVID‑19 cases in shelter settings, and to ensure the continuity of critical supports for vulnerable households, including food banks, rent assistance programs, protection of residents and staff in homeless shelters and the creation of longer term housing solutions. This is one of the largest community housing investments in Ontario’s history.
Protecting People from Systemic Racism and Hate
To help address systemic racism and hate, the Province is providing nearly $10 million over two years through new and enhanced initiatives. This includes doubling investments in the Anti-Racism Anti-Hate Grant Program and introducing a new Racialized and Indigenous Support for Entrepreneurs (RAISE) grant that will provide $5 million in support for women entrepreneurs and Indigenous, Black and other racialized people. Together, this funding will provide Indigenous, Black and other racialized people in businesses, workplaces and communities with support to overcome barriers and participate in the economy.
The government has zero tolerance for hate and discrimination of any kind and is taking concrete steps to address root causes of racism and harassment in communities and workplaces across the province, including the Ontario Public Service.
With more than 60,000 staff, the Ontario Public Service is one of the province’s largest employers. As society is coming to terms with historical injustices and systemic racism, it is important to lead by example. This is why the government is investing $8.8 million over three years to lead and champion work to create an equitable, anti-racist and accessible workplace. Key to this will be creating a dedicated team with a Black and Indigenous focus.
Investigating Indian Residential School Burial Sites
Across Canada, more than 150,000 Indigenous children were forcibly removed from their families and communities and sent to Indian Residential Schools between 1870 and 1996. There were 18 Residential Schools located in Ontario. It is important that the people of Ontario continue to deepen their understanding of the legacy of Residential Schools and support meaningful reconciliation.
Ontario is working in collaboration with Indigenous leaders and providing an additional $10 million, bringing the total investment to $20 million over three years, beginning in 2021–22, to support the identification, investigation, protection and commemoration of Residential School burial sites across the province. In addition, the government will waive fees over three years, beginning in 2021–22, to help families and communities obtain death registration searches and certificates for Indigenous children who attended Residential Schools, and will extend the fee waiver for Residential School Survivors and their families to reclaim a traditional name.
Ontario will also ensure that there are culturally appropriate, trauma-informed mental health supports available to Residential School Survivors, their families and Indigenous communities.
Protecting the Environment for Future Generations
Ontario is acting to protect the environment and fight climate change for people today and in the future. A broad range of actions are helping to ensure the province has healthy communities while supporting economic growth and protecting Ontario’s air, land and water.
This includes helping to finance public transit initiatives, extreme weather resistant infrastructure and energy efficiency and conservation projects through Ontario’s Green Bonds. In addition, the government is growing the Greenbelt to help build resilience to and mitigate climate change, while protecting Ontario’s environmental, groundwater and agricultural resources. The government is also funding a portion of the cost of non-hydro renewable electricity contracts, with 94 per cent of Ontario’s electricity supply produced from zero carbon emitting sources in 2019.
Chart Descriptions
Chart 1.1: Building Up the Health Sector Workforce
The chart illustrates the number of nurse practitioners, registered nurses, registered practical nurses and personal support workers that will be added to the health care system.
- 225 – Nurse practitioners in long-term care
- 5,000 – New and upskilled registered nurses and registered practical nurses
- 8,000 – Additional personal support workers
- A total of over 13,000 new and upskilled health sector workers added to the system.
Sources: Ontario Ministry of Health and Ontario Ministry of Long-Term Care.
Chart 1.2: A Fair Federal Share versus the Status Quo
This chart illustrates the gap between a fair federal share (35 per cent) and status quo in Canada Health Transfers (CHT). In 2021–22, this gap represented $28 billion nationally. This gap occurs when CHT as a share of provincial–territorial health spending is 22 per cent rather than 35 per cent in 2021–22. By 2039–40, this gap is estimated to grow to roughly $80 billion nationally, as the status quo CHT is projected to decline further to less than 18 per cent of provincial–territorial health spending.
Sources: Estimate of provincial–territorial (PT) health costs and status quo Canada Health Transfer (CHT) from PT Finance Ministers report to Council of the Federation (COF) titled Increasing the Canada Health Transfer will Help Make Provinces and Territories More Financially Sustainable Over The Long Term (March 4, 2021), and Ontario Ministry of Finance calculations.