Budget Overview

Ontario's 2015 budget focuses on long term plans to expand transit infrastructure, and measures which aim to balance the books by 2017 through spending freezes and selling off some public assets. A massive investment of $130 billion over ten years in public transit, highways and bridges is confirmed as a key plank of this government's agenda, partly financed by the sale of 60per cent of Hydro One.

 

Investment in infrastructure is one of the four main components outlined in the budget plan to create jobs and growth. The other three components are: support for skills training, creating a more dynamic business environment, and providing income security in retirement.

 

There are no new announcements for the health care sector, and for AOHC members this budget has no surprises. We know that members are highly concerned about fiscal pressures and the need for new funding to address staff retention and recruitment issues, and may have been hoping for good news in this budget. But the 2015 Ontario budget does not include any commitments that address these issues.

 

Community Sector and Primary Care

Funding for home and community care will continue to increase by about 5 per cent per year, which will mean a total investment of over $750 million over the next three years. This includes $75 million to support more home visits for those who need nursing services and $40 million over four years to enhance services for frail seniors. Funding will also be dedicated to supporting the 69 Health Links and to moving forward the recommendations of the Community Care Expert Group.

 

AOHC staff at the budget lock up asked MOHLTC staff if there was an allocation within this home and community care funding increase, or elsewhere in the primary care funding envelope, to ensure increases in base funding for CHCs, AHACs, NPLCs and CFHTs. The answer was no - there is no budgeted increase to base funding.

 

Along with our partners at AFHTO and NPAO we also asked if there is an allocation which will be dedicated to addressing staff retention and recruitment issues for interdisciplinary primary care organizations - the answer was again, no.

 

While we are very disappointed that there wasn't a formal commitment in the budget to address primary care retention and recruitment, we remain optimistic that there's still an opportunity to move on this issue within this fiscal year. Conversations with Minister Hoskins' political staff during the budget lockup confirmed the Minister is committed to making progress on this issue in the next few months. This is evidenced by the Minister's statement on April 23 in the legislature during question period when he stated he's looking at this issue of retention and recruitment and knows it affects NPs and other health care practitioners.

 

Other comments related to health care

The budget includes a section on primary care which states the government remains committed to ensuring timely access to primary health care providers. It notes the importance of interdisciplinary primary care teams, mentioning CHCs, AHACs, NPLCs and FHTs. The government plans to continue organizing primary health care providers and teams around the needs of the population - this confirms that MOHLTC is moving toward population based risk-adjusted primary care planning.

 

Nurse Practitioners will be interested to know that the government is removing barriers to direct referrals to specialists by NPs, enabling them to work to full scope of practice.

 

The next phase of the Mental Health and Addictions Strategy includes investing $138 million through LHINs over three years starting in 2014/15 for community organizations to improve mental health and addictions services. This may present opportunities for members to access funding in partnership with local agencies.

 

The MOHLTC budget for 2015/16 is $50.8 billion which represents about 38 per cent of all program spending by the government and a 1.2 per cent increase over 2014/15.

 

As in the past three years the budget freezes all hospital funding. Colleagues at RNAO are concerned that financial pressures at hospitals are leading them to lay off nurses and replace them with other professionals.

 

Poverty Reduction

The budget included few new measures that address the social determinants of health.

 

Of interest to AOHC members: the budget re-announced the new Local Poverty Reduction Fund that will provide $50 million over six years to support local solutions to poverty. The call for proposals will go out in May. AOHC members would be eligible to apply if they are involved in partnership projects which reduce poverty.

Other poverty reduction measures include indexation of the Ontario Child Benefit in 2015 so it keeps pace with inflation and a minimum wage increase to $11.25/hour in October 2015. Social assistance rates will rise by only 1 per cent, with an additional top up for single people on Ontario Works amounting to a $25 increase/month. In 2012, the Social Assistance Review Commission recommended an increase of $100/month for single people. With this announcement, the Government has moved to a total of $75 of the $100 recommended increase.

Next Steps:

AOHC will continue our internal and external advocacy work with partners to call for funding increases to address staff retention and recruitment challenges, as well as operating pressures. At the local level we need to ensure that MPPs remain aware of these issues and the urgent need to resolve them. A strategy will be discussed at the upcoming ED Network meeting and we look forward to member input.