Presentation to Standing Committee on Social Policy on Bill 74 The People's Health Care Act
By Deborah Simon, CEO
I want to thank you for the opportunity to appear before this committee and to provide thep erspective of the not-for-profit home and community support services health sector on Bill 74, The People's Health Care Act.
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My name is Deborah Simon and I am the CEO of the Ontario Community Support Association. OCSA represents nearly 240 not-for-profit agencies across the province who provide compassionate, high quality home care, community support services and independent living services to over one million Ontarians.
There are many organizations in your ridings that provide invaluable services to seniors and people with physical disabilities such as in-home nursing and personal support, Meals on Wheels, Alzheimer day programs, transportation to medical appointments or supportive housing.
Our sector is a key part in ending hallway health care as we offer over 25 health and wellness services that keep people healthy, living in their communities, and gets them discharged faster from hospitals. This includes the delivery of over 3 million meals, providing over 2 million rides and over 225,000 clients served in Adult day programs.
We know that the current model was not working for providers or clients. We share the conclusions in the first report by the Council that home and community care services haven’t grown fast enough, that caregivers are facing bigger and bigger challenges and that there is a clear need for a long-term capacity plan for the health system.
Our association supports the government’s goal of creating seamless transitions between hospitals and home and community care – and across the entire health system. We recognize that the government’s new vision of local Ontario Health Teams who support their patients throughout their journeys through the continuum of care, offers plenty of opportunity to strengthen collaboration between providers.
The proposed model definitely has the potential to enable stronger and more direct relationships between service providers that can translate into smoother care for clients. However we do have concerns regarding the inclusion of community support services and attendant care in the core basket of services, the role of not-for-profit delivery, the role of community governance and the need to address front-line worker shortages. We would like to share 5 recommendations with you.
The first is that Ontario Health Teams must incorporate a strong model of community governance and not-for-profit delivery of services. Shared community governance will ensure Ontario Health Teams understand the health needs of their communities. This knowledge is necessary to ensure that services are tailored to what a specific community actually needs as opposed to a one-size-fits-all solution that wastes taxpayer dollars. In addition, a strong shared community governance will ensure a strong focus on upstream services – including health promotion, social determinants of health and preventative health.
The important contributions not-for-profit home and community care bring the health system cannot be overstated. Its return on investment can be measured in many ways. For example, volunteers contribute over 3 million hours of service each year, providing a value of over $78 million for free to the health care system. We must ensure these important contributions are not lost in this system transformation.
Our second recommendation is that a list of core services Ontario Health Teams are expected to deliver across the province needs to be identified. Core services must include community support services and independent living, along with home care. Keeping people healthy at home and out of hospitals isn’t achieved through home care services alone. Last year, community support services and attendant care services enabled over a million individuals to thrive in their community.
Our third recommendation relates to health human resources. For any transformation to be successful it must include a plan to support and address the continuing shortage of frontline workers across the health system.
The current shortage of personal support workers (PSW) is having ripple effects across the entire health system. People are staying in hospitals longer or delaying the start of home care services due to the lack of qualified human resources. The government needs to implement a health human resource strategy to attract and retain PSWs, nurses and other care providers in the home and community care sector. Any strategy must include a plan to close the compensation gap for front-line workers between the home and community care sector and institutionalized care, such as hospitals and long-term care.
The government should also amend the Public Sector Labour Relations Transition Act to ensure it does not become a barrier to innovative service integrations. One way to do this is to return it to its pre-2006 application, ensuring it only applies to full organizational integrations.
Our fourth recommendation is that existing local collaborations should be leveraged to build Ontario Health Teams. Good work to build partnerships across sectors has already taken place at the local level in many parts of the province. Home and community care organizations are working directly with hospitals to encompass new models of care to streamline handovers and wrap services around patients. The sector has shown itself to be supportive of integration for the benefit of patient and client care, we caution against the strategy of reducing the number of providers arbitrarily.
Our last recommendation regards public accountability. OCSA recommends that the legislation be amended to ensure that the meetings of the board of governors of Ontario Health must be open to the public. In the administration and spending of public dollars there must be strong and open public accountability.
In closing, we are convinced we can utilize the strength of this sector to help government eliminate hallway health care. We call on the government to strengthen the relationship with our sector and ensure CSS and home care play a vital role in solving hallway medicine and build a better system for people that is based on a health and wellness approach.
With the appropriate supports, our sectors alleviate hallway medicine by keeping people healthy and out of hospitals in the first place and by shortening their stay by ensuring they have appropriate supports when discharged.
At this point I would welcome any questions to further explain the rationale behind our recommendations. Thank you.
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Ontario relies on community health workers every day to treat illness, support mental health, provide care at home, help people live independently, and keep families well, and in many cases, they provide this care 24/7. They care for people of all ages and backgrounds, often with highly complex needs, and they are essential to achieving a sustainable and high performing healthcare system. Closing the wage gap is not simply about fairness; it is about protecting access to care, reducing system pressure, and ensuring Ontario ’ s healthcare investments deliver maximum impact. The ten provincial community health associations are committed to working collaboratively with the government to build a stable, sustainable community health workforce, which supports a stable and sustainable healthcare system, a goal we all share.
Ottawa, Ontario – [January 14, 2026] — The Ontario Community Support Association (OCSA) is calling on the provincial government to prioritize sustained investment in Home Care and Community Support Services in the 2026 Ontario Budget. Without action, seniors will lose essential services and hospital emergency rooms will face even greater pressures. Appearing today before the Standing Committee on Finance and Economic Affairs, OCSA CEO Lori Holloway highlighted that community-based care is a cornerstone of Ontario’s health system—keeping people healthy at home, enabling them to age with dignity and preventing unnecessary hospital and long-term care admissions. “Without new investment in Community Support Services, seniors will lose meals and personal care services, caregivers will lose day programs for their loved ones, and hospital beds will fill up as more people are stuck waiting for care that should be delivered at home,” said Holloway. OCSA represents more than 200 not-for-profit home care and community care providers across Ontario, delivering services such as high-needs home care, Meals on Wheels, assisted living, transportation to medical appointments, adult day programs for people living with dementia, and respite supports for caregivers. While the province has made recent investments in home care expansion, OCSA emphasized that these gains are fragile if the community supports that enable people to remain safely at home are allowed to erode. Community Support Services account for less than two per cent of Ontario’s total health budget, yet received no funding increase in Budget 2025 . As a result, many providers are already planning service reductions or facing difficult decisions, including reducing meal delivery routes, limiting day programs and respite services, scaling back transportation programs, and closing adult day programs for part of the week. In turn, service reductions will place additional strain on working caregivers, 69% of whom are experiencing burnout and nearly half of whom are considering leaving the workforce to care for their loved ones. “These are not abstract risks,” Holloway said. “They are real service reductions being planned right now in communities across the province.” When community supports are unavailable, patients end up in hospital and/or remain in hospital beds longer—not because they need acute care, but because the services required for safe discharge do not exist. A hospital Alternate Level of Care (ALC) bed costs approximately $730 per day , compared to $103 per day for home and community care. Ontario’s aging demographics make the issue increasingly urgent. Nearly one in five Ontarians is now over the age of 65 , and the senior population is expected to grow significantly over the next decade. OCSA is urging the government to immediately: Sustain home care through a renewed multi-year investment of $442 million investment annually, and predictable funding; Invest $150 million annually to stabilize Community Support Services and prevent service cuts; and Address workforce shortages by closing the wage gap facing community health workers, who earn 23 to 46 per cent less than their hospital counterparts. “Ontario cannot build its way out of an aging population with hospitals and long-term care beds alone,” Holloway said. “Care delivered at home and in the community is where people want to be, and it is the most cost-effective and compassionate approach for the health system.” About the Ontario Community Support Association The Ontario Community Support Association represents more than 200 not-for-profit organizations providing home care and community support services across the province. OCSA members deliver essential services that help people live independently, age at home, and reduce pressure on hospitals and long-term care. For more information visit www.ocsa.on.ca or @OCSATweets For media inquiries please contact: Karla Sealy (she/her) Manager of Communications 416-256-3010/1-800-267-6272, ext 242 karla.sealy@ocsa.on.ca
Toronto, ON – The Ontario Community Support Association (OCSA) welcomes the Government of Ontario’s announcement in the 2025 Fall Economic Statement of a $1.1 billion investment to protect and expand home care services. This significant commitment demonstrates government’s recognition of the vital role that home and community care plays in the province’s healthcare system. “The Ontario Community Support Association welcomes this significant investment in home care. Previous funding commitments have helped stabilize the sector, supporting a measurable reduction in staff turnover and fewer missed care visits. These improvements mean more Ontarians are receiving the care they need, when and where they need it. We encourage the government to continue to invest in programs like Hospital to Home and organizations that bring together home care, community support, and independent living services, which are essential to building a system that keeps people healthy, connected, and cared for at home.” — Lori Holloway, Chief Executive Officer, Ontario Community Support Association As the province looks ahead, OCSA stands ready to collaborate with the Ministry of Health and system partners to advance innovative models that integrate home care, community support, and independent living services. Together, these efforts will help build a sustainable, connected system that keeps people healthy and cared for at home. About the Ontario Community Support Association (OCSA) OCSA represents the full spectrum of organizations that deliver home and community support services across Ontario, helping people live independently and with dignity where they want to be—at home. Through advocacy, research, and member collaboration, OCSA works to strengthen the sector and build a more connected, person-centered health system. Media Contact: Karla Sealy Ontario Community Support Association Email: karla.sealy@ocsa.on.ca Website: www.ocsa.on.ca
