University of Toronto logo

Originally published at the University of Toronto


Blair Roblin, PhD
University of Toronto (Institute of Health Policy, Management and Evaluation)
Raisa Deber, PhD
University of Toronto (Institute of Health Policy, Management and Evaluation)
Kerry Kuluski, PhD
Lunenfeld-Tanenbaum Research Institute, Sinai Health System
Michelle Silver, PhD
University of Toronto (Department of Sociology/Interdisciplinary Centre for Health and Society)

Keywords: retirement homes, regulation, governance, Ontario, seniors, residential care, health policy reform

Abstract:
In 2010, the Ontario government introduced Bill 21, the Retirement Homes Act, 2010 (the Act), which required the licensing of retirement homes (RHs), residents’ rights, care and safety standards, inspections, compliance and a newly formed Retirement Homes Regulatory Authority (Authority). The Act and its regulations drew heavily from the content of legislation pertaining to long-term care homes (LTC homes), recognizing that many RHs provided high acuity care. However, the Authority was constituted with a multi-sectoral board, which was arm’s length from government. The stated goal of the Act was to ensure the dignity, respect, safety and privacy of residents, though the government also recognized the importance of preserving autonomy and choice for the predominantly private, for-profit operators and their residents. A consultation process spurred considerable debate over the content of the proposed legislation as well as the authority that would oversee it. The unwillingness of the government to fund care services in RHs (unlike LTC homes) influenced its policy decision to pass the Act in a form that gave greater autonomy to the industry to oversee its regulation through a multi-sectoral Authority, rather than one directed by government. A formal five-year review showed the reform to be well received by the public and key stakeholders, and an Effectiveness Survey for Stakeholders conducted by a third party indicated positive results, pointing to the success of both regulatory content and oversight.

Resumé:
Le gouvernement de l’Ontario a introduit en 2010 le Projet de loi 21, Loi de 2010 sur les
Maisons de Retraite (la Loi), qui imposait l’accréditation des Maisons de Retraite (MR), des

droits des résidents, des normes de soins et de sécurité, des inspections, une norme de con-
formité et la création de l’Office de réglementation des maisons de retraite (l’Office). La loi

et ses réglements se sont fortement inspirés du contenu de la législation des foyers de soins
de longue durée, de nombreuses MR fournissant des soins intensifs. Cependant, l’Office est
doté d’un conseil d’administration multi-sectoriel, autonome par rapport au gouvernement.
L’objectif déclaré de la Loi était de garantir la dignité, le respect, la sécurité et l’intimité,
même si le gouvernement affirmait aussi l’importance de maintenir l’autonomie et le choix
des opérateurs, principalement privés et à but lucratif, ainsi que de leurs résidents. Un
processus de consultation a lancé un débat nourri sur le contenu de la législation proposée
ainsi que sur l’office chargé de la gouverner. La réticence du gouvernement à financer les
soins dans les MR (comme il le fait pour les foyers de soins de longue durée) a motivé la
décision politique d’écrire une Loi donnant une plus grande autonomie à l’industrie pour
mettre en oeuvre sa propre régulation à travers un Office multi-sectoriel, et non piloté par le
gouvernement. Une évaluation formelle à cinq ans a montré que la réforme avait été bien
reçue par le public et les principales parties prenantes, et une enquête d’efficacité auprès des
parties prenantes, conduite par un tiers de confiance, suggère des résultats positifs, tant sur
le fond que sur la gouvernance.

 


Our Aging World is a place for everyone who is interested in matters related to aging– the biggest social phenomenon to hit us in the 21st century. If you want to be part of our journey, sign up to our newsletter.

   

 

  • You may also like

University of Toronto logo
Ontario’s Retirement Homes and Long-Term Care Homes: A Comparison of Care Services and Funding Regimes
Originally published at the University of Toronto Ontario’s Retirement Homes and Long-Term Care Homes: A Comparison of Care ...
Winnipeg Free Press logo
Living longer not the same as living healthy longer
Originally published at Winnipeg Free Press Of the terms used in the health-care lexicon, "compressed morbidity" is one ...

Leave a Reply