Item - 2013.HL21.5
Tracking Status
- City Council adopted this item on May 7, 2013 without amendments.
- This item was considered by Board of Health on April 29, 2013 and was adopted with amendments. It will be considered by City Council on May 7, 2013.
HL21.5 - Medically Uninsured Residents in Toronto
- Decision Type:
- ACTION
- Status:
- Adopted
- Wards:
- All
City Council Decision
City Council on May 7, 8, 9 and 10, 2013, adopted the following:
1. City Council request that the Ministry of Health and Long-Term Care in collaboration with the Local Health Integration Networks:
a. increase the dedicated provincial funding currently provided to community health centres for uninsured residents;
b. enable community health centres to use the dedicated provincial funding for uninsured residents for services beyond diagnostic and specialist care;
c. fund primary care at clinics that currently provide healthcare to uninsured residents, but do not receive dedicated provincial funding to provide this service;
d. fund essential healthcare services for uninsured children and youth;
e. establish a centralized hospital compassionate payment fund with clear eligibility requirements for urgent and major expenses including labour and delivery, newborn care, serious injury and urgent mental health needs; and
f. establish transparent and consistent practices for uninsured patient registration, patient accounting and cost recovery via a standardised non-insured fee schedule similar to OHIP rates, including the elimination of hospital registration fees/outpatient fees/facility fees for uninsured residents, building on the system already piloted within the Toronto Central Local Health Integration Network.
2. City Council request that the Ministry of Health and Long-Term Care in collaboration with the Local Health Integration Networks:
a. establish a centralised information source to promote programs and services available to uninsured residents for both users and practitioners; and
b. establish healthcare facilities as safe environments where immigration status will not be reported to federal authorities.
3. City Council reaffirm to the Federal Minister of Citizenship, Immigration and Multiculturalism its support to rescind the cuts to the Interim Federal Health Program.
4. City Council request Citizenship and Immigration Canada to establish clear and operationally feasible guidelines for the administration of the Interim Federal Health Program.
5. City Council request Citizenship and Immigration Canada, the Ministry of Health and Long-Term Care and Local Health Integration Networks to undertake initiatives to educate refugees, refugee claimants, community and settlement organisations and healthcare providers on the healthcare services covered by the Interim Federal Health Program.
6. City Council reaffirm to the Minister of Health and Long-Term Care its support for the elimination of the three month wait period for OHIP coverage.
7. City Council direct that a copy of the report (April 15, 2013) from the Medical Officer of Health be forwarded to Social Development, Finance and Administration to inform their work on improving access to City of Toronto programs and services for undocumented residents.
Background Information (Board)
https://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57588.pdf
(April 29, 2013) Presentation - Medically Uninsured Residents in Toronto
https://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57997.pdf
Communications (Board)
Communications (City Council)
(May 5, 2013) Submission from Michaela Hynie, PhD., York University and Women's College Hospital Network for Uninsured Clients and Angela Robertson, Past Chair, Women's College Hospital Network for Uninsured Clients, and current Executive Director, Central Toronto Community Health Centres (CC.Supp.HL21.5.3)
(May 5, 2013) E-mail from Paul Caulford (CC.Supp.HL21.5.4)
(May 5, 2013) E-mail from Ritika Goel (CC.Supp.HL21.5.5)
(May 5, 2013) E-mail from Peter Clarke (CC.Supp.HL21.5.6)
(May 6, 2013) E-mail from Axelle Janczur and Russ Ford, Co-chairs, Community Health Centres of Greater Toronto (CC.New.HL21.5.7)
https://www.toronto.ca/legdocs/mmis/2013/cc/comm/communicationfile-36962.pdf
(May 6, 2013) E-mail from Abeer Majeed, on behalf of Health for All (CC.New.HL21.5.8)
(May 6, 2013) E-mail from Peter Clarke (CC.New.HL21.5.9)
(May 6, 2013) Letter from Simone Atungo and Susan Himel, Co-Chairs, Hospital Collaborative on Vulnerable and Marginalized Populations (CC.New.HL21.5.10)
https://www.toronto.ca/legdocs/mmis/2013/cc/comm/communicationfile-36969.pdf
Motions (City Council)
Vote (Receive Item) May-09-2013 7:22 PM
| Result: Lost | Majority Required - HL21.5 - Del Grande - Receive the item |
|---|---|
| Total members that voted Yes: 11 | Members that voted Yes are Gary Crawford, Mike Del Grande, Frank Di Giorgio, John Filion, Doug Ford, Rob Ford, Doug Holyday, Norman Kelly, Gloria Lindsay Luby, Peter Milczyn, David Shiner |
| Total members that voted No: 18 | Members that voted No are Paul Ainslie, Maria Augimeri, Shelley Carroll, Raymond Cho, Vincent Crisanti, Janet Davis, Glenn De Baeremaeker, Sarah Doucette, Mark Grimes, Mike Layton, Pam McConnell, Mary-Margaret McMahon, Joe Mihevc, Frances Nunziata (Chair), Cesar Palacio, Gord Perks, Adam Vaughan, Kristyn Wong-Tam |
| Total members that were Absent: 16 | Members that were absent are Ana Bailão, Michelle Berardinetti, Josh Colle, Paula Fletcher, Mary Fragedakis, Chin Lee, Giorgio Mammoliti, Josh Matlow, Denzil Minnan-Wong, Ron Moeser, John Parker, James Pasternak, Anthony Perruzza, Jaye Robinson, Karen Stintz, Michael Thompson |
Vote (Adopt Item) May-09-2013 7:23 PM
| Result: Carried | Majority Required - HL21.5 - Adopt the item |
|---|---|
| Total members that voted Yes: 21 | Members that voted Yes are Paul Ainslie, Maria Augimeri, Shelley Carroll, Raymond Cho, Gary Crawford, Vincent Crisanti, Janet Davis, Glenn De Baeremaeker, Sarah Doucette, John Filion, Mark Grimes, Mike Layton, Pam McConnell, Mary-Margaret McMahon, Joe Mihevc, Peter Milczyn, Frances Nunziata (Chair), Cesar Palacio, Gord Perks, Adam Vaughan, Kristyn Wong-Tam |
| Total members that voted No: 7 | Members that voted No are Mike Del Grande, Frank Di Giorgio, Doug Ford, Rob Ford, Doug Holyday, Gloria Lindsay Luby, David Shiner |
| Total members that were Absent: 17 | Members that were absent are Ana Bailão, Michelle Berardinetti, Josh Colle, Paula Fletcher, Mary Fragedakis, Norman Kelly, Chin Lee, Giorgio Mammoliti, Josh Matlow, Denzil Minnan-Wong, Ron Moeser, John Parker, James Pasternak, Anthony Perruzza, Jaye Robinson, Karen Stintz, Michael Thompson |
HL21.5 - Medically Uninsured Residents in Toronto
- Decision Type:
- ACTION
- Status:
- Amended
- Wards:
- All
Board Recommendations
The Board of Health recommends that:
1. City Council request that the Ministry of Health and Long-Term Care in collaboration with the Local Health Integration Networks:
a. Increase the dedicated provincial funding currently provided to community health centres for uninsured residents;
b. Enable community health centres to use the dedicated provincial funding for uninsured residents for services beyond diagnostic and specialist care;
c. Fund primary care at clinics that currently provide healthcare to uninsured residents, but do not receive dedicated provincial funding to provide this service;
d. Fund essential healthcare services for uninsured children and youth;
e. Establish a centralised hospital compassionate payment fund with clear eligibility requirements for urgent and major expenses including labour and delivery, newborn care, serious injury and urgent mental health needs; and
f. Establish transparent and consistent practices for uninsured patient registration, patient accounting and cost recovery via a standardised non-insured fee schedule similar to OHIP rates, including the elimination of hospital registration fees/outpatient fees/facility fees for uninsured residents, building on the system already piloted within the Toronto Central Local Health Integration Network.
2. City Council request that the Ministry of Health and Long-Term Care in collaboration with the Local Health Integration Networks:
a. Establish a centralised information source to promote programs and services available to uninsured residents for both users and practitioners; and
b. Establish healthcare facilities as safe environments where immigration status will not be reported to federal authorities.
3. City Council reaffirm to the Federal Minister of Citizenship, Immigration and Multiculturalism its support to rescind the cuts to the Interim Federal Health Program.
4. City Council request that Citizenship and Immigration Canada establish clear and operationally feasible guidelines for the administration of the Interim Federal Health Program.
5. City Council request that Citizenship and Immigration Canada, the Ministry of Health and Long-Term Care and Local Health Integration Networks undertake initiatives to educate refugees, refugee claimants, community and settlement organisations and healthcare providers on the healthcare services covered by the Interim Federal Health Program.
6. City Council reaffirm to the Minister of Health and Long-Term Care its support for the elimination of the three month wait period for OHIP coverage.
7. City Council direct that a copy of the report (April 15, 2013) from the Medical Officer of Health be forwarded to Social Development, Finance and Administration to inform their work on improving access to City of Toronto programs and services for undocumented residents.
Decision Advice and Other Information
The Board of Health requested the Medical Officer of Health to work with community stakeholders and Local Health Integration Networks in Toronto to:
a. devise communication strategies around where and what services are available to uninsured residents; and
b. support advocacy strategies to the Provincial and Federal Governments.
The Medical Officer of Health gave a presentation.
Origin
Summary
Ontario Health Insurance Plan (OHIP) funded healthcare services are available to the majority of people living in Ontario. However there are several resident populations that do not have access to publicly funded provincial healthcare, including people who have lost their identification, people in the three month OHIP wait period, temporary visa holders (e.g., students, visitors), some refugees and undocumented residents. The majority of uninsured residents are immigrants and within this group the most vulnerable are undocumented immigrants. Undocumented residents are not authorised to be in Canada. The vast majority of undocumented residents arrived in Canada through authorised channels, but their immigration status has changed over time.
This report describes groups that do not have access to OHIP funded healthcare and identifies their priority health needs, including obstetrical, newborn care and mental health. Children have unique and essential health needs that impact on their health in the short and long-term. Healthcare practitioners and agencies have developed a limited system to serve the uninsured population. At present, the demand for this care exceeds the capacity of the services available and few healthcare agencies receive dedicated funding to treat uninsured residents. The current healthcare system does not provide adequate access to essential healthcare services for uninsured residents.
Background Information
https://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57588.pdf
(April 29, 2013) Presentation - Medically Uninsured Residents in Toronto
https://www.toronto.ca/legdocs/mmis/2013/hl/bgrd/backgroundfile-57997.pdf
Communications
Speakers
Dr. Paul Caulford, Medical Director/Assistant Professor, Community Volunteer Clinic
Denise Gastaldo, Associate Professor, University of Toronto
Jay MacGillivrary, Midwife, Director, Positive Pregnancy Programme, St. Michael's Hospital
Bob Gardner, Director of Policy, Wellesley Institute
Juana Berinstein, Director, Policy and Communications, Association of Ontario Midwives
Dr. Abeer Majeed, CCFP, Member, Physician/Organizer, Health for All
Russ Ford, Co Chair GT Community Health Centre Non-Insured, Working Group and Exec. Dir. LAMP C.H.C.
Axelle Janczur, Executive Director, Access Alliance Multiculture Health & Community Serv.
Bob Frankford, Right to Health Care Coalition
Motions
That:
1 the Medical Officer of Health be requested to work with community stakeholders and Local Health Integration Networks in Toronto to:
a. devise communication strategies around where and what services are available to uninsured residents; and
b. support advocacy strategies to the Provincial and Federal Governments.
2. the Board of Health recommend that City Council endorse the recommendations in this report.