White Papers

White Papers October 2012

Enhancing Community Care for Ontarians (ECCO) – A Three Year Plan

Registered Nurses’ Association of Ontario

Executive Summary (Download the full PDF here)

Ontario’s nurses call on government and stakeholders to collectively strengthen our publicly-funded, not-for-profit health system and make it more responsive to the public’s needs, easier to navigate and more efficient and cost-effective. To make this happen, focus must be placed on advancing primary health care for all through health promotion, disease prevention, social and environmental determinants of health and community care. Equally important are changes that enable nurses and all other regulated health professionals to work to their full scope of practice, a commitment to reducing structural duplication, and advancing system integration and alignment.

Ontario’s Action Plan for Health Care supports a continued shift of care delivery to the home and community settings to improve patient outcomes and system cost-effectiveness.1 However, the ability of government to achieve a robust community care sector and health system cost-effectiveness is seriously hampered by existing duplication and excess structure.

Today, Ontario’s home health-care and support services are organized by 14 Community Care Access Centres (CCAC) that utilize nearly $2 billion of public resources each year. In 2008/09, $163M in operational and administrative costs was expensed by CCACs,2 demonstrating significant growth in administrative budgets that outpace growth in direct care dollars. At the same time, duplication and role conflict exists between CCACs, primary care, acute care hospitals, home health-care providers, support service providers, and Local Health Integration Networks (LHINs).

Given the growing maturity of LHINs and the primary care sector, the time has come to fully advance health system integration and eliminate unnecessary duplication, by transitioning the functions of CCACs into existing structures within the health system over the next three years – a proposal outlined in Enhancing Community Care for Ontarians (ECCO) model. Using the analogy of an eco-system, RNAO has created a responsive model that is meant to reflect the realities and interactions between people and their communities, within the context of primary health care. The model does not propose a one-size-fits-all approach to community care; rather it provides a conceptual template that can be localized within the specific geographical and community context where it is applied.  

(Download the full PDF here)

About the Author(s)

Dr. Doris Grinspun RN, MSN, PhD, LLD(hon), O.ONT. Chief Executive Officer Registered Nurses’ Association of Ontario Contact her at:dgrinspun@rnao.ca

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