Ontario is moving in the right direction: care is shifting at home, and in the community. Hospital at Home, Hospital to Home, ALC transitional programs, Nursing Home Without Walls, home care and community support services are all expanding. But many of these models are growing up in parallel, under separate funding, governance and accountability structures, serving similar people and drawing on the same limited workforce.

The question is no longer whether care moves home, but whether we build one system or several. Will new models truly be designed around the needs of people, or around inherited silos and providers’ competitive advantages? This session brings hospital and community leaders to the same table. Dr. Andy Smith | Sunnybrook Health Sciences Centre, Dr. Kathryn Nichol | VHA Home HealthCare, Madonna Gallo | SE Health and Lori Holloway | Ontario Community Support Association will hold a candid conversation about where roles overlap, what effective partnerships look like, and how new models can build on the clinical capacity and infrastructure already in communities.

Key questions:

• When a new care-at-home program is designed, who should be at the table, and how do we know whether it fills a gap or recreates a service that already exists?
• What is one uncomfortable change each sector, including home and community care, must accept to create a genuinely integrated system?
• How do we spread what works through common standards without discouraging provider innovation?

The panel will propose, and test with the audience, principles for an integrated system: build on existing capacity, involve home and community providers early, clarify roles, plan the workforce across sectors, and measure success from the perspective of clients and caregivers.