The anticipated release date of application materials for the establishment of Community-Based Specialty Clinics (“Specialty Clinics”) is now here. This follows the Ontario Ministry of Health and Long-Term Care’s (the “Ministry”) announcement in December 2013 of its plans to improve healthcare services in Ontario by shifting the provision of some routine health procedures out of hospital settings and into Specialty Clinics. Specialty Clinics will be funded on a Quality Based Procedures (‘price times volume’) basis. Capital funding to establish Specialty Clinics will not be provided by the Ministry.

The Ministry is currently calling for applications for the establishment of Specialty Clinics providing OHIP-insured, low-risk cataract procedures and has set an application deadline of April 22, 2014. Any questions relating to the application process must be received by the Ministry by March 31, 2014, at the following email address: specialtyclinics@ontario.ca.

Applications will be accepted through two processes:

  1. Public Hospitals - New Sites (“Hospital Sites”). Public hospitals planning to operate cataract- focused Specialty Clinics may do so through a new site of the hospital by seeking Ministry approval under the Public Hospitals Act.
    Alternatively, a public hospital may incorporate an Ontario non-profit corporation, and have that corporation apply to operate a Specialty Clinic under the Non-Profit Independent Health Facilities process (see below).
  2. Non-Profit Independent Health Facilities (“IHFs”). Other applicants wishing to operate cataract-focused Specialty Clinics may do so by becoming licensed non-profit IHFs. IHFs are health facilities in Ontario which provide insured health services generally falling under the categories of diagnostic services (i.e. ultrasound and x-ray) and surgical/treatment services (i.e. cataract and dialysis). The distinctive factor of  an IHF is its ability to charge fees to the Ministry or the LHIN to cover the overhead expenses associated with the provision of insured services. The Independent Health Facilities Act and its regulations (collectively, the “IHF Act”) require that IHFs be licensed by the Ministry. Among others, corporations operating public hospitals are exempt from the IHF Act and are not permitted to apply under this process unless they do so through a separately incorporated corporation that is an Ontario non-profit corporation. Applying to operate a cataract- focused Specialty Clinic is currently the only opportunity available to be issued a new IHF license. Existing IHF license holders willing to operate a cataract-focused Specialty Clinic can apply under the same application process.

Application materials for each process are available on the Ministry’s website: http://www.health.gov.on.ca/en/pro/programs/ihf/specialtyclinics/. Public hospitals applying under the Hospital Site process should refer to the “Business Case Form” (application) and its corresponding “Business Case Guidelines”, which incorporate the requirements under the “Section 4 Approvals Protocol: Under the Public Hospitals Act ”. The Business Case Form replaces the business case that is usually submitted under Section 4 of the Public Hospitals Act.

Applicants applying under the IHF process should   refer to the “Application: Call for Applications to Create Non-Profit Community-Based Specialty Clinics as Independent Health Facilities to provide Low-Risk Cataract Procedures in Ontario” and its corresponding guidelines entitled the same.

The Ministry recommends as follows in preparation for submission of an application:

  1. consult with your LHIN (and local hospital, if applying under the IHF process) to discuss the LHIN’s vision care plan and to determine if there is a need and an opportunity for a cataract- focused Specialty Clinic in your area;
  2. become incorporated as a non-profit corporation under the Corporations Act (Ontario), if not already incorporated as such (as set out above, all applicants must be Ontario non-profit corporations); and
  3. if applying under the IHF process, become acquainted with the Clinical Practice Parameters and Facility Standards of the College of Physicians and Surgeons of Ontario available at http://www.cpso.on.ca/policies-publications/cpgs-other-guidelines/independent-health-facilities/ophthalmology.

For more information on community-based speciality clinics, please contact Anne Corbett (acorbett@blg.com), Marco Deiana (mdeiana@blg.com) or  Heather Pessione  (hpessione@blg.com).

 

Authors

Anne Corbett 
ACorbett@blg.com
416.367.6013

Heather Pessione 
HPessione@blg.com
416.367.6589

Expertise

Health Law