Ontario’s 2023 Budget: What does it mean?

Ontario’s 2023 Budget: What does it mean?
May 24, 2023
Ontario’s 2023 budget – proudly called Building a Strong Ontario – emphasizes building and manufacturing, and it’s quick to list the new long-term care homes built and planned. It’s much less specific about services for older adults in their own homes.
In Care Watch’s pre-budget submission, we asked Ontario to invest enough in home and community services to add 2.72 million hours and meet growing needs. We asked it to give priority to services from community-based non-profit agencies, hire and keep community-based personal support workers, and pay those workers as much as those in long-term care homes and hospitals.

The 2023 budget says government will work with home care partners to modernize the system, remove barriers, and help people get care for their individual needs. To make all this happen, it plans to invest $1 billion over three years to expand home care services. It mentions “accelerating” investments “up to” $569 million in 2023/2024. This funding includes $300 million for rate increases to “stabilize the home and community care workforce” and to promote personal support work in the “long-term care sector.” There are also more opportunities for students.

“I’ve read the headlines. Ontario has a new 2023 budget. But I don’t know what to make of it.

The personal support worker who used to come to my house quit because she couldn’t earn enough. My community agency doesn’t have enough workers to give all their clients everything they need.

What’s going to change?”

The budget has some promising ideas, but there are missing pieces. Government is still emphasizing long-term care homes. For example, there are some development loans and loan guarantees, but to municipal non-profit long-term care homes. What about the non-profit community agencies that provide services outside facilities? Promoting personal support work and expanding opportunities in the “long-term care sector” both refer to long-term care homes. People who work in the community are still excluded.

The expanded Community Paramedicine for Long-Term Care Program provides care to older adults in their homes, but specifically before admission to a long-term care home. What about using these services to keep older adults out of institutions altogether?

The sick days provided during the pandemic are gone. Personal support workers, who go from home to home, won’t be able to take time off to isolate or be vaccinated. Government continues to fight for Bill 124, which limits wage increases. Personal support workers in the community, already behind those in institutions, will fall even farther behind. If agencies can’t increase what they pay, who will deliver the services?

WHAT CAN YOU DO?

  • Don’t be dazzled by numbers, and don’t be afraid to ask hard questions. That’s the only way you’ll know what’s really going on.
  • Remember that promising and spending aren’t the same. The Ontario Financial Accountability Office reports that in 2021/2022 the provincial government spent $7.2 billion less overall, and $1.8 billion less on health, than it had budgeted. That’s money that didn’t go to services, but to reducing the deficit. How do we know what will happen to the money budgeted for home care? Who will control it? Who will receive it? How will it be spent?
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