Laboratory services funding guidelines
Learn about funding that helps long-term care homes cover phlebotomy costs so they can maintain service levels.
Overview
Laboratory Services Funding helps operators of long-term care (LTC) homes pay for phlebotomy and related services. The funding helps homes maintain service levels for residents.
What the funding covers
The Ministry of Long-Term Care provides funding to help operators pay for:
- phlebotomy services provided at a prescheduled time
- phlebotomy services provided at times that are not part of the regular scheduled visits
- courier services to pick up specimens at times that are not part of the regular pick-up times
The funding applies whether the service was provided by a private medical laboratory, another provider, or staff hired by the operator. Homes are reimbursed for the actual cost of each service, up to the maximum eligible amount listed in the table.
| Service | Maximum eligible cost |
|---|---|
| Phlebotomy services provided at a prescheduled time | $75 per session, plus $7.50 for the second and each additional resident |
| Phlebotomy services provided at times that are not part of the regular scheduled visits | $112.50 per session, plus $7.50 for the second and each additional resident |
| Courier services to pick up specimens at times that are not part of the regular pickup schedule | $37.50 |
How to apply
Operators must complete and submit claims to the Ministry every quarter through the Transfer Payment Ontario Portal (TPON). Each submission must include copies of the original invoices showing:
- dates of scheduled and unscheduled visits
- number of residents who received the service on each date
- cost for the visits and the number of residents who received the service
- total invoice cost paid by the operator for the month
- home name
- invoice number
The Ministry notifies the operator of submission and payment deadlines every year.
Payment
The Ministry reimburses the operator after the completed submission is made on TPON and the invoices are reviewed and verified. Charges that are not related to Phlebotomy will not be reimbursed.
Funds for eligible costs are issued on or about the 22nd day of each month.
Operator responsibilities
The operator must use the funds reimbursed by the Ministry to pay for the eligible services listed under What the funding covers.
To be eligible for reimbursement, there must be a written contract between the operator and the providers of laboratory and phlebotomy services. When negotiating contracts with laboratory services providers, the operator must ensure that the agreement includes:
- quality management expectations for laboratory services, including but not limited to laboratory supplies, frequency of specimen pick-ups and instructions on collecting, storing and transporting specimens
- providing reports on each resident based on resident needs and accepted laboratory practices
The contract must also outline specific requirements for the following services.
Routine phlebotomy, STAT phlebotomy and STAT specimen pick-up
It needs to include:
- costs for each service
- contacts for resolution of issues and timelines of responses.
Laboratory testing
The agreement must include:
- supplies to be provided at no cost by the laboratory performing the testing
- frequency of routine specimen pick-ups and flexibility of pick-ups based on the specimen type (for example, fasting blood glucose and international normalized ratio (INR))
- method of reporting for STAT, abnormal and routine results (for example, phone or fax to the ordering physician)
- turnaround times for STAT and routine test results
- consultation on and interpretation of, test results
- instructions for specimen collection and patient preparation
- summary reports on organisms identified in the home for infection control
- contacts for resolving issues within an agreeable timeframe