January 11, 2016

The Honourable Kathleen Wynne
Premier of Ontario
Room 281, Main Legislative Building
Queen’s Park
Toronto Ontario
M7A 1A1

Dear Premier:

I want to thank you for the opportunity to work with you in my role as the Associate Minister of Health and Long-Term Care to make a difference in the lives of all Ontarians. I am pleased to report that we have made significant progress on the priorities you outlined in 2014.

Modernizing and Improving Long-Term Care Homes

When it comes to modernizing and improving long-term care in Ontario, the priorities are to ensure sufficient spaces are available and that residents get the quality of care they need. To that end:

  • Work is well underway to implement the Enhanced Long-Term Care Home Renewal Strategy to modernize Ontario’s long-term care homes. Over the next 10 years, we will help redevelop approximately 300 older long-term care homes to our current design standards, thereby improving quality of life and reducing wait times.
  • In parallel with the above-referenced redevelopment, work has started on a province-wide capacity planning exercise to ensure we have the right number and right type of long-term care beds now and in the future.
  • We have improved quality by completing the first round of mandatory annual Resident Quality Inspections in 2014, and in 2015 we were well into the second round of this landmark protocol. In addition to strengthening oversight, the mandatory inspections are providing us with rich data sets that will enhance evidence-based decisions.
  • We have further strengthened the quality framework by making Quality Improvement Plans mandatory in long-term care homes beginning in 2015. Work is already underway for the next phase of quality enhancement initiatives, with a focus on strengthening compliance and managing quality by outcomes.
  • We are enhancing resident care with the introduction of Attending Nurse Practitioners into Long-Term Care Homes. The hiring of the first 30 attending nurse practitioners is underway, and is part of a three-year plan to provide funding for up to 75 new positions in long-term care homes.

Moving Ahead on Health and Wellness Initiatives

  • The passing of the Making Healthier Choices Act, 2015, has made Ontario a leading Canadian jurisdiction in reducing smoking rates. Effective January 1, 2016, the sale and supply of e-cigarettes to those under the age of 19 has been banned, and the sale of e-cigarettes in retail locations (if prescribed signs are not posted) is prohibited. As well, we have banned the sale of certain flavoured tobacco products, and increased the maximum fines for youth-related sales offences under the Smoke-Free Ontario Act.
  • We also continue to make significant progress in our efforts toward a smoke-free Ontario. On January 1, 2015, new regulations came into effect that made it illegal to smoke on bar and restaurant patios, playgrounds, and public sports fields and surfaces.
  • In addition to strengthening smoking-related legislation, we know we must also focus on cessation to reduce smoking rates. To that end, the ministry is working on a revised cessation strategy.
  • We are on track to fully deliver on our commitments under the Healthy Menu Choices Act to post calories on menus in restaurant chains and other food service premises with 20 or more locations in Ontario. This will make it easier for Ontario families to make informed and healthier food choices, and will mean we will have fully delivered on our commitments in this regard.
  • Through the revitalization of a Minister’s Working Group, we are collaborating with our partner ministries to develop the next set of initiatives for the Healthy Kids Strategy. In addition, we continue to implement existing initiatives, such as the Healthy Kids Community Challenge, in 45 communities across Ontario, and partnering with the Ministry of Education to advance the goal for students to have access to 60 minutes of activity connected to their school day.

Developing a Health and Wellness Strategy

  • Preliminary work on launching consultations on how best to improve culturally appropriate care, with a particular focus on long-term care homes, has commenced.

While we have made a great deal of progress, there is still much work to be done. I look forward to continuing to carry out the priorities you have entrusted to me as we work towards delivering sustainable long-term care to Ontarians, and strengthening a culture of health and wellness across the province.

Yours sincerely,

Signature of Dipika Damerla

Dipika Damerla
Associate Minister

Results achieved

Mandate Letter Commitment Progress To Date
Lead our efforts to deliver sustainable long-term care to Ontarians and champion a culture of health and wellness in the province.
  • The ministry has continued to implement Healthy Kids Strategy initiatives, including the Healthy Kids Community Challenge, 24/7 telephone breastfeeding supports, menu labelling legislation and expansion of the Student Nutrition Program.
  • Associate Minister Damerla announced engagement with the long-term care sector to deliver on the Enhanced Long-Term Care Home Renewal Strategy. The ministry is committed to ensuring that Ontarians who need long-term care receive high-quality care as residents of long-term care homes. Long-term care home funding has increased to $3.97 billion in 2015-16 from $2.10 billion in 2003-04. This has included funding investments in direct care, staff training and development opportunities that focus on improving resident safety, preventing abuse and neglect, and advancing quality of care for residents with responsive behaviours or other specialized care needs.
  • The passage of the Making Healthier Choices Act, 2015 will support healthier choices by reducing youth access to flavoured tobacco and electronic cigarettes as off January 1, 2016 and will support Ontarians to make healthier food choices by requiring food service premises to post calories on their menus by January 1, 2017.
Your work will complement the work of the Minister of Health and Long-Term Care in making Ontario the healthiest place in North America to grow up, and grow old.
  • Passed the Making Healthier Choices Act in May 2015, including legislation on menu labelling, electronic cigarettes, and Smoke Free Ontario Act amendments.
  • Continued to support Healthy Kids Strategy initiatives, including the Healthy Kids Community Challenge, 24/7 telephone breastfeeding supports, and expansion of healthy eating and physical activity programs for Aboriginal communities.
In pursuit of our commitment, I ask that you keep in mind three key goals: people receiving the right care at the right time and in the right place, an accountable, efficient and transparent system — and promoting healthier lifestyles for Ontarians through shared responsibility across government.
  • The ministry has continued to implement Healthy Kids Strategy initiatives, including the Healthy Kids Community Challenge, 24/7 telephone breastfeeding supports, menu labelling legislation, and expansion of the Student Nutrition Program.
  • The ministry is also taking steps to regulate the fast growing market for e-cigarettes in Ontario, by banning the sale of e-cigarettes to minors.
Implementing the enhanced Long-Term Care Home Renewal Strategy to modernize and improve long-term care facilities. Your goal is to ensure that Ontarians who require long-term care will get the best care and services to meet their needs.
  • Associate Minister Damerla announced engagement with the long-term care sector to deliver on the Enhanced Long-Term Care Home Renewal Strategy. This includes the Construction Funding Subsidy Policy and the Long-Term Care Home Design Manual.
  • Over the next 10 years, we will help redevelop 300 long-term care homes to current design standards to improve quality of life and reduce wait times.
Further strengthening our quality framework for the long-term care sector. You will focus on resident outcomes and will plan appropriately to meet the future need for long-term care services.
  • We have strengthened quality by completing the first round of mandatory annual Resident Quality Inspections in 2014, and we were well into the second round of this landmark protocol in 2015.
  • In addition, work has started on province-wide capacity planning in long-term care homes. This work is critical to ensuring we have the capacity we need now, and in the future.
Partnering with the Minister of Health and Long-Term Care to explore options for continued changes in the funding of long-term care homes to reflect the care that people need and receive.
  • The ministry has finalised the implementation of a new resident classification system that enables the ministry to equitably fund long-term care homes based on resident care characteristics and need.
  • In addition, we have partnered with the long-term care sector to identify practices to maintain home funding stability by introducing a floor below which funding could not drop.
Continuing to implement the Healthy Kids Strategy and lead the Healthy Kids Ministers' Working Group to further our efforts in this area.
  • The ministry is collaborating with partner ministries to develop options for future Healthy Kids Strategy initiatives while continuing to implement current initiatives.
  • The Healthy Kids Community Challenge has been launched in 45 Ontario communities. This challenge aims to reduce and prevent childhood obesity by promoting healthy eating, physical activity and healthy lifestyle choices for children.
Delivering on our commitment to post calories on menus in food and restaurant chains.
  • Passed the Making Healthier Choices Act in May 2015. This includes the Healthy Menu Choices Act, which requires food service premises with 20 or more locations in Ontario to post calories on menus.
  • On September 10, 2015, the ministry posted draft menu labelling regulations to the Regulatory Registry. The effective date of the legislation and accompanying regulations is January 1, 2017.
Continuing to drive our commitment to a smoke-free Ontario.
  • The Making Healthier Choices Act was passed to strengthen the Smoke-Free Ontario Act by further protecting youth from the harmful effects of tobacco.
  • The legislation amends the Smoke-Free Ontario Act to make it harder for youth to obtain tobacco products, bans the sale of flavoured tobacco and permits the government to further limit exposure to second-hand smoke in public areas.
Partnering with the Minister of Education and others across government — and with schools, community organizations and private organizations — support students to get 60 minutes of activity connected to their school day.
  • The ministry is working as part of the Physical Activity Advisory Committee with members from ACTIVE AT SCHOOL, Raise the Bar, ParticipACTION and the Ministry of Education, among others, to provide advice and share best practices on how to reach 60 minutes of physical activity for students each day.
Developing a strategy on community wellness and a culture of health, including ways to provide more culturally appropriate care.
  • The ministry is working with Aboriginal partners and investing in the development of Indigenous cultural competency training for mainstream providers, public health units and Local Health Integration Networks.
  • The ministry is developing an approach to support Associate Minister Damerla’s community engagement on culturally appropriate care in the long-term care and wellness sectors.
Supporting the Minister of Health and Long-Term Care in the drive toward a sustainable, accountable system that provides co-ordinated quality care to people, when and where they need it. You will partner with administrators, health care providers and patients to achieve our commitment for a system that delivers the best quality care to meet the needs of patients — and that continues our success in lowering the growth in health care spending.
  • The Patients First Action Plan was launched in February 2015, and focuses on transformation of the health care system to improve access, better connect services to deliver coordinated and integrated care, inform through information and transparency, and protect our public health care system.
  • A discussion paper was released in December 2015, identifying a series of proposals that describe structural changes to Ontario’s health care system to improve integration, population health based services and access to care.
  • The ministry is at the beginning of a consultation period, which will include key health care stakeholders, associations and partners, as well as people from the community. The consultation plan is currently being finalized.
Updated: June 01, 2021
Published: January 10, 2016