Community-Based Specialty Clinics

Community-Based Specialty Clinics are non-profit health providers that will offer select low-risk procedures that are currently provided in acute-care hospital settings. Specialty Clinics will focus on providing high volume procedures, such as routine cataract procedures, colonoscopies, and other procedures that do not require overnight stays in a hospital. Specialty Clinics will be subject to high quality standards, oversight and accountability. They will provide OHIP-insured services with no additional fees.

Community-Based Specialty Clinic models fall into two categories :

  1. A public hospital operating in a new site (i.e., a satellite or ambulatory care centre) under the Public Hospitals Act (PHA); or
  2. A non-profit Independent Health Facility (IHF) licensed under the Independent Health Facilities Act (IHFA).

Why Community-Based Specialty Clinics?

In January 2012, the Ministry of Health and Long-Term Care released Ontario's Action Plan for Health Care. Non-profit Community-Based Specialty Clinics are a key commitment of the Action Plan and part of Ontario's current health care system transformation, which aims to:

  1. Keep Ontarians Healthy
  2. Provide faster access and a stronger link to family health care
  3. Provide the right care, at the right time, in the right place.

Non-profit Community-Based Specialty Clinics will help patients receive timely access to the most appropriate care in the most appropriate place.

Shifting low-risk procedures into non-profit Community-Based Specialty Clinics that focus on key low-risk procedures will improve patient access to high quality care at better value.

Initial Rollout of Specialty Clinics

The Ministry of Health and Long-Term Care (Ministry), the Local Health Integration Networks (LHINS) and Cancer Care Ontario (CCO) are working together to rollout Specialty Clinics, which will initially focus on low-risk cataract and colonoscopy services.  In the future, additional procedures that do not require overnight stays in a hospital will be eligible to be performed in Specialty Clinics. 

Additional information about the Specialty Clinics initiative can be obtained through the documents on this website and by e-mailing questions to specialtyclinics@ontario.ca.

Cataract Specialty Clinic Applications

The Ministry of Health and Long-Term Care is launching the application process to create non-profit Community-Based Specialty Clinics for low-risk cataract procedures.

Public Hospital – Application Materials

Public hospital applicants interested in operating a Specialty Clinic in a new site in accordance with the Public Hospitals Act (PHA) will find the appropriate application materials here : 4910-85 - Public Hospital Guidelines and Forms

Independent Health Facility – Application Materials

Applicants interested in creating a Specialty Clinic as a licensed Independent Health Facility (IHF) will find the appropriate application materials here : 4911-85 - Independent Health Facility Guidelines and Forms

Application Submission Deadline

Completed Applications are to be submitted electronically, via email, to the Ministry at SpecialtyClinics@ontario.ca and the LHIN in which the Specialty Clinic would be located (see Application Guidelines for contacts). The deadline for submission of Applications is April 22, 2014 at 11:59 PM (Eastern Standard Time), according to the time that the e-mail is received in the Ministry and LHIN's e-mail systems.

Question Submission Deadline

Questions about the applications process, the Application Guidelines, and/or the Application Form can be e-mailed to SpecialtyClinics@ontario.ca and must be received by the Questions Submission Deadline. The Questions Submission Deadline is March 31, 2014 at 11:59 PM (Eastern Standard Time), according to the time that the e-mail is received in the Ministry e-mail systems (the Questions Submission Deadline).

All questions (without identifying who submitted the questions) received by the deadline and the responses will be posted on the Ministry's Specialty Clinics web page prior to the Application Submission Deadline so that all potential Applicants can benefit from the response.

We encourage applicants to (see Application Guidelines for further details) :

  • Engage the local LHIN and hospital(s) early in discussions on plans for shifting procedures out of hospital to Specialty Clinics to ensure agreement
  • Confirm non-profit incorporation structure at time of submitting your Specialty Clinic application to the LHIN/Ministry.  Refer to the Not-for-Profit Incorporator's Handbook for more information on incorporation

Note that the LHIN has been asked to post a summary of applications received to the LHIN website for public notification.

Frequently Asked Questions: A "Frequently Asked Questions" document is available to provide general information about the Community-Based Specialty Clinics application process.

Document download

4910-85 - Public Hospital Guidelines and Forms

  • Business Case Guidelines for Public Hospitals : Cataract Procedures in Non-Profit Community-Based Specialty Clinics in Ontario
  • Business Case Form

4911-85 - Independent Health Facility Guidelines and Forms

  • IHF Guidelines for Call-for-Applications : Cataract Procedures in Non-Profit Community-Based Specialty Clinics in Ontario
  • Application Form

Policy Guide

The Policy Guide for Creating Community-Based Specialty Clinics (Policy Guide) provides a high level overview of key principles and eligibility criteria for establishing Community-Based Specialty Clinics. When the Ministry of Health and Long-Term Care is ready to proceed with establishing Specialty Clinics an "Application Process" will be issued. The Policy Guide is intended to provide interested applicants with helpful information to begin discussions in their community.

Document download

Community-Based Specialty Clinics: Executive Summary
4 pages | 1 Mb | PDF format

A Policy Guide for Creating Community-Based Specialty Clinics
22 pages | 1 Mb | PDF format

To view Portable Document Format PDF files, you will need to have Adobe Acrobat® Reader installed on your computer. You can download this free software from the Adobe website.

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Frequently Asked Questions


Community-Based Specialty Clinic Strategy

What is the Commuity-Based Specialty Clinics Strategy?

In January 2012, the Ministry of Health and Long-Term Care released Ontario's Action Plan for Health Care, which included the commitment to shift more procedures out of hospital and into non-profit community-based clinics if it will mean offering patients faster access to high-quality care at less cost.

Since that time, Ontario has announced that two midwife-led Birth Centres would be established in Toronto and Ottawa. These new centres will give women more choices about where to deliver healthy babies while freeing up hospital beds for high-risk births. The ministry has also funded additional eye surgeries at the Kensington Eye Institute, a clinic in Toronto.

What are Community-Based Specialty Clinics?

Community-Based Specialty Clinics are non-profit community-based settings where low-risk OHIP-insured health services are provided.  They can be an Independent Health Facility licensed by the ministry under the Independent Health Facilities Act, or a hospital planning to operate in a new site (e.g., hospital satellite or ambulatory care centre).

Independent Health Facilities (IHFs) currently provide a broad range of procedures in Ontario, for example, vision care provided at the Kensington Eye Institute in Toronto. The Ministry may create new IHFs through an application process under the Independent Health Facilities Act.

Hospital sites may be located at the hospital main campus, or may be a satellite providing hospital services in a separate location. Hospital sites are created through approval under the Public Hospitals Act.

Why is the ministry moving low-risk procedures from hospitals to Community-Based Specialty Clinics?

Hospitals are currently performing low-risk procedures that could be performed in Community-Based Specialty Clinics efficiently with improved patient experience and at the same level of quality. This allows hospitals to concentrate resources on more complicated procedures.

Low-risk procedures will be shifted from hospitals into Community-Based Specialty Clinics, if the shift meets Ministry requirements, and is supported by the hospital and the hospital's Local health Integration Network. It will be mandatory for every Community-Based Specialty Clinic to be non-profit and affiliated with the local hospital.

Is there any evidence to support the decision to move procedures into the community?

Yes. Ontario has received advice from the Provincial Vision Strategy Task Force (Task Force), which has supported the use of Specialty Clinics for low-risk vision procedures. The Task Force report identified a number of community-based service delivery models that provide rapid, safe and efficient vision care (i.e. hospital and IHF models)

Also, a number of hospitals have moved their low-risk procedures out of acute hospital settings to out-patient clinics.  For example, several hospitals in Toronto have shifted low-risk cataract procedures to the Kensington Eye Institute, which is a non-profit IHF.

What services are planned for the initial Community-Based Specialty Clinics?

The Ministry of Health and Long-Term Care is planning a phased approach to implementing the Community-Based Specialty Clinic Strategy. Initially, the Ministry plans to establish Community-Based Specialty Clinics to deliver low-risk cataract services.  The Ministry is also working with Cancer Care Ontario to establish Specialty Clinics to deliver colonoscopy services. 

In future, the Ministry will be expanding the scope to additional routine procedures, such as minor orthopedic surgeries, diagnostic procedures, therapeutics and surgical procedures.

Why are cataract services planned for the initial Community-Based Specialty Clinics?

Many cataract procedures are low-risk and do not require overnight stays. These procedures are appropriate for Specialty Clinics and community-based settings, which can improve patient access, increase efficiency, and provide high quality care.

Specialty Clinics are supported by Ontario's Vision Strategy Task Force, and the Ministry of Health and Long-Term Care has experience funding cataracts and other low-risk vision procedures in community-based settings such as at the Kensington Eye Institute and the Stein Surgical Centre.

The Ministry has developed clinical pathways and best practices for the cataract Quality-Based Procedure, as well as pricing for cataracts that allows funding to more easily follow the patient served by a Specialty Clinic.

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Improving Services For Patients

How will patients be referred to a Community-Based Specialty Clinic?

Patients will be referred to a Community-Based Specialty Clinic by their family physician and/or specialist (e.g. optometrists).

Will there be a charge to patients for services received at a Community-Based Specialty Clinic?

No. Moving procedures from hospitals to Community-Based Specialty Clinics will not result in charges to patients for OHIP insured services.   All medically necessary insured services provided at Community-Based Specialty Clinics are paid for by OHIP just as when the services were provided in a hospital.

Will patients receive the same quality of care at a Community-Based Specialty Clinic as at a hospital?

Ensuring services are provided safely and according to the highest quality standards is a priority to the government of Ontario.

High standards will remain for services shifted out of hospitals to community clinics, including inspection by the College of Physicians and Surgeons of Ontario for Independent Health Facilities.

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Process To Establish Community-Based Specialty Clinics

How will Specialty Clinics be rolled out across the province?

Services will shift out of hospitals to clinics in different parts of the province gradually, depending on local community needs and opportunities. In some communities, it might not be appropriate to shift procedures out of hospitals. The LHINs will work closely with their hospitals to identify potential opportunities to shift procedures into the community, and will work with hospitals that express interest in participating.

An "Application Process" will be issued in early 2014 to shift services from hospitals to Community-Based IHF Specialty Clinics. Hospitals proposing new sites (e.g. satellites or ambulatory care centres) will be required to prepare business cases. This process will be gradual, so that hospitals and communities have time to plan and adjust.

What information will be provided about the process to establish a Community-Based Specialty Clinic?

A Policy Guide for Creating Community-Based Specialty Clinics has been developed as a resource for potential applicants and interested stakeholders.  The Guide outlines the principles and eligibility requirements for establishing a Community-Based Specialty Clinic. More detailed information will be made available in the IHF Applications Guidelines and the Hospital Business Case Submission Guidelines.

What are the general requirements for establishing a Community-Based Specialty Clinic?

Applicants proposing a new IHF will need to have endorsement from the LHIN and the hospital(s) transferring procedures, a hospital agreement for service continuity, and be willing to establish as a not-for-profit corporation, among other requirements. A full description of the requirements will be available in the Application Guidelines.

Will all Community-Based Specialty Clinics be required to be non-profit?

Yes. Community-Based Specialty Clinics will be required to be non-profit Independent Health Facilities, or established as a hospital site under the Public Hospitals Act. Ontarians will not have to pay to receive OHIP insured services in Specialty Clinics and physicians practicing in Specialty Clinics will continue to be paid by OHIP. The government will ensure that patients will not have to pay fees to access insured services.

Will those who are interested in establishing a Community-Based Specialty Clinic work with Local Health Integration Networks (LHINs)?

Interested participants would be expected to consult with LHINs and other health care providers for their input in advance of submitting an application, to help ensure patient needs are met and the right procedures are being provided at the right place and at the right time.

How will Community-Based Specialty Clinics be funded?

Community-Based Specialty Clinic funding details, including the price provided for direct costs of services, will be provided in the Call for Applications for IHFs and the Business Case Submission Guidelines for hospitals. Clinics will be funded based on Health System Funding Reform and Quality Based Procedure (QBP) funding. There are no plans to provide capital funding to establish Specialty Clinics for cataract and colonoscopy procedures.

How will an Application Process be announced?

A Call for Applications and a Business Case Submission notice will be announced through the Ministry website, as well as notices in newspapers for the Call for Applications for IHFs. Successful applicants will be notified by the Ministry in writing.  For each application process, the Ministry will develop and publish detailed information and guidelines for reference by interested applicants.

Questions about the Community-Based Specialty Clinics initiative that cannot be answered after a review of the material published on the Specialty Clinics section of the Ministry of Health and Long-Term Care's website can be sent via e-mail to: specialtyclinics@ontario.ca.

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Application Process for Cataract Procedures

Do hospitals that do not plan to shift volumes have to submit business cases to keep their existing volumes?

No, the hospitals that do not plan to shift volumes do not have to submit a business case to keep their existing volumes.

Will the Business Case Submissions requirements be based on section 4 approvals under the Public Hospitals Act, which involves working with the LHIN and getting the minister's approval to operate the facility?

Yes, the "Business Case Submission" will involve approval under section 4 of the Public Hospital Act and will require the hospital to work with the LHIN and obtain Ministry approval to establish the Specialty Clinic. (Note: the above documents for cataract services have now been posted on the Ministry's website at www.ontario.ca/specialtyclinics.)

There is a section in the application form that asks for 'business number of the non-profit corporation in Ontario'. Where can the business number of the non-profit corporation in Ontario be found?

The number to be entered in the 'Business number of the non-profit corporation in Ontario' section of the Business Case Cover Sheet is the business identification number assigned to the hospital upon incorporation as a non-profit.

The Policy Guide indicates that existing IHF's may respond to a Call for Applications as long as they convert to a non-profit status.   Is the process shortened for existing IHF's answering Calls for Applications, given they are already licensed?  Would these existing IHF licensees be responding to the Call for Applications (as is expected of non-licensees) or would they be "Adding Services To Licence" under section 8 of the Independent Health Facilities Act.

The same process applies for existing IHFs.  All organizations interested in applying to the Speciality Clinic initiative, including existing IHFs, must apply to a Call for Applications to create an IHF Specialty Clinic. 

Can a subsidiary of a corporation which operates a hospital under the Public Hospitals Act apply to operate a Community Based Specialty Clinic using the 'Call for Applications process' and become a licensed IHF,  instead of applying using the 'Business Case Submission' process that is intended for public hospitals? 

Yes, a subsidiary of a corporation which operates a hospital can apply to operate a Specialty Clinic as a licensed IHF provided that the subsidiary is not a corporation that operates a hospital approved as a public hospital under the Public Hospitals Act, and based on hospital and LHIN endorsement.

Section 2 of Regulation 649 exempts corporations that operate a hospital under the Public Hospitals Act from the Act and its Regulations.  Is this exemption intended to be broad enough to exclude wholly owned subsidiaries of corporations operating hospitals under the Public Hospitals Act?  If the answer is yes, can a not-for-profit corporation apply for an Independent Health Facility Licence if this corporation is set up so that the only members of the corporation are the directors and officers (Ex-Officio) of a corporation that operates a public hospital under the Public Hospitals Act (therefore the corporation is not a 'subsidiary' of the corporation operating the hospital under the Public Hospitals Act)? 

Hospitals may choose to set up a separate non-profit corporation, which is not excluded under the IHFA from being licensed as an IHF operator. 

The Fact sheet indicates that a licensee of an IHF may be an individual or a corporation. Are partnerships prohibited from holding an IHF license?

Yes.

The Fact Sheet refers to a "Call for Applications" when the MOHLTC intends to issue new IHF licenses to operate an IHF.  Is this the same as the request for proposal process found in section 5 of the Independent Health Facilities Act?

Yes.

Is Call for Applications' process to obtain a license to operate a 'Cataract Community Based Specialty Clinic' the only opportunity that is currently available to obtain a new IHF license?

Yes.

Is the RFP process found in section 5 of the Act separate from the designation of an independent health facility under section 4(2) of the Act?   In other words, if the minister designates a health facility as an independent health facility under section 4(b) of the Act, will a request for proposals process not be necessary, instead, an application for a license would be submitted under section 7(1) of the Act. 

The creation of IHF Community-Based Specialty Clinics for cataract services will be through a Call for Applications process, according to Section 5 of the IHFA.

Policy Guide indicates that an IHF operating a Community-Based Specialty Clinic must be a non-profit organization.  How is a non-profit organization defined?  Is this limited to non-share capital corporations incorporated federally under the Canada Not for Profit Corporations Act or provincially under the Corporations Act (Ontario)? 

For Specialty Clinics purposes, a non-profit organization is defined as a corporation without share capital under the Ontario Corporations Act published.

Individuals will not be licensed as an IHF to operate a Specialty Clinic since sole proprietors are not non-profit corporations.

Does a hospital Specialty Clinic need to be its own separate legal not-for-profit entity?

For the Business Case submission, the applicant must be a public hospital.  Alternatively, a not-for-profit subsidiary corporation controlled by a hospital(s) may be incorporated and apply as an independent health facility.

Could Specialty Clinics rent any excess available space from a hospital?

Provided all of the quality, physical and design standards are met, as specified in sections 3.3 and 3.4 of the Business Case, the proposed cataract services specialty clinic can be located within the hospital's main campus or at a separate location.

Would the funding for a community based specialty clinic be the same for public hospitals and IHFs?  In other words, will the only funding be on a "price x volume" basis?

The funding for both public hospitals and IHFs will be based on a "price x volume" basis.  For more details please see the Application Guidelines for cataract services posted at www.ontario.ca/specialtyclinics.

Would the community based specialty clinic be required to fund its own equipment and overhead?

The "price x volume" (referred to as Quality Based Procedures) funding covers costs directly related to the provision of care to the patients such as nursing care and medical supplies. Information about Health System Funding Reform, including an overview of Quality Based Procedures.

What are the staffing requirements for specialty clinics? Are they required to have RN?

The staffing requirements for a cataract specialty clinic that is an Independent Health Facility need to be in accordance with the College of Physicians and Surgeons of Ontario's Clinical Practice Parameters (CPP) and Facility Standards for Ophthalmology Services.  These include qualifications for nursing and other medical staff for the facility. CPSO's Clinical Practice Parameters and Facility Standards [PDF].

As per the CPPs, IHFs performing any ophthalmological services must be in compliance with the Canadian Ophthalmological Society Clinical Practice Guidelines, Policy Statements and Standards.

The staffing requirements for a public hospital satellite clinic need to be in accordance with any relevant policies of the hospital. 

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Cataract Community-Based Specialty Clinics Application Process

Application Process, Evaluation and Submission Timelines

Will the ministry share the evaluation framework?

The Ministry has developed evaluation criteria that will be used to evaluate the applications that receive their respective LHINs endorsement. The Ministry has provided the LHINs with a high level overview of those criteria. The criteria are based on the requirements described in the Guidelines and principles of the Specialty Clinics Strategy. Those interested in the requirements should consult the Application Guidelines (for the establishment of Independent Health Facilities) and Business Case Guidelines (for Public Hospitals).

Is it anticipated that all appropriate applications will be approved or will there be an artificial limit imposed?

The Ministry will review all applications that are endorsed by the LHINs and the number of successful applicants will depend on how many applications meet the requirements as described in the Application Guidelines (Independent Health Facilities) and Business Case Guidelines (Public Hospitals).

Please review timelines for application and review process.

Well in advance of April 22nd 2014 (the Application Submission Deadline), applicants should contact their LHIN to determine the LHIN's plans and readiness to shift cataract services out of hospitals to specialty clinics in their LHIN.  If LHINs are ready to shift volumes out of hospitals then applicants would proceed with contacting hospitals about their interest in shifting volumes.

Completed applications, including notices of intention to integrate (if applicable) under the Local Health System Integration Act, 2006 are due to the LHINs by April 22nd2014.  Also due by April 22nd 2014 are completed applications to the Ministry (with hospital endorsement but no LHIN endorsement).   After April 22nd 2014, LHINs will review integration notices to determine if they have any objection to the voluntary integration.  LHINs will also review eligible applications to determine if they will endorse them.  As part of this review process, LHINs will post summaries of each application to their website as notice to the public, and LHINs may conduct consultations as they see fit. If the LHIN chooses to endorse the application, the LHIN CEO will sign the application prior to submitting it to the Ministry.

By June 23rd2014, the LHINs will submit endorsed applications with their recommendations to the Ministry. If more than one eligible application is received by the LHIN, they will also provide a ranking of the applications. Once these recommendations and endorsed applications are received by the Ministry, the Ministry will proceed with evaluation of LHIN endorsed applications. This evaluation process is expected to be completed by late summer/early fall. 

Can you share timelines post April 22nd, 2014? What is the turnaround time for approval post April 22nd, 2014?

See question above (#3).  By June 23rd 2014, the LHINs will provide their advice to the Ministry with their recommendations on eligible applications. The Ministry's evaluation review process will then begin and is anticipated to be completed late summer/ early fall.

 What is the possibility of postponing the April 22nd, 2014 deadline for 30-60 Days?  

While the Ministry recognizes that it will take time for applicants to complete their applications, at this time, the Ministry is not planning on changing the deadline for applications. If applicants are unable to complete the application by the April 22nd deadline, they can apply to future application processes.  The Ministry will post information about future application processes on the Ministry website once that information is available.   

We have reached out to the LHINs and hospital CEOs and our experience has been that the launching of the application process caught people off-guard, including the CEOs.  The timelines for this extensive application may not allow us to get meetings with hospital CEOs or LHINs prior to April 22nd.

Ontario first announced plans for Community-Based Specialty Clinics in its Action Plan for Health Care in January 2012, and released the Policy Guide for Community-Based Specialty Clinics in December 2013.

Not all LHINs or hospitals are ready or appropriate to shift volumes to Community-Based Speciality Clinics. Some LHINs are in the process of developing Vision Care Plans that will guide the shift of cataract procedures to Specialty Clinics.

The Ministry is planning future application processes so applicants unable to meet the current timelines will have another opportunity in the future.

Does the notice of integration letter have to be submitted to the LHIN prior to April 22nd, 2014?

The notice of integration must be submitted by April 22nd, 2014 to the LHINs.

This application process is for cataracts however, there are other eye procedures that can be done in an out-patient setting. Can these procedures be funded through this IHF funding model even if the hospital did not sign off?

This application process is focused on cataract procedures that will be shifted from hospitals into Specialty Clinics. In future, the Ministry will look at other vision care procedures that may be appropriate to shift to Speciality Clinics. The Ministry will communicate which other procedures are eligible for shifting out to Specialty Clinics following work with expert panels.  Future information about other procedures shifting out of hospital into Specialty Clinics will be posted on the Speciality Clinics website.

If a hospital has two potential applicants, both requesting all the volumes, can the hospital sign both applications and leave it up to the LHIN /Ministry to decide which should be awarded. Or must the hospital make that choice and only sign one application?

It is up to the hospital whether to support one or more applications. Ideally, hospitals moving out procedures would work with the LHIN to determine which application best meets the needs of the community. Whether it is one or more applications, will depend on the volumes being shifted from the hospital and the capacity of the applicants. Applicants must have the support of the hospital to receive those cataract services.

It will be the hospital's decision on whether to support more than one application.

Are hospitals required to respond to private providers if they are not interested in setting up clinics in their community and not willing to transfer the volumes?

Procedures will only move out of a hospital if the hospital and LHIN are supportive of the move. It is up to the hospital and LHIN to determine how they respond to potential applicants.

It is recommended that potential applicants engage in dialogue with the LHIN and hospital early to determine whether or not there is interest in moving out procedures.

Not all LHINs and hospitals will be ready to move procedures to Specialty Clinics as part of this application process. Some LHINs and hospitals may consider moving out procedures in future application processes.

How is it not a conflict of interest to have both the LHIN and the Hospitals sign off on an application that the hospital may also choose to ''compete'' on? In the application process applicants are actually giving information over to the competitor.

There are two eligible models for Community-Based Specialty Clinics:  the hospital model and the Independent Health Facility Model.   While the Community-Based Specialty Clinics Strategy is an opportunity to shift cataract procedures out of a hospital, any potential shift must consider the impact on the hospital, as well as the impact on the broader health community. The Ministry has been clear that no shifts of services will take place without the support of the LHIN and the hospital.  LHINs and hospitals have no duty or obligation to shift volumes to interested parties and therefore are not in a conflict of interest.

The Ministry recognizes that communities are diverse. For some communities the hospital-based model may be more appropriate and for other communities the Independent Health Facility model may be appropriate.  All applications will need to meet the core requirements for specialty clinics as described in the Application Guidelines (IHFs) and Business Case Guidelines (Public Hospitals).

Why are hospitals allowed to compete for (submit application for) out-of-hospital specialty clinics?

There are two service delivery models eligible under the Speciality Clinics Strategy. Both hospitals and Independent Health Facilities are allowed to apply under the applications process.

In many communities, hospitals have already invested in ambulatory care facilities, or satellites, or centres of vision excellence that would make the most effective and efficient Community-Based Specialty Clinics.

The Ministry has heard from LHINs and other stakeholders that this cannot be a one-size- fits-all strategy. The Ministry recognizes that communities are diverse. For some communities the hospital-based model is more appropriate and for other communities the Independent Health Facility model is more appropriate.

Can a Hospital submit an application if they plan to shift volumes to an existing hospital outpatient clinic? 

There are two service delivery models eligible as part of the Specialty Clinics application process. One is the Hospital based model and the other is the Independent Health Facility model. If the hospital has already set-up an ambulatory care center or a satellite then the hospital can submit an application to shift out procedures from the main hospital campus to the ambulatory clinic or satellite.

Can cataracts stay in hospitals or MUST they be outside of hospital?

There is no requirement for hospitals to move cataract procedures to Community-Based Specialty Clinics. The hospital may be the most appropriate place for those procedures. Cataract procedures will not move out of the hospital without the support of the hospital, the LHIN and the Ministry.

Every community is different. Not all LHINs and hospitals are appropriate for moving procedures to Specialty Clinics. LHINs and hospitals will need to consider what model is best for their community and community readiness.   Some LHINs and hospitals may choose to participate in future application processes.

Can a hospital submit a proposal if they do not have a separate ambulatory clinic and plan to use existing day surgery resources?

Applicants, including hospitals, are encouraged to work with the LHIN to determine whether or not their facility/proposed facility is appropriate for a Community-Based Specialty Clinic.
Regardless of location, facilities will need to meet the core requirements and key principles for Specialty Clinics as described in the Application Guidelines (IHFs) and Business Case Guidelines (Public Hospitals).

Core Requirements:  Quality, Non-Profit Status, Quality-based Pricing

Is there an Accreditation Process for IHFs?

Licensed IHFs must operate their facilities and provide their services in accordance with generally accepted standards.  For physician-based services, such as ophthalmology, these standards are published by the College of Physicians and Surgeons of Ontario (CPSO) and titled Clinical Practice Parameters and Facility Standards (for Ophthalmology). 

In order for the Director of Independent Health Facilities to consider issuing a licence to an applicant, the Director must, among other things, be of the opinion that the quality and standards of the facility will conform to the generally accepted quality and standards for the facility and the services to be provided in the facility.  As mentioned above, these standards are published by the CPSO.  For a copy of the Clinical Practice Parameters and Facility Standards for Ophthalmology, please visit the CPSO website.

Why it is necessary for the IHF to be a not-for-profit corporation?

As part of the Community-based Specialty Clinic Strategy, one of the core requirements as set out in the Policy Guide and the Application Guidelines for Community-Based Specialty Clinics is that clinics are non-profit.  Services that will be shifted as part of the Community-Based Specialty Clinic Strategy are currently provided in public hospitals. The Government committed to maintaining these services in non-profit settings in Ontario's 2012 Action Plan for Health Care.

Is there any possibility that the requirement of not-for-profit status for IHFs may change?

There are no plans to change the mandatory non-profit status requirement.  It is a core requirement for establishing a community-based specialty clinic.  

Has the Ministry made available the Quality-based Procedure price for cataracts in individual hospitals, and if so, where can that information be found? 

Please see the Application Guidelines.  In order to find out the Quality-based Procedure (QBP) price for cataracts in individual hospitals, applicants should contact the hospital's LHIN, and request the Hospital-Specific HBAM-Adjusted Direct Cost per Case (hospital QBP rate).

Other

After a transfer, does the specialty clinic sign a service accountability agreement with the LHIN?  

Accountability agreements will be required prior to any shift in volumes.  For successful applicants for the hospital model, agreements or amendments to existing accountability agreements would be signed between the hospital and the LHIN as all hospitals have service accountability agreements with their LHINs.

For successful applicants applying to the IHF model, accountability agreements will be signed with the Ministry as currently the Ministry funds all licensed Independent Health Facilities. 

Will the Ministry share a copy of the slide deck used for the webinars?

The content of the slide presentation used for the webinars was a high-level summary of requirements taken from the applications materials.  These materials are available on the Community-Based Specialty Clinics' website. No new information was provided.

All questions and answers from the two webinars (held on March 18th and March 19th) have been collected and are available for all prospective applicants and interested stakeholders on the Community-Based Specialty Clinics' website.  We encourage applicants to review the Guidelines and Forms, as well as all questions and answers, on the website.

Would an applicant be able to speak to someone for clarification to questions?

Questions can be submitted by e-mail to: SpecialtyClinics@ontario.ca.

During the Call for Applications process, we ask that applicants not make direct contact with individual Ministry staff to ensure that the application process is fair to all applicants. All questions regarding the application process or forms may be submitted to the Specialty Clinic e-mail address (as provided above).  Answers to questions asked by the Question Submission Deadline (March 31st at 11:59PM (Eastern Standard Time)) will be posted (without identifying the requestor) on the Specialty Clinics website so that all applicants can benefit from the answer.

 

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