We all have a role to play in creating an equitable and inclusive city.

New Report

Two Steps Back: The Impact of Ontario’s Rollback on Healthcare Access for Uninsured Residents

  • The Impact of Ontario’s Rollback on Healthcare Access for Uninsured Residents

    On March 31st, 2023, the Government of Ontario ended the Physician and Hospital Services for Uninsured Persons (PHSUP) funding. The Ministry of Health implemented the PHSUP policy in March 2020 as a response to the COVID-19 pandemic, expanding access to free hospital care and some physician services for people without provincial health insurance (OHIP). This program marked a positive step towards making healthcare accessible to all residents of Ontario.

    To capture the impacts of the cuts to this important program, the Health Network for Uninsured Clients (HNUC) surveyed members working directly with uninsured people and interviewed key informants about their experiences providing care to their uninsured clients since the removal of the PHSUP policy.

    Health and social service workers reported concerning impacts on their clients’ access to health services and general well-being, as well as an increase in their workload in supporting their clients, because of the end of the PHSUP program. A number of access and system barriers were noted, including poorer coordination between community-based care and hospitals, higher service fees, and increased discriminatory practices toward uninsured clients. Participants linked these barriers to worsened health outcomes among their clients who are uninsured.

    Read the full report here.

  • Read the full report here

The following advocacy tools and resources are for frontline workers.

They provide helpful information about services available to people who are undocumented, as well as tools for advocating for access to services.

Resource Package:
Newborn OHIP eligibility for undocumented parents

  • Babies born in Ontario to parents who live in Ontario are legally eligible for OHIP, even if the parents do not have status. Check out the resources below for more information.

  • Babies born in Canada are citizens by birth. In order for babies to qualify for provincial health insurance in Ontario, they must be born in Ontario; their parents/guardians must stay in the province with them for 4 out of 12 months; and one parent/guardian must be a resident of the province. The baby’s eligibility to access OHIP is not dependent on their parent’s status. However, in practice, many families report that their babies have been declared ineligible by hospital staff.

    Receiving a health card at birth is crucial for protecting the health of our youngest Ontarians. Not providing OHIP to eligible babies in a timely way can lead to delayed care, high costs for families and potentially adverse health outcomes for these children. 

    To address this, the HNUC developed a resource package aimed at midwives, hospital staff and service providers to support their advocacy efforts for eligible babies to receive OHIP at birth. To access the full package, email us at uninsurednetwork@gmail.com. 

  • To access the full package, email us at uninsurednetwork@gmail.com. 

    LINKS:

Advocating for hospital care coverage

  • From March 2020 to March 2023, uninsured people did not need to pay in order to seek essential medical care in hospitals. If your clients received bills for care provided during that time, we have kept links below to the MOH Directive as well as a template advocacy letter. No fees should have been charged to people during this period.

    As of April 1, 2023, this has changed - the provincial government cut this vital program and people are now being asked to pay to seek care. You can support your clients to set up payment plans so they do not need to pay the entire cost of care at once. See the Healthcare Services section for more tips.

  • The Healthcare For All Coalition is a group of health care workers, organizations (including HNUC) and community members advocating for permanent access to healthcare for everyone in Ontario. We have come together to demand that the Ontario government implement permanent and adequate funding for medically necessary hospital and community-based health services for uninsured people. Click here to learn more about our demands.

Report: A Bridge To Universal Health

  • The Benefits of Ontario’s Program to Make Hospital Care Accessible to All Residents of the Province.

    In March 2020, in response to the COVID-19 pandemic, the Ontario Ministry of Health (MOH) issued a directive to extend funding for all medically necessary hospital care to residents without health insurance. Members of the Health Network for Uninsured Clients (HNUC) have observed significant improvements to healthcare access for uninsured clients since the MOH directive has been in place.To capture the directive’s impacts, the HNUC surveyed members who work directly with uninsured clients and interviewed key informants with several years of experience working with uninsured clients. Eighteen healthcare professionals responded to the survey, and six key informants participated in interviews, including a midwife, a nurse, a hospital-based physician, two client care coordinators at community health centres, and the coordinator of a primary care clinic for uninsured clients. This report highlights their observations and stories about how the directive has changed access to healthcare and its impacts on the well-being of people without health insurance.

  • You can read the full report here.

Social assistance for undocumented people

  • Generally, people without status are eligible to apply for Ontario Works (OW, aka “welfare”) or Ontario Disability Support Program (ODSP), except in a few circumstances. See below for detailed information explaining how to support your client in applying.

Legal rights for undocumented people

Group portrait of five women smiling
Portrait of a man wearing a baseball hat and glasses, holding his phone and smiling.

Sanctuary Cities

  • A “Sanctuary City” is a city with a policy that attempts to provide access to services for all people, regardless of immigration status.

  • In February 2013, Toronto became the first “sanctuary city” in Canada. This policy, which is formally referred to by the municipal government as “Access to City Services for Undocumented Torontonians (Access T.O.)”, directs city officials to:

    1. NOT ask about immigration status when providing select services,

    2. NOT deny a resident without permanent immigration status services that they are entitled to,

    3. NOT share personal or identifying information with federal authorities, unless required to do so by law.

    In other words, this policy attempts to provide protection and safety to residents without permanent immigration status with “don’t ask, don’t tell” practices by the city service providers, police or transit enforcement.

  • Municipal services that fall under this policy include recreational programs, libraries, City operated child care centres, emergency shelters, and some public health programs and transportation. Some municipal programs are governed at the federal and provincial level such as social assistance (Ontario Works), healthcare and housing, and the City has yet to fulfill their commitment in advocating at these government levels to gain broader and safe access to these services for undocumented people. In addition, the Toronto Transit Commission (TTC) and the Toronto Police Services (TPS) continue to have practices that can put undocumented people at risk. For example, TTC officers have been known to ask for identification in suspected cases of “fare evasion”. Also, there is evidence documenting that the TPS collaborates with, and provides information to, the Canada Border Services Agency (CBSA). Additional resource allocation and commitment from the City of Toronto would help to strengthen implementation of the sanctuary policy.

  • As service providers, we encourage you to ensure the safety of residents without permanent immigration status by:

    • upholding and/or following this policy when working in our respective organizations, and unlearning our conscious or unconscious biases of who is deserving or undeserving of these services; and

    • encouraging our institutions to have or follow their own access without fear policies, if they do not already.

    We all have a role to play in creating a welcoming and inclusive sanctuary city. If you have any questions, feel free to email us at uninsurednetwork@gmail.com