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In 2010, the Ontario government introduced Bill 21, the Retirement Homes Act, 2010 (the Act), which required the licensing of retirement homes (RHs), residents' rights, care and safety standards, inspections, compliance and a newly formed Retirement Homes Regulatory Authority (Authority).  The Act and its regulations drew heavily from the content of legislation pertaining to long-term care homes (LTC homes), recognizing that many RHs provided high acuity care. However, the Authority was constituted with a multi-sectoral board, which was arm's length from government.  The stated goal of the Act was to ensure the dignity, respect, safety and privacy of residents, though the government also recognized the importance of preserving autonomy and choice for the predominantly private, for-profit operators and their residents.  A consultation process spurred considerable debate over the content of the proposed legislation as well as the authority that would oversee it.  The unwillingness of the government to fund care services in RHs (unlike LTC homes) influenced its policy decision to pass the Act in a form that gave greater autonomy to the industry to oversee its regulation through a multi-sectoral Authority, rather than one directed by government. A formal five-year review showed the reform to be well received by the public and key stakeholders, and an Effectiveness Survey for Stakeholders conducted by a third party indicated positive results, pointing to the success of both regulatory content and oversight. Le gouvernement de l'Ontario a introduit en 2010 le Projet de loi 21, Loi de 2010 sur les Maisons de Retraite (la Loi), qui imposait l'accreditation des Maisons de Retraite (MR), des droits des residents, des normes de soins et de securite, des inspections, une norme de conformite et la creation de l'Office de reglementation des maisons de retraite (l'Office). La loi et ses reglements se sont fortement inspires du contenu de la legislation des foyers de soins de longue duree, de nombreuses MR fournissant des soins intensifs. Cependant, l'Office est dote d'un conseil d'administration multi-sectoriel, autonome par rapport au gouvernement. L'objectif declare de la Loi etait de garantir la dignite, le respect, la securite et l?intimite, meme si le gouvernement affirmait aussi l'importance de maintenir l'autonomie et le choix des operateurs, principalement prives et a but lucratif, ainsi que de leurs residents. Un processus de consultation a lance un debat nourri sur le contenu de la legislation proposee ainsi que sur l'office charge de la gouverner. La reticence du gouvernement a financer les soins dans les MR (comme il le fait pour les foyers de soins de longue duree) a motive la decision politique d'ecrire une Loi donnant une plus grande autonomie a l'industrie pour mettre en oeuvre sa propre regulation a travers un Office multi-sectoriel, et non pilote par le gouvernement. Une evaluation formelle a cinq ans a montre que la reforme avait ete bien recue par le public et les principales parties prenantes, et une enquete d'efficacite aupres des parties prenantes, conduite par un tiers de confiance, suggere des resultats positifs, tant sur le fond que sur la gouvernance.

Bringing Care Governance to Ontario's Retirement Homes Sector