Municipal Implications

The devastating toll of the COVID-19 pandemic has had disproportionate impact on residents in long-term care (LTC), profoundly affecting families and communities across the province and country. The situation has improved in 2021 but the experience has underscored the urgent need to transform long-term care in many ways.

The provincial government established an independent LTC COVID-19 Commission in July 2020 to investigate how COVID-19 spread within long-term care homes, how residents, staff and families were impacted, and the adequacy of measures by the province and other parties to prevent, isolate, and contain the virus. The Commission released its findings and recommendations in their final report in April 2021. AMO worked with the municipal sector and AdvantAge Ontario, the association that represents municipal and non-profit long-term care service providers, to analyze the impact of COVID-19 on seniors in LTC and provide recommendations and feedback.

The Final Report from the Long-Term Care Commission was thoughtful and well-considered. Many of the findings and conclusions resonated with municipal homes. In July 2021, AMO provided a submission to the Minister of Long-Term Care in response to the Commission’s Final Report. This submission identifies opportunities for further study and consultation, and recommends how to use the Final Report as a platform to transform long-term care in Ontario. AMO continues to provide municipal perspectives to the Commission and Ministry of Long-Term Care.

AMO also supports measures outlined in the provincial Staffing Plan and has long called on the government to increase funding to provide an average of four hours of care per day to residents. In addition to full funding, AMO made a submission to the Ministry outlining a number of factors that contribute to how effectively a municipal home can meet this standard.

AMO is also pleased with the provincial government’s commitment to expand new long-term care beds, and to support redevelopment of older long-term care homes. The application process presents municipal homes with some unique barriers and considerations, such as:

  • raising capital and accessing financing, especially with limited tax base
  • finding staff capacity and expertise for development/redevelopment, including building system capacity, building construction and applications processes
  • the need for lifecycle funding
  • meeting rural and remote needs
  • accommodating the “campus of care” model
  • the need for federal funding.

AMO has provided recommendations to the Ministry of Long-Term Care on how to make this a viable and affordable option for municipal governments.

AMO has long called for adequate, stable, and predictable multi-year funding. Municipalities contribute significant dollars – about $350 million per year – over and above the provincial funding subsidy, not including capital. Given that long-term care has evolved to provide complex health care services, AMO believes that the municipal property tax base is neither a sufficient nor fair source to top up provincial funding. AMO has also highlighted the challenges for communities, particularly in northern and rural Ontario, to recruit and retain qualified staff such as nurses and personal support workers. The province needs to work with the sector to develop a province-wide human resources strategy to address staffing issues.


While the provincial government is responsible for LTC legislation, regulation and program requirements, municipal governments go above and beyond to make sure local seniors have access to quality services in the community. Many local governments operate additional homes and offer services that surpass provincial requirements. As per the Long-Term Care Homes Act, upper and single-tier municipal governments in southern Ontario are responsible for establishing and maintaining long-term care facilities. In northern Ontario, municipal governments can operate a home or come together with other municipalities to jointly fund a home managed by a District Board of Management. The municipal sector operates 100 (16%) of the 626 LTC homes in Ontario – accounting for about one in five LTC beds in Ontario.

AMO remains committed to working with the government to take action to transform the long-term care sector. Updates are found on the LTC and Seniors Services section of the AMO website.


Michael Jacek
Senior Advisor