Municipal Implications

The devastating toll of the COVID-19 pandemic has had disproportionate impact on residents in long-term care (LTC), affecting families and communities across the province and country in profound and tragic ways. Approximately 80% of deaths due to COVID-19 in Canada have been in LTC homes.

In response, the provincial government released the “COVID-19 Action Plan: Long-Term Care Homes”. Further the province announced the establishment of an independent LTC commission on July 29, 2020. The commission will investigate how COVID-19 spread within long-term care homes, how residents, staff and families were impacted, and the adequacy of measures taken by the Province and other parties to prevent, isolate, and contain the virus. The commission is expected to deliver a final report back to the Ministry by no later than April 2021 with their findings.This commission will provide a much-needed opportunity to transform the long-term care sector and enhance the quality of care received by Ontario’s seniors.

AMO is working with 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 submit recommendations. AMO and AdvantAge have called on the commission to consider a number of issues in its scope including staffing models, the physical structure of LTC homes, governance models, regulations and inspections, and access to infection prevention and control measures.

Although AMO looks forward to the commission’s findings, we have not forgotten about the long-standing issues facing the LTC sector. Across Ontario, the demand for LTC services has exceeds capacity. Provincial funding has not increased to meet the increased needs of residents.  Municipal governments continue to face even greater challenges in trying to address these gaps, which have only been exacerbated by COVID-19.

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 not 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 often jointly fund a home managed by a District Board of Management. The municipal sector operates more than 100, or 16%, of all LTC homes in Ontario – accounting for about 1 in 5 LTC beds in Ontario.



Michael Jacek
Senior Advisor