On July 2, 2025, the Director of Integrated Community Health Services Centres (the "Director") issued a call for applications for new integrated community health services centre ("ICHSC") licences for orthopedic surgery services (in particular, prescribed hip and knee procedures).1
The call for applications, issued in accordance with the Integrated Community Health Services Centres Act, 2023 ("ICHSCA"), is the first step in the ICHSC licensing process aimed at expanding access to hip and knee joint replacement procedures in community-based settings. We described the ICHSCA regime in a previous bulletin.2
Background
In September 2023, the ICHSCA replaced the Independent Health Facilities Act. The ICHSCA sets out a new funding and licensing regime for ICHSCs. Also described by the Ministry of Health as "community surgical and diagnostic centres", ICHSCs are intended to support the provision of OHIP-covered diagnostic services, surgeries, and procedures outside of hospital settings.
The call for applications to license ICHSCs for orthopedic services is the third in a series of calls for applications made over the last year by the Director under the ICHSA. Previous calls for applications include for MRI/CT imaging services and gastrointestinal ("GI") endoscopy services. These calls closed on August 12, 2024 and November 4, 2024, respectively, with the province recently announcing investments of $155 million toward 57 new ICHSCs for the delivery of publicly funded MRI/CT imaging and GI endoscopy services.
Call for Applications for Orthopedic Surgeries
While the ICHSCA prescribes certain required information to be included in a licence application, including a detailed description of services to be provided, a detailed staffing plan, and a description of any uninsured services to be provided at the proposed ICHSC, the list is open-ended.3 The licence application for orthopedic surgeries features a number of additional requirements as compared to the applications for MRI/CT imaging and GI endoscopy services, including:
- Rapid Access Clinic Referrals: All operators of orthopedic surgery ICHSCs are required to establish formal partnerships with local Rapid Access Clinics, as all patients receiving funded orthopedic surgery services at the ICHSC must be referred through regional intake programs that are supported by Rapid Access Clinics. Applicants are required to provide documentation of established connections with regional Rapid Access Clinics, for example in the form of an agreement or letter of endorsement.
- Hospital Partnerships: All operators of orthopedic surgery ICHSCs are required to establish and maintain partnerships with at least one local hospital4 with an established orthopedic surgery program prior to delivering the ICHSC services. Local hospital partners must be able to provide emergency and in-patient care to ICHSC patients where needed. Applicants are required to provide formal documentation of arrangements with local hospitals, or, otherwise, of efforts to establish such arrangements. It is also a requirement that all physicians providing orthopedic surgery and anesthesia have active hospital privileges at a local hospital.
- Post-operative Rehabilitation Services: All orthopedic surgery ICHSCs must provide funded post-surgery rehabilitation care to patients who clinically require it. Applicants are required to provide documentation of partnerships with rehabilitation partners for the provision of rehabilitation services such as out-of-hospital rehabilitation, in-house rehabilitation services and home-care rehabilitation services, for example.
Successful applicants will receive facility cost funding from the Ministry of Health for prescribed orthopedic surgeries. The application materials provide additional information about funding.
The deadline to submit a completed application for an orthopedic services ICHSC licence, including all supporting materials, is August 27, 2025. If you have any questions on the ICHSC licensing process or are considering becoming an applicant, please contact us.
Footnotes
1. To access the application materials, see: Resources for community surgical and diagnostic centres | ontario.ca. LEARN MORE
2. See also: What to Know About the Draft Regulation to the Integrated Community Health Services Centres Act – Part I | Fasken LEARN MORE
3. ICHSCA, Section 5(4).
4. As described in the Application Guidelines, for a hospital to be classified as "local," the ICHSC must be geographically located in the catchment area of the hospital to receive emergency cases.
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