Pre-Budget Submission for the 2026-27 Ontario Budget


​Introduction


March of Dimes Canada (MODC) was pleased to present its Pre-Budget Submission to the Minister of Finance in December 2025 for Ontario's fiscal year 2026-27. As a transfer payment agency and key stakeholder delivering a wide variety of services for people with disabilities and their families, caregivers, and communities, MODC welcomes the opportunity to deliver insights and recommendations into how we can build a more equitable and inclusive Ontario. In developing this submission, MODC has listened to the priorities of our community of service users and stakeholders.

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Summary of Recommendations

  • Recommendation 1: That the government of Ontario prioritize funding care at home and in the community to enable Ontarians with disabilities and seniors to have independence, dignity, and choice by:  

    • Investing in a comprehensive suite of services including community support services and home care, allowing people with disabilities and seniors to remain independent in their homes and communities while reducing system pressures, totaling $641 million.

    • Establishing an integrated planning requirement by working across ministries of Municipal Affairs and Housing, Health, Finance, and Treasury Board and with service delivery organizations to ensure that investments in, or incentives for, the development of supportive housing/assisted living for people with disabilities include long-term system planning to ensure funding to support service operations is in place upon building completion.

    • Continuing to increase funding for the Home and Vehicle Modification Program (HVMP), enabling seniors and people with disabilities to remain in their homes and fully address the need, by an additional $10-15 million annually.

    • Re-imagining the Ministry of Health's Assistive Devices Program to provide seniors with 100 per cent coverage for the costs of equipment essential to remaining independent and to live with dignity, including implementing improved processes to better meet rising demand and expanding the list of equipment considered medically essential.

  • Recommendation 2: That the government of Ontario supports employment for people with disabilities by revising incentives so employment service providers receive payments for assisting clients with disabilities who cannot work 20+ hours per week, ensuring jobs align with individual needs and abilities.

  • Recommendation 3: That the government of Ontario support stroke survivors by complementing and deepening brain injury community support services with a $1.2 million investment in MODC's After Stroke program.


Recommendation 1: Investing in Care at Home and in the Community


We applaud the government of Ontario for recently announcing a $1.1 billion investment to protect and expand home care, including community support services. A home-first approach is more cost-effective and efficient, and receiving care in one's own home and community improves quality of life, preventing unnecessary hospitalizations, emergency room visits, and premature institutionalization.

Nearly one in five Ontarians is over age 65, signalling a rapidly aging population. More than 2.5 million people are without access to primary care and hospitals face persistent Alternate Level of Care (ALC) pressures. Meanwhile, long-term care waitlists have surpassed 48,000 people—and they're still growing.

 

Building on investments in home care


With these pressures, the community care sector faces challenges that are preventing the home-first approach from meeting needs of Ontarians. As the largest transfer payment agency providing Ministry of Health-funded community support services for Ontarians with disabilities, MODC has seen firsthand the impact of inadequate funding for the sector in the forms of system strain and staffing shortages.

MODC supports and echoes the Ontario Community Support Association's (OCSA's) pre-budget recommendations1 to address this growing need and the current challenges the sector faces, totaling $641 million, by investing:​

  • $442 million annually for three years to protect home care progress with a 5 per cent base budget and service volume increase.

  • $150 million annually for three years to strengthen Community Support Services and Independent Living agencies with five per cent base and service growth, workforce supports, and digital infrastructure. This includes an increase to dedicated funding for supportive housing/assisted living services.

  • $20 million annually to expand Healthy Ageing initiatives by funding coordinators in 100 Naturally Occurring Retirement Communities (NORCs) and connecting 30,000 seniors to Community Wellness Hubs.

  • $25 million annually for two years to expand and optimize home care clinics, providing wrap-around care and stronger links to primary care and rehabilitation.

  • $4 million over three years to build leadership and governance capacity across home and community care organizations.


Ensuring people with disabilities and seniors have access to supportive housing/ assisted living services in affordable homes


MODC is honoured to provide supportive housing/assisted living services to Ontarians across the province. We offer these services to seniors, people with physical disabilities, and those with brain injury by assisting with activities of daily living (bathing, dressing, toileting, supports with medications along with ventilation care and bowel and bladder routines), and more. These services facilitate a higher level of independence, while reducing the demand for more complex and expensive care services. Given the government's $1.1 billion investment in home and community care in the recent Fall Economic Statement, we know this is a high priority for Ontarians.

However, providers like MODC face major challenges in capitalizing on partnerships with housing developers that include affordable, accessible units. These units enable people to receive supportive housing/assisted living services at home, often with onsite providers. Developers frequently approach service providers like MODC during planning to act as the service delivery agency for supportive housing units, leveraging municipal, provincial, or federal incentives. The developers of these units have already received approvals and funding to create accessible, affordable units in their developments, covering all capital costs.

Ontario Health lacks a transparent, timely process for funding supportive housing/assisted living, and the municipality or Ministry of Municipal Affairs and Housing does not notify the Ministry of Health that new units will be coming online at any point in the construction phase. This poor coordination forces service providers to seek last-minute, unbudgeted funds, straining health resources and risking accessible and affordable supportive housing/assisted living units reverting to market housing instead of serving those in need.


Over 900 Ontarians currently sit on the centralized waitlist for assisted living/supportive housing with an average wait time of 1870 days (over five years)2. In many cases, the people waiting for supportive housing/assisted living spaces in the community are Ontarians who are in hospital as 'Alternate Level of Care' (ALC) patients. Without service funding to go along with these accessible, affordable homes, those who need them remain in ALC settings or moved to long-term care, all at significantly more expense to the province than a supportive housing/assisted living home.


The need for dedicated funding for supportive housing/assisted living services will continue to grow as the population ages and as the federal government implements the new Build Canada Homes strategy.3 Build Canada Homes have committed to “grow the supply of affordable and community housing led by mission-driven organizations whose core purpose is to advance social, community, or equity-focussed goals. These include, but are not limited to, non-profits, co-operatives, Indigenous housing providers, and organizations supporting women, people with disabilities, newcomers, and those in need of supportive and transitional housing". Without operational funding from provinces and territories, these initiatives will not be successful.

 

Enabling more people with disabilities to access the supportive housing/assisted living they need requires:​

  • Increasing dedicated funding for supportive housing/assisted living services (as recommended by OCSA).

  • Establishing an integrated planning requirement by working across ministries and organizations to ensure that investments in housing developments with supportive housing/assisted living units include long-term system planning (service funding to support assisted living operations upon project completion). This requires a four-corners approach to enhance collaboration between the Ministry of Finance, Ministry of Municipal Affairs and Housing, the Ministry of Health and the Ministry of Children, Community and Social Services to eliminate barriers for people with disabilities accessing the housing and services they need.

  • Ensuring that a community support services lens is included in supportive housing/assisted living planning and consultation, recognizing the unique needs of people with physical disabilities, brain injury, and seniors with regards to housing and services.

  • Ensuring Ontario Health can respond to requests from assisted housing/supportive living providers for service funding in a timely manner or government clarification if these requests should be made through another agency, such as Ontario Health at Home, through the expansion of the Hospital to Home program.

 
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Home & Vehicle Modification Program


MODC's Home and Vehicle Modification Program (HVMP) embodies the home first approach and is delivered on behalf of the province of Ontario in partnership with the Ministry for Seniors and Accessibility (MSAA). HVMP grants enable people to complete basic living tasks such as eating, bathing, toileting and mobility, allowing them to remain in their homes and age-in-place longer.


“The stairlift we installed thanks to HVMP has given my mother her freedom and independence back. I hope more people become aware of this program – it's changed our lives."

Lorraine V, Milton Ontario


We welcomed a $5M increase to the HVMP budget in 2022 from the MSAA, an increase the Ministry provided due to the exceptional program delivery, customer satisfaction, and the value derived from ensuring Ontarians with disabilities of all ages return to, or remain in, a home that is safe and independent. This reduces unnecessary admissions to long term care, hospitals, and other institutional settings. We thank the government of Ontario and Hon. Raymond Cho, Minister of Seniors and Accessibility, for this investment and for their confidence in MODC to continue to build on this successful partnership.


To date, over 30,000 Ontarians have received funding to improve the accessibility of their homes and vehicles through the HVMP.  Last year, 2,570 grants were issued to people of all ages across Ontario, providing support through HVMP to secure 5,150 devices, adaptations, or modifications. Grant recipients work with local contractors and vehicle modification businesses, resulting in direct benefits for the local and provincial economy.

 

HVMP has proven outcomes that illustrate how even simple modifications can make a life-changing impact in the lives of people with disabilities, and reduce costs to the health care system, including:

  • Reducing visits to the Emergency Department by 85 per cent.

  • Reducing reliance on Emergency Medical Services by 80 per cent.

  • Enabling 80 per cent of grant recipients to remain in their homes and facilitating early hospital discharge for many others.

 

The program has experienced a significant increase in the volume of applications. Every year, the program must turn away hundreds of eligible clients due to insufficient funding. To fully meet the demand for the period for 2026-27, the program's annual budget would have had to double to $25 to $30 million.

 

This calculation considers the number of applicants we must turn away every year. Additionally, we know the volume of applications will continue to rise, especially as more seniors seek to remain in their homes. In 2020, there were 2.52 million people aged 65 and over living in Ontario. This number is projected to increase considerably to 4.4 million by 2046, according to Ontario population projections.4

 

Access to healthcare services and financial insecurity pose not only barriers but also significant challenges that prevent older adults from aging with dignity, independence, and safety. These challenges are compounded by rising living costs and fixed incomes, making it imperative that we address these issues.

 

To meet the growing needs of Ontarians to be supported to remain in their own homes and communities, reducing costs and demands on long term care and the health care system,

  • MODC asks the government to increase annual funding for HVMP by $15 million (for a total of $30 million) in 2026-27.
 

Assistive Devices Program


People with disabilities with low incomes are often forced to decide between buying food or being able to shower or toilet independently, safely, and with dignity. Without access to assistive devices, they cannot safely care for themselves. For example, the cost of a new wheelchair can mean not being able to afford to pay rent, which could force people into homelessness. Alternatively, not being able to pay for an assistive device can mean an inability to access basic human needs and worse, can result in being hospitalized or institutionalized. Current supports do not adequately support low-income seniors with disabilities, especially with the rising cost of equipment and the increasing cost of food and shelter in Ontario.

“Disabilities don't retire at age 65. They get worse. The costs of my first two wheelchairs were fully covered because I was an ODSP recipient. The third was only 75 per cent covered because I'm a senior. It's only because of a family member's generosity that I met my 25 per cent contribution requirement. Not everyone can rely on this kind of support, nor should they have to. Going through this ordeal unleashed shock and stress that I continue to wrestle with."

Sandra R, MODC Disability Advocacy Network member.


The current Ministry of Health's Assistive Devices Program provides 100 per cent coverage for those in the Ontario Disability Support Program (ODSP). However, once people turn 65, they are eligible for only 75 per cent coverage for medically necessary assistive devices. The program criteria also narrowly interpret what equipment is considered essential, funds the cost of replacement only every five years, and entirely excludes the cost of repairs. The demand for this program and number of service users over the age of 65 (60 per cent in 2017/18) is expected to continue to grow.5


To that end, we recommend that Hon. Sylvia Jones, Deputy Premier and Minister of Health:

  • Reimagines Ministry of Health's Assistive Devices Program to provide seniors with 100 per cent coverage for the costs of equipment essential to remaining independent and to live with dignity, including implementing improved processes to better meet the rising demand and expanding the list of equipment considered medically essential.


Recommendation 2: Supporting Ontarians with Disabilities to Access Employment

Service providers across Ontario who support people with disabilities are experiencing substantial challenges as a result of the provincial government's restructuring of Employment Ontario (EO). While the intention behind the transformation is to streamline employment services and create a more outcomes-driven system, its implementation has had unintended and deeply concerning consequences for inclusion of people with disabilities in our province.​

Under the new model introduced in 2019, all job seekers, including those receiving Ontario Works and the ODSP, now access employment services through a single system managed by Service System Managers (SSMs). In this system, funding to service providers is increasingly tied to performance-based outcomes, including incentive payments triggered only when a job seeker is employed for a minimum of 20 hours per week.

 

This threshold presents a major structural barrier for many people with disabilities for whom working twenty hours per week may not be feasible. Individuals may face episodic health conditions, post-neurological illness fatigue, require workplace accommodations, or need to re-enter the workforce gradually after extended periods of unemployment or recovery. In these cases, part-time employment, flexible schedules, and progressive work experiences are critical and meaningful steps toward long-term employment and financial independence.

 

The current funding model doesn't allow for these options. It forces service providers into choosing between helping people who can and want to work part-time – albeit under 20 hours each week – without getting paid for that support, or focusing on clients who meet the 20-hour requirement to keep their operations running. This creates an unfair system that excludes people with disabilities, goes against the idea of inclusive employment, and undermines person-centered services.

 

In practice, this restructuring has resulted in reduced access to appropriate employment services for people with disabilities, strained provider capacity, and the erosion of specialized expertise that has been built over decades. Without changes to the funding and measurement framework to reflect the diverse realities of job seekers with disabilities, the system risks excluding those it most urgently needs to support.

 

MODC asks that:

  • The government of Ontario supports Ontarians with disabilities to access employment by re-evaluating and adjusting the incentive structure to include incentive payments for employment service providers to support clients who are unable to work a minimum of 20 hours/week, to better support people with disabilities to access employment that is the best fit for individual needs and abilities.

 

Recommendation 3: Supporting Stroke Survivors


As a community support organization, MODC is a major provider of brain injury services across the province, providing assisted living, case management, day programs, and outreach services to people living with the effects of a brain injury. People impacted by stroke represent a growing proportion of brain injury survivors.

 

More than 40,585 people in Ontario experience a stroke each year, with 423,260 people living with the effects of stroke.6 With advancements in medical care, the survival rate for stroke has increased dramatically, and more people are surviving stroke than ever before. As more people survive a stroke, it has become one of the leading causes of adult disability in Canada. Nearly two-thirds of stroke survivors leave hospital with a disability, such as mobility and cognitive disabilities, aphasia and communication disabilities, and/or debilitating fatigue. Stroke impacts every aspect of a person's life, from physical health to mental health, family life, financial, and social and community participation.7

 

Recognizing this increased need, we applaud the Ministry of Health for identifying stroke as one of four priority conditions requiring a common clinical pathway to improve patient care, including touchpoints with primary, hospital, and community care.8 It is crucial that the final part of this equation – community-based support– is prioritized for stroke survivors transitioning back to their homes and communities while navigating the path forward after a stroke. When stroke survivors have access to this support, they experience improved quality of life and less need for further medical support/hospital re-admission.

 

After Stroke: tailor-made for stroke survivors' needs

As a response to the increasing needs of stroke survivors, MODC's After Stroke program was created in collaboration with stroke experts and people with lived experience of stroke to directly fill the gap. Guided by lived experience and evidence-based design, After Stroke provides world-class stroke support and is based on Canadian Stroke Best Practice Recommendations. Health navigation system support is delivered by After Stroke Coordinators at a time when the health and rehabilitation systems are new and overwhelming to survivors and their families and caregivers. Our After Stroke Coordinators fill the gap by giving stroke survivors and their families a seamless transition from hospital to home and then reintegration within their community.

 

After Stroke puts stroke survivors and their families at the centre of care, helping them meet their personal recovery goals and connecting them to community supports. After Stroke begins providing support to stroke survivors and their families just before they are discharged home, and then the support is carried through to their return home where we offer coordination and community navigation.

 

In partnership with the Northern Independent Living Agencies, MODC has been funded by Ontario Health North to provide post-stroke services in Sault Ste-Marie and Timmins since 2014. In Waterloo-Wellington, Home and Community Care Support Services has recognized the importance of stroke services past the walls of the hospital through the Aging at Home Strategy and has been funding the program for residents of that region through Grand River Hospital since 2008. Our goal is to bring the invaluable support of the After Stroke program to stroke survivors and their families, in every region across the province.

 

With the goal of closing gaps for stroke survivors and their families across the province, MODC is recommending the government of Ontario:

  • Support stroke survivors by complementing and deepening brain injury community support services with a $1.2 million investment in MODC's After Stroke program.

 

An essential community program for stroke survivors and their families and caregivers, the After Stroke program can, with public funding, be a sustainable and long-term support service for the growing population of stroke survivors in Ontario, reducing the burden on existing funded brain injury services by providing investment focused on this specific population.

 

About March of Dimes Canada

March of Dimes Canada (MODC) is a leading national charity committed to championing equity, empowering ability, and creating real change that will help people with disabilities across the country unlock the richness of their lives.

 

Together with our partners, we serve, connect, and empower people with disabilities to participate fully in life and in their communities on their own terms. Our work is grounded in the voices of the people we serve, built on a foundation of service, and backed by more than 70 years of success.


We've proven time and again our dedication to serving the needs of people with disabilities. Born in one of the 20th century's greatest public health crises, we know that seemingly impossible goals can be achieved, and barriers can be broken. In the 1950s, MODC helped fund a vaccine for polio. Now, we are working on creating communities in which people with disabilities can live and thrive nationwide.

 

We're proud to support people with disabilities across Canada, from the early years to seniors. Our services extend beyond the individual to families who feel the impact of disability in different ways. Their collective experiences play a critical role in shaping our work as a service provider, resource, and advocate, which is focused in four areas: ​

  1. The best start for children, youth, and families.

  2. Independence at home and in the community.

  3. Active, healthy, connected lives.

  4. Financial security.

 

These are the things people with disabilities told us they need, want, and expect out of life.

 

Our staff and volunteers are allies, supporters, and champions committed to making a difference for people with disabilities. With the guidance of our community, and working together with our donors and partners, we provide the tools and support our service users need to live independently, improve their health and wellness, and thrive in all they aspire to do.​

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1 Ontario Community Support Association (OCSA), 2025 Pre Budget Recommendations. October 2024. https://www.ocsa.on.ca/2025-pre-budget-recommendations

2 ASAC (Attendant Service Application Centre) wait list, accessed December 16, 2025.

3 Government of Canada. “About Build Canada Homes". https://housing-infrastructure.canada.ca/bch-mc/about-apropos-eng.html. Accessed December 8, 2025.

4 Government of Ontario. https://news.ontario.ca/en/release/1004835/ontario-expanding-seniors-active-living-centres, July 16, 2024.

5 Auditor General of Ontario. “3.01 Assistive Devices Program." Annual Report, December 5, 2018.

6 Government of Canada, Canadian Chronic Disease Surveillance System, January 27, 2023, https://health-infobase.canada.ca/ccdss/data-tool/Comp?G=00&V=11&M=5

7 ibid.

8 Ontario Ministry of Health, Ontario Health Teams: The Path Forward, November 2022.​

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