Designation process for health service providers

The purpose of designating agencies is not just to build French-language service delivery capacity but also to ensure the continuity of those services under the French Language Services Act. The designation process is usually voluntary. Therefore, an agency that offers French-language health services must take steps to obtain designation on its own initiative, including applying to the Ministry of Health and Long-Term Care, which in turn forwards the request to the Office of Francophone Affairs, before it receives final approval from Cabinet. Having said this, nothing in the Act would prevent a “forced” designation by the government. Given that over the years several difficulties arising from the process have been noted, perhaps it is time to consider designating agencies even if they have not voluntarily requested such a process.

As the Commissioner explained in his 2011-2012 annual report, the actual designation process is cumbersome and complex, which limits the actual provision of French-language services to Francophone patients. The Commissioner’s Office notes weaknesses in the designation process’s evaluation criteria, the evaluation of services provided after obtaining designation, and the introduction of pre- and post-designation accountability mechanisms.

These grey areas have an impact on the delivery of services to the French-speaking public. The absence of a framework and a genuine accountability mechanism are impeding patient access to French-language services. Some designated agencies are unable to honour the commitments associated with designation, to the point that they simply ignore them, without consequences. The entire community in Ontario is affected by this unfortunate situation.

In his 2011-2012 annual report, the Commissioner pointed out these weaknesses and made some recommendations to improve the process.¹¹ In response to these recommendations, the Office of Francophone Affairs said it was willing to review the designation process and criteria in conjunction with its ministerial partners and Francophone community representatives.

The Office of Francophone Affairs set up a working group to develop an accountability framework and a more transparent designation process.

The Office of Francophone Affairs revised the designation criteria and introduced a new designation plan, which includes a designation application and compliance certification form, in place since January 1, 2014.¹² Every three years, designated agencies are required to submit a report to the sponsoring Ministry demonstrating their capacity to deliver their services in French in accordance with their designation, supported by “a resolution by the board of directors attesting that the agency has remained compliant with the criteria for designation.”

Criteria for the designation of organizations under the French Language Services Act

Source: Office of Francophone Affairs, 2013.

The working group’s mandate was only to update the designation criteria, develop a new template to analyze requests for designation and develop a process to monitor existing designated agencies. Each ministry is responsible for the continued compliance with the French-language services (FLS) obligations of the agencies they sponsor.

However, this has not led to a simpler, more accountable and transparent designation scheme.

In addition, this year, designated agencies are required to submit their first compliance report, even though there is every indication that very few providers have presented such a report on the programs and services they deliver on behalf of their Ministry. The implementation of the working group’s recommendations has not fully met the Commissioner’s expectations and concerns.

Recommendation 2

For the 2017-2018 fiscal year, the Commissioner recommends that the Minister Responsible for Francophone Affairs, develop and implement a directive that supports the new organization designation plan developed by the Office of Francophone Affairs, which includes simplified criteria, an independent mandatory triennial evaluation, as well as transparent accountability mechanisms and accessible evaluation reports following the designation.

11. In particular, he recommended the establishment of a mandatory directive on the designation process for agencies, which would include consistent designation criteria that provide for a minimum representation of Francophones on their boards of directors, accountability mechanisms that are transparent and accessible to the public, a complaint resolution mechanism, and a mandatory and independent assessment every three years.

12. For more details, see http://www.reseaudumieuxetre.ca/wp-content/uploads/2014/09/02.1-OFA-Designation-and-Evaluation-Form-010514-1.pdf (page consulted in May 2017).