Written Submission for the Pre-Budget Consultations in Advance of the Upcoming Ontario Budget 2026/27

By: Respiratory Therapy Society of Ontario (RTSO)

List of Recommendations:

• Recommendation 1: Continue to expand the scope of practice for healthcare professionals to improve access to care, including Respiratory Therapists.

• Recommendation 2: Work to reduce the wage gap between acute care versus primary/community care for healthcare professionals and in particular, respiratory therapists.

• Recommendation 3: Fund dedicated, full-time clinical educators in hospitals to ensure high-quality, reliable clinical training for respiratory therapy students, addressing current gaps created by part-time educators who manage both patient care and student supervision.

• Recommendation 4: Fund anesthesia care teams, specifically respiratory therapist-anesthesia assistants’ positions.

• Recommendation 5: Continue to fund the Provincial Long-Term Ventilation Strategy and expand it to include northern and rural communities.

• Recommendation 6: Support the upskilling of RTs, those wanting to return to practice as well as internationally educated RTs.

Background:

Recommendation 1: Continue to expand the scope of practice for healthcare professionals to improve access to care, including Respiratory Therapists.

RTSO supports the Ontario Minister of Health’s on-going initiative to enable health care professionals to work to the full extent of their expertise and training. RTSO agrees with the Ontario government that scope of practice changes improve access to care, especially for Indigenous communities and those living in rural, northern and remote areas of the province.

RTSO has been working together with the College of Respiratory Therapists of Ontario and will submit a proposal in 2026 to modernize the profession’s scope of practice statement; add new controlled acts authorized to respiratory therapists; ask for recognition of an Advanced Practice Role for Registered Respiratory Therapist Anesthesia Assistants; ask for prescribing authority for medications related to respiratory care; and request ordering authority for oxygen, chest x-rays and invasive and non-invasive positive pressure ventilation.

RTSO strongly supports these or any scope of practice changes that will allow RT’s to work to the full extent of their expertise and training.

Recommendation 2: Work to reduce the wage gap between acute care versus primary/community care for healthcare practitioners and in particular, respiratory therapists.

Similar to other healthcare practitioners, there are significant gaps between wages in acute care versus community settings. RTSO estimates these differences to be around 20% which creates challenges when trying to recruit respiratory therapists into family health teams, community health centres and respiratory therapy home and community care.

Recommendation 3: Fund clinical educator roles to ensure students in respiratory therapy programs can get the clinical training they need to learn and graduate.

Respiratory therapy programs are facing challenges in finding clinical partners which are necessary for clinical training. Currently, hospital or community-based clinical educator positions are funded by those employers. While some colleges pay a stipend per student that is given to the clinical site, it does not cover the clinical instructor’s full salary.

Due to this cost impact on the employer and the inability of the colleges to cover the entire cost through stipends, the clinical educator roles have been reduced or eliminated by clinical partners. The situation is exacerbated by a respiratory therapist shortage whereby short-staffed hospitals or other community partners are reluctant to take on students.

Recommendation 4: Fund anesthesia care teams, specifically anesthesia assistant positions.

The province is facing a severe anesthesiologist shortage, which is causing major disruptions in patient care. This includes extended wait times and reduced access to critical procedures.

The expansion of Anesthesia Care Teams (ACT) which include anesthesia assistants presents a proven solution to address these challenges. Anesthesia assistants are either registered respiratory therapists or registered nurses that have undergone additional training and certification. The ACT model has been shown to increase the number of procedures performed and provide significant cost savings.

We urge the Ontario government to take immediate action and invest in the expansion of Anesthesia Care Teams as part of a comprehensive strategy to address Ontario’s anesthesia capacity crisis. Hospitals, centers, and physicians need support to establish, supervise and maintain ACTs, including funding for clinical support, recruitment, and retention strategies.

Recommendation 5: Continue to fund the Provincial Long-Term Ventilation Strategy and expand it to include northern and rural communities.

Respiratory therapists are included in the provincial long-term ventilation strategy in some, geographic locations in Ontario, but there are many regions without adequate support. RTSO applauds this program and the impact it has for Ontarians and strongly encourages the government to expand it to ensure that all areas of the province (including the north) have equitable access to paid/funded respiratory therapist care for these very vulnerable and high-needs patients.,

Recommendation 6: Support the upskilling of RTs, those wanting to return to practice as well as internationally educated RTs.

Add Respiratory Therapists to the Learn & Stay grant which currently includes practical nursing, paramedic and medical laboratory technology/medical laboratory science. Consider bringing back the Allied Health Professional Development Fund to support continuing education for in-demand healthcare professionals, including respiratory therapists.

The Ontario Learn and Stay Grant provides funding for students studying in priority postsecondary programs in underserved and growing communities in Northern, Southwestern and Eastern Ontario. The grant covers the cost of tuition, compulsory fees, books and other direct educational costs. RTSO recommends that the Ontario Learn and Stay Grant includes respiratory therapists given shortages in underserved communities and the critical nature of respiratory therapists’ work, highlighted by the COVID pandemic.

RTSO also recommends that the Allied Health Professional Development Fund or a similar type of program be created to support the continuing education of in-demand healthcare professionals. The Allied Health Professional Development Fund was a HealthForceOntario initiative that provided reimbursement grants (up to $1,500 per person) for continuing education to nine eligible regulated health professions in Ontario which included respiratory therapists.

RTSO would also recommend that the government explore ways to financial support internationally trained RT’s to re-certify in Ontario. Several colleges offer such programs so this could include tuition support and/or grants.

About Respiratory Therapy Society of Ontario:

The Respiratory Therapy Society of Ontario is a non-profit organization of professionals devoted to the promotion of Respiratory Therapy in the province of Ontario.

The RTSO’s purpose is to:

• Promote leadership and direction in the expansion of the role of the Respiratory Therapist in response to the changing health needs of the community.
• Encourage the professional growth of our members by supporting the development, promotion and provision of educational opportunities
• Participate in the planning and delivery of high-quality health care.
• Support and provide public education on respiratory health and disease.
• Support programs in research, patient care, education and management.
• Promote the profession of Respiratory Therapy.
• Represent the professional interests of Respiratory Therapists voicing concerns in a consistent, unified fashion