Test case profile

Challenging funding limits for home visits for ‘complex care’ patients

In 2012, Ian Cole, a 52-year-old man born with a severe intellectual disability that prevents him from speaking, developed complications to a long-standing bladder disorder that caused him to need an increase in catheterizations by a nurse to five times a day—which was one more than the Community Care Access Centre (CCAC) allowed for nurse visits to people living in the community. His mother, Audrey, was told that the CCAC had no options for providing the additional service other than placement of Mr. Cole in a long-term care facility.

With legal aid help, Ms. Cole retained lawyer, David Baker, on behalf of her son to fight the regulation. The argument was that it was discriminatory to unnecessarily increase the risk of forcing someone out of their home into an institution. During the Coles’ human rights case against the province, the Ontario Ministry of Health recommended a new rule to give CCACs discretion to increase daily nursing visits for people with “complex care needs.”


“During our litigation, the provincial government amended its regulations. The government acknowledged that approximately 1,900 persons with developmental disabilities residing in provincial long-term care facilities needed to have their circumstances reviewed. In addition, the government acknowledged that the previous regulation had the potential to create hardship and disadvantage for individuals and committed to further amending the community care regulations by removing community nursing service caps altogether for persons with ‘complex care needs.’

Mr. Cole’s important case was supported extensively by financial contributions from the Coles and their supporters as well as services provided pro bono by his lawyers at Baker Law.”

— David Baker, lawyer for Ian Cole

More information