Tag Archives: ALC

Walker misses point on why for-profit nursing homes cherry-pick residents

Dr. David Walker is accusing long-term care homes of cherry-picking patients who are easy to care for, leaving more complex ones to hospitals.

As the province’s point person on the alternate level of care issue, did he just discover this?

When Ontario decided to put the more than half of its nursing home beds in the hands of profit-seeking companies, what did they expect?

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Want to solve the ALC problem? Stop designating patients as ALC.

In Dr. David Walker’s summer ALC (alternate level of care) report he gives the example of the Toronto Central LHIN’s efforts to reduce their ALC roster.

Alternate level of care patients are said to be indivdiuals who have completed their acute care but are unable to go home or secure a long term care bed. There used to be an ugly word for them — bed blockers — which appeared to put the blame on the patient for a failure of the system to provide a continuum of care.

The Toronto Central LHIN identified 148 long-stay ALC patients for review. While the LHIN was able to transition 28 of these ALC patients to alternate destinations, 22 were deemed medically unstable and not ALC at all. That’s nearly 15 per cent.

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NDP platform takes on dysfunctional home care system

Ontario NDP leader Andrea Horwath recently told the media she would not be revealing the NDP platform all at once, but the party web site does already contain a comprehensive platform.

The platform includes four major headings –  Making Life Affordable; Creating and Protecting Jobs; Building Healthcare That Works For You; and Living Within Our Means.

The NDP is the only party to commit to taking on the dysfunctional home care system which the most conservative estimates suggest 30 per cent of costs are tied up with administration surrounding the competitive bidding. The NDP would conduct a review of home care with the goal of bringing back a publicly-owned and accountable system. They would also target funding to increase the supply of home care by a million hours within four years.

The NDP see fixing home care as part of unlocking the puzzle of patients stuck in hospital waiting for community-based care. They also plan to add long term care (LTC) beds to eliminate the 2,650 Ontarians presently on the wait list. A recent OHA survey did suggest there were alternate level of care patients waiting for home care, although the majority – 61 per cent – were waiting for LTC. Patients in ALC beds were also waiting for rehab, complex continuing care, palliative care, convalescent care, assisted living/supportive housing as well as placement in mental health care.

The NDP would also add 50 round-the-clock health care clinics to alleviate emergency wait times. The goal would be to increase alternative options to cut hospital emergency department wait times in half.

The NDP commits to bringing more health services back under public OHIP coverage, including the elimination of ambulance fees.

The platform includes a hard cap on CEO salaries, limiting compensation to twice the Premier’s salary. They make the point that it would still compensate CEOs at seven times the level of a nurse. The NDP would also crack down on the use of outside consultants.

An NDP government would also forgive student debt to new doctors willing to locate in underserved areas with the goal of adding 200 doctors over four years to these communities.

The party would make drug costs a priority in any negotiations with the Federal government around a new health accord.

The NDP would open up hospitals to the scrutiny of the ombudsman – something Andre Marin has been asking for in his annual reports.

Like the Tories the NDP would scrap the Local Health Integration Networks (LHINs), however, unlike the Tories, they pledge to replace them with some undetermined form of local decision-making.

No platform would be complete without a promise around prevention, and the NDP do that with a pledge to make mandatory physical education in post-secondary schools, ban junk food advertising to children and force large chain restaurants to label calorie counts.

Coalition hosts one-day briefing/summit on “ALC” issue

The Ontario Health Coalition is hosting a one-day briefing and summit on retirement homes and alternative level of care.

Ontario hospitals are presently under tremendous pressure to relocate “alternate level of care patients” — patients who are finished their acute care treatment but are not well enough to go home.

Increasingly they are being sent to retirement homes, which are ill equipped to provide the level of care many require.

The Coroner’s office has issued warning to the Ontario Hospital Association about inappropriate placements of patients to retirement homes.

The government requires retirement homes to abide by standards of long term care in order to accept such patients, but is it enough, and are these standards really being met?

How can we best protect the comprehensiveness and accessibility of Ontario’s health care system for those with chronic care needs?
How can we best protect patients, residents and staff from harm?

High-Level Briefing and Summit
June 20, 2011
Lillian H. Smith Public Library
239 College St., Toronto
Registration 9 am – 10 am, Adjournment 3 pm

Registration is $0-$10.

Sponsored by: Ontario Health Coalition; Alliance of Seniors/Older Canadians Network; Older Women’s Network.