Ontario’s Community Care Access Centres could have been very different had events unfolded differently in the early 1990s.
At the beginning of that decade home care was considered to have more of a leg in social services than health care.
The Rae government, like those that followed, were attempting to transition services from hospital to community and realized the potential of home care to look after patients discharged early from hospital.
The NDP were also sensitive to complaints that health care policies were being decided by the provider community, not by the users of the system. To that end, they not only encouraged widespread consultation, but even funded groups – particularly those representing seniors and the disabled – to speak to their communities and report back on what they heard.
That process was massive, involving more than 75,000 people, 110 provincial associations, 1,800 submissions and nearly 3,000 public meetings – all taking place within a five month window.
While the previous Peterson government had preferred more of a brokerage model – similar to today’s CCAC model which contracts to for-profit and not-for-profit agencies – the consultation process demonstrated that there was little appetite for a system most believed to be bureaucratic and fragmented.
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Tagged CCAC, Coalition home care roundtables, Community Care Access Centres, Competitive bidding, George Smitherman, Home care, Hudak position on home care, Liberal position on home care, NDP multi-service agencies, Ontario Community Support Association, Ontario Health Coalition, VON
Here we go again. This week news of another shocking nursing home death – this time in The Wexford, a Scarborough long term care residence. A second resident was also injured in the resident-on-resident attack.
Health Minister Deb Matthews predictably told the Toronto Star “if there is anything that can be learned from this incident, you have my commitment that action will be taken.”
In 2003 then Health Minister George Smitherman was moved to tears after a Toronto Star series on resident abuse. His famously vowed a “revolution” in long-term care.
In 2005 a Coroner’s jury made 85 recommendations after investigating the 2001 deaths of two residents at the hands of another in a different Toronto-area nursing home.
At the time the report was released, the home’s lawyer suggested there was a gap in the system for specialized long-term care units for residents with cognitive impairment (today that describes almost a third of all long-term care residents).
Smitherman declined comment that time.
In 2008 David Caplan was asked about a Canadian Press series that showed three-quarters of Ontario long-term care homes were not in compliance with provincial legislation. Caplan said he was too new to the post to comment and promised nothing.
In 2010 Metroland, which operates community newspapers across Ontario, ran its own series on long-term care. They called it “Situation Critical.”
We all remember former Health Minister George Smitherman tearfully promising a revolution in long-term care.
That revolution never really happened.
Now we’re beginning to wonder if modest gains made during the Smitherman years are now beginning to be reversed.
It’s been a while since the Ministry has offered us their estimate of hours of direct care nursing home residents are actually receiving. The most recent Ministry data we could find is from 2009.
Nursing homes have received a modest increase in funding this year – the largest amount going to the accommodations envelope (although the biggest percentage increase was for raw food). The smallest percentage increase went to direct care.
Last week Edgewater Gardens in Dunnville gave notice that they are reducing scheduled registered practical nurse (RPN) hours by 75 hours weekly effective February 15, 2013. The non-profit home adjacent to and operated by the Haldimand War Memorial Hospital, is putting a small portion of that back in the form of additional personal support (PSW) hours. The home says it is doing so to be “fiscally responsible,” meaning it’s about money, not about reorganizing the home to improve quality.
September 10 Doris Grinspun, executive director of the Registered Nurses Association of Ontario, tweeted that Health Minister Deb Matthews had just announced to a nursing meeting that the moratorium on competitive bidding in home care would be made permanent. No formal confirmation of this announcement has been made by the Ministry of Health.
No services competition has successfully taken place since 2004 when then Health Minister George Smitherman announced the appointment of Elinor Caplan to conduct a review into the competitive bidding process.
The Caplan review followed months of campaigning in the Niagara region after the Victorian Order of Nurses had lost the local home care nursing contract during its centenary in the community. OPSEU-represented VON members had met with MPPs up and down the Niagara peninsula to point out problems with the competition.
The union complained that the bidding process had been tainted by the then Niagara CCAC administrator who told at least one patient in advance of the competition that VON would not be a successful bidder.