What would you change What would you create

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What would you change?What would you create?
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What model works best?

• Client or service-based model?
• Labour-based model?
• Funding/financial-based model?
• Scenario
• What would happen if we empowered the user and
  let them choose their preferred type of care?

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(No Transcript)
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Principles

• Consumer-driven, emphasis on choice
• Competition, broadly speaking
• Health care costs separate from housing costs
• Got. regulation vs. govt.. direction
• Satisfaction performance measures
• Funding sources open to private options

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Current situation clients follow the funding

• Clients in need of home community care are
  placed according to need eligibility
• Three different funding systems
• Facilities are not client-based
• Care levels are not standardized
• Care varies geographically
• Clients choice is limited to home support or
  residential care

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Current situation clients follow the funding

• The Home Community Care system must change to
  meet emerging socio-economic demands
• - aging population
• - increased acuity levels
• - consumer expectations
• - financial pressures on govt.

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A case for Care Credits

• With this model, the funding follows the client
• Government should continue to subsidize Home
  Community Care even though not covered by the
  Canada Health Act
• We do not want the program to become strictly a
  subsidy program for low income seniors (why?)
• Care Credit model will support home community
  services based on client choice, promoting low
  cost alternatives and high quality services

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How the model works

• All BC residents are eligible for Care Credits
  based on need
• Clients need eligibility are assessed by their
  local health authority using MDS
• Care credits are assigned accordingly
• Got pays for care
• Client pays for housing hospitality (non-care
  costs)
• Client then chooses how they want to use their
  credits

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How the model works

• Client can also choose their preferred service
  delivery model service provider
• - home support - adult day care
• - assisted living - residential
• - other?
• Care credits are applied to the service provider
• Clients can top up as they so desire

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Benefits of competition

• A truly competitive system
• Limit the amount of providers at the start
• As the market grows, add new providers
• Define guaranteed service levels
• Let the market drive demand
• Home support would grow
• Niche marketing would flourish

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How service providers are affected

• Providers are approved/designated by the health
  authority
• to limit expansion as a transitional step?
• Client-based model places emphasis on service
  client satisfaction
• Care Credits are for care services only
• Housing non-care services are clients
  responsibility
• (potential for private insurance and/or asset
  testing)

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How service providers are affected

• Government could subsidize housing hospitality
  services for those unable to pay (Income Support
  Program)
• Facility could provide a variety of housing
  hospitality services and charge accordingly
• New incentives may help expand residential
  services, including those services which replace
  or augment hospital services -
• rehab services
• emergency care
• primary care

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Potential impact

• This model embraces a market-driven, consumer
  choice system rather than a got-provider system
• Alternatives to residential care as we know it
  today increase
• Standardizes funding for care component
• Ensures fairness and equity for provider funding
• Confirms govt. responsibility to fund care
  services while client/family fund housing
  hospitality

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Potential impact

• Got controls spending by increasing or
  decreasing care credits number of providers
• Encourages elimination of silos
• Invites an environment of heightened quality
• Fosters multi-service providers with a wide
  range of services products
• Clients are in the driver seat influencing
  choice quality through their purchasing power

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Discussion

• What would you change?
• What would your create?
• 1. The long term health care system we want to
  create is
• 2. How do we reposition our sector as an esteemed
  profession?
• 3. What do people require to love their work?
• 4. What should our sector say to govt., to the
  public?