Long Term Care in 2003

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Long Term Care in 2003

• A Presentation for Family, Staff, Volunteers and
  Others

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Long term care in Ontario

• Publicly funded healthcare service.
• 3-party delivery partnership.
• Government funds care nursing and programs.
• Residents contribute to accommodation government
  subsidy where there is demonstrated financial
  hardship.
• Operators private, municipal, not-for-profit,
  charitable contribute to buildings and provide
  management.
• Accountable amount of funding, spending,
  services are all government regulated.
• Standards manual, reporting, funding
  reconciliation, compliance, inspections etc.

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Sector size and structure

• 1998 57,000 beds 2004 - 77,000 beds.
• Government 20,000 new bed construction program.
• Modern design standards for living and privacy
  spaces.
• Larger, on-unit dining, less shared space, etc.
• 16,000 structurally non-compliant beds being
  redeveloped to new higher design standards by
  2006.
• 41,000 beds, or over half the sector, in existing
  homes.

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Current funding

• Government sets the amount of funding all homes
  receive for care and basic accommodation and
  regulates preferred (semi and private)
  accommodation charges.
• Nursing 59.81
• Programs 5.35
• Accommodation 45.57
• Total 110.73 (prpd)

5
Long term cares reality

• 2001independent MOHLTC funded Level of Service
  Study showed Ontario funded the lowest level of
  care of 11 jurisdictions in the study.
• Over an hour less care each day than residents
  received in Saskatchewan in 1999 (8th in the
  Study), and 2 hours less than in Mississippi.
• Yet, Ontario residents had amongst the highest
  levels of care needs.
• Confirmed that care funding had not kept pace
  with the increased care residents now needed.
• MOHLTC data shows care needs have increased by
  17.5 in past 10 years.

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Resident care needs profile

• Average age is 86.
• 9 out of 10 need help to dress and eat.
• 9 out of 10 are incontinent.
• 8 out of 10 need some help to move about.
• 6 out of 10 suffer from dementia and related
  disorders.
• 5 out of 10 have some medical condition and some
  more than one.
• Residents need average of 6 medications per day.
• Source 2002 MOHLTC Level of Care Classification
  Survey.

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Whats been happening

• OLTCA identified 750 million required over three
  years to bring Ontarios level of service to
  Saskatchewan.
• Move Ontario into the Top 10.
• Began advocating in 2001.
• Major campaign in 2002.
• Over 55,000 residents, families and others signed
  cards asking government to provide more care.

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Governments response

• Increased operating funding by 230 million
• 60 million in 2001 (2.60 prpd)
• 170 million in 2002 (6.33 prpd)
• Announced 7.02 per day increase in resident
  co-payment
• 3.02 in 2002 (included in 170 million)
• 2 in 2003 (50 million per year)
• 2 in 2004 (50 million per year)

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A small step

• Began to address highest priority residents
  needs.
• Created public awareness and concern.

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But, Ontario is still last!

• Residents still get 45 minutes less care each day
  than those in Saskatchewan got in 1999.
• Not enough staff in the homes to provide the care
  and assistance needed.
• Not enough staff to provide the specialized 11
  small group and evening and weekend programming
  residents need and Compliance Advisors recommend.
• 9 out of 10 still dont get the physical therapy
  that would help maintain their strength and
  health.
• Less than half get the special exercises they
  need to deal with stroke and other physical
  conditions.
• Increasingly difficult to meet nutritional and
  special diet needs on 4.49 per resident per day
  provided for raw food costs.

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And now, two classes of accommodation

• Government programs to build 20,000 new beds, and
  redevelop 16,000 D beds mean
• 41,000 residents, or over half the sector, will
  not have access to the new living and privacy
  standards.
• This is an issue of fairness and equity for the
  majority of LTC residents.

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People are concerned

• OLTCA, the Provincial Auditor, some politicians
  and consumer groups have spoken out.
• October 2002 results from an Ipsos-Reid Survey
  conducted for OLTCA showed
• 72 agreed that raising levels of care to match
  Saskatchewan should be a government spending
  priority.
• 90 agreed that government should introduce a
  program that would enable existing homes to
  redevelop to improve resident comfort and
  privacy.
• 72 agreed that government and residents should
  share the increasing costs of long term care
  But, only 3 said it should be the resident alone.

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The questions is.. Is government concerned, or
do they think they have already taken care of the
needs of the oldest, frailest and sickest people
in this province?
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What is still needed

• A government commitment to increase operating
  funding by 260 million (10 per resident per
  day) in 2003 and again in 2004.
• Raise Ontarios level of care to Saskatchewans
  in 1999.
• Move Ontario into the Level of Service Study Top
  10.
• A government commitment to introduce a capital
  renewal program that would enable older homes to
  upgrade their living and privacy standards.

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These commitments would..

• Provide more care staff to assist residents with
  health care and daily living needs.
• Provide more programming staff for the
  individual, small group, evening and weekend
  programming that is recommended and required.
• Provide more access to physical therapy, special
  exercise and other services.
• Provide increased access to enhanced privacy,
  living, dining and activity design standards.

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Yet, governments only commitment is.. That
residents will pay 2 more per day in 2003 (50
million) and another 2 per day (50, million)
more in 2004.
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Ontarios seniors deserve more We need your help
to tell government It is time to do your share,
too!
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Why we need your help

• Additional operating funding and a capital
  renewal program to support better resident care
  and service is about political choice.
• Your tangible support will
• Help convince government it is the right choice.
• Help demonstrate that residents needs have not
  been met.
• Residents may be out of sight, but they are no
  longer out of mind.

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How you can help..

• Contact your MPPcall, write, email and ask
  him/her to tell government that it is time to do
  their share for long term care.
• Contact information for MPPs is available on the
  OLTCA web site at www.oltca.com.
• Sign the Do Your Share Card that is available
  here.
• Talk to your family members and friends and
  enlist their support.

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What this home is doing

• Through OLTCA we are lobbying government
  intensely and directly.
• We are one of over 360 member OLTCA homes across
  the province actively seeking the support of
  staff, families, volunteers and others.
• Circulating information inserts in account
  statements.
• Holding meetings such as this.
• Getting Do Your Share cards signed.
• We will deliver all signed cards to MPP
  constituency offices on March 7 as part of
  province-wide initiative
• The more cards, the more we show that people care
  and the more we demonstrate that government
  should do more.

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QUESTIONS