Home and Community Care Sector

1
Home and Community Care Sector

• Home Care(Ontario)
• 1.7 billion
• 400,000 persons served
• private delivery - not-for-profit/commercial
• Community Care Access Centres(CCACs)
• managed competition for choice of provider

2
Community Support Services

• Community-based volunteer services
• Need for minimum service requirement
• Benchmarks for sector
• Increased funding

3
Value of our Sector

• Maintain the independence of vulnerable seniors
  and persons with debilitating diseases or
  disabilities to live at home
• Keep people out of institutions
• Promote health and well-being
• Cost-effective health and social services
• Could be the base of primary care

4
The Challenges - Funding

• Funding - major growth but 2001/02 was major
  disaster
• Government froze budgets
• Some CCACs had major deficits
• Very significant cuts to services
• Providers saw 40 reduction in volume
• Major hardship to consumers
• CSS significant service demand

5
The Challenges - Acuity

• Five years ago - 75 long-term (chronic)
• Today - 75 acute
• Major changes in hospital service and in medical
  developments
• Care being provided that we never dreamed
• Great but what is the impact on funding and
  service to long-term consumers

6
The Challenges - Human Resources

• Fairness - poverty wages, limited benefits and
  inadequate working conditions
• 25-40 less than institutions
• Pay Equity Impact
• Last March service was being denied because lack
  of staff
• Today staff are being laid off

7
The Challenges - Stability

• Inconsistency of practices
• Impact of management competition
• Legalistic emphasis
• Continuity of care
• Lack of government confidence

8
CCAC Reform

• External Review
• Findings
• Inconsistent policy and practice
• lack of leadership by government and CCACs
• Government lost confidence in management
• Ineffective advocacy by sector

9
CCAC Reform

• CCAC Act, 2001
• Statutory corporations
• Board and ED appointed by OIC
• Increased control by government
• Greater accountability of Regional Offices

10
Provider Advocacy

• One voice by sector
• Strong working relationship between
  commercial/not for profit
• Regular dialogue with politicians and staff
• Lobby for ADM, Home and Community Care
• Cooperative agreement amongst commercial/not-for-p
  rofit and OACCAC

11
Recent Recommendations

• Premiers August Meeting
• Health Care System Framework
• Three key pillars
• Acute Care
• Residential Services
• Home and Community-based Services

12
Recent Recommendations (cont.)

• Overriding Principles of a mature home and
  community care system
• single point of access,
• continuity of care,
• evidence-based practice based on the determinants
  of health,
• value for money
• positive health outcomes.

13
Recent Recommendations (cont.)

• Issue there is a major gap in linking the Home
  and Community Based Services with the other two
  pillars.
• Access to and navigation through the home and
  community care system is a serious issue across
  the country.
• Clients have no consistent way of obtaining
  information and accessing the provincial services
  they need to remain at home in the community.

14
Recent Recommendations (cont.)

• Launch a Home and Community Care Strategy to
  build each province/territorys capacity to
  attain the essential elements of a mature system
• IT funding for data collection and service access
• Initiate a Strategy to support caregivers, e.g. a
  Chronic Illness Caregiver Program, CPP for
  disabled children extended to their parents who
  care for them, a Patient Charter.
• Enhance access to essential medical supplies and
  drugs at home as a substitute for hospital care
• Launch Provincial/territorial Primary Care
  Studies with Home Care as the driver to assist
  with Primary Care Reform initiatives.

15
Key to the Sustainability of the Health Care
System