What Disaster Could Look Like

January 10, 2023

It’s a catchy title. Who could argue with making home care more convenient? If we look more closely, though, this legislation, which is supposed to make it “easier for people to connect to the home care services they need,” doesn’t say much about either convenience or care.

Instead, it’s all about structures. Working through the Ontario Health Teams, a new agency – Ontario Health atHome – is replacing Home Care and Community Support, which replaced the Local Health Integration Networks (LHINs), which replaced the Community Care Access Centres (CCACs), which replaced many regional authorities. That’s a lot of names and a lot of initials, but nothing about fixing the real problems in home care – inconsistent access to services, staff shortages, and swallowing up of non-profit community agencies.

The legislation emphasizes care planning for people when they leave hospitals but ignores those who want to stay in their homes and avoid those hospital stays. Care coordination can go from Ontario Health atHome to the Ontario Health Teams and it can then go to service provider agencies, many of them for-profit and some already not providing the care they’ve been contracted to provide. Accountability is unclear and public oversight lacking. Details will live in regulations that can be written with no public scrutiny or input.

“What’s going to happen to me? I live in my home. One agency gives me personal care, at least when it’s available. But my agency doesn’t have enough wound care nurses, so I get wound care from a different agency. How many care coordinators will replace the one I have now? Who coordinates all these coordinators? Who will be responsible? How many calls will I have to make? Will my care coordinators talk to each other? Will they talk to me?”

In our submission to government on Bill 135, Care Watch recommends:

• Developing clear pathways and care plans for older adults to receive services in their homes before or, even better, instead of being admitted to hospitals
• Assigning only one care coordinator to each client
• Supporting non-profit service delivery by giving non-profit agencies priority when contracts are awarded and making processes for awarding contracts public
• Establishing systems for accountability, consequences of non-compliance, and public reporting
• Carrying out a comprehensive plan for stabilizing a home and community care workforce paid as much as the workforce in hospitals and long-term care homes

What can you do?

Your tax money is paying for all these organizational changes. Make sure they mean something. Don’t be taken in by catchy titles with no real information. Demand answers.

• What is your government doing to provide more home care services and make them easier to get?
• What are they doing about shortages in home and community care? What are they doing to pay those workers the same as those in hospitals and long-term care homes?
• How are they reporting to you and other members of the public about the results of what they do?