Auditor warns of long home care wait times

Posted on December 3, 2015 in Health Delivery System

TheStar.com – News/Queen’s Park – Auditor general Bonnie Lysyk’s report looks at a number of problems within Ontario’s health system.
Dec 02 2015.   By: Theresa Boyle, Health

The province’s home care system is still beset with problems such as long waits and unequal access, even though they were flagged by the auditor general five years ago and the government has identified the sector as a priority.

Provincial auditor Bonnie Lysyk’s annual report, released Wednesday, said the health ministry has yet to correct problems identified in her 2010 annual report.

“Although the ministry has recognized the importance of strengthening the home and community care sector, clients still face long wait times for personal support services, and they still receive different levels of home care service depending on where in Ontario they live,” she said.

Her findings spell more bad news for the province’s 14 beleaguered community care access centres (CCACs), which co-ordinate home care in distinct geographic regions of the province. Sources say the province is on the brink of scrapping them.

This is Lysyk’s second review of home care this fall. Her first, released in September, revealed that nearly 40 per cent of the money the province spends on CCACs does not go to “face-to-face” treatment of patients.
Her latest report shows that spending on home care has grown sharply in recent years, as have demands.

Between 2008-09 and 2014-15, the health ministry increased home care spending by 42 per cent, to $2.52 billion from $1.76 billion. Clients served increased 22 per cent, to 713,500 from 586,400.

Meantime, 70 per cent of CCAC long-stay patients have complex care needs today, compared to fewer than 40 per cent five years ago.

There are still no provincial standards for specifying the level of services clients with similar needs should get, a problem Lysyk highlighted in her 2010 report. Because of that, individuals with the same level of need may get five hours of personal support worker care weekly in one part of the province, eight hours in another and 10 hours in a third region.

Even within the same region, service levels vary according to time of year. There were nine times more people on a wait list for home care at the end of the fiscal year 2014/15 compared to the beginning of the year in one CCAC, the report noted.

Health Minister Eric Hoskins has said that a major restructuring of the province’s health system is on its way and has hinted that Ontario’s 14 local health integration networks (LHINs) may take on some of the work now done by CCACs.

But Lysyk’s report also identifies problems with LHINs, which share the same geographic boundaries as CCACs, and are charged with planning and integrating health services and a local level and delivering provincial funding to them.

It says that LHINs’ marching orders are not clear enough and that performance gaps are widening. For example, patients who no longer needed acute hospital care stayed in hospital more days in 2015 than 2007. There is nowhere else for them to go because, for example, of backlogs in home care and long-term care.

Hoskins also said that in the coming weeks, he will be releasing a discussion paper that addresses many of the concerns raised by the auditor.  “The observations and recommendations provided through this audit will be considered and incorporated by the ministry as we work towards our goal of higher quality, more consistent and better integrated home and community care,” he said.

The government is committed to improving home care wait times and to that end is increasing funding by $250 million this year and in each of the next two years, Hoskins said.

Meantime, the auditor’s report also found that a backlog of inspections of nursing homes, following complaints and critical incidents, is rapidly growing and placing residents at increasing risk.

“We found the ministry often did not take timely action to ensure residents were safe and their rights protected,” the 773-page report says in reference to those living in Ontario’s 630 long-term care homes. It noted that the backlog of complaints and critical incidents had more than doubled — to about 2,800 in March 2015 from 1,300 in Dec. 2013. Critical incidents include neglect, abuse, unexpected or sudden death and misuse of residents’ money.

The auditor found 40 per cent of complaints deemed high risk, which should prompt immediate inspections, took longer than three days. High-risk cases involve alleged improper care, abuse, neglect that can place residents in serious harm.

Medium-risk complaints, such as alleged verbal or physical abuse leading to minor harm, often took longer than the ministry’s own 30-day target to investigate.

< http://www.thestar.com/news/queenspark/2015/12/02/auditor-warns-of-delays-in-responding-to-nursing-home-complaints.html >

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