Dissolve CCACs: Nurses association

Posted on October 14, 2012 in Health Delivery System

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TheSudburyStar.com – news/local
October 6, 2012.   By Carol Mulligan

An organization representing 33,000 nurses in Ontario is calling on the province to dissolve Community Care Access Centres and integrate their long-term care placement and home-care responsibilities into the primary health-care system.

Doris Grinspun and the Registered Nurses Association of Ontario will release a 30-page report next week, calling for 14 CCACs, including the North East CCAC, to be dissolved because they are top-heavy with administration costing the system millions of dollars.

CCACs were established to place seniors and others in long-term care, and provide home nursing, personal support and other home assistance.

Policy-makers at the RNAO say getting rid of CCAC administration would save Ontario’s health-care system at least $163 million a year.

That money could provide 4 million more hours of home care for Ontarians who desperately need it, said Grinspun.

The RNAO will release its white paper called “ECCO: Enhancing Community Care for Ontarians” next week. It’s a three-year plan that would phase out CCACs by 2015.

The RNAO is proposing the 3,500 case managers working for CCACs — 3,000 registered nurses and 500 social workers and other health professionals — be transferred to the primary care system under the direction of the 14 Local Health Integration Networks in the province.

“Imagine how primary care will function then,” Grinspun said Friday.

Those nurses would be divided proportionally among the 14 LHIN areas, working out of family health teams and community health centres, helping give patients access to primary care within 24 hours, a goal of the Ministry of Health and Long-Term Care.

With four million more home care hours and 3,500 more experts working in primary care, that will mean fewer visits to hospital emergency rooms “and people will be able to live better lives in their communities,” said Grinspun.

The RNAO believes it is impossible to have integrated seamless care for patients the way the system is carved up now.

People have been critical of the LHINs, organizations established by the Health ministry to bring health care decision-making closer to residents in 14 geographical areas.

With all their pitfalls, LHINs “need to continue to evolve way more,” said Grinspun.

Still, she called it “mind-boggling” how little the percentage of LHIN budgets go to administration, in contrast with CCACs.

According to figures from Ontario’s auditor general, 9.3% of the total provincial CCAC budget in 2008-09 went to administration.

By contrast, the Health ministry reports LHINs perform planning, accountability and administrative functions for 0.3% of their budgets.

The RNAO is proposing community health centres, nurse practitioner-led clinics, aboriginal health access centres and family health teams expand their roles with assistance from a temporary LHIN-led primary care transitional secretariat.

The 3,500 case managers transferred to primary care practices could help patients navigate the health-care system. That would better integrate the care of Ontarians, particularly the 10% with the most complex health-care needs.

For instance, navigators might direct patients from their primary care provider to a hospital, arranging for home-care or a long-term care placement when that patient would be released from hospital.

Former case managers working in primary care would know their patients “for their entire life, not just when they break a hip.”

The point is to avoid duplication and costs, and improve patient care, said Grinspun.

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