Nurses urge streamlined care
Group wants restructuring of agencies in charge of providing provincial home health services
In an upcoming report, the Registered Nurses’ Association of Ontario is seeking an end to the province’s Community Care Access Centres, calling them a duplication of existing services and provincial bureaucracy.
“Our report actually proposes that a better system would be to transition the role of CCACs to other existing structures,” said Doris Grinspun, the association’s chief executive officer.
“CCAC contracts out services, that costs administrative money that in our view will be better spent, quite frankly, in primary care and in home-care hours, so these families and others can experience more home-care hours.”
The Star recently highlighted the story of Doris Landry, an 84-yearold woman who outlived a 90-day CCAC home-care program. She is still dying but now faces cuts to her hours of care.
An advance copy of the nursing association’s white paper viewed by the Star calls for the co-ordination of home care to be handled, not by CCACs, but by primary health-care organizations — places like community health centres, nurse practitioner-led clinics, aboriginal health centres and family health teams.
The proposed change would involve moving some of the responsibilities of the CCACs to Local Health Integration Networks, which currently are responsible for planning and funding health care services. Case managers in the CCAC system would transfer skills and expertise to the “primary care setting.”
“If the LHINS didn’t exist, it would be a different story, but you cannot have two highly expensive bureaucratic structures and expect integration,” Grinspun said. According to the auditor general’s 2010 report on home care, the CCACs cost the province $1.76 billion in 2008-09, 9 per cent of which went to administration costs. Using figures from that report, the nurses’ association estimates they could add 4,075,000 additional hours of home health care for Ontarians by eliminating the CCAC administrative infrastructure, such as CEO positions, buildings and operating expenses.
What the nurses are proposing doesn’t match what Tim Hudak wanted
The report is a less extreme alternative to a similar policy initative Tim Hudak’s PC Party released earlier in September that called for abolishing the province’s LHIN and the CCAC structures, with their responsibilities turned over to about 40 hospital “hubs” in communities across Ontario. When asked about the nurses’ plan, Health Minister Deb Matthews said she couldn’t comment because it hasn’t been released. “What I can tell you is that people right across the health-care system are very much engaged in the conversation about what we need to do differently. We are in some challenging times fiscally, what that is doing is generating a lot of people thinking very creatively and very constructively about how we can provide better care with more money — but not a lot more money.” Sue VanderBent, executive director of Home Care Ontario, said she never rushes to embrace or criticize new ideas when it comes to systemic changes in health care. “I always think you have to be thoughtful particularly about big system ideas for change because of the disruption to people,” she said. VanderBent said about 600,000 people receive home care in Ontario, and there are “certain structures in place that are really trying to round the corner on getting a hold of getting more care into the homes.”