Bill changing rules could die with ontario election
The window is quickly closing for passage of a bill named for former Windsor autoworker Dan Duma, who died fighting for the right to receive homecare in his final days. Bill 54, the Homecare and Community Service Amendment Act, colloquially known as Dan’s Law, received second reading in 2016 and was to be reviewed by the justice policy committee. “Dan’s Law has remained in purgatory ever since,” says Dr. Darren Cargill, who was Duma’s palliative care doctor. With the provincial election set for June, Cargill is ramping up his government lobbying, fearing the bill will die if it’s not passed before this legislative session ends.
Duma and his wife Ana moved to Alberta to find work after GM’s Windsor transmission plant closed. There, Duma was diagnosed with liver cancer and was told he had only a short time left to live.
During the Alberta wildfires of 2016, Duma was airlifted to Edmonton when the hospital in Fort McMurray was evacuated. Duma and his wife decided to return to Windsor, where their two daughters live, for palliative care. But OHIP requires new residents to the province to wait three months for coverage. Under interprovincial reciprocal billing agreements during that waiting period, new residents can be admitted to hospital for medical care, but they don’t qualify for home care or a bed in a hospice home.
Dan’s Law proposes eliminating the waiting period for palliative care patients who move to Ontario after residing in another Canadian province.
Duma moved in with one of his daughters, but got no homecare. Duma’s daughters have medical backgrounds — one is a nurse practitioner and the other is a registered nurse — and they took turns caring for their father, bathing and dressing him. Cargill made house calls. Duma would have spent his final days in hospital were it not for Cargill pulling some strings to get him into a hospice bed in Leamington. Duma never got his wish to die at home, surrounded by family.
“We could have taken better care of Dan,” said Cargill. “It was like trying to care for a patient with one hand tied behind your back.” Cargill said there is no medical nor financial justification for the waiting period. During the waiting period, doctor fees and the cost of acute care beds in hospitals are covered, billed to the home province. But homecare and hospice residential care cost a fraction of hospitalizing palliative patients. An acute care bed costs about $1,000 a day compared to $250$350 a day for care in a hospice centre, Cargill said. Giving families support to care for a loved one at home costs the province $150$250 a day. “It makes sense from a financial standpoint,” Cargill says of the proposed legislative change. Cargill is urging people to contact new Health Minister Dr. Helena Jaczek, the house leaders for each party and Liberal MPP Shafiq Qaadri, the head of the committee where the bill is supposed to be dealt with.
Windsor West MPP Lisa Gretzky introduced Dan’s Law.
“I’m not understanding why this isn’t moving faster,” she said, explaining the bill seems to have widespread support in government. “To my knowledge, there is no opposition.”
Outside of government, the Ontario Medical Association and the Ontario Nurses Association endorse it.
Gretzky said the bill offers the opportunity to make better use of acute care beds at a time when hospitals are routinely over-capacity. Every province has a waiting period, Gretzky said. Ontario could pave the way to make exceptions — and save provinces money — in the case of palliative care patients.