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By Natalie Harmsen and Megan Sibley<\/p>\n
[\/et_pb_text][et_pb_image src=”https:\/\/cusjc.ca\/catalyst\/wp-content\/uploads\/2018\/03\/catalyst-2.jpg” align=”center” force_fullwidth=”on” _builder_version=”3.0.89″]<\/p>\n
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CBI Home Health is one of many groups offering home care services in the Ottawa area.<\/p>\n
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Miranda Ferrier, president of the Ontario Personal Support Workers Association, knows that the daily tasks her members are counted on to perform are anything but glamorous.\u00a0“It\u2019s not attractive at all,” says Ferrier, a former personal support worker (PSW) who provided home care to elderly clients.<\/span><\/p>\n “To work in home care, it\u2019s crap.”<\/span><\/p>\n It’s also challenging work, she adds, delivered under challenging conditions.<\/span><\/p>\n \u201cThink about everything you do for yourself when you get up in the morning. And think about if you\u2019re doing it for someone [else]. It\u2019s a lot more difficult.\u201d<\/span><\/p>\n Ferrier’s career is now dedicated to the membership-based PSW advocacy organization that defends the rights of workers who do the jobs that many cannot. What she sees is a system under strain.<\/span><\/p>\n In 2012, over 2.2 million Canadians received home care due to illness, disability, or elderly needs. In 2016, <\/span>home care services helped over 660,000 people in Ontario live independently according to the Ministry of Health and Long-term Care.<\/span><\/p>\n Now, an aging population is placing increasing demands on home care services.\u00a0In 2016 there were 2.3 million people in Ontario over the age of 65. That number is set to double in 2041, by which point seniors will make up 25 per cent of the province\u2019s population. Without more resources to accommodate the growing number of patients, home care faces an uncertain future.<\/span><\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.0.47″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”1_2″][et_pb_text _builder_version=”3.0.89″]<\/p>\n In a report published in January, Home Care Ontario–the organization representing home care providers and agencies across the province–argued the home care system is chronically underfunded. The report noted that the Ontario government allotted approximately five per cent of Ontario\u2019s total health care budget for home care, which is not enough to keep up with the increasing demand when home care accounts for $2.7 billion out of the current $53.9 billion spent on health care in Ontario each year.<\/span><\/p>\n [\/et_pb_text][et_pb_testimonial background_layout=”light” _builder_version=”3.0.89″]<\/p>\n \u201cOntario\u2019s home care system is at a tipping point. Families want and need more care, but patient complexity, an aging population, and government underfunding has meant they are actually getting less, and professional home caregivers are being asked to do more with fewer resources,\u201d said the report.<\/p>\n [\/et_pb_testimonial][et_pb_text _builder_version=”3.0.89″]<\/p>\n Last November, Ontario\u2019s provincial government announced the creation of a new agency, Personal Support Services Ontario (PSSO), to address the issue. The purpose of PSSO is to standardize home care across the province, but some believe that such a fix could mean further complications for an already-overworked system.<\/span><\/p>\n The agency\u2019s non-profit model would assume the care of patients who receive more than 14 hours of care weekly. Subsequently, this group would include acute, chronic, and palliative clients: the most demanding and technically challenging conditions to treat. Ferrier is concerned that provincially funded personal support workers would not be trained to provide this high standard of care.<\/span><\/p>\n \u201cThere [are] no medical backups, so they don\u2019t have registered staff. \u00a0They don\u2019t have Occupational\/Physical Therapists that they can rely upon if they have questions or concerns, or for delegation purposes, because a PSW cannot administer medications. They cannot do catheterizations, or feeding tubes, or anything like that,\u201d says Ferrier.<\/span><\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″][et_pb_code _builder_version=”3.0.89″]<iframe src=’https:\/\/cdn.knightlab.com\/libs\/timeline3\/latest\/embed\/index.html?source=1wpgXCKQJaTwFhUYczbPdwAZqz3XDFkmE9vlFhznUPrw&font=Default&lang=en&initial_zoom=2&height=650′ width=’100%’ height=’650′ webkitallowfullscreen mozallowfullscreen allowfullscreen frameborder=’0′><\/iframe>[\/et_pb_code][et_pb_text _builder_version=”3.0.89″ text_font_size=”11px” text_text_color=”#878787″ text_orientation=”center” module_alignment=”center”]<\/p>\n The history of home care, explained in this visual timeline.<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.0.89″][et_pb_column type=”1_3″][et_pb_code _builder_version=”3.0.89″]<script id=”infogram_0_d09ecc8e-358c-4854-a9c2-3a6bcaca6cde” title=”Flow Light” src=”https:\/\/e.infogram.com\/js\/dist\/embed.js?BIF” type=”text\/javascript”><\/script><div style=”padding:8px 0;font-family:Arial!important;font-size:13px!important;line-height:15px!important;text-align:center;border-top:1px solid #dadada;margin:0 30px”><a href=”https:\/\/infogram.com\/d09ecc8e-358c-4854-a9c2-3a6bcaca6cde” style=”color:#989898!important;text-decoration:none!important;” target=”_blank”>Flow Light<\/a><br><a href=”https:\/\/infogram.com” style=”color:#989898!important;text-decoration:none!important;” target=”_blank” rel=”nofollow”>Infogram<\/a><\/div>[\/et_pb_code][\/et_pb_column][et_pb_column type=”2_3″][et_pb_text _builder_version=”3.0.89″ background_layout=”light”]<\/p>\n Responding to this concern, David Jansen, a spokesperson for the Ministry of Health and Long-term Care says, \u201cThe ministry recognizes the important role of personal support workers in the health care system. We have undertaken a number of initiatives, including investing in PSWs by providing funding to increase the minimum base wage for publicly funded home and community care personal support services over three years to $16.50 per hour.\u201d<\/p>\n The current home care system in Ontario is comprised of both private (for profit), and government funded non-profit home care options: a patient’s socioeconomic status and other unique needs determine which route is more fitting for their treatment needs. Under the PSSO model, personal support workers (PSW’s) would become employees of the provincial government, and the agency would take over some of the services that are currently performed by private-sector providers.<\/p>\n Ferrier argues a better approach would not be a new agency, but instead further investment in this system that is functioning, but needs significant improvements.<\/p>\n Paul Williams, a professor of health policy at the University of Toronto, says when it comes to providing home care, \u00a0European countries are much more advanced compared to Ontario\u2019s system because they focus on preventative care.<\/p>\n \u201cIn Ontario it is very difficult to get any public service before you go to the hospital. If you’re not sick, you can\u2019t get anything. In most countries, they want to make sure that people don\u2019t get sick, because that gets even more expensive,\u201d he says. \u201cIn Ontario, we put all of our resources after the hospital, so the only way you get home care is after you’re discharged. [It\u2019s] totally bizarre, nobody does this, because they know you can\u2019t sustain a system like that.\u201d<\/p>\n To make improvements, Williams suggests the federal government should bargain harder to push the provinces to prevent illness before patients require home care.<\/p>\n \u201cWhen [people] need things like home care and support, that\u2019s organized around you and your caregiver,\u201d he says. \u201cOntario is a particularly bad case of where we have so many invested interests that it is impossible to make the really innovative change that aligns us with every other G7 country.\u201d<\/p>\n Other improvements may exist within the Self-Directed Care model, a trend in the health care industry where instead of an agency determining the type and implementation of care, patients decide and tailor their home care services to their specific needs themselves. Ideally, patients gain more control in specifying their care schedules, and voicing the types of care they prefer. <\/span>\u00a0<\/span><\/p>\n According to a 2010 study by the Commonwealth Fund, self-directed care programs are a cheaper, higher quality alternative to traditional home care programs, and generate greater patient satisfaction. A 2006 report for Health Canada explained that for many self-directed care programs \u201cinstead of funding professionals or agencies who deliver services to clients, governments directly fund clients who then purchase services from providers of their choice.\u201d<\/span><\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.0.47″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”2_3″][et_pb_text _builder_version=”3.0.89″ background_layout=”light”]<\/p>\n \u201cThey have the right idea with the [Self-Directed] Care model,\u201d Ferrier says. \u201cI think it\u2019s a great idea, and that clients deserve to have more say in what happens with their care.\u201d<\/span><\/p>\n The move to implement the new provincial agency this year came about in part due to existing labour issues surrounding Ontario\u2019s current PSWs. Under the new model, PSWs would be hired directly to the non-profit provincial agency, and then hired out to clients. Ferrier says this is a bad idea because patients will be the ones delegating tasks to the PSW, giving them excessive control.<\/span><\/p>\n The current public home care system relies on both personal support services, and professional services. Professional services provide medical care, as well as physiotherapy, occupational therapy, nutritional services, and speech pathology, while PSWs execute personal support services with bathing, dressing, administering medications, and assisting with other daily activities. Home Care Ontario suggests that a lack of government funding means these PSWs are burning out, underpaid, and unable to visit their patients as frequently as they would like. <\/span><\/p>\n Ferrier agrees. According to her, 21 per cent of PSWs are leaving the field.<\/span><\/p>\n \u201cPSWs are already inundated with countless hours, driving, over exhaustion, and being stressed; this [PSSO] crisis has made matters worse,\u201d she says.<\/span><\/p>\n <\/p>\n [\/et_pb_text][et_pb_testimonial background_layout=”light” _builder_version=”3.0.89″]<\/p>\n \u201cWhy is the government spending more money, 2.5 million dollars [to create the agency]? Why re-create the wheel? Why not take that money and invest it back into front line health care,\u201d she says. \u201cIt would make more sense. Imagine how many PSWs you could hire for 2.5 million, and right now there’s a mass shortage across the province.\u201d<\/span><\/p>\n [\/et_pb_testimonial][et_pb_text _builder_version=”3.0.89″]<\/p>\n Jansen says aside from PSSO, the Ministry of Health and Long-term Care created a $10 million PSW training fund, which has aided training and education. <\/span><\/p>\n \u201cWe believe that the people who are doing this work need to be supportive, and they need to be supported,\u201d he says.<\/span><\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″][et_pb_text background_layout=”dark” _builder_version=”3.0.89″ text_font_size=”12px” header_font_size=”18px” background_color=”#757575″ border_radii=”on|10px|10px|10px|10px” text_orientation=”center” module_alignment=”center” custom_padding=”15px|15px|15px|15px” box_shadow_style=”preset1″]<\/p>\n Home Care Ontario had requested the federal government provide funding to alleviate the effects of long wait lists, caregiver burnout, and infrequent visits from nurses- all of which they say are major issues in today\u2019s home care industry. Ahead of the 2018 budget announcements, it requested $600 million more over six years to improve some of these realities (a 6% increase from last year\u2019s funding numbers). <\/span><\/p>\n As of today, the federal budget released on February 27 suggests that Home Care Ontario\u2019s $600 million proposal will not be fulfilled: the federal government has allotted the same dollar amount to their home care budget as was seen in the last federal budget. In addition, home care has been placed in an expense category with mental health, suggesting that funds will be divided between two crucial industries that are in need of support.<\/span><\/p>\n Sue VanderBent, CEO of Home Care Ontario, says that “government funding would absolutely help.”<\/span><\/p>\n “Right now home care receives about $2.7 billion [per year], which is a lot of money, but proportionally that hasn\u2019t changed in 20 years,” says VanderBent. “This does not help us to address what we\u2019re seeing now in terms of the growing number of patients in total.”<\/span><\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.0.47″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”1_2″][et_pb_code _builder_version=”3.0.89″ max_width=”93%”]<iframe src=”https:\/\/www.google.com\/maps\/d\/embed?mid=1RStQshruog650GUTOZhExVuqXhVOZUcd” width=”480″ height=”400″><\/iframe>[\/et_pb_code][et_pb_text _builder_version=”3.0.89″ text_font_size=”11px” text_text_color=”#707070″ text_orientation=”justified” module_alignment=”justified”]<\/p>\n This map outlines each of the 14 Local Health Integration Networks across Ontario.<\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″][et_pb_text _builder_version=”3.0.89″]<\/p>\n Individuals can acquire PSWs via Local Health Integration Networks (LHINs), the provincial government agencies responsible for overseeing home care and community care across Ontario. LHINs work locally with health service providers including nurses, social workers, occupational and physical therapists, and PSWs to enhance access to care in people\u2019s private homes and in the community. <\/span><\/p>\n There are 14 such regional agencies across the province, all of which are funded through Ontario\u2019s Ministry of Health. To be eligible to receive care, Joanne Billing, vice president home and community care of the South-East region (The South East LHIN), says that any individual seeking home care must meet several requirements: A person must be insured by the government of Ontario and possess a health insurance card. They must also have care needs, which are divided into personal support services and professional services. Then the LHIN must assess eligibility by determining if they are able to provide care in the home environment.<\/span><\/p>\n \u201cSo, for example, because we serve all types of people, if somebody has a need for personal care and they live in a cardboard box, that’s going to be a problem for us,\u201d Billing says.<\/span><\/p>\n <\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.0.47″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″][et_pb_text _builder_version=”3.0.89″ background_layout=”light”]<\/p>\n Once someone is eligible, they may not necessarily be admitted right away due to waitlists and the availability of health human resources. However, those with more severe needs are prioritized for admission. According to <\/span>How Canada Compares: Results From The Commonwealth Fund’s 2017 International Health Policy Survey of Seniors<\/span><\/i>, more than 86 per cent of seniors surveyed who received publicly funded home care, said the services helped them remain at home. Billings says it is unclear what the impact of PSSO will be on the LHINs and those receiving the care.<\/span><\/p>\n \u201cWe know any time you take resources out of the community system and dedicate them somewhere else, the supply is affected and therefore our ability to procure and deliver services is affected,\u201d she says.<\/span><\/p>\n Ferrier agrees.<\/span><\/p>\n \u201cThe government likes to make decisions about our profession without speaking to us,” she says.\u00a0<\/span>“They are 30 thousand feet in the air looking down. They have no clue.\u201d<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section bb_built=”1″ _builder_version=”3.0.89”][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" [et_pb_section bb_built=”1″ _builder_version=”3.0.89″][et_pb_row _builder_version=”3.0.47″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″][et_pb_post_title meta=”off” featured_image=”off” _builder_version=”3.0.89″ text_orientation=”center”] [\/et_pb_post_title][et_pb_text _builder_version=”3.0.89″ text_orientation=”center” module_alignment=”center” background_layout=”light”] By Natalie Harmsen and Megan Sibley [\/et_pb_text][et_pb_image src=”https:\/\/cusjc.ca\/catalyst\/wp-content\/uploads\/2018\/03\/catalyst-2.jpg” align=”center” force_fullwidth=”on” _builder_version=”3.0.89″] [\/et_pb_image][et_pb_text _builder_version=”3.0.89″ text_font_size=”11px” text_text_color=”#707070″ text_orientation=”center” module_alignment=”center”] CBI Home Health is one of many groups offering home care services in the Ottawa area. [\/et_pb_text][et_pb_text _builder_version=”3.0.89″ background_layout=”light”] […]<\/p>\n","protected":false},"author":37,"featured_media":3245,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"project_category":[135],"project_tag":[],"class_list":["post-3174","project","type-project","status-publish","has-post-thumbnail","hentry","project_category-feature"],"yoast_head":"\nFederal flatlining: Ottawa and home care<\/h1>\n