Saturday, January 9, 2016

The Province is making a mess of home care

In an auditor general report, released in December, they found high CEO salaries, high administrative costs and a level of care that varies widely across the province of Ontario. Having given authority to individual LHINs to make decisions in local regional care, there is much discrepancy.

Special Report: Community Care Access Centres ...(PDF)

• Between 2009/10 and 2013/14, CCAC expenses increased 26% to provide more hours of care to patients with more chronic and complex health needs.
• Costs that CCACs considered to be for “direct patient care” included items that did not involve direct interaction with patients, such as service providers’ overhead and profit.
• CCAC CEOs’ salaries up 27% between 2009 and 2013.
• Not all CCAC CEOs followed the common compensation framework designed specifically for them; service-provider CEOs followed different frameworks.
• CCAC nurses and therapists were better paid than their service-provider counterparts in the year ending March 31, 2014.
• No cost/benefit analysis of CCAC nurses directly providing services under three new programs (rapid response, mental health and addiction, and palliative care) was prepared before the programs were launched, and the effectiveness of these programs has not been evaluated.
• Billing rates for the same service categories varied by service provider and CCAC.
• Service providers use a variety of clinicalcare protocols; use of outcome-based pathways do not always result in cost savings.

I seldom agree with Denley, but he makes some excellent points.
We lack staff, they are hard to find: PSWs, nurses, and palliative physicians, for example.

Province giving only the appearance of fixing home care

Unfortunately, the provincial government’s latest proposals are closer to tweaking than they are to the fundamental change the sector requires. The biggest change on offer is eliminating the Community Care Access Centre boards and transferring their responsibilities to the boards of the Local Health Integration Networks. 

No comments: