Ontario Long Term Care in Crisis
Introduction
Our organization, the Ontario
Association of Non-Profit Homes and Services for Seniors (OANHSS), very much
appreciates the opportunity to present our views to the Standing Committee on
Finance and Economic Affairs as part of the provincial pre-budget consultation
process.
We believe that the Committee can make an important contribution in raising the awareness of the Legislature, the Ministry of Finance, the media and the public at large regarding the critical need for adequate operating funding in the long term care sector.
OANHSS is a voluntary province-wide non-profit association which, for over eighty years, has represented non-profit providers of services and housing for seniors. Our 400 members from across Ontario span the full spectrum of the not-for-profit long term care continuum, including municipal and charitable homes for the aged, non-profit nursing homes, seniors’ housing projects, and community service agencies.
We are committed to exploring the best ways of providing and delivering much needed health services and programs to our clients. Last fall all MPPs received from us a comprehensive package of information as part of our on-going facility funding awareness campaign. It will be my intention today to highlight certain aspects of our concerns and to update you on recent developments.
We will also be leaving with you today two key
recommendations which we hope you will seriously consider when formulating your
advice to the Legislature and the government.
‘Something Has to Give ... ’
Last year, in our submission to this
Committee, we warned that "we must invest in our own future and we must do
it now." We indicated that our members, as front-line providers of care,
were "increasingly frustrated with, and constrained in their ability to
maintain innovative, responsive quality programming for seniors."
The situation for providers and those to whom they provide care continues to worsen.
Government funding for the operation of
municipal and charitable homes for the aged and nursing homes is not keeping
pace with the changing requirements of residents who today are being admitted
with far more complex health care needs. As a result, our facilities are now
finding that their ability to provide adequate, appropriate, quality care is
being compromised.
These two factors – continued underfunding by the provincial government, and
an older and sicker resident population, with increasingly complex needs – are
causing major stresses in the system.
Something has to give, and it should not be the residents or their families. We are rapidly approaching the point where our facilities can no longer cope.
We have estimated that the Ontario government is now underfunding long term care by at least $230 million a year. The number is in fact higher and continues to grow as more information and analysis becomes available. That is the minimum amount of new funding required to meet current demands. Significantly more will be needed to address future needs.
Currently, Ontario long term care facilities receive an average of about $100 a day for each resident. Of this, about $60 is paid by the province – one of the lowest rates in the country – with the balance coming from client payments.
Over the past two decades, the average age of long term care residents has increased from 73 to 86. The typical resident today is not only older, but also sicker (often having multiple chronic illnesses) and is in need of more care. As well, about half of all residents suffer from Alzheimer disease and other dementias.
"So What is Happening?"
Faced with this underfunding situation, long term care facilities have had
little choice but to cut back on programs and services. This means that they
have had to reduce the level of individual care, as well as the personal support
for activities of daily living. For example, routine bathing may be provided
only once a week. The care that is provided is still of the highest quality but
the level, quantity and intensity of that care is not what it should be for the
residents of Ontario and their families.
Each registered nurse, in many of our
facilities, now looks after an average of 60 residents in a normal day shift and
over 100 in a night shift. And keep in mind that these staff are now looking
after people with much higher care needs than in the past.
Long Waiting Lists
According to Ministry of Health and Long-Term Care statistics, there are about
14,000 Ontarians currently waiting for placement in long term care facilities.
In some communities, the wait can be as long as four years.
The Ontario government has announced the creation of an additional 20,000 beds, but most of these will not be available for several years. In the meantime, many facilities are having to turn people away who need long term care. Even when the much needed and much appreciated 20,000 new beds are added, the problem of under-staffing and inadequate levels of care will continue to plague the system as long as the province fails to provide the necessary day-to-day operating funding.
Impact on Hospitals
As you are well aware, the province’s acute care hospitals are crowded with
elderly patients requiring long term care. These individuals cannot be
discharged because often there is nowhere for them to go, so they remain
inappropriately placed in hospitals (at about $400 per day, or four times the
cost of long term care facility placements.)
Long term care facilities, if properly funded, could help alleviate this problem.
It is worth noting that provincial government
spending on long term care represents only 13.6% of the total Ministry of
Health and Long-Term Care budget. About half of the $3.1 billion long
term care envelope goes toward facility funding and the other half to
community-based services. Increases in ministry expenditures in the long term
care area have recently been averaging less than one per cent a year. This is
clearly inadequate given the current projected rising demand for services.
The Future?
In Ontario, the 85+ age group is expected to increase four-fold by 2028.
Currently, there are some 100,000 people in Ontario who have Alzheimer disease.
This number is expected to triple over the next 30 years. According to the
Ministry of Health and Long-Term Care, the number of people with dementia will
increase 85 per cent by 2010.
Conclusion
In spite of the good intentions of this government and previous governments and
some substantial steps taken to address certain funding concerns, long term care
in Ontario is in crisis.
With an older and sicker resident population, staff stretched to the limit, long waiting lists, people being turned away from facilities, and lack of proper funding from the government, is it any wonder that many long term care facilities are at the breaking point?
OANHSS and other provincial provider associations have been working with government, as part of the current budgetary process, to more accurately quantify the crucial need for increased operating funds for facilities. Those figures are now before Cabinet, and therefore, cannot be released. It is for this reason that we continue to reference the need in terms of a minimum of 230 million dollars.
And finally, a longer-range vision and plan is
also needed. Longer term, the province must invest significant new money in long
term care to ensure needs are being met for a growing and aging population. We
are committed to working with the new Minister of Health and Long-Term Care, the
new Minister of Finance, and all members of the government and Legislature to
address these very serious concerns.
Recommendations
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Ontario Association of Non-Profit Homes & Services for Seniors
7050 Weston Road, Suite 700, Woodbridge, Ontario L4L 8G7
(P) 905-851-8821
(F) 905-851-0744
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Contact
Debbie Humphreys
at 905-851-8821 ext. 233
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© Copyright 2008 OANHSS
OANHSS members include not-for-profit providers of long term care, services and
housing for seniors in Ontario.
Members include municipal and charitable long term care homes, non-profit
nursing homes,
seniors' housing projects and community
service agencies.