Caring for, or finding care for an aging parent, relative, friend or neighbour is no easy task. It is an emotionally difficult and draining experience for everyone involved. There is no shortage of research pointing to the guilt, stress, confusion and anxiety families and their elderly loved ones feel when it comes time to make decisions regarding care. 

At the very least, those going through this process should be able to take comfort in knowing that they will get the care they need.

Right now, in Ontario, this is not the case.

But this can be fixed. Immediate and adequate investments by government in long term care will alleviate the funding crisis and ensure that seniors in our province receive the care and services they deserve.

Meeting the Need

Residents no longer “walk in the door” of long term care facilities as they did years ago. They are coming from hospitals, psychiatric facilities and crisis situations in the community. Intravenous treatments, gastric feeding tubes and oxygen are regular parts of the care that is given. Residents suffering from dementia require a high staff ratio to meet their very complex and challenging needs. All this is not reflected in the funding facilities receive to the extent required.

The government commissioned Level of Service Study found that Ontario ranked dead last out of 10 jurisdictions in meeting the needs of long term care residents. Conducted in 2001 by PricewaterhouseCoopers, the study concluded that residents in Ontario receive the least amount of nursing and therapy services.

But perhaps the most telling example of the need for increased funding, and something we can all relate to, is the food allowance. Facilities are expected to feed residents on a budget of $4.49 a day -- and this amount has increased by only 23 cents or 5.4% since 1993!

Last summer’s announcement of $100 million in new operating funding for facilities was a good first step in addressing the funding shortfalls that have plagued our sector for years. But even with this increase long term care remains underfunded by $430 million a year. What is needed is an $18 per day increase -- from $70 to $88 -- in the government’s share of the per diem for each long term care resident. We recommend that this be spread over two years with an investment of $215 million, or $9.35 per resident, in the upcoming fiscal year and the same in 2004-05.

This would go a long way in addressing the problems caused by chronic underfunding. Without it, Ontario will not be providing the level of service our seniors need and deserve.

Funding Equity Critical

Funding for long term care facilities is not equitable. A succession of government policy decisions has created funding inequity within the sector. Our analysis has revealed that nursing homes receive on average 10 per cent more government subsidies through supplemental funding initiatives than the typical charitable home for the aged. The estimated additional amount going to nursing homes can be as high as $6.00 per resident day, which represents about $70 million per year.

The provider associations, OANHSS, the Ontario Long Term Care Association and the Association of Municipalities of Ontario, have come together and reached agreement on a solution, which we presented to government in December. We are anxiously awaiting a response. It is critical that the province take immediate steps to rectify this inequity and level the playing field to ensure that residents are funded at the same level of care regardless of which type of facility they live in.

A Healthy Continuum

The entire continuum of seniors’ services in Ontario – home care, community services, supportive housing and facility care – must be adequately funded.

We urge the government to make good on its 1998 commitment of $551.8 million for home and community care, which includes important services such as homemaking, respite care, adult day programs, visiting health services, meal programs, supportive housing and others.

There is $257 million that has not yet been allocated. We recommend an investment of $170 million in 2003-04 and the balance in 2004-05. This is money that is desperately needed by a sector that, if properly funded, will go a long way in taking the pressure off more costly components of the health sector.

Long term care is a public priority. The people who have helped make Ontario what it is today deserve to receive the care they need.