HOME CARE

February 14, 2008

From: Dalton McGuinty, Premier of Ontario
To: Linda MacGregor, President, CFUW Ontario Council
Sent: Thursday, February 14, 2008 2:19 PM

Subject: Home Care services

Thank you for your letter regarding home care services provided by St. Joseph’s Home Care and the Victorian Order of Nurses. I have also noted your comments regarding the competitive bidding process. I value your views and am grateful to you for sharing them.

Our government remains on the side of Ontario patients who want — and deserve — the best possible heath care including home care. As you may know by now, our government has halted the competitive bidding process for home care contracts across the province to ensure that Ontarians receiving home services continue to receive the highest quality of care.

Our government has asked all Community Care Access Centres to cancel bidding processes now underway for nursing, personal support, homemaking and therapy services and to not restart such processes. Existing contracts will be extended, but all processes for other contracts are being halted pending a review of the bidding process and related policies and procedures to ensure they support the principles of putting the client first, continuity of care and stability for health care workers to ensure Ontarians receive the highest quality home care services possible.

Thank you again for writing. My colleagues and I will keep taking your views into consideration as we continue our work to achieve further results and keep Ontario moving forward. Please accept my best wishes.

Dalton McGuinty
Premier of Ontario

January 22, 2008

From: Linda MacGregor, CFUW OC President
Sent: Tuesday, January 22, 2008 5:19 PM

Subject: Urgent Action Request Home Care

ATTENTION: ALL MEMBERS OF CFUW ONTARIO COUNCIL

MYRTLE GREVE AND LINDA HALL (CFUW HAMILTON) ARE ASKING FOR YOUR HELP. PLEASE READ WHAT FOLLOWS AND THEN E-MAIL THE MESSAGE IN BLACK TO EVERY MEMBER IN YOUR CLUB WHO HAS E-MAIL. ASK THEM TO E-MAIL OR FAX THIS MESSAGE TO PREMIER MCGUINTY, MINISTER SMITHERMAN AND THEIR MPP IMMEDIATELY. THEY MUST RECEIVE IT BY THURSDAY. LET’S PUT A STOP TO UNFAIR HOME CARE BIDDING.

Thank you,
Linda MacGregor,
CFUW OC President

Hamilton Home Care Crisis
An URGENT MESSAGE

As a result of the provincial government's recently reintroduced Request For Proposal (RFP) process for visiting nursing, the Community Care Access Centre (CCAC of Hamilton, Niagara, Haldimand, Brant) has taken the decision to eliminate the nursing services of Hamilton's VON (Victorian Order of Nurses) and St. Joe's Home Care, two agencies that have been providing 80% of all nursing services in Hamilton. We believe we have only three days to stop the process that is unfolding in Hamilton right now, and we are calling on you for your assistance.

Even if you have already written a letter, we urge you to now e-mail or telephone Premier McGuinty and Minister Smitherman, the key decision-makers, either as an individual or on behalf of an organization you represent (other than CFUW Ontario Council). Please convey the following in your telephone or e-mail message.

Premier McGuinty/Minister Smitherman,
I am calling/writing about the outcome of the RFP process in Hamilton. You have the power and responsibility to do the right thing and halt the RFP process in Hamilton for visiting nursing services and I call on you to do so immediately.

Your name
Your address.

The addresses:

Premier Dalton McGuinty ph: 416-325-1941 dmcguinty.mpp@liberal.ola.org

Hon. George Smitherman, Minister of Health and Long term Care ph: 416-327-4300 gsmitherman.mpp@liberal.ola.org

Thank you for your support and for your action on this very important issue for home care in Hamilton. Hamilton just happens to be the first region to experience this flawed RFP bidding process. Other CCACs across the province plan to use the same RFP process. Let’s get it stopped now, before other communities find themselves in a similar home care crisis.

Background Media Release

Hamilton Coalition for Quality Home Care
Hamilton Council on Aging – McMaster University, Centre for Gerontology –
McMaster University, School of Nursing - Hamilton Cares –
Canadian Federation of University Women-Hamilton

September 8, 2007

On September 8, 2007 Hamilton Cares, the Hamilton & Burlington Chapters of the Canadian Federation of University Women, and Mohawk College presented another in their series of Forums to the public regarding the on-going need for continuing supportive care in the home for persons of any age who are unable to undertake all the activities of daily living yet do not want to enter an institution. In other words, they want to stay at home–with some assistance.

As taxpayers, we want the same for them because it is less expensive for the public purse to keep people at home than to provide institutional care.

In the late 1980s into the mid 1990s home care was designed around the idea of “aging in place” that is, supporting people to live independently with dignity. In the late 1990s that role for home care was largely replaced by home care as an extension of the hospital system.

However, the lack of continuing supportive care in the home increases the number of persons inappropriately using a hospital bed and, paradoxically, increases the pressure on hospital bed use.

Mr. Hugh MacLeod, Assistant Deputy Minister of Health and Long Term Care, spoke to the audience regarding the changes in approach to this issue that the present government is prepared to consider.

The Local Health Integration Networks (LHIN) have been directed by the government to develop innovative ways to deliver services in the Home Care sector. And significant money has been allocated to assist people in “aging at home” for the next three fiscal years - $60 million for the Haldimand-Niagara-Hamilton-Brant LHIN (formerly LHIN 4).

The request of the community for continuing supportive long term care in the home is one of the issues the present government would like to support. Community Care Access Centres appear to be equally supportive of the option.

However, there are some hurdles to overcome

• the present CCAC criteria militate against the provision of continuing supportive care
• the CCAC is geared toward relieving the pressure on acute care (hospitals) by providing acute and palliative care in the home, however, if continuing supportive care is not available in the community many persons remain in hospital until a long term care bed is available, this approach actually increases the pressure on keeping people in hospital
• there is a province wide shortage of nurses
• nurses in community programs do not receive salaries and benefits equal to nurses in hospitals
• supportive care workers are poorly paid and usually do not receive benefits, pension plans, etc. and are therefore hard to recruit
• non professional supportive care workers are not provided with adequate education for the important roles that they play in supportive care
• the CCAC regulations require that contracts be awarded to community based care providers following a rigorous application process known as RFP (Request for Proposals). This is expensive for the applicants, small companies often cannot afford to comply with the RFP process
• the RFP process uses a competitive market model and awards contracts to the companies which offer the lowest cost (downward pressure on already poorly paid staff), although 35% of the RFP does focus on quality of care
• companies which lose in the RFP process often have to fire their staff and, research has shown, these workers seldom stay in the home care workforce and so their work related knowledge is lost to the system.

Myrtle Greve
CFUW Hamilton