Ford government reveals plan to change Ontario's home care system

The Doug Ford government is making significant changes to how publicly funded home care is provided, as part of its sweeping reforms to Ontario's health system.

The changes announced Tuesday will affect the 700,000 people in the province who receive publicly-funded home care every year.

Home-care patients often complain that Ontario's system is too difficult to navigate, according to a new report by the province's patient ombudsman.

Health Minister Christine Elliott said the home care reforms will help fix that, and make the experience better for patients.

"They will tangibly see — before they leave the hospital to go home — what their care plan is going to be," Elliott told a news conference Tuesday. "They will know what to expect, they will know who to call if things don't happen exactly as they're supposed, they will know what to do if complications arise."

Claude Beaudoin/CBC
Claude Beaudoin/CBC

Ministry officials described the reforms as changing how home and community care is delivered, not changing what care is delivered.

Asked about the cost of the changes, Elliott said, "In the long term I believe it will end up saving the government money in terms of helping to reduce hallway health care."

The home care reforms are an important part of the Ford government's efforts to keep its promise of ending hallway medicine. The government's hope is that better home care will get patients out of hospital sooner, and reduce re-admissions, relieving pressure on Ontario's overcrowded hospitals.

A recent investigation by CBC News shows dozens of Ontario's hospital are filled beyond their capacity on a routine basis.

Ministry officials said improved home care can help reduce hospital admissions, but could not say by exactly how much.

Elliott made the announcement at Toronto's Michael Garron Hospital.

The change "takes Ontario's disastrous home care system, and tinkers and meddles a little, instead of fixing the system," said NDP health critic France Gélinas in a statement.

"We know that most patients don't want to be here; they want to be home, with their loved ones and with reliable and supports that keep them safe and well," the hospital's president and CEO Sarah Downey told the news conference.

Claude Beaudoin/CBC
Claude Beaudoin/CBC

A key part of the changes focus on the 4,000 nursing staff known as "care co-ordinators" who assess patients for their home care needs. The reforms would allow those co-ordinators to work in hospitals and directly with family doctors' offices, instead of the current model that places them in Ontario's regional health bureaucracies, known as Local Health Integration Networks (LHINs) .

Agencies that provide home care have been critical of the existing system over communication breakdowns.

"We don't necessarily know who's leaving the hospital when they're leaving the hospital, what the discharge plan is going to be," said Sue VanderBent, CEO of Home Care Ontario.

Health Ministry officials say the changes would strengthen communication between home-care providers and the rest of the health system and reduce the risks of patients falling through the cracks.

The current Local Health Integration Network structure to deliver services will stay in place for the next few years, but will be rebranded as Home and Community Care Support Services.

The officials said the ultimate goal is to bring the system under the government's new Ontario Health Team approach of co-ordinated, community-based care.

The current Local Health Integration Network structure to deliver services will stay in place for the next few years, but will be rebranded as Home and Community Care Support Services.

Health officials said the new system will still see agencies deliver home care through contracts and limit the delivery of community services to non-profit corporations.