News Room

Speeches

HCC Launch Webcast

THE HONOURABLE DR. ERIC HOSKINS
MINISTER OF HEALTH AND LONG-TERM CARE

May 13, 2015

(Check Against Delivery)

I want to recognize the partners who are with us today: The Ontario Association of Community Care Access Centres, the Ontario Hospital Association, Home Care Ontario, the Ontario Community Support Association, SEIU Healthcare, the Ontario Retirement Communities Association, the Ontario Association of Non-Profit Homes and Services for Seniors. And because it's national nursing week, a special thanks to the Registered Nurses' Association of Ontario and the Ontario Nurses' Association.

I think that probably covers about 90% of the people that are in the room. And there's a few more that I'll be acknowledging in a few minutes. But I also want to thank The Second Mile Club and the team at Kensington Gardens, this wonderful space for welcoming us here this morning.

The Second Mile Club is a day program for seniors. I think it would be wonderful enough if it was just the breakfast that is out there this morning, but they do much much more and it plays such an important role in helping our seniors live independently at home.

And as I heard over breakfast, you provide such a wide array of programming from computer classes to yoga to even line dancing and those services provide seniors with not just a sense of community and connection, but ultimately support and that's incredibly important.

Day programs like this one are just one example of the supports that we provide and support for people of all ages at home and in the community, helping them to live healthy and independent lives.

As our population ages Home and Community Care is only becoming more and more important. And as we transform our healthcare system to truly put patients first, helping people live independently at home where they want to be is a central part of that.

But we know we must do more to improve access and expand services and that's what I'm announcing today.

But that transformation is already underway. We're building on a solid foundation of success. Today 93% of eligible home care clients are receiving their first nursing visit within five days of being accepted and 84% of home care clients with complex needs receive a visit from a personal support worker within the five day target.

The province is providing 6.5 million nursing visits every year and 27 million hours of personal support and homemaking services to more than 600,000 clients every single year.

And since 2003 we've more than doubled funding for home care services.

Now, beginning with our 2013 budget a couple of years ago, we announced that we would be increasing funding for Home and Community Care by 5% for three years going forward. Those increases were set to end in 2016, but I am proud that in our most recent budget we extend that funding increase for an additional three years which represents an additional $750 million dollars and that increase in funding is recognition of the importance of our Home and Community Care sector. It's recognition that we must make the necessary investments to improve access and expand services. And it's recognition of the priority our government places on insuring that people can live independently at home and in the community rather than having to be admitted to hospital or long-term care.

It's better for our system and it puts the needs of patients first.

Now, earlier this year, I released our government's Patients First: Action Plan for Health Care. And as its title suggests, its fundamental element is our commitment to put the needs of people and patients at the centre of our health care system.

And one of its four pillars is to deliver better coordinated and integrated care in the community closer to home.

The plan I'm announcing today will help us deliver on that commitment. It is our Roadmap to Strengthening Home and Community Care.

This is the right plan and it's the necessary plan because we know from the feedback that we've received from literally thousands of individuals and families that the care that they're currently receiving is patchy, uneven and fragmented.

To improve the sector the very first step is making sure that Ontario's Home and Community sector works for the clients and patients who rely on it. That it responds to their needs and the needs of their caregivers and that it puts them first. Home and Community Care must be client-centered and fully integrated with other healthcare providers including primary care. It must provide seamless transitions between other parts of the healthcare system. It must be accountable and transparent and deliver the best possible value.

Now, the demand for home and community services will continue to grow and we're learning that people with more complex care needs can be cared for safely in their own home, but it requires working together to improve the care we provide.

That means measuring quality better, reducing variation in services and exploring more innovative models of care. That's why our government announced back in April of 2014, the formation of a group of healthcare experts led by Gail Donner to study how to improve the quality and value of the care provided by the Home and Community Care sector.

In January, the Expert Group delivered its report entitled “Bringing Care Home” and today I'm here to tell you about the action we are taking to implement the report's recommendations.

And ladies and gentlemen, today we are implementing every single one of the report's recommendations.

So, my sincere thanks go to Gail and the other expert members for their hard work to develop the report and for their insightful recommendations.

Gail is with us today along with fellow group members Kevin Smith and Samir Sinha and as suggested by the Expert Group the first phase of our plan is focused above all on the experience of people receiving care at home or in the community because we believe that our first priority must be to improve the services that our system provides to our loved ones in need of care.

But I want to be clear: the 10-point plan I'm announcing today is only the first phase of a multi-phased approach.

This phase of our plan is not focused on changes to the structure of the system; this is intentional. We believe that our first priority must be on improving the services that our system provides to our loved ones in need of care. The question of the system's structure and governance will follow naturally from the conversation around what families can expect for their loved ones when it comes to Home and Community Care and this too is consistent with the Expert Group Report.

Changes to the governance of the system must follow our most important goal: providing the best quality services to those who need them.

So, as we move forward with our efforts to provide better quality services we're committed to making the changes necessary to ensure that these high quality services are being provided consistently, efficiently and effectively to all Ontarians no matter where they live in the province.

This first phase of our 10-point plan...I'm getting to it don't worry...is focused on expanding service and improving access and consistency of care no matter where you live in the province.

So, the first of the 10 points: we will develop a Statement of Home and Community Care Values.

Too often our system is designed around the needs of providers. Patients and their caregivers are left out of the decision-making process, and patients and their families are in the dark around how assessments are done and what services are available. So, we will develop a statement of Home and Community Care values to guide our transformation of Home and Community Care with the needs of clients and their caregivers at the centre. Think of this the same way that hospitals have a statement on patient values or a patient charter. It sets a high-level standard with patients at the centre against which patients in the sector can measure their success.

The second step that we're taking: we will create a level of care framework.

Ladies and gentlemen, there is too much variation and inconsistency across the system and across the province. Services available in Ottawa are different than the services available in London or in Sudbury. Families don't know what they can expect for their loved one. So, we will create a levels of care framework to help us ensure that there is an easy way for the public to understand the level of care they can expect. When a patient is assessed as requiring a certain level of care, the basket of publicly funded services that that patient is eligible for will be available, transparent and accessible to the patient and their caregivers and be provided at a consistently high quality no matter where they live in the province.

Number 3, we will increase funding for Home and Community Care and I touched on this earlier.

As we transform our healthcare system, patients with complex care needs will be increasingly cared for at home and in the community where they want to be, instead of in the hospital or in long-term care. Increased investment is required to ensure the wide availability of services in a consistent standard of care. So, in Budget 2013 as I mentioned we began increasing the funding for Home and Community Care by 5% and in the 2015 Budget, , we extend that 5% increase for the next three years.

Step Number 4, I think Kevin will like this one, we will move forward with bundled care.

Now, when a patient is discharged from hospital the follow-up care they receive whether it's from the hospital, from their primary care provider or in the Home and Community Care sector, it's delivered usually, almost invariably, by different providers with insufficient coordination and integration. So, we're introducing a bundled care model where a group of providers will use a single bundle of funding to cover all of the care that a patient needs leading to more integration between the patient's entire care team. And this will lead to a better more seamless patient experience.

Number 5, we will offer self-directed funding.

Some patients receive care from a variety of PSWs, personal support workers, for example, on a schedule that's set by the CCAC or the service provider agency without necessarily considering the patient's unique situation, for example, the availability of family members who are caregivers. So, we're going to begin to offer self-directed funding where, for example, certain clients would be given their funding directly so that they have the flexibility to hire the PSW or nurse of their choice and set a schedule that's convenient and works for them.

Number 6, we will expand caregiver supports.

The important role that caregivers play in Home and Community Care has not been sufficiently recognized and we need to change that. They are central to the quality of care, the independence, the quality of life that their loved ones attain and we need to acknowledge that and we need to understand and acknowledge that they are central to that individual's care plan, as well. Those caregivers often lack the resources themselves that they need to continue providing care to their loved ones. So, we are going to introduce expanded caregiver supports including education and training and respite care. This will ensure that those caregivers can take care of their loved ones, but also take care of themselves.

Number 7, we will enhance support for personal support workers.

Our PSWs deliver the majority of care that patients receive in the Home and Community Care sector. But these PSWs are not compensated as well as their counterparts in hospitals and long-term care homes leading to instability in the work force and affecting the care that patients receive. So, we're continuing to invest in our home and community care PSW workforce, implementing a wage increase of up to $4.00 per hour over three years, beginning in 2014/15, raising the base wage of these publicly funded PSWs to at least $16.50 per hour by April 1, 2016. We're also investing in education to further help stabilize our PSW workforce and ensure that they have adequate training and compensation.

Number 8, we will provide more nursing services.

Current regulations set a maximum number of nursing visits that a patient can receive. But for certain patients with complex care needs or in extraordinary circumstances – such as a patient reaching the end of their life - this maximum may not be enough to meet their needs. So, we're proposing to introduce amended regulations that will increase the number of visits patients with complex care needs and patients in extraordinary circumstances can receive. This will result in 80,000 additional nursing hours across the province.

You're probably glad I've only got 10 steps and not 30, right?

Number 9, we will provide greater choice for palliative and end-of-life care.

Our healthcare system currently does not offer patients and their families sufficient choice around palliative and end-of-life care. Furthermore, patients and their families do not have sufficient resources to plan in advance for the care that they will need as they approach the end of their lives. So, we will offer greater choice for patients who wish to spend the end of their lives either in a hospice or in the home. This includes new funding to expand hospice services in the province, and better access to care and coordinated support for families and caregivers. Additionally, we will enhance public education around advanced care planning so that families are aware of their loved ones wishes for palliative and end-of-life care.

And lastly, we will develop a capacity plan for the sector for Home and Community Care.

Over the next three years we will develop a capacity plan that includes targets for the provision of services and quality of care for local communities, as well as standards for access to home and community care and for the quality of client experience across the province.

So, ladies and gentlemen, that is our plan to transform the Home and Community Care sector so that it delivers better access and expanded services. And I want to reiterate that as a result of the incredible work done by Gail, Kevin, Samir and the others on the Home and Community Care Expert Group we have accepted and are implementing every single one of the recommendations made in the Expert Group Report..

But, ladies and gentlemen it's a journey ahead that we cannot take alone. We look forward to continuing to work hand in hand with our partners in the Home and Community Care sector, as well as with patients, clients, residents, their advocates and caregivers.

Improving home and community care is a priority for our health care system and a priority for our government. And with this 10-point plan, this Phase 1, we will put patients first, helping them stay healthy and live independently at home and in the community.

Thank you very much.

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