Category Archives: ReportingMethods2019_1

Long-term care funding a concern as 2019 Ontario Budget Looms

February 11, 2019ReportingMethods2019_1Devon Platana

(The Salvation Army Grace Manor is one of the many long-term care homes in the Champlain network —the health network that Ottawa falls under— that wants to see Premier Doug Ford give them additional funds.)

Despite the steady increase in long-term home care funding over the last four years in Ottawa, some advocates are afraid that the increases won’t keep up with the increasing demands for health networks as the 2019 Ontario Budget approaches.

Ottawa falls under the Champlain network.

There has been a five percent increase in operating expenses for Champlain long-term care homes from 2014 to 2018, according to calculations done with provincial public spending records.

In 2014-15, the operating expense for Champlain was $345,598,800 and rose to $363,641,729 according to that same data.

(The graph shows a year-to-year increase in expenses for Champlain long-term homes. Although funds increase each year, it still isn’t increasing as much as some people hope. – Data taken from 2014-18 Public Accounts of Ontario.)

Two weeks ago, the Ontario NDP released a leaked draft of the Conservative’s health care privatization bill, where the Ford Government plans to restructure the province’s health care network into one “Super Agency” in order to save money.

This change comes one year after the Ontario Liberals spent almost $1 billion above what they expected to for the health sector, according to the 2017-18 spending records.

Ontario Health Minister Christine Elliott brushed off the leak by stating it was only an early draft, according to media reports.

Elliott was contacted for an interview specifically about long-term care but did not reply.

While Teresa Armstrong, the Opposition Critic for Home and Long-Term Care, declined an interview, they did issue a statement via email.

Armstrong’s office stated that “the Ford Government is making Ontario’s bad health care situation worse.”

The major concern that Armstrong voiced in the email is that this change would make people in rural and remote areas have a tougher time finding access to health care because combined bureaucracies means combining patient lists.

This will include long-term care homes.

Fourteen Local Health Integration Networks (LHINs) are described as being “crown agencies established by the Government of Ontario to plan, coordinate, integrate and fund health services at a local,” according to the Central West LHIN website.

If Armstrong is right when she says this “super agency” will make it harder for people to get into long-term care homes of their choosing, it would create an issue among advocates.

Jeff Querel is the director of finance at the Salvation Army Grace Manor, a long-term care home on Wellington Street West. He said that more government help is needed to operate the facility.

“I don’t think you’d find anyone who says that it [additional funding] is not needed,” Querel said. “Our expenses tend to be more than the funding they give us most years.”

Querel has been the director of finance at the Salvation Army Grace Manor for almost 17 years.

“Even if the funding goes up by a little bit every year, we still need more,” he added.

Querel said that he didn’t expect any cuts from the 2019 budget because a lot of people would be angry, however, he added that he wouldn’t be happy if any amount was chopped.

“I’m not worrying about it happening – only if it happens.”

While there is a shared sentiment that general funding for long-term care homes is needed in Ontario, there are more specific issues that some would like to see addressed.

“I think more funding is needed, but also more availability for long-term spots is needed,” said Katherine Arnup, a retired Carleton University associate professor who specializes in caring for elderly parents.

Premier Doug Ford tweeted that he plans to add 30,000 long-term beds across Ontario in April 2018, but that remains to be seen.

Arnup added, “I think there is another issue with long-term care homes when it comes to how seniors are treated. They need somewhere to go.”

Uncertain fate of health networks have healthcare providers worried about funding

February 5, 2019Assignment 2, ReportingMethods2019_1Steve Zhang

The future of health care funding in Ontario is in doubt. A leaked draft of a Conservative health care plan indicates an intention to create a new “super agency” to replace the province’s 14 Local Health Integration Networks. The Ford government ran on a platform promising to save money and cut government spending. (Photo © Michael Burns/Flickr Creative Commons)

In the lead up to the new provincial budget, all eyes are on the future of healthcare spending and where cuts will be made. According to an analysis of the Ontario government’s spending from 2014 to 2018, funding for acquired brain injury to the Champlain Local Health Integration Network increased by roughly seven percent over that time. However, due to recent developments related to the budget, health care providers are worried about their future funding.

On January 31, the NDP leaked a draft Conservative health care plan. In it, the administration lays out a plan to create a “super health agency,” confirming the province’s plans to disband the 14 Local Health Integration Networks (LHIN) in Ontario, including the Champlain LHIN, which manages services in Ottawa. Health Minister Christine Elliott later released a statement confirming the document is genuine, but emphasized that it is a draft and reaffirmed the Ford government’s commitment to health care.

The 2018 Ontario Public Accounts reports the Champlain LHIN, received roughly 2.7 million dollars for ABI that year, which is less than five percent of all provincial funding given to ABI. Judy Gargaro, Executive Director of the Ontario Neurotrauma Foundation, a non-profit brain injury prevention organization, says this shows that funding should be increased, not slashed.

“It’s an expensive group to do right and if you do it wrong, there’s all sorts of other costs that come to society,” she says. “It’s easy for governments to look at other chronic conditions or diseases, like cancer, that have more perceived impact to the public, and part of our frustration is that people don’t realize ABI is a huge number.”

According to a 2016 report by the Champlain LHIN, Ontario records roughly 18000 new cases of acquired brain injury (ABI) each year, with 6500 new cases in Champlain alone, which is home to roughly 10 percent of Ontario’s population. ABIs, which can be either traumatic (stemming from an acute injury to the head) or non-traumatic (such as from a stroke), is a leading cause of death and disability to people under the age of 45.

The Ford administration ran on a platform promising to help Ontario save money by cutting down on government spending. France Gélinas, the NDP Opposition Health Care Critic, says the current government ran on a platform to save $6 billion in the province, adding it will ‘absolutely’ mean cuts to health and long-term care spending.

“Health care represents half of the expenses of the provincial government, so half of six billion dollars is three billion dollars,” says Gélinas, the New Democrat MPP for Nickel Belt. “They have said, and they are on the path, to cut three billion dollars out of health care and any reason, any words that they use will not change the end result.”

With the future of the LHINs in doubt, care providers are concerned they won’t be able to provide adequate levels of support service. Gargaro says she believes the government doesn’t truly understand the ramifications of not funding care for afflictions like acquired brain injury properly, and that the government needs to establish a properly funded “brain injury strategy.”

“If you look at community providers and their waitlists, you have 10-year waitlists for housing, 10-year waitlists for supportive service. Even if it’s a one-year wait list, for someone who’s struggling with the aftereffects of a brain injury, one year is a lifetime,” she says. “It’s not just Champlain’s problem, this is a provincial problem.”

The government is holding budget consultations until February 8.

Advocates hope for an increased investment in youth mental health services

Funding for Child Youth Mental Health Services has decreased by 1.2% over the past four years, according to provincial budgets. Piktochart by Michael Smith

Michael A. Smith

OTTAWA — Doug Ford’s government has promised new investments into mental health, however, youth advocates worry about how the funding will be distributed. According to an analysis of public records, youth mental health services has decreased in funding by 1.2% over the past four years, while advocates say hospitalizations have increased by 79%. The discrepancy is resulting in programs having a lack of funds necessary to provide intensive treatment in Ottawa.

“On behalf of Ottawa, we know we do not have efficient intensive specialized services for young people … that’s where we should put some of our dollars” said Joanne Lowe, executive director at the Youth Services Bureau.

The bureau runs the Bridges project, its goal is to help youth ages 13 – 25 access intensive mental health treatment after their initial hospitalization. A lot of the times’ ER visits and hospitalizations only treat the symptoms of an emergency not the source of it, said Lowe. The bridges project is meant to build on the gains made in the hospital and “catch the patients at a point when we can actually intervene more intensively,” she said.

The project has continually lacked proper funding, which has impeded its ability to serve patients. According to Lowe, it costs about a million dollars a year to operate the program, but it has only received $600,000 in provincial government funds in the past seven years. It is causing the program to rely on fundraising and help from Ottawa Public Health and the Royal Ottawa Mental Health Center to contribute staff.

“This last year we lost an occupational therapist position and we lost time with psychologists,” thus stunting the project’s growth, explained Lowe.

The hope is that the federal and provincial governments additional investment of $3.8 billion over ten years into mental health will be distributed evenly amongst the adult and youth systems.

As of now, adult services are funded in the billions while youth services are funded in the millions said, Lowe. Furthermore, the investment is $330 million a year less than what was promised by the liberals when they were in office.

That doesn’t discourage groups like Children Mental Health Ontario, who are optimistic about the investments. Their CEO, Kim Moran, calls it a “landmark announcement” and Lowe says it is “a step in the right direction.”

However, Bhutila Karpoche, NDP’s mental health and addictions critic, is not as optimistic. “It’s unclear where the money is going to go at this point,” she said.

But the Ford government has announced that a part of their investment will go towards training for police and first responders in how to deal with peoples with mental health issues.

Since speaking to Karpoche, the government has also announced that they’ll spend $665 million on the construction of two new Centers for Mental Health.

The two new buildings will house 235 inpatient beds for various levels of mental illness, along with specialized clinics. These additions will alleviate some of the demand for resources, but they do not focus specifically on youth care, which was the main concern for youth advocates.

Number of Youth hospitalized between 2006 – 2016. Piktochart by Michael Smith

It is not only a lack of beds in hospitals that are impeding youth mental health care but it is also the lack of clinical staff says, Moran. She believes that “the bottleneck in care comes from a lack of high-quality intensive treatment using counselling and therapy.”

The bridges program provides such care, but there has been no indication that programs like it will receive an increase in funding.

Both Moran and Lowe have lobbied the Ford government to fund more youth services. However, they will have to wait until the budget is announced in the spring to find out if their wish comes true.

Provincial task force calls for improved health technology despite annual cutbacks

February 4, 2019Assignment 2, ReportingMethods2019_1Dexter McMillan

Cam MacLeod, Executive Director of Carlington Community Health Centre, says his clinic has had to cut back on use of technology to buy health care because it has become too expensive. Photo: Dexter McMillan

A group of medical experts appointed by the Ontario government is calling for improving health technology — or eHealth — as part of their strategy to address overcrowding in hospitals.

The call came this month in the first of a series of reports from the Premier’s Council on Improving Healthcare and Ending Hallway Medicine. The group was assembled by Premier Doug Ford to propose solutions to “hallway healthcare,” a term used to describe the current lack of space in the healthcare system.

At the same time, provincial eHealth spending has decreased by 8% over the past four years, according to analysis of the government of Ontario’s spending records. This includes a reduction of more than 60% in capital spending, which represents the purchase of new hardware and eHealth equipment.

In the same period, the Ontario provincial government’s overall healthcare spending has grown at a rate of more than 9%.

Carlington Community Health Centre in Ottawa has seen the value of eHealth technology but has had to reduce usage as it became more expensive.

“It was the link that allowed us to have conference video with other providers,” said Executive Director Cam MacLeod. “The cost went up, and we had to make choices. So now we use very little of it.”

eHealth is a broad term for technology used for healthcare. It includes telemedicine — video chat for seeing your doctor — and Electronic Health Records, a digital record of a patient’s contact with the healthcare system that tracks important measurements like blood pressure and x-ray results.

OntarioMD, owned by the biggest organization representing doctors in Ontario, receives funding from the provincial government to implement eHealth technology and train care providers in its use. Today, it brings in 60% less annual revenue than it did in 2015.

According to OntarioMD’s CEO Sarah Hutchison, this is partly because they receive less and less money each year from a fund set up by the Ontario Medical Association to support doctors upgrading their technology. The money they receive from the provincial government has held steady.

“We’re serving more folks and doing more work,” said Hutchison. “But our funding envelop is not increasing.”

Hutchison’s company has been involved in eHealth for over 15 years. She said funding from the provincial government allows them to better link patients to their doctors or nurses, improving efficiency and unclogging the healthcare system.

She said the real problem with eHealth funding has more to do with how it’s handed out. Both the federal government and the regional bodies that allocate funds — called Local Health Integration Networks — are also trying to distribute their own eHealth funding.

“I think we need to work in a very aligned way,” Hutchison said. According to her, streamlining the system is an important step towards improving support for eHealth.

Politicians have echoed this sentiment, describing eHealth as being important, but also as being a “boondoggle.”

eHealth Ontario is the provincial organization tasked with provincial eHealth development. In 2009, the group was embroiled in controversy after a special report by the Auditor General found that the organization overpaid for favoured companies to be consultants on projects, resulting in high program costs.

eHealth Ontario did not return requests for a phone interview.

Just seven years after their initial report, the Ontario Auditor General released a follow-up news release indicating that although over $1 billion had been budgeted for eHealth initiatives by eHealth Ontario, only 80% of projects had been completed.

Canada Health Infoway is an organization that receives federal money and aims to improve access to healthcare across Canada through investments in new eHealth projects. They have also seen a 20% reduction in their revenues since 2015, according to analysis of their annual reports. A small amount of that money also goes to OntarioMD.