The Ford government is under increasing pressure to explain how new health care legislation could affect Ontario families, as it would allow hospital patients to be moved to a long-term care facility that is not of their choice or likely to face exorbitant daily fees.
The spotlight comes as the government has submitted a proposal to bring the bill directly to third reading – meaning it will not be considered by the committee or go through a public hearing at that point.
Long-Term Care Minister Paul Calandra introduced Bill 7 last week. The legislation would give hospitals the authority to temporarily transfer patients who no longer need acute care to long-term care homes selected by the shelter coordinator. Hospitals will be required to make “reasonable efforts” to obtain patient consent, but the text of the law states that this can be done without consent if necessary.
The legislation came under scrutiny this week by opposition parties and some health care experts, who raised concerns about its vague wording and wondered how it could ultimately affect patients and their families.
“The government has not made any clarification. They are talking about moving people, perhaps away from their families and support. You know, we don’t move cattle here, it’s not cattle. They’re human beings. They’re at risk,” interim Liberal leader John Fraser said in Queens Park this morning. .
Fraser and fellow Liberal Parliamentarian Dr. Adel Shamji held a press conference to express their concerns about Bill 7 and encourage the progressive Conservative government to withdraw the bill as written.
The Liberals said they had been told that in northern Ontario, the patient could be moved to a long-term care facility 300 kilometers away. Shamji said that in much of southern Ontario, patients can be transported up to 100 kilometers from their homes, while in cities they may be as far as 30 kilometers.
CBC Toronto has not confirmed this information and the government has not yet released relevant details of the extent to which patients could be transferred under the proposed legislation. CBC Toronto has contacted the Department of Long-Term Care for more information.
“It’s actually cruel for the government to be so opaque,” Fraser said. “There’s no reason for that.”
The bill is part of a larger plan first announced two weeks ago by Health Secretary Sylvia Jones to help ease pressures on the health care system. The proposed changes are aimed at hiring more health professionals, freeing up hospital beds and reducing surgical waiting queues as emergency departments across the county close for hours or days at a time due to staff shortages.
A controversial component of the legislation is exactly what steps hospitals could take if patients refuse to be transferred to a long-term care home not of their choosing. The legislation does not allow patients to be physically forced to transfer, but it is not clear what will happen if the patient refuses the transfer.
How hospitals can charge patients
In an interview with CBC Radio, morning metro Dr. Samir Sinha, chief of geriatrics at Sinai Health and University Health Network in Toronto, explained Thursday how the current system works.
He said patients are listing several long-term care homes that they may agree to move to after they no longer need hospital care. If the patient is admitted to one of these facilities, but cannot be transferred immediately, the hospital will charge about $62 per day for the interim period, the same amount of co-pay that the patient will face in long-term care.
If a patient deemed no longer in need of acute care refuses to consider alternative facilities for care or transition after being accepted into one of their preferred long-term care options, a hospital network spokesperson added, the hospital can formally discharge them and bill the uninsured daily rate.
It could be $1,500 or more per day.
“A discussion about the cost of staying in an acute care bed is often enough to start the discussions needed to support someone in an acute care bed [alternate level of care] Rosa Kim, UHN’s senior public affairs advisor.
morning metro8:15Charging elderly patients to leave their hospital bed to receive long-term care would leave vulnerable people behind: Dr. Sameer Sinha
However, it is unclear from the current text of the legislation whether the long-term care facility chosen by the patient’s placement coordinator becomes the preferred option, even if the patient is not interested in going there.
During a meeting in Queens Park Wednesday, Calandra supported hospitals that charge an uninsured daily fee to patients who refuse to be transferred to a facility of their choice, saying beds are needed for others.
“If someone refuses to move into a home, if someone refuses to move into a home of their preferred choice, then yes, should the hospital charge for it? Sure. Because we need these spaces for patients who need acute care. We need them for “We need them in the emergency rooms,” he told reporters.
Fraser said the looming threat of exorbitant bills should not be used to coerce patients to move to long-term care homes they did not choose.
“The government has to say – unequivocally – that this will not happen,” he said.
More than 2000 waiting for LTC beds: Hospital Association
According to the Ontario Hospital Association (OHA), there were 5,930 patients with an “alternative level of care” in the hospital as of August 17, of whom 2,400 — 40 percent — were waiting for an LTC bed.
That number also includes hundreds of patients in reactivation centers — a level of care set up a few years ago to “temporarily” address hospital capacity pressures, said Anthony Dale, the association’s president and CEO.
“This is the largest number of ALC patients ever recorded in Ontario,” Dell said in a statement.
Dale said capacity challenges affect all patients, including people who need urgent care, surgical procedures and diagnoses. He said OHA supports the new Ford government’s plan, particularly as hospitals approach the colder months, as it will “help maintain access to health services” for what he expects to be another challenging period.
“Ontario hospitals are fast becoming the healthcare provider of last resort for thousands of people who already need access to home care, long-term care and other services. This is not appropriate for these patients.”
But Bill Vangorder, chief operating officer and chief policy officer for the Canadian Association of Retired Persons, said he had hoped to have a say at public meetings along with other advocacy organizations such as Seniors Social Work Ontario and the Seniors Advocacy Center. .
He said his members had real concerns about the bill and that it was an approach to relieving pressures in hospitals and long-term care.
“She looks at them from a systemic point of view, not from the patient’s own point of view,” he said.
What will come next?
The bill is currently in its second reading. No committee meetings have been scheduled to collect public opinions.
Sinha said he is already hearing from concerned patients and their families about what the law could mean for them moving forward.
“They are afraid. They are worried,” Sinha told CBC Radio. morning metro Thursday.
Because the proposed bill could theoretically see patients transferred to long-term care facilities not of their choosing, without their consent, or face exorbitant daily fees, it would leave many families in “horrific situations,” Sinha said.
“This will only lead to strained relationships and reduced trust between health professionals and their patients, between hospitals and patients.”