Home care is the answer to freeing up hundreds of beds at Hamilton Health Sciences, pleads provincial association
Home Care Ontario says it could get many of the 270 patients stuck at Hamilton Health Sciences (HHS) out of hospital with the proper staff and resources.
The Hamilton-based association that advocates for home care is calling on the Progressive Conservative government to immediately provide $1 billion it promised to shore up the sector instead of doling it out over three years.
These 270 people who are stuck are just the tip of the iceberg," said Sue VanderBent, CEO of Home Care Ontario. HHS is just a little microcosm."
One in five beds at HHS are taken up by those ready to be discharged - patients known as alternate level of care (ALC) - but unable to leave because they are on long wait lists for services in the community such as long-term care, home care, rehabilitation, complex continuing care and mental-health care.
The number of ALC patients is at its highest in seven years at HHS, which has been using the former Crowne Plaza Hotel at 150 King St. E. as a satellite health facility since October 2020. The facility is now above its 150-bed limit and still doesn't come close to housing all of the ALC patients at HHS and St. Joseph's Healthcare.
To think that one in five beds are being occupied by people who could have gone home is unbelievably shocking," said VanderBent. Home care is where the answer lies."
But Home Care Ontario says decades of underfunding and low wages - exacerbated by the pandemic - has left the sector unstable. It's launching a campaign Friday to urge the province to fast-track funds pledged in April 2022. The association says just $120 million of that additional funding has gone to home care so far and it needs the other $880 million now to help ease unprecedented strain on Ontario's hospitals and long-term care homes.
It estimates the extra cash would add 2.72 million hours of home care to tackle a wait list that has grown to 15,000 Ontarians. It's also cheaper, costing $103 on average per day for home care compared to $201 for long-term care and $730 for ALC, says the association.
Ontario's home-care system can be stabilized and scaled up faster than any other part of the health system," states its prebudget consultation submission. It is the quickest, most effective way we can give our loved ones the care they deserve and relieve the pressure on overcrowded hospitals - and it can be done in a matter of months, not years."
As much as two-thirds of the money would go to staffing home care, which has a vacancy rate of 17 per cent for nurses and 12 per cent for personal support workers (PSWs). The association says low pay is a big issue, with PSWs making $20.30 an hour after a $3 wage enhancement provided by the province over the pandemic. In comparison, the association says Amazon warehouse workers make $20.37 an hour and Costco cashiers make $19.87 an hour.
We lost thousands and thousands of them during COVID," VanderBent said about burnt out staff leaving health care in droves. We can offer better wages and bring them back from wherever they are - at home, working in retail, working at Amazon. They are trained to do this work."
The association also wants Premier Doug Ford's government to develop a system-wide strategy for human resources in the health sector that prioritizes home care.
A long-standing problem has been that staff in home care are paid less than other parts of the health-care system, with a PSW making $4.61 more an hour in hospital and an entry-level nurse getting $11 more. It makes it hard for home care to compete - especially at a time when hospitals have unprecedented staffing shortages. HHS alone had 1,400 vacancies in November, up from 750 in September 2021. Of those job openings, 700 were for nurses.
We've lost tremendous members of staff to long-term care and to hospital care," said VanderBent. That really happened very quickly during COVID. Government paid them a lot more money to work in hospitals and long-term care. I don't think we understood what the impact of it would be."
Lastly, the association is asking the province to modify and enhance its Ontario Seniors Care at Home Tax Credit. Currently it provides a maximum credit of $1,500 of claimable medical expenses such as hearing aids, hospital beds and attendant care. The amount is reduced by five per cent of family net income over $35,000 and fully phased out by $65,000. The association says the income threshold is too low and a required disability certificate too difficult to obtain.
These three recommendations together would go a long way to moving Ontarians out of overcrowded hospitals and keeping them off wait lists for long-term care, says Home Care Ontario in its submission.
We have to pivot and we have to build up our home-care system," said VanderBent. We're still putting all of our eggs into the institutional basket ... We will never be able to build enough beds."
Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com