Advocating Quality Home & Community Care

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Care Watch is a volunteer- run, not-for-profit advocacy organization led by seniors.

We work with policy makers and those who influence policy. As well, through public events and research we raise issues relative to older people. We drive positive action.

OLDER PEOPLE IN ONTARIO MUST HAVE:

CHOICES – Opportunities to make choices that will enable living at home with dignity and as much independence as possible.

A VOICE – The right to be involved in decisions about policies and practices that affect their lives.

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SUPPORT – Access to services and programs that help them to be productive, active participants in their own communities.

Care Watch fights for services and programs that facilitate “aging at home”. Read our Pragmatic Proposal

Be a part of Care Watch! Shape the future you want.

There are many ways you can get involved in Care Watch and have your voice heard. Become a member to stay abreast of issues affecting older Ontarians. Join our mailing list to receive our bimonthly e-bulletins. Contact us to participate in advocacy initiatives.

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Announcements

June 8, 2016

Let’s think about the new Patients First Act before jumping on or off the bandwagon!

Introduction of Bill 210, the Patients First Act, 2016 offers a key opportunity for Ontarians to assess the health system changes that Minister Hoskins proposes.  These changes will have a significant, long-term impact on the range and quality of health services Ontarians receive through our publicly funded Medicare system. They will affect our experience as users, providers and taxpayers.

The draft legislation will amend approximately 20 pieces of legislation in order to implement the proposed reforms.  The Bill is complex and the way it amends these other Acts requires careful analysis of the intent as well as effects or probable outcomes.

Care Watch has a longstanding commitment to advocate for better, more accessible home care for senior citizens.  It is through this lens that we will be watching and commenting on the proposals.

Several commentators, such as The Toronto Star’s Bob Hepburn, note that it is a “first step” in the reform and restructuring process to reduce bureaucratic barriers, improve coordination, access and geographic equity for patients; facilitate patient transitions from hospital to home care; and reduce wait times for home care services, all while re-directing spending from management to front line services.  These are high hopes indeed, but Ontarians are capable of amazing things given sufficient political will and resources!

Also, legislation alone will not change the less than healthy culture of our health care system – affecting both providers and patients – which underlies or exacerbates many current problems.  Long term improvements will require changes in the way we think of and use health services, in our expectations and requirements, and in the ethos of providers we employ.

In the short term, changes will need to be carefully synchronized with appropriate transitional funding and risk management.

There is a lot to ponder.  Care Watch encourages senior citizens to think about the proposals and share your thoughts with us.  We will offer advice to Minister Hoskins through the public legislative committee hearings that the government promises to hold.

Board of Directors, Care Watch

 

May 10, 2016

The Ontario Health Coalition is collecting information from individuals, and their families, who have been charged extra fees for medically necessary services. They have asked us to share their survey with our members and supporters. If you have been charged, follow this link to participate: https://www.surveymonkey.com/r/OHC-user-fees-survey

Please assist them in collecting this important data.

April 7, 2016

Care Watch thanks The Toronto Star’s Carol Goar, who announced her retirement in an article yesterday. Read our farewell to Ms. Goar, written by long-time Care Watch member and former Chair of Care Watch’s Social Action Committee, Dr. Sheila Neysmith, here.

February 29, 2016

Submission to the Ministry of Health and Long-Term Care

Re: Call for Feedback on Patients First: Proposal to Strengthen Patient-Centre Health Care in Ontario

Dear Minister Hoskins:

Care Watch, a not-for-profit, volunteer-run organization led by senior citizens, advocates for quality home and community care services in Ontario.  We are pleased to provide input to the consultation process regarding the restructuring of Ontario’s health care, and home and community care systems.  We appreciate and applaud the Province’s willingness to engage system users, especially seniors, along with service providers in the discussion and decision-making process.

Care Watch supports the two principles of “patient-centeredness” and “client choice in service provision and providers” which are intended as foundations for restructuring. We would, however, add a third principle – provision of public service to Ontarians. While efficiency and efficacy in the use of public dollars should always be goals, and are demonstrably essential respecting health expenditures, reducing, eliminating or privatizing needed public services primarily to achieve “cost savings” is the antithesis of caring government policy.

Read the full submission here

February 3, 2016

Care Watch Ontario Budget Submission 2016

In its pre-budget consultation submission to the Government of Ontario, Care Watch hihglighted the following priorities:

1.  Increase investment in the Home and Community Care Sector to Support System Change

2.  Ensure Dedicated Funding to Set Up and Support Local Service Coordination at the Community Level

3.  Develop A Dedicated Envelope of funding for Community Care Sector and Services – not Integrated Funding

Click here to read the full submission.

January 12, 2016

For Ontario’s seniors, “Patients First” mistakenly emphasizes clinical solutions to community issues

Re-release: For immediate release (Toronto) January 12, 2016

Care Watch commends Minister of Health and Long-Term Care Dr. Eric Hoskins on his recent Discussion Paper, “Patients First: Proposal to Strengthen Patient-Centred Care in Ontario”. However, Care Watch has significant concerns about several aspects of the Paper:

1. Restructuring Discussions – The paper focuses almost exclusively on the organization and support required by clinical care providers. However, to get the best system change outcome for Ontarians, the Ministry should ensure that restructuring discussions are also accessible to and incorporate the voices of seniors, family caregivers, and non-health community-based organizations which also provide critical home and community care services.

2.  Expansion of LHIN Mandate and Responsibilities – The Paper does not identify community social and support services as being part of either primary care or the continuum of care. Services like transportation, home-making, meals-on-wheels, adult day programs, and respite care are essential to support autonomous living for seniors, the chronically ill, and people who live with disabilities. Care Watch advocates that the primary care sector, including community and social services, be addressed in the earliest phase of a carefully planned and timely process to implement proposed changes. The Ministry should also second senior staff from the home and community care sector to inform its analysis of needed changes with current practical experience.

3.  Local Service Coordination – Care Watch opposes the further medicalization of the design and delivery of services to seniors and people living with disabilities, who are striving to maintain their autonomy in their homes and communities. This is reflected in the repeated references to “patients”, “health care” providers, and “clinical” services. Care Watch advocates that multi-disciplinary, primary health and/or community care agencies assume local care coordination and be funded appropriately.

4Integrated Funding – An ageing population needs community-based chronic care, yet Ontario’s health system continues to operate on an antiquated, acute care model. The powerful influences of the acute care sector drown out the voice of the community services sector. Care Watch opposes the “bundling” of funding that encompasses hospitals, primary care, and the community services sector. Instead, Care Watch advocates the establishment of a protected budget envelop dedicated solely to home and community services, an envelope that cannot easily be re-allocated elsewhere.

5.  Increased Investment in Home and Community Care – System reorganization requires extra resources. Care Watch recommends that the Ministry set aside funding to assist community agencies in undertaking the necessary research, planning and organizational changes required for successful system restructuring.

6. Significant Missing Details – The Paper fails to enumerate the range of services to be delivered within the restructured home and community care sector.  As well, the Paper lacks details about how to fix the perpetual problems of system navigation, problems consistently voiced by users for countless years.

“Care Watch welcomes the Province’s willingness to engage system users, especially senior citizens, and looks forward to being an integral part of the restructuring discussions and decision-making processes,” says the Chair of the Care Watch Board of Directors Josephine Grayson.

“Unfortunately, the Discussion Paper gives insufficient recognition to the central role that home and community services must play in the long term care of ageing Ontarians. We need to reframe the discussion to avoid further medicalizing the system, and to ensure its sustainability and affordability.”

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Originally released January 7, 2016
For more information contact Care Watch:
Michèle Harding,
Board of Directors
Direct: (416) 465-6438
Cell: (416) 573-6438

 

Care Watch: 

 

Care Watch is a not-for-profit, volunteer-run advocacy organization led by senior citizens.  We work with policy makers and those who influence policy to raise issues relevant to older people.  We believe that we – the senior citizens of Ontario – must have a say in how services are organized, delivered and evaluated.   Care Watch advocates for quality home and community services that are:

  • Seamlessly integrated with primary, secondary and tertiary health services;
  • Effectively coordinated;
  • Securely funded; and,
  • Led by not-for-profit, community-based agencies.

January 12, 2016

Backgrounder

For Ontario’s seniors, “Patients First” mistakenly emphasizes clinical solutions to community issues

 

On December 17, 2015, Dr. Eric Hoskins, Ontario’s Minister of Health and Long-Term Care released a new Discussion Paper “Patients First: Proposal to Strengthen Patient-Centred Health Care in Ontario.”  While espousing principles of patient choice and health equity, this paper provides a high level outline of proposed restructuring of the planning, funding and delivery of health services, to achieve service integration, increased efficiency and improved health outcomes.  All of these objectives are highly desirable, but, to paraphrase an old saying, the “devil will be in the details”.

Restructuring Discussions:    

Care Watch welcomes and applauds the Province’s willingness to engage system users, especially seniors, and service providers in discussion regarding the future of home and community care services, and looks forward to full participation in restructuring discussions and decision-making processes.

Care Watch also appreciates the “patients first” principle underlying the Discussion Paper, despite the Paper’s almost total focus on the organization of and support required by “clinical” care providers. The proposed maintenance of client choice in service and service providers is essential in a client-centred system.  We anticipate that a variety of legislative mechanisms and culture-change strategies will be needed to guarantee user choice.

However, to get the best system change outcome for Ontarians, the Ministry should ensure that restructuring discussions are also accessible to and include the voices of seniors, family caregivers, and non-health community-based organizations which also provide critical home and community care services.

Expansion of LHIN Mandate and Responsibilities: 

Care Watch acknowledges the potential efficacy of transferring current CCAC functions to the LHINs and the proposed expansion of the LHINs’ mandate to include primary care planning and performance management; home and community care management and service delivery; and the development of formal linkages with population and public health planning, in order to improve system planning and accountability, funding equity, delivery standards and client outcomes.  Integration of the primary health care sector (e.g., community health centres, Aboriginal health access centres, and family health and nurse practitioner teams) within the ambit of the LHINs is required to provide critical local anchors for the continuum of health care.

Care Watch is concerned that despite repeated references, the Discussion Paper does not identify community social and support services as being part of either primary health care or the continuum of care. Services which support autonomous living for seniors, people with disabilities and persons with chronic illnesses – like transportation, home-making, meals-on-wheels, adult day programs and respite care – are critical to the success of any home and community care plan.

Additionally, the scope and complexity of the anticipated system change cannot be achieved all at once.  The Ministry needs to identify priorities for incorporating and integrating the various existing sectors and proceed in a phased manner along agreed time lines. Care Watch advocates that the primary health care and community social and support services sectors be addressed in the earliest phase. The Ministry should also second senior staff from the home and community sector to inform and augment its analysis of needed changes.

Local Service Coordination: 

Care Watch supports the proposal that home care coordinators be housed at the LHIN sub-region level and deployed into community settings.  However, the Paper is silent on how the sub-LHIN areas will be selected, governed, and operated.  Repeated reference to “patients”, “health care” providers and “clinical” services and leadership demonstrates that medicalized paradigms still dominate the government’s discourse and priorities in designing and delivering home and community-based services to seniors and people living with disabilities who, in fact, strive to maintain their autonomy in their own homes and communities.

Based on prior experience, Care Watch worries that local service coordination responsibility will be delegated predominantly to local hospitals and that home and community care services will consequently become even more medicalized and expensive.  Based on cost alone, Care Watch disagrees with the apparent perception that hospitals are appropriate lead agencies for “home and community care coordination”, and advocates that multi-disciplinary primary health and/or community care agencies assume local service coordination responsibilities and be funded appropriately.  

Integrated Funding: 

In order to remain affordable, Ontario’s health system needs to respond to the demographic implications of an ageing population. An antiquated model oriented to acute care is clearly no longer sustainable; it cannot meet the needs of people living with chronic health conditions. Service users live in the community and that is where services must be provided. However, hospitals and acute care services consume the lion’s share of health budgets. The influence of the acute care sector, with its powerful advocates, easily drowns out the voice of the community services sector.

Based on experience, Care Watch opposes the proposed “bundling” or integration of funding that encompass hospitals, primary health care, and community care sectors and services.  Care Watch advocates that instead of bundling funding, the government establish a protected budget envelope that is dedicated solely to home and community care services; a budget envelope that cannot easily be reallocated elsewhere, even when increasing hospital, physician or pharmaceutical costs stretch existing resources. 

Increased investment in home and community care:  

System reorganization requires intensive planning, support and evaluation, especially during transition periods.  These activities require investment. Perhaps in the long run the savings generated by eliminating the CCAC structure may be sufficient to support the enhanced responsibilities of LHINs and other organizations, but this is unlikely to be true in the short term. It is unclear what new funds will be provided to support the change process.

Care Watch recommends that the Ministry set aside funding to assist community agencies to undertake the necessary research, planning and organizational changes required for successful system restructuring.

Significant Missing Details:

Multiple system reviews have identified gaps and inconsistencies in accessibility and service provision across the province.

A significant missing detail in the Ministry`s Discussion Paper is consideration of the range of services to be delivered within the restructured home and community care system.  Redefining government and provider relationships and accountability outside the context of required services and supports will not, in the long term, produce better outcomes for Ontarians.

Multiple reports have also highlighted the difficulties that seniors and caregivers have navigating the health care system.

While having “services closer to home in sub-LHIN areas” may mean smaller bureaucracies, we do not yet understand what mechanisms will be put in place to improve system navigation and wait times for home and community care.

Care Watch:

Care Watch is a not-for-profit, volunteer-run advocacy organization led by senior citizens.  We work with policy makers and those who influence policy to raise issues relevant to older people.  We believe that we – the senior citizens of Ontario – must have a say in how services are organized, delivered and evaluated.   Care Watch advocates for quality home and community services that are:

  • Seamlessly integrated with primary, secondary and tertiary health services;
  • Effectively coordinated;
  • Securely funded; and,
  • Led by not-for-profit, community-based agencies.

– 30 –

 Media contact:

 

For more information contact Care Watch:
Michèle Harding, Board of Directors
Direct: (416) 465-6438
Cell: (416) 573-6438

 

 

November 19, 2016

The 16th Annual General Meeting of Care Watch

Please join us for the 16th Annual General Meeting of Care Watch, From Policy to Action

Date: Thursday, November 19

Time: 2 – 4 pm

Place: The Older Women’s Network Co-op, 115 The Esplanade, Toronto

Program: Mary Kardos Burton, former Assistant Deputy Minister of the Acute Services Division with the Ministry of Health and Long-Term Care, will address Bringing Care Home, the March 2015 report of the Ontario’s Expert Panel on Home and Community Care.

Light refreshments will be served.

 

Election 2015  —  Please check our blog for up-to-date commentary on election issues. Remember to vote on October 19th!

Five federal parties completed the Canadian Nurses Association platform questionnaire on home and community care. Answers may be accessed at Party Platforms

The College of Family Physicians of Canada have released their infographics on the 2015 federal election platforms. View their grades for National Home Care Programs

Visit the Canadian Medical Association site “Demand a Plan” and sign the online petition in support of a National Seniors Strategy

Canadian Medical Association press release “Canadians to federal candidates: Ignore seniors care at your peril”

“Health care gets short shrift on campaign trail” Theresa Boyle, Toronto Star

“Elizabth May pledges health transfers to reflect aging populations” CBC News

“Canada needs a national seniors strategy: Editorial”  Dr. Chris Simpson, Toronto Star

“Canadians not confident about future of seniors’ health care: polls” André Picard, Globe and Mail

“Canadian Medical Association urges health-care strategy for seniors” André Picard, Globe and Mail

 

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Nov 19, 2014 

Annual General Meeting

Please join us for Care Watch’s Annual General Meeting, 2014 “Mobilizing Against Ageism!” Thursday, December 4,  2:00 – 4:00 pm, at the Older Women’s Network. This year’s program will feature a presentation and workshop on strategies to eradicate ageism through direct action.

Add your voice. Act with us.

Click here to view the event invitation.

Sept 22, 2014

Globe and Mail health columnist Picard cites 2014 Statistics Canada Study to highlight the unmet home care needs of Canada’s growing elder population.  Please visit our Care Watch blog for an on-line discussion of Picard’s article and the study it refers to.

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August 29, 2014

Important Toronto Seniors Forum notice

Also, don’t miss the following advocacy messages.

Ageism Exists: Name it! Resist it!

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May, 26 2014.

Dear Fellow Member of Care Watch

Below is a letter and package of material the Care Watch Board has sent out to all provincial candidates in both hard copy and electronic format.     We are very concerned that during this election campaign there has been very little discussion of the increasing need for supportive home care services. Care Watch has been pursuing several avenues to turn up the volume on this issue. However, it is an uphill battle. We ask you to forward this to the people you are in contact with. Please also put a link to it and/or the Care Watch website  http://carewatchtoronto.org /on your Facebook page.

Thanks

Care Watch

 

Dear  Candidate:

The 2014 Provincial election is occurring as Ontario faces a number of challenges. How we address these will determine what kind of a society Ontario will be in the years ahead.

Frequently one hears concerns about issues that many people associate with population aging. Care Watch is an advocacy organization composed of Senior Citizens. Our sole purpose is to ensure that Senior Citizens receive the supports they need in order to sustain the quality of their lives as they age.

Attached are several short documents that outline key issues that are affecting supportive home care policies and programs in Ontario today:

Ø  The rationale for implementing designated funding for supportive services;

Ø   The impact of ageism on policies and programs;

Ø  An election post card with questions that we are encouraging Senior Citizens to ask of all candidates during the campaign.

We are sending these materials to you to inform you of issues that are important to senior citizens — major voters in the upcoming election. For further information, please visit our website http://carewatchtoronto.org/ where we will be posting updates throughout the election period.

Finally, we welcome the opportunity to meet with you around issues affecting Senior Citizens.

Sincerely,

     Lorna MacGregor

     Chair

For important resource information on  what electoral candidates need to know about supportive home care services, please click here.

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Care Watch’s Bea Levis, honoured with the Ontario Gerontology Association’s 2013 Positive Aging Award, shapes policy discourse on ageism and senior citizenship. Click here for the tribute.

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Care Watch’s Charlotte Maher, posthumously awarded the Francis Lankin Community Service Award from Social Planning Toronto: Click here for the tribute.

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Care Watch mourns the loss of its founder and leader, Charlotte Maher. A long-time social activist with a hunger for justice and the capacity to make a difference. We will miss her deeply, but will continue to follow her lead.

Charlotte’s Obituary

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In The News

Home-Care Crunch Coming by  Sherri Torjman of the Caledon Institute of Social Policy

On Saturday October 6 2012 Sherri Torjman, Vice-President of the Caledon Institute of Social Policy, wrote an op-ed piece in the Toronto Star articulating some of the implications for home care as the Canadian population ages.  She reiterates the well-known cost concerns that accompany most discussions of population aging. Home Care is usually proposed as one response because studies document that it is cost efficient and effective. Of course, these calculations do not include the costs that families bear (see Care Watch’s Pragmatic Proposal for a graphic presentation of these private costs). As more and more people embrace the idea of home care, how to finance it is seldom seriously considered. In this article Sherri points out that Canada has confined its use of social insurance to income security, while  other countries have used it to finance home care. She also notes several other approaches that are in use. Importantly, she highlights that the funding issue has been addressed in other jurisdictions – it is not insolvable but it does require innovation and an active debate about alternatives. Care Watch, in our Pragmatic Proposal, raised very similar concerns. In the past year we have made numerous presentations to groups on the topic but have found that when it comes to debating new ways of funding home care people get nervous. Why are we so reluctant to consider options that have worked elsewhere? Thank you Sherri for raising this central home care issue in the media.

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In response to: Aging with Dignity – Globe & Mail Editorial Sept. 9, 2012

“Care Watch also praises Susanna Lafarge for her generous gift to Mac Masters for the purpose of studying optimal aging. It holds promise for those of us who are aging and all the rest who will age. Care Watch has for many years promoted preventative options. Some of the innovative ideas described in the editorial are truly remarkable and perhaps life changing but, not for today.

The purpose Care Watch is to promote the development of early need, supportive home care which is easily assessable and consistent as has been shown empirically (Hollander and others) to reduce admission to hospital and long tern care, aiding optimal aging and economy. We have great trouble understanding why this piece of the puzzle is consistently missed by editorial writers and , indeed, the government”

– Charlotte Maher

 

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