Open Letter on Budget 2020 Priorities for the Home and Community Care Sector

Open Letter on Budget 2020 Priorities for the Home and Community Care Sector

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Toronto - October 22, 2020

Dear Premier, 

As Covid-19 case numbers rise and we reflect on the first wave of the pandemic, OCSA knows that the home and community care sector could be better utilized to support the province’s battle against the disease. Seniors and people with disabilities are safer at home. 

For the home and community care sector to be able to alleviate capacity pressures on hospitals and long-term care homes the province should make the following investments:
• Annualize recent one-time COVID related investments for the High Intensity Supports at Home Program and the funding for the expansion of Meals on Wheels and delivery of essentials.
• Raise the wages of personal support workers (PSWs), nurses and other staff in the home and community care sector to create parity across health sectors. 
• Create 2,500 additional Assisted Living spaces to reduce the number of people being admitted to long-term care prematurely.
• Provide a 3% funding increase for home and community care organizations to ensure they have the tools and capacity to meet their client’s increased needs. 

Annualize Recent Investments
Covid-19 created tremendous strain on the health system. It also demonstrated that the home and community care sector can play a bigger role when properly supported. Investments such as the High Intensity Supports at Home program and the expansion of Meals on Wheels and delivery of essentials, must be continued to provide appropriate supports to vulnerable individuals. Investments such as this demonstrate that the home and community sector can keep people safely at home. With the continuing wave of new Covid-19 cases, we know that seniors and those with disabilities will benefit from these services. These investments should be annualized to ensure the people receiving these services don’t find themselves prematurely institutionalized. 

Wage Parity
In our January 2020 pre-budget submission, we called for closing the pay gap of front-line workers between health sectors. At the time, we called for wage parity with long-term care homes to be achieved over a 5-year period, however the pandemic has made it clear that this needs to be achieved now across all sectors and positions. The pandemic pay premium and the most recent temporary wage enhancement for PSWs were welcomed and brought much needed recognition of the heroic efforts these front-line staff have made during this pandemic. However, we must ensure parity for front-line PSWs and nurses, which would cost the province approximately $164 million. This investment would considerably help to narrow the province’s current shortfall of 6,000 PSWs and create the capacity to treat and keep people well at home.*

Expand Assisted Living
A recent report by the Canadian Institute for Health Information confirms that there were over 2,800 people admitted to long-term care homes this year in Ontario who could have been kept safely at home with adequate home and community care supports. Keeping these people at home would have lowered their risk of exposure to COVID as well as generated health system savings of $31 million to up to $104 million.**  These savings would go a long way in shoring up hours of care in LTC and front-line staff pay in community.

To better utilize the sector, we repeat our call for an investment of $57 million into the expansion of Assisted Living for Frail Seniors programs across the province and for the government to review its policy to ensure this program’s impact is maximized. An investment of this magnitude would enable an additional 2,500 seniors to live at home safely rather than in long-term care.

Infrastructure for Home and Community Care Organizations
Between 2003 and 2018 the proportion of home care and community support service clients who are high risk or very high risk of an adverse event has almost doubled.***   Providers supporting this population are in immediate need of increased funding to keep up with this growing acuity. 
 
We are urging the province to ensure an adequate increase to the base funding of organizations by investing $125 million to address the growing acuity of their clients, to make up for the lack of base funding increases and to address the additional COVID related costs. Home and community care providers can help, but we need additional investments to keep hospitals and long-term care homes focused on patients that cannot be served elsewhere.

One of the key lessons learned during this first wave of the pandemic was that people are safest at home and that home is where Ontarians want to be. A public opinion poll conducted by Campaign Research for Home Care Ontario found that 95% of seniors believe that staying in their own home with the support of home care is the safest environment for them to live during a pandemic and 91% want to stay in their own home or apartment as long as possible.****  

Premier, we recognize the magnitude of the economic realities that this province is facing going forward. Investing in the home and community care sector will help enable our province to weather the remainder of this pandemic and save money by diverting care out of hospitals and long-term care for years to come. 

We would like to be able to discuss these recommendations with you at your convenience. To arrange a meeting please contact, Janice Bedore, Executive Assistant, at Janice.bedore@ocsa.on.ca or 416-256-3021 ext.224.

Thank you,
Deborah Simon,
CEO 
Ontario Community Support Association

Cc:  
Hon. Christine Elliott, Deputy Premier and Minister of Health Christine.Elliott@ontario.ca
Hon. Rod Phillips, Minister of Finance Rod.phillips@ontario.ca 
Hon. Peter Bethlenfalvy, President of the Treasury Board Peter.Bethlenfalvy@ontario.ca

*Analysis of 2019 OCSA & Home Care Ontario Wage Reports. $164 million would allow home and community care PSWs wages to be brought up to $21 an hour to align with the average long-term care homes and for home and community care RN wages to be brought up to the starting ONA hospital rate of $31 an hour. A benefits premium of 22.5% is included.
**OCSA analysis based on CIHI Report
***Ontario Home and Community Care Client Profile, Prepared by InterRai Canada for OCSA, 2018
****Home Care Ontario Poll Research conducted by Campaign Research Inc

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