There are no major healthcare gains for older Canadians in this budget. $223 million of the 1.1 billion already set aside for the Aging at Home Strategy will be spent in 2009-10. This spending represents an increase from the $94 million spent in 2008-09. The money will be administered by the Local Health Integration Networks (LHINs) and is meant to also provide an integrated continuum of community-based services, home care services as well as caregiver support. Because service plans are to be determined by the LHINs according to local need, they will vary across jurisdictions.
Answers to the question of how exactly the LHINs will deliver these services have been nebulous at best and there is yet to be a comprehensive report to explain how the LHINs propose to spend the money. CARP hopes that the LHINs will provide an interim report before the money has been spent. The Aging at Home Strategy is one of the initiatives the province is using to shorten ER wait times. CARP has argued that wait times should not be shortened at the expense of ‘alternate level of care’ patients (ALC). These post-acute patients are often sent to other health care facilities to shorten ER wait times. According to Judith Wahl, executive director Advocacy Centre for the Elderly: “ALC patients are quite often not ready to return home. Their needs are such that they are unable to function on their own, and need rehabilitation and more comprehensive care then families are often able to provide.” These patients are sometimes being forced to take placement in a (LTC) facility, sometimes many miles away from their friends and/or family, and in some instances, are being pushed into private retirement homes.
The budget states there will be an incremental $65 million going towards home care but we are told that this includes 39 million spent in 2008-2009. There will be only a $26 million increase in home care services.
We know that increased delivery of home care services is cost effective and as the population ages, this area of healthcare is badly in need of expansion. A $26 million dollar increase from a $42 billion budget makes home care the poor cousin of the healthcare system and that’s not acceptable. We know that a long term care bed costs the province $41, 600 a year, perhaps if we had adequate home care funding, we wouldn’t need to invest in as many incremental beds as we do now.
The budget lacks forward thinking with respect to the aging population. CARP has called for the training of more geriatricians since there is a dire need to produce more of them: in 2007 it was reported there were fewer than 200 geriatricians across Canada. This is partially the reason why this year, CARP will be launching a scholarship fund for students of geriatrics and gerontology. Yet of the $35 million earmarked to create an additional 100 medical school spots, there is no targeted funding for gerontology or geriatricians.