Patients in Ontario occupying a place in a hospital, but no longer requiring an acute care bed, may be moved to a selected long-term care home (LTCH) without their consent which may be located up to 70 kilometers from the home of their choice. If they refuse, they will be charged a daily fee of $400.
These are regulations established under Doug Ford’s Progressive Conservative government’s controversial Bill 7. The bill was rushed through two weeks after it was introduced. There are approximately 5,000 patients who no longer require a hospital bed – also called “alternate level of care” (ALC) patients – in Ontario. These are patients who occupy a hospital bed in acute care, but who could be cared for elsewhere. 1,900 of them are waiting to be transferred to an FSLD. The province wants to free up those beds to reduce pressure on hospitals.
By way of comparison, there are 2,195 patients in this category in Quebec hospitals, and 696 of them are waiting for a bed in a CHSLD. The presence of these patients also contributes to overloading the two health systems.
Ontario patients can normally stay in the hospital for $60 a day while they wait for a space to become available in one of their chosen homes. If the patient is accepted in one of them and refuses to move there, he may have to pay around $1500 a day for his hospitalization, as if he were not insured.
Some lawyers defending seniors were concerned that the same fee would be imposed on NSA patients refusing to move to an FLSD they did not choose, but the province announced that fee would instead be $400 per day.
According to the regulations, the province will respect the language preferences of patients, but at a press conference Wednesday afternoon, two ministers did not guarantee that a French-speaking patient would not be transferred to an English-speaking FLSD. In northern Ontario, where 20% of the province’s Francophones live, ALC patients may have to move to an LTCH up to 150 kilometers from the home of their choice.
The provision of long-term care in the patient’s mother tongue is a crucial issue for several stakeholders in the health sector interviewed by The duty since the introduction of the bill. In an interview with earlier this week, Dr. Rose Zacharias, president of the Ontario Medical Association — the organization that represents Ontario physicians — also believes that the patient’s language should be “in top of mind” when transferred.
A new tool in the trunk
The bill has aroused emotion since it was tabled. Vivian Stamatopoulos, a professor at Ontario Tech University and elder rights activist, described it as “disgusting” in an interview with CBC; NDP MP France Gélinas, Queen’s Park Opposition Health Critic, is asking the Ontario Human Rights Commission to intervene in the case.
According to the CEO, the hospital is not the ideal place for an elderly patient who is waiting for a place in an LTCH. A message on the hospital intercom interrupts the interview for 10 seconds. “It’s the kind of interruption that doesn’t happen in nursing homes,” she notes.
Geriatrician George Heckman had previously made a similar point to the To have to. The hospital stay, he said, can cause delirium in some patients. But the graduate of Laval University argued in the same breath that he can persist if the patient was moved to a place he did not know and where the caregivers did not speak his language.
Arden Krystal says his hospital “would never force patients to go hundreds of miles from home, especially if they have an elderly husband.” (The regulations specify that couples will remain together). “These are patients, not numbers”, she illustrates. The CEO of the Southlake Regional Health Center asks the population to trust hospital employees. “It’s not a conveyor to free up hospital beds,” says Ms. Krystal. She notes, however, that a patient could be sent further if his family does not already visit him regularly.
This story is supported by the Local Journalism Initiative, funded by the Government of Canada.