(Québec) Christian Dubé estime que le CISSS de la Côte-Nord a mal interprété les directives ministérielles sur le transfert d’aînés. Le ministre de la Santé demande leur révision pour éviter d’imposer des pénalités financières à un patient, dans un contexte de crise de la main-d’œuvre.
« Je voudrais en profiter pour dire, dans des situations exceptionnelles comme on vit en ce moment, est-ce qu’on pourrait suspendre [la tarification] ? That’s what I asked [au sous-ministre Daniel] Ready to watch,” explained the minister on the sidelines of the tabling of a bill by his colleague Jean Boulet on reducing the administrative burden on family doctors.
Christian Dubé tore his shirt on Thursday when he learned that the CISSS de la Côte-Nord – which is plunged into a labor crisis with the end of the use of employment agencies – had updated a procedure which could have led to the expulsion of patients who refused a transfer to a CHSLD elsewhere in the territory or outside the region.
In the event of refusal, the user would have had to pay for the days of unauthorized occupation. However, the establishment affirmed that it relied on ministerial directives in force.
A ministerial circular updated in 2023 specifies the costs relating to the accommodation of an adult who “has received their leave […] and whose condition allows him to return home or for whom a place is guaranteed in another establishment, but who refuses to leave the establishment which accommodates him.
Furthermore, it is written in black and white in the provincial reference framework for the mechanism for access to accommodation in residential and long-term care centers of the Ministry of Health and Social Services that “if an impasse remains , the establishment may consult its legal advisors to determine what options exist to choose the most appropriate solution.”
However, according to Mr. Dubé, these directives should not apply in a situation like that experienced on the North Shore, where patients would have had to vacate beds due to a reduction in services.
There is a difference between charging for the service, because it is billable. But there, we were further, we were that if the person does not accept […] that there be an injunction. We’re not there at all.
Christian Dubé, Minister of Health
The price list is currently being revised following revelations from the Duty, more than a year ago, of the case of a 90-year-old man from Estrie who received a bill for more than $27,000 because his family had refused his transfer to a CHSLD 40 kilometers from home him. Mr. Dubé wants to take the opportunity to make adjustments to “frame the interpretation” of the transfer directives.
No solution yet
The Deputy Minister of Health, Daniel Paré, will also have to establish the care trajectory to follow in a case like on the North Shore. What could be the protocol then? The minister did not have the answer on Friday.
“The issue is always the same, it is patient safety. […] We are not happy to transfer the patient. Is there the staff to serve it? Can we wait one more day, two days to see if there are other solutions? », Lists the minister.
He recalls that his access coordinator, Michel Delamarre, was sent to the North Shore two weeks ago when management announced several service reductions.
We went from a disaster scenario to a scenario, I wouldn’t say perfect, but which improved a lot because there was help from almost everywhere.
Christian Dubé, Minister of Health
On Thursday, the minister’s office indicated that Mr. Paré would “remind” the president and CEO of the CISSS de la Côte-Nord, Manon Asselin, about his “interpretation” of the directives. On Friday, the minister explained that he still needed to carry out checks to establish the decision-making chain. “There will always be accountability,” Mr. Dubé said.
The CISSS management has not granted an interview until now.