Ontario Health Coalition
BACKGROUNDER: Homecare
November 2003

Privatization

In 1996, the Conservative Government established 43 regional Community Care Access Centres (CCACs) to govern the delivery of nursing home visits, homemaking services and admissions to long-term care facilities. The CCACs were directed to contract for services through a process established by the province that year. Private profit-seeking corporations were invited to compete for contracts against the non-profit service providers and the CCACs were directed to withdraw from providing any services directly, even where it was proven to be cheaper.

For profit companies under-bid the non-profit VON & Red Cross and won the contracts to provide services in communities across Ontario. In order to make room for profit and to drive out the non-profits, they cut the wages, benefits and working conditions of the staff. Serious staffing shortages, duplication, excess administration and profit taking are the results of this privatization.

Liberal Campaign Promises

  • No promise to stop for-profit homecare.
  • Promise new investment in homecare starting with care for frail seniors.
  • Promise to make homecare available as long as cost does not exceed the cost of a nursing home.
  • No clear promise to bring homecare under the principles of Canada Health Act (cited as "long term vision" in the platform.)

    • Cuts to Access

    In January 1999 the Ministry of Health drafted service guidelines for CCACs to determine eligibility, priorities for service and levels of care. Later in 1999, the conservative cabinet passed Regulation #386/99 limiting homecare and home nursing visits. Under these measures, the CCACs were directed to determine eligibility for care based on several criteria including whether family, friends, volunteers, cleaning ladies, grocery delivery services or others are able to provide care, and were directed to ration care based on service maximums. Access to care was no longer to be based on need.

     In May 2001, after having given indication to the Community Care Access Centres (CCACs) in the late winter to plan for the same operations they had in the 2000/01 fiscal year, the government announced a funding "freeze" that essentially cut millions from the CCAC budgets, leaving them $175 million short of meeting demand. Not surprisingly, services were cut, hospitals backed up and a flood of complaints ensued.

    The result is that personal support services were cut for patients across Ontario. There was a reduction of 115,000 patients served from April 1/01 - April 1/03. In this period 6 million hours of service were cut - a 30% drop.

    Bill 130 - Elimination of Democracy

    On November 7, 2001 the provincial Conservatives introduced Bill 130, An Act Respecting Community Care Access Corporations. The Act entirely removed all democratic control and public accountability.

    Among the key provisions of the Act are the following:

    ... CCACs became statutory corporations. This means that hundreds of community memberships in CCACs will be discontinued.

    ... Elected Boards of CCACs were replaced with Boards appointed by the provincial government.

    ... Current elected Chairs and Vice Chairs of CCACs were replaced by those appointed by the provincial government.

    ... The hiring and firing of Executive Directors of CCACs may be ordered by the provincial government.

    ... Over forty current CEOs of CCACs were to be terminated unless the province appointed them as Executive Directors under this new Act.

    ... The Act stipulates that the public will only have access to Annual Reports of CCACs. Other information is to be available only if the Minister deems it to be "necessary to the public interest".

    ... The Corporations Act and the Corporations Information Act will not apply to the new CCACs. Therefore, public filings of information under these Acts are not required.

    ... Directions from the Minister to the CCACs will be exempted from the Regulations Act. This means that they may not be made public.

    ... The Minister may demand any information, documents or records in the custody of or under the control of the CCACs - without exemption in the Act for client or personnel records - and may impose a personal fine of up to $25,000 for non-cooperation.

    Some of Our Key Concerns

  • Stop for-profit homecare
  • Restore access to those who have lost services and provide homecare based on need
  • Restore access to personal support services
  • Repeal Bill 130 and restore democratic governance of CCACs
  • Allow direct service provision by CCACs immediately
  • Improve transparency and democratic control of homecare – institute public access to information for this sector


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    Ontario Health Coalition
    15 Gervais Drive, Suite 305
    Toronto, Ontario  M3C 1Y8
    tel: 416-441-2502
    fax: 416-441-4073
    email: ohc@sympatico.ca

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