80 Percent of Funding Goes to Bureaucracy

Ontario’s home care system is too bureaucratic, with too much public funding going towards administration and case management costs. "As little as 20% of the funds actually go to front-line service workers" says Gail Acton of the National Association of Certified Caregivers/Personal Support Workers.

Public funds are transferred through multiple levels of administration before any money reaches the front lines of care. A fifty five year old mother of two married daughters, who will remain anonymous, has recently been trying to cope with the palliative care needs of her 80 year old mother. She was told by CCACs to just keep her head above water, and was asked repeatedly to call the CCACs if she needed anything. Assurances were given that the CCACs could be of help, yet out of the other side of their mouth, they were telling her that she had maxed out all of the available care services. In response, the daughter said "I am not trying to keep my head above water, all I am trying to do is keep my mother above the ground!"

Does anyone care out there? These CCAC employees are making big dollars to sit around and talk about what they can do. Their website appears helpful, but they show their true colors when you actually ask them to do anything.

There are 14 Community Care Access Centres spending $500 million a year for administration and impression management.  There are few within this system who seem concerned about the damage created from care that is too little, too late. The CCACs have 700 contracts with provider agencies that employ the heathcare workers. These workers include nurses who visit and make assessments without taking any action, leaving Personal Support Workers to attempt to fill in the gaps in service for clients. The PSW is battling unorganized and overpaid nurse supervisors who can neither schedule or care about what happens to the client. The CCACs do not care about this overburdened woman who is trying to assist her mother and allow her to pass away with dignity and decency.

The competitive bidding process that takes place every three years leaves the PSWs with lower salaries, patch work scheduling and fewer client hours. As a result, there is improper service delivery and inconsistent care. The supervisors still get paid their full rate, in spite of the fact that they downsize the number of care hours for an 80 year old woman with a colostomy. She wants to stay in her own home rather than moving to a nursing home, but with her limited financial resources, she has to rely on the services of agencies who are caught in the downward spiral of bidding and lowballing eachother for contracts.

Due to inefficient restructuring by the provincial government, aging at home now means begging for care. Jobs for supervisors are created, but no additional care is provided.  The home care funds pass from the Ministry of Health to Ontario's 14 local health integration networks (LHINs, which oversee the delivery of care). This is not good, as we now have new overseers overseeing the poor planning and unfair distribution of care.  There is now an additional level of oversight as the overseers of the agencies oversee the front line health care worker.  Taxpayers are footing the bill for an unorganized, incompetent health bureaucracy who has no interest in doing anything beyond their 9-4 office hours. God help you and your family if you do not die suddenly and quickly. Is anyone listening out there? Does anyone care?

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