Fighting for long-term care beds
By Chad Ingram
The Central East LHIN says it’s trying to maintain the number of long-term care beds in Haliburton County, but provincially mandated requirements are making the future of 60 of the community’s beds unclear.
The CEO of Central East Local Health Integration Network visited Haliburton County councillors during their Sept. 23 meeting.
Deborah Hammons gave council an update on the activities of the LHIN, including the creation of its 2016-2019 integrated health service plan, during Wednesday’s meeting.
“As you know, [the numbers of] long-term care beds have been frozen for quite a while now,” said Dysart et al Reeve and County Warden Murray Fearrey. “We are getting a lot of Alzheimer’s patients in long-term care, sometimes they’re disruptive. To me, that should be separate. Is that something the LHIN is working with the province on?”
Hammons told Fearrey that the province is in the process of “redeveloping” 30,000 long-term care beds in Ontario and that she and other LHIN CEOs had recently met with associate minister of health and long-term care, Dipika Damerla.
“Our question to her is, how do you know that these beds that are being redeveloped need to be redeveloped?” Hammons said. “How do you know they’re going to be placed in the right place?”
Hammons said within the Central East LHIN, 38 of its 68 long-term care facilities are scheduled for “redevelopment.”
A long-term care renewal strategy was announced by the province in 2014, requiring that long-term care facilities be brought up to new ministry design standards by 2025.
“We’re not going to move ahead with those until our board chair and our board feel comfortable that we’re going to at least maintain the beds and they’re going to be at the right location, and obviously Haliburton is one of those areas that we can’t stand to lose one bed in,” Hammons said.
The spectre of losing any long-term care beds did not sit well with council members.
“Service is one thing, but to our small community, so is jobs,” Fearrey said. “If we lose those jobs, there’s going to be a war.”
Minden Hills Reeve Brent Devolin, referencing the community’s high senior population, said the idea of fewer beds was unacceptable and that more are required.
“You’re talking about not losing beds, you’ve got the picture wrong,” Devolin said. “That’s not acceptable at all. There’ll be marching in the streets. The province needs to, through the LHIN, put more bricks and mortar in, and it’s as simple as that.”
Fearrey wondered how long it would be before a decision was made about the long-term care beds.
Hammons said the LHIN would either come back to visit council or at least meet with county staff before any decision was made.
“We’ll make sure we loop back around,” she said.
There are 152 long-term care beds in Haliburton County. Ninety-two of them are located at Haliburton Highlands Health Services facilities Hyland Crest (60) and Highland Wood (32). The other 60 beds are located at Extendicare Haliburton, which is a separate entity.
“Both our facilities meet the long-term care standards,” said HHHS CEO Varouj Eskedjian, of the organization’s long-term care facilities. “The Haliburton Extendicare facility does not meet the standards.”
Like HHHS’s long-term care facilities, the older Haliburton Extendicare receives provincial funding, using that in concert with fees from residents to operate.
Eskedjian said it’s really a corporate decision of Extendicare whether the company will upgrade the facility.
“We feel the same way as the county,” Eskedjian said, adding the Extendicare beds are vital to the community. “We’ve been in discussion with them about keeping these beds in the county.”
If the beds are not maintained, it would be almost inconceivable that many beds would be added at the HHHS facilities, at least any time in the near future.
“For us to even think about, we’d have to go through an extensive capital planning process,” Eskedjian said.
Extendicare, which operates facilities throughout the country, has not yet made a decision on what might happen with its Haliburton beds.
“Extendicare is reviewing the new requirements to determine how best to approach the redevelopment of its Class C beds located in communities throughout the province,” communications manager Sofia Mavumba wrote in an email to the paper. “The economics of the redevelopment program require that providers such as Extendicare optimize the size and location of long-term care centres to ensure optimal efficiency and care. We have a long history of serving the community and would be happy to continue to operate [in Haliburton]. We have been in discussions with the LHIN and other stakeholders to explore any and all options to ensure we continue to deliver care more efficiently. No decisions have yet been made with respect to the redevelopment of this particular centre. We will be sure to keep all stakeholder informed when a plan is developed.”
Hammons told Fearrey his comment on dementia patients was important, and that a LHIN-wide dementia strategy needs to be developed, involving training people to help identify the onset of dementia, as well as educating caregivers and family members.
“The medical staff are not trained to do that,” she said.
Lack of affordable home care for the elderly was also brought up at the council table.
“I’m living the aging-at-home reality right now,” said Algonquin Highlands Reeve Carol Moffatt, whose mother recently returned home from five weeks in hospital.
Among other gaps in the system, Moffatt said that home care services are over-subscribed and under-funded and explained her family is now paying for expensive in-home care out of Sudbury.
“How do we get those people here?” Moffatt said.
Last week, Ontario’s auditor general released a report condemning the state of home care in the province.