Alternative Level of Care- Take 2

Written by Audrey Miller and originally posted

Our Ontario government is short sighted. We/They have not planned well for the changing and aging of our society. There simply is no place for those of us who need care and are not fortunate enough to either have the funds to pay for it themselves or have the necessary family available who can pay for and assume this heavy burden – both in terms of financial, emotional obligation and time availability.

I have previously blogged on Alternative Level of Care (ALC) as I had a client who had been residing as an inpatient on a psychiatric floor of a busy downtown hospital for over 3 years. At that time I shared that as of June 30, 2016, there were a total of 2765 ALC patients.

The most recent data available that I could find on current numbers of ALC was from a ‘Guidance Document’ dated June 2017, titled ‘Expression of Interest for Reducing ALC Pressures through Short-Term Transitional Care Models ’. It actually is an ‘Expression of Interest’ to the LHINS ‘ to solicit local, innovative solutions that build on or develop partnerships and use existing capacity along the continuum of care to reduce ALC pressures’. Sounds good, doesn’t it?

They report as of January 31, 2017 there were 4,734 open ALC cases and patients designated as ALC had accumulated a total of 627,933 days while waiting to be transferred, typically to either a long term care facility or assisted living setting. In six month, the number of individuals with no place to go had increased by 70%.

The Ontario 2017 budget identified that over 15% of hospital beds were occupied by patients who did not need to remain in the hospital. Within the budget, new funds ($24 million) have been allocated for ‘innovative models to ensure patients are receiving care in the most appropriate care setting’ This is only one area of need and is the tip of the iceberg.

In a May 11, 2017 Globe and Mail article by Kelly Grant, titled Bad hospital discharges among top complaintsOntario watchdog finds, she wrote that ‘The Globe and Mail reported earlier this week on the case of an 88-year-old widower whose son says a Markham hospital pressured his father to leave, threatening to charge the elderly man $1,100 a day or drop him by ambulance at a homeless shelter.’

As our small company is not a LHIN and receives no public funding, we don’t have an official voice; but we do have a suggestion.  We recognize that there are a number of hospitals that have been converted to urgent care centres thereby leaving many empty floors of existing facilities.  We are wondering if those buildings could be converted to Long Term Care? Presumably there would be limited capital costs. We are aware that there are a number of such facilities in Toronto as many of the hospital amalgamations left Metro hospitals as the 9-5 urgent care centres while moving full hospital facilities outside of the city. In Etobicoke – both Queensway (now part of Trillium) and Etobicoke General (now part of William Osler) are urgent care centers. Both centres have ample space for conversion and it would greatly increase the long term care spaces.

Just saying…….

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