by Nancy McDermid
LITTLE CURRENT—With a goal of changing how health care is experienced and delivered on Manitoulin Island, staff from the Northeast Local Health Integration Network (NE LHIN) held a community engagement seminar on June 27 at the Northeast Town Recreation Centre resulting in a request for more assisted living for seniors on Manitoulin.
Chief Executive Officer Louise Paquette delivered a presentation outlining the Northeast Ontario context for health care needs and delivery, which was followed by a discussion forum. Small groups were given set questions posed by the NE LIHN staff.
“We have had about 30 of these engagements in Northern Ontario so far this year and pose the same questions each time, both to community members and to health service providers so that in the end, when we roll it all up, we will have a really good sense of what people want for the future of health care,” said Cynthia Stables, NE LHIN senior corporate advisor.
In one small group discussion that followed the presentation, participants were asked whether NE LIHN health care investments in “their community,” aligned with the needs of people living there. The consensus among the members was that there are strong concerns about the amount of services for seniors on the Island considering the fact that the aging population continues to grow.
With 26 percent of the population on the Island presently over age 65, the group felt that services are urgently needed right away.
Little Current resident Wendy Gauthier came to the meeting feeling that there had to be a relationship between patients in long term care and assistive housing and was pleased to see that there were a large variety of people present representing different interests, but together wanting accessible, affordable housing for seniors. Ms. Gauthier has been involved in making seniors housing more of an issue in the Little Current community and worked with Northeast Town in the final stages of its sustainability plan.
When told that some seniors could be accessing home care and are not doing so, Ms. Gauthier was concerned that people might not know how to access these services and if they did, she wondered if the 10 percent of the provincial pie allotted to community care services would be sufficient to serve all of them.
MHC director Angela Becks stressed the importance of seniors having an advocate to help them navigate the system to find the proper supports such as exploring the Internet for research.
Jim Bousquet agreed, reminding the group that many seniors are not familiar with computers and may not choose to use them even if they had access to one.
Lack of adequate funding at the Centennial Manor was discussed with Centennial Manor board member Ed Bond stating that the funding dollars are not available for those who need the greatest assistance because too many residents are at level one (on a scale of 1-4 in relation to needing assistive care). Without alternatives for those on level one, the people who need the greatest amount of care are on a waiting list or in hospital. It was a surprise to some in the group that people in category one could be accessing dollars to live in their own homes through assisted living programs.
It was suggested by Pam Williamson, executive director at Noojmowin Teg Health Centre, that the use of a navigator (home visitor who is familiar with government programs) would be a proactive and useful way on the First Nations to inform seniors of services available to them that might help to keep people in their homes.
Derek Graham, CEO of the Manitoulin Health Centre (MHC), stressed the importance of the role of hospitals in small communities in that they provide a broader base of care than larger hospitals and are also in need of funding.
“Deciding where to spend the dollars becomes part of municipal planning and involves a lot of partners,” Ms. Paquette said in her discussion with the group. “As a community, you need to come together and decide how the 22 million that is allotted to the region is re-distributed if you want these changes. Today is a start and we are hearing that there is a need for more assisted living.”
It was suggested by Georgie Hari, chairperson for the MHC board, that having some models as to how to proceed would help people come together more easily to find a solution.
The purpose of the NE LHIN, started in 2006, is to ensure that local decision making reflects the needs of Northerners as 1.3 billion is invested in front-line health care services.
“To meet our health care needs today and in the future, change is absolutely essential,” said Ms. Paquette during her presentation. “What does change mean to people on Manitoulin and in Northeast Ontario?”
In order to make changes, we need to understand the demographics of the region and how they are changing, the CEO explained.
With the second largest landmass in Ontario and just 4.5 percent of the population, the region has more people aged 65 and over than any other region in the province with 17 percent. This population is expected to be 30 percent in 2030 compared to 22 percent for the rest of Ontario, she said.
Compounding the issue is a higher percentage of smokers, heavy drinkers, obesity, chronic disease and rate of cancer deaths in the Sudbury/Manitoulin/Parry Sound area. These areas, called HUBS, were created based on hospital referral patterns, Ms. Paquette continued.
Explaining how the NE LHIN works, Ms. Paquette stressed the importance of local decision making replacing Toronto-based decision making. “Staff work in offices in North Bay, Sudbury, Sault Ste Marie and Timmins on a five million dollar budget. More money is going to front line care now as 36 NE LIHN staff have replaced the previous 98 ministry/district council staff,” she said.
Stating “health care does not equal hospitals anymore,” Ms. Paquette talked about the growing need for community service providers that assist people in staying in their homes rather than going into long term care.
Out of a 21.5 million dollar budget for Manitoulin Island, 59 percent goes to hospitals, 28 percent to long term care, 10 percent to community support services and three percent to community mental health and addictions.
“Primary care is quality care and we need to spend more time and energy here,” she said referring to the 10 percent.
The cost of a bed for long term care is $126 a day compared to $41 a day to provide services at home. Those in care are rated on a scale of 1-4 for their ability to care for themselves and many are scoring 1 or 2 and therefore would benefit from community support services, Ms. Paquette explained.
“We have introduced measures to bring those numbers down to increase patient flow,” she said.
The CEO told those assembled that currently 661 local individuals currently receive home care services and more than 300 seniors benefit from NE LHIN-funded programs such as homemaking, transportation to and from appointments and social and congregate dining. A total of 743 individuals receive service from the Community Care Access Centre and every year $500 million is invested in the local health care services including $21.5 million to the Noojmowin Teg Health Centre, the Alzheimer’s Society and Mnaamodzawin Health Services Inc.