In our last blog, we reviewed a recent lawsuit filed by an Ontario man who sued a hospital and other healthcare organizations for failing to provide him with “assisted-life” and self-directed care. This week we explore the Ontario government’s recently created Self-Directed Personal Support Services Ontario (the agency) and the reaction it has evoked.

Self-Directed Personal Support Services Ontario

The agency was introduced by the provincial Liberals last fall and is intended to provide home-care patients with more choices in both choosing a personal support worker or workers (PSW) and in determining their care schedule.

Currently, patients who are assigned a PSW by either a private or not-for-profit agency must be available for care based on the schedule of the PSW rather than the schedule of the patient.

Few details about the agency have been made public since the provincial government first alluded to the creation of a new agency in October 2017 via a Ministry of Health and Long-Term Care announcement that included a reference to “the establishment of a new personal support services organization in early 2018”. The Public Appointments Secretariat notes that the Self-Directed Personal Support Services agency was created in August 2017.

The National Post has since reported that the agency is slated to become the exclusive provider of home-care workers to certain patients province-wide, including patients with high-needs requiring at least 14 hours of support each week (such as adults with acquired brain injuries). It will be responsible for working with the 14 Local Health Integration Networks (LHINs) in Ontario as a pilot project to:

  • Directly recruit, screen, and employ PSWs;
  • Work with LHINs to receive client referrals;
  • Manage client intake;
  • Manage client matching with PSWs; and
  • Facilitate client scheduling of services.

A full province-wide rollout is expected by March 2021.

Reaction to the Creation of the New Agency

Earlier this year, 11 publicly funded home-care providers calling themselves the Home First Alliance for Patients (the Alliance) filed for a judicial review of the government’s decision to launch the agency.

The Alliance claims that the agency, which has yet to fully launch, “puts home care patients at risk by giving exclusive authority for self-directed care services to an untested provincial government agency” and that this will “have dire consequences for patients and their families, for Service Providers and their employees and for the home care and healthcare systems at large”.

The Alliance is asking the court to stop the agency, arguing that former Health Minister Eric Hoskins made the decision to establish it “in secret” and that he “acted recklessly” by failing to consult with home-care providers:

The decision to introduce an untested home care delivery model, centred on an agency with no track record, without consulting key stakeholders in the home care sector jeopardizes Ontario home care patients and will have effects that reverberate across the health care system.

The Alliance claims that while the government neglected to consult with them, it did “work closely” with the Service Employees International Union (SEIU), which represents home-care workers. The Alliance’s application further claims that the SEIU favours a central employer model for PSWs and had begun to lobby the government to create the agency more than a year before it was announced. In addition, Hoskins allegedly have a speech at a 2016 union convention where he indicated that he would be seeking a “common employer for care providers”, and also that “it would appear that [the decision to start the agency] was made for the improper purpose of creating a single body of PSWs that could be unionized by SEIU Healthcare”.

More than 700,000 people in Ontario currently receive publicly funded home care. More than 95% of these services are provided by the 11 organizations behind the legal action.

The Ministry of Health and Long-Term Care has declined to comment on the legal action.

At Wise Health Law, we provide exceptional guidance on health law matters to public hospitals, long-term care homes, and other health-care organizations across the province. We monitor trends and developments in health so that we can provide forward-thinking legal and risk management advice to all our clients. We will continue to follow developments in this matter and will provide updates as it proceeds. In the meantime, if you have any questions please do not hesitate to contact us online, or at 416-915-4234 for a consultation.

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