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Preamble:
WHEREAS rural Alberta’s population is aging, and the demand for healthcare services is growing correspondingly; and
WHEREAS rural residents face unique challenges in accessing home care services, including geographical barriers, limited availability of healthcare professionals, and lack of specialized care; and
WHEREAS Alberta Health Services (AHS), through the Resident Assessment Instrument for Home Care (RAI-HC), designates individuals needing home care into one of six categories: acute, rehabilitation, long-term supportive, end of life, maintenance, and wellness; and
WHEREAS home care services may be provided by AHS or contracted providers; and
WHEREAS many Alberta home care patients have unmet care plans and service needs, especially concerning housekeeping, grocery assistance, bathing, and therapies, indicating that more comprehensive services are needed beyond traditional health supports; and
WHEREAS there is an increasing reliance on for-profit providers in Alberta’s rural areas, which deviates the standard set for quality of care; and
WHEREAS the current funding model for home care services in rural Alberta is insufficient to meet the needs of the aging population, leading to a gap in healthcare provision and impacting the quality of life;
Operative Clause:
THEREFORE, BE IT RESOLVED that the Rural Municipalities of Alberta advocate to the Government of Alberta to enhance home care services for rural residents by increasing funding, improving accessibility, implementing innovative care models such as community-based care tailored for rural settings, and other means.
Member Background:
Rural Alberta is witnessing a significant increase in its aging population, resulting in a rising demand for home care services. As this demographic trend continues, the urgency to address the issue becomes inevitable. Rural residents face a distinct set of challenges when accessing these services, such as geographical barriers, a scarcity of healthcare professionals, and a shortage of specialized care.
The foundation of the problem lies in the fact that home care is not entirely insured under the Canada Health Care Act (CHA). Depending on the province’s commitment, the eligibility for publicly provided home care services varies. In recent history, the annual budget increments for Alberta’s home care barely kept pace with inflation or population growth, increasing at a rate of just 1.4% per year. Although the 2023 budget has seen a 15% uplift, a significant portion is directed towards capital projects.
A 2019 MNP report titled Including Quality of Life for Residents in Facility-Based Care emphasized the inefficiencies in the current system, pointing out Albertans’ prolonged stays in higher levels of care while awaiting transfer to an appropriate care facility. Such inefficiencies result in higher hospitalization rates for conditions treatable outside hospital settings. Much of this challenge arises from a lack of suitable home or community care facilities outside of the primary hospital establishments.
A concerning trend in Alberta is the increasing reliance on for-profit providers, especially in many rural areas. Such providers often prioritize profitability by catering to clients with less complex needs, sidelining communities with high service costs, paying lower wages, resisting unionization, and under-investing in worker training. As a result, seniors, who constitute roughly 70% of home care patients, are often left with compromised care plans that include late or missed appointments and rushed care.
Further emphasizing the gravity of the situation, the MNP Senior’s Housing Study of 2021, Improving Quality of Life for Residents in Facility-Based Continuing Care, developed an integrated financial model to estimate the cost implications of the current care system. With care spaces anticipated to grow from 69,732 in 2020 to 112,960 by 2030, operating costs could skyrocket to $1.8 billion annually by 2030, with capital costs reaching $4.9 billion. Significant savings could be realized by enhancing home care service hours, thereby reducing the dependency on long-term care facilities.
Given the projections, it is evident that the present provincial model for home care services is falling short, especially for rural Alberta. The Rural Health Services Review by the Canadian Mental Health Association (CMHA) Alberta Division reiterated the necessity for enhanced home care supports for the elderly in these areas. A particularly poignant challenge is the separation of elderly couples due to care requirements, leading to emotional distress during times when familial support is of utmost importance.
Considering the escalating demands, there is a pressing need to revisit and revamp the current model, placing a higher emphasis on home care services. This would allow seniors to remain in their familiar environments, respecting their wishes to age in their homes, while also addressing the heartbreaking issue of couples being separated.
The ramifications of this issue extend beyond the immediate need for enhanced care. Stakeholders, ranging from healthcare providers to senior advocacy groups and families, are deeply affected. Rural municipalities, in particular, are feeling the pressure as they fund housing management bodies in their regions. A failure to innovate could place a heavier burden on municipal resources. However, by proactively addressing these challenges, not only can seniors receive better care, but potential financial savings could also benefit municipal ratepayers.
RMA Background:
RMA has no active resolutions directly related to this issue.
Alberta Health Services
As announced in the Government of Alberta’s 2023-26 Budget and Fiscal Plan, Alberta Health provided Alberta Health Services (AHS) with funding to begin transformation of the continuing care system, which includes enhancement projects in rural home care services.
AHS is taking action to:
The AHS Home Care program is preparing to meet increased demands for rural home care service. Growth in the number of Albertans over the age of 65 will steadily increase to one in five by 2046. Capacity and service plans must align with government and organizational principles while creatively delivering equitable, high quality and safe care to Albertans of all ages in their homes and communities.
AHS strives to improve access and services to all Albertans including those living in rural communities.
AHS is working to align home care services by developing a standardized home care delivery service framework for use across Alberta and improving equity in home care service delivery for rural clients. In 2023, AHS implemented a provincially standardized contract for home care agencies, which includes updated quality & safety compliance reporting and metrics for all contracted home care service providers.
AHS home care programs strive to achieve the following client outcomes:
Alberta Health
Through the recommendations outlined in the Facility-Based Continuing Care Review, we are initiating a multi-year transformation of the continuing care system. As part of Budget 2023, we invested an historic $1 billion over three years to begin this transformation. This strategic investment is supporting initiatives that will help shift to care in the community, enhance workforce capacity, increase choice and innovation, and improve the quality of care within the continuing care sector.
One of the first steps to transforming the sector was the introduction of the Continuing Care Act, which received Royal Assent on May 31, 2022. The Act introduces a new legislative framework that will support and enable transformational shifts to improve the continuing care system in the short term and over the years to come. This includes enabling more innovative approaches to home and community care.
I am pleased to report that we are making progress in the first year of the continuing care transformation. This includes enhancements to home care, including increasing funded rates to home care operators, and putting out an Expression of Interest and Qualifications for innovative models of home care delivery. This open call has resulted. in ten new contracts with providers of community home care services.
Further, we are providing supports to caregivers through several initiatives, by:
Ministry of Seniors, Community and Social Services
Excerpt from Resolution: “BE IT RESOLVED that the RMA advocated to the GoA to enhance home care services for rural residents by increasing funding, improving accessibility, implementing innovative care models such as community-based care tailored for rural settings, and other means.”
SCSS does not have a direct role in the provision of home care services. This accountability rests with the Ministry of Health. SCSS collaborates with Health and other cross-ministry and community partners to deliver programs that support Alberta seniors to age well at home and in their chosen communities.
As part of Health’s transformation of continuing care, SCSS is committing additional funding for the delivery of non-medical home supports (NMHS) to support the work of community organizations, including rural ones, to enable Albertans to age well at home. NMHS range from social and emotional supports to receiving help with everyday tasks such as housekeeping, yard and snow removal, and grocery assistance.
In March 2022, $3.21 million for NMHS was granted to Healthy Aging Alberta to distribute to communities, with a focus on mental health and overall well-being. In March 2023, SCSS provided Healthy Aging Alberta $3.5 million to develop a provincial approach for delivery of community-based rural assisted transportation services for older adults and individuals with disabilities.
Development:
RMA appreciates the measures being taken for continuing care services across the province. The initiatives proposed for rural Albertans to receive more equitable access to care are a step in the right direction and will be monitored closely.
However, the response from Alberta Health, Alberta Health Services and Alberta Seniors, Community and Social Services do not acknowledge the unique needs and challenges of people requiring care in rural and remote areas. There are a variety of unmet service needs that are not accounted for in this response, and there is no clear increase in funding for how these needs will be met. While the commitments to programming enhancements are encouraging, and, if properly implemented, should meet the intent of the resolution, RMA plans to monitor their progress in the coming months. RMA assigns this resolution as Accepted in Principle and will continue advocacy efforts on this issue.
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