St. Marys Journal Argus
The Community Action Group (CAG), a St. Marys-based group that formed in reaction to a proposed but never-implemented scaling-back of Emergency department coverage at St. Marys Memorial Hospital back in 2010, is hosting a rally in St. Marys in support of a larger action being planned for Friday, Nov. 21 by the Ontario Health Coalition (OHC).
The proposed Emergency changes were contained within “Vision 2013,” a planning document created by the Huron Perth Healthcare Alliance (HPHA) and approved by its board of directors. Those proposals came under harsh criticism during public meetings held as a lead-up to a vote for approval of Vision 2013 by the South West LHIN (Local Health Integration Network) — the arms-length provincial government agency charged with allocating Ministry of Health funding in this part of the province.
“Vision 2013” was approved by the LHIN, but the elements of the plan related to Emergency departments were not carried out.
Last week, the CAG sent out invitations to attend a rally on the sidewalk in front of St. Marys Memorial Hospital at 4 p.m. on Friday, Nov. 21. That’s the same day the OHC and its member organizations throughout the province will gather at Queen’s Park in Toronto.
The message from the CAG explained the group wants the public in St. Marys and area to “demonstrate your support for the health services we need.”
Although the Emergency department at the Queen Street West institution remains in place, other elements of Vision 2013 were implemented over the past four years. Among those was a shifting of types of care provided in some of the facility’s beds, with fewer beds now used for patients requiring so-called “acute care,” and more available for those needing so-called “complex continuing care.” The St. Marys hospital has been identified by the HPHA as one of two facilities — among the four it administers in St. Marys, Stratford, Clinton and Seaforth — at which complex continuing care (CCC) is now a focus.
The CAG is concerned that a continuation of the realignment of beds will eventually lead to cutbacks at St. Marys Memorial. In its invitation to the Nov. 21 rally, the group raises the possibility that “the South West LHIN, in their Vision 2017, is planning on cutting the number of CCC beds in half. We must fight this!”
Contacted by the Journal Argus, HPHA Chair Mary Atkinson said there is no LHIN document officially entitled “Vision 2017,” and suggested the CAG is, in fact, referring to a document entitled “Living Healthy, Independently and Safely at Home: Integrated Health Service Plan 2013-2016.” This is the current in a series of three-year LHIN strategic plans that are meant, ultimately, to lead to the year 2022 and the full roll-out of a so-called “Integrated Health System of Care” model of service provision. Available on the LHIN website, the 2013-16 report lacks specific details about how these strategic directions will be pursued.
CAG member Gayle Beattie, meanwhile, pointed the way to an entirely different document on the LHIN website — this one entitled “CCC/Rehab Steering Committee Phase 2 Bed Realignment Recommendations,” and provided to the LHIN on June 2, 2014. The recommendations contained in this report have not yet all been approved, but they are specific . . . and they do spell a possible significant decrease in CCC beds in the Huron-Perth region of the LHIN.
“Further shifts in the utilization of CCC beds (are projected), strengthening the case to increase CCC beds in London and further reduce the number of CCC beds across the remaining area of the South West LHIN, most particularly in Huron Perth,” states the conclusion of the report, which details a snapshot image of the utilization of dedicated CCC and rehab beds at one point in time — in the case of St. Marys Memorial’s CCC beds, it was February of 2014 — throughout the South West LHIN’s jurisdiction.
Contacted by the Journal Argus, HPHA CEO Andrew Williams explained that hospitals within the LHIN have already followed through on the first phase of changes recommended by the CCC/Rehab Steering Committee. Specifically, a proportion of the resources needed to serve CCC patients were taken away from the Oxford and Elgin regions, and transferred into London and Grey-Bruce.
Phases 2 and 3 will, potentially, decrease the capacity to serve CCC patients in Huron-Perth region (which includes the four-site HPHA, but also hospitals in Wingham, Listowel, Goderich and Exeter that are not part of the HPHA) from the current 76 patients down to 43 by 2016 and eventually to 34 by 2017.
The report suggests that the target occupancy rate for CCC beds is 93 per cent, thereby ensuring that a high proportion of CCC resources are being utilized at any given time, but also that there should be available beds within the entire South West LHIN whenever a patient needs one.
The February, 2014 snapshot of available CCC beds in the Huron and Perth showed that, at that time, there was one empty CCC bed out of 10 in the HPHA’s Seaforth site, and one empty out of five at the St. Marys site. At the HPHA’s Stratford General Hospital, all 20 of the facility’s CCC beds were occupied.
The situation was quite different in both the Wingham and Listowel hospitals, which are aligned with each other as one hospital group. In Listowel, out of 25 CCC beds, 11 were unoccupied. And in Wingham, only two of the 12 CCC beds were being used.
“We haven’t yet finalized the year two and year three recommendations,” Williams commented, when asked if these statistics put the HPHA facilities in a more positive light, compared to their northern neighbours. “Plus, we’ve also got to consider that we’ll be looking at this in the context of rehab bed changes at the same time.”
The Steering Committee recommends, over the same time period, that the Huron-Perth region of the LHIN see an increase in rehab capacity by two beds.
And, in a wider context, Williams added, the LHIN’s “Home First” initiative — which aims to have people stay in their homes longer before being transferred to long-term care facilities or palliative care — has also just begun to be rolled out in the HPHA.
Beattie expressed uncertainty about the future ramifications of the “Home First” model, arguing, “this program is not successful in other areas of Ontario due to lack of Personal Support Workers and other support workers.” And she warned if it’s not successful and CCC beds have been decreased in keeping with the Steering Committee recommendations, patients could find themselves having to travel a considerable distance for hospital care.
Williams confirmed that, through the implementation by the HPHA of the Vision 2013 elements that moved some CCC beds to St. Marys, the HPHA has met the Steering Committee’s recommendations, to a degree. He couldn’t speak to the situation in Listowel or Wingham, but offered confidence that HPHA communities will have adequate opportunities for input into any future changes.