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April 9, 2002 Agenda SPECIAL MEETING ELGIN COUNTY COUNCIL TUESDAY, APRIL 9TH, 2002 - 9:00 A.M. 1) Call to Order 2) Disclosure of Pecuniary Interest and the General Nature Thereof 3) Motion to Move Into "Committee Of The Whole Council" 4) Reports of Council, Outside Boards and Staff 1) Director of Financial Services - Ratios (ATTACHED) 5) In-Camera Item - Conclusion of CAO.'s Performance Evaluation 6) Motion to Adopt Recommendations from the Committee Of The Whole Council 7) Consideration of By-Laws 8) Adjournment REPORT TO COUNTY COUNCIL FROM: Linda B. Veger, Director of Financial Services DATE: 02 April 2002 SUBJECT: Ratios INTRODUCTION The Fair Municipal Finance Act (Bill 106) and the Fair Municipal Finance Act (2) (Bill 149) brought about a re-write of the Assessment Act and the way the province was assessed commencing January 1, 1998. The changes in the Act were to bring consistency to assessment across the province leading to a simpler and more understandable system. The assessed values became current value assessment or CVA. Section 363 of the Municipal Act provides for the establishment of tax ratios. The Province developed transition ratios for every upper-tier. These ratios, when applied to assessment and utilized to calculate tax rates, were to approximate the same tax burden for each class as the burden prior to CV A. The Province also, in Ontario Regulation 386/98(see attached), prescribed" Ranges of Fairness". These ranges are the Provincial notion of what the relative tax burden per class should be. The Province requires that any movement of the ratios be towards or within the ranges. Since the ratios are weighting factors, the reduction of any class will shift the tax burden to other classes. The greatest effect will be felt by the residential class and subsequently the two classes that are a percentage of residential, namely farmlands and managed forest. Bill 140 prescribes provincial Threshold Ratios. In municipalities where the tax ratios are above the threshold or "hard cap" for multi-residential, commercial and industrial classes, the class in question may not absorb any municipal budgetary increase. When this circumstance prevails, levy changes may only be passed through to unrestricted classes that have ratios below the thresholds. The County ratio for the industrial class is above the hard cap. In 2001, the industrial/large industrial tax rates were actually lower than 2000 rates due to the calculation of notional rates, as prescribed by the Province. All other classes absorbed the total levy increase that could not be included in the industrial/large industrial tax rates. The hard cap for industrial is 2.63. The County chose to separate a large industrial class from regular (or residual) industrial. Therefore, in order to meet the hard cap, regular industrial (titled residual by the Province) will actually have a slightly lower than 2.63 ratio and the large industrial ratio will be higher than 2.63. This mix will satisfy the requirement of meeting the hard cap. 04/02102 changingratios Tax rates across the County vary due to the mix of assessment. Changing the ratios will have varying effects on the lower-tier municipalities. DISCUSSION: The hard cap did not change for 2002, however there is no guarantee that it will remain unchanged in future years. The Treasurers agree that a proactive approach to reducing the ratios is far preferable to waiting for the Province to prescribe the change, perhaps with a cookie cutter approach. At the County level, movement of the ratios will result in changes to the levy share for each municipality. Reassessment occurs again in 2003. Increases in assessment should soften the effect of any ratio changes. Council has several options: · Do nothing and wait for the Province to regulate the change · Move to the industrial hard cap in 2002 or 2003 · Move all classes to the ranges of fairness over five years Discussions with our neighbours results in the following information: County of Oxford - will bring forward a report for discussion to move towards the hard cap. However, no change to ratios as yet. County of Huron - moved to range of fairness early in the process. As a side note, Huron's transition ratios were very close to the range offairness. County of Bruce - below the hard cap - will not move the ratios until there is some pressure from the Province. County of Wellington - below the hard cap. Do not anticipate any changes this year however there is pressure from multi-residential taxpayers to reduce. County of Lambton - reduced to the hard cap in 2001. They are receiving some pressure from commercial taxpayers to make further reductions. County of Middlesex - below the hard cap. City of St. Thomas - moved to hard cap in 2001. Have not made a decision on whether or not to recommend any changes in 2002. "Range of Unfairness" - The Province has regulated the ranges of fairness for all classes. Are these ranges reflective of a mostly rural County or do the ranges more closely match the Province's notion of tax burdens within large urban centres? It is clear that the Province's mandate is to greatly increase the tax burden to the residential class. If the Province regulates movement towards those ranges, it is our local municipalities explaining, once again, that the Province is forcing changes that negatively affect the majority of our taxpayers to the benefit of a few. 04/02102 changingratios CONCLUSION: Moving the industrial ratio to the hard cap in the first year results in increases to residential, farmlands, and managed forests ranging from 1.32% to 8.96%. All classes excluding industrial/large industrial (hard capped class) will absorb tax increases. Two conclusions can be drawn from the above information. 1. Neighbouring Municipalities are split between those who were already below the hard cap, those who have already moved to the hard cap, and those who are in the same decision making process as the County. Inaction on ratio movement could make the County unattractive to prospective business especially when compared to our neighbours. Inaction could also place the County in the tenuous position of playing catch-up to provincial policy. Therefore the first conclusion is to move the industrial/large industrial to the hard cap. 2. The Province has not yet forced municipalities to move towards the ranges of fairness. This may be the reason why there has been little pressure on the Province to review those ranges to ensure they capture the nature of taxation across the entire province and not just within large urban areas. Therefore the second conclusion is to defer any ratio movement until 2003 and, during 2002, to lobby the Minister of Finance to review the ranges of fairness to ensure they accurately reflect taxation not only in large urban centres but also in mostly rural areas. RECOMMENDATION: THAT the industrial class ratio be reduced to 2.63 for the 2003 taxation year with the residual industrial and large industrial ratios being lowered accordingly; and, THAT as matter of tax policy, the County move towards the range of fairness in equal instalments over a five year period starting in 2003; and, THAT each year, prior to any movement in the ratios, Council review the above tax policy to ensure it meets legislative requirements and the needs of County taxpayers; and, THAT Council actively pursues, through the Western Wardens Association, a thorough review of the "Range of Fairness" by the Ministry of Finance. Respectfully Submitted ~;!r Director of Financial Services Mark. aid Chief Administrative Officer 04/02102 changingratios O.R. 386/98 Made: July 1, ·1998 Filed: July 2, 1998 REGULATION MADE UNDER THE MUNJ:CIPAL ACT TAX MATTERS - ALLOWABLE RANGES FOR TAX RATIOS 1. (1) The allowab!ë ranges for t~~ ratios set out in the following Table are prescribed, for the purposes of subsection 363 (6) of the Act, for the property classes set out in the Table. (2) The upper and lower limits of the ranges are included in the ranges. TABLE ÞLLOWABLE RÞ~GES FOR TAX RATIOS Property class Allowable range for tax ratio Multi-residential property class 1.0 to 1.1 - Commercial property class 0.6 to 1.1 Industrial property class 0.6 to 1.1 Pipe line property class 0.6 to 0.7 New multi-residential property class 1.0 to 1.1 Office building property class 0.6 to 1.1 ShoDDing centre property class 0.6 to 1.1 2 Parking lots and vacant land property class 0.6 to 1.1 Large industrial property class 0.6 to 1.1 Minister of Finance Dated on ........................, 1998. County of Elgin Rate Change and Five Year Phase in Industrial to Hard Cap in 2002 Bayham Estimated Rates Municipal County Total % Inc. 2001 0.537889 2002 0.546748 2004 0.553465 2004 0.560347 2005 0.594768 2006 0.558483 Overall Five Year Increase 0.9968 1.017959 1.037652 1.058246 1.107178 1.086275 0.458911 0.471211 0.484187 0.497899 0.51241 0.527792 2.12% 1.93% 1.98% 4.62% -1.89% 8.78% Change Industrial to Hard Cap Municipal County Total % Inc. 0.537889 0.458911 0.9968 0.548009 0.479339 1.027348 3.06% Malahide Estimated Rates Change Industrial to Hard Cap Municipal County Total % Inc. Municipal County Total % Inc. 2001 0.518382 0.458911 0.977293 0.518382 0.458911 0.977293 2002 0.531879 0.471211 1.00309 2.64% 0.528534 0.479339 1.007873 3.13% 2003 0.538611 0.484187 1.022798 1.96% 2004 0.562958 0.497899 1.060857 3.72% 2005 0.588371 0.51241 1.100781 3.76% 2006 0.574825 0.527792 1.102617 0.17% Overall Five Year Increase 12.26% Aylmer Estimated Rates Change Industrial to Hard Cap Municipal County Total % Inc. Municipal County Total % Inc. 2001 0.687543 0.458911 1.146454 0.687543 0.458911 1.146454 2002 0.719033 0.471211 1.190244 3.82% 0.705174 0.479339 1.184513 3.32% 2003 0.740381 0.484187 1.224568 2.88% 2004 0.763034 0.497899 1 .260933 2.97% 2005 0.78712 0.51241 1.29953 3.06% 2006 0.812772 0.527792 1.340564 3.16% Overall Five Year Increase 15.89% Central Elgin Estimated Rates Change Industrial to Hard Cap Municipal County Total % Inc. Municipal County Total % Inc. 2001 0.68848 0.458911 1.147391 0.68848 0.458911 1.147391 2002 0.697268 0.471211 1.168479 1.84% 0.692436 0.479339 1.171775 2.13% 2003 0.703447 0.484187 1.187634 1.64% 2004 0.709736 0.497899 1.207635 1.68% 2005 0.700449 0.51241 1.212859 0.43% 2006 0.72266 0.527792 1.250452 3.10% Overall Five Year Increase 8.69% Southwold Estimated Rates Change Industrial to Hard Cap Municipal County Total % Inc. Municipal County Total % Inc. 2001 0.207625 0.458911 0.666536 0.207625 0.458911 0.666536 2002 0.247981 0.471211 0.719192 7.90% 0.246917 0.479339 0.726256 8.96% 2003 0.262699 0.484187 0.746886 3.85% 2004 0.279275 0.497899 0.777174 4.06% 2005 0.298084 0.51241 0.810494 4.29% 2006 0.319609 0.527792 0.847401 4.55% Overall Five Year Increase 24.65% Dutton/Dunwich Estimated Rates Change Industrial to Hard Cap Municipal County Total % Inc. Municipal County Total % Inc. 2001 0.5367 0.458911 0.995611 0.5367 0.458911 0.995611 2002 0.544955 0.471211 1.016166 2.06% 0.536068 0.479339 1.015407 1.99% 2003 0.550568 0.484187 1.034755 1.83% 2004 0.556297 0.497899 1.054196 1.88% 2005 0.562148 0.51241 1.074558 1.93% 2006 0.568122 0.527792 1.095914 1.99% Overall Five Year Increase 9.69% West Elgin Estimated Rates Change Industrial to Hard Cap Municipal County Total % Inc. Municipal County Total % Inc. 2001 0.628519 0.458911 1.08743 0.628519 0.458911 1.08743 2002 0.650342 0.471211 1.121553 3.14% 0.622474 0.479339 1.101813 1.32% 2003 0.662703 0.484187 1.14689 2.26% 2004 0.675543 0.497899 1.173442 2.32% 2005 0.688893 0.51241 1.201303 2.37% 2006 0.702777 0.527792 1.230569 2.44% Overall Five Year Increase 12.52% SPECIAL MEETING ELGIN COUNTY COUNCIL TUESDAY, APRIL 9TH, 2002 - 9:00 A.M. 1 ) Call to Order 2) Disclosure of Pecuniary Interest and the General Nature Thereof 3) Motion to Move Into "Committee Of The Whole Council" 4) Reports of Council, Outside Boards and Staff 1) Director of Financial Services - Ratios (ATTACHED) 5) In-Camera Item 6) Motion to Adopt Recommendations from the Committee Of The Whole Council 7) Consideration of By-Laws 8) Adjournment ~'orÞ~ p~T-.5S Co f'l (Ff1I 1Ó !hSS) Administrative Services Department Administration Building 450 Sunset Oriv., St. Thomas, Ontario, N5R 5V1 Phon.: (519) 631-1460 Ex!. Fax: (519) 633-7661 County of Elgin Fax To: Fax: PRESS SEE BELOW From: Administrative Services Date: Pages: 2 CC: Phone: Re: o Urgent X For Review o Please Comment o Please Reply o Please Recycle ·Comments: TO: Aylmer Express 773-3147 London Free Press 667-4528 Dutton Advance 762-5767 st. Thomas Times-Joumal A TTN: Marg Berry 631-5653 The West Elgin Chronide ATTN: Keith Peever 519-768-2221 THE INFORMATION IN THIS FACSIMILE IS INTENOEO FOR THE NAMEO RECIPIENT ONLY. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIOENTlALANO EXEMPT FROM DISCLOSURE UNOER APPLICABLE LAW. IF THE READER OF THIS MESSAGE IS NOT THE INTENDEO RECIPIENT, OR RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, ANY DISSEMINATION, OISTRIBUTlON OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBrrEO. IF YOU HAVE RECEIVEO THIS COMMUNICATION IN ERROR, OR THERE ARE ANY PROBLEMS IN TRANSMISSION. PLEASE NOTIFY US BY TELEPHONE. 1 February 27, 2002 5920 Fairview Road, R.R. #4, St. Thomas, Ontario, N5P 3S8 To the Warden and Members of Central Elgin Council, Weare retired employees of the Rehab. services at the S. T.E.G.H. I am Mary Muscat and was the coordinator of in-patient physio services and Karen Stuart was the coordinator of recreation. We have had an opportunity to review a lot of literature in the last twò weeks since the hospital announced that they would be closing the Rehab. Unit and maintaining core services for the in-patient population only. From the "Quest for the Best"bulletin dated February 25, 2002 we would like to challenge a few statements that are contradictory to the announcement. "Our new model will be more patient centered, will more clearly identify accountability for decision making, will move decision making closer to the point of care/point of service, will increase staff and physician involvement in the decision making and will help us be better stewards of our hospital resources." Another quote "their mission is clear....continuously improve your programme for the benefit of the patient and, involve your entire team in the decision making." We note that "patient-centered care" is referred to frequently along with clear roles and accountabilities, point of care/service decision making, open channels of communication and a high degree of participation. These all looks very nice on paper but were these steps taken and followed by the hospital administration? Another article that we reviewed is the "Report to the Region 200l""we are fortunate to have a community hospital with a comprehensive and robust array of services. This is worth preserving. It is clearly a factor in attracting doctors, nurses and other health care professionals who value the breadth of support, the quality of learning, the opportunity to excel and a healthy community lifestyle." How could "worth preserving"change so drastically in such a short time? From the Sharing the Vision dated July, 2001, we read "To respond to new levels of public accountability" "To build confidence and attract resources" "to consistently challenge the status quo" and lastly "to preserve the comprehensiveness of our clinical services" " so that appropriate hospital care is just around the corner. Right next door." For the many patients that attend Rehab. Services on a daily basis, this must make very little sense. All of these above quotes are very commendable and very responsible as they 2 should be but we are confused and don't find the actions taken to be in line with what has been said As a retired physio, I had a need to challenge the Announcement to Rehabilitation Patient. I personally worked on inpatient physio for many years. "Out-patient services of Occupational Therapy, Physiotherapy and Speech-Language Pathology will only continue to be provided to patients who fit within the hospital's core programmes. E.g. patients who have total hip or knee replacements or suffered a stroke". What will happen to anyone suffering from a condition other than a stroke? Over the years I have treated such conditions as spinal cord injuries, A.L.S., head injuries, Alzheimer's, Multiple Sclerosis, C.O.P.D., asthma, Myasthenia Gravis, fractured hips, fractured pelvis, fractured femur, fractured ankles or rotator cuff repairs just to name a few. Do these conditions not warrant follow up after their discharge? We both served on the Occupational Health and Safety Committee while working at the hospital. Like all industries, the hospital has its share of staff injuries. At the present time, staff are treated in-house at the WSIB clinic. What will be the cost when staff will no longer be able to access treatment in-house? What will be the cost of the increased lost time hours? Did the $400,000.00 in saving take this into account? Are new programmes on the agenda for down the road when the space now used by Rehab. is available? Can we justify initiating new programmes when we are being told that we can't afford the old? The more we look into this the more confused we become. An interesting lady to talk to is Deb Sugar from the Thames Valley (663-5317 ext. 2430). She can explain the consequences to the community and the hospital if the tyke Talk programme has to move. Phone the hospital and ask for the number of new patient referrals and attendance's for 2001. Our numbers indicate for all services-3447 new patients and 38,164 patient visits. Please take the time to confirm how correct these numbers are. This does not include patient visits to the WSIB clinic. Please take the time to review the literature and if in agreement, voice your concerns regarding the recent decision to close Rehabilitation Services at the hospital. ~u str~IY' ~. ß~ , ~cr-'1' .J "'-. ~~ .' ary~u cat and Karen S art wp75-0054 631-1913 h. 637-7496 February 9,2002 5920 Fairview Avenue, R.R.4, St. Thomas, Ontario, N5P 3S8 519-637-7496 Dear Members of Elgin County Council, We are taxpayers of Elgin County and former employees ofthe St. Thomas Elgin General Hospital Rehabilitation Services and we strongly disagree with the recent decision of the present administration to close Outpatient Rehabilitation Services. Physiotherapy, Occupational, Speech, Audiology and Chiropody outpatient services will now have to be accessed at private clinics and those that don't have insurance coverage will have to pay and possibly travel to get these services. This will have a great impact on Elgin County's aging population and families with young children. The hospital's mission statement is to provide client focused care. The core values are compassion, accountability, respect and simplicity. Are these values being demonstrated by administration? We do not think that they are. A little over 11 years ago, the residents and businesses of Elgin County opened their hearts and gave generously to the hospital because the hospital needed a new facility to replace Memorial Hospital and expand Rehabilitation Services. They have continued to donate generously toward equipment needs. Now we are being told, by the present administration, that they must close the same rehabilitation uuit to save money. Lack of goverumeut funding and balancing a budget is cited as the cause. We are challenging this decision and the manner in which it was arrived at. Yes, they need to save money and to balance the budget. Everyone in business and the private sector knows how challenging that can be but we suggest that the figures being presented are less than accurate. We must speak up and stop this from happening. We are asking you to obtain answers to the following questions. How and by whom did this decision come about? Figures stated by administration are very inaccurate. There is over 40 staff in rehab. How can only 11 to 15 jobs be affected? There were over 2000 new referrals seen and 19,000 visits, not the 3,500 quoted from the paper. An outpatient quoted in the paper gave more accurate figures than hospital administration. Where did administration get their numbers and statistics? Were rehabilitation services involved in arriving at this decision? Were the doctors consulted? Did the board ask to speak to anyone from rehab? What were the facts and figures presented to the board so that they could arrive at an intelligent educated decision? We all know that you can skew figures to make them work in your favor. These are all questions that need to be answered in an honest forthcoming manner. The manager of Rehabilitation Services is the most honest and honorable person we have had the pleasure of knowing and working for. Ask him to give you a true picture. He will answer your questions with honesty and integrity. Several months ago, staff members at the Elgin General were told that the new administration had a "vision". We now know what that vision was. We strongly suggest that this is not just a cost saving measure but that there is a hidden agenda behind all this. One rumor is that they need room for a new ambulatory care unit. Staff were also told that this is a "done deal"and no amount of protest will change the outcome. The Ministry of Health was in on the plan from the very beginning. Was the ministry shown the true picture or just what administration wanted them to see? When people went searching in London, they found that the Ministry of Health had indeed been given inaccurate figures. The paper suggested that the sleep cliuic would be expauded. How many people does this affect? Compare it with the number of people accessing Physiotherapy, Occupational Therapy, Speech Pathology, Chiropody, and Audiology? Would this clinic generate the same amount of income for the hospital that Rehab does? Please ask all these questions and demand honest answers. Anything that has been published so far insults the intelligence of the citizens of Elgin County and they're elected officials. Thank you. Yours truly, Mary Muscat (519) 637-7496 Karen Stuart (519) 631-1913 cc. St. Thomas City Council Board of Directors, St. Thomas Elgin General Hospital Steve Peters Gnar Knutson Paul Collins Ken Higgs Hon. Elizabeth Witmer Hon. Toni Clements Ernie Eaves Chris Stockwell Jim Flaherty ~ St. Thomas-Elgin ~ ~r~n~:~:lfo~~~~~~:~ 189 Elm Street, PO Box 2007 St. Thomas, Ontario. Canada N5P 3W2 Tel SI9 631-2020 . Fax519 631-IB25 March 14, 2002 Mrs. Mary Muscat 5920 Fairview, R.R.#4 St. Thomas, ON N5P 3S8 Dear Mrs. Muscat, Thank you for your communication of February 9th and February 27th regarding our decision to reduce some of our current out-patient rehabilitation services. Many of the issues you raise have been echoed in other communications we have received. Recently, the Board of Governors reviewed these issues and once again reviewed the facts and information behind the decision. As a result, we restated our unanimous support for this decision as being in the best long term interests of our community. May I specifically address the issue you raise about patient visit numbers as quoted in the papers rrom our CEO Paul Collins. Let me assure you that we on the Board were well aware, based on the facts shared with us, of the approximate number of new referrals and visits that would be affected, and the distinction between the two. May I further add that we take our responsibilities to this community and our integrity very seriously and were diligent to ensure that all of the facts were obtained and all of the alternatives were considered in our decision making process. I have enclosed a letter rrorn the Board that explains our position, as well as answers to questions that have been rrequently repeated in communications with us or through the media. Both of these documents will be published in the media to facilitate a broader communication to the citizens of St. Thomas and Elgin County. Should you have further enquiries please feel rree to contact me through the hospital at 631 2020 ext 2184 or e-mail atBoard@stegh.on.caormailtoBoardofGovernors.St. Thomas-Elgin General Hospital, 189 Elm Street, Box 2007, St. Thomas, Ontario N5R 5C4. You may also contact our President and CEO, Paul Collins at ext 2192 or our Communications Facilitator, Cathy Fox at ext 2191. Sincerely, J¿X&l (}~#-- Tom Cunniffe, Chair, Board of Governors Our Core Value! Compassior Respea Accountabilitj Simpiicitj St. Thomas-Elgin General Hospital Working Together for Your Good Heolth 189 Elm Street. PO Box 2007 St. Thomas. Ontario. Canada N5P 3W2 Tei 519 631-2020 . Fax 519 631-1825 Frequently Asked Questions Are all of the rehab services being eliminated? No. We will still provide all of our rehabilitation services for patients admitted to the hospital (in-patients). We will also continue to provide out-patient rehab services in Physiotherapy, Occupational Therapy and Speech-Language Pathology as follow-up for those treated as inpatients, or in the surgical day care. What happens to patients who can't pay for private services? There are some patients who are not covered through insurance or employer plans, or do not have the means to self-pay. The Board has committed the hospital to begin working immediately with public and private groups to find creative ways to assist these people as much as possible. Doesn't OHIP pay for these rehab services in the hospital? The hospital cannot bill OHIP for rehabilitation services. With the exception of Audiology, these services are provided through the same funding the hospital receives trom the Ministry of Health to operate all of our services. Although we can bill OHIP for Audiology services, the total revenue has consistently been less than its cost. Last summer, OHIP implemented new billing restrictions for Audiology requiring physician supervision for many Audiology services. This change will further erode the revenue position. You're only saving $400,000 dollars. Isn't this a small amount compared to your deficit and your whole budget? Our total deficit reduction package, including Rehab is conservativelv estimated at $900,000. We have worked hard to identify these dollars. Our current financial position threatens the Hospitals future. Our yearly budget is nearly $50 million. However, we carry a growing debt load of $7 million dollars and a growing yearly deficit of $1.9 million dollars. We do not have money to re-invest back into the hospital, nor will we have for some time. We will continue to work with the Ministry of Health to achieve a balanced budget. If you charge a user fee and get donations from the city/county councils or from citizens directly, couldn't you raise enough money to keep the services open? Hospitals in Canada are legally prevented trom charging user fees (Canada Health Act) and trom accepting donations to fund hospital operations. We can only accept donated funds for building projects and equipment through our Foundation. The community raised funds for the construction of the rehabilitation area and donations were made for some of the equipment. When you reduce the rehab services will this facility lay empty? No. This facility will continue to be used for patient care. We are in the process of developing a "Master Plan" which will be submitted to the Ministry of Health before any renovation or construction projects go ahead. This plan will identify where services will be provided in our buildings in the coming years. The rehabilitation space will be part of that plan. Our Core Value, All of the equipment will continue to be used for patient care as well whether in the hospital or in the community. Compassior Respec AccountabiJit.¡ SimpliÔt.¡ Steve Peters Uberal M.P.P. Elgin-Middlesex-London ~ ""'""" . .: .. . ..... PRESS RELEASE February 06,2002 For Immediate Release Tories methodically destroying health care in Southwesterc O!'tSl!"io St. Thoma.~ - it doesh '\ matter whether it's Premier Harris, Eves, Clement, naherty, Stockwell or Witmer-Ontark;'s Tory Government is determined to establish a two-tier health care system in this province, says Elgin-Middlesex-London M.P.P. Steve Peters. This was Peters' reaction to today's news that the St. Thomas-Elgin Genend Hospital will no longer provide some outpatient services including physiotherapy, audiology, occupational therapy, chiropody and speech language pathology. The move - to take place over an eight-month period - will see these services shifted to private sector agencies in the community. ..y ou don't have to read between the lines with this announcement - this is Government imposed two-tier health care," said Peters. "Once again this Government is forcing hospitals to balance their budgets - budgets that were woefuIly in&dequate in the first place. My Liberal colleagues and I have been warning Health Minister Tony Clement since last year what would happen when services like audiology were deslisted /Tom OHIP and now we see the result. Because of this Government's slavish addiction to its zealous cost-cutting philosophy, hospitals have to tow the line just to stay afloat. "Aller watching the London Health Sciences Centre being battered by this Tory Government, now it's apparently the turn of Lie St, Thomas-Elgin General Hospital. Patients, their families and hospill!l staff= who are slated to lose their jobs wil! equally share the pain of remov¡¡¡g .acs~ Sf:f\oiœs. w'hile this may be ille end result of Minister Cleme3t's slash a:1d bum healthcare policies, I ask just where are the other Tory leadership hopefuls and what are they saying? Apparently nothing because Iheir track records on health care prove they are all moving further down the road to two-tier healthcare.~ Peters called the Government's moves towards two-tier health care a slap in the face to the entire Southwestern region. "Everyone - patients, families, hospital staff and the general populace alllose,~ he said. "The attack started at the London Health Sciences Centre and now it's spreading throughout the region." The St. Thomas-Elgin General Hospital- with an emergency department serving more than 56,000 patients annually - has a staff of more than 1,000 employees. -30- For further information ;¡iease ~ntact: Steve Peters, M.P.P. SuzaDne Va.. Dommel Elgin-Middlesex-London Executive Assistant (519) 6Jl..o66fi (phone) (519) 631-9478 (fax) Constituency Office: 542 Talbot Street, St. Thomas, Ontario N5f 1&4 Tel: (519) 631-0666 Fax: (519) 631-9478 E-mail: Steve_Peters-MPP-CO@ontla.ola.org ~ o ~ ~ -- E c: -- ~ o o - o ....... CJ) -c CD (J) c: - --, ü c:: ::J a Ü ~.~.bE J;¡~6'~ ~ ~.-ð ~ .B ~ '±I ¡:¡"oJ1 fË'@'~~ -:6 è;';¡> -<"(j('-_;..¡ v ~~~~ w~w roB ~v ~ 0...0-.- ¡:; ~.~ s:: #-(0.. ID¡:;~ s:: Eroi-lo o~· Q) o;§ -pO a CIj::; +>~Q) Q,I....G.£j ~ ~~ :;3~r.J:¡........a.i OO~~Q) Q)~Q) v~ ~ro v~ ro c::....-.ooo............ 0 a-9c:: (1).- .- . :j.... -;:: c: 0..00 :;;.... 0 Cl:I 00 ,,,. :j ~ as Q)~Q)o~Q)~oQ) ~. 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"'":-õ= G)(I)a: co g..c cJ!!=ã ëtn ã 7:!:!Oo.c"CZo .;, U) ::::s"C G) to "C"'; )"" ~ ~G) 0 CI>~.c ca c~i'; .51S3: G> t»G)OC) ~>~tnC(l)_cñ-: G)Q)CDctI.!!!mca::::S1 .c.c.c.!2 -J! E 0- I-I-ED...!!!D..o~12 ::J Þ .:::,_ C Ø) I- tV .'~ "-." '. '- St. Thomas-Elgin General Hospital Working Together for Your Good Health i 89 Elm Street, PO Box 2007 St. Thomas, Ontario. Canada N5P 3W2 TeI51963i-2020· Fax519631-1825 Dear Citizens of St. Thomas and Elgin County, Mar 14,2002 , Recently we, the Board of Governors of the St. Thomas-Elgin General Hospital, announced that as of October 1, 2002 the hospital would no longer provide some of the out-vatient Rehabilitation services currently available at the hospital. At our Board meeting held on February 27,2002, we again reviewed all the relevant information and discussed the concerns raised in letters sent to us, as well as those concerns raised to Board members personally. And again we restated our unanimous support for this decision. Weare convinced that our failing financial position threatens the survival of our hospital as a St. Thomas and Elgin County operated health care service, and that it must be addressed. Reducing hospital-based, out-patient rehabilitation services has been a trend over the last ten years in communities across this province, as they too have had to grapple with shrinking resources. Anyone, especially other community volunteers like us, can relate to the personal anguish these difficult decisions cause. Our first consideration was, and continues to be, for those affected by the change .... those patients without means and some of our Rehabilitation employees. At our last board meeting, we recommitted the hospital to work with our staff, private providers and other groups in the community to find creative new ways over the next seven months to assist all those affected by the decision. In our decision making process, we were well aware ofthe need for accurate data about all of the services in the hospital. We reviewed many alternative actions including cutting back emergency room hours of operation, eliminating the obstetrical service, reducing the number of operating rooms and reducing hospital beds, to name a few. However, we determined that these make up the core services that a community hospital is here to deliver, and that we must preserve them. As elected, unpaid community volunteers we are expected to represent the interests of the whole community that we serve. We take this role, and our dedication to the preservation of this hospital for the citizens of Elgin County very seriously. We intend that STEGH will continue to be a vibrant community hospital for many years to come. Our service choices must match our financial resources so that STEGH can be preserved and strengthened. We invite, and will continue to respect the feedback and input of every concerned citizen. Sincerely, Members, Board of Govemors, St. Thomas-Elgin General Hospital (Board Chair, Tom CunnifJe, can be contacted through the Hospital at 631-2020 ext. 2184, or e-mail Board@Jste¡zh.on.ca , or mail Board of Governors, St. Thomas-Elgin General Hospital, 189 Elm St, P.O. Box 2007, St. Thomas, ON, N5P 3W2) Our Core Value Compassio' Respec AccountabiJit Simplicit -- FOCUS OHA Hospital Funding Update As a follow-up to aHA's pæ-budgIIt sul>-kdnn to the provincial government the aHA Is """,II...dng tis efforts to wæt with government in addresSing hospital cost ....u ,Ule5. On March ZOo John l(Iøg. AssI~nt DeJIIIIY MinIster of Hœ1th Care PrupoolllS. and John MeKtnIey.1)Im:tOr ofF\DaDC:e and Infonnatlon Maœgement Brandl. met with the aHA's Board ofi)h.:..klls to disœSs ~ c:ost presswes. It Is dim dIat the .,."...meat. egress with aHA's ana\Ø'I 011 the iiIIIc1bIg needs of1øJsplÞk, The aHA Is hcipeY dIIt the 1JIhv'-'-wBI be nspondIDg shortly with a t1mdiÐg- "'- Uøtl1sucli time, the aHA amtIDues to rw-mI tbatbt~""I..I"'''e''' IlaIgliMlsofseniœ. FOIl IDOIe JuiW....~ ""........ HilalySlMtâ JIG- "'t45!Ól4'~~com . HAAnnounces 2002 ConventIOn .. exhibition Theme Mark JOII1' caleJ¡dars for the 2IIOZ OHA QmveIIIiIIn &: ExbIbItloD on November 18.19 and 20 at the Metro Toronto (;onwaIIoD Qmtœ. ThIs yffds convention theme is. "JhIk 7'1Itw1¡Jtr The theme ratJoDallS endosed In 1hIs week's .".._cd>. CODIII'nn~ padIage. For mare iDfœmation about die 2IIOZ c..... ..Ai.. .. p_. please contact EdacadoøaI Services at 418 ZlS-13GZ, emaII convention@...... c¡øn III' Wiit _web site at www.oM c:01D Educatlon8l ServIceS would like to thank this years ConventloD P""'nIng Com""- fur their CIJIltIii¡utio1 in deYdopIDg the 1heme. VaI.14 No.11 M8mh20.2002 eo---1IKP-~ Leo sœvm. WIIIIIIm OIlEr HaIth Centre MaIy LoIp"I-. AJupdra MariDe and Gemra1 HospItI! Todd seep.nun., Perth &: StIIIth FaDs DIsUIct HQSpI!aI Peg HogardI. TJUonn1wtg DIstIIc:t Hospital \'Vam:D CIumt. L ......1- DIsIdct MIimorial a...pItaI GtIidaD Key. Humata DIsIdct HœpiIa1 CIIIides BbI,In -', AJ&<no"'t',I" HelD semœs OHA Initiates DlsGUøaIon8 on NatIonal Pwtient .Iht;rdon survey On March 13, aHA bosœd a tdeooIIfesltllCe with ~of.dèp...QØSand toá~1n Canada to d<pkire the poUmtIaI of _~ a --..¡ suite of patient. ~ measurement survey tools. ~ -4H III Ii ¡pat Iøtere5t In Ihe wøœptof a -- roppmadt to met "I..s p~ and a folloW-Up ....etIoB" been sdIeduIed fur ApI 1 The tiJDIng Is dgbt for these dJlc:Qp-" theœ lie a m..... of I""'Ii.;lì ..,.. who - in die p«esS of idadIfÚl& wødors to..-sure patient ......IIon. The cumIIIt aHA c:ontnd. with Pa1'IœIdefPæss Ganey ezpües injuøe 2IIOZ aød Pœa Ganey hils IIlYiøI that in !be fUÞœ, It wII...d¡nIte tis dIeD1s &om the QnImiO tooI- that bas been used for the past 1hJœ yœrs - to the Aøier\CaI1 survey tool. Sinœ Ihe &II of2OO1. ~ RøpIS. DIœc:tOr ofPadent ~ at Uø~...ãIty HeIIlth NetWGØ. _led a process for obtaIøIø& a"""'- SUM}' tool for QnI¡øiO hosp1t/'lc The pdodIy Is to find a way to UI'I~INI m .MiM"eo patIeØt .,acL Ium while _$Uiøg a IoDg- tem1 "'ofutI.... T\IIiøIIS to the CEOs oP.1be HospItal BepDñ AchIsm:Y eo--- for .,o.dl..ulllg to pvdde atMœ 011 tIieIIe IWIb...Aa&S. St. Thomas-Elgin General Hospital Working Together for Your Good Health 189 Elm Street. PO Box 2007 St. Thomas. Ontario, Canada NSP 3W2 Tel 519 631-2020· Fax519631-i825 February 6, 2002 Dear Rehabilitation Patient, As a community hospital we have a mandate to provide primary and secondary core services. These include Surgical, Medical, Ambulatory Care, Maternal Child Care, Complex Continuing Care, Inpatient Rehabilitation, and 24 hour Emergency Services. In order to preserve our core services we must be on solid financial footing. Our projected deficit of 1.9 million dollars will continue to grow unless we take immediate action. We have made a difficult but necessary decision for St. Thomas-Elgin General Hospital. Effective October 1, 2002, the following changes will be made. The outpatient Rehabilitation Services of Audiology and Chiropody will no longer be provided in the hospital. The outpatient services of Occupational Therapy, Physiotherapy and Speech-I:,anguage Pathology will only continue to be provided to patients who fit within the hospital's core programs. e.g. patients who have total hip or knee replacement or suffered a stroke. All other outpatient treatment currently provided by these services will be discontinued. One exception is the Health Maintenance Pool Program which will continue to operate beyond October 1,2002, until an appropriate partnership with an outside agency can be established. The above changes are in keeping with the trend toward shifting the delivery of outpatient rehabilitation services out of hospitals and into the private sector. Many of you will have some form of extended health insurance coverage through your employer which will assist with the treatment which, in most cases, is provided on a fee-for-service basis in these settings. I want to assure you that we have carefully weighed all the options and have not made the decision without careful consideration of core service requirements. We will do everything we can to make the transition as smooth as possible for you, our patients. If you have any questions/comments about these changes, call Cathy Fox, Communication Facilitator at 631- 2030, ext. 2191. Sincerely, Paul Collins, President & CEO Our Core Value, Compassior Respec Accountabilit: Simp1idr: Quest for the Best: Bulletin Steps towards implementation of a new organization model on April]. 2002 Paul Collins, President and CEO This is just a quick update, more information will be coming to you on March 1'1. On September 6,2001 we introduced a new organizational model. Our new model will be more patient centered, will more clearly identifY accountability for decision making, will move decision making closer to the point of care/point of service, will increase staff and phvsician involvement in decision making and will help us be better stewards of our hospital resources. The implementation process is now nearing completion. I know this has not been an easy time for everyone and would like to thank you all for your patience and support. Here are some answers to afew questions you might have. I'm sure the list is not complete. I encourage you to raise other questions you might have with your current manager (or any of the program directors previously named). If they cannot answer your questions, they will try to get the answer for you. When will I know who my manager is in this new model? We are just completing the consultations for the manager, specialist, consultant and service leader roles. Most of these roles will be announced on March] " (others will be announced when filled). An organizational chart (effective April]") will also be distributed at that time. In addition, we are planning a special "coffee & cake break" introduction for them in early April (particulars will follow). If I have a new manager, when do I start reporting to himlher? Should you have a new manager, you will begin reporting to that person on April I ". How will I be helped through this change? Your manager and the director of your program will create opportunities for you to be part of team dialogue in March and April. They look forward to your participation and to answering your questions. Why do we need this new organizational model? To become the best community hospital in Ontario we must take a fresh approach to how we are organized to deliver service to our community. Our new model is focused on patient care programs, led by capable directors in partnership with committed physician leaders. Their mission is clear...continuouslv imorove vour orozram for the benefit of the oatient and. involve vour entire team in decision makini!. Our support programs have the same mandate. They will provide clinical services, assist staff growth and development, process useful data for decision-making and maintain a safe, comfortable health care environment. Why are we hiring physicians in this new model? Their perspective and contribution to organizational decision-making is critical to effective, efficient and patient centered care. That is why we invited 5 physicians to partner with our program directors (Medical; Ambulatory; Surgical; Clinical Support and, Systems Decision/Support) and become part ofthe leadership team. They are not full time employees. They contribute on a part time, contracted basis. They have already made an invaluable contribution since their appointments last November. How can we make these structure changes at the same time as we are making cuts? Becoming financially sound is vital to our future. The Board of Governors defined the mandate of a community hospital and carefully reviewed all service options. The choices they made recently were difficult ones, but reflect their determination to focus on core services, become the best and strengthen the hospital for long term survival. Our organizational redesign has the same goal. February 25, 2002 r , . ::r;, V\<C Î I 2= 1 Appearing in "Report to the Region 2001" Message from Paul Collins I am delighted at this opportunity to address you as the next President and CEO of the St Thomas Elgin General Hospital. First, I must acknowledge Mr. Terry Kondrat, our retiring CEO who has been a valued ooach and mentor for me. I will miss his perspective and his wisdom. During my twelve years as an employee of the hospital, I have leamed of the depth of caring, the oommitment to quality and the sense of service to the oommunity demonstrated every day by my fellow employees, the medical staff and our amazing volunteers. I am humbled by your contributions and by the chance to work with you and our oommunity in this leadership role. ~'~~':'fþftµa~t~Î~"h1:iY~';#c:oiriI1ÎÓnitý:hosPitalwith;a'C()ri1Þrehe~sive.androbustarray,ofcseOOg¡s~",,;¡;his ~ 'ÎŠè~~rtffjJt§§§EYJQ~:~'!J~;SI~íitlrI~~~~q~PiÌ1iâttr'âêtin~"(ôCtòrS,"l'1óffies'andottìefHêâ¡thêafeprofé"ssiöhals '¥ìf.íõ"Válû1i'1fiê'breál:lfh:Öf'šuppor('thêi:jûälitY-'Oflêamirii#thëoþportunityJQ"!:!",cetand~,'healthY,{!Jf' ~~ "-community&1îfestylej'Ø,¡t,,¡ç,, ¡ . ~ :...·"¿i"'iv.~~·',",'_···- In this age of acoountability I have a "vision" of ours being the best community hospital in Ontario, by all measures. We find the best practices in health care and implement them. We are patient-focused, completely. We are financially rewarded for our efficiency. We are truly a partner of our many and valued health service providers across our region. Most importantly, our patients, our oommunity and our employees, medical staff and volunteers say with conviction, "We are the best!" I am grateful to the Board of Governors for giving me this opportunity to lead and to serve. I will visit your department on... Administration - to join other departments Ambulance Department - date to be set Central Registry - August 2 @ 1430 hrs. CCC - A.C,D - Aug. 14 & 28 @ 1430 hrs., Aug. 29 @ 1830 hrs. Chemotherapy - August 15 @ 1000 hrs CICU - August 9 @ 1430 hrs., August 13 @ 1830 hrs. ECG - August 16 @ 1300 hrs. Emergency Department - Sept 5 @ 1900 hrs. Engineering Services - August 15@ 1100 hrs. FCMCC - July 26 @ 1400 hrs., August 1 @ 1100 hrs. Finance/Switchboard - August 23 @ 1100 hrs. Health Records - August 9 @1030 hrs. Human Resources - August 15@ 1500 hrs. Infection ControUOccupational Health - to join other depts. Information Services - August 9 @ 1300 hrs. Laboratory - August 29 @ 1430 hrs. Materiels MgmtlCentral Supply/Housekeeping - Aug. 8 @ 1000 hrs. and August 23 @ 1500 hrs. 2"" Floor ~ August 30 @1430 hrs. 4'" Floor - Aug. 20 @ 1500 hrs. and Aug. 20 @2230 hrs. 5'" Floor - Aug. 21 @ 1500 hrs. and Aug. 21 @ 2230 hrs. Nuclear Medicine - August 1 @ 1430 hrs. Nutrition & Food Services - August 22 @1315 hrs. OPS - August 14@ 1000 hrs. Organizational Development - August 20 @ 1000 hrs. ORlPACU - August 15 @ 0730 hrs. Pharmacy - August 29 @ 1300 hrs. Quality-Utilization Management - August 17 @ 0815 hrs. Radiology - Aug. 22 and Sept 5 @ 1230 hrs. Rehab Services - July 31 @1130 hrs., Aùg. 14 @1530 hrs. Respiratory Home Care/Sleep Lab -Aug. 15@ 1400 hrs. Respiratory Therapy - August 1 @ 1830 hrs. Security - to join other departments Staffing - Sept 5 @ 1400 hrs. Ultrasound - to join other departments Volunteers/AuxiliarylTuck Shop - Aug. 1 @ 1915 hrs. & August 22 @ 1000 hrs. Please feel free to join any department meeting if you are unable to meet with your own at the scheduled time. Staff BBQ Dates \ "~ if! June 12'" @ 1645 hours in Cafeteria -- June 1f1h @ 1100 hours in Auditorium, Snell Bldg. June 18'" @ 1200 hours in Auditorium, Snell Bldg. June 26'" @ 1715 hours in Cafeteria en !-< Z f.;i¡ :¡; :¡; o u - >< ~>< o~ ~!-< 0-< ~..... .....~ =0 u~ >< " o ...< o ..... ~ þ -< ~ ""d I C--- o '^ k Aü>-' 8 ..;::: ~ .- 00 "<::"<::0 01::.,¡- 00<>'> ~ ó , x S '" "'0 :S:S'D '" 0 k bJ)+-><2 <=: ,0 .- 0' 0 ~oo <>o.,¡- "<::-<>'> b1J '" k '" k 0 <=: '""0 tH.s '" <lJ_ "'b1J0.. ..J::: ro ï::::: >-.tü - ;;. 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Editor: When I read in the St. Thomas Tunes-Journal that Paul Collins, St. Thomas-Elgin General Hospital CEO, confirmed that there will be layoffs as the hospital will no longer provide some out-patient rehabilitation ser- vices, including physiotherapy, audiology, occupational tllerapy, chITopody and speeCh language pathology, I was in shock to sóv the least that such essential services are o~ thp ·,hopping block. As an o:.rt pauent of .the physiotherapy deparbnent, i ãœ. against the closure of this deparbnent to out-patients. The dedicated staff in all areas of the announced services to be cut are very dedicated to their work and patients.' . With the older population in St. Thomas and Elgin county how are such services go- ing to be provided to these residents? Many of the seniors within this geographical area are on fixed incomes and would not have medical coverage under a private contractor. They cannot drive to Lon- don for treatment, nor should they have to put the re- sponsibility on their family members to see that they are taken for required treatments. There are other people on fixed incomes who require the services of the pfiysiotherapy, audiology, occupa- ~ . tional therapy, chiropody and speech language pathol- ogy. What will they do for treatment in the future? It is easy to say let them go to the private clinics for treatment and/ or services required, but unless these clinics are covered by OHIP many, many people will not seek the care they deserve or require. The hospital board has a vision to be- come the best hospital in Ontario. How do board members expect to achieve such sta- tus when they are cutting a very much needed service at St. Thomas-Elgin Generai Hospital? I feel that to achieve their goal they should r:ot mt services, but provide all the currently avallable services to all resi- dents of St. Thomas and Elgin. St. Thomas-Elgin General Hospital should be one of the hospitals providing the services of out-patient physiotherapy, "mdi- ology, occupational therapy, chiropody and speecl:i Ian, guage pathology rather than a hospital known for cut- . ting essential services. The proposed changes will have an effect on the re- cruitment of physicians to St. Thomas and area. What deparbnent will be next on the chopping block? Robert A. Holt St. Thomas The Times-Journal welcomes your letters. They should be topical and must include your name an\l signature, address and telephone number. We do not publish addresses or phone numbers, but require them for verification. Please keep letters to a reasonable length. We reS3r\19 the right t>:! edit letters for clarity, style, length and legal co¡¡t~r;·;. Please address your letter to: L..>tterto the Editor, Times,)our;;ai, 16 Hincks Street, St. Thomas, Ont. N5R 5Z2. Your letter can also be e-mailed to (butterwick@stthomastimesjournal.com) or faxed to us at 631-5653. Announcement to Rehabilitation Services Staff February 6, 2002 The Board of Governors is committed to reaching a balanced budget in 2003-2004 and making changes to support our hospitals core patient service mandate. These changes affect the Rehabilitation Services. These decisions were carefully evaluated and not taken lightly. We recognize and regret the personal impact of these changes and will do all that we can to support those affectèd throughout the transition. Please know that these changes have nothing to do with the quality of your service which has always been recognized as exceptional and patient focused. The specific changes are as follows: Effective Octcher I, 2uU2 we will end out-patient Rehabilitation Services in Physiotherapy, Chiropody, Audiology, Occupational T:1erap:y and Speech Language Pathology. Out-patient service that supports the contimmm of care for in-patients, specifically Orthopeadics and stroke care, will still be required to assist patients with their transition from hospital. ¿ In-patient rehabilitation services will be integrated into the in-patient programs. The Master Planning process will recommend an alternative patient care option for the existing Rehabilitation space. The Pool Program will be maintained while we investigate community agency partnerships. Existing contracts will be discontinued. · Acute Injuries Rehabilitation Clinic (WSIB) · tyke Talk and Infant Hearing Screening (MOHLTC) · Elgin Audiology Consultants (hearing aid dispensing clinic) Referrals will continue to be accepted for scheduled treatment plans that are expected to be complete by September 27,2002. We have prepared ail infonnation letter for patients tho' idf"'tifioo:s t,'1C s~r.¡i;;c changes, resources and the time lines for the referral process. , Discussions with local private providers will be undertaken to assist with the transition of these services to those resources. The expected cost recovery from this change is a conservative estimate of $400,000. We anticipate a reduction ofFTE's in the range of 12 to 15 that would include a mix of management, clerical, professional and aid positions. The actual number must be confinned following a comprehensive analysis of the resources required to support the out-patient continuum of care for the core services. This assessment will begin immediately and be completed by May 1, 2002. fjt Paul Collins, President & CEO Budget Message to Employees. Volunteers and Medical Staff February 6, 2002 We have a vision to become the best hospital in Ontario. Our Board of Govemors believes that to be the best we must take steps to ensure the survival and growth of our hospital and the core patient services we provide. As agents of the community they represent, the Board's obligation can be no less then to make wise strategic choices on their behalf. The Board has agreed that the role of our community hospital must focus on our "core" patient services at a primary and secondary care level. These include Surgery, Medicine, Ambulatory, Maternal Child, Rehabilitation and 24 hour Emergency care. In addition, they have endorsed a restructuring of our services and management to support patient-centered care, physician leadership involvement, clear accountability and decision-making close to the point of care or service. ** I want to acknowledge the dedication, knowledge, skill and hard work of our employees, medical staff and volunteers to support our hospital and the community we all serve. Yet, our financial position threatens our hospital's continued survival and growth and so it must be addressed. The Board has committed to reaching a balanced budget position in 2003-2004, and to making the changes that will get us there. On February 1, we submitted an Operating Plan Brief (budget) as required to the. Ministry of Health and Long Term Care, that included changes for the coming fiscal year (April 1 , 2001 to March 31, 2002). Changes include: · Reducing Rehabilitation Out-Patient SeNÍces (effective October 1,2002) · Parking Rate Increase for all visitors (April 1) (emD/ovees/medical staff not affected) · Sleep Laboratory Expansion (date) · Integration of ECG, Respiratory Tlìerapy and Oxygen Home Therapy/Sleep Lab to form Cardia-Respiratory Services (date) · Implementation of an Unguarded Boiler Plant (effective July 2002) · Reorganization of duties in Engineering and Housekeeping (date) (Please read "Change Descriptions" for a more detailed description of changes and/or speak with your manager) These changes were carefully evaluated for their impact on our core patient services and our budget among other important evaluation guidelines. They will account for close to a $1 million dollar annual improvement to our financial position. However, I know that the process will be painful for many and regret the stress that change like this brings into people's lives. We will do everything we can to support those affected through this difficult transition. We are demonstrating our dedication and commitment to taking the steps and measures necessary to achieve a solid financial position, and to preserve this hospital for years to come on behalf of the community we serve. Ours is a vibrant and valued community hospital. We have launched a new vision to become an example of the appropriate and responsible role of the modem community hospital in tomorrow's healthcare system - "to be the best community hospital in Ontario". With the foresight, I?atience and specific support of our employees, medical staff, volunteers, management, B:~.r~?ovemors and the Ministry of Health and Long-Term Care, this will be achieved. '~~ins P~ent and CEO . "*Note: We wi/l modify the remaining steps in the restructuring process so that the changes made so far can be absorbed and evaluated before continuing with the roll-out over the next 2 years. The new organization structure formally takes effect on Apri/1. St. Thomas-Elgin General Hospital Working Together for Your Good Health 189 Elm Street. PO Box 2007 St. Thomas, Ontario, Canada N5P 3W2 Tei 519 631-2020 . Fax519631-1825 February 6, 2002 Dear Rehabilitation Patient, As a community hospital we have a mandate to provide primary and secondary core services. These include Surgical, Medical, Ambulatory Care, Maternal Child Care, Complex Continuing Care, InDatient Rehabilitation, and 24 hour Emergency Services. In order to preserve our core services we must be on solid financial footing. Our projected deficit of 1.9 million dollars will continue to grow unless we take immediate action. We have made a difficult but necessary decision for S1. Thomas-Elgin General Hospital. Effective October 1, 2002, the following changes will be made. The outDatient Rehabilitation Services of Audiology and Chiropody will no longer be provided in the hospital. The outpatient services of Occupational Therapy, Physiotherapy and Speech-Language Pathology will only continue to be provided to patients who fit within the hospital's core programs. e.g. patients who have total hip or knee replacement or suffered a stroke. All other outpatient treatment currently provided by these services will be discontinued. One exception is the Health Maintenance Pool Program which will continue to operate beyond October 1, 2002, until an appropriate partnership with an outside agency can be established. The above changes are in keeping with the trend toward shifting the delivery of outpatient rehabilitation services out of hospitals and into the private sector. Many of you will have some fonn of extended health insurance coverage through your employer which will assist with the treatment which, in most cases, is provided on a fee-for-service basis in these settings. , I want to assure you that we have carefully weighed all the options and have not made the decision without careful consideration of core service requirements. We will do everything we can to make the transition as smooth as possible for you, our patients. If you have any questions/comments about these changes, call Cathy Fox, Communication Facilitator at 631- 2030, ex1. 2191. Sincerely, Our Core ValUE Compassic Respe Accountabili Simpiici Paul Collins, President & CEO -. -~:~ - ~St. Thõmas-Elgin Generàl Hospit:al ) Woriûnr ~(rN You' ~-Hedth _ ¡ Introducing the St. Thomas ElgiTl Generàl Hospital Board ot Governors 2001/2002 These commun;ty volunteers.have bee" elected or appointed.:to serve. as - members of the STEGH Bóard of Governors, representing the interests of citiZens" across Elgin County. Representing the County otElgin: Tom Cunniffe, current Chair, elected 1998. Retired teacher and Director of Education tor Elgin "County School Board. Rien VanBrenk sppointed by the. Council of the County of Elgin in 1998. He is a t!:usineSsi'nan. Representing the City of St. Thomas: .Jerry O'Brien, elected June 2001. Elementary School Principal: . Larry Smith. elected 1994. Retifled lawyer. and past Board Chair. Reþresenting th~ Hospital Foundation: Don Page, apPointed by the Hospital FoUndation in 2000. Retired. is 'an aCtive volunteer in numerous ~3tthar':'d~u.~ services. and is PreSident 01 the Hospitaf FQundation. - SecretarY: Paul Collins, Secretary to the Board· of Governors, HospitaÎ President and CEO~ sylvia HÒfhuis, elected June 2OOt. OffICe manager 01 a Port StaJ1¡ey medical office~ former Reeve 01 Port Stan~y. and termer Board Chair. u.ian ..iI¡¡,....~, ~ 2009~ ,Aeii..oo Roi:.gisterÐØ Nurse, former R~-.:: ~f Yarmouth Township, former Warden of Elgin County, and active vOlunteer_in community activities. Peter Ostojlc, appointed by the Council of the City of St. Thomas in 2000. Mayor of the City of St. Thomas. Wi" Riecker, current Vice Chair. etec1ed 1999. Manager of Human Resources and, Corporate Secretary of Canadian Timken and. Secretary Treasurer of the ~ Leaf Foundation. _. Representing the HospItal Auxiliary: ..Jean FOtheringhame. appointed by the Hospital Nnd&:ary in 1998. Past P.resident of Ü'le Ho.c;oital Auxlüary. . Dr. Tom Faulds, appointed 1998. PTesident of the Medical Staff and a physician in the Clinical Associate and Emergency Depanments- Dr. Don Lawrence, _led 1'996_ Physician ·specializing in ObstetricslGynecoIogy and H~VK:e Presidènt of MeälC8l Affai<s- Our Mission: "We will work together with you and your family to provide quality healthcare.ft Summary of Rehab Services currently available in St.Thomas and Elgin County Physiotherapy · A limited amount of publicly funded home care Physiotherapy is provided through the Elgin Community Care Access Centre (ECCAC) if patients meet the admission criteria for delivery of care in the home. · The Arthritis Society also provides limited in-home treatment for qualifying patients. · Other than the above there are no other source of publicly provided and funded Physiotherapy services available in Elgin County. · There is one OHlP clinic operating in London called The London Physical Therapy Clinic. Elgin County residents who have a physicians referral may access this clinic however patients need to be aware that there may be a sigillfk=t waiting !Ú!le and the clinic is located on the second story of an older building on Dunðas Stre<::t and there is no elevator so patients must be able to climb stairs. It has also been rumoured for Sl)me time that the Ontario government is planning to de-list these OHIP clinics at some point in the near future. · There are currently 3 private clinics operating in St.Thomas. They are On Trac, the physician owned clinic, Kettle Creek Physiotherapy and the Spine & Joint Centre which are both owned and operated by Physiotherapists. These are all fee-for-service clinics that are able to bill WSlB, auto insurance companies or third party insurance companies such as Liberty Health if individuals are covered. Otherwise patients will have to pay for treatment privately. Occupational Therapy · There are no private OT clinics in Elgin County. There are some.private Occupatioual Therapists that can be contracted to go into homes to do assessments on a fee-for-service basis. · Publicly funded home care Occupational Therapy is provided through the ECCAC if patients meet the admission criteria for delivery of care in tht: home. Chiropody · There is one private Chiropodist practising in Elgin County who practices on a fee-for- service basis. There will be no available publicly funded Chiropody services as of October 1,2002 or sooner if the one Chiropodist dècides to leave the employ of the hospital before that time. Speech-Language Pathology · There are no other publicly funded sources of SLP services for adults in Elgin County. Pre-school services funded through tyke Talk and currently delivered by SLP's employed by St. Thomas-Elgin General Hospital might continue to be provided by another service providei'. Audiology · There are no other Audiology services available in Elgin County. Limited types of hearing testing is perfonned by Dr. Fetterly in his office. Patients will be able to access the ENT's at LHSC and St.Joe's in London through a physician's referral however the delays for these services is expected to be very lengthy. GYM VISITS IN REHABJLITATION SERVICES YEAR 1998/1999 5465 1999/2000 7375 2000/2001 7382 200112002 (to date) 7258 TOTAL 27,480 - ACTIVE POOL VISITS IN REHABILITATION SERVICES YEAR 1998/1999 4747 1999/2000 4706 2000/2001 3932 200112002 (to date) 3579 TOTAL 16964 - - Note: These numbers do not iücladc: the Health Maintenance Pool Program ULTRA VIOLET BOOTH VISITS IN REHABILITATION SERVICES YEAR 1998/1999 1171 1999/2000 1233 2000/2001 1447 2001/2002 (to date) 862 TOTAL 4713 ,- Audiology Statistics Total Direct Patient Care New Patients Attendances Timo . In'''' %of . %of IP OP OP Totals IP OP np Totals 1996/1997 21 672 97 693 151 2,038 93 2,189 125,612 1997/1998 11 965 99 976 150 2,318 94 2,468 150,778 1998/1999 26 700 96 726 131 2,490 95 2.621 157,427 1999/2000 30 795 96 825 123 3,028 96 3,151 183.576 .32Q.OI2001 26 770 97 796 71 3,675 98 3,746 189.528 2001/20û2 As of Dec 14 5::>7 97 521 22 2,817 99 2,839 144,535 Attendances New Referrals IP OP IP OP 199912000 123 3,028 30 795 200012001 71 3,675 26 770 -------- ---- Chiropody Statistics Total Direct Patient Care New Patients Attendances T;m"lln;'" %of %of IP OP ()P Totals IP OP OP Totals 1996/1997 132 122 48 254 309 2,139 87 2,448 62,120 1997/1998 139 162 54 301 289 2,746 90 3,035 65,168 1998/1999 118 186 61 304 306 2,656 90 2,962 62,451 1999/2000 109 . 322 75 431 296 3,019 91 3,315 78,507 2000/2001 92 300 77 392 202 2,992 94 3,i()~ . 74,695! 1\ 68,~881 iJ\verages 118 218 63 336 280 2,710 90 2,991 2001/2002 As of Dec ~1 101 58 242 81 300 139 2,365 94 2,504 59,364 IP includes aU Acute, cce and Rehab patients Attendances New Referrals IP OP IP OP 199912000 295 3,019 109 322 2000/2001 202 2,992 92 300 --....----..-.---- _ _._~_.... _~_n""__ _ .___.. ____.._______ Speech-Langauge Pathology Statistics Total Direct Patient Care New Patients Attendances Tim..llni'" %of %of IP eee OP OP Totals IP eee OP "P Totals 1996/1997 82 19 121 55 222 484 198 2,010 75 2,692 201,940 1997/1998 103 34 133 49 270 724 346 1,989 65 3,059 176,126 1998/1999 137 63 159 44 359 1,064 255 2,164 62 3,483 149,131 1999/2000 160 76 111 32 347 875 352 2,489 67 3,716 198,988 200012001 159 35 98 "''"- '>0'> 922 3{i512,209 6;1 3,486 206,042 ".,. ~ --I I ! Averages 128 45 124 43i 2981 8141 31)1 2,172 66 3,287 186,445 2001/2002 As of Dee 1..1/n1 142 33 81 32 256 709 387 1,549 59 2,645 124,164 eee slats include Rehab - ------------- ---_.~-_._--~ ------- -- --..---..... .-- ..- Recreation Statistics Total Direct Patient Care New Referrals Attendances Time Unil~ IP/OP/CCC/R IP/OP/CCC/R <>hah eh"b . 1996/1997 265 N/A 125,550 1997/1998 148 N/A 125,140 1998/1999 149 5,203 110,765 1999/2000 169 5,288 134,685 2000/2001 169 4,884 136,944 12001!2002 IAs of Dec 131/01 i - I 152\ 5,3041 122,5961 ---- --- ------ --.--...--.-- ----..-------.-.--..-.-- ...- - Pre-School Speech-Langauge Pathology Statistics Total Direct Patient New Patients Attendances Car" Time Ilnit" - OP OP 1999/2000 85 1,213 70,401 2000/2001 80 1,883 115,825 -.. - -----------.. -.........----.------ --------- ----- -- --- -..-- ---..- --- --.-....--- Rehab Service Statistics for 2000/2001 Fiscal Year New Patients Patient Visits Audiology 767 3,742 Chiropody 299 2,972 Occupatinal therapy 369 . 3,133 . Physiotherapy 1,914 . 26,108 Speech-Language Pathologv 98 2,209 Totals 3,447 38,164 -- - PHYSIOTHERAPY NEW PATIENT ANALYSIS - 2001 Jan 1 - Dec 31, 2001 By AGE group Adults 19 & over 71 % > 65 23% Paediatrics 6% By REFERRAL source G.P's 59% Specialists 41 % By FUNDING source Global Funding (OHIP) 86% STEGH Staff 3% WSIB 11% ONTARIO Total Population = 10 753 573 % seniors: aged 55-64 = 8.73% aged 65-74 = 7.38% aged 75+ = 5.03% 'l'otai - 21.14% ST. THOMAS Total Population = 32 275 % seniors: aged 55-64 = 8.35% aged 65-74 = 8.23% aged 75+ = 7.17% Total = 23.75% ELGIN COUNTY Total ponulaíion = 35 580 .. % senio!S: aged 55-64 =9.16% aged 65-74=7.1% aged 75+ = 4.74% Total = 21.07% STATISTICS 1996 PRIVATE PHYSIOTHERAPY FEES Initial Assessment Subsequent Treatment On Trac $50 $35 Kettle Creek Physiotherapy $55 $40 Spine & Joint Centre $65 $35 Feb 2002 Ôllíario Ministrv of Health and Long-Term Care - MinIster of Hea)th and Long-Term Care ,.; J Page 1 of2 v Ministry of Health and Long-Term Care ceM~ sit. I h.~ I n..ch I sit. I'M) I fr..nc.is I ® Ontario The Honourable Tony Clement M.P.P. Brampton West - !\!Iississaujla Minister of Health and Long-7i!rn1 ~a"" for Ontario ~ ~~ Tony Clement is the Member of Provincial Parliament for Brampton West - Mississauga and was appointed by Pre'TIier Mike Harris as Minister of Health and Long-Term Care on February 8, 2001. In this portfolio, he oversees the province's hospitals, long-term care facilities, the Ontario Heaith Insurance Plan, community care access centres. public health and emergency health services. Prior to his appointment as Minister of Health, Tony was appointed Municipal Affairs and Housing on October 23, 1999" In this portfolio. his key priorities as minister were to promote sucœssfullocal governments that are committed to excellence. accountable 10 taxpayers, and responsive to local needs; and a healthy, competitive housing sector that promotes construction and development of affordable housing by the private sector. In his previous rcie as Minister of the Environment, his responsibilities included developing programs and pv¡¡rJA~ mat prated our land, air and water while encouraging gí.&en industry and ~xhnology. T ony's current responsibilities also ¡nclude serving on the Health and Social SeNices Committee of Cabinet aod on the Management Board of Cabinet. First elected as the MPP for Brampton South in June 1995. Tony was subsequently appointed by Premier Harris as Parliamentary Assistant to the Minister of Citizenship. Culture and Recreation and the Parliamentary Assistant to the Premier responsible for developin9 proposals re9arding direct democracy. Appointed Minister of Transportation on October 10.1997 by Premier Harris. Tony focussed his efforts on maintaining a reliable, safe and affordable transportation network as a key component of Ontario's economic competitiveness. Tony was born in Manchester, England. He is a graduate oflhe University of Toronto, where he completed degrees in political science in 1983 and law in 1986. Called to the Ontario Bar in 1988, Tony also worked in Central and Eastern Europe as a consultant to Weslem companies and local governments seeking counsel on privatization and ecoi1omìc restructuring. V'.Ihile buildin9 a successful career and prior to running for public office, Tony selVed as President ofthe Progressive ConselVative Party of Ontario from 1990-92. In 1992, he became the Assistant Principal Secreiery to Mike Harris. Beyond provincial politics, Tony is the Honorary Chair cfthe Brampton Salvation Army Red Shield Appeal Campaign and honourary co-sponsor ofthe Brampton Safe City Fundraising Campaign. He and his wife, Lynne Golding. a lawyer. reside in Brampton with their three children. hap:! !www.gov.on.calheaIth!engiish/mînistry/dement.html 2!8f02 Ontano Ministry of Health and Long-Term Care - Minister of Hea1th and Long-Term Care Page 2. of2 , Send an emaH to the mi_nister -.;z~/ ~ .=-I·=-ð\."=-=-.'.21.:IIIt!i~.IiI'." Contact the Communications and Infonnation Branch at 416-327-4343 It ---... ¡ cent'el site I feedback! search I sitemap I français I horn< : ~",hl;qt¡o~s ¡ ""'alth links I telephon. directory tŸJ 0ï~1o This site maintalnoo by the G<MIm",,,,ø. r;.: Or>tar1Q, Q¡¡¡'\8da C 2000 Queen's Plinterfo(OotariQ J lastMod¡fied: 071301200'1'13:25:28 lmp:/iWWW.gov.on.carheaJth/english/ministryfçlementhtrnJ 2/8/02 I NEVVS For Immediate Release February 7, 2002 Tory government walks away from health care responsibility - McGuinty Restore St. Thomas-Elgin General Hospital funding, Liberal Leader says ST. THOMAS _ The Tory government is walking away ftom its responsibility to provide essential health services to working families in St. Thomas and Elgin County, says Ontario Liberal Leader Dalton McGuinty. "We have a respaf1~¡:;¡!;'Y to pro~"Íde quality health care for everyone, not just a wealthy few," said McGui..~y. "How are seniors ¡¡;;d workings families supposed to pay for these services?" Services such as physiotherapy and audiology are being dropped by the hospital due to funding cuts. At the same time, the Tory govemment is delistin~ ~hese services fi"om OHIP. . "The wealthy few can always afford to get the health care they need, but I'm concerned about the working families ofSt. Thomas and Elgin," said McGuinty. "The Tory government is walking away ftom its responsibility to ensure these essential health services are provided." ~'First the London Health Sciences Centre was battered by this Tory government," said Steve Peters, MPP for Elgin-Middlesex-London. "Now it seems to be the turn ofSt. Thomas-Elgin General Hospital. Patients and working families in this community will feel the pain." Sadly, the situation in St. Thomas and Elgin is an example of what is happening across Ontario, McGuinty said. "The Tories are paying for their corporate ta.x cut by dismantling our health care system through a double whammy offLlnding cuts and de1isted services," said McGuinty. "The Tories are imposing two-tier health care through the back door. I believe we have to fix Qur health care system by making it more efficient and accessibie. In the meantime, funding for St. Thomas-Elgin General Hospital must be restored so it can continue to provide these essential health services." . . . -30- For more information please contact: Meghan Lauber Associate Press Secretary Office: (416) 325-3522 Cell: (416) 522-4905 Le 7 février 2002 POUR DIFFUSION IMMÉDIATE < . .1TTTTTTTT!TT!'TTTT~TTTTTTTTTTT1TTTTTTTT~TTTTTTTT'TTTTTTTTTTTT!TTTTTT!TTT1!TTTTT _L.dal : .: ;:,'_. : !..: "; ::.'. -"", ': ~4 -~.:": :::.; , I Feedback Letters to EdItor CIrœIaIIoD AdftI'tiIIIDI EIœII DIrectory Newøpllpenlln Ed1IcII1on "LondoR · Movle8 · Newa · Restanrams · B.-..I\: CInbI · EftIIt Gulde · ReI: .I\: Leisare ·ShoppIIII · BooIts, CDs .I\: Media · CIU1IIda Gtunes · Mn..... · London Knigbts · c.re.s r " " Newa Sports Today BasIneM Bu8ineIIII Monday CIassifteds 0piDl0a LcaIoo W-.. ,..~ : r.....,¡.)1 ,....___.._1 CIId< ..... r.r doe -.....~ Search FYI: ø O! What's luippenlq... Today Feb. 'IbIs Week SMTWTFS 1 . , 7 10111213 ~. . "'" EHTRR icl FYI Cit)' Sites Inside CAr unicef. ]1,û ~¡'¡/J b Øll~.¡ 100,000 AJiAw. ~iIiltIrNt ~ '"' .., fIhlkt il dfnlll" ,,," ";'I~ {S/r-, r ¿npr:rtu«r 11~(,J. .r"U" h-rif '--'--."- CLASSIF1IID './~'~_" ". ,- ',' '~.- .,~. .....r.w_ d1Jt ÙII.Jm,pms NEWS J1uDp to: Select. pide 1- Free Pnu BoD Select. pille - SECI'IONS -- News s¡iom Today Swt.- ...- MODd8y ('I-lfIeðs 0piIIi0a - GENERAL - F~ Subøcribe Letters to EdICDr Ckalatlaa Ad._..... Emd Di>.clbo:l . SPECIAL SECTIONS . N4.....,..1n Education Thursday, Februaty 7,2002 St. Thomas hospital cuts back services Being dropped are outpatient physiotherapy, audiology, occupational therapy, chiropody and s¡ therapy pathology. By JANE SIMS. Free Prell Reporter The cutting of outpatient rehabilitation services at St. Thomas General Hospital is one more step toward a "two-tiered health system," a local MPP warned yesterday. "This government, because of controlling the purse-strings, is imposing a two-tiered health-care system upon us," said Liber; MPP Steve Peters (Elgin-Middlesex-London), reacting to new progmms would be cut at his hometown hospital and transfem private sector clinics over the next eight months. "The attack started at the London Health Sciences Centte and it's spreading throughout the region," he said, pointing to cant struggles in London to maintain services. "We know hospitals all across this province are gong to be SWIß8Jing with the same issue ~l1se of the inadequate fundi being provided. " ft. c" ne_ · CNEWS · JAM! Showbiz · WebFln Money .C-HEALTH · LIFEWISE .SHOP.auoe · SLAM! Spor1s · ALLPOP · NEWSPAPERS · TRAVEL · AUfONEf (yh, {¡·.H¡lnq .....~:. P":JH'¡ .Hld The St. Thomas hospital is cutting outpatient physiotherapy. audiology, occupational therapy, clùropody and speech therap: pathology. The cuts will save $400,000 a year for the struggling hospital, is wrestling with a $1.9-million deficit on a $45-million budge "Those resources we will be putting back into our deficit redUt then strengthening and growing our core patient services," sail Collins. the hospital's president and chief executive officer. The hospital board chose to firm up its core senices mandate , provide primary and secondaIy care, including surgical, ambU: care, matemal-child care and emergency serviœs. But the looming deficit meant the board bad to make a tough decision. "We've got take some steps to put ourselves on a solid financi footing." Collins said, aðml1g the board had to look.t "the Ion survival of this hospital for this community." Collins said the hospital will continue to have inpatient rehabi: services as part of its care and some outpatient services "to ~ transition into the home setting. " About 1.500 of 3,500 outpatient rehabilitation visits will be af by the cuts. Collins said 12 to 15 jobs will be c1iminated. The hospital will invite private care providers to talk about the transition of services. There is no OHIP-licensed facility in St. Thomas, meaning patients will have to payout of their own IX for services. Collins said there have been simU,.. transitions to private clini. the province over the past decade. but added the hospital is "VI sensitive" to the hardship the decision may cause for some pat Peters blamed the provincial Tory government for squeezing t hospitals until they have to cut services. "These boards are being forced to make some extremely diffic deci$ions beç.n~ of the lack of stable funding from this government," he said. He said he plans to discuss the cuts with Liberal leader Dalton McOuinty, who will be in the area today. " . ~ 1:. @ 1. St. I h/lfT/It·/ {di¡if", C!assífieds ... _,_._IIUNwno____ ," , c c "",", ',',r:w' .", ¡. ~:-",..: R}g·"l..·. (~.'ìli'1rn"nit)o· C;¡,Jond,1I# OlHtU.UJl'¡';' II 1\'0 physio at oospital : MPP blasts cut I CroislD' will go on I Maya' set to hobnob with Tory hopefuls II Tuesday, January 15, 2002 g PLACE YOUR T·J CLASSIFIED ADS ONUNE! VISA f N.,". .~'''~: .:: .'1; ·.i""~" ,.'}¡¡ \·f~.-: (~. l\!..~>tN':'':'Hl! to PdV_"._~:~ur c!assituJd ~i.ds :_¡ft.1I...ea_.....aõU'llí_ No physio at hospitsl By Marg Berry Timcs-JOIImal Staff When Grant Briuon went for his physiotherapy treabnent at St. Thomas-Elgin General Hospital Wednesday, some hospital staff were in tears. Brillon. of St. Thomas. said his appointment had been put off to a later time in the day to make way for a staff meeting al STEGH. At his treatment session he learned his physiotherapy sessions would not be avai1able, starting in October. "That's quilC a jolt, .. Brillon said. "There's a lot of sadness out there. And it's all being done to save $400.000. That's peanuts in a place like thai." Paul Collins. hospital CEO. confinned there will be layoffs as the hospital wiU no longer proviœ some O\!tpoUe!!' rehabilitation servicc.', including physiotherzpy, audiology. oœupationaJ th".",py, eh~y and s~h language pathology, From 12 to 15 people, including professionals. clerical staff, 1Tk'ID"!S~rnen¡!lJld aide-s ",m re laid off a.s a result of the cui, which takes effect Oct L Some oUlpatienl rehab services wiU be maintained relating to recovery from hospital stays involving surgery or slroke. to ensure a smooth tramition from hospital to home. Inpatients will continue to receive rehab services as part of their hospital care. The therapeutic pool program will continue 10 operate under the volunteer program until a partnership with an outside agency can be established. Coliins said oUlpatients who have been receiving the rehab care have had their treattnents paid for directly from the hospital budget. They will now have to go to private providers in the commm1iry. One clinic in London provides rehab services paid for under the Ontario Health Insurance Program (OHIP). Waiting time to get treatment at this facility can be as loog as a year. Some private insurance plans cover the cost of these services. Otherwise the patient will have to pay. ", regret OHIP coverage is nOI there for them." said Collins. Collins said he is sympathetic with those who will be laid off, and those who must go elsewhere for treatment. "We are going to be working closely with the private sector, some here and some in London, to see how we can make this a smooth transition for patients and staff.' . . . Thc movc win cut about ¡.500 visits to the hospital for treatment annually and save the hospital about S4OO.ooo. Although Collins regrets thc "pain and slreS.,· caused by the move. he said it is imponam to balance the hospital budgct and cnsure the continuation of core services into the future. Current deficit for the year ending March 3 ¡ is projected at $ 1.9 miUion. The provincial health ministry is working with the bospital to balance the budget. "Thc board of govcmors has committed to achieving a balanced budget in 2003/2004." Collins saià. The !oc.a\ hospital is not a pioneer in this type of cut. as it is being done at other hospitals. "Wc'rc trying to rcspond to realities. We need to identify how to preserve this hospital into the future. Strengthening core servicc,s involves making choices. These choices were not made lightly." STRONG BASICS Collins said it will be cvcn more impottant to have strong basic service at the hospital as London hospitals lean ¡¡::;~ toward te¡u:hing in the future. "It is impor'..ai.; ;" strengthen and grow core services for people in this CO'DIDunity: Thcphysiotherapy dcpar'_'01ent. çç:npleted in 1990. will not close, but some of the space may be used differently in (he future. as detennined by the hospital ma.ster plan. . One position will be lost in housekeeping as pan of the internal changes. Also. the sleep laboratory will be expanded by one bed. for those suffering from sleep apnea, and this move will gencrale more provincial funding for the hospital. Parking rates will increase from S2 to $3. starting April I, to bring in about $80.000 annually in additional revenue. The rate increase will not impact employees. Collins said four or five stationary engineers at the hospital will be impacted by the installation of an unguarded boiler plant. which will not need 24-hour supervision. The ministry of health is funding half of the capital cost for this heating servicc upgrade, which will result in an annual operating cost saving of about $250.000. ~. Info......_ ror RoeII.1S: 11 Hdp _Ibis stte 11 AhoaI. Us II LeIter to the ecIIt<tr II General Wonnotloa II Site r_1I Site h4-'FAQ IIAroto -.. GoIIft'Y y Ir.i'om..doo i.... Ad~~:-;; ~fM~ ~:!! Su_ dqptà _....." Print Ad...rtIoiD&" eom.u .-. " ¡ fl- @ fiSt. I /1I/('n:/'I FdilÙ", Classifieds M. ftMaM, 0Meri0. CMMe. (liWJ Ua-21II .~ (1:19) ........., ,., . .¡",,"', '". ;1' ';_''''''1':' ,'."~,,,.,, R~t~"'''-'' (:"-,'''f''Hmity "C:o,1f'1<nd;>\f" Ohitl"~'¡'~~. II No physio at hospital I MPP blasts rot I Cruìsin' will go on I M.yor set to hobnob wich. Tœy hopefuls n Th~y,January 15. 2002 VIS~ .~~~,~~\,~~~~,,~~,~, ~~~~~~~~d~~o~r~~~~~I ;,t:';'ì.a~,I.._......."'..ml¡- MPP blasts cut By Times-Journal Staff A decision by St. Thomas-Elgin Genera] Hospital to eliminate some outpatient services is another step on a journcy to two-ticr health care in Ontario, Elgin-area Libern1 MPP Steve Peters charged Wednesday. "You don't havc to read between the lines with this announcement," Peters said in a statement. "This is govcrnmenHrnposed, two-tier health care." STEGH said it is turning over a list of outpatient services to the private sector to save $400,000 annually. Pctcrs said the 5t. Thomas hospital's hand i. being forced by "woefully inadequate" provincial funding. And noling thc local cuL, corne shortly aftcr London Realm Sciences Centre announced controversial cuts in its serviccs, Pctcrs also said hc holds littlc hope for cbange after mHng Tories pick a new leader. .. . _ . Thcir track records en heal'-', carc rrov~s they are all moving further down the road to two-tier health care." Sor"~ patienL~ out of luck rcL~ting 10 recovcry from hospital stays involving surgery or stroke, to ensure a smooth uansition from hospital to home. Inpatienls will conlinue to receive rehab rervices a~ part of their hospital care. The therapeutic pool program will continue to operate under the volunteer program until a partnership with an outside agency can be cslablishcd. Collins said outpalienL~ who have been receiving the rehab care have had meir treatments paid for directly from the hospilal budget. They wiU now havc to go to private providers in the community. One clinic in London provides rehab services paid for under the Ontario Health Insurance Program (OHIF). Waiting lime to get treatment at this facility can be as long as a year. Some private insurance plans cover the cost of these services. Otherwise the palient will have to pay. "I regret OHIP covcrngc is not there for them:' said Collins. Collins said he is sympathelic with those who wilJ be laid off, and those who must go elsewhere for treatnrcnt "We arc going to be working closely with the private sector, some here and some in London, to see how wc can makc this a smooth transition for patients and staff." Thc move wi11 cut about 1.500 visiL' to the hospital for treatmenl annually and save the hospital about $400,000. ./ Although Collins regreLs the "pain and stress" caused by the move, he said it is importsnt to balance the hospital budget and ensure the continuation of core services into the future. Current deficit for the year c:nding March 31 is projected at S 1.9 million. The provitJcial health ministry is working with the hospital to balance the budget. "The Þoard of governor.; has commined to achieving a balanced budget in 200312004," Collins said. The local hospital IS not a pioneer in this type of cut, as it is beitJg done at other hospitals. "We're trying to respond to realities. We need to identify how to preserve this hospital into the future. Strengthening core services involves making choice-so These choices were not made lightly." STRONG BASICS Collins said it will be even more important to have strong basic service at the hospital as London hospitals lean more towa.-d teaching in the future. "It is imponant to strengthen a"d,.row core s::rvices for people in !tis community: The physiotherapy department, completed in 1990, wi1! not close, but some of the space may be used differenüy Îõ the l'utu~ as determined by the hospital mast.er plan. One position will be lost in housekeeping as part of the itJtemal changes. Also. the sleep laboratory will be expanded by one bed. for those suffering from sleep apnea, and this move will generate more provincial funding for the hospital. Parking rates will incrca.'>C from $2 to $3. starting April I, to bnng in about $80,000 annually in additional revenue. The rate increase will not impact employees. Collins <;sid foor or five stationary engineers at the hospital will be impacted by the installation of an unguarded boiter plant, which will not need 24-hour supervision. The ministry of health is funding half of the capital cost for this heating service upgrade, which will result in an annual operating cost saving of about 5250,000. D<p8rtmmts: Iofonnotloa for Rade"" 11 Help with 1Iùs....1I Abo" Us 11 r-rto the ecIIIorB Gene..1 Inronnotloø 11 SIte feed_II SiW helplFAQ II A....PhŒo G.hryH Inf'ormldiœ for Ad:~rdsen: II Media KIt 11 s.._di&ltà _ II '!'rl:ii Ad...~ II c-<:ods ~ . .., J/I ... _._.~{IJ.I_ano_{In¡U1'_ tiO£;lt !'to......... ~P()1"h Cùhmw!o (;orntTIOllt J j $mit-il' 8n:OrHI.,.. COmmu.JIit)f Caten., Obituari.s :; LI~'lal ¡t!~d-=I ;¡IS~t5 Çl~ I A hot time for an ¡ Southwold backina book ¡ Bus worries in DuttonlDunwich n Tuesday. January 15. = V/~1.) !~~~,~~~~'!:~a ~~~~~~,~~~:,. Liberal leader visits city By Ian McCallum Times-Journ&! 5taff "What we've got here is privatization by stealth." Ontario Liberal leader Dalton McGuinty didn't mince his words Thursday afternoon as he met with an angry group of staff and out-care patients affected by service cuts announced Wednesday at 5t. Thomas-Elgin General Hospital. About 30 people, including mothers with young children, crowded into the tiny office of Elgin-Middlesex-London Liberal MPP Steve Peters to voice their frustration with the axing of physiotherapy and audiology services at the hospital in an effort to balance its budget. The cuts come at a time when these same services are being de-listed from OHIP. "Why is it the government can find $2.2 billion for tax breaks for the large corporations" questioned McGuinty, "but we can't find the small amount of money necessary to support these essential services for families right here in 5t. Thomas and Elgin county?" "More than 37,000 patients go th'<:Iugh rehab in a year," notad Donna Moore, ~ St. Thomas elementary :;chool teacher. "and now where are they supposed to go, to Tillsonburg or London. What happen" to these people. Be a number... get in line." Lines that are getting increasingly longer, charged McGuinty. "For a youl'gster with a hearing impairment, the waiting list in London, Ont., is six months They're not awaiting for us with open arms and all kinds of room. If we don't deliver these essential health services in this community then we're not meeting our responsibilities to the families in this community." Deborah Brittain, a physiotherapist at the hospital, questioned the real valuè of the savings that will be realized as a result of the cuts. "When we were told about the cuts (Wednesday) we were given a figure of $400,000 in savings. But when they make these cuts what is it really costing us?" "This is gomg to have a ripple effect," McGuinty warned, "far beyond the families immediately affected. You make it jess attractive for doctors in the community. You're making it less attractive to drawing students into residency programs at the University of Western Ontario medical school." AuOiologist Dam Pfingslgraef was at a loss to explain where people would go for these services. "The'e ;s no other audiology service in Elgin county. Where are people supposed to go?" · "~C'Ii; In June of last year during question period: McGuinty recounted, -I put a question to the minister of health about de-listing physiotherapy and audiology services. And he told me. 'Don~ worry, McGuinty, you're just scare-mongering_ These services will always be available in our hospitals.' Thafs what he said to me_" What we are witnessing. noted McGuinty, is "the Tories imposing two-tier health care through the back door." 'ThiS is a disease that seems to be spreading right across the province, beginning right here in ~uthwestern Ontaric_ It would be pure fiction to believe the administration of this hospital was acting in a voluntary manner. They are being forced to make cuts and they're cutting essential services_" Departments: Intormat;on for Re.(l¡ders: II HelD with this site U About U. II Letter to the editor II G~'fleral hlformation II Site feedback II Site helolFAQ 1\ Area Photo Gallerv 1\ Information ror Advertiset"s: fI Media Kit II Submit diaital material!! Print Advertlsina II Contacts Concerned about closures Editor: As a citizen of St. Thomas, I as writing to share my concerns regarding the recent announcement of St. Thomas-Elgin General Hospital CEO Paul Collins relat- ed to the scheduled closure of outpatient re- habilitation services including physiothera- py, audiology, chiropody, occupational therapy, Md speech/language pathology. Ir. fact, I am qui~e s:uprised that there has Ú0t t'etü ¡"pre cove¡,ag~ of this stoiyespe- cîall y ~ven the siyïiñcant 10SS this corrunu;.. nity faces as of O"'"ber of this year. There are tremendous ramifications for all mem- bers of Our'CGiDlllW1iiy; eSpe"ClzL.;.y our large senior population. Given the hospital's M;ssion Statement that states, "We will work together with you and your family to provide quality health care:' I must ques- tion why there were no consultations with the very community impacted by such a move. What other op- tions were explored? Perhaps with the input of the community, the hospital, could become aware of alter- natives not considered, and save our out-patient rehab services. ____ i - / _ _ 7,.}" /1'7Ò/IJ mll;é!{!/!II /v"¿. My fear is for those who require these valuable out- patient services; those who cannot afford the fees of pri- vate services, those who cannot afford the travel to Lon- don, or do not have transportation and those who can- _ not wait, possibly a year, for the few options available in London. Why should anyone have to travel at all? St. Thomas is a com- munity unto itself, and should have these services available, as needed, to all citizens.. not just those with private health mv-erage or who can afford :thé- "additiofta1 t~~s .:,~ health care of this nature. -. Enough is enough. At this point, we should stand up and say to Tony Oement, Minister of Health, that less money should be spent on researching the effectiveness ::,f our health care system, and more should be focussed on health care itself. The two tiered-system is coming, whether by the government, the hospital, or the conservative response of taxpayers to devastating situations like this. It's time to join as a community and find a satisfactory resolution for all. Patricia Kaye-Burge St. Thomas WmOílrÆ . IJ_S - ,.:, ,:-~ The Times-Journal welcomes your letters. . They should be topical and must include your name and signature, address and telephone number. We do not publish addresses or phone numbers, but require them for verification. Please keep letters to a reasonable length. We reserve the right to edit letters for clarity, style, length and legal content.· Please address your letter to: Letter to the Editor, Times-Journal, 16 Hincks Street, St. Thomas, Onto N5R 5Z2. Your letter can also be faxed to U$ at 631-5653. - . I ~rYjD'~i foutQvérc.t7~! ; tæf£~~~~~£~~'E~¡p~~:¡~~~~;-- 1:~~~~t~:~1 .' . . ;=t~~E~t~=r I department will'd~ muchwilhit éÌ>1ptywhíIè pa~ti.r' haTdshi wresídèntS of.St beg futhelþ. KnßWiI1g th~:. ; ~~~~~~~t fu OffiF hemswho- 1¡:;'11:a~T": i:4àil 1 ~:;F!!~;;:,. .Lond~ Qnt; over h95¢W· . t~ot".;u: ~7ys~~~eî§Ift-- . -. :::~a~~~:;~~f:J c~ee W810.;. ..!. \V.'_"-'--_f~ _":'" ./_ '.:."" .._:.,.,,,~.: ':<_.;-_.'.~~-"""-'" -- ~ -- . -.--fT Lit f!1¿rf;Jéf!c:>s f'¿:Íi.1 31í)~ . nospltaI CU?tS$lrvlçes - raising cap ,fftkjþg Parking rate at St. Tho- . outpatient rehàbilitation R~~1';;~~<\rVice~,~' mas-Elgin General Hospital g¡:ams effecti"eOct.9þer . ':Y<~;'" Resaid the changes were is tobnai~edto $3fro.Dl$~~ They iriÇl\l.d~ ." ~,t;;'if1 I:jeeping with a shift in. ::,:;-:;~-çI:!:~èt;mççlf&"'Þ"1':tîl1t~"~PY:. áu~~"", . . .Jâl",,~~itãlC'Cate~Oívardß1!),ving ¡ Paul. CQUins said;QffiCi¡¡IS ther¡Ípy;". 'c~IJP~¡~>a~jii'f~~~ªºjlitatiÐ¡fré~cësí,rilie ¡ ¡ had to cut the hospital's op- speechianguage,pat!iologý.t ptív.¡¡teseéto¡',¡' . ' . erating deficit which he. ex- They will cOnti'nue to'qe'pro- SÚvices would be avail- ~ct~ would reach $1.9- vided to inpatientS as;.þ¡irt or . able m. the. tegiOhii!hrough a mIlhon by the fi,scal year- their hospital c_. .' (;j .,'. variety ofproviQêrS'; end, March 31. This meant In thearinO!IDcemeni',' The. ch!lng~would be r¡,ducing some outpatient board chairman'f-òm CUn~ made gradu~y 'duHng the services. , .' niffê said, "as aC éómmUIiity neiteigbt IilOi!ths. .i.' He said the board of di- hospital we have a mandate Mr. CùnDÍffe said the hos- . rectors examin¡,d'all sery,iceS to provide .primary and sec- pit¡¡! was'· èÒIiunitt¡,d to provided at, the hospital to ondary core services. working wìth patientS; doc-' find as, inany efficiencies '.as _ "These include., surgical, . tors,. agencies aridpiivate possible: · ,without compro- medical, ambulatory c_, sector providerS to' ease the mising,êore serVices. :, . maternal chìld care, complex transition. .' The board announced last continuing c_, rehabilita- Mr. Collins 'said the an" week it would cut several tion arid 2+bout emergency COfmNUED oÑ PÅ<;e 13 coNTiNuEo FROM PAGE 1 pita!.'!iJüi¡ë:ling aridgi:'ounds. ....... tiêÌelt*,s. . nounceq ~Ùts ..... ',V0uld .'not .' :'TI1.eheatin~sysfep1".whiè~. ",.":W;~~" eliiuinatethe <le~cit.". .: ., 'D1u~>be mOn!tor~d 24-'-~purs"tIj~tY¡III.grl\t,.ó,~k . .."CuttingthOse'progTa;ns. dâÌl~.by qualifi7d 'S~ff"lst9inllf':.!I\ilke's<;p?~~{,. . will.·ri:J.e¡m . saVings Of.about· be ¢placed~s. .;Yearby.'~; ;ficl~~~'~I"'Yl.~\,,~,?r~,¿;):,::¡;,,; $4OQ,000." . system. n,0t requmngso 111u(.>I1;, t(),:::,~~e'\~~~¡¡~.~::;.i ;,'ijJ'á . He expected an additional SUI?~fVlSlon... _. .' ,,<·()f,,(.:0I1f"\'~m"\'.-' f9,P- $400,000 to $500,000 in . ':So f:u- we're I()okirigat, ti~l1e'~(),~s;~~t~~I .'~; savings would. be generated s8:V1?gs 10 the range. of $1-:. (On!¡1ri<?J;~.111~~> ~, through changes .'to the hos- mtlhon. As we go along ~e At '" the, ,~est . f':MPP will be looking at all services ..' Stev.e¡;>e~rs; 'W"C~1Iilïs,'!n.et at the hospitàl apd worki"g with} ;P!()~ti$¥;'-.:,;~~ ;. withdepartmerlt . manageJ,'S. lea<ler.);)¡¡l~<?n\'M;~I1-m~t:!~t·. and staff to find more' sàv-' Th,ursdaY'~J1ÏÎÎIt;!íjs.":tOl\!?pf . ings " he said: ' .' Southw~Stêfu'ODiitiÕ;;"'è4; "Òne thing we don't want Mr. ,Cç1liJlS said, that . to cut is Our emergency 're- meeting '¡¡~d ''''more of a' fact , , sources." " finding 1I1oQe" 1ÍS theiLJbew; He said the emergency de- leader sought infomm,ti.oli'1?Il . partment was one of the best reasons for' the, bòard . deei:',' in the province and "if we sion.··.· · t¡)Jiêh~:;th;¡tw~:, ~ill. lose <:,~PJ¡'e~rs sai4::tI:te_I¡,~c:., . (tÎ:¡Îìjj~aëfuergency) physi- pitài deèisiQltwas.. ariother cians," . " eXample of ilièOntiírio gòv- Mr. Çollins said ,hospital emment pushing health carè ¡officials wanted to .improve ,toward~ a two,tiei system. ' : hòspitals~rvice' to help at- He' said 'the ,gôvernment . tract general practitioners to -was Jqrcing hospitals to bal-: Elgin. '.' ,ance" "inadeq~at~'" budgets.. : "We have to find more ef-and·, to!(;Jhe fuje Just to ,stay ", 'afloat," -- , " .. - ---.- .- - "*!F-'!Jv't(f 'Pet,Tg'- -,' , ' '" ,- 1, . ' 2'ë>o'"Þ-:: ,',-' >- 0"" :-'.~. --,:," . . . - - .-' . ,-< ELSI/V}:iWANTS> IFl1løìIÎ~x:-'- "'" iR~~~~~!cifi:¥~'~ 1~a££Qrd{9iPiØvid~øu9?a~l(,'-!"ti, \fo:~,~¡)~~~é,iitOf'¿W~:f~~1~' Ohtariô :bv".de.oliStino' i"""""" $4iJO,ooo'M" i" médici1ts.;fy¡œs {&;;~ ,,'~H~I) -The ,p.<>!IPjtiilj, F~~1t'~tfp~-j~~~~~t~,~ 'tals' has' ",', tOO 'fät:''--'<>nres, thiS year Will rmg ~~~:!!;~:i:gtJp-~'~t;9'~øn4~ë2:' 'Jindêtf.u.rlding' ',ofc;løø1it 1igspi~ ~ ~'-'W.,- icial b114gèti<!ttts WiJi þve . rnegañveäil4urûR~d~- "~~~;£.~~~t~z; W'ùsóh, \j, -vètêràrthOg.; pital.-!x.iâì'4iµ~sai4 pùtpáti~tswP.õ '<;åBh0f a£fof4 ß-¡e t!(jgt of.; píiyate , cliniç ,ì;\ay:f9rgoti:éàt- i 1JÌ9'1C, iiWJ;ncb.hf'Said' ~. <'.' , s. _ peq. I--~~ ; .rÈ!hâI>~'" ¡1Jri~~ ~ . / I,F~;l~!~ . \ .. ..... I r-F .'. 1 .,-:-,:,_:_,,--~,-~--, _ --"_:/'.- : Public üïgt\d to jóip. :' . ElgiI1110$pitalfight' ': : . 'once~~~ee "'cbiefexe~: S' utive òfahospi!ál {~: Thomas" ." :.' ~lgiJ),ßeii~ta1)J1Ìlttingthebi¡~}< i)' ¡ton; l).n.ebèforepatj.eri~.'I'I1E'èlO¡¡""': ' I '. ~ofthe·.ou~tiep.~Physiotlìe~:'·, \.··.~!=J}liæj~.;.i. I"'. Irt. re. tire..·...·..ìn.. e.nt...'fiI...e.,.bav.e....p.re.·.·.....-\.:. 'goodbeWfits, biítÍlßÏJ'e forp" ," I va.t8Physio,'Ihi!.yebaÌlÍ'''· ... : . get pl)'Ysió å't$t."J'hO .... . hi;spitål¥,:my,tiníe'~ ov yeàiS,wit1>,jiety'gó9d . \ I hap¡.m~òÍ\;l1.o'\ftherii:1S· \::æli:~~~i·P., f to $!ìO 1'Visit; sometimes thrêeè:~" timeS,a week¡atàprivatè ".nn!~:; :,' \'.Why'wasaneW'PhY$jjj.~~¥"..:.,,: ;~n;~~~;J~h*~~f¥t~~j·<· \hl~Il~~1~!~.g,; ! ,ElgÜI'ßÓJÌÎítyroï'omp-patj.éllti;: "". " . \ ~~þ~~~e~~)~r( ;,:':' : .. ..' Còn;eOn St:Th()masâIid,'~3' fQ~ .~1,ipnowand~'â\9:> '..} ~1~"!~··.····· ,....:.:~:, 'ò .,', , ._,_,0'"'' ,- :_!.<,¿,:,;-:._:;~:;,,-:~i~'.,.· ~ , EJÄ~:::> ;¿~"'k- - ^*~ !>een~gC - ···..._c· .__ U,"_ " ~.."'----.- ~ - ~ " ~NDC,.) F~EE PIC6$S lUES DAy, Fef3. i9, ol0ð2. Health fight needs all of us There is also a clinic in London, where treatments are coyered by ORIP, although they say the wait is about a year. That's a loug time to go without cleaning your teeth. My "hockey elbow" was not life- threatening. It made doing my job tougher - ever try to type witli one hand? - but I managed. Whether that service should be provided by the hospital can be debated. Just as it is still being deb,lted whether procedures the LHSC is cutting àre necessary. But those who need those ser- H vi~es want to k!1ow what's going eisan older man. He on? We all want to knew. steppéd into an elevator at ï'har:1's no ~~t in taking out St. Thomas-Elgin General Hospital our anger on hospital administra- looking for the office of the man in tors who, mrrch lik: Ontario'. charge. ... school boardS, a.."'e doing the best He's aµgry and he wants they can with ever41iminb:hing answers. He's not alone: resources. Resources we, as tax- Hospital staffers are angry,·o payers, provide. patients are angry. In fact, St. We should get answers from Thomas residents are angry. those we elected to look after our Th!'y've just learned as of Oct. 1, interests ~ politicians. How did their hospital will no longer pro- we come to this state? . vide some outpatient rehab ser- Canadians keep hearing the vices, including physiotherapy, health system they feel helps audiology, occupational therapy, derme what Canada is all about is chiropody' and speech language in crisis, despite more than ample pathology. evidence to the contrary. It seems The hospital says,12 .to 15 peopl", . everyone has his or her own set of· will lose their jobs, but runiours numbers proving it will soon face . persist it will be more like 40. collapse or, conversely, it needs E1giJÌ residents will learn how ouly a little refming. Lomioners felt when the London " One thïn¡i seems certain. Cana- Health sciences Centre decided to: dians can't leave the fate ofmedi-' cut 18 programs in a process they c:µ-e to provincial premiers the çalled "COping, a wonderful word... likes of Ralph }Gêin, Mike Harri,; London aàhii\'1ÌStrators ultimately and Gordon Cr:mpbell. As a bent under a barrage of public reporter onœ said after being told criticism and backed off on seven : his paper's lawyer would also rep~ programs.. . temporarily. ': resent him in the joint defence ofa Losing the St. Thomas services : libel case: "No thanks. He doesn't may not compare to chopping. have my best interests at heart." some of the cutting edge, potential-' The battle over health care is a ly live-saving services facing the battle over big bucks. Your bucks. economic axe in London, but for And it seems, for the most part, many the health-care "crisis". those working on the problem takes on a new, perSonal meaning.: don't have your interests at heart.' Here's what making it personal' It's time to find a way to get means. I once damaged an elbow involved, to try to make a differ- playing hockey (Gordie would ence, just like that small group of have been proud). It was so bad, I determined Londoners. Other- couldn't hold a toothbrush and wise, we could find ourselves like had to make several visits to St. those millions bf Americans who, Thomàs-Elgin's physiotherapy even though the U.S. spends far department, one of the depart- more money on its System than ments being surgically removed Canada, don't have health cover- by a bean cOunter's scalpel age of any kind. . , Treatment, however, will still bè Visit the www.healtchcarecom-. --1, '- ¡H~îí¡ê"~ PMva'te <:µnics . . . for - - - mission.ca Web site to comment to a pnce. This IS what IS known as Roy Romanow's Commission on - - --tw<>-tier-medieine.'I'he kind we --·the-FntunmfiIealtlrearein"Canao- - c. don't have fu Canaèa. da. It's a start. JIM TAYlOR .' J ThatmanOnthéSt.:Thomas . hospital elevat!>!' lias everyi-ight, to be angry. But instead oflookii1Î!) forthe'hospital'sdirectò~;Jre· '. ....; should be l()Qking'fotHarris,KleÏIi CamPbell ;urdJearrChi:etieJI, and,' -'U1Y{)therpolitièianwhô would .... sellÿo\Ù'righttohealth care to the hig~~stbidder'!eaJI:$h°u1d. JŽ1iz1'ayÍOtis afree~.;He 'can berëa¢edontžne a . htwJk@WÍ1Jdc;cmti . I ,,_- . ,'-_:. . -- $]§GH decision quesnQrn'øø Edito~: ~.~.. "~". .~. .' .... . - . What figures and factswrte-~tèd.'tØ_t4~'bóard Wear¢;f(mi..!iI~~lI!pioYe¢s of the tehabilitatio,!de- so that it wu).d ¡;each an ÎI)i;<>llig.,.nttl11b~~ucated partment\lt$t.rl'bpÍ!J1ISE!gin General H~itaU>Ve re- decisioll.? ~ ~ .'. ~. >.; ..... ~. . j me)Ilber:whw:~;,rèsip.ents of St.. Tl1OlfÍ.wElgin Wb.eredidthDi~d~.f;:ctse· "-~~dfi~. .. ~.v·~e··.~~.èoan··mo~e....<~.~. ~~'..·'?/..'.·.Ht. :~^.'" . ~ ¡ oBenedth~h~fÙ\dg'\yesogenerously . ~ . m vv=}¡ayè )p}uHw.n'J <U ~ ì. juSt oVe}:.11.ye~7~..'Th<) goal w QS to re- spe,¡¡k andfu;!~, t() ~Y9nefi6Írl theIÍ\ed~ ¡ pla~ fuè'þl~I.ÌMéJJ11¡i@ Hospital a..Tid to èX-- ical cornmul1Ítýo¡: ~taP9nsemœs? ~ ! PanÇ.therehabwm1ionser,nces. .,. . Døe¡¡.. St.Th~. .Elgm~~~.··a·l""ger ~ ~'. QireftJ1é.laStJJ-.Y~private cit:izeru¡, ~ sl€q> deprivationdiÎlic1 .~f'~.- ~. ~ .. ~ !' groJ-lpS å,ud COI'pØ¡:¡¡tí.oiÏ$ ¥ve continued tp ~ Howma;r.y peoplewiU UJisbe¡1.efitCOlÍl~ í give$eI1er<JU!'lY~\y'~¡¡quipIRent needs. pared to rehabiliiatioll.;ni.d Will the ádded \' ~."W" eÏì...:.:~...'...'..'.·~. ..... ....kse.to.....~......ld...~.y....~ .:. ..~..f:=.tt..::... =. incomebethe~e~iþ¡itgen9l'ate4by.re- æSaryand the.dtiffihs of gt.Thomas-Elginháf:~~~~'1~~v~~~.j·¥¡jjsent .. I"~,,,,,.. .. (11.. ~.9orW.';ID?~~~· ·c....fèSS.,=.···.~}.·d.th..~~...~.·.~~~...On·~. æt.!y1H· œs. ·o·ma~. gt en"p1'ero'~'v~ ~uste... skle\fed .figui'i!fifu·.-prove 'Ò11.é'Sjiojntof - . ~ UtiUU,. .""'~' ".~n . vievy-:Is thatwha.t¥ppened?.'Jj1eSe. .... careáll ~ ! will.thešé~è'~~~ua1ßbe thehexttime questi ns thàt the taXpaY\'1l\S.ånd .5TEGH ~ 1'1heh%Pitþ1~tol"mOhey? ~._: sal. aryl".' ro.. viders..·. ~~to. hå. v~..~.··.·.··ered....·~~.·..~..··.·.·.··..·éd.·.·.;~t.,Iy.: ~"~ ~....~.~.....~...·..e.~. liã"è..·V'.....è...~......~.t..o.....~.ld.......~ that the co.st sa.vm.. .. g.s.' Will be -St, TÞomas-El.gm needS;tospe,*,AI¥~~"$p thiS '$400,OOO.<1¥ear>lÍl\lWùyll to 15 staff will loSe their from .happènjI1g- y~ nev¢r~j£downjlie,road you !j()]j~'It;"f~Ï1I1p1j~(lß:µit~e <;>ut-patieilt seiviçes 'had C.onáll. Y Will ""qµµ:e theæ 5erV1. . ..èê '\fl~Jhw-wo.. lit. be. .?Á()ºVjsits~¡nf,\¢tl'.~ á,re over 40 staffin\Tolved;t1¡e reunlesswe£peakandacthÇ>w.· .,. ~ ~. d'Œ¡¡rtm~t~Â-!JI1!lf¡e'V'Pa.µen~,. ye~ ándha'doyer. ~Ma;ryl\1µSca.t 49,OOOV1slts:¡Ai\~ti"\1tient h¡ldmore aC()tl111teíigttres .~= thanh?§FibÙa~atioIiPlease do no! fu£ult our ~ ~ jp.t¢¡;q~*,yJiJ'lim~~lea¡:1ingfigures'th~' .. .~ "Í<T P¿.~ RID.. v St. 'fhotUaS ~ . Whui1ll~e¡¡~'tionto~er e føllowing . qu~111Jl>~Yn@Id with c¡mdor. ~ ~ Who was involved Îh thedecisiorr?' What is tl'.è re'1l m¡jtiv~Jorélosing ~unit? ... . . w;þa~~et·~J.¡n¡s do th<iylmvein tP.è ~ that",e ! arè:~~d~~l::.rum4atesOf the or~aniza- tiOI}'s mission statement ar><J, Co"" values?' ~ ~. D~ this decision takè !nt0accotiI\t the de¡npgraph- - icsofSt.TÞö~ElßÍI10t'tnJly meet the rieedS of the çi1¡l!'J,t,\,l1}. .-' . ....... .... .' '<~"."'~,; "~'."'~-'-'- -:-,:_-::_- 1'2.,=>0 4-> :;-¿::;; "t:1S~¿~{,·,,;:,~;,:g:~é:i;;"' Í,:'::'; ___ ---":~:,~-> _'-' ~ -. . -~-::';,-,-.. ;. 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A plea to'íetain hospital services :':__ ,', _ Wl}~nlreàd pospital ~xeCutive p"ct .... CoUÎnSlÍad conÎITilleq there will De '.la~Toffs_ã9 ::t. Thp~~s~E;lgin,Ger..er~ HospìµÛ will nq,l?nger provide some Qut-patientrehabilitatiort services~ ",I includingphysiofuerapY',audiology, occupational thet¡¡py, chiropody and speech language pathology, I was in shock such _essëntials~rvices are on the chopping block. .. ASaphysi0tl1~rapydèPat#ehtout- patient, 1 am ag(iinstthe ctósureof this department Staff in all areas fac- ing èuts are dedicated to their· work aI1dpaiiehts. With an older population in St.'Thomas and Elgin County, how will such serVices 'be: provided? \Ma:ny seniors in this,'areaare on fixed incoUles and WQuld not have medical coverage unqer a private con- tractor. 'They can'hITive to Lo¡1don for treatInent,norsh0ul~ they have to ma.Ke îamily ò.GmhP.~s responsi.ble. ~le,€ are thoseonflXeçi irtcuí~C3 whc require. the services of-the phy£'- ~')t.h~rapy. à".lnio10gy,;-)ccüpahonal .. therapy, chiropody ahd speeòh lah: guagè pathology;Whatwj]] they do? It is èàsy tosaylèttheJil'go to pd- vatè èliniCS, bUt unleSs thesccliniCS are. covered by DRIP, many will not ~t7/1/0t?/Y r~-¿r /::}ÜT.s-S S4-/.. /.. /J-/,/1Æ¿ß:¿/ó 2: seek the care they deserve or require. The hospital board of governors wants the hospital to become the b~st in Ontario; HQW do they expect to achieve that when they cut much- needed services? To acbieve their goal they should provide ,all-currentlyavailable_ser- vi~s to all residents -of St. Thomas \ and Elgin. . . 'ThéprOPQsed changes will impact the "recruitment of dOG, tors for the 'city and area. . . , _ '" " What department Will be next on the chopping block? Robert A. Holt 5t. Thomas ~ ~ 4C;''!G'" t;g- ",;.~.<¡~,.:,_"'t....ÿ~,~'-.y"". >-. ~ ::ffif;'~ · .... ;'.:. ,;': c t:::¿'< ;-' t·,-;' ..i-;~~:;;~~f::~{:?) -~';{9;t-/:<:f~::: cr:~~t~ea~~~er:oPha~<t;~~;h[~1~~~:::::·::"~T :.Hiffz;'¥ilii~~ar~::,:,,~~~ , , -- '" w " o " .. I~ I~ I- t" I. , 0 il --- '01 c .- ., .r: , õ 'OJ) '" ~ 1- ~ LI. 3 0 Õ ~ ~ , IIII-------r' .r--rl I ¡ -'I "'::,,__ ;; tß~ ,~ : ,";~_c~~~ .',"_ CI) I 1"'-' I"~ fJ)~~dJ""dtb:>:'6.¡!. ~tí ,.!t¡~g%"iC~ ¡qC~N ~ 11: ê·~16~·~U);... §...r::~o..,~ >'bDõ a ._~ §-<roZ ~ oern ~~.£; 0 -- ¡:s §""Ö ~ ~ >-. tti ~ < Cl) ~ ro §"'[.Q.£ g. '"d Q) <lJ l? ;j E ~ '"d ~ æ Q:; .:l A <J)..o:';",.8..z:i:iÜ u~.,g§o"':å8.:tJ ôjj ~->.:8';?;·¡g.£Suiê1Ô¡..;- ...... v ;;! f-< ~ 15 >, '" '" '" ê.£ =' >, <=: '" > ~ 0 '" .S H gj 2 2 z 111""\ @iii¡ II!III¡¡¡ <: un, u:ß 1! .§ £.5·S æ '" 0 "'.§ -g 6 -;; <I:i J:::r: ê $ g;.,.B "" bJ)2! ~~ -~ 1IIIi¡¡¡¡..L..i '" "'O~H<=: ~"'Ei¡:;",~ o~ <=:~ ~:=; o<=:..o: U "'bJ),", &I&I!I( -;;: g '5'-5'£-,§'&E> ~~'" @"'$ > 0 <=: 1:: o-',.oQ.ij ~i ~- s'"' .Q ..... iJ g61 ~i¡j~~--, U '" ~~] ~5:]:@ :~] gjj&] ¡t,,,, ß"§ ~~;g~ A 0 Ö, ¿ Èb g p~ '1ã ~ 6 ~ ·50 ~ lß ~.s ~ {i "2 2 " 2 -§ ~i1 i¡' ~ ~ G ~ 8 Jj s.9 ~ ~- e w '''''N",,.o'''HO'''~:¡:¡.",.£o"2..o:''''''<=:u,.oo,", """" ~~s H"'''' - II! A iQ :¡:¡:5 i'J "1!,e.Q U :-..0- ~":¡:¡ ., õ 2. 5;) S æ.s I o1š og I ¡¡:; ~'bJ) .B.£ U') ~ . ~ U rtI (]) u......-- ¡.J.. __ V'J..¡...,J oJ::¡._ "J ~ I ' . Ontario Physiotherapy Association Page 1 of4 tog"" I~~ ,~~:!.!~~ l~~l!_~,s. DELIVERING THE MESSAGE: MAINTAINING THE VIABILITY OF PUBLICLY FUNDED HOSPITAL-BASED PHYSIOTHERAPY SERVICES An education document for members of the ..:.:.. . . . , . ~ . . . . . . . . It . . . . . Ontario Physiotherapy Association ©1997 prepared by Ontario Physiotherapy Associailon Introduction This information is designed to assist physiotherapists in presenting arguments and evidence supporting the maintenance of publicly funded physiotherapy services in hospitals, and to effectively communicate the arguments to key members in the local hospital and health care community. Two strategic phases are outlined that will assist in lobbying for the maintenance of services. Phase I Bul/dlng an Alllanæ Phase II Presenilng Your Case Background Hospital restructuring has been so prevalent in the last decade, that it is difficult to think of an institution that hasn't been affected by the process. Ontario hospitals are currently facing a cumulative funding cut of 30 per cent over a three-year period. In some cases, hospitals are closing or merging with other facilities, but in the majority of cases, institutions are restructuring services to better manage dwindling resources. Hospitals are variously dealing with budgetary constraints by downsizing physiotherapy services, by closing entire departments, or by outsourcing the service to an independent contractor. The Canada Health Act requires that publicly funded hospitals provide physiotherapy services when medically necessary, but it doesn·t stipulate what level of service must be provided. The OPA is aware of several hospitals where external independent contractors have taken over the mana ement of in atient and/or out atie h ~a services, with buClãë' uctions of u to nt. IS may e a very a ra Ive option for hospitals that are comml e to maintaining the outpatient service, yet looking for cost efficiencies. A. Building an Alliance Presenting an effective case requires a communications strategy to ensure that your arguments are heard by key people in the community. While gathering evidence to support your case, begin to assemble a network of http://www.opa.on.ca/opalDcqeiohvpMsuxvxarufbfhdYklixexrhooCrjFjhvjnIMnOtuealUxadgm/pages/opaiss _ 2.html 2/8/02 1-' Ontario Physiotherapy Association Page 2 of 4 allies in the hospital, the District Health Council, and in the broader community that will support the maintenance of hospital-based physiotherapy services. How do you identify the gatekeepers In the hospltar? Like many organizations, a hospital is defined by a hierarchial, top-to-bottom structure of authority, responsibility and leadership. This is known as the formal organizational structure. Ultimately, you will want your case heard by the chief administrative officers in the hospital, and the Board of Directors. Before doing this. however, it is vital to identify those people within the hospital and the District Health Council that may support your case. This is called building an alliance. Analyzing referral patterns is a very important element in the networking strategy. Physicians who refer patients to the outpatient clinic are potentially the strongest source of support for the clinic. · Identify specialists and physicians within the hospitai who make referrals to the outpatient clinic. · Obtain a current membership list for the hospital's Board of Directors. · Identify Key people in the District Health Council. · Identify the informalle~è9rship structure within the hospital. Leadership and influence does not always conform to a pos~ion on the organizational chart. Just as in the political realm, considerable influence can be exerted by those not in formal positions of power. It is important to be familiar with the political structure of the hosp~al, to identify the informal power structure. · Identify key donors to the hospital, either businesses or local philanthropists. · Contact the Hospital Foundation, and determine if there is any way fund raising efforts can target rehabilitation services, and how you can help. · Communicate with political representatives at the local, provincial and federal government levels to identify support. B. Presenting the Arguments After establishing a network of support, the next phase is approaching the key decision makers and presenting evidence and arguments that support your case. Effective communication at this stage will be enhanced by using the following guidelines. 1. :Jave/oping a Communication Strat~gy · Match the message to the audience. Although the principles of your case should be communicated consistently across all sectors, different elements of your case can be emphasized depending on the audience. For example, a hospital administrator will be primarily concemed w~h funding issues, while the Board of Directors may look at funding issues in the overall context of care, and the ethical and legal responsibility of the hospital to provide publicly-funded services. A Communications Planning Template is available from the OPA office. · The most effective way to get your message across is through personal communication, preferably in a meeting. In the event this isn't possible, don't hesitate to use other means of communication, such as local newspapers. · Evidence and research are the platform of your presentation. A presentation can be effectively delivered using the F.E.A.R strategy. Facts - Present the facts Evidence - Introduce the evidence Analogies - Use analogies Research - Support with research http://www.opa.on.ca/opa/DcqeiohvpMsuxvxarufbfhdYklixexrhooCdFjhvjnlMnOtuealUxadgm/pages/opaiss _ 2.hnnl 2/8/02 I - . 'Ontário Physiotherapy Association Page 3 of 4 Two generic speeches on physiotherapy and public speaking tips are available. The tip sheet and one generic speech are available on this website. 2. Present the General Arguments Establish the role of phvsiotherapv in the rehabilitation process Emphasize the integral role of physiotherapy in the rehabilitation process. Reinforce the Canada Health Act The Canada Health Act states that hospitals must provide medically necessary physiotherapy services, yet it doesn't establish the level of service that must be provided. The restructuring of outpatient and/or inpatient departments may compromise a hospital's ability to provide physiotherapy services, although some level of delivery would remain intact. Despite the absence of clear guidelines, the Act does entrench the principle of providing medically necessary physiotherapy services, which should be stateå. Report findinos of MoH Phvsiotherapv Review The Phy~iotherapy- Review conducted by a Task Force of the Ministry of Health was never comp!3ted. The did;~ ìeport concluded that Ontario is generally underserviced by publicly funded physiotherapy. Emphasize thet thE: highest per capita rates of service should be considered a minimum benchmark. Lack of alternative publiclv-funded outpatient services The downsizing or closure of outpatient clinics will simply transfer the burden of care to other institutions and the community sector, neither of which is able to absorb a significant increase in caseload at this time. Report limitations of Schedule 5 OHIP clinics -1966 MoH prohibits establishment of new OHIP clinics. - 1993 MoH caps billings to OHIP clinics. Home Care Home care services and outpatient services are usuaily nf)t directly interchangeable. Home care clients ofter. de- not have fu.,cti(\!"::3.! mobility ~o aœess outpatient services, which may be one reason they are being treate~ at hc",e. If a client does attain sufficient mobility, there ar'" ~arriers to accessing publicly-funded outpatient services. Transportation may not be available to access the service, especially ifthe clinic is located in a rural region. While sufficient transportation resources would help to resolve this problem, publicly-funded outpatient waiting lists are often prohibitive, so that the client is faced with returning to the home care sector for needed care. Reducing the level of publicly-funded outpatient services, especially in rural regions, will only intensify these problems. The reduction of publicly funded services will inevitably lead to longer waiting lists at other institutions and clinics, while patients in rural regions may find their only source of outpatient care eliminated. Patients that don't œ.ceive timely access to care may be at greater risk of developing a chronic condition, which inwrn places a greater long [arm Duman on toe neöltll vale "y~tt:llI. .-- Research shows that earl intervention is im 0, nt in oreventin the onset of chronici . The lonQer the wait be ore an r e reater the likelihoo a more resource intensive forms of care will be required, sue as inpatient hospital care or t e home care progra ommum are ccess en res. ---- Discouraae develoDment of two-tier system of care When waiting lists at publicly funded facilities are contrasted with private facilities, where waiting time is much shorter, the development of a two-tiered system of care can be discerned. Although the quality of care at each clinic may be equivalent, patients that endure long waits are at risk of aggravating conditions that could otherwise be treated and prevented through earlier intervention. http://www.opa.on.ca/opa/DcqeiohvpMsuxvxarutbtbdYklixexrhooCljFjhvjnlMnOtuealUxadgmlpages/opaiss _2.html 2/8/02 ·Ontar.û Physioilierapy Association Page 4 of4 3. Present Local evidence Compile utilization data for outpatient service Compile data in the following areas: · Utilization of physiotherapy outpatient service in hospital from year to year. · Determine if the number of full-time equivalents in the outpatient physiotherapy department have been cut over the last several years, and by how much. · Determine if waiting pertods have increased for physiotherapy outpatient services. District Health Council position Examiií€ DHC or HSRC recommendations for rehç;¡.bilitatinn services, and comµc::-e tha~wit:1 t;¡~ evolving situation in the region. COiÎiclusion Hospital restructuring may dictate that some change will occur in the structure and/or administration of rehabilitation services. Some hospitals have outsourced inpatient and/ or outpatient services to private contractors, while other hospitals will be considering this option. If the hospitat does proceed in this direction, physiotherapists within the hospital may wish to respond to with a proposal to manage the service. The OPA has pre cared a companion piece that will assist in responding to restructuring initiatives, which is available on this we site and througn me aSSOciation ull1œ. Web Site Designed & Maintained by Seilu6on. That Produce ¡¡..'IIII$:;;,:"" ¡ :0 i¿;-jf jHitf1' In D taB ..... R1.. I '>.' ,; ",y:¡ ¡t temet · a " ase .leQIUO ogì,es'úf;¡;¡¡ "":"'"f",fi?fJl http://www.opa.on.calopaIDcqeiohvpMsuxvxarutbtbdYklixexrhooCrjFjhvjnlMnOtuealUxadgmJpages/opaiss.2.html 2/8/02 AISI Update: Registration Now Open Facilities and health care providers can now register to use the new AISI. Facilities and health providers offering rehabilitation services to auto accident claimants will soon be required to use the Auto Insurance Standard Invoice (AIS!) for Ontario Health Claims. In order to facilitate use of the new AISI. each individual provider and each facility providing services to auto accident claimants is encouraged to register at www.aisiregistration.on.ca. For Stage I of implementation, registration is voluntary. but will be made mandatory in subsequent stages. We recommend you register now. For detailed information on the new stan- dard invoice form and for ongoing updates, providers can continue to visit the AISI web- site located at www.standardinvoice.on.ca. Following the implemen~ation of the AISI. payments will be made contingent on use of the standard Invoice. Any provider or clinic that bills an Ontario auto insurer for health services and receives the payment directly may register as an AISI Facility. Solo practitioners billing an auto insur· ance company directly for services they provide should register as both a facility and a provider. This registration system is available to: Facilities and solo practitioners billing auto insurance companies directly for services . Regulated health care providers Unregulated health care providers. Many health care practitioners in the regulated professions are being registered automatically through their regulatory Colleges: occupational therapists; physiother· apists: audiologists; massage therapists; and. speech·language pathologists. Members of these professions do not need to register as providers. Their AISI Provider Registration Number is their College registra- tion number. The online registration system is now available. as well as- a paper registration option. For a paper regis[ration form, you may call either (416) 362-9528 or 1-800-387-2880 during business hours and a registration form will be mailed [0 you. Because paper regis[ra- tion may take a week or two. you are advised to use the online system. For additional information concerning the registration process and to download the pdffile for paper registration. please visit the AISI regis- tration homepage at www.aisiregistration.on.ca. OHIP / Schedule 5 Alert The delisting of OHIP coverage for all health-care services that are not covered under the Canada Health Act has been under active consideration by the Ontario government for a number of months. There are two possible scenarios: One is a complete deUsting; the other Is a partial delisting by which physio- therapists' would have a copayment· structure similar to that now applying to chiropractic and podiatry. The debate on delîsting within the gov- ernment continues to go back and forth~ On one side are the fiscal conservatives who see delisting as a small. but important, step in con- taining the escalation of health care expendi- tures and as leverage to force the federal gov- ernment to contribute more funding to provincial bealthcare. On the other side are those who remarked on the reaction to the dellsting of G·467 and audiology and fear the political fallout that would result from further delîsting. The longer a decision. is postponed. the more Ukely it is that delisting will not occu'r. at least not during the current fISCal year. The first hint that delisting was a possibili- ty was the freeze Imposed on the sale ofOHIP licences by the Ministry In February. The OPA received compelling evidence that delisting OHIP Schedule Five was defmhely on the agenda several days before the Budget Statement in early May. Since then we have been doing everything possible to dissuade the government from delisting physiotherapy. or at least to convince the government to put a1temate funding mechanisms in place for community-based physiotherapy before dellst- ing occurs. While we have done our absolute best. our efforts have been somewhat limited by the fact that the Ontaño Physiotherapy Association is not recognized by the Ministry of Health and Long-Term Care as the ·offi- cial" negotiator for purposes of OHIP Schedule Five. The OPA has also investigated - Le~"" .pLvv,~~ ~1 &.."-^-c - f\ \l~V\ b~ ~&10-{~ êØ:.. A... \.- c... some of the Jegal issues unique to OHIP Schedule Five that would be raised by delistlng in order to provide members with that infor- mation and some options for their considera- tion. As the OPA explained in a submission to the Ministry. there are a number of structural problems with OHIP Schedule Five. such as the rapid escalation of billings for nursing home visits and hospltal·based rehabilitation services and the increasing number of OHIP Schedule Five clinics for which the beneficial owners are not physiotherapists. Other organ- izations. such as the Ontario Association of Non- Profit Nursing Homes and Services for Seniors. have wñtten to the Ministry about the quality of service provided to nursing home residents by practitioners billing through OHIP Schedule Five. In bringing forward these structural problems it was hoped that they would be addressed and. In so doing. improve access to publicly funded physiother- apy. In the end. inaction may provide a C(;>o- venient excuse to justify delistlng to the public Accordingly. even if no announcement is made on delisting OHIP Schedule Five. it probably only represents a postponement. not a repñeve. The OPA Is committed to safe- guarding access to publicly-funded physiother- apy across the spectrum of health care. The OPA will continue to try to address the struc· tural problems that persist with OHIP Schedule Five. We must also plan for the day when OHIP Schedule Five Is either delisted. or fundamentally altered. The OPA will con- tinue to be proactive in developing alternate models for publicly-funded, community-based physiotherapy to present to the decision mak- ers at the appropñate time. Should delistlng be announced. the OPA will bnmediately con- vene a meeting with its members who are Schedule Five licensees to discuss alternate courses of action. The Students' Perspective By: Amee Mehta PT II. Scott Deluca PT II and Carla Simon PT III Surveys, student packages, Find a Physio updates. surveys. mailings. new member recruitment surveys. database updates. surveys, marketing and web site promotion. Did we mention surveys? This summer has been an interesting one, full of learning and ,excitement. Although we all return to school this fall. we feel as though we have learned much more than theory can explain. Who really knows the difference between the College and the Association? Now - we can proudly say conûnued on page 8 I /.0.'i(~t !2ßC( PHYSIOTHERAPY TOday Issues Update 1. Sept. 11th, the Aftermath The events of September 11th touched many of us personally and professionally. It is hard to imagine the horror and devastation in New York or the profound sense of loss that the families of those who died must feel. CPA sent a letter of condolence and support to our counterparts in the United States and offered assistance through the Canadian Red Cross. We have already seen a significant impact on the world economy and on the Canadian economy. The downturn will have a serious effect on government revenues in Ontario and Canada. While the federal government can operate with a deficit, the Ontario government may not Balanced budget legislation requires the Minister of Finance to ensure that there is no deficit. This will likely impact on all areas of government funding with the potential for significant cuts in health care spending. These cuts will impact on all sectors, hospitals, home care and community. At the same time, the insurance industry has sustained incredible losses. This will impact on their programs in all areas of their business, around the world. There is a poten- tial impact on funding for rehabilitation pro- grams, property arid casualty programs, etc. The economic downturn may cause employ- ers to reconsider many of their benefit pro- grams. All of this will have an impact on our members and the public they serve.' The Board of Directors has identified these as key issues for the short term and will develop strategies to assist members in coping with these changes. 2. WSIB Pilots and Programs The uncomplicated low back injury pilot in the Hamilton area will continue while WSIB analyses the results of the pilot and makes a decision on where to go next with the program. The Work Related Asthma Program is just about ready for testing and the Work Induced Hearing loss Program development is underway. Fee models that better reflect the real market are under development. WSIB has released its expert panel report on chronic pain. That report will provide the foundation for the development of a Chronic Pain Program of Care to begin development within the next month. We need members interested in this area to participate in a review group. They should have an interest in, a~d working knowledge of, chronic pain management, have access to e-mail and the ability to access attachments in Word, and be willing to provide feedback within 3 days of receipt of a document. If you fit this descrip- tion please contact Signe Holstein bye-mail at sholstein@opa.on.ca. 3. OHIP Schedule 5 In the Spring, OPA began to hear rumours that the government was considering de·\ist- ing all health care providers not included in the Canada Health Act. While physiotherapy is included in the CHA, it is limited to servic- es provided to in and outpatients in hospitals. If the government follows through on these plans chiropractic, optometry, physiotherapy and podiatry would lose their OHIP funding in the community. OPA has been actively lobby- ing government to retain funding for physio- therapy and/or to provide a transition period to some other form of public funding which would ensure needed services are provided. While we have had some success in delaying the process, a serious budget shortfall for the Ontario Government would virtually guaran- tee de.listing. A meeting was held with Schedule 5 owners who are members of OPA to outline the situation and suggest some options for them. We will continue to meet with decision makers in the government to try to influence the outcome. A summary of the meeting has been posted on the OPA website. 4.Auto Insurance Standard Invoice The Insurance Bureau of Canada UBC) Ontario Division has been working on the development of a standard invoice which will allow for streamlined claims management and payment of invoices. In addition, it will collect information on diagnoses and treatment fund- ed by the auto insurers. Many of the provider groups, including physiotherapy, have sup- ported the development of a standard invoice which would lead to the development of elec· tronic billing and streamlined management and payment. The principles of concern to us were that the form be simple, any coding reflect a nationally acceptable standard, that data collected be shared with the provider groups to assist them in developing best prac· tice guidelines and in negotiations and that the data be provided in aggregate form. While OPA participated in the development of the AISI, it was frequently in a reactive mode with limited opportunity to affect the directions being taken. The process, while consultative, was not a collaborative one. OPA still sup- ports the concept and will continue to work with IBC and FSCO to try to make this form, and the electronic billing mechanisms more user friendly. OPA will provide educational opportunities and manuals to assist in using the final product. If you want to access the standard invoice and the proposal from IEC to the Financial Services Commission go to www.standardinvoice.on.ca. 5. Review of the Auto Insurance Rate Stability Act The five year review of the Act was com- pleted and recommendations forwarded to the Minister of Finance. The review and recom- mendations are available on the Ministry of Finance website at www.gov.on.calf.in/eng- lish/neweng.htm. OPA will be responding to this review and to the recommendations from the Insurance Bureau of Canada; Of concern to the profession will be protection of the early intervention provision, no dispute provi- sion and increased cost control measures. 6. HPRAC Reviews The Minister of Health and Long Term Care released a number of reports from the Healih Professions Regulation Advisory Council (HPRAC) with consultation responses to be submitted by October 31st. One proposes that Naturopathy become a regulated health pro- fession with a large scope of practice and numerous controlled acts. OPA expressed considerable concerns with this approach. The second report recommends regulati.on of acupuncture and Traditional. Chinese Medicine. OPA did not comment on TeM but strongly recommended that, sinçe acupunc- ture was part of the physiotherapy scope of practice before RHPA, the scope of practice of physiotherapy be expanded to include the controlled act of performing procedures beyond the dermis for the· purposes of acupuncture and that this expansion occur in lock step with the regulation of_ acupuncture and TCM to ensure that physiotherapists do not lose the ability to use acupuncture as one of their treatment modalitie·s. The third document is the five year review of RHPA. This document contains over 60 rec- ommendations. Some - are easily supportable and others are of considerable concern. OPA discussed some of the issues with the College, organized a meeting of the RHPA professions and prepared a response to the Minister. Our focus was on ensuring the rights of members in complaints or disciplinary procedures, pre- serving a reasonable level of confidentiality and supporting administrative efficiencies that did not undermine those areas. Two other reports dealt with quality assur- ance programs and sexual abuse programs. Recommendations from both of these reports are included in the recommendations or the five year review. The above mentioned reports may be found on the HPRAC website at www.hprac.org. Continued on page 7 PHYSIOTHERAPY Today FCLl/ 2ev ( I ,. The Commission Courier Read the Commission's electronic newsletter to stay inforrr.sd regarding our activities. Media Release~ Find links to Commission media releases here. Commissioner's Speeches View highlights and find links to the Commissioner's speeches here. Events Follow the Commissioner FeQuests For Proposals The Commission has identified three areas in which it feels there is a need for new research CommÎssion on the Future of Health Care P.O. Box 160, Station Main Saskatoon, SK, Canada, S7K 3K4 T o!l-F ree: 1-800-793-6161 EVENTS Horne / Newsrcom / Events / Ontario / Comissioner's .¿. Print this paqe Intenm Report: Statement by Roy J. Romanow, Q.C. Event Date: 6 February 2002 STATEMENT BY ROY J. ROMANOW. C.C. COMMISSIONER On the release of the INTERIM REPORT of the COMMISSION ON THE FUTURE OF HEALTH CARE IN CANADA at the National Press Theatre, Ottawa February 6, 2002 Earlier today, the Commission's Interim Report was tabled in the House of Commons. This is an important milestone on the way to the Final Report this November. I want to briefly outline what's in this Report, what isn't, and its purpose and significance. Focus and Intent In the first instance, the Report summarizes our activities to date: how we've organized ourselves, our rules of engagement, what we've done to explore and frame key issues, who we've heard from so far, and most importantly, the path ahead. In the second instance, the Report is intended to serve as a broad framework for our consultations with Canadians on the future of their health care system and the choices they must ronfront. I deliberately use the word choices. My mandate is to provide advice on how to sustain Medicare and this will require choices on renewal. Our purpose must be to ensure future generations can continue to access quality care in a timely way on the basis of need. Our focus is on tomorrow: Medicare for future generations. But today's realities cannot and will not be ignored. Medicare exists because there was. and there remains, a consensus among Canadians that a pubficly funded, universal health care system makes both social and economic sense. But this consensus, our con1klence that we have the creative genius and collective will to preserve the system, is being tested. If the test is to be met, this collective will, will be an essential ingredient to the modemization of Medicare. The social arguments for health care are not În question. Canadians have continually expressed strong support for the underlying principles of our system. Poll after poll, process after process, debate after debate confirms this. The overwhelming majority of Canadians- and all of Canada's provincial and territorial govemments- agree on a few basic things: 1. All Canadians should have reasonable access to quality care regardless of income or where they reside. 2. Individuals should not have to choose between bankruptcy and obtaining necessary health care services. With the proliferation of new treatment options and promising drug therapies falling outside the CHA, this is a crucially significant issue. 3. Any reforms to the s,o;em must not negaiJvel;< impact the poor or vulnerable~ 4. There is an important and c:y';>ðing role for Ao~mm..i1t In health care. This is a strong foundation on which to build. It should thus come as no surprise to anyone that it is almost impossible to find anyone advocating that Canada abandon Medicare, or move to a US-based system. Indeed, the economic case for Medicare is strong. It not only benefits Canadians. it confers on Canadian businesses important comparative advantages. A healthy population is an invaluable component of our competitiveness. But the economic arguments for Medicare are being questioned. This is especially so in regard to its long-term sustainability. Many Canadians-and certainly all govemments- are quite rightly concemed about the pressures on Medicare in light of demographic and technological changes, growing demands on the system, changing expectations and better insights a$lo ...'he! works, what doesn't, and what needs to be changed. To be ¡;ure, spendin90n haalm care is forecast to grow. 2:...U dù not accept that we can do nothing to alter these spending 1raJectories, or that the system is somehow on autopilot and that we are powerless to affect needed changes. There are creative initiatives underway in all jurisdictions, and many more to explore, before reaching such a conclusion. Indeed, a key challenge for my Commission will be to try and reconcile the various interpretations of sustainability. Are the pressures on the system the result of the federal govemment not paying its fair share. as some provinces argue? Or are there pressures because Medicare's principles are anachronistic and its operating assumptions administratively and economically untenable? Or are the pressures the result of unrealistic public expectations and anticipated future demand? Each assumption requires a significantly different policy response. Four Schools of Thought Taking account of the health care consensus I referred to earlier, there appear to be four clear schools of thought on how best to address the challenges confronting Medicare. My interim Report summarizes these four approaches and they will be explored with Canadians over the coming months. Each approach has its own compelling rationale and reflects values-based choices. . The f"lfSt approach is more public investment. The system has clear needs, and these should be met through the tax system, either by reallocating spending from other government programs or by raising taxes. o The second approach is more user~y. The system need!¡ money, but as taxes are high enough, this money should be raised through user-fees and co-payments schemes that have the added benefit of gMng individuals an incentive to use the system prudently. . The third approach is to increase private choice. In order to relieve pressure on the public system, Canadians should be able to access health care services from a private sector provider (either for-profit or non-profit), and pay for these out-of-pocket or through private insurance. . The final approach is to reorganize service delivery. The central thesis here is that our health system is fragmented, poorly organized and provides few incentives to focus on health promotion and prevention. By restructuring how care is provided, we can preserve and enhance the system. There are elements in each of these approaches that will clearly resonate with Canadians. But the values-base underpinning each approach is profoundly different. My Final Report will summarize where consensus exists. how these appro;¡t'hes stack up against one or another, and what the values reflected therc;jn mean ;51 terms of the choices before governments. Canadians are mature, realistic. intelligent and fully capable of engaging in debate and mai<i"9 hard decisic:1S. Thay expect leadership, but they want a strong say in how their health system is reformed. Indeed, this is why my Commission's consultation agenda is so ambitious. I want to give Canadians the opportunity to express their views and to think like Canadians. Collaboration, Dispute Resolution and the CHA Issues of governance and leadership also figure prominently in this Report. I believe that the corrosive and long-distance hollering that passes as federal-provincial discourse on health care is a symptom of dysfunctional institutional mechanisms. This Report frames key questions relevant to governance with a view to obtaining input on how to improve collaboration across the health care spectrum. These questions range from identifying new instruments or approaches for constructive engagement, to fostering the greater use of standards. to enhanced information sharing, including electronic patient records. . The Report also outlines the need for public input on a proC85S for either . avoiding or r(¡iioMng disputes over the intef'!M'etetioa of fue Canada Health Act (CHA) and more inclusive mechanism.. :,,; rniilkiò'lg àecbìi(¡~ on key health care issues. In that regard, our Interim Report also seeks input ilnd advice on whether and how to modernjze the CHA, to ensure it remains a beacon that expresses our social solidarity. rather than a lightning rod for discontent. Addressing Top of Mind Issues am acutely aware of the top of mind issues that are eroding Canadians' confidence in their health care system. They are worried about waitlists for emergency rooms, fer diagnostic services and for treatment. They are worried about the supply of health professionals, about access to appropriate care by the right providar and, to the extent possible, within their communities. They are worried about quality of care, about de-listing of services, and about growing out-of-pockets expenses they are being asked to bear for what appear to be medically necessary services. Moreover, they are worried about who is making decisions about what is medically necessary and to what ends. ~ And a growing number of Canadians are concerned about the potential impact of globalization for our publicly administered health care system, and of the failure cf our polilicalleadership to make progress on meeting the unique health needs of our First Nations. Over the coming months. we can and will address these and other issues uSÎng the information from our discussion on values to frame the choices we eventually propose. Conclusion In closing, I would like to hearken back to last ·week's Premier's conference in British Columbia. where Premier Klein suggested all provinces send me their respective health care reports to consider. I welcome this suggestion. Indeed, since Day one, I have affirmed that as primary jurisdiction for the delivery of health care rests with the provinces, my Finat Report would absolutely take account of any relevant health reform or renewal proposals resulting from provincial consultative initiatives. By necessity, both this Interim Report and my Final Report, will deal ;;.ith most issues at the level of governance. - I also want to acknowledge the thoughtful and prescient observation by Premier Harris about the prospect of Canada having not a two-tiered health system. but a ten-tiered one. with each province going its own way- and all of the attendant risks of growing disparities between have and have-not provinces in terms of the level and quality of health care available. I think all provinces implicitty recognize the risks this poses to the ongoing relevance of the CHA. And I believe they also implicitly recognize the potentially divisive risk of "care-$hopping' - of people making decisions about where to reside, now and when they get older and may require more care, based on what services are or aren't listed under different provincial health regimes. A reading of the varÎous provincial health reports that have recently been presented underscores this. Alberta is proposing to go in one direction under Mazankowski; Saskatchewan in another under Fyke. The focus of the reform proposals of New Brunswick's Premier's Advisory Council on Health differ substantially from those suggested by Michel Clair in his report for the Quebec gcvi!mmer.t. ~nJ gO and on. I think this is telling in two ways. First, it puts paid to the notion that the CHA somehow limits innovation and creativity. Every jurisdiction in Canada is experimenting with new 1i\o'Bys of keeping Canadians healthy, and of improving access to effective, quality care when they are not. Second, it underscores the need for a Commission like mine to step back from the fray to see how the pieces of this puzzle will fit together- especially over the longer-term. My sense is that the vast majority of Canadians view Medicare as a defining aspect of their citizenship. They don't identify only with the particular attributes of their provincial health care sYstem. as important as they are; their main connection is with principles and va!ues on which Medicare rests. This Interim Report is designed to rais" questions about key issues in health care and the choi.:"s that flow from them; it does not reach conclusions or make recommendations. Recommendations will be presented in my Final Report and these wi¡ be based on the best research we can muster, and the most compelling evidem:e we can gather. from experts here at home and abroad. And they will absolutely take account of what Canadians say they want and expect from their health care system. ·~w~v.,.hf'!~_lt!!!=ag!C9-'.ll!11i".sion. c,! <, . ,'... ,- t·' ¡ '-ì '··,v't~,·- '_'.':.2_ .!;_:- dt¡:..: .); t:" \t L ~.: .....\...; u...; U<; !:D.D0rtant. ~otlces Francais The coming months will be exciting and challenging on8$. We remain on track for a Fif1at Report in November. Thank-yoÜ. Email this Paqe to If Friend Use this fonm to send this page URl to a friend. Receive the Courier Receive the Health Care Commission Newsletter by Email. HG¡'H / News"¡)Qr; / Evel 'Is / Ontario I Comissioner's Statement Last updated: 7 February 2002 © 2001 Commission on the Future of Health Care in Canada , . IDestination Salt Lake 2002 cock Ill'll' l'm,1il all>rt~ Man Fob 11,2002 - Updated a! 08:03 AM News lGreat2rTorontn!.Bui;;Àess 'Y ~TEn-"ment T. Life" lYleelcly-s' .....News Ontario Canada World Opinion · Editorials Letters Obituaries Editorial Cartoon If you're a typical Canadian, you believe Headlines that medicare needs more money, but Only! taxes should not be raised. You want a universal publicly funded Star health care system, but you'd like the option of paying for medical Columnists treatment if you're in a hurry. You think: medicare should be , Car modernized, as long as services aren't cut, choice isn't res1ricted, ; Cla:eds quality isn't compromised and costs don't rise, , Newinhomes.com In sh ha . . ·b1 b li fs S ·al ort, you ve some mcompati e e e . pecl s , Crash Course , War Against · Terrorism , New Deal for , Cities ; H<:alth , Queen's Jubilee · Walkerton ,. Tragedy Features } Archives ; Babies 2001 " Contests ; Crosswords , Dream Days · Auction · E-mail , · Newsletters , Horoscopes ; Lottery Results ¡. TV Listings Thestar.com > News> Editorials Feb. 9, 2002. 01:00AM g.g Prink.. :.:!::ndIy version ~ M.n this story to a friend Real dialogue needed Roy Romanow's task, over the next nine months, will be to get Canadians to work through their conflicting values and come up with a realistic set of priorities. Tne head of the national coI!'.illÌssion on the future of health c-'lre is confident that a consensus will emerge. But it will take a different kind of public dialogue than Canadians are used to. Romanow's approach to the trade-offs that lie ahead is much more interesting than the bland interim report he released this week. He intends to hold 12 "deliberative dialogues" in different cities. In these sessions, 40 participants, representing a cross-section of the population, will be led through a series of choices to determine which of their values should be the bedrock of medicare. Individuals who wish to go through the same exerdse, will be able to order a workbook from the commission (1-800-793-6161) or download it (http://www.healthcarecommission.ca). At the same time, the commission will hold highly focused policy debates among citizens and experts and on issues such as 1·.···'-.";::::'--.-:<-}:-:o:.>-1 ¡ Get A Oream Pñce! i Weather GTA Canada USA Worlà Seard1 TheStar.coo: ~ Advertising <,-",,' l'lll1;~\ .'iC,hA . i ll_1...· arr0\V "'~... ~~" e%. Searcl.llie Web m byGoogk Inside Stock Qu_ TIci= Name m by Financia1s.com . Thestar.com ~ Subscribe 1 Advertising . Info 1 Special . Sections ~ Retail Promotions > About Us } Help/FAQs ; Privacy Policy > Classroom Connection > StarInt~mships ; Site Map oeDares among cmzens ana expens ana on Issues sucn as phannacare, home care and doctor shortages. Romanow will still hold traditional public hearings in 17 cities and accept written submissions. But, as he told The Star's editorial board, he expects Canadians to think and listen, not just rattle off their own views. In the end, he will have to decide what to recommend and what to reject But Romanow expects to receive some clear and realistic advice by the time he sits down to write his report. He is challenging Canadians to stop dreaming, stop grumbling and get involved in fixing medicare. An enthusiastic response would be the best tonic Canada's ailing health-care system could get. ',. News IGreater TorontolBusinesslSportslEntertainmentlLüelWeekly Sections ?_~~...wæ ,..,...,_...,.,..-....."..,.... .-..".... ,._....-...y, Legal Notice:- Copyright 1996-2002. Toronto Star Newspapers Limited. All rights reserved. Distributi, transmission or republication of any material from www.thestar.comis strictly prohibited without the pJ written permission of Toronto Star Newspapers Limited. For infonnation please contact us or send ema Webmaster@thestar.com. J I For Immediate Release February 7, 2002 Tory government walks away from health care responsibility - McGuinty Restore St. Thomas-Elgin General Hospital funding, Liberal Leader says ST. THOMAS - The Tory government is walking away rrom its responsibility to provide essential health services to working families in St. Thomas and Elgin County, says Ontario Liberal Leader Dalton McGuinty. "We have a responsibility to provide quality health care for everyone, not just a wealthy few," said McGuinty. "How are seniors and workings families supposed to pay for these services?" Services such .as physiotherapy and audiology are being dropped by the hospital due to funding cuts. At the same time, the Tory govemment is delistin~ ~hese services trom OHIP. "The wealthy few can always afford to get the health care they need, but I'm concerned about the working families of S1. Thomas and Elgin," said McGuinty. "The Tory government is walking away from its responsibility to ensure these essential health services are provided." "First the London Health Sciences Centre was battered by this Tory government," said Steve Peters, MPP for Elgin-Middlesex-London. "Now it seems to be the turn of S1. Thomas-Elgin General Hospital. Patients and working families in this community will feel the pain." Sadly, the situation in S1. Thomas and Elgin is an example of what is happening across Ontario, McGuinty said. "The Tories are paying for their corporate tax cut by dismantling our health care system through a double whammy of funding cuts and delisted services," said McGuinty. . "The Tories are imposing two-tier health care through the back door. I believe we have to fIX our health care system by making it more efficient and accessible. In the meantime, funding for St. Thomas-Elgin General Hospital must be restored so it can continue to provide these essential health services." . . -30- For more information please contact: Meghan Lauber Associate Press Secretary Office: (416) 325-3522 Cell: (416) 522-4905 Le 7 février 2002 POUR DIFFUSION IMMÉDIATE Steve Peters Uberal M.P.P. Elgin-Middlesex-London ~ Ootirio . . .' PRESS RELEASE February 06,2002 For Immediate Release Tories methodically destroying health care in Southwestern Ontario St. Thoma.~ _ It doesn't matter whether it's Premier Harris, Eves, Clement, Flaherty, Stockwell or Witmer - Ontario's Tory Government is determined to establish a two-tier health care system in this province, says Elgin-Middlesex-London M.P.P. Steve Peters. This was Peters' reaction to today's news that the St. Thomas-Elgin General Hospital will no longer provide some outpatient services including physiotherapy, audiology, occupational therapy, chiropody and speech language pathology. The move _ (0 take place over an eight-month period - will see these services shifted to private sector agencies in the community. "You don'( havc to read between the lines with this announcement - this is Government imposed two-tier health care," said Peters. "Once again this Government is forcing hospitals to balance their budgets - budgets that were woefully in6dequate in the first place. My Liberal colleagues and I have been warning Health Minister Tony Clement since last year what would happell when services like audiology were deslisted from OHIP and now we see the result. Because of this Government's slavish addict¡on to its zealous cost-cutting philosophy, hospitals have to tow the line just to stay afloat. "Alter watching lhe London Health Sciences Centre being battered by this Tory Government, now it's apparently the turn of the St, Thomas-Elgin General Hospital. Patients, their families and hospital staffers who are slated to lose their jobs wili equally share the pain of removing these services. While this may be the end result of Minister Clement's slash and bum healthcare policies, I ask just where are the other Tory leadership hopefuls and what are they saying? Apparently nothing because their track records on health care prove they are all moving further down the road to two-tier health care." Peters called the Governmcnt" s moves towards two-tier health care a slap in the face to the entire Southwestern region. "Everyone _ patients, families, hospital staff and the general populace all lose," he said. "The attack started at the London Health Sciences Centre and now it's spreading throughout the region." The St. Thomas-Elgin General Hospital- with an emergeney department serving more than 56,000 patients annually - has a staff of more than J .000 employees. -30- For further information please contact: Steve Peters, M.P.P. SnzaDne Va. Bommel Elgin-Middlesex-London Executive Assistant (519) 631-0666 (phone) (519) 631-9478 (fax) Constituency Office: 542 Talbot Street, St. Thomas, Ontario N5f 1C4 Tel: (519) 631-0666 Fax: (519) 631-9478 E-mail: Steve_Peters-MPP-CO@ontla.ola.org ::It . "C tJ !' .. Q. :0. ~ .. ¡ a. .. .. .. o c:: ... ~ :3 :3 -. 3 ! ... õ ~ CD ~ :J 3 c:: :s -. ~ .. .. I ZØ-d tH't:1t w,,_ g.3ii !. a.- a!]1! ~~; à[š !!! s·ft G; =' ;::~ !"1!0 _.<= ;i .. ~!' ",a ..." -." ,,- i!i! ,,¡¡ g.~. ""!!. Æ= ..... ......'" ..." ~ 0> 0" ¡ra- w - õ·... u ¡ä ea- .~ .. ;¡. "0 - ~ ¡¡ ;:;." "" ''-' ¡,¡ ... -0> !! tZ '< - ~ ::. ~ 0.0 ..... il:=i.'"= t ~ 0;:' ,:;. .."'" ~ m:3-' . w I:· ..... =.C Si- w., ..... 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Editorials Letters Obituaries Editorial Cartoo!Î' Ifyou~re atypicalQanaðian,YPJ.1þeli~ve Headlines that medicare needs more money,but Only! taxes should not be raised.; Yòwwânt a universal publicly funded Star health care system. but you'd like the option of paying for medical CQlunmists treaúnent if you're in a hurty. You think medicare should be , Çai-eêrs' modeÌnized, as long as services-aren't cut, choice iSlÏ't restricted, '~~eds quality isn't compromised and oosts don't rise. r N'éwiÌlhomes.com In· sh ha . ·bl be" f: Specials ort, you ve some mcompati e ue s. · Crash Course · War Against TelTOrism · New Deal for Cities , Health , Queen's Jubilee } Walkerton Tragedy Features } Archives } Babies 2001 } Contests , Crosswords · Dream Days Auction E-mail } Newsletters · Horoscopes · Lottery Results · TV Listings ~ PriDterfriendIy versiœ ¡§! Mail this ~;to a-friend Real dialogue needed Roy Romanow's task, over the next nine months, will be to get Canadians to wOIk through their conflicting và1ues and come up with a realistic set of priorities. The head of the national commission on'the future of health care is confident that a consensus will emerge. But it will take a different kind of public dialogue than Qanadians are used to. Romanow's approach to the trade-offs that lie ahead is much more interesting than the bland interim report he released this week. He intends to hold 12 "deliberative dialogues" in different cities. In these sessions, 4Q participants, representing a cross-section of the population, will be led through a series of choices to determine which of their values should be the bedrock of medicare. Individuals who wish to go through the same exercise, will be able to order a workbook from the commission (1-800-793-6161) or download it (htlp://www.healthcarecommission.ca). 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""'" -v ->,~ a: '" ., <C ct ;:E", >-'" "',:¡: , 1 March 26, 2002 5920 Fairview Road, R.R. #4, St. Thomas, Ontario, N5P 3S8 Dear Mr. Cunniffe, Thank you for the letter dated March 14,2002. We appreciate the dilemma faced by the board and the hospital and the difficult decisions that you have had to tackle. We appreciate that you are volunteers and take your responsibility very seriously, however we continue to have many unanswered questions and a strong need to object to this decision. The board has explained that you are reaffirmed your commitment to this decision at your meeting on February 27,2002. Please explain why we could find nothing in the local press regarding this board meeting. Usually there is some sort of coverage. We still feel that publicly funded Rehab services is a very necessary in Elgin County, that all avenues have not been explored, and we must advocate on behalf ofthe chronically disabled and financially disadvantaged that will no longer be able to access these services in this community. Unfortunately our frustration has only grown. The board has stated that this is a funding issue and to contact the Ministry. We did. The Ministry is telling us that this is a board decision and to contact the hospital. Who is responsible and where do we direct our questions and concerns? We are aware of board members that could have a conflict of interest when it came to making this decision. We need reassurance that these members of the board were not involved in either the discussions or in the final decision. You have the difficult task of serving on a board for a community hospital and you are mandated to meet Ministry guidelines plus service the needs ofthe citizens within the community. You also have the difficult task of running a business and a business is ultimately responsible to and must listen to its customers. Your letter stipulates that that you received accurate data about all the services in the hospital but we challenge you to look at how many sources of data were used in arriving at this decision. To make a good sound business decision, one must search out information from as many available avenues and not rely on one source of data. Was the board allowed the opportunity to form a fact-finding committee that could source out data from other hospitals and boards? Did the board members speak to anyone from the Four Counties Health Services-Strathroy or Woodstock hospitals to ask why they remain committed to providing outpatient services? Your letter mentions a trend. Could you share with us where this trend has been? Mr. Collins received a copy of a recent survey of76 Ontario hospitals and the conclusion was that there is no trend to close these services. In fact it tells us that no where has a whole county been deprived of outpatient Rehab. Services. Did the board have an opportunity to talk to any board members from the five affected communities? Who else will this decision impact from outside the community? One group will be the many students from across Canada, but mostly from Western, that accessed Physiotherapy, Occupational Therapy, Speech Language, and Audiology. The university is an excellent resource of information, future staff and talent. Did the board have the opportunity to discuss this with anyone from the university? We could write a whole other letter on the negative economic impact this decision will have on St. Thomas and Elgin County. 2 During our inquiries and search for answers, we too have uncovered a trend. That trend has been to incorporate one large board and administration that runs many small satellite hospitals. Many in the province are doing this and other provinces have done this in order to maintain patient services at the local level and keep costs under control by decreasing the amount of administrative staff required to run the hospital. One argument against this approach is you lose your voice and local representation and you will not have any inpnt into changes that are being implemented in your community hospital. We personally do not remember being part of a needs assessment or being asked what we wanted to happen at our hospital. We do not feel that Elgin County has enjoyed any of the above. This decision will save the hospital money but we are also aware that the hospital will now have to pay $100,000.00 annually because they are no longer providing space for the Tyke Talk programme. The acute injuries and W.S.LB. clinic made money for the last 3 years. What will be the indirect cost to the hospital when hospital staff can no longer access an in house W.S.LB. clinic? Please ask to speak to someone from Occupational Health and Safety and see what the financial impact will be for this organization. Progressive businesses have already noted that this saves them money and have developed their own in-house physio clinic. (Ford and Cami). Your letter mentions that Audiology services has been delisted and funding is a concern. Did not Audiology present a plan with a break-even budget to administration prior to the announcement of this decision? Most businesses that have an area or section of concern consult personnel from that area so that they can be part of the solution and the problem solving process. Rehab was not consulted or given the opportunity to be part of the solution. We note that the emergency and obstetrical services were also considered. The board has members from each of these services available to give them all the necessary information. We can only assume that they were part of the problem solving process. Why was rehab left out but other services were represented? Mr. Monteith presented an excellent idea the other night when he asked if the hospital had thought to contract out the service in the hospital but this was left unanswered. Rehab staff could definitely been part of that solution. We see the phrase "Master Plan". What is the "Master Plan"? Does this include putting ambulatory care in the space vacated by Rehab? We understand that renovations and changes will not require money from the operating budget but from the capital budget- money that the ministry will not approve until the hospital has a balanced budget. This is a wise business decision but after all the dry wall is up and the new rooms filled, will this area not fall under the operating budget? Are we creating yet another programme that we will not be able to maintain in the very near future? How can this be justified to a patient with multiple sclerosis on a disability pension that will no longer access O.H.LP. funded Rehab in her community but her next door neighbour can have his stitches removed in a newly renovated building. As taxpayers, we have difficulty understanding how the hospital can't afford to maintain one programme under the global operating budget but can afford a new one. Ambulatory care will have to be maintained under the global operating budget when it is up and running, will it not? This is a community hospital with a mandate to meet the needs of the community. How was it determined that the community needs an ambulatory care programme? Why weren't we told up front about this programme as it obviously has been part ofthe plan for some time? It has been difficult to get any information about this new programme but from the limited information that we have gathered from discussions with physicians and others, it appears to be meeting the needs of the physicians and not the needs of the 3 community. We are aware ofthe crisis situation in Emergency. When we worked at the hospital, it was a well-known fact that physicians used Emergency to see many patients that could be seen in the commnnity or at their offices. The ministry wanted Emergencies to be used for Emergency care only and that is why walk-in clinics were set up in the community. Appropriate care was to be received at the appropriate level with a decreased cost to the hospital and to health care. Can V.O.N. be utilized as a community resource? Why have they been excluded from the Ambulatory Care planning phase? Why is the board looking at creative solutions after the fact? Why was a plan not in place at the time of the announcement so that the affected patients would be aware of all their options? Are we giving the community caregivers enough time and information to put a plan in place by October 1,2002 so that the patients with coverage and money are taken care of adequately? Did the hospital look at asking the Rehab department staff to come up with a business plan proposal, making themselves independent service providers using the hospital facilities? The hospital had a recent meeting with the community caregivers? Why were some ofthese community caregivers and a representative of Rehabilitation Services excluded? Why did they have to invite themselves? How can any plan be implemented without direct input from the Rehabilitation Department? They are the professionals that best know the patient population that will be affected by this decision and their needs. These people are professionals and their ultimate goal is to see that their patient's needs are met. The individuals that own the private physio clinics in St. Thomas must be looking at the hospital as the goose that laid the golden egg. To have an opportunity to have a W.S.LB. clinic as part of your business portfolio is highly sought over. Friends in the private sector left that meeting more confused and less informed than before. One of the primary roles of all 5 services in Rehab is to assist patients to remain in the community at their highest level of function and not access a hospital bed as frequently. Exactly what does "some of the out-patient services" mean? What % of patients do they represent of the 38,000 visits annually? How many staff will be needed to provide these services? The letter to the Rehab. patients after the initial announcement, mentioned total hips, total knees and strokes. We both saw patients with many other conditions, many ofthem deteriorating conditions. Do these people qualify? Will physicians admit patients to hospital unnecessarily just so they can access Rehab Services? What would be the ramifications if this happens? Will we be using our resources and limited beds, as we should be? Twelve years ago the hospital had 204 acute care beds and 105 chronic beds. According to a recent advertisement we are now a 176-bed facility. How many management staff did the hospital have twelve years ago and how many do they have now? How many management staff is now in place for each patient bed? We realize that we have given you many more questions but we feel that they are legitimate questions that deserve answering. Lastly, we agree with the many press releases and hospital memos that advocate open communication and dialogue with the community and the patients and staff. Imagine what would have happened if the hospital had appealed to the community, the patients, the businesses of Elgin County, the staff of the hospital and the staff in Rehab 8 months ago and told us about the seriousness of this situation and what decisions they were faced with. We could have been one loud voice to the ministry- the ultimate culprit in this dilemma. We would still welcome a public forum. We would like the opportunityeto work with you and to problem solve with you. It would be wonderful to use our energy and time in a positive way and to work with the hospital. Ask the community what it 4 wants and what it can do without. Give them the parameters that they would have to meet. We watch a small group of determined patieuts and we are very impressed at how they have rallied and how professionally they have stated their concerns. There is a tremendous wealth of creativity, resources, ideas and support out in our community and within your own organization iffostered. Much of that support is now angry, confused and hurt and there is a tremendous lack oftrust. How long will it take the community to heal and is it worth $400,000.00? We only need to look back to the initial fundraising for this same building and remember with pride how everyone worked together and how the community rallied behind the hospital. We could do it again if asked. Yours truly, Mary Muscat h.637-7496 w.775-0054 Karen Stuart 631-1913 Cc. Paul Collins Steve Peters M.P.P. Peter Ostojic- Mayor of St. Thomas John Wilson- Warden of Elgin County Ernie Eaves- Leader of the Progressive Conservative Party FROM :STAPLESII8 FAX NO. :519-645-8569 Mar. 24 2002 Ø2:27A1 P2 March 22, 2002 Mr Paul Collins, Presídent & CbiefExecutive Officer, St.Thomas-Elgin General Iiospital, 189 Elm Street, St. Thomas, ON, NSP 3W2 Dear Mr. Col1ins Thc Ontario Physiotherapy Association (OPA) is II voluntary, professional association that represents 4,200 practising physiotherapists and physiotherapy students in Ontario. The OP A is thc provincial braneh of the nationa.! association, the Canadian Physiotherapy Aasoeiation. On February 6, 2002, the OP A office received a Press Release indicating that as of Octobð1' 1, 2002, St. Thomas-Elgin General Hospital (STEGH) will no longer provide somo outpatient Rchabilitation services, including physiotherapy. The Press Release also indicated that "these changes are in keeping with II shift in hospital care toward moving rehabilitation services to the private sector." In follow up to these announcemCTIts our office conducted an electronic survey of members across thc province. The purpose of this survey was to ascertain the number and percentage of Ontario hospitals, who in the last 18 months, have closed, decreased. or limited their outpatient physiotherapy services. A summary ofthe raw data that was returned to the OP A office in response to this survey. is attached. An analysis of the results has been completed and the key findings ftom our perspective are as follows: 1. Only 4 of76. or 5% of hospitals reported that their outpatient services had been closed within the last 18 months. (one site. Hamilton Health Sciences Centre. bas closed 2 of its 4 sites but continues to provide the same level of service at the existing sites). 2. Of the 72 hospitals who had not closed their outpatient PT services, 13 or 18% indicated their outpatient servioes had been reduced or restrieted and 72% indicated their services had not been affected. Of the 13 hospitals who indicated their PT services lmd been reduced or restricted, 5 were due to staffing shQrtages and 5 were duc to restrictions on physicians wìth admission privileges, neither of which represents a true reduction in publicly funded services. Removing these 10 hospitals reduces the number of hospitals who have reduced or climinatcd services due to financial or other reasons to 3 of72 or 4.2%. FROM : STAPLES118 FAX NO. :519-&45-8569 Mar. 24 20Ø2 02:27PM P3 The OP A recognizes the fact that an. increasing number of Îts members are now working in some form of private practice however, the results of our survey and other reliable sources of information would not support the statement in the STEGH press release ofFebro:uy 6, 2002, that outpatient physiotherapy hospital care is being shifted to the privatc sector. We believe that what has actually happened is that there has been a significant shift of those patients with altemative coverage to the private sector. This means that the majority of the patients either being treated in, or on the waiting lists of, hospital outpatient departments have no alternative 8OU{CCS of funding or coverage for their rehabilitation. It is our further understanding that thc decision to significantly reduce the outpatient physiotherapy servÎces offered hy STEGH was made without any form of public input or consideration of how those patients who have no third party insurance or ability to pay a fee witl be able to access physiotherapy services once the hospital based ones are eliminMcd. The OP A strongly urges the Board of Directors and Administration of STEGH to rc-consider its decision around the reduction of the outpatient services. Sincerely, Signe Holstein Executive Director co: Laura Hey, Physiotherapy Coordinator, STEOH FROM :5TAPlE5!18 FAX NO. :519-£45-8569 Mar. 24 2002 02:27PM P4 Ol1fPATlENT PHYSICAl- THERAPY SERICES CLOSURES AND RESTRICTIONS MARCH, 2002 OIP OlP REDUCED OR HOSPITAL CI-OSEO? RESTRICTED? CoMMeNTS CENTRAL TORONTO . Discussions surrounding issues Toronto We<;tem NO NO of third party payers have been Hospital put off Humber River NO NO Regional Hospital , RNerdale Hospital NO NO . Neurorehab hOspital Toronto Rehab NO NO Institute - UnIVersity Centre St. John's NO NO Rehabilitation Hospital Sunnybrook & NO NO Women's College, $unnybrook Site · Referrals only by affiliate<l Sunnybrook & NO YES physicIans Women's College, Women's College Site · Limits due to staffing shortages Sunnybrook & · Only see patients from post- Women's College, NO NO surgery and It is education Orthopedic and mostly Arthcitlc Site Toronto !:ast General NO NO Hospital Bloorview Macmillan NO NO Children's Ceotre Baycfest centre . Physiotherapy serivces on outpatient basis discontinued over a years ago . ~~~ratlent;lls primarily group ro rammlno FROM : STAPLESII8 FAX NO. :519-645-8569 Mar. 24 2ØØ2 02:28PM P5 O/P Ô/P REOUCED OR HOSPITAL CLOSED? RESTItICTED? COMM¡:NTS C~NTRAL TORONTO · Have lost ana posltlQn St. Michael's Hospital NO NO · CurrenUy undergoIng program westpark Healthcara NO NO review and cuts to physlo are Centre always a wony · Only receive referrals from North York General - NO YES orthopedic surgeons In the Bl'3n$on Division hospital Mount Sinai NO NO DURHAM · Do not lake chronic patients Southlake Regional NO NO Health Centre Rouge Valley Health NO NO System lakeridge Health - NO NO Oshawa, ON · Threat of closure b/c of budget .lakerldge Health - NO NO cuts required to meet:zero Port Perry, ON balance budget GEORGIAN BAY · Discussion regarding prlvltization Stevenson Memorial NO NO of OP services Hospital - Alliston Royal Victoria Hospital NO NO HAMI~TON Hamnton Health YES · Two offour hospital outpatient YES physio departments have been Sciences eor¡¡orntion closed, outpaUent services (6 h05pitals include consolidated McMaster, Chedoke, · Priority given from Inpatient total General, Henderson Joint replacement program and Children's · Limited access from community Hospital) for acute orlho and no access for chronic patients · Laroe waltlno lists (un to 1 year) $I. Peter's Hospital NO NO FROM :STAPLE5!!8 FAX NO. :519-645-8569 Mar. 24 2002 02:28PM P6 O/P OfP REDUC¡;O OR HOSPITAL ClOS¡;O? RESTRICTED? COMMI:NTS HAMILTON 51. Joseph's Hospital- NO NO Hamilton Halton Healthcare NO NO Services . In past 6 months have received Joseph Brant NO NO app¡oval to increase OIP Memorial Hospltal- services In response to decrease Buriington, ON in servlœs at CCAC . New building will Increase size of n"lnatient services KAwl\RTHA Haliburton Highlands NO NO Health Services Northumbertand NO NO Health Care Corporation · Maternity leave fcrced OP dept. Campbellfora YES to close and no replacement Memorial Hospital found · Unsure of situation when physic returns Petarborough NO NO Regional Health Centre KrrCHENER-WATiõRL.OO Groves Memorial NO NO District Hospital Palmerston District NO NO Hospital Grey Bruce Regional · Difficulty finding staff sometimes NO NO leads to reslric\lons Health Centre - Owen · Increase in wait list times due to Sound staff decrease (4 pnyslos to 3) South Grey Bruce NO · 1Wo of four sites may close NO physio aspartments unless Health Centre - recruitment is successful Walkertcn FROM :5TAPLESOO FAX NO. : 519-£45-8569 Mar. 24 2= 02:28PM P7 OIP OIP REDUCEP OR I HOSPITAL C\.OSEP? RESTRICTED? COMMENTS KlTcHENER-WATERLOO . Closed August, 2000 51. Joseph's Hospital - YES Brantford . Have been without OP services Guelph General for 3 years Hospital Brantford Genèral NO NO Hospital 51. Mary's General NO NO Hospital - K1tchener · looking to Increasè services Grand RiVer Hospital NO NO · Nauro facility LONDON · Lack of funding for more Woodstock Genera1 NO NO physiotherapists results ina Hospital constant 12 to 16 month waiting list · Increased wait list time, only Four Counties Health NO NO edmit patients within catchment Services - Strathroy, area Rodney, ON · Board of Dlractors remains comm1ted to providing outpatient services NIAGARA Haldimand Memorial NO NO Hospital Niagara on the Lake NO NO West Haldimand NO NO General Hospital Sl Catharines General NO NO Hospital Hotèl Dieu Health NO NO Sciences Hospital FROM :STAPLES118 FAX NO. :519-645-8569 Mar. 24 201'12 02:28PM P8 OIP OJP ReDUCED OR HOSPITAL CLOSeD? RESTRICTeD? COMMENTS NORTHERN ONTARIO Notre Dame Hospital- NO NO Hearst. ON Bingham Memorial NO NO North Bay General NO NO Hospital Smooth Rack Falls NO NO Hospital - Geraldton District NO NO Hospital Weeneebayko General NO NO Hospltal- Moose Factorv Temiskaming Hospital NO NO NORTHWESTERN Thunder Bay Regional NO NO Hospital SI. Joseph's Care NO NO Group - Thunder Bay · Large walt list (70-100 people) McCausland Hospital NO NO Terrace Bay · Outpatient s9fViœs restricted to Lake of the Woods NO YES post-surg, fracture and staff District Hospital - · Others are seen one-time for Kenora home program · Restricted due to lack of staff Sioux Lookout District NO YES · Referrals only for post surg, Health Centre fracture acute Lap and staff Anson General NO NO Hosoital · Short staffed. only one physlo Atikokan General NO YES · Long waiting list and some wSla Hospital patients sent to Thunder Bay · Prforty patients seen are post-op. ortho, acute inìuries, naeds, staff "JM : STAPLESII8 FAX NO. :519-645-8569 Mar. 24 2002 02:28PM P9 OIP O/P REDUCED OR HOSPITAL CJ..OSED? REsTRICTED? COMMENTS OrTAWA · Only admit patients who's Queensway-Carelton NO YES doctors have admItting Hospital priveleges · Refemlls only from doctors with Alexandra Hospital NO YES aåmittins priveleges · Restricted to clients living within a oeonranhÎCal boundarv · Patients with priVate insurance Almonte General NO NO encouraged to use Hospital · Cfinlc Is publicfprtvate Montfort \-ospital - NO NO Ottawa, ON · Increased access due to opening ottawa Hospital NO YES - referrals ecceptad of 4 satellite clinics In community only from MD's affiliated with hospital · Outpatient department closad In Hotel Dleu Hospital - YES YES Feb, due to staff shortages Cornwall · May open If position can be fllIad · Referrals restricted to hospital- based. Deeds Winchester District YES Memorial Hospital Hawkesbul)I General · Only acute patients seen due to NO YES shortage of staff Hospital · Slight increase In services ble of Cornwall General NO NO new hire Hospital · Services remain limited with chronic waitinG list at aOO patients (2 yr. waitinG fist) · ClOSure Is alWavs a concern QUINTE-5T. LAWRaleE Kingston General NO NO · Hospital closed OIP dept. in 1999 Hospital Quinte Healthcare NO NO Corporation - Picton Kemptville District NO NO Hospital 1-. St. Mary's of the Lal<e NO NO Hospital- KIngston. ON FROM : STAPLESOO FAX NO. :519-645-8569 Mar. 24 2002 02:29PM P10 O/P O/P ReDUCED OR HOSPITAL CLOSED? RESTRICTED? COMMENTS SCARaOROUGH · Acute. surgery, live in catchment Markham-Stouffvtlle NO YES area. GP has referring priveleges Hospital are only patients accepted Scarborough Hospital NO NO General and Grace WWfGATE · Have opened outpatient services Credit Valley Hospital NO NO to all patients and walt list has grown unmanageable William Osler Health NO NO Centre Trillium Health Centre NO NO WINDSOR lambton Hospital NO · Dua to slaffing shortages YES Groups Windsor Ragional NO NO · Coming under Increasing pressure to justify why OP dept. Hospital should be kept open Chatham-Kent Health NO · 2 physics have been cut YES · In-patient is priority, making Alliance outpatient wait list longer