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'Top heavy' CCAC needs overhaul, report suggests

The Hay Group interviewed a number of external stakeholders — including staff and management at hospitals and long-term care facilities across northeastern Ontario — who said they perceived the North East CCAC to be “top heavy.
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A report titled "Pushed Out of Hospital, Abandoned at Home: After Twenty Years of Budget Cuts, Ontario’s Health System is Failing Patients," is expected to comment on how Ontario's health care system has failed the elderly. File photo.
The Hay Group interviewed a number of external stakeholders — including staff and management at hospitals and long-term care facilities across northeastern Ontario — who said they perceived the North East CCAC to be “top heavy.”

“While other CCACs have reduced or minimally increased their management and operational support FTEs (full-time equivalents), the NE CCAC has seen the largest growth in this category of staff in the province this year, and for the last three years,” the report said.

“NE CCAC has added new programs that other CCACs have not added, but have not increased the number of patients being served to the same degree that other CCACs in Ontario have.”

Louise Paquette, CEO of the North East LHIN, said the North East CCAC has a lot of room for improvement.

“I think the organization seriously needs to look at their design and how they are organized,” she said.

Last fiscal year, the North East LHIN provided $131 million for the North East CCAC to provide home and community-based health care across the northeast.

That included $11 million in extra funding to address a projected deficit of $12.5 million for the 2013-2014 fiscal year.
“We can't just find excuses,” Paquette said. “$131 million is a lot of money.”

Lloy Schindeler, the North East CCAC's senior director of clinical services, said the organization had to hire more managers than other CCACs to cover the region's vast geographic area. The North East CCAC, she said, covers around 42 per cent of Ontario's landmass.

“Compared some of the smaller geographic areas in the south, where they may only have two or three hospitals to work with, we find there is a large demand by small rural communities for us to have some leaders present,” Schindeler said.

The northeast region includes 25 hospitals — many of them quite small — and hundreds of long-term care facilities, she added.

The report said the North East CCAC has faced growing demand for its services, which has made it more difficult for it to respond to client needs and operate with the financial resources available to it.

“However, our comparisons of changes in demand across all CCACs shows that the pressures faced by the NE CCAC are not unique,” the report continued. “Other CCACs have faced greater demands and have not had increases in costs as significant as the NE CCAC.”

Those cost increases, Schindeler said, have been due in part to a number of new programs the North East CCAC introduced in 2013.

Those included a new telehomecare program, a mental health and addictions program, and a program that brings palliative care services from nurse practitioners certain northern communities.

“Because we're such a geographically huge CCAC, we've had to hire more nurses than some of the other CCACs,” Schindeler said.
Last year, the North East CCAC hired 16 nurses and two managers to cover more remote regions.

To make the changes necessary to meet the report's 16 recommendations, Schindeler said the North East CCAC will need to collaborate more with partners on the field and thinks of northern solutions to connect patients with the care they require.

Richard Joly, the North East CCAC's CEO, and Ron Farrell, chair of its board, will present a detailed plan to address the Hay Group's 16 recommendations to the North East LHIN on Sept. 23.

Jonathan Migneault

About the Author: Jonathan Migneault

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