08/09/2012

AMO’s 2011 report, Coming of Age: The Municipal Role in Long-Term Care shows that increasing costs, an aging population and increased provincial regulations are making the costs of LTC unsustainable for municipalities. 2012 Backgrounder.
Long-term care homes are designed for people who require 24-hour nursing care and supervision within a secure setting. Each municipality in Ontario is required to establish and maintain a long-term care facility, either directly or jointly with another municipality. The service is provided on a cost-shared basis with the province.

While the provincial government has provided increased funding for long-term care over the last few years, municipal governments are facing increased challenges in meeting this requirement:

  • Increased costs. Municipalities spend $300 million above the long-term care cost-sharing requirement annually. This is part of nearly $1.4 billion municipalities spend on support for the aged. Most municipalities have seen their share of service costs increase over the past 10 years. 
     
  • Increased complexity of health care needs. The population is aging and people are living longer. The result is that the elderly have increasingly complex health care needs. There is growing concern that long-term care beds and senior services have become health services – a provincial responsibility. 
     
  • Increased regulatory requirements. Provincial authorities are rightly striving for greater accountability in long-term care services, but the increased administrative oversights come with a price tag. Municipalities need financial support for these increased costs, as well as recognition that they are already an accountable level of government, and should not be treated the same as private service providers. 
     
  • Sweeping authority of LHINs. Local Health Integration Networks (LHINs) have been granted broad decision-making powers on service integration and funding for municipally operated long-term care homes, including discretion to unilaterally change or terminate funding. As publicly owned and operated facilities, municipal long-term care homes have transparent accountabilities and municipalities question such oversight from an unelected body. 
To deal with these challenges, AMO supports greater municipal flexibility in determining funding for seniors to respond to local needs.  

The Ministry of Health and Long Term Care has organized a sector working group on the next Long Term Care Service Accountability Agreement (LSAA), the funding agreement between LHINs and long-term care homes. The working group includes AMO, the City of Toronto, the Ontario Association of Non Profit Housing and Services for Seniors (OANHSS) and the Ontario Long Term Care Association (OLTCA).

AMO believes municipal governments are in the best position to know what their respective communities are asking for and need. What municipal governments need is the flexibility to invest their tax dollars in the areas of senior services that best suit their residents.