Pressure mounts for more answers on Ford government's controversial long-term care bill

The Ford government is facing mounting pressure to clarify how a new piece of health-care legislation could affect Ontario families, since it would allow hospital patients to be moved to a long-term care facility not of their choosing or potentially face hefty daily fees.

The spotlight comes just as the government moved a motion to advance the bill directly to third reading — which means it will not be considered by committee or subject to public hearing at that stage.

Long-term Care Minister Paul Calandra tabled Bill 7 last week. The legislation would give hospitals the authority to temporarily move patients no longer needing acute care into long-term care homes chosen by a placement co-ordinator. Hospitals would be required to make "reasonable efforts" to obtain patient consent, but the text of the bill says it could be done without consent if necessary.

The legislation has come under scrutiny this week from opposition parties and some health-care experts, who have raised concerns about its vague wording and questioned how it could ultimately impact patients and their families.

"The government has provided no clarity. And they are talking about moving people, possibly far away from their families and their support. You know, we're not moving livestock around here, it's not cattle. They are people. They are vulnerable," said interim Liberal Leader John Fraser at Queen's Park this morning.

Fraser and fellow Liberal MPP Dr. Adil Shamji held a news conference to air their own concerns about Bill 7 and encourage the Progressive Conservative government to withdraw the bill as it is written.

"It is actually cruel that the government is being so damn vague. There is no reason for it," Fraser said.

An especially controversial element of the legislation is exactly what steps hospitals could take if patients refuse to be transferred to a long-term care home not of their choosing. The legislation doesn't allow patients to be physically forced to move, but it's not clear what would happen if a patient refuses a transfer.

In an interview with CBC Radio's Metro Morning on Thursday, Dr. Samir Sinha, head of geriatrics at Sinai Health and the University Health Network in Toronto, explained how the current system works.

Patients list several long-term care homes they would consent to move to after they no longer require hospital care, he said. If the patient is accepted into one of those facilities, but cannot be moved right away, the hospital will charge about $62 per day for the interim period, the same co-pay amount the patient would face in long-term care. 

If a patient deemed no longer in need of acute care refuses to move after being accepted to one of their preferred long-term care choices, Sinha continued, a hospital can formally discharge them and bill the uninsured daily rate. This can be $1,500 or more per day.

Unclear from the existing text of the legislation, however, is if a long-term care facility chosen by a placement co-ordinator for a patient then becomes a preferred choice, even if the patient has no interest in going there.

CBC Toronto has reached out the Ministry of Long-term Care for more information.

During a scrum at Queen's Park Wednesday, Calandra endorsed hospitals charging uninsured daily rates to patients who refuse to be transferred to a facility of their choice, saying the beds are needed for others.