August 01, 2012

Province takes control of home care agency

As published in The Erin Advocate

Reports from health authorities are normally pretty dry, filled with statistics and vague promises of progress. Recent ones surrounding accusations of erratic service at our regional home care agency, however, have taken on a more dramatic tone.

Tension has been high between the Waterloo Wellington Community Care Access Centre (WWCCAC), which coordinates nursing and other in-home care to the sick and elderly, and the Waterloo Wellington Local Health Integration Network (WWLHIN), which provides direction and provincial funding to area hospitals and the WWCCAC.

Here are some excerpts from press releases and public reports, which tell at least the surface highlights of this story.

"WWCCAC announces the departure of (Chief Executive Officer) Kevin Mercer effective Monday, July 16, 2012. The Board of Directors thanks Kevin for his contributions to the organization and extends their best wishes to him as he pursues new opportunities in the future."

Did he resign? Did he get a generous severance package? Is it any of our (the taxpayers') business?

Ministry of Health, July 13, 2012: "Ontario has appointed Brenda Flaherty as supervisor for the Waterloo Wellington Community Care Access Centre to address leadership, governance and operational issues...The appointment comes in response to a recommendation by the Waterloo Wellington Local Health Integration Network Board based on the findings of a recent organizational review and report.

"(She) will work to implement the report’s recommendations and will ensure that CCAC clients in Waterloo Wellington receive quality care, better access and value for their health care dollars. As Supervisor, Ms. Flaherty will report directly to the Minister of Health and Long-Term Care."

Is the minister embarrassed at having to get personally involved in this mess? In February, the ministry refused to intervene, when requested to do so by the WWCCAC.

Minister Deb Matthews: "We take the findings of the organizational review and the recommendation of the LHIN Board very seriously. I have full confidence in Brenda Flaherty’s leadership. She has my full support to make necessary changes that will ensure sound management...”
A WWLHIN Briefing Note, July 4, 2012, says an extra $3 million was given to WWCCAC over the last two years to "accelerate its own transformation". But, "by the end of summer 2011, the WWCCAC started communicating that it would need yet more financial resources to meet service demand, or it would have to reduce services. This was the third consecutive year the WWCAC had sent the same message, at approximately the same time, to the WWLHIN."

There were extensive discussions surrounding a Performance Improvement Plan, but it appears the WWCCAC board was at odds with its own staff and did not have adequate control. The WWLHIN found the WWCCAC reform proposals inadequate and hired an outside consultant to review the matter.
Consultant's Report, June 21, 2012: "The review team concludes that a failure of leadership at the highest levels within the WWCCAC resulted in a degree of organizational disfunction with regard to its role in the larger system in Waterloo Wellington, especially with regard to its formal relationship with the WWLHIN.

"Services restrictions were put in place with virtually no advanced notice to the provider community [nursing companies], and some patients were immediately impacted in terms of their ability to access care. Later, when WWCCAC determined it would end the year in a surplus position, restrictions were lifted and providers were asked to increase volumes...but found it difficult to respond on short notice.

"The Provider Community describes this as a situation that has occurred repeatedly... and they clearly state that it has had a direct impact on patient care, access and ultimately quality. This situation could have been avoided or at least mitigated through more contemporary and thoughtful processes on the part of senior leaders."

The Guelph Mercury reports that CEO Mercer sent a letter to providers, asserting that variations in client care were "well communicated at all appropriate authorities".

Is it too much to expect that the province ensure firm control and fair sharing of health care dollars, and efficient resolution when problems arise? This situation went on far too long, and similar ones probably exist in other parts of the province. There seems to be a culture of entitlement within agencies, which does not serve the public good, and responsibility goes right to the top.

LHINs were created in 2005 to allow local decision-making and improve public accountability. But they've been slammed by Conservatives, such as local MPP Ted Arnott, as another expensive layer of bureaucracy between government and the public. It will be interesting to see if they survive.