Sunday, August 28, 2011

Will CCACs survive the election of a Progressive Conservative government?

Ontario's 14 Community Care Access Centres (CCACs) have come out with a new report just before the provincial election.  They make five recommendations, notably including a plea for their continued existence and a call for better alignment and formalized relationships between public health, primary care, CCACs, and Local Health Integration Networks (LHINs).

The call for recognition of the important role of CCACs is hardly surprising: their sister organizations, LHINs, play a somewhat similar role and they have been sharply attacked, with the Progressive Conservatives damning the LHINs as an ineffective and costly layer of government bureaucracy.  Instead the CCACs insist their role in case management provides a vital "neutral broker" in the health care system, and is not simply another layer of administration.

The call for better alignment and a formal relationship is hardly relevant to the LHIN--CCAC relationship -- the CCACs were already restructured to align with the LHINs and the relationship is pretty darn formal: the LHINs fund the CCACs.  The call for alignment is however relevant to public health -- currently public health is a municipal responsibility and definitely not aligned on a geographic basis with the CCACs or the LHINs.

As the CCACs and LHINs do not correspond with any municipal boundaries, geographic realignment would have a major impact on bargaining unit structure.

Notably, the CCACs don't say a word about the requirement of CCACs to contract out home care services-- the highly controversial system of so-called "competitive bidding" that has been suspended for the last six (almost seven) years due to its many problems.

No one knows if the Liberals or PCs will try to bring compulsory contracting back after the election, so the CCAC silence is interesting.  CUPE and other community groups have called for an end of compulsory contracting out -- something that could see an expanded role for CCAC-like bodies, once the for-profit providers are disposed of.

The five CCAC recommendations are:


  • Continued investment in home and community care as a cost effective strategy that ensures Ontarians receive the right care at the right time in the right place.
  • Better alignment and formalized relationships between primary care, public health, CCACs and Local Health Integration Networks (LHINs) to enable more consistent and effective integrated approaches to chronic disease prevention, management and care across the continuum.
  • Ongoing investment in innovative care delivery that promote a person’s ability to self manage their own illnesses and chronic diseases.
  • Continued recognition of the important role of the CCACs to connect people with health  care services to keep them healthy and independent in the home and community.
  • The rapid implementation and broad application of the Ministry of Health and Long-Term Care’s Excellent Care for All Act to all health care providers.

The report is available by clicking here.

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