Final Report of Levels of Care Expert Panel for Home and Community Care released
In December 2017, the Ministry of Health and Long-Term Care released Thriving At Home: A levels of care framework to improve the quality and consistency of home and community care for Ontarians. This is the final report of the Levels of Care Expert Panel which was asked to:
- Develop and recommend a levels of care framework that would group individuals who need home and community care into care levels based on their functional, clinical, social, cognitive and other needs, and to provide typical examples of individuals at each level, including client profiles and care plans
- Provide advice on eligibility criteria and service ranges for each level of care
- Provide advice on tools to help assign individuals to care levels and allocate services
- Recommend how the levels of care framework will take into account issues related to clinical quality, including how it will use the quality standards developed by Health Quality Ontario
- Provide advice on best practices for assessments and reassessments to inform the development of an assessment policy
- Provide advice on an approach to maximize transparency about the levels of care framework, as well as the consistency and quality of home and community care in Ontario.
Read the report: Thriving at Home
Key elements of the Report and its Recommendations include:
- The Panel was guided in its work by its vision that home and community care would enable people to maximize their independence and thrive in their own homes and communities.
- The proposed Framework is designed to meet the functional needs of adults who require home and community care services for a longer period of time and their caregivers.
- A 7 level framework is proposed based on defined functional needs with proposed total support hours per level proposed.
- Services provided within the context of the proposed Framework include homemaking and personal support.
- Individuals and caregivers would have a Care Coordinator responsible for assessing their needs and priorities, developing a care plan, arrange and coordinate their services and work with other members of the care team.
- Access to rehabilitation, mental health services and other interprofessional services such as occupational therapy are not specifically addressed in the Framework. There is a suggestion that needs for these services would be assessed but be addressed in a broader planning process.
A levels of care framework is intended to be a consistent process of working with individuals and their caregivers to assess their needs, determine their level of care based on those needs, and develop a care plan to meet those needs. A levels of care framework can help ensure greater consistency and transparency in home and community care across the province. A levels of care framework will give everyone – individuals who need services, individuals receiving services, their caregivers and service providers – a better understanding of how people are assessed, and the type and amount of home and community care services they may be eligible to receive.
Proposed Regulation Changes
Subsequent to the release of the Report, the Ministry released a Regulatory Consultation relating to amendments proposed to Ontario Regulation 386/99 – Provision of Community Services which will increase service maximums for homemaking and personal support services and allow for provisions for LHINs to exceed service maximums for these services and nursing services in extraordinary circumstances for clients with complex needs. The consultation deadline is January 30, 2018.
Participate in the regulation consultation here.
Implications for Occupational Therapists
Occupational therapists who work in the home and community care system should read the Expert Panel’s Report as it lends significant insight into directions the Ministry of Health is considering for service provision. Read Thriving at Home.
OSOT is currently reviewing the Levels of Care proposals to provide a response to the Ministry and to contribute to the consultation on proposed regulation changes. Initial review suggests some concern about the lack of attention to access to interprofessional team members such as occupational therapists. While silent on these issues, OSOT has advocated for increased access to OT services for clients being assessed for personal support so as to assure that care needs and orientation of PSWs are built upon principles of enablement and don't simply provide care that promotes dependency. Your input would be valued. Please discuss your thoughts with your colleagues, consider your reactions and share them with OSOT! Please for your comments to Christie Brenchley.