Homecare must operate under the principles of the Canada Health Act. Quality must be foremost. In addition to the current government focus on using homecare for post-hospital care, homecare should provide continuing care for persons with disabilities or chronic illnesses (including mental illnesses). Care should provide dignified lives for care recipients and dignified employment for workers in the homecare system.
Homecare must not be a cheap way to replace facility based services, or be used to cut wages or download care to unpaid caregivers. Appropriate home care is a public good, not a commodity bought and sold for profit.
Homecare must be of the highest quality. It must be universal, comprehensive, accessible and provided by not-for-profit organizations. The local bodies providing home care should be democratic organizations with local community governance. They must incorporate diversity.
Homecare should be integrated into the continuum of health care services, and have enforceable, high quality standards. Homecare must be treated equally to the rest of the health care system.
Immediate steps
- Stop competitive bidding. Competitive bidding diverts tremendous resources from care into marketing, administration, profit-taking and redundancy.
- Stop for-profit delivery of homecare by building high quality, community-controlled, integrated, not-for-profit delivery. Eight years of expanded for-profit care has created instability and removed resources from care giving.
- Repeal directives requiring the CCACs to divest direct care and allow CCACs to hire direct care staff. Move to a system where at least 50% of services are provided directly by the CCAC to set a high standard of quality care.
- Establish a granting fund for non-profit agency pilot projects. These pilot projects would provide program innovation and meet specific local community needs that would:
- improve access and services for ethno-cultural and marginalized communities.
- fill service gaps and emerging needs.
- promote health and prevent unnecessary hospitalization or institutionalization.
- Establish terms of employment that are equal to other health sectors (i.e. at the hospital standard). Equitable working conditions must include standardized wages and benefits, pay equity, paid sick leave, pension benefits, employment security and guaranteed hours of work. The continuity of care relies upon a stable workforce, which, in turn, depends upon respectful employment conditions.
- Repeal Bill 130 and restore democratic community governance of homecare services.
- Fund homecare to meet population need for services, including supportive care to allow seniors to age in place and persons with disabilities or chronic illnesses to live in the community.
- Ensure that culturally sensitive services are accessible on an equitable basis.
- Establish clear and enforceable whistle-blower protection for staff and care recipients.
- Establish strong protections of public access to information.
- Establish a clear complaints system and a pro-active evaluation system for homecare under the Long Term Care Ombudsperson.
- Establish a code of respect for homecare, including rights to access democratic, local control of services, rights to dignified working conditions, wage parity with health institutions (i.e. hospitals), job security, and (when necessary) successor rights.
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H:NATIONAL REPSDoug AllanFact Sheets - 2008CUPE Homecare Principles - Jun 11-08.doc