On August 31st, 2022, the Government of Ontario passed Bill 7, More Beds Better Care Act, through Provincial Parliament. The past few months have seen an unprecedented shortage in acute care beds in Ontario hospitals, largely due to the shortage of nursing staff. Bill 7 was created as a direct response to this public health crisis. At OBIA, our goal is to be transparent in the face of policy and legislation changes that may have a direct effect on individuals with a brain injury. The More Beds Better Care Act may affect you or someone you know with a brain injury. We have taken this opportunity to break down what the More Beds Better Care Act is, who it affects, and how it can influence brain injury care moving forward.
The More Beds Better Care Act was passed as an effort to free up acute care beds in Ontario hospitals, which are occupied by persons who require an alternative level of care (ALC) but no longer need to receive care in hospital. ALC, in this case, refers to patients in hospital who are waiting to be transferred to a long-term care (LTC) home for which they have been waitlisted. The Bill states that in an attempt to free up acute care beds ALC patients can be temporarily relocated to a home they are not waitlisted for, with or without their consent.¹ The waitlist status of ALC patients who are temporarily relocated to an alternate home will remain unaffected, whether a patient is moved or not will not affect their waitlist status for their preferred home. The Bill on the Legislative Assembly of Ontario states that while ALC patients can be transferred without consent, actions cannot be performed without reasonable efforts to obtain consent.² While the More Beds Better Care Act is new and still being revised, questions have been raised about what will happen if an ALC patient does not give consent to transfer.
The Bill states, under no circumstance, will an ALC patient be physically forced to move to a long-term care home they are not waitlisted for, regardless of their waitlist status.
There are many aspects of the Bill that remain relatively uncertain, with one of the main questions being how far a patient will be moved away from their community. The Minister of Long-Term Care, Paul Calandra, has stated that ALC patients will not be moved further than 70 km from their community in Southern Ontario, and 150 km in Northern Ontario.² Minister Calandra has also stated that the choice of home will be part of an ongoing dialogue between the LTC placement coordinator and patients, family members, and caregivers. This dialogue will include choosing a home that coincides with the patient’s medical needs and accommodation requests and is in line with their linguistic and vocational needs. Another question raised is what will happen if a patient does not consent, or withdraws consent to being transferred. Some concerns have been that patients may be required to pay the uninsured rate of $1,800/day to stay in an acute care bed in the hospital.¹ Premier Doug Ford has stated that under no circumstance should ALC patients pay $1,800/day, but that there may be a billing process should they refuse to be transferred.¹
The More Beds Better Care Act may affect individuals with a brain injury who are waitlisted for a home and are currently in an Ontario hospital receiving acute care. This does not mean that every individual with a brain injury who is waitlisted for a LTC home will be transferred. The Act only applies to ALC patients who are waitlisted for long-term care homes. ALC eligibility requires designation from an attending physician, with proper documentation and protocols to follow.² ALC designation is also subject to the opinion of an attending physician who reasonably believes a patient is eligible for long-term care and would benefit from receiving care outside of a hospital setting.² In the case that a patient or their substitute decision-maker believes an ALC designation is incorrect or inappropriate, the right to a second opinion from an alternate attending physician is protected within the Canadian Patient Rights. If a patient is still in need of acute care in a hospital setting, they will not be designated ALC or transferred.²
We are following this Bill closely, and will continue to inform and update you when necessary. OBIA is working closely with the Ontario Coalition for Aging in Place and is actively in touch with the appropriate government officials concerning legislation that involves individuals with brain injury and the aging population. Together, we have expressed our concerns about Bill 7 to the Minister of Long-Term Care and will continue to speak up for the individuals it may affect. If you would like more information on the More Beds Better Care Act please visit the Legislative Assembly of Ontario website, or call the OBIA Helpline at 1-800-263-5404.
Download a copy of the summary report here.
- The Canadian Press. (2022, August 31). Ontario government passes controversial long-term care bill without public input. CBC News. Retrieved September 2022, from https://www.cbc.ca/news/canada/toronto/bill-7-passes-ontario-long-term-care-1.656812.
- Bill 7, More Beds Better Care Act, 1st Sess, 43rd Parl, Ontario, 2022, from https://www.ola.org/en/legislative-business/bills/parliament-43/session-1/bill-7