From The Desk of The Executive Director

by Donna MacDonald

I recently attended the joint symposium of the Ontario Community Support Association and the Canadian Research Network for Care in the Community, "Ideas to action - Integrating Community Support Services within Regionalized Models: Innovations and Best Practices from Across Canada".

The main guest speaker was Dr. Marcus Hollander, who is described as "one of Canada's leading experts on home and community care" His presentation was entitled, "Providing Integrated Care and Support for Persons with ongoing care needs: Policy, Evidence and Models of Care". His speech focused on "continuing care" which is a term "to describe integrated models of care delivery for the elderly and persons with disabilities"... and "the term refers to care continuing over time, and across types of services (e.g.: hospital to home care)".

He stated that we need to have policies as "not making a decision is as much a policy choice as making a decision". and " policy is made by people and can be changed by people".

He stated the following summary of evidence from Recent Canadian and International Research regarding the cost-effectiveness of continuing care services:

• "Most of the home care provided as a substitute for residential care is supportive services.
• Home Support can be a cost-effective way to maintain people's independence.
• Home support can prevent admission to hospitals and long term care facilities
• Integrated systems of care delivery appear to make possible cost-effective substitutions of home care for residential care and acute care."

And research in B.C has found that there was "a significant shift of clientele from residential care to home care, while the overall utilization rate remained relatively constant."

In 1994 in B.C. a policy was put in place to cut clients with the lowest care needs from services (house cleaning), a service provided by local Public Health in B.C. Not all Public Health participated and hence they were able to research the effect on clients. In the first year there was no substantial difference in costs to the system. But by the 2 and 3rd year there was a significant decrease in cost to the system for those that were receiving house-cleaning services. Many clients that did not get the service ended up entering into Long-Term Care facilities and the hospital due to lack of a basis support as their health deteriorated at a very rapid rate and hence cost the system significantly more. This study proved that having basic house cleaning enables people to remain in their own homes longer and out of Long-term care facilities and hospitals and costs the system less. Community Care Haliburton County provides such a service.

More information is available at: www.homecarestudy.com www.hollanderanalytical.com

The panel guest speakers for the rest of the day were renown people in their field who presented various models of integration and care in Canada and in Europe and Japan

All speakers provided evidence that there is a time and place for people to enter into hospitals and residential care facilities but... people with services provided by health service providers, such as Community Care Haliburton County, can keep people in their homes longer, which is where they want to be and we do it cost effectively without giving up the quality of service.

The Honourable George Smitherman addressed our breakfast meeting on Wednesday. He stated that community support services are at the centre of a sustainable health system.