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Coming of Age:The municipal role in caring

for Ontario’s seniors

NOMA Annual Meeting and ConferenceApril 27, 2011

Petra Wolfbeiss, AMO

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Municipalities and Long Term Care

• 1947-The Homes for the Aged Act

• 1949 designated municipalities required to establish home for the aged

• 2007- Long Term Care Homes Act, requirement to “have a long term care home”

NOMA Annual Meeting and Conference

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What AMO has heard

• Growing concern with municipal requirement

• Desire for greater flexibility

• Principled consideration of municipal role in health services

NOMA Annual Meeting and Conference

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AMO’s Interest in Long Term Care

• Examine the municipal context-issues and pressures

• Local diversity

• Changing context of long term care

NOMA Annual Meeting and Conference

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What we know

• Demographics-aging population

• Supply and demand-long term care as a growth industry

• Municipal issues and cost drivers

NOMA Annual Meeting and Conference

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Demographics• In Canada, 65 and older:

3.9% in 1881 to 8% 1941

• January 2011-baby boomers turn 658.4% in 1956 and 13.6% in 2006

Ontarians over 6513.7% in 2009 to 23.4% by 2036

NOMA Annual Meeting and Conference

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Demographics

• Percent increase in seniors in next 20 years:

86%

• This shift will require a shift in municipal fiscal priorities

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Supply and Demand

• Current waitlist: over 25,000, 5.1% increase over the last year

• Collateral Effects

• More seniors means more beds

NOMA Annual Meeting and Conference

Municipal Issues and Cost Drivers

• Municipal dollar share increasing

• Provincial legislation and initiatives

• Other factors: arbitration, pay equity, local challenges

NOMA Annual Meeting and Conference

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Municipalities Lead

• Innovation

• Contribute over $300,000 million annually

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What are our options?

• Series of reports telling us we have to plan now

• Some municipalities have explored options

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Possible options for consideration

• Fulfill legislative requirements• Change the requirement• Outsource operations but keep

governance• Maintain ownership but outsource

operations and governance• Sell the home and redirect contributions• Transfer beds to non-profit and/or for

profit• Various forms of partnership

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What we also know• Municipalities can no longer support the

province

• Municipalities must be supported by appropriate and sustained funding

• Health care is a provincial responsibility

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What is unclear

Who will fill the void?

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