N.S. home-care system to be redesigned to address complaints, backlog

Senior officials in Nova Scotia's Health Department told an all-party committee Wednesday that home care in the province will be redesigned to place families and clients at the heart of a more flexible system.

Vicki Elliott-Lopez, senior executive director of continuing care, said the process was started before the pandemic, but the virus and its impact have highlighted other changes that need to be made.

"We're ready to start to move to change the way our system operates," she told members of the legislature's public accounts committee.

She and deputy health minister Dr. Kevin Orrell were called before the committee to answer questions about criticism levelled at the department in a November 2017 audit of home-care support contracts by the province's auditor general. 

Outstanding recommendations

Michael Pickup's audit, which was a followup to one done by the auditor general's office a decade earlier, noted the government still didn't know if the hours charged by providers were accurate. Pickup said one of his biggest concerns about the lack of checks and balances was that it made the system susceptible to fraud.

He was also "concerned and troubled" by the number of outstanding recommendations from the previous audit.

On Wednesday, Orrell assured committee members that better tracking measures are in place and that the department is monitoring the performance of companies contracted to provide home-care services.

"The responsibility for home care rests with [the province's health authority] and they have been monitoring their performance since June 2018 in response to the auditor general's recommendations," said Orrell.

Wait times have grown

But he also noted that more people are waiting for those services as a result of the pandemic. Wait times increased by approximately 35 per cent between January 2020 and January of this year, he said. 

Orrell said there were "1,086 clients waiting for about 4,680 hours of home support" as of last month. 

He said the province has been trying to improve the situation since last July through a number of measures, including increasing financial support to those who need care so they can pay for private services, as well as an expansion of adult daycare and respite services.

Elliott-Lopez told the committee the provincial government is looking at redesigning the system rather than continuing to make "ad hoc" changes.

"We're developing a timeline right now," she said. "And so I can't give you a definitive timeline at this time, but it is forthcoming."

Phone line dedicated to complaints

So many Nova Scotians have had problems or concerns about the service that the province set up a phone line dedicated to home-care complaints. Many of those calls have been about lengthy wait times or a shortfall in the services promised.

This week, CBC News reported on Nova Scotia family suing a home-care company for missing two scheduled visits with their 84-year-old father, who spent nearly two days on the floor after a fall at his home in Terence Bay.

Speaking generally about the service, the deputy minister told provincial politicians that the vast majority of those receiving home care are satisfied with the service.

"With 17,000 people that receive home care in the province, there are thousands of people who are extremely happy with it," he said.