Home-care costs need more monitoring, says AG in new report

The province's auditor general says a decade after the last audit of home-care services in Nova Scotia, the government still doesn't know if the hours charged by providers are accurate.

Overall, Michael Pickup found there are still eight outstanding recommendations from the 2008 audit, all of which were accepted at the time by government.

"This is too much time and I don't think that's acceptable," Pickup said in a video posted on his office's website on Wednesday as part of his latest report.

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Speaking to reporters in Halifax, Pickup said one of his biggest concerns about the lack of checks and balances is that it makes the system susceptible to fraud. He was also "concerned and troubled" by the number of outstanding recommendations from the past audit.

"Those controls have not been fixed yet," he said. "Of course I think we need to be concerned."

Better monitoring needed

The report includes a chapter on managing home-care contracts, something the government spends about $140 million a year on. There are 20 providers across the province.

Pickup said the government could be doing a better job monitoring payments to providers and services received, to make sure they meet contract terms.

The government isn't monitoring the complaints process, he said.

The government has accepted all seven of his office's recommendation, including calling for performance indicators for all home-care service providers.

Health authority's role

Pickup also calls on the Department of Health to monitor whether the provincial health authority is meeting responsibilities on the matter.

"Another decade should not pass before these recommendations are complete," he said in the video.

While Pickup found funding for the service is accurately calculated and documented, he noted providers worry there isn't much for travel and continued education and that the health authority is concerned with the approach to funding.

Other checks and balances

Lindsay Peach, vice-president of integrated health and community support for the health authority, told reporters the Health Department does audit home-care providers for standards. While there is work to do, Peach said monitoring includes a financial component and examination of service standards.

"There are actually other checks and balances in place," she said. "I think both organizations had their own processes in place and the other thing this recommendation speaks to is the need to be specific."