Except translation, this story has not been edited by achinews staff and is published from a syndicated feed.
TORONTO – A new Charter challenge that began Monday will test the constitutionality of a controversial Ontario law that allows hospitals to place discharged patients in long-term care homes they don’t choose or face a $400-a-day charge if they refuse.
The Seniors Advocacy Center and the Ontario Health Coalition argue that the law, known as the More Beds Better Care Act or Bill 7, violates the Charter of Rights and Freedoms.
The province disagrees.
One core item that the court will address is whether the new law has achieved its purpose by improving patient flow. Documents filed with the court reveal that the two sides have come to different conclusions on that question.
Premier Doug Ford’s government rammed Bill 7 through the legislature within days in September 2022, avoiding public hearings.
The law allows hospital placement coordinators to select a nursing home for a patient deemed by a physician to require “another level of care,” or ALC, without consent.
They can also share the patient’s health information with such homes without consent. Patients can also be sent to nursing homes up to 70 kilometers from their chosen location in southern Ontario and up to 150 kilometers away in northern Ontario. The law sparked outrage among seniors.
In the fact that it has been filed with the court, the organizations that oppose Bill 7 say that it has not had the intended effect of reducing the number of so-called ALC patients. They point to government data from Ontario Health that shows the number of these patients actually increased by 30 percent more than a year after the law went into effect.
About 2,300 discharged patients were waiting at the hospital for a place in a nursing home at the end of January, according to court documents.
“The evidence contradicts any claim that Bill 7 actually facilitated the transition from hospital for the vast majority of ALC-LTC patients,” the organizations say.
The main reason for the bottleneck is not the patients’ fault, they say.
“The most significant cause of delay in transfer from hospital is the lack of long-term care beds as seen in the very long waiting lists for admissions especially for homes that provide better and more suitable care,” wrote the organizations.
Because the law is ineffective, they argue, it is arbitrary. They say the law should be scrapped.
Ford defended the law on Monday, but lamented the threat of fines.
“I’m never in favor of that,” he said at an unrelated news conference.
He said hospitals need beds and patients being discharged should be in a long-term care home, not a hospital. The hospitals appreciate the new law, he said.
“There’s nobody happier than the CEOs of all the hospitals, I’ve spoken to, and it’s the right thing to do for the elderly,” said Ford.
The Ontario government argues in court documents that the growing number of so-called ALC patients is not proof of the ineffectiveness of the law, but due to a sudden increase in population growth.
The province also points to testimony from several hospital administrators who support the law and say it has increased patient flow.
Trillium Health Partners, which runs two large hospitals in Mississauga, Ont., said the law has helped move 240 ALC patients into nursing homes over a recent three-month period.
“In the absence of Bill 7, I expect that patient flow would decrease, as more acute beds would be occupied by patients who do not require acute care, resulting in more patients waiting for a bed,” Scott Jarrett, Trillium’s chief operating officer, said in an affidavit.
Other hospital leaders cited similar progress.
The Ontario Health Coalition and Advocacy Center also says the law largely targets older people with poor mental and physical health and deprives them of their ability to choose where to live and how their health information is shared.
More than 80 percent of ALC patients are 65 years or older and the vast majority live with incurable conditions that are usually age-related. The law, both organizations argue, interferes with the Charter right to life, liberty and security.
“Bill 7 violates the liberty rights of ALC-LTC patients by depriving them of personal autonomy regarding their medical treatment and health care,” they argue.
“Simply put, Bill 7 clearly deprives ALC-LTC patients of the basic rights to informed consent to where they are likely to spend their final days, and to protect their personal health information.”
What both sides agree on is that there are not enough hospital beds or long-term care in Ontario. While the province is building more hospitals and encouraging the construction of dozens of nursing homes, there is nowhere near enough supply to meet demand, the documents say.
Lawyers for the state say the law is needed to open up beds for patients who need to go into hospital.
“The purpose of a hospital bed is not to act as a waiting area for home (long-term care) admission,” the province said.
Ontario argues that patients do not have a Charter right to live free of charge in a hospital after discharge. The law also does not discriminate on the basis of age or disability, he said.
“Bill 7 does not infringe on anyone’s Charter Rights,” state lawyers wrote.
As of Jan. 31, 2024, there were 2,243 ALC patients waiting for a spot in a nursing home who had spent a total of nearly 200,000 days in hospital beds, the province said.
The Charter does not protect against the sharing of private health information, state lawyers argue, pointing to several other laws that specify how personal health information can be shared, including under court orders.
The province also said the law does not force patients into any particular nursing home. The patient can refuse such placement.
“The consequence for an ALC patient who refuses to leave the hospital despite being discharged is purely economic: they must pay a portion of the cost of the publicly funded hospital bed they have chosen to occupy,” the province said.
The organizations say the threat of a $400-a-day fine is “mandatory,” while the province argues it acts as a “deterrent” to patients in an effort to get them to agree to be moved to a non-chosen home by them. .
Only five people have been charged under the law, the health minister’s office said recently.
The threat of a fine did not deter Ruth Poupard’s family. Michele Campeau, who has power of attorney for her 83-year-old mother, rejected hospital efforts to force Poupard into a long-term care home that Campeau hated in Windsor, Ont.
Hôtel-Dieu Grace Healthcare began charging the family $400 a day and ended up with a $26,000 bill in the spring, which Campeau refused to pay. Poupard became her top choice for a nursing home.
By mid-September, no one had come calling for the money, Campeau said.
“I would encourage others to fight back because in the end, the fight is worth more than putting your loved one in a horrible situation,” Campeau said.
This report was first published by The Canadian Press on September 23, 2024.
(Except translation, this story has not been edited by achinews staff and is published from a syndicated feed.)
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