Controversies about Community Care Access Centres and home care

Shortened hospital lengths of stay, and a growing number of people living with chronic diseases has meant that more Ontarians than ever are receiving health care services in their homes.

In 2010, the Ontario Auditor General raised concerns about the quality and value of home care services, some of which remain outstanding.

Resolving these issues is important because the recently released Drummond Report suggests directing more resources towards home care. 

‘Delores’ is a fictional home care client in Ontario. She is 85 years of age, and lives alone in a bedroom community west of Toronto. She has mild dementia, diabetes, high blood pressure and heart failure. Delores needs help to take her medication and with activities around the home including bathing, meal preparation and grocery shopping. Delores has needed support for many years in order to live independently in her home, and over time has seen many nurses, rehabilitation therapists, personal support workers and other providers come and go. Currently, Delores has providers from four different agencies delivering care, all coordinated through the local Community Care Access Centre.

What kinds of services are delivered by Community Care Access Centres?

The 14 Community Care Access Centres (CCACs) in Ontario coordinate the delivery of a range of services in the home and community including highly complex medical care provided by nurses, rehabilitation services, personal support and homemaking services like food preparation, and community service supports such as transportation.

55% of CCAC clients are aged 65 and above. Although many are the frail elderly, CCAC clients also include those receiving end of life care, children living with chronic diseases or complex disabilities, and those recently discharged from hospital who receive medical treatment or rehabilitation in the community.

Who pays for home care?

Unlike physician services and hospital care, home care is not included in the Canada Health Act. However, in some provinces like Ontario, there is a long history of paying for some forms of home care with public dollars. For example, skilled nursing services and providers have been publicly funded in Ontario for decades. Compared to other provinces, Ontario has a relatively well-resourced home and community care sector.

CCACs received $1.9 billion in funding from the Ministry of Health and Long-Term Care in 2009, with which they served 600,000 Ontarians. However, the demand for home care often outstrips the resources available. In order to balance budgets, CCACs manage the volume of services provided to clients by restricting the number of hours of care per week, or placing patients on wait lists for services. Clients can also purchase additional services from service provider agencies directly.

Who delivers home care?

CCAC staff do virtually all the the care coordination and case management for home care services. But most care – representing more than 70% of CCAC budgets – is provided by external, private sector agencies which can be either for-profit or non-profit.

How are external providers chosen?

Traditionally home care were delivered through a patchwork of for-profit and non-profit agencies and organizations associated with different regions, ethnicities, religions and voluntary groups. When CCAC’s were established in 1997, the government determined that the service provider agencies would compete for contracts to provide home care services through a competitive bidding, or procurement, process. It was felt that the competitive process would lead to the selection of agencies which provided the best value for money. George Smitherman, Ontario’s Minister of Health from 2003 to 2008 says “the theory behind procurement is that the competitive tension can be a pathway to both improve quality and control costs.”

The competitive bidding process, however, has been modified over time. In 2003, motivated by concerns about the quality of home care services, the government froze procurement processes. Procurement was restarted in 2005 following a two-year review with longer terms for providers, and a greater focus on measuring quality of care. However, in 2008 the procurement process was frozen again, after a controversy broke out in Hamilton, Ontario when two large non-profit agencies were disqualified from the competitive bidding process. The procurement process remains frozen today.

Watch an episode of TVO’s The Agenda with Steve Paikin,‘The Cure for Home Care’ to learn more about the Hamilton controversy.

The Auditor General’s report

In 2010, the Auditor General of Ontario conducted a review to assess whether CCACs were meeting home care needs in an equitable, consistent and high quality way across the province.

The major findings of this review were that:

  • Funding to CCACs was based on the financial support they received historically, rather than on the needs of patients in their regions. This had led to substantial variation in the amount of services provided by CCACs across the province.
  • There were major differences in how much providers were paid, with CCACs indicating that they could not obtain the best cost and service value because of the procurement freeze.
  • There was a great deal of variation among CCACs on patient guidelines for services, as well as around how the quality of services and providers was measured.

What has been the response to the Auditor General’s report?

The Auditor General’s report made five recommendations, which included making services delivered across Ontario more consistent, obtaining cost savings from procurement and improving the measurement of quality and performance of CCAC services and providers.

Nevertheless, the procurement freeze put in place in 2008 remains today.

CCACs have been working to improve their ability to measure the quality of home care. Developing quality measures and standardizing data collection is a complex, time consuming undertaking. Margaret Mottershead, CEO of the Ontario Association of CCAC’s says that her organization has been working with Health Quality Ontario on “…testing ways to improve the approach to procuring services.” In addition, Mottershead indicated that “there has been a lot of progress made in the measurement and reporting of quality, beginning before the release of the Auditor’s Report and since, including working with Health Quality Ontario in development of performance indicators and with the LHINs on a common set of indicators based on our service accountability agreements.”

The future of home care in Ontario 

We have heard from a number of health care professionals that the quality and continuity of home care in Ontario is insufficient to meet the needs of some of their patients. They attribute this to the increasing number of patients with complex needs, the lack of an organized care delivery model that allows for routine measurement and reporting on quality, and their perception that increases in funding have not kept pace with the number and complexity of patients being served.

The Minister of Health and Long-Term Care, Deb Matthews, announced Ontario’s Action Plan for Health Care last month, which includes a commitment to provide seniors with “better quality care at home.” Matthews also argues that Ontario’s health care system requires increased efficiency, and a “shift of spending to where we get the highest value.”

The importance of care in the community has been echoed in the Commission on Reform in Ontario’s Public Services, led by Don Drummond, and released on February 15, 2012. While this report suggests reducing funding to many sectors of the health system, it recommends that Ontario “increase the focus on home care, supported by required resources, particularly at the community level”. The Auditor General’s Report and recommendations provides insights about how to improve the value and quality in home care services.

The comments section is closed.

  • Devi says:

    Due to lower bidders getting the contract the outcome is it goes to wrong agencies particularly in home care everything is compromised like:
    • Field staff PSWs are not trained extensively, missing to have high work ethics, no reliability and accountability.
    • The scheduling staff PSW behaves like we have to agreed to anything , they must get rid of some of their non compassionate staff including there administration manager .
    • Not feeling safe and the PSW stories are exaggerated, when called out will LIE and say all kinds of crazy things.
    • They use their position to make our life more miserable or what I call “personal politics” and they are great at that.
    • We afraid, particularly in home care that if raised a complaint, the care will suffer for our loved once.”
    • Complaints founded must be heard. They construe a vital component of the ‘feed-back’ loop that should serve in every healthcare, to drive higher quality service, outcomes, and productivity which is missing with agencies who bid for lowest.
    • When you award a contract before hand you need to check their performance reviews and client care complaints.
    • You also have to validate and make recommendations for change that will make the experience better for other people who are taking services from PSWs.

  • Fed up says:

    Nurses USED TO be able to order sterile disposable dressing trays… oh no…not anymore….too much $$$. Instead, we are going to make the nurses use tap water and put that into a cereal bowl or empty margarine container. And while we are at it, supply them with the most horriffic excuse for tape we can find, but when there is an infection in the community or a complaint, NOPE, NOT OUR FAULT….. BLAME THE NURSE

  • Fed up says:

    LHIN ONLY cares about saving $$$$$$ and they will put patients at risk to do so. Cutting corners so they can then run to their big shots up the food chain and brag about how much $$$ they are saving. Disgraceful. Wanna save $$$? Here’s a thought.. STOP GIVING PAY INCREASES TO THOSE WHO DO OR ACCOMPLISH NOTHING.

  • B J Bodnar says:

    A care agency in Ontario has agreed to provide my elderly mother with 1/4 hour, 7 days a week to remind her to go for dinner or prepare and leave her with a snack. In reality, this is not the case. From my view after speaking to several supervisors, more emails, and spending 3 week’s staying with Mum, there is big communication and reliability problem. During this time, on average, the PSW’s come 3 days out of 7.

    Not living in Ontario, there is much about your health care system I do not know. But, in my opinion, I could not recomment or want their funding increased. Services are very much needed, but an other angency may be able deliver better services.

  • C Sarvian says:

    My has been getting 2 baths a week for the last 4 years or so.. Scheduling has really gone down hill in the last year. Psws used to have a set time. Now it is all over the place. Sometimes they call 15 minutes before they come. This is in London On. I can’t really schedule anything else on bath day anymore. Lately they have been trying to have a man come even though we requested women only.
    So this week she may not have any because they sent a man and she said no so she missed one. It isn’t fair that a 90 year old widow should be bathed by a man if she doesn’t want to be for modesty reasons or no bath at all.

  • Robin says:

    I am also on the CCAC roller coaster. My mom can do nothing for herself except use the bathroom and eat. We have a different psw almost everyday — I don’t know why they don’t have the same people coming in so they get it know the person and what there abilities are. I have asked 2 psw’s to make sure they wash her hair but I honestly think they just wet and brush it they do not shampoo it ??? like whats the point. I have spent 2 all nighters at the hospital as she was very weak and a bad cough. Welland hospital needs to be torn down and a new one built it is disguisting there so the next time I went to St. Catharines and waited 8 hours with my poor mom – they said they wanted to admit her but they have no beds after waiting for 8 hours. I am wanting to form some kind of group in my area to picket the hospitals not because of the workers as they are getting all the noise about this when the government is the one responsible–I was told there are blacked out areas of our new hospital with beds but no staff to care for them and this makes no sense–Trudeau needs to step up or Wynne as this is a major problem

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  • Irene Broughton says:

    CCAC was recommended by my “Doctor” – I qualify.The girl who answered the phone recited what she had been told but didn’t understand a thing and recommended “volunteer visitors” who visit and “chat” once every 2 weeks and phoned the alternate weeks for a chat. She ended by saying I was not qualified for their service. A social worker should have been the one to make that decision. Do they pay their staff $11.00 an hour? My government job was as a 24 hour hot line dealing with lawyers, doctors and disabled clients being refused DSB pensions. It took years to clean up the system.. (CCAC sounds like they have a problem.Is it possible to speak with a social worker? Is this for an MP to investigate?

  • shawn says:

    I live in port elgin and have been dealing with ccac with my parents I have never seen such a useless bunch in my life they might as well not exist

  • Laurie says:

    The elderly deserve respect as do caregivers. They require help and respect. Having the elderly taken care of at home puts less of a strain on the economy overall. People are more well taken care of in the comfort of their own home and loved ones. BUT more hours should be provided as a max of 14/week is really outrageous. Caregivers are strained and require at least 4 hours of PSW’s a day.

  • Kat says:

    What home care with CCAC?
    This is a Complete joke expecting help to be provided for the sick and needy. Every person that works there lucks of empathy and professionalism, no transparency and no honesty.
    need to get rid of this useless power trippers for the management.
    Someone needs to review this whole corrupted organization.
    The only ones benefiting from the fundings intended to provide help for the sick, are the ones who manage this funds.
    Something needs to be done about CCAC corruption and management.

    • Tim Lachapelle says:

      Kat…….you are absolutely right about them.

    • Fed up says:

      it is a total disgrace. Can’t get supplies for patients because of the $$$, but they can sure pony up 60 grand to glorify the head of the ccac for all his “stellar” contributions….. Fed up….. they are as useless as any hospital here. Head injury, resulting in staples and NO CAT SCAN OR EVEN HEAD AND UPPER SPINE ASSESSMENT. TAKE TYLENOL AND GO HOME….. DISGUSTING!!!!!!!!!!!!!!!!!!!!!

  • Kelly says:

    My experince with the CCAC has been frustrating, unproductive and insulting. The family has been dealing with Mom, a diagosed Alzheimers sufferer for 5 years. There is zero help from CCAC for any home care. When she needed 7/24 supervision, could no longer shop, cook, do her banking, her taxes, do laundry or be trusted at home to operate a stove, set her thermostat properly or drive anymore, we moved her into a private retirement residence. Our first attempt with the CCAC to get help, we were told as long as she can groom and dress herself, she is not eligible for any home care, nothing! Now she is in a retirement residence (thank goodness she has the income to support this). Now its round two with the CCAC. We want to put her on the waiting list for a nursing home as mom is at risk for wandering. Waiting lists are years long and its such a beuracratic process. We are not asking for home care, we gave up on that long ago. She doesnt need any PSW support as she is physically healthy. Just to get on the nursing home waiting lists. We are trying to do our part. She doesnt need to be assessed. She doesnt need any PSW support. She has been diagnosed with Alzheimers. She is 88. She needs supervision and security. Waiting lists can be 3-6 years. There are only a few nursing homes with secure facilities for Alzheimers. Do the math. Put her on the waiting list. Or, lets all sit back and wait until we have the local police conduct a search when she wanders off. At least we will have a police report. If she is a danger to herself, then the Mental Health Act kicks in and she will be placed on a priority basis. Thank goodness there are Menta
    Health laws!!! Or, we can wait until she has a medical emergency and she cant return to the retirement home, then ccac will have to place her in a nursing home as a priority. Or, use some common sense, try to be proactive and avoid an emergency. Try to understand the unique challenges of Alzheimers. Acknowledge that mental health is just as important as physical health but the needs are much different. Stop ignoring this fact. Alzheimers sufferers deserve better than this.

  • Carl says:

    I too have just had to deal with the CCAC at Hamilton’s St Joseph Hospital and what I have witnessed is close to a Gulag for the most vulnerable!
    My sister just had a hip operation and within days of having her staples removed the Social Worker stated she had cognitive problems (who doesn’t after a traumatic event?) and he suggested, and still claims it is the only thing available, Long Term Care even though she still rents her own apartment and tries desperately to remain independent.
    CCAC says she is getting rehab but at the same time denies her access to a walker, her splints for her legs which are sitting in her cupboard and now is arranging a family meeting with their “team” which somehow don’t have any last names for reference. No Doctor listed and only a Nurse to dictate orders.
    Nobody seems to accept any accountability and the direction of forcing her into long term care is the only suggestion. My sister would be capable of taking care of herself with a little help at home if she got some serious physiotherapy but that seems to be non existent with the exception of raising her legs and arms once a day off the ground 10 times each. Minimal at the best!
    Ontario’s Health system is about as corrupted as anything I have ever witnessed in my life.
    I’m sure if my sister had a million dollar bank account she would rehabbed to the point that she could run a marathon.
    Does the words “Elder Abuse” come to mind?
    One message here is to never grow old in Ontario!

  • Tracy says:

    CCAA should stop using trickery and lies and be honest and up front with people. Tell people the truth because it only looks bad on CCAC. It is a sad situation when this is what our tax pays for lies and deceptions. They say they are there for you but leave you stranded to struggle in the end. I hope I never have to use CCAC EVER again after the experiences I have been through.

  • Sandra Lutchman says:

    My Mum is 83yrs old and lives at home with my Sister who walks with a cane because of Arthritis and is also looking after my Mum, I contacted CCAC to ask for help with Mum, at this time Mum was using a walker but was very shaky, but a few weeks after we bought her the walker, she got worse and could not walk at all, she can’t do anything for herself she very feeble, we have to feed her sponge bath her and change her etc. she wears depends because she does not know when she’s going. I contacted CCAC in the summer they came in met with my Sister and myself and saw my Mother at the time she was using the walker but was not strong, we asked for any help we could get but she was put on a waiting list, the only help she got from them was physiotherapy. Since then I called them to update them on her condition and was told they have no further help for her, and suggested that I should speak to my siblings, and make a decision for Long Term Care, and when we’ve decided that I should give her a call, although my first meeting with her I strongly suggested that the intent is to have Mum stay at home. They are so very mean. I know of two ladies that are my friends and their Mothers are in the same situation as my Mother, and they’re getting care through CCAC 20hrs a week. How is this working from some people and not for others? it’s not the CCAC worker to make the decision to put my Mother in a home. Who the hell is she? is the money coming out of her pocket? my Mother worked hard in the Country for many years. How can I get this problem resolved. I need answers and will do what ever I have to to get them.

  • Rena says:

    My Mom was hospitalized from October 2015 to April 2016, six months and one week in hospital. She was initally admitted due to a failed aortic valve and further tests showed she required a triple bypass. The cardiac surgeon temporarily booked her for surgery November 9th. He suggested keeping her in hospital for the week to prep her and get her strong for the surgery. This was October 28th. Medical staff relocated my Mom from ICU to a private room to await surgery. This evening, I got the call from the cardiologist on staff, my Mom suffered cardiac arrest. She suffered two heart attacks, two strokes and two emboli. Over time she endured her setbacks. During her time at the hospital, we dealt with 40 or so doctors and specialists (as this is a teaching hospital). Staff suggested to my family narcotics. They had not seen her off any meds or minimal dosages. Fast forward, discharged from the hospital, April 28th, 2016. My Mom has been home with my Dad, now four months +. Initially, CCAC, nurse, physiotherapists, occupational therapist, PSWs, PSW supervisors, speech language pathologists all came for home visits. Her PSW services were bundled through two agencies as my Mom was deemed a 2-person assist. After the 3 months, the one agency terminated PSW services. Now she has 3 one-hour PSW visits – but these individuals will NOT transfer my Mom from the bed to wheelchair. So she is now in bed. This transfer – daily three times was her only form of exercise. The hospital staff described her a 2-person assist and thus, documented in her file. CCAC and agencies ALL know this. My Dad is the primary caregiver, but cannot assist with transfers – as he had heart surgery and suffered a stroke in 2015. PSWs, whom were discontinued, were experienced, compassionate and took time to speak and listen to my Mom. The other agency’s PSWs are inexperienced. I find myself contacting agency daily with issues such as, not changing my Mom’s diaper, leaving soiled diapers in her room, not sponge bathing her, not brushing her teeth, lying to my Dad – stating they must leave to attend to other clients. I am at work and as such, cannot be present to monitor the services provided. In January 2016, CCAC encouraged family to apply for LTC. She was rejected. March 2016, yet another rejection – this after I was told “get medical reports to support her application from doctors”. I proceeded to request reports. Please apply again after six months. Recently, CCAC visited my parents home to complete and sign LTC application. This time, my family applied to 3 LTCH. Her first choice was REJECTED again. Pending status from #2 choice and accepted immediately into third choice on list. CCAC failed to remind me (as the SDM) that a cognitive/behavioural evaluation, had to accompany her application. In fact, CCAC evaluated my Mom along with a Greek interpreter. This was submitted but now, I find out that CCAC could not submit/bypass this testing on-line due to a glitch. The decision of rejection was based on an INCOMPLETE application. The Director of Care at the LTCH based her decision on an outdated report from March 2016. I have proceeded to contact the Ministy of Long-Term Care Action Line and a reference # was given to me. I await to hear the the CCAC Manager’s Director. If this fails, the next step would be to assign a mediator, followed by last step, appealing decision to HSRB. I contacted the home’s CEO and was told to contact CCAC. I want my Mom to be assessed and a proper decision made based on currect evaluation. I feel being in this home would benefit both my parents. The language, family an friends and facility have both independent living section as well as nursing home. It is challenges enough for a couple to leave their home after so many years so my goal is to strive to provide the quality of life for both…. “Quality of Life” is the term used by medical and support staff. I have written to Dr. Eric Hoskins office and have not received acknowledgment. I did receive a letter of support from Councillor Josh Colle and this was submitted with second application.
    My Mom is NOT behavioural. She was on narcotics which DID NOT help her in a positive way. Once I asked to have her off these meds, she did remarkably well. The results of her being on the narcotics while in hospital, were documented and thus have followed her. I ASK CCAC to reconsider her application o the one LTCH with the appropriate evaluation to be completed and submitted…. then a decision can be appropriately be made.
    The last year has been a horrific journey. Like many comments here, the system is flawed. One thing is certain, the best skill I have acquired is that of complaining. I AM MY MOM’S ADVOCATE. I AM HER VOICE. I WANT TO HELP HER AND MY DAD. One uses a good approach, no one listens, one complains, no one likes a complainer. My parents gave be a wonderful childhood/life and I want to HELP them!

  • Angelo says:

    I’m brand new to this whole situation, but so far, I’ve found the process an exercise in frustration. I am next-of-kin to my uncle, who is in his 80s. He has never been married, has no children, and lives in another city. Due to a serious illness he had a child, he’s lived with a permanent disability for his whole life and has never had a job. His only income was from disability/social assistance benefits, and later, from the Guaranteed Income Supplement (after he turned 65). He lives in subsidized housing. A few years ago, we convinced him to sign a Power of Attorney for Personal Care with me as the designated attorney. His memory and judgment have been of serious concern for several years. We started getting reports from mutual acquantances that he was getting lost in familiar places, couldn’t find his way home, and so on. We had him assessed twice at a Memory Clinic. On both occasions, they said he only had “mild cognitive impairment,” despite the fact that we told them he was getting lost around town. Because he was still deemed mentally capable, it was determined that he had the “right to live at risk” if he so chose, and he did so choose. I had to deal with angry phone calls from people who belonged to his church who thought it was terrible that we were “allowing him to live like that.” This summer, he ended up in hospital in a state of confusion. He was finally diagnosed with moderate-to-severe dementia and deemed incapable of looking after himself. This diagnosis permitted me to begin the process of applying for admission to long-term care facilities. The CCAC and the team at the hospital seemed to have totally unreasonable expectations of us. My only request was that we get him on waiting lists for long-term care closer to us so that we would be able to visit him on a regular basis. Understand that both my wife and I work full-time and have two small children at home. The CCAC co-ordinator indicated that he might be stuck at the hospital until a bed opened up, at which point they began floating the idea of him coming to live with us while he waited for a bed. At the same time, they indicated that we could only expect two to three hours a day of personal care. I pointed out (repeatedly) that this wouldn’t work, since he has dementia and a tendency to wander. My wife and I are gone during the day. We’d have no way of guaranteeing his safety while we were out. Among the hospital and CCAC suggestions: a) Could one of us take a leave from work to care for him while he waits for a bed; b) Would we be in a position to hire additional PSWs to fill in the gaps not covered by CCAC?; c) Would we be willing to pay for a daycare program where he could go during the day while we work until a bed opened up? d) Could we find some money to pay for a semi-private bed for a few months while waiting for a “basic” bed to open up? I must have explained at least a hundred times that he is on a FIXED INCOME and has NO SAVINGS. We are not in a position to contribute financially to his care, so any arrangements need to be covered by the limited means he has. No matter how many times I explain this, they keep coming back at us with suggestions that involve spending money he doesn’t have. They keep saying, “No, we don’t expect you to pay for it…” but I’m not sure where else they expect the money will come from, since I am his only living blood relative. Just last week, they called and proposed a short-term care program with a daily cost. They went on about how great it was, how lucky they were to be able to secure the bed, and how it would be an amazing stop-gap until a long-term care bed opened up. I said, “As long as his pension will cover it.” I told her the net amount of his monthly pension. She then cited a daily rate that was more than his income. When I pointed out that his income wouldn’t cover that amount, she went silent for a moment. Then she started in again telling me about all the benefits of the program and how it would be so much better than the hospital. What part of, “There NO extra money!” do they not understand? They seem to think that if they keep calling me, I’ll relent and just agree to take out a line of credit or something to cover the cost of his care. I can’t do it. I’m not his child or his parent. I’m a nephew. I can’t expect my family (my wife and kids) to assume a financial burden. It’s so frustrating.

  • John Chadwick says:

    My father is at Brantford General Hospital which is in the LHIN area “Hamilton Niagara Haldimand Brant” area. However his children are in the LHIN area “Central East”. It is urgent we find him a LTC in our area. We are told by the CCAC person at the hospital that his high ranking regarding his assessed urgency only applies to LTC homes in the hospital’s area, being “Hamilton Niagara Haldimand Brant”. What sense does this make? It should apply to the 5 LTC homes we chose in Ontario.

    • Aikaterena says:

      No John, you and your family have the right to apply to any homes – up to 5. In discussions with our CCAC contact and family and friends dealing with same issues, it is clear that each CCAC coordinator recommend differently. Contact the MLTC Action Line for more direction . You will get instructions to escalate matter. A mediator can be assigned to you and help out. Hope this helps. I am presently going through the system.

  • frustrated says:

    As someone that works in the community my opinion is that a lot of people take advantage of the fact they have care at home. A lot of people demand I spend my time thoroughly cleaning their home and do not accept personal care. This is exhausting work and runs down the support worked much more quickly than say bathing and dressing and applying lotions. We therefore need to take more time to recover or are just completely mentally exhausted and can’t deal with the requests anymore. As far as the patients with memory issues goes they forget that we do the things we do and complain to their loved ones that something wasn’t done. Another problem I have encountered is they are extremely lonely and want to chat. So they try to have you sit and talk and don’t want to be rushed into the shower if they are accepting one that day and your now in a position where your taking more time than allowed because they won’t get going.

  • Abdirisaq says:

    hi we are home health care agency the name is EXCESS HOME HEALTH here in Ottawa we do have people who need our service but CCAC told them we are not going to Transfer your service you have have to stay with the agency that we are sending you

    bylaw they have to offer to choose but in this case no way stay or no care for you..

  • Annoynmous says:

    As a PSW who works through contracts with CCAC, I believe that CCAC needs to take a look at what some of their clients are using their hours for. There are so many people out there who need the help for ADL’S, and yet a TON of clients use their “psw’s” as personal maids, chefs or beauticians. I believe that as a psw, we should be there to help clients remain independent in their homes, but using 90 hours of “free” services to them is just an easy way to have their house cleaned, meals made and their hair/nails done (just to name a few things). There are so many people out there who would love to have the help to get dressed, or have a shower but so many existing clients use and abuse the taxpayers dollars. These are health care dollars not molly maid or chef ramsay hours. These hours could be used for others who have posted who are waiting for services or posters who haven’t got enough hours. I’ve seen personally many clients who abuse the system.

    • invisigal says:

      Well Annoymomous, believe it or not, meal preparation and housecleaning are also ADL’s and are necessary for someone to remain independent in their homes. Why do PSW’s think they can pick and choose as to what they will or won’t do for a client? If a client needs it done, then your mandate is to do it.

      • Annonymous says:

        Your point is valid. I’m saying it moreso for the clients who don’t use the hours for personal care and strictly toward housekeeping etc. I don’t mind doing these tasks, but when it becomes more of these tasks than actual personal care, then I feel it’s just taking advantage. I am well aware these tasks are necessary to remain independent. Are you a PSW? Do you work in home care? If you do/did then you’d know exactly what I’m talking about. You know thr difference between doing what is expected with this job, vs being taken advantage of.

      • invisigal says:

        No I am not a PSW. Even better, I have had the care of an elderly disabled and demented mother in my home for over 20 years. I have had CCAC PSW’s for more than 12 years and I have come to the conclusion that housework and possibly laundry are the most responsibility these “workers” should be trusted with. They come in with long gel manicures, neglect to wash their hands, touch my mother and all of her personal items thereby contaminating them with whatever superbugs their other clients have. They are rough and rushed and far from thorough in their care. I have had damage to person and property caused by careless and lazy PSW’s including fractures, infections and bruises. I would not trust food preparation to a PSW. They are handling other people’s feces and bodily fluids with inch long manicures and then coming to my home, refusing to wash their hands. It’s a recipe for illness and infection.

      • Tim Lachapelle says:

        Holy fuck tiger!

      • MouseMan says:

        It’s true that meal prep and housecleaning can be apart of the care plan but if it’s through CCAC then we’re talking about simple meal prep and very light tiding. The problem with those things is that people are given 45 minutes to complete a shower/sponge bath, dressing, grooming, toileting and exercises and then want “extra” things done when there’s insufficient time and/or prohibited tasks.

        No where in a psw job description does it say, “do whatever the client wants you to do.” You erroneously assume that’s our mandate but in actuality our mandate is, “complete the client’s care plan.” So yes, PSWs do get to choose what is acceptable and what isn’t.

      • invisigal says:

        In 12 years I have yet to have a PSW read or review the care plan, much less complete it. More like 10 to 15 minutes of “care” and then 30 minutes of reading the paper, checking the flyers, watching the TV, chatting with me or my husband or my favourite, complaining about what the other PSW did or didn’t do when they were here last! Imagine a job where you can show up for 10 or 15 minutes and get paid for an hour. Sign me up!

      • Olga says:

        At least they stay to read the paper. In my dad’s case they stay 10 minutes and take off. I finally got a private company in for an extra hour to help him with his catheter befor bed. These private PSW have a GPS. They have to clock in when they arrive and they have to clock out from the clients home. The government needs to implement a system like this. But all in all, he will not be able to afford this extra private hour for to long. And I agree I would love to have a job where I would work for 10 min and get paid for an hour.

      • frustrated says:

        I am a psw in the community and this is a huge vice of mine. I have client who have been told that we are there to help them with “everything” I have a client that after I shower her and she’s sitting in the couch then makes me dust, vacuum and mop her whole house. I did it and then she turned around and wanted me to wash the corners and stairs with a rag by hand then yelled at me when I said I could not do it. Where are my rights with this? I don’t think it’s fair to me. The family sees it as a way to save money on a maid service. Before I go to my manager I would like to know what to say

      • Olga says:

        I do partly agree with you frustrated. I am sure you do have clients that feel you should do everything for them. These type of people need to be reminded from higher up of what the care plan is. It is unfair to you. But unfortunately my experience so far with PSW’s has been bad. My dad does not require a lot. Bring out already prepared meals out of the fridge, maybe heat the odd thing, help with his bath and above all make sure he gets his meds. I hire a cleaning lady for him so I do not expect a PSW to do that. But the PSW’s we have had so far out of about 25 different ones only 3 have been exceptional, the others are abusing the system. So I guess it works on both sides.

      • Tim Lachapelle says:

        Ummmmmm………..ya it does say that, and I have the paperwork to prove it. But that doesn’t mean it’s going to get done.

  • Susan Rocco says:

    I see there is no mention of the extradinary wages that are paid out to the Case Managers who work for CCAC .
    I believe there were more on the Sunshine List this year than ever.
    The Audit touched base on that as well!

  • Thereishope says:

    I am the owner of a “in-home” care organization, and provide “private pay” home making and personal care services. Having read all the comments on this thread, I would agree that cost of private care is very prohibitive and most individuals cannot afford it. Especially if they are seniors who are frail and have dementia and other chronic ailments.

    The CCAC allotment of hours and the care provided by their contracted agencies is only as good as the cost to the patient. Therefore, if you pay peanuts you should expect monkeys. (It is human nature).

    Good service is never free. A private pay agency is 100% answerable to you and will give you tremendous value for your money. After all, they do not want to lose your business. (Again it is human nature).
    Private pay agencies are expensive because they charge for the cost of finding, training, educating, monitoring, retaining, scheduling, administering, insuring, bonding, and paying a caregiver a decent wage, not to forget the tremendous cost of having to network and advertise to win your business.

    That said, private pay is not the answer or alternative for those who cannot afford it. So……I suggest the following technique that can resolve the issue.
    1.) Let us all first acknowledge that it is time we all took responsibility for our own care that will come in the future and save and invest as much of our income as possible.
    2.) Invest the savings in an account that will return a high interest (At least 13% – talk to an investment broker)
    3.) Use the interest only, to fund the care needed for your loved one, while building your investment portfolio.
    I have used this technique successfully and am currently generating over $3000 per month for my self and my loved one if we ever need home care. No need to pay for expensive long term care Insurance either (which is a huge saving on its own!).
    A cooperative family could cash pool and start a large investment to pay for the care for their parents. Home Equity loans are available at 3% and the interest paid on the loan is tax deductible. In some cases the caregiving expenses are tax deductible too (Ask your accountant)

    Hope this helps remove some of the bitterness and pain which has been expressed in these posts

    • Sad says:

      Thank you for your sane and well-thought out suggestions.
      People do need to take responsibility for themselves and come to grips with the fact that they often feel guilty when they need to accept help to care for their loved ones. Many people do not want to pay for the quality that they expect. If people put the energy and time into caring for their own loved ones that they put into demanding more and complaining, it would go a long way.

  • Errol JOHNSTON says:

    should the police investigate why ccac employees are assisting health store owners to gouge elder people in nursing homes? An example is a wheel chair cushion which retails at $50.00 is sold at $594.00 by a private health store owner. The sales person is a CCAC employee. The product is not shown to the buyer nor is any paper trail in existence. The cushion for all the person knows could of came from the city dump. CCAC and the health store send an invoice when no agreement of purchase was ever agreed upon. They hoped to take a cushion and go to the Care Home and ram it into the patients wheel chair receiver and probably play strong arm tactics to get payment. Why is a govt. agency employee carrying on like this. Is he getting a share of the spoils and how deep in the chain is this practice going on? I can tell more stories of how CCAC employees are trying to scam elder people through private companies. Does the O.P.P. stop citizens and sell cars for the local car dealers. If no then why is CCAC DOING ALL THE SALES PITCH FOR PRIVATE HEALTH STORES.

  • f.c.Muller says:

    The Ont. CCAC is a terrible run unit way to heavy in layers of management who have no authority of
    much having to go to several more layers of management for even the smallest decisions.
    The case Managers are all mostly overworked and work 1 to 2 hours of their own time on a daily basis trying to keep up to there heavy work load.
    more than 35 % of the budget goes to management running the ccac?
    could it be that management is totally incompetent.

  • dong says:

    where do i start? nothing but trouble with ccac. terrible management and services. they mislead people and keep them in the dark. they promote the idea that they will provide all types of services and do not deliver even when they say they will send someone. social workers or grieve counsellors, forget it. and all that homecare, one hour a day if lucky. rapid response when released from hospital after serious injury, no show. it goes on and on. they are deliberately slow, misleading and deceptive. what a terrible time i had like tooth and nail to get anything basically done. they also screwed up file, late on transferring vital inform. for hospital purposes, made numerous errors on file, on and on. it was obvious to see that someone there at the top was trying to cache the money for the agency to make the numbers look good. what a bogus, misrepresentation of government services under the taxed paid ministry of health. should be a federal investigation into this which i believe they are conducting right now. terrible.

  • Laurie McGoldrick says:

    I have been the sole caregiver to my Mother, who is now 87 years of age, for the past 4 years. Initially I bought into the rhetoric of the Community Care Access Center but within a short time I came to realize the nature of the beast. The CCAC (government loves their acronyms) is not your friend nor advocate for your aging parent. The CCAC does not directly provide services. All services are contracted out to private companies. The Ontario Government has put in place a program for support services to seniors to allow them to stay in their homes. The sole and ONLY purpose of the CCAC is to ensure that the patient/client receive the absolute MINIMUM care and services under the mandate. The CCAC is comprised of bloated bureaucrats making arbitrary decisions.

  • David Lawrence says:

    Monopoly of the contracts sends the wrong message for contracted services in Ontario. Those currently servicing the CCAC contracts should not feel so comfortable in their service contracts , it is like a gift of taxpayers dollars.

    • John says:

      True!!! Its a rip off. CCAC has contracts with so called brokers ( Profit and Non profit companies) that eat 60% of reimbursements dollars and pay the direct provider only 30-40% of the reimbursement rate be it Nurse, PT, PSW, OT’s or SLP . What do you expect these professionals to do? Maintain sanity, provide care or otherwise…Its pathetic.

    • Olga says:

      So very true David. They take our money but believe they do not have to provide the service.

  • Angry and depressed says:

    CCAC has a few carers who are good, and then a whole host of lazy, irresponsible, untrustworthy, and frankly stupid carers. At first they only gave us 1 hr a day, 5 days a week. Granted, my mother could at least walk on her own then – if nothing else. Only after she ended up in the hospital (which was a whole other bad care story), did we get 50 hours over 7 days. We’ve been through a host of horrible psws and CCAC has done everything possible to cut our hours to a measly 15 per business week, which, if you do the math, is not enough to help a person with severe dementia when you have a reliable carer, let alone when you have a lousy one who does nothing except talk on her phone and watch tv. The quality of care provided is so poor that other agencies immediately sympathise (though you probably can’t afford their care) and go, “oh yeah they’re really bad. We never hire someone who has worked with CCAC.” The government needs to get it together and start providing reliable, safe home care.

    • Olga says:

      You got it right on the nail. Around where my dad lives the CCAC determines the hours eligible then they out source to an agency for the PSW’s. If you get crappy service and let the CCAC know they tell you it is not their problem you need to talk to the agency that provides the PSW’s.

  • Mrs Joan Norgaard says:

    CCAC is a valuable necessity for seniors in need of health care at home- whether the person lives alone, or is taken care of by a caregiver spouse who needs hours for the loved one in nursing, physio therapy, occupational therapy or hours from a supportive personal support worker. This keeps people in their homes, and out of Nursing Homes as long as is possible.
    The need does not only include seniors, but is required for all ages of life.. CCAC is an amazingly organized health care seriously required in Ontario Communities.
    My husband has had a speech pathologist come to our home to assess his swallowing; and was diagnosed with Dysphagia related to his illness. The service was very professional, and from caring people. I would always recommend CCAC to others.
    Thank you,
    Mrs Joan Norgaard
    Caregiver for husband with Lewy Body Dementia/ Multiple System Atrophy

    • Sad says:

      Thank you for the reminder that home care isn’t just PSW services but a whole host of other professional health services as well as medical supplies, infusion therapy and equipment rental.
      Many people are upset with the quality of the PSW service but do not want to pay more for better quality. With a service that is not a health-regulated one, it is much more difficult to get quality workers. That, to me, is where the system is broken. How do we entice intelligent, diligent young people to do that type of work? Most of our younger generation is not going to bathe, toilet, feed, clean house for $16.50/hour. We raised them that way. In addition to that, consumers want to be able to yell at them, hurl abuse, call them “girls” and make demands such as the same worker seven days a week, no males, no other ethnicities and for these workers to show up at exactly the same time and when they want it. We as a society cannot afford that. It’s like demanding this service be equal in quality to aerospace engineering for $16.50/hour. It will never add up.

  • Toni says:

    I don’t know that I would be concerned with CCAC providing care, some of them are good at what they do, just my opinion, but it’s pretty far and few that do care about the people. My Senior home care business is up and running and I have a few clients, who I care very much for and don’t charge an arm and a leg for services! I have been doing some research, and discovered that it is getting harder to keep PSWs in the home care sector because of the low pay and all the traveling they have to do, the most recent article I just read said that 7000 PSWs are trained yearly in Ontario, and most of them are 50 or over, and we are loosing 9000 PSWS yearly….most of them are going into LTC, or hospitals where they can make up to $25/hr. …keep in mind people…this is also YOUR future, private homecare?Government provided homecare? Or long term care?
    Question…if YOU have someone new coming to your home everyday/week to help you bathe…rather then the same person every week, how likely are you going to want to bathe??
    Do your research, you get what you pay for! I would rather be in charge of my care (private care) then someone tell me what they are allowed to do for me (government care) and how long they can spend with me!

    Good luck with your business Margaret! I wish you all the best :)

  • Toni says:

    I have started my own Senior Care business, and have been trying to figure out how to get some new clients. I also was thinking about getting into CCAC but as I read all of your comments, I have no doubt that I have made the best decision to go at it on my own. I would love to help give Senior In-home care a better name, as apparently some of the bigger companies have forgotten how to do. I don’t know how many people who have commented actually return to look at the comments, but perhaps you should look at some of the smaller businesses such as myself, who actually care, and have compassion for Seniors and not in it just for the money. I can’t speak for all small home care businesses, but you would probably get a more personal touch with having the same person coming to your house every time, and a quicker fix to your complaints if you went that route. Don’t just settle for what is given to you, explore your options. Just because a company is BIG and WELL-KNOWN doesn’t mean that you are going to get the best quality or service for your dollar. I have been in customer service for many years, some days I was absolutely mortified at how a customer can be treated and ashamed to have my name attached to that business. Thats why I now have my OWN business and am able to treat people the way they deserve to be treated.

    • Monika Croydon says:

      Hi Toni,
      I’m reading this thread and am more and more concerned about having the CCAC provide a PCW to help my mum. I’d like to know more about your business.


    • Margaret says:

      Hi Toni, i have read your thread as well and feel that what you are saying is right on the money.
      I am not here to bash the bigger companies but I know from my own experience that people can be second to money. I to have left the bigger companies and set out on my own because I feel that one-on-one experience is not is good for the person being cared for. I have seen patients who just want someone to sit and talk to and due to the rushing around of the care giver the person was left feeling the same way at the end of the day ( lonely). I feel that caring for someone is a gift and not everyone poses that gift.
      But it seems sometimes the gift of true care giving is not enough when you are starting your own care giving business. I truly believe that a person needs to feel safe and happy. and there is no better way than having that one-on-one atmosphere.
      I was also thinking about connecting with CCAC but all ways felt that i need to do this on my own as add my personal touch to the home care sector.

    • Esther says:

      Hi Toni, someone is looking for good care for an elderly lady who is in a nursing home and is not getting the money’s worth. Is there anyway we could check into your company. How do we go about connecting with your little agency for starters. Essie

    • Olga says:

      Toni, you have to remember that your service is private which means the client has to pay. Most seniors cannot afford this. Going through the CCAC the service provided is free (in a round about way, because I believe our tax dollars pay for it). The CCAC should be made to monitor the company they hire to provide help to seniors. If this company does not do their job properly they should be “fired” I have seen on more than one occasion a PSW come in, stay for 5 or 10 minutes out of 45 and leave yet this PSW will get paid for the 45 minutes.

  • Heather Marsh says:

    There is no such thing as quality service in Southwestern Ontario.

    • Stephanie says:

      Hi Heather,

      Would you be able to suggest few improvements, specially since I am starting my business that will help me to improve our service.

      I really appreciate your insight on this.

      Thank you,


      • Angry & depressed says:

        How about:

        Respect your client. If they are yelling at you, you are probably doing something wrong.
        Listen to their family members. They have been there longer than you and are much more concerned than you with their family member’s well being.
        Understand that your client (and their family) is often not rich. Don’t expect them to foot all of your high wages or be able to give you a raise.
        Employ multiple races and make sure no language is spoken around the client that the client doesn’t understand.
        Talk to your client. Treat them like a person. Help them, don’t ignore them. Never ignore client
        Be firm but gentle when cleaning.
        Don’t spend your entire visit talking on your cellphone.
        Cook real food for your client. Don’t feed them fruit and muffins or candy all day. It will just make them poo messy and leave them uncomfortable.
        Engage your client. This is true even when they don’t look engaged. The more you do it, the more likely they are to engage back.
        Smile. Don’t yell. Help them if they need it.
        Don’t steal from their homes.

  • Stephanie says:

    Hi All,

    I was reading through all post and I was sadly surprised to see all the issues with CCAC. I was planing to start my own Home Care business to help seniors. When I start planning my business first thing came to my mind was provide high paying salaries to staff (PSW, RN etc) to get good quality service. For example if I can make my staff happy with high pay, I trust that the staff will provide great service to clients.

    My current challenge is getting access to CCAC referrals, I am not big enough to be part of their contracts!! Anyway for now, I am just trying to find my own clients and unfortunately they have to pay them-self.

    Thank you,

    • Jay says:

      Stephanie if you pay a high wage then the seniors have to pick up the bill most of them are on pension only, They would not be able to afford your service and there are plenty of them, only the rich can afford this type of private service something to keep in mind.

  • Trish says:

    My friend is 85 years old and is having so many problem with the red cross, the workers are great it’s the disorganization of red cross is the problem. She is now very upset because they are sending different people to her home, she used to have a regular and she was happy and trusting. Now they cut her off and are sending different people strangers I must add to her home. From the perspective of the elderly client, they want to be able to trust who is bathing them and coming into their home. When a call went out to red cross to explain the unhappiness she now has, the conversation was very cold on their part. They simply didn’t care. They even threatened to cut the service off if she was not happy with the service. One time a lady who was the coordinator said do not interrupt me when I am talking, and the lady who is a friend to the senior said I was not interrupting you I just wanted to correct your words as she was quoting a statement that was said previous but had it all wrong. She could not believe the rudeness.o as it stands now take it or leave it we don’t care what you want we are in control Burlington division I will contact the ccac complaint dept about this problem after all they are funding this rude girl.

    • Olga says:

      Trish the same thing is happening to my dad. We were told he would have a team of 3 or 4 people and in the 6 weeks he has had the service he must have had at least 25 different PSW’s. Every time it is someone new which confuses my dad immensely. This reflects on the care they are providing because these PSW’s come in and don’t know what they are supposed to do. So out of the 45 minutes they are supposed to be there, they leave after 15 with no help given.

  • Len says:

    I don’t understand why ccac is even necessary. It’s health care money that ends up not actually going to patient care. Meanwhile nurses and psws working for organizations under ccac are under payed and overworked, living by the rules of ccac.

    The ministry of health should cut out ccac and referrals be sent to the nursing organizations or personal support organizations directly. That way there would be lots of money savings and the government money could actually go to good quality care.

    • trish says:

      the workers are great it’s the red cross who is funded by ccac is the problem they simply don’t care about the seniors and they don’t have a voice.

  • HM says:

    In my opinion, CCAC is a non-value added government organization robbing our most vulnerable citizens of much needing funding to have dignity and quality of life and care in their final days (years) and to do so in a place they are comfortable – home! Our seniors for the most part, have paid a lifetime of taxes! I’ve been involved with CCAC in my life for the past 8 months and have seen them do no work other than have “meetings” . They come to my home, talk a good talk, make promises they do not keep, leave and when you dare to get upset, even slightly that nothing changes, they label you “difficult” and stop working to make things better. Wish I could get away with that at my job! – NOT. These CCAC are making huge amounts of money, dictating who we can or cannot have come into our home, dictating who can or cannot provide OT/|PT supports to our loved ones, dictating, dictating, dictating – this is the nuttiest system I have ever had to deal with!!!

    • lo says:

      that it was only me. ccac is a front that does not deliver what it promotes, plain and simple. they had 3 interviews with us (me and mother) promised services and never delivered. at times she was in dire need of help especially when released from hospital after serious injuries from falls (she lives alone). no phone call from them, no nurse to check in on her, no social worker or grieve counsellor when she lost her only son, on and on. oh yeah a psw for one hour once or twice a week. i was given wrong infor. about applying for nursing homes and they would often ignore me, the only caretake and pow and preferred to deal directly with her (with dementia) to make decisions. very very bad management, numerous oversights and errors and also staff who do not have a proper comprehension of english. it was a burden on top of everything else. i had to find other resources on my own which they should have given info about. what a lazy inept bunch!

  • Shay says:

    The funds are not being distributed to the front line care providers. Furthermore, the strict parameters given to provide care are ridiculously unreasonable and set by people who do not actually provide the care and see the issues at hand. Simply looking at statistics is not a way to provide healthcare, it simply justifies funds..yet the stats on’t even capture the real issues. %featured%We need to pay health care providers properly to entice people to want to work in the community%featured%, we need nursing homes, we need less strict parameters such as offering a client 2 hours a week of care for a shower to a more reasonable amount ( this is just one small example) All these and many more factors are a vicious circle in the healthcare loop that will not improve unless the real barriers are considered.

  • Beverly Thomson says:

    Consistency is critical for the senior requiring home care especially if they are failing mentally and are easily confused. They feel vulnerable as it is having strangers constantly in and out of their homes. Because I have experienced the lack of consistency with my mother who requires home care, I know what I speak of! On one occasion, a male PSW turned up at my mother’s door at 9 o’clock at night! to put her to bed. She had never seen him before.
    In my mother’s case, CCAC uses an agency where they simply cannot keep staff. The good PSW’s leave. The exit rate is so high, they have orientation weekly!! I’ve lost count of the different PSW’s who have cared for my mother. The problem: The agency that hires these workers don’t pay them enough and have them, in some cases, double booked and running from one end of the city to the other.

    Question: Who is responsble for regulating these Home Care Agencies that the CCAC hires?

    • HM says:

      Hi Beverly

      We had the same issue with my mother-in-law. Call the Cssemanger for CCAC if that person won’t listen, doesn’t address the issue, contact the Ministry of Health. If that doesn’t work, CALL the OMBUDSMAN.

      People like you, like me need to speak up – this system is nuts!

      If you refuse the male putting your vulnerable person to bed – they call that refusal of service! If you are expecting service at 0800hrs and they come at 0900 hrs and you say that’s too late – they call that “refusal of service”

      If you complain too much you are a “difficult client”

      What this system needs to do, is the work it commits to doing in the manner in which they commit to doing it and the minute they cannot, they need to step aside, stopping making excuses and let someone who can do the job, the way it is needed!

      Apply for dedicated funding!! Then you make the rules, the times and have some semblance of care and control over who and when the care is provided.

      Good luck to you! Stay strong! Keeping our elderly loved ones out of institutions is worth it in the end!

  • Maria says:

    I hope my message wont be deleted, it’s because when some one tells what is real happen some people don’t like what is written and they delete the messages, and the only positive ones are heard, any people people who see the problems their messages I seeing then all deleted!
    I am responsible for this old lady who needs home care services from CACC in London Ontario and one big problem is I can’t find in the internet how to evaluate poor or fine how the agency operates I believe this is a big mistake because if the government provides the funds for these type of agencies the families have the rights to evaluate their services so reads can see who are the people who comes to take care of their love one in their home! Today families don’t have the time or cannot loose their jobs to take care of their parents but as government offers service to help them part time (28 days if they come home from the hospital and need 24/7 care for that period of time) and 3 hours after the limit. When we bring strangers to our homes we have the right to evaluate their services so other families could go on the internet and check the performance of the agency, so we should have the right to choose another company if we are not happy??? We are deal wit St Elizabeth and I find the girls very aggressive and not well trained for the job! Another thing is they damp the food in front of the person if they eat fine if not that’s to bad! Then they refuse to do anything else. They never touch a broom to clean the floor if they leave thing fall into the floor! What is the point complain to the manager she said is not their jobs! And is more to it! Those agencies should be investigate by the government what they do! Because they always right and we the families are wrong, nothing happens to them we the families are the complainers and they always are right with their work in the home!!

    • HM says:

      Call the Ombudsman after you’ve notified the Ministry of Health. Good Luck to you and those you care about, the system is frustrating, wrought with issues and needs an overhaul that is one thing that is evident, but never stop telling people because that would mean giving up on those you care about.

  • anomynous fool says:

    I have been waiting over 3 months for a basic service, walker replacement and they will not address other needs that a 87 year old lady has even though she has falls, dementia and needs some assistance or simply programs that ccac is suppose to provide. the frontline caseworker keeps stalling and not responding. maybe she has family or friends to take care of first?

  • StuckonOutcomes says:

    Having worked with CCAC’s as a vendor, the CCAC’s have to work on their procurement processes. Typically, most CCAC’s follow the government mindset whereby their underlying assumption is that “if they ensure that they have the right process” then the outcomes they desire will naturally follow. If they don’t achieve their desired outcomes, their solution is to layer in more process. The unintended consequence of this is that the vendor spends more time and effort getting ready to do the work (i.e.responding to more and more detailed RFP’s) than they actually do doing the work! The whole procurement process is broken. The CCAC sees increased costs because guess who pays for the increased procurement costs. If the CCAC wants to see improved return on their money – base the procurement process on outcomes of the larger picture. For example: how well is the CCAC working with other primary care providers to ensure better home care. How much traffic has been diverted from emergency rooms? How long is the waiting list for LTC? If the primary purpose of the CCAC is to promote and provide home care then the measure of effectiveness of any CCAC (and consequentially – vendors to the CCAC) is how much pressure did they remove from other health delivery organizations? Right now all I see is a bunch of dedicated persons (CCAC’s) so bound by process that they have no time to view the big picture and really accomplish their mandate.

  • Heather says:

    As a current family member of someone receiving CCAC services I can only say stay tuned. We are preparing our story and preparing to share with Ontario how the current system DOES NOT work. It is also my opinion that giving CCAC the ability to procure services, takes away the choices of the service recipient, inhibits the abilities of persons in their homes to make informed decisions in regard to their health care and essentially if not utterly discriminates against those who receives services. The LHIN from where I sit is an utter waste of tax payers dollars and the CCAC is a bureucratic nightmare who cannot seem to communicate amongst themselves never mind with the people whose lives depend on them. Creating a LHIN and a CCAC in our opinion is like having a “wallless” institution but make no mistake an institution and we have proven in this country time and time again that institutions do not work. There are better answers, there is a way to measure quality of service and there are ways to keep our aging populations in their homes with the supports and services they require we just need someone in government with a core values who doesn’t at their core believe that human beings that don’t “appear” to contribute to our society, actually do. Think about this….without service provision in this province, where would alll the PSW’s work? The aging and disabled are actually driving our service-driven economy, keeping our citizens working and therefore ARE contributing to our society. There are better answers, LHIN and CCAC are not two of them. My opinion

    • Denise says:

      Heather, your comments are excellent and I believe they sum up what many of us think, myself included.

    • Christine says:

      Agreed Heather!! Well said.

      • Heather Marsh says:

        My words meant nothing, our complaints, nothing. We went as far to the top of the complaint chain and nothing, except more useless meetings, happened. My mother-in-law now resides in long term care and I can barely muster the strength to go and visit her most days. When I do visit, Mom hasn’t been bathed in days, she is forced to eat last because she requires assistance and then is told – RIGHT in front of us that the food she would like to eat is not available, because they have run out of it???????? I find Mom wearing other people’s clothing when she has a closet full of her own and even have found her wearing a recently deceased woman’s clothing. I’ve also seen Mom in men’s clothing and rarely see her smile anymore. My partner and I could no longer physically care for Mom as CCAC cut us back to 3 hours per week which allowed for banking and groceries and not much else. Nothing happened that we are aware of to the PSW that left Mom alone in an up down bed in fully upright position, nothing happened to the agencies that we are aware of that could not seem to get their scheduling straight. Nothing happened to our knowledge to the “Upper Management” of the CCAC and the care provider who sat in our home making promise after promise and delivering ABSOLUTELY nothing. My husband’s back is now forever damaged for assisting me to carry Mom in and out of the tub and in and out of bed. We are today, the day before Mother’s Day wishing nothing more than for Mom to be with us but she isn’t :( :( :( :( One day we will get a call that Mom has died and we will to degree blame CCAC and the care providers because at home, Mom was happy and somewhat healthy despite her disabilities. Mom TOLD everyone she wanted to remain at home until the end of her days, with us, her ONLY family and there she lays, day after day being plunked in front of tv in her wheelchair, tipped back to encourage her to sleep, with nothing to look forward to except her next shot at maybe getting food she likes. We visit often and take dinner often but it’s hard because we now live with guilt, and the place is hard to be in as it ALWAYS smells like bowel movements. HOmecare? what’s that and how does the elusive HOMECARE benefit anyone?? Sad that people year after year buy into their garbage! I hope what happened to our family and continues to happen, NEVER happens to your family. Anyone reading this at the beginning of your journey – move to AUSTRALIA – at least they value human life there.

      • Tracey says:

        Heather, I am living your nightmare now. I have had workers brush my mother’s teeth with a denture brush, injuring her gums, arrive at 11pm for a 9pm visit and drag my mother out of bed for toileting and bathing then drop her in the bathroom, fracturing her wrist. I have had PSWs leave the print of their hand on her arm. One PSW smashed her bathroom sink by knocking a soap dispenser into the sink and she didn’t even tell me about it. Most of the time they don’t brush her teeth or clean her dentures at all. Many meetings, all amount to nothing. Yesterday I received a letter from CCAC warning me that PSWs have complained about me because I point out to them when they claim to have brushed her teeth but her toothbrush is dry, etc. They say if PSWs complain again, service will be terminated. I was even asked to sit on a committee at the LHIN, but at the first meeting when I was very honest about my experiences, they emailed me before the next meeting and told me I would not be needed for that meeting and they would let me know the date of the next monthly meeting. That was 6 months ago and I still haven’t heard. My heart breaks for your mom and mine. Why can’t we come together as a group and fight this inhumane system?

      • Olga says:

        I feel with you ladies because I am going through the same thing with my dad. My brother lives in another province and I live 3 hours away. The CCAC keeps screwing up the hours that they said he was entitled to with the VON. You keep getting the run around. The PSW’s are another piece of work. I was there at one time visiting. The PSW was an hour late when she did arrive she was made aware that my dad had not had his medication yet. She took the binder, filled it out and left the room. This was at 2 minutes to 11. I thought she went to get my dad but then heard the front door close. She was gone, his meds still sitting on the counter. I checked the binder at 2 minutes after 11. Well her entry stated that she was there from 10:30 am until 11:15, that she administered his meds, made him breakfast, and helped with a bath. All this in 4 minutes. I called and I doubt anything was done about this. As far as I see it she was putting my dad’s life on the line. I have found this with a lot of the PSW’s that come by. We are lucky if the stay 10 minutes out of the 45 minutes they are supposed to be there. If you inform the CCAC about this they say that it is not their job and I should be talking to the VON who sents these PSW’s

      • TrulyDisgusted says:

        All the posts I have read, and all the people I have talked to that have and elderly family member or friend trying to deal with CCAC – well they all say the same thing. CCAC is a disgraceful system that doesn’t treat the elderly with any respect or dignity, most of the time they are crash and uncaring. CCAC is a bureucratic nightmare, and I my experience case workers, case managers don’t return phone calls because they don’t want to deal with complaints. I have been trying to get some assistance for my Mom who is 92 years old, and she now requires some assistance with her weekly shower. CCAC denied our request for assistance. I have been calling the case manager for the past 7 days and she has never returned my calls…. so I keep calling. What am I supposed to do if they never call me back, I know I need to request a copy of the Complaint Process, and a copy of my Mom’s case file and a written explination of why service was denied but good luck when they won’t return my calls. When I do reach someone in the office all they will do is put me through to the case managers voice mail, so I keep leaving messages. So my experience so far is that CCAC and the Government Health Service do NOT value our elderly and it’s really a NON existent “Home Care” service. CCAC is a huge waste of tax payers money when prople who need these services can’t get them, and even when they mange to get approved for service the service is substandard, inconsistent, unprofessional, unorganized… truly this system is very inhumane. There seems to be no recourse for “clients” who are unsatisfied, when these clients or their families need to be able to evaluate CCAC and the PSW services……truly feels like no one cares. I have heard from many people that if clients complain too much, they are labelled to be a “difficult client”, and no positive action is ever taken anyway, all seems pretty unfair to me. If I could get away with ignoring issues/complaints at my job well wouldn’t that be something. My final conclusion is that CCAC is a NON-value added government organization robbing our most vulnerable citizens of quality care and dignity in their final years (months). CCAC is not a friend or advocate of your aging parent. If you can even get services through CCAC the service provided is absolute MINIMUM care and very substandard. I won’t give up, I plan to keep calling CCAC (even though they don’t appear to want to call me back) I will be writing to the local MPP, and will contact a lawyer. In the meantime my Mom can’t wait for them to provide some assistance so I will have to hire an independant PSW or someone to assist her with her shower. (Unfortunately I live in another city and am over 1 hour away.) Where is our government when all this is taking place, they don’t really care do they. If they did care they would not allow for our aging population to be treated so poorly, it’s all very degrading and I am completely disgusted with the whole process.

      • Ccac incompetence says:

        I hear ya and why are we all not coming together to do a class action lawsuit against them???.. it’s hard to find a honest integrity lawyer or individuals these days to do the right thing. It all comes down to facts, those who are rich or well known to Cera in individuals or groups get the benefits and not us truthfully individuals trying 200% to get what is written by law and regulations to be implemented and can’t because we don’t have the right resource(s) unless we all come together and a legal protest in numbers we are stronger. I. E. Black lives matter.. all lives matter. I. E… ELDERLY LIVES MATTER. .. LOVED ONES MATTER.

      • Sad says:

        Don’t worry any more. CCACs will soon be disbanded. The legislation has passed that collapses them into the LHINs. Just imagine how much easier it will be to get a hold of someone once they are that much closer to the MOHLTC. The answer was all-so-clear. Get rid of the layer that actually goes out and sees and assesses patients. Keep the LHINs that are a completely administrative body. Ontario will now get a glimpse as to what CCACs were actually doing to lobby and keep patient rights at the forefront. During this entire “transformation” process I have rarely heard any one actually mention the patients except in the name of the program “Patients First”. Let’s just see how this pans out. A program of change with no defined measures to see if the change was for the better.

  • Jana Keller, M.Sc. HRM says:

    LHINs are only labeled local integrated and networked. They are the least transparent of any of the local health administrative “bodies” have too much power and employ way too many people who spin wheels rather than think creatively, particularly when it comes to measuring and modifying quality service toward community driven care. There is very little actual input from the community about needs. It seems to be provincial summary data driven. A huge paradigm shift in culture of quality indicator monitoring is required before any real community sensitivity and responsiveness will occur.

    • Tim Lachapelle says:

      Well put, I am currently dealing with a level of arrogance and incompetence never found in the private sector health care. These organization are top heavy poorly run and self perpetuating. I was recently at a meeting regarding my father where the coordinator had 15 staff around a board room table. The self importance and stupidity was dripping onto the floor. The local LHIN’S have to cut to the bone on the management level and redistribute funds to the front lines.

      • Marisa says:

        You are so right Tim. All true. I know how these people work since I have seen it all from working in healthcare at a big hospital. Now I have to deal with trying to get my mother services tailored to her medical physical and dementia needs. They are liars of all liars and all the funding is being used in top levels of the LHIN. New group hired to give care and they cannot meet the needs or hours we are allocated. Mom has me but if I die from their lack of help,than who does my mom have?. A bigger voice has to be heard. We are not heard. This is a crisis for me now . I honestly wish that all families contact any form of goverment who will hear about what’s going on with this sub standard homecare. I will be starting my journey tomorrow.

  • Aaron says:

    Sadly, all the investment in home care in recent years has not seen an improved system. Recent initiatives such as Home First emphasize the CCAC focus on clearing out hospitals. While this may be admirable, it has come at a price. The article notes 55% of CCAC service is for seniors. Many of these seniors do not need intenseive services like Home First but just a bit of support to remain independent. Reductions in personal support and therapy services by CCACs make these people so vulnerable, ultimately resulting in increased costs to the health system.

    It seems the home care system in Ontario has lost its way…

    • Maria says:

      It is very disgraceful the way CCAC responds to client’s needs. My mother is at the advance stages of dementia and the case worker told me that she is only entitle to 2 hours per week. His reason is that we decided that my mother was better off at home rather than in one of the undesirable, dirty and with a record of mistreatment ltc facilities that the CCAC keeps pushing to us. The case worker of the Mississauga Hlton CCAC told me that if I thought that my mother needed more care and that if I was under distress; that I should bring my mother to the nearest hospital and abandon her there and to let the region place her any were the CCAC decides. My mother is not able to wash herself, prepare food, clean, she suffers from bladder and bowel incontinence, is not able to sit in the toilet properly, can not dress herself, does not know the time, date or use the phone. However, the case worker informed me that it was not their problem due to our decision to keep her home. So I asked him what happens if she falls down? To what he responded that it depends on her injuries. That due to our decision the only way that she will be entitle to more help is if she was completely paralyzed and unable to swallow. I told him that I am spending over 38 hrs per week and that i have not been able to work and my financial situation is drastic. He then repeated the same suggestion. To bring my mother to the nearest hospital and to leave her there and to tell the hospital that I was walking away and abandoning her. So either that organization is very corrupted and not really working for the seniors or Mr Jason Darnell should not be working for any government organization any longer. I am a shamed to tell people the kind of respond that we received for the 4 additional hours per week that i was requesting.

      • bloomoonBonnie says:

        Your mother sounds like mine was. Get her in a privately owned care facility & sell her house for the funds. You may notice in the publicly funded ones, alzheimer patients are trying to escape when you visit but private care places seem to give meds to calm those ones; making it a more pleasant atmosphere. (if things are still the same) As long as your mother is not violent or a wander risk, you can keep a vigilant watch that they DON’T medicate her. My mother just sat there, no trouble but they did medicate her for 2 weeks without telling me until I stopped it. You have to make your presence known to the care workers with unscheduled visits ….& ;) be extra nice to them – it is in your mother’s best interest! Then cost was $3,600 a month for everything.

      • Tracy says:

        I feel for you and CCAC has made my life a living hell and after several letters to go over their heads they send 10 hours a week. Too little too late she was going in a home a week later. The process in which we got her there was a sad one and one that I will hold CCAC responsible for the rest of my life. Some are corrupt and don’t give a crap about anybody. Some shouldn’t even have this job at all.

      • Tim Lachapelle says:

        Tracy, they are corrupt as hell. The organization needs to be razed to the ground. The corporate culture is steeped in arrogance and incompetence. They spend more time assessing than dealing with client needs. The “Care Coordinator” in my LHIN is destroying our family anc doesn’t give a damn. I’m truly sorry for your mother having to go to a home.

      • Heather Holdship says:

        I realize that you left this comment a long time ago and I hope your situation has improved. Sadly, I doubt that it has. I am currently dealing with an aging parent and CCAC and find that they just want to get them off there list. Some of the nurses are great but as everything today, the big CEO’s want there big pay checks at the expense of the population. The nurses are at the mercy of there bosses. Too many demands on them, creates an overwhelming situation. The problem is that everything comes down to a numbers game. Who ever has the most money when we die wins. To bad they don’t teach you that in school. Everything political is corrupt and basically they want us to keep paying out, but when it comes time that you need the care, they try to get out of paying. I guess my question is, have you been able to find out who to contact…is this an ombudsman issue…

      • Martin McAllister says:

        Hello, Heather. Did you ever discover if your question on CCAC deserves investigation by the Patient Ombudsman?

        Kind regards.

        Martin McAllister

  • The Health Council of Canada says:

    In Ontario, it has been made clear that home and community care is being made a priority. In the Health Council’s upcoming report Seniors in need, caregivers in distress: What are the home care priorities for seniors in Canada? we discuss the issues and challenges related to home care for Canadian seniors and their caregivers. In our analyses of home care data in 5 regions across Canada, we are finding some very similar trends. Many seniors with complex needs are not getting the care they require and as a consequence their family caregivers are becoming distressed. Home care needs to become a cornerstone of the health care system and become integrated with other health care sectors in order to provide seamless care to Canadian seniors in the appropriate setting and to ensure that they are able to maintain their well being and quality of life.

    • Adama says:

      Government’s know pelrectfy well what impacts the patient and the family when discharged from hospital with little to no medical follow up care in the community. In some cases, follow up care never arrives because a referral for CCAC is not confirmed; so the patient, care giver or family are left without or they hire medical support privately. This is not providing access to medically necessary care and is against the Canada Health Act. The very fact that our government and / or its’ representatives do not enforce the law means only one thing; they support private health care in Ontario.

    • ronney says:

      Is there any way to negotiate CCAC’s mandate to find out if we are receiving the care we are entitled to? I would like more way more transparency !

      • ALSFighter says:

        I am a chronic terminal patient who receives 60 hours go psw services through the CACC. According to the lthc act, we are entitled to 90 hours of support and homemaking services. I am unable to feed myself, or care for myself, and could use the additional 30 hours a month. My worker continues to insist that I am only entitled to 60. Complaint process is lengthly and designed to discourage complaining.

    • Fed up says:

      Blah Blah Blah Blah…typical political answer. It can be MADE CLEAR relentlessly, but that is tantamount to buying a brand new car with no engine or wheels…… good for nothing

  • Maya says:

    Just wondering…how does one actually measure the quality of home care? based on qualitative measurements like responses of patients or other home care workers? Because if some more focus is done on home care, then there can be reduction of chronic patients taking up hospital beds. This can in-turn reduce wait times say in the emergency section making them available to more immediate patients.

    I know that the relationship isn’t as simple I made it sound but just a thought…

  • Mark MacLeod says:

    This seems a classic case for care guidelines, funding guidelines and so on. The idea of reducing the tails of the curve to ward the mean will improve quality of care at the low end and reduce overspending at the top end. This scenario cries out for one home care agency.

    • Faco says:

      While I do not trust Hudak, as a Health Care Employee the LHIN’s soulhd be most definitely disbanded. (just my opinion) Provincial auditor Andre Marin berated them as being borderline corrupt, with next to no public input on any decisions made with regards to the areas they service . The pseudo public input meetings and requests were just window dressing so they can claim they had public input. NO LHIN’s! If you don’t agree with me, perhaps check public input in Welland, Port Colborne, Fort Erie and St, Catherine’s and see how they feel about these wonderful LHIN’s . No thank you.


Karen Born


Karen is a PhD candidate at the University of Toronto and is currently on maternity leave from her role as a researcher/writer with

Andreas Laupacis

Editor-in-chief Emeritus

Andreas founded Healthy Debate in 2011. He is currently the editor-in-chief of the Canadian Medical Association Journal (CMAJ)

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