Ontario passes bill that would transfer hospital patients to alternative long-term care homes

Ontario's Progressive Conservative government passed legislation Wednesday that would force hospital patients awaiting long-term care into nursing homes not of their choosing on a temporary basis, but many details of the new law remain unknown.

Patients who refuse to move to long-term care are expected to be charged a fee, although it's unclear how much. Premier Doug Ford has said, however, that they won't be billed an uninsured rate of $1,800 per day.

Ford said the legislation is aimed at providing appropriate care to those patients.

"It's not about the cost, it's about giving proper health care to people that should be in long-term care," he said at the legislature.

NDP Leader Peter Tabuns said the new law will hurt seniors and cause needless suffering.

"It's very clear: people will get bullied, they will get huge bills, they will be pushed out the door," he said.

Neither Long-Term Care Minister Paul Calandra nor Health Minister Sylvia Jones spoke to reporters following the passage of the bill.

Calandra's office did not immediately respond to several questions seeking clarity on the new law. The province has also refused to answer questions about how far patients might be moved from their families.

Earlier in the day, Calandra scoffed at the idea hospitals would charge exorbitant amounts to patients who refuse to move into a nursing home not of their choosing.

"(The Opposition) talk about huge fees -- not the case," he said in question period.

The province pushed through Bill 7 quickly as part of its efforts to deal with an ongoing health-care crisis, moving earlier this week to bypass public hearings on the legislation.

Hospital emergency departments have been closed for hours or days at a time in recent months, largely due to a nursing shortage.

The province says there are about 6,000 patients in hospital who require an "alternate level of care" and should be discharged. Among those patients, about 1,800 are on a waiting list for long-term care homes, the province said.

The new legislation doesn't allow patients to be physically forced to move to a long-term care home, but it's not clear what would happen if a patient refuses a transfer.

Hospitals can already charge alternative-level-of-care patients a co-pay of $62 per day, which advocates say is roughly what they would be paying in long-term care.

Senior and long-term care advocates have said hospital uninsured rates could be upwards of $1,800 per day.

Ford has said that amount is "absolutely ridiculous." He said hospitals and Ontario Health are determining the cost patients would have to pay.

"I can pretty well guarantee it's not gonna be $1,800," Ford said Tuesday night. "We just want these patients to go into a proper environment that is just better for them."

The province has said those costs will likely be made public next week.

The new bill focuses on patients who are well enough to leave a hospital to an "alternate level of care." The legislation would allow "certain actions to be carried out without the consent of these patients." Those actions include allowing a placement co-ordinator to choose and authorize admission to a home.

However, the bill says the "actions cannot be performed without first making reasonable efforts to obtain the patient's consent." It also says it "does not authorize the use of restraints in order to carry out the actions or the physical transfer."

Several organizations asked the Ontario Human Rights Commission to use its public inquiry powers to "to investigate systemic discrimination based upon age against the elderly in the provision of health care in Ontario."

"Under the Ford government's new legislation, frail, vulnerable seniors have been targeted, wiping out their human right to informed consent for health care," Natalie Mehra, the executive director of Ontario Health Coalition, wrote in a statement.

"This is a fundamental question of justice. Elderly patients are not taking undue resources any more than other patients. It is the cruelty of ageism laid bare and the Ontario Human Rights Commission must finally take action."

The new law and how quickly it went through the legislature is appalling, said Jane Meadus, a lawyer with the Advocacy Centre for the Elderly who fights for the rights of those in long-term care homes, hospitals and psychiatric facilities.

"It's a very sad time when the government takes such action to try to fix problems that shouldn't be there in the first place because of underfunding and poor planning in the health system," Meadus said.

"It's going to create a lot of problems and a lot of burdens on people."

This report by The Canadian Press was first published Aug. 31, 2022.