The Invisible Program
**This featured case is one example of the concerns people have brought to us. Names have been changed to protect the identity of the people involved.
Two families contacted us about the Saskatoon Health Region’s Individualized Funding (IF) program. The program is an option available in the Region’s Home Care program. Eligible individuals who are accepted into the IF program are given funds to arrange and pay for supportive care services on their own.
Josie & Iona
Josie’s mother Iona was receiving home care from the Region. Josie thought her mother needed more services than home care could offer, so told Region staff that she was looking for alternative care. Thinking there were no other options, she hired a live-in caregiver. A few years later, Josie learned about IF from Service Canada, so she requested it from the Region. Iona was placed on a wait list. Region staff estimated that the wait would be about 19 months. After about two years, Josie contacted our Office. She told us that she had trouble getting clear information about where Iona was on the wait list. After our initial inquiries, Iona was reassessed and offered IF program funding.
Jessica & Issac
Jessica’s husband, Isaac, needed constant care. When an acquaintance told Jessica about IF, she contacted the Region. Isaac was assessed and placed on the wait list. Staff told Jessica that due to lack of funding, no new clients were being accepted into the program. She told us that when she called the Region periodically over the next few months, she did not get clear information about when IF would accept new clients. She hired a lawyer who advocated for Issac’s acceptance into the program. The Region granted funding a couple of months later.
Although both families were eventually offered spots in the IF program, they encountered similar problems: they did not hear about the program from the Region; and they did not understand how the wait list was being managed or how long they would be on it. One family also questioned whether Ministry of Health rules permitted the use of a wait list.
We investigated and found that the Ministry of Health’s Home Care Policy Manual requires regions to offer an IF program, but does not require it to be provided immediately to all who qualify. We concluded that wait lists can be used as long as the criteria are understandable and periodic updates are provided.
The Saskatoon Health Region provided an IF program, but only funded a small number spots. A Region official told us that the Region did not promote the program because there is little point in telling people about it if there is no hope of them ever receiving funding. In our view, it was not fair to withhold information about the program from families. If the wait list increased as a result of the program being properly promoted, then the Region and the Ministry would have useful information for making funding decisions, and families would have the information they need to make decisions about how to care for their loved ones.
The Region staff we interviewed did not have a common understanding of how the wait list is managed or how service requests are prioritized. Neither Jessica nor Josie knew who to call and both told us that they received different information from Home Care and the Region’s Client/Patient Access Services (which conducts the eligibility assessments for IF).
Based on our findings, we made the following recommendations to the Saskatoon Health Region:
1. Take reasonable steps to inform the public and Home Care clients about the program.
2. Have consistent and transparent wait list assessment criteria.
3. Provide applicants with accurate and timely wait list information.