Health Care Providers
Individuals requiring skilled home care services usually receive their care from
a home health care provider. Services provided by these providers are highly
supervised and controlled. Some providers deliver a variety of home care services
through nurses, therapists, social workers, homemakers and personal support workers,
durable medical equipment and supply dealers. Other home health providers limit
their services to nursing and one or two other specialties. For cases in which
an individual requires care from more than one specialist, home health providers
coordinate a caregiving team to administer services that are comprehensive and
efficient. Personnel are assigned according to the needs of each patient. Home
health providers recruit and supervise their personnel; as a result, they assume
liability for all care.
Homemaking providers employ homemakers, personal support workers and companions
who support individuals through meal preparation, bathing, dressing, and
housekeeping. Personnel are assigned according to the needs and wishes of
each client. Homemaking providers recruit, train, and supervise their personnel
and thus are responsible for the care rendered.
Home Support Providers
Community Support providers generally are not-for-profit organizations who
receive funding from the government and are comprised of paid and volunteer
staff. Services include adult day programs; Alzheimer/dementia overnight
care; friendly visiting; intergenerational programs, social and recreation;
and transportation. Some community support providers also employ nurses and
personal support workers and have contracts with CCACs.
Institutional and Private-duty Providers
Staffing and private-duty providers generally are nursing providers that provide
individuals with nursing, homemaker, personal support worker, and companion
services. Some staffing and private-duty providers assign nurses to assess
their clients' needs to ensure that personnel are properly assigned and provide
ongoing supervision. These providers recruit their own personnel. Again,
responsibility for patient care rests with each provider.
Pharmaceutical and Infusion Therapy Companies
Pharmaceutical and infusion therapy companies specialize in the delivery of
drugs, equipment, and professional services for individuals receiving intravenous
or nutritional therapies through specially placed tubes. These companies
employ pharmacists who prepare solutions and arrange for delivery to patients.
Nurses also are hired to teach self-administration in patients' homes. Each
company assumes responsibility for personnel and the services rendered.
Durable Medical Equipment and Supply Dealers
Durable medical equipment and supply dealers provide home care patients with
products ranging from respirators, wheelchairs, and walkers, to catheter
and wound care supplies. These dealers employ staff who deliver and, when
necessary, install these products as well as instruct patients on their proper
in-home use. Durable medical equipment and supply dealers usually do not
provide physical care for patients, but there are a few exceptions. Some
dealers offer pharmacy and infusion services, where a nurse administers medication
and nutritional formulas to patients and teaches them the proper techniques
for self-administration. Some companies also provide respiratory therapy
services to help individuals use breathing equipment. Each dealer is liable
for its personnel and the services provided to patients.
The Ministry of Health and Long-Term Care (MOHLTC)
is the department of the Ontario government that is responsible for administering
the health care system and providing health care services to the public
through such programs as health insurance (OHIP), drug benefits, assistive
devices, care for the mentally ill, long-term care, home and community
support services, public health, health promotion and disease prevention.
The MOHLTC also funds and regulates hospitals and long-term care facilities,
operates psychiatric hospitals and public health laboratories and co-ordinates
emergency health services.
Care Access Centres (CCACS) are the provincially-funded organizations
providing information about the care options available in designated
geographic areas. In 1996, the Ministry of Health and Long-Term Care
established 43 Community Care Access Centres covering all of Ontario.
CCACs serve as a local point of contact and service co-ordination.
CCACs also determine eligibility for government-funded home and community
support services and admission to a long-term care facility.
Government or Publicly-Funded Services are
the services that receive partial or 100% funding from the Ministry of
Health and Long-Term Care (MOHLTC). In some cases the funding is administered
via a CCAC, and other times the funding is administered directly by MOHLTC.
Provider Organizations are the corporations
that deliver services to the client directly and/or operate a building
where care is provided. These organizations are usually incorporated
entities, and can be one of the following: a non-profit organization,
a private corporation, a municipal government or an aboriginal organization.
Home care services are usually provided by provider organizations but
may also be obtained from registries and independent providers. Home
care organizations include home health providers; community support providers;
staffing and private-duty providers; and companies specializing in medical
equipment and supplies, pharmaceuticals, and drug infusion therapy.
Home care services generally are available 24 hours a day, seven days
a week. Depending on the client's needs, these services may be provided
by an individual or a team of staff working on a part-time, intermittent,
hourly, or shift basis.
Registries serve as employment providers for home care nurses and homemakers
by matching these providers with clients and collecting finder's fees. Clients
select and supervise the work of a registry-referred provider. They also
pay the provider directly and must comply with all applicable provincial
and federal labour, health, and safety laws and regulations, including payroll
tax and other withholding requirements.
Independent providers are nurses, therapists, homemakers, personal support
workers and companions who are privately employed by individuals who need
such services. In this arrangement, the responsibility for recruiting, hiring,
and supervising the provider rests with the client. Finding back-up care
in the event that the provider fails to report to work or fulfill job requirements
is the client's responsibility. Clients also pay the provider directly and
must comply with all applicable provincial and federal labour, health, and