The Progressive Conservative government is poised to back off from controversial cuts to the MedsCheck prescription counselling program and changes to dispensing fees for pharmacists who serve nursing homes, the Star has learned.
In the wake of recommendations from the inquiry into the insulin murders of nursing home residents by nurse Elizabeth Wettlaufer, the Tories are rethinking plans unveiled in the spring budget and detailed in a more recent regulatory posting.
The MedsCheck program, which mostly helps senior citizens, covers the cost of having a pharmacist counsel patients who are taking three or more different prescription medicines for chronic conditions.
Restricting the free MedsCheck consultations to “patients transitioning between health-care settings” was designed to save $140 million annually by 2022, according to then-finance minister Vic Fedeli’s April spending plan.
Fedeli was demoted to economic development minister in Premier Doug Ford’s massive cabinet shuffle on June 20 when Rod Phillips became treasurer.
The cut would leave nursing home residents more vulnerable to potential drug interactions, said a veteran long-term care pharmacist who spoke on condition of anonymity.
On Friday, a spokeman for Health Minister Christine Elliott emphasized that the situation remains fluid despite what was in the budget.
“While our government identified certain commitments in the budget concerning MedsCheck and pharmacy funding models, the Ministry of Health has been working with stakeholders over the past few months to identify alternative proposals that continue to achieve our objective of a more sustainable Ontario Drug Benefit program,” said Travis Kann.
“These discussions have been incredibly productive and demonstrate the value of government and stakeholders working together. We expect to have more to say on the new proposals shortly,” said Kann.
The Wettlaufer inquiry and alarms being sounded by seniors and pharmacy groups seem to be having an impact at Queen’s Park.
“We’re quite worried about the safety of the patients,” added the pharmacist, noting Fedeli’s proposed capping of dispensing fees to $1,000 per bed annually by 2023 from about $2,000 would jeopardize services.
That includes customized daily medication packages for each nursing home resident.
“It means the nurses get the right meds at the right time for the right person,” the pharmacist said, speaking confidentially out of a fear of retribution.
“We won’t be able to do as much as we’re doing now. If they stick with the cuts we’re going to be hard-pressed to just deliver the meds.”
That warning was echoed in a May submission to the government by AdvantAge Ontario, the association representing non-profit long-term care homes in the province.
“The proposed changes are likely to result in reduced pharmacy expertise in LTC homes, leading to an increased financial burden on already-strained budgets to maintain current levels of care and services. The changes would also likely lead to an increased risk of adverse medication events and the potential for avoidable hospitalizations of residents, which will undermine efforts to end hallway healthcare.”
In June 2017, Wettlaufer pleaded guilty to killing eight residents in two southwestern Ontario nursing homes, Caressant Care in Woodstock and Meadow Park in nearby London. She admitted to killing a ninth person after she began serving a life sentence.
Her deadly spree would have gone undetected had she not confessed of her own volition in September 2016.
The public inquiry headed by Justice Eileen Gillese of Ontario’s Court of Appeal made 91 recommendations and urged the province to increase “the role of pharmacists” and fix “systemic vulnerabilities.”
Other findings included calls for intensive ministry oversight of nursing homes; more ministry funding for training and education of nursing home staff; increasing the number of registered nurses and staff in the homes; and urging nursing homes to build a more stable supply of staff while limiting the use of agency nurses who roam from one workplace to another.
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The four-volume report also called for government grants of up to $200,000 for each of Ontario’s 626 nursing homes to make infrastructure and other changes to better secure medication. Wettlaufer murdered her victims with overdoses of insulin.
But the report did not specify how much extra ministry funding all the recommendations would require.
“The best way to prevent similar tragedies is to strengthen the long-term-care system,” said Gillese.
In her response, newly minted Long Term Care Minister Merrilee Fullerton, herself a medical doctor, promised “new funding to address the recommendations” and pledged “immediate action” but did not specify what it would be.
Fullerton committed to table a study in the legislature by this time next year on the status of the government’s progress on implementing the recommendations.
The Tories have been backing off other planned health-related changes in recent days.
On Thursday, Elliott postponed the cancellation of out-of-country emergency medical coverage under OHIP until Jan. 1, which had also been announced in the budget.
That’s when a new program will begin in order to continue the funding of life-saving kidney dialysis for Ontarians travelling outside Canada.
The climbdown after dialysis patients pressured Premier Doug Ford’s government with warnings that they would not be able to leave the country without subsidies for their expensive treatments.
Out-of-Canada coverage for medical emergencies under the Ontario Health Insurance Plan had been slated to end Oct. 1.
Officials said the deadline had to be pushed back to allow for a more seamless transition amid concerns from travel health insurance companies and their customers.
Robert Benzie is the Star’s Queen’s Park bureau chief and a reporter covering Ontario politics. Follow him on Twitter: @robertbenzie
Rob Ferguson is a Toronto-based reporter covering Ontario politics. Follow him on Twitter: @robferguson1