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DIAGNOSTIC AND MEDICAL EQUIPMENT INITIATIVE FUNDING

1.         RECOMMENDATIONS

It is recommended that:

1.       Regional Council approve the receipt and expenditure of $382,668 in additional 100% one-time grants from the Ministry of Health and Long-Term Care (MOHLTC) for the purchase of new and/or replacement medical, diagnostic and patient care equipment under the Federal/Provincial Diagnostic and Medical Equipment Initiative.

2.       Staff be authorized to immediately proceed with the procurement of the equipment and the award of the contracts for the supply and delivery prior to approval of the 2005 Regional Budget.

3.       Staff be authorized to enter into the necessary agreements with the MOHLTC to facilitate the receipt and expenditure of the funds.

2.         PURPOSE

The purpose of this report is to secure approval from Regional Council for the receipt and expenditure by the Long Term Care and Seniors Branch (LTCSB) of additional 100% one-time subsidy from the MOHLTC for the purchase of new and/or replacement medical, diagnostic and patient care equipment related to the Federal/Provincial Diagnostic and Medical Equipment (DME) Initiative. 

3.         BACKGROUND

The Federal/Provincial DME Initiative provides funding for both Long Term Care (LTC) Community Agencies and LTC Facilities.  Grants for LTC community agencies are targeted to improve access to equipment that helps people remain safely and independently at home and avoid costly hospital and physician services.  The DME Initiative is also part of a larger investment by the federal government to upgrade and modernize medical, diagnostic and treatment equipment for long term care facilities in Ontario.

3.1       Approved LTC Community Agencies

On January 27, 2005, the MOHLTC advised the LTCSB that approved LTC community agencies under the Long Term Care Act are eligible to apply for funding under the Federal/Provincial DME Initiative (see Attachment 1).  The Region's approved LTC community agencies include:  Community Support Services, Supportive Housing Services and Acquired Brain Injury Services.

3.2       Long Term Care Facilities

On January 31, 2005, the MOHLTC notified the LTCSB of the 2004/05 DME Initiative grant allocations for long term care facilities (see Attachment 2).  The Region's two health care centres are eligible for a total of $121,218 in 100% one-time grants under this initiative.

4.         ANALYSIS AND OPTIONS

The following provides a more detailed overview of the funding allocations and their recommended utilization.

4.1       Utilization of Funding - Approved LTC Community Agencies

Several regionally operated LTC community agencies qualify for DME funding under the DME Initiative.  These agencies include: The Alternative Community Living Program, the Acquired Brain Injury Day Program, Alzheimer Day Program, Physically Disabled Day Program, and Speech Disorders Day Program, Client Intervention and Assistance Services and the Regional Psychogeriatric and Mental Health Consulting Service.  The MOHLTC has not predetermined specific funding limits/amounts for approved agencies.  Agencies have been invited to submit lists of eligible equipment which the ministry will then use to prioritize and allocate funds.

The Ministry has directed that funds in these programs must be used for the purchase of equipment resources that will:

�       Enable people to live more securely in their homes

�       Reduce hospital stays and prevent accidents that would lead to hospitalization

�       Reduce stress and decrease potential for injuries in caregivers

�       Help people avoid requiring admission to a long term care facility

�       Enable people to be more independent and keep their jobs

�       Encourage an active lifestyle, possibly delaying the need for physician services, home care or other costly services

Based on MOHLTC guidelines and consultation with staff, a list of equipment for purchase under this program has been developed.  Items identified include:  automatic door openers, specialized therapeutic/pressure relief mattresses, lifting devices, and specialized seating.

In order to qualify for this initiative, funding documents had to be received by the MOHLTC by February 14, 2005 and equipment has to be delivered by March 31, 2005.  As a result, the equipment list and application for $261,450 were submitted to the MOHLTC by the LTCSB subject to Regional Council approval.

Once notification from the MOHLTC is received regarding funding allocations, the LTCSB will proceed with the purchase of equipment.

4.2       Utilization of Funding � Long Term Care Centres

The Newmarket and Maple Health Centres are eligible for a one-time grant of $121,218, which equates to an allocation of $522.44/bed.  The funds must be used for the purchase of DME that is new and not previously used, is greater than $250 per unit in value, and "replaces" equipment currently located within the existing, licensed and approved premises. 

Based on the guidelines provided by the MOHLTC and consultation with staff, a list of replacement equipment for purchase under this program has been developed.  Items identified on the list include:  specialized therapeutic/pressure relief mattresses, lifting devices, wound and skin care equipment, diagnostic and treatment equipment, fall prevention equipment and security/safety equipment.  These priorities are based on upgrading equipment that will promote client independence and/or enhance the quality and effectiveness of services provided to residents. 

The required agreement with the MOHLTC stipulates that equipment must be purchased and received by the LTCSB on or before March 31, 2005.  In order to qualify for this funding, the equipment list and application were completed, signed and submitted by the LTCSB to the MOHLTC, subject to Regional Council approval.  As well, to meet the MOHLTC requirements and timeframes it was necessary to issue Purchase Orders for the equipment subject to Regional Council approval.

4.3       Relationship to Vision 2026

The upgrade and purchase of the identified equipment for long term care programs will contribute to the attainment of Vision 2026 goals of developing Quality Communities for a Diverse Population and Responding to the Needs of our Residents. 

The Long Term Care and Seniors Branch offers a continuum of community-based, outreach, day and institutional services that support clients with a diverse range of care and support needs.  The equipment will facilitate the promotion of wellness, independence and autonomy in our client programs and lead to enhanced outcomes for the clients.

5.         FINANCIAL IMPLICATIONS

As a result of the approval for the receipt and expenditure of the 100% one-time grant funds, there will be a gross increase of a maximum of $382,668 in the proposed 2005 LTCSB Operating Budget (see Table 1).  There will be no net tax levy impact.

Table 1

DME Initiative 100% Funding

	Total Funding
LTC Community Agencies Grant (awaiting MOHLTC approval)	$261,450
LTC Facilities Grants:*
Newmarket Health Centre	68,969
Maple Health Centre	52,249
Total 100% MOHLTC Funding	$382,668

* This funding equates to an allocation of $522.44/bed.

In order to comply with the terms and conditions established by the MOHLTC (which stipulate that these funds must be expended by March 31, 2005), it is necessary to receive and expend these funds in advance of approval of the proposed 2005 Regional Budget.

The life cycle of the new/replacement equipment ranges from approximately four�five years for therapeutic mattresses to seven�ten years for diagnostic equipment and automatic door openers.  Approximately 90% or $340,000 is targeted for replacement equipment and 10% or $38,000 is for new equipment.  Receipt of these 100% provincial funds will allow us to accelerate planning upgrading of resident care equipment and expedite a number of our accessibility objectives at no cost to the Region.

6.         LOCAL MUNICIPAL IMPACT

The purchase of the identified equipment will enhance our ability to deliver long term care services for all citizens receiving these services in Regional Health Centres and Long Term Care programs.

7.         CONCLUSION

The approval of the recommendations regarding the receipt and expenditure of the additional subsidy from the MOHLTC under the Federal/Provincial Diagnostic and Medical Equipment Initiative will enable staff to proceed with the purchase of the identified equipment within the required timeframe to qualify for the funding.  As well, the additional equipment will enhance the delivery of care and contribute to client wellness, independence and safety.

The Senior Management Group has reviewed this report.