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The Ontario government announced new legislation on Wednesday that could force elderly patients into long-term care facilities they don't choose, and charge those who don't comply $400-per-day.Fred Lum/the Globe and Mail

Ontario hospitals will be able to temporarily enroll elderly patients in long-term care homes they did not choose within a 70-kilometre radius from their preferred facility in Southern Ontario – and a 150-kilometre radius in Northern Ontario – while charging those who refuse to leave a $400-a-day fee.

The new details come from a government statement, released on Wednesday, summarizing just-filed regulations meant to give force to the government’s new health care legislation, known as Bill 7. The province says the legislation, fast-tracked through the legislature last month, is needed to free up hospital beds and address the overcrowding in its buckling health care system.

Speaking to reporters, Long-Term Care Minister Paul Calandra said some patients in Northern Ontario could end up sent to nursing homes even farther away than a 150-kilometre radius, if no spot within that range could be found. The government said its changes to hospital powers will take effect Sept. 21, with the $400-a-day fee enacted as of Nov. 20.

Advocates for seniors and opposition politicians at Queen’s Park have warned for weeks that Bill 7 would see frail seniors and their families coerced by the threat of massive bills into accepting spots in long-term care homes far from loved ones – or that lack air conditioning or suffered high death rates in the COVID-19 pandemic. Mr. Calandra had repeatedly dismissed their criticism as “fear-mongering.” But until Wednesday, he would not say precisely what guidelines would apply when hospitals use the new powers.

Opposition critics say the new regulations confirm their fears. Ontario NDP health critic France Gélinas, criticizing the requirement for hospitals to charge those who refuse to leave, invoked Tommy Douglas, the former federal NDP leader and Saskatchewan premier regarded as the father of Canada’s public health care system.

“Tommy Douglas is stirring in his grave right now, that you would be charged $400 to stay in a hospital bed,” Ms. Gélinas told reporters.

The legislation is aimed at what are known as ALC or “alternate level of care” patients. These patients, no longer in need of full-blown hospital care, are often awaiting a bed in their preferred long-term home. Ontario says its hospitals are home to about 2,000 such patients, even as crowding and staff shortages have forced some to temporarily close emergency rooms.

Before the bill passed, critics warned about the potential for it to increase hospitals’ rare use of existing powers to bill discharged patients who refuse to leave as much as $1,800 a day.

Mr. Calandra, asked last month about Bill 7 and this practice of charging fees, said he would “absolutely” encourage hospitals to use them in some cases. But a few days later, Premier Doug Ford told reporters the notion of an $1,800 fee was “absolutely ridiculous” and that the fees associated with Bill 7 would be lower.

On Wednesday, Mr. Calandra and Health Minister Sylvia Jones announced the $400-a-day charge and the other details at a news conference at Queen’s Park, right after the legislature met for an hour to pay tribute to the Queen and then adjourned until Oct. 25.

The government has said it hoped to move 250 patients out over the next six months and 1,300 by next March. But Ms. Jones said Wednesday she hoped to create 400 new spaces in hospitals with the plan.

Asked how the new policy amounted to anything but coercion of patients, Ms. Jones said long-term care beds would be better for those involved.

“We are making sure that you are most appropriately placed,” she said. “And that appropriate place is not an acute care facility where you no longer are in need of acute care.”

In a joint statement released before they took questions from reporters, the ministers said the policy will be “implemented compassionately.” Other provinces, the statement reads, have had this kind of policy in place for decades – a statement the NDP’s Ms. Gélinas disputed, saying other provinces do not override patient consent in the same way.

The statement also says regulations and guidance to hospitals, which Mr. Calandra said is still being drafted, will “respect religious, ethnic and language preferences.” Couples will be kept together, the statement says.

Jane Meadus, a lawyer with the Advocacy Centre for the Elderly in Toronto, said many patients are reluctant to go to older long-term care homes with poor records in the pandemic – which tend to be the homes with vacancies where they could now be sent under the new rules.

“The homes that have beds waiting, there are reasons for that,” she said. “Frankly, maybe nobody should be living in those homes.”

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