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The peopleCare Oakcrossing long-term care home in London, Ont., on Mar. 24.Fred Lum/the Globe and Mail

New legislation aimed at addressing Ontario’s health crisis gives hospitals sweeping powers to eject anyone from their facilities if they no longer need acute care, a move experts warn will put vulnerable, complex patients at risk.

The More Beds, Better Care Act, which recently took effect, was touted by the government as a way to temporarily move seniors who require medical help but don’t need urgent hospital-based care into long-term care facilities they didn’t choose in order to free up hospital beds.

But the new law goes far beyond that, allowing hospitals to label any patient no longer in need of acute or life-saving care as alternate level of care (ALC) and trigger an involuntary move back to their homes, into a shelter, care facility or elsewhere. As of Nov. 20, hospitals are required to charge patients who don’t comply with the discharge order $400 per day.

“They can kick anyone out of a hospital,” said Samir Sinha, director of geriatrics at Sinai Health and the University Health Network. “A discharge planner can come up with a whole plan without your involvement or your family. If you say no, you’re on the hook.”

Laura Tamblyn Watts, CEO of seniors advocacy group CanAge, said the new rules make it too easy for hospitals to discharge frail seniors, people with disabilities, individuals with mental health or substance use issues and others who are sick but don’t necessarily require hospital services. Many of these individuals don’t want to be in the hospital, but end up staying there because they have nowhere to go, given the lack of available home care, mental health supports, long-term care beds or other necessary resources, she said.

“What this is going to create is a dumping ground, particularly for psychiatric patients, particularly for patients with mental health and addiction issues, no matter what their age, and particularly for patients with complex needs,” Ms. Tamblyn Watts said. “If you put a human face on this, it’s absolutely horrifying.”

While many provinces across the country have long used “first available bed” policies to incentivize seniors or their caregivers to quickly accept placement in a long-term care facility, Ms. Tamblyn Watts said Ontario’s new law is unique because it eliminates the need for patient consent before triggering a move out of hospital.

Jane Meadus, staff lawyer and institutional advocate with the Advocacy Centre for the Elderly, said over the past decade, she’s seen a major upswing in hospitals putting pressure on patients to accept discharge in the absence of adequate post-hospital care. Until now, patients have been able to withhold consent from such moves, but that’s no longer the case. It’s a situation that will allow hospitals to remove a host of vulnerable patients who are in the hospital because they need help and have nowhere else to turn, she said. Ms. Meadus added this will make it more difficult for already overwhelmed long-term care facilities and other community resources to manage.

“They pick the least able to fight and the easiest target here,” Ms. Meadus said.

There are currently about 6,000 ALC patients in Ontario hospitals and less than half are waiting for long-term care. Many on the list are waiting for services such as home care, rehabilitation or palliative care.

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There are about 39,000 people on the waiting list for long-term care in Ontario and the median waiting time is about four months, according to the provincial government. Many on the list are waiting at home for a bed to open up. Ms. Tamblyn Watts said the new legislation likely means those in the community will be bumped down the list, resulting in an even longer wait.

The Ontario Hospital Association, which represents the province’s hospitals, declined an interview request. In an e-mail statement, president and CEO Anthony Dale said it’s not appropriate for patients awaiting long-term care, home care or other services to remain in hospital.

Ontario’s health ministry declined an interview request. In response to questions, a spokesperson e-mailed a previously distributed letter from hospital executives who support the changes, as well as a fact sheet and statement about the new legislation.

Dr. Sinha said the new rules creates a “huge power imbalance” between hospitals and vulnerable patients. And it fails to address staff shortages and other underlying reasons why hospitals have been facing such strain in recent months.

“We have a lot of beds at our hospital currently sitting empty and cannot service patients because the nurses have left,” he said. “We’re not fundamentally solving this issue in a meaningful way.”