The Ontario government is closing a gap in medicare that temporarily denies home-care coverage to Canadians who relocate from other provinces, including terminally ill patients who are not expected to live past the three-month waiting period for an Ontario Health Insurance Plan card.
The province’s Liberal government, which is facing a tough re-election fight next month, is making the move 18 months after an NDP MPP tabled a private member’s bill in memory of Dan Duma, a Windsor, Ont., man who was refused publicly funded home care after he returned to his hometown from a job in Alberta.
Mr. Duma died of liver cancer at the age of 48 in July, 2016. His final wish was to die at home, but that was not possible without the help of nurses, personal-support workers and medical equipment to ease his end-of-life suffering.
In the end, a doctor bent the rules to secure a bed for Mr. Duma at a hospice in Leamington, about 45 minutes from Windsor, Ont. Hospice services are subject to the same three-month waiting period as home-care services.
Laura Duma, Mr. Duma’s eldest daughter, said she was thrilled that other Ontario patients would not face the same lack of home care as her father did.
“That’s amazing. Amazing. I’m floored,” Ms. Duma, a 30-year-old nurse practitioner, said in an interview on Tuesday. “It was a difficult story to tell and a difficult story to revisit, but it’s been worth it if it’s led to this.”
The Duma family first shared their experience publicly in October, 2016, when Windsor West MPP Lisa Gretzky introduced a private member’s bill that would have waived the three-month waiting period for home care for patients who move to Ontario from another province where they qualified for public health insurance.
Despite nominal support from all three parties, Premier Kathleen Wynne and her majority government let Ms. Gretzky’s bill languish in committee until now, six weeks before Ontarians go to the polls.
“It does look like they’ve stolen another idea from us,” Ms. Gretzky said. “But at the end of the day, the important thing is that the change gets made so that other families like Dan’s family don’t have to go through what they had to go through.”
John Fraser, the parliamentary secretary to Ontario Health Minister Helena Jaczek, said on Tuesday that his government took its time because it hoped to convince other provinces and territories to amend the national interprovincial billing agreement that caused the problem in the first place.
“We just weren’t getting movement there,” Mr. Fraser said. “We felt we had to go it alone and take some leadersship.”
The Ontario Liberals are now proposing that regulatory amendments would not apply to other provincial governments.
Under the current reciprocal billing agreement, every province and territory is supposed to foot the health-care bills of their residents for the first three months after they move to another province.
But the agreement only covers “medically necessary” hospital and physicians’ services guaranteed by the Canada Health Act, the federal legislation that underpins the country’s publicly funded, single-payer health-care system.
The Act does not cover home care.
The Liberals’ plan goes one step further than Ms. Gretzky’s bill would have: The regulatory changes would offer full OHIP coverage, including drug coverage for qualifying patients, during the three-month waiting period in Ontario.
It would also cover three months of home care in other provinces for patients who move out of Ontario.
The changes are expected to cost $2.3-million a year and affect between 600 and 650 patients annually, a spokeswoman for Dr. Jaczek said.
The proposed regulatory changes will be posted online on Wednesday, but won’t take effect before next fall.
Mr. Fraser said he does not expect the election to derail the changes because all three parties are in favour of closing the home-care gap.
“This stake is in the ground very deep,” Mr. Fraser said. “I don’t think anyone is going to try to pull it out, whatever happens after [the election] June 7. It’s a non-partisan thing.”
Darren Cargill, the palliative physician who cared for Mr. Duma and championed Ms. Gretzky’s bill, called the Liberals’ move great news for patients, but said he wished it hadn’t taken so long.
“We wanted the government to act as quickly as possible, because we knew other people were going to fall into this trap,” said Dr. Cargill, the medical director for the Hospice of Windsor and Essex County.
Laura Duma said her father would have been “so happy” to see some good come of his struggle to access home care in his final days.
“When he was still able to communicate with us, he always said, ‘You’ve got to change this for people.’”