1. 1 Coming of Age: The municipal role in caring for Ontario’s seniors NOMA Annual Meeting and Conference April 27, 2011 Petra Wolfbeiss, AMO

2. 2 Municipalities and Long Term Care 1947-The Homes for the Aged Act 1949 designated municipalities required to establish home for the aged 2007- Long Term Care Homes Act, requirement to “have a long term care home” NOMA Annual Meeting and Conference

3. 3 What AMO has heard Growing concern with municipal requirement Desire for greater flexibility Principled consideration of municipal role in health services NOMA Annual Meeting and Conference

4. 4 AMO’s Interest in Long Term Care Examine the municipal context-issues and pressures Local diversity Changing context of long term care NOMA Annual Meeting and Conference

5. 5 What we know Demographics-aging population Supply and demand-long term care as a growth industry Municipal issues and cost drivers NOMA Annual Meeting and Conference

6. 6 Demographics In Canada, 65 and older:  3.9% in 1881 to 8% 1941 January 2011-baby boomers turn 65  8.4% in 1956 and 13.6% in 2006 Ontarians over 65  13.7% in 2009 to 23.4% by 2036 NOMA Annual Meeting and Conference

7. 7 Demographics Percent increase in seniors in next 20 years:  86% This shift will require a shift in municipal fiscal priorities NOMA Annual Meeting and Conference

8. 8 Supply and Demand Current waitlist: over 25,000, 5.1% increase over the last year Collateral Effects More seniors means more beds NOMA Annual Meeting and Conference

9. Municipal Issues and Cost Drivers Municipal dollar share increasing Provincial legislation and initiatives Other factors: arbitration, pay equity, local challenges NOMA Annual Meeting and Conference 9

10. Municipalities Lead Innovation Contribute over $300,000 million annually NOMA Annual Meeting and Conference 10

11. What are our options? Series of reports telling us we have to plan now Some municipalities have explored options NOMA Annual Meeting and Conference 11

12. Possible options for consideration Fulfill legislative requirements Change the requirement Outsource operations but keep governance Maintain ownership but outsource operations and governance Sell the home and redirect contributions Transfer beds to non-profit and/or for profit Various forms of partnership NOMA Annual Meeting and Conference 12

13. What we also know Municipalities can no longer support the province Municipalities must be supported by appropriate and sustained funding Health care is a provincial responsibility NOMA Annual Meeting and Conference 13

14. What is unclear Who will fill the void? NOMA Annual Meeting and Conference 14