A staff shortage means extra costs for a user

The complaint

Every once in a while, a quadriplegic user who lives at home has to be lodged temporarily because of a shortage of CSSS staff accustomed to giving him the home support services he needs to remain at home. He has complained about having to pay the hospital centre for his meals when he is lodged there for that reason.

Seeing as how he is lodged occasionally not out of choice but because of a lack of staff able to provide him with home support services, the user argues that he should not have to pay for his meals.

The investigation

• Under section 99.7 of the Act respecting health services and social services, CSSSs are responsible for coordinating the services required by users. They must, among other things, "take in charge, accompany and support persons, especially those with particular and more complex needs, in order to provide, within the local health and social services network, the continuity of service required by their state of health."
• During the user’s hospital stays, the hospital centre provides him with the care and personal assistance services he is entitled to as if he were at home.
• The user’s intervention plan also includes domestic help services such as housekeeping, meal preparation and shopping.
• Although his needs for personal assistance services are met when he is lodged temporarily, there are other essential needs, including meal preparation.
• The Ministère de la Santé et des Services sociaux’s Home Support: Always the Option of Choice policy provides for free home support services for people with disabilities. Charging for meals indirectly breaches the principle of free services.

The Québec Ombudsman’s conclusions

The Québec Ombudsman believes that when intervention plan measures cannot be implemented due to a lack or shortage of staff, temporary lodging is an element of service continuity. Users should not have to incur extra costs for this measure. The Québec Ombudsman therefore recommended that the health and social services centre responsible for the region where the citizen lives:

• ensure, with a view to service continuity, that the services received by users who must be lodged temporarily due to a lack or shortage of CSSS staff accustomed to giving them the home support services provided for in their intervention plan are free, and that it inform the Québec Ombudsman of the measures taken in that regard.

The CSSS agreed to act on the Québec Ombudsman’s recommendation.

For more information on the subject of home support, see the investigation report entitled Is Home Support Always the Option of Choice? Accessibility to Home Support Services for People with Significant and Persistent Disabilities.