Ontario to change homecare funding rules for palliative care patients


Dan Duma, shown in this family photo, died one month into a three-month wait period for home care.

Courtesy of the Duma family / Windsor Star

Nearly two years after the death of former Windsor autoworker Dan Duma, the provincial government is closing a gap in OHIP that denies home care to terminally ill patients who move to Ontario from elsewhere in Canada.

“It’s a long time coming,” said Laura Duma, a nurse practitioner who, with her sister and mother, helped take care of her dying father at home without needed medical equipment, nurses or personal-support workers.

“I know how much he wanted to make sure other people didn’t go through what we did.”

The Ontario Ministry of Health announced Wednesday it is eliminating the three-month waiting period for OHIP for people who move here from other provinces. Under current reciprocal billing agreements, provinces and territories will pay for hospital stays and doctors for its residents for the first three months after they move, but they will not pay for hospice or home care.

Dr. Darren Cargill, shown in this April 30, 2014, photo, is a palliative care doctor at the Hospice.

Jason Kryk /

Windsor Star

Under the new regulation, Ontario will not only pay for out-of-hospital care for people who move into the province from elsewhere in Canada, but it will cover those services for Ontario residents who move out of province.

Dan Duma and his wife, Ana, moved to Alberta to find work after GM’s Windsor transmission plant closed. There, Duma was diagnosed with liver cancer and told he had only a short time left to live. After the Alberta wildfires displaced the couple, Duma and his wife decided to return to Windsor for palliative care.

Duma moved in with his daughter, but received no homecare. Dr. Darren Cargill, medical director for The Hospice of Windsor and Essex County, made house calls until there was no way to keep Duma comfortable at home. Duma would have had to be in hospital for his final days were it not for Cargill pulling some strings to secure a hospice bed in Leamington.

Duma, who was 48 when he died, never got his wish to die at home, surrounded by family.

After Duma’s death, Cargill and Duma’s family began lobbying for changes to the homecare rules.

In October 2016, Windsor West MPP Lisa Gretzky introduced a private member’s bill she called the Homecare and Community Service Amendment Act which became known as Dan’s Law. The bill, endorsed by the Ontario Medical Association, the Ontario Nurses Association and other associations of healthcare workers, enjoyed all-party support but was never called to the committee stage to be debated.

While the bill won’t become law, the essence of it is included in the regulatory changes, Gretzky said. “I’m taking this as a win… This is a win for Dan’s family.”


Cargill called the regulatory change a partial victory. He said he would have preferred the bill to be made a law since laws are more difficult to change than regulations.

“In the end, I’m pleased, but you look back and say, ‘Why couldn’t this have been done sooner?’”

The government estimates the regulatory change will affect 300 families a year. Cargill said it’s a difficult number to back up since he knows some patients did not move because of it, or ended up in hospital rather than at home or in hospice care.

“To me, one is too many.”




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