Attachment 1
1.
Home dialysis annual rebate
program programme de remise annuelle pour dialyse a domicile |
That Council approve that the City of Ottawa in cooperation with the
Chief Medical Officer of Health develop an annual rebate program for home
dialysis patients to offset the increased costs associated with home dialysis
to be considered as part of the 2007 budget.
Recommandation du Comité
Que le Conseil autorise la Ville d’Ottawa
à élaborer, de concert avec le médecin chef en santé publique, un programme de
remise annuelle à l’intention des personnes qui reçoivent des traitements de
dialyse à domicile, de façon à compenser le coût croissant de ces traitements,
qui sera examiné dans le cadre du budget de 2007.
DOCUMENTATION
1. Councillor Holmes report dated 1 June 2006 (ACS2006-CCS-HRS-0011).
Report to/Rapport au :
Health,
Recreation and Social Services Committee
Comité de la santé, des loisirs et des services sociaux
and Council / et au Conseil
Submitted by/Soumis par : Councillor/
Conseillére Diane Holmes
|
SUBJECT: |
HOME DIALYSIS ANNUAL
REBATE PROGRAM
|
|
|
|
|
OBJET : |
PROGRAMME DE REMISE ANNUELLE POUR DIALYSE À
DOMICILE
|
REPORT RECOMMENDATION
That the
Health, Recreation and Social Services Committee recommend to Council that the
City of Ottawa in cooperation with the Chief Medical Officer of Health develop
an annual rebate program for home dialysis patients to offset the increased
costs associated with home dialysis to be considered as part of the 2007
budget.
Que le Comité de la santé, des loisirs et des
services sociaux recommande au Conseil d’autoriser la Ville d’Ottawa à
élaborer, de concert avec le médecin chef en santé publique, un programme de
remise annuelle à l’intention des personnes qui reçoivent des traitements de
dialyse à domicile, de façon à compenser le coût croissant de ces traitements,
qui sera examiné dans le cadre du budget de 2007.
BACKGROUND
On 1 June 2006, Councillor Holmes put forward the following Notice of Motion, for consideration at a subsequent meeting:
Whereas chronic kidney disease afflicts a growing number of
residents of the City of Ottawa each year;
Whereas the Ottawa Hospital currently operates a newly established
Home Hemodialysis Program for patients who require dialysis as part of their
treatment;
Whereas home hemodialysis decreases the amount of time an individual
must spend in hospital and increases the amount of time they can spend at home
and in the community with their families;
Whereas home hemodialysis patients can experience less side effects
from this treatment and can lead more productive lives;
Whereas the amount of water required to support home hemodialysis is
significant, increasing one household from an average of 20 cubic meters per
billing period to approximately 80 cubic meters per billing period;
Whereas the Ottawa Hospital Home Hemodialysis Program estimates that
approximately 20 households currently utilize the program and the target number
for this program is 60 households;
Therefore be it resolved that the City of Ottawa in cooperation with
the Chief Medical Officer of Health develop and institute an annual rebate
program (approximately $500) for home dialysis patients to offset the increased
costs associated with home hemodialysis.
CONSULTATION
The Nephrology program of The Ottawa Hospital (TOH) is tailored to meet the distinct needs of those patients requiring acute and chronic renal replacement therapy. The program consists of three in-centre units, four satellite units and one Home Dialysis program providing service to the majority of patients within the Champlain LHIN. More specifically, the Home Dialysis Program at the Ottawa Hospital provides care to all patients with ESRD who choose a home-based dialysis modality. Currently the program has 20 patients on home hemodialysis therapy with 50% of those patients living in the City of Ottawa.
In March 2006, I met with the Chief Medical Officer of Health, a representative from the City’s Finance Branch, representatives from the Ottawa Hospital and Mr. François-René Dussault, a constituent regarding the needs of home dialysis patients.
Mr. Dussault began home hemodialysis treatments in 2004 due to his permanent kidney failure. These treatments are performed at night for eight hours and are required six nights a week. Each treatment requires a large amount of water. A summary of water consumption for his home account follows:
Water & Sewer Bill
November 5, 2003 $24.92 14 cubic meters
January 5, 2004 $49.84 28 cubic meters
March 29, 2004 $36.71 21 cubic meters
May 27, 2004 $36.89 21 cubic meters
July 28, 2004 $35.75 20 cubic meters
September 28, 2004 $42.75…$226.86 24 cubic meters…….Total 128 m3
DIALYSIS TREATMENT BEGINS
November 24, 2004 $222.75 140 cubic meters
January 31, 2005 $45.96 26 cubic meters
March 24, 2005 $216.79 136 cubic meters
May 30, 2005 $31.37 20 cubic meters
July 26, 2005 $263.45 147 cubic meters
September 26, 2005 $152.34…$932.66 85 cubic meters……Total 554 m3
Water consumption increased from 128 cubic meters to 554 cubic meters in the one-year period following the start of home hemodialysis. The annual cost for water service for this individual has increased from $226 annually to $932 annually.
Public
Health
Ottawa
Public Health concurs that the home hemodialysis program benefits both the
patients and the community. The program
benefits the patients (more independence, less travel, better health) and the
system (many economic analyses show reduced cost attributable primarily to
decreased nursing and reduced hospitalizations).
Public
Works and Services
Staff of the Drinking Water Services Division met recently with representatives of the Ottawa Hospital and local private hemodialysis clinics to review the needs of the hospital, clinic and in-home customers and patients. While the City provides a reliable supply of high quality safe drinking water that meets or exceeds all federal and provincial health based drinking water quality guidelines, the water quality requirements for hemodialysis systems are even more stringent. For this reason the nature of hemodialysis makes it extremely important that:
- Hospitals, clinics and in-home patients develop their own comprehensives contingency plan to address the risk that an interruption of drinking water service, brought on by such things as a watermain failure, which may cause corresponding interruption in water service;
-
In-home
patients recognize the importance of regular drinking water quality monitoring
and avoid the complacency of repeated testing with very similar results. We strongly recommend the development of an
in-house drinking water quality monitoring program that is carefully followed
by patients because of the slight variation in drinking water quality. These situations can occur by such things
as the seasonal variation of our source water, the need to adjust our secondary
disinfection processes to meet regulatory requirements and by regular
distribution system operating and maintenance practices.
FINANCIAL
IMPLICATIONS
As part of the 2007 budget, the Community and Protective Services
Department will bring forward a budget pressure identifying the funding
requirement.
The tax increase
forecast for 2007 as presented in the 2006 Draft Budget Summary document was
projected to be 8.1%. The impact of
this additional requirement in 2007 will result in a .001% tax increase (or
approximately $10,000 for 20 households based on annual rebate in the estimated
amount of $500). All additional
requirements approved by Council that have a 2007 budget implication will be
summarized and presented in the City’s quarterly status reports.
Subject to approval of this report, the Community and Protective Services Department will coordinate development of the Home Hemodialysis Program.
Letter from Julie Régimbald,
Ottawa Hospital – Riverside Campus.
Attachment 1