Sustainable Community Hospice Funding Model
IT IS THEREFORE RESOLVED THAT Alberta Municipalities advocate for the Government of Alberta to implement a sustainable operational funding model for the provision of hospice services by community hospice societies across the province.
WHEREAS the demographics in Alberta are shifting, it is projected that over the next 25 years, the share of the population 80 years and older will increase significantly, more than doubling to as much as 7 per cent of the total Albertan population; (1)
(1) https://open.alberta.ca/dataset/90a09f08-c52c-43bd-b48a-fda5187273b9/re…
WHEREAS the Government of Alberta has communicated, “adopting the palliative approach to care when life-limiting diseases are diagnosed is an effective way of managing health care spending. It reduces the cost of delivering care, frees up acute care capacity and improves quality of life for patients with life-limiting illness and their families;” (2)
(2) https://open.alberta.ca/dataset/130eb68f-c7b5-4ab1-8a4a-ce6181c34610/re…
WHEREAS there is an increasing demand on community providers, such as non-profit hospice societies, to deliver palliative end-of-life care (PEOLC) in Alberta;
WHEREAS the ability to meet the Alberta Health Services’ accepted standard for PEOLC bed capacity is severely limited by the lack of a province-wide, sustainable funding model;
WHEREAS Alberta Health Services’ Rural Palliative Care In-Home Funding Program can only be used to cover end-of life care received at home and cannot be utilized to cover end-of-life care provided by hospice societies in their facilities; and
WHEREAS the Government of Alberta’s Palliative End-of-Life Care Grant Fund was one-time grant funding that was not eligible for operational costs for hospice societies.
There has been ongoing engagement from the Government of Alberta regarding Palliative End-of-Life Care, highlighting the importance of these supports and services to Albertans. The need to develop the capacity of these community services, especially in rural settings, is clear; the following provincial frameworks and reports are all consistent in that message:
• Government of Alberta – Advancing palliative and end-of-life care in Alberta – Palliative and End-of-Life Care Engagement Final Report November 2021
• Alberta Health Services – Palliative and End of Life Care – Alberta Provincial Framework Addendum 2021
• Alberta Health Services - Palliative and End of Life Care - Alberta Provincial Framework 2014
What remains is the question of continual operational funding for PEOLC hospice community providers.
The Government of Alberta identified the service gaps that exist for PEOLC needs in Alberta in the Advancing Palliative and End-of-Life Care in Alberta Final Report November 2021. The report included the following recommendation:
“Government, AHS, and their partners, should grow and expand community-based PEOLC services via home and community care programs and facility-based continuing care… Stand-alone hospices face challenges in maintaining sustainable operational budgets and workforce.”
The Government of Alberta committed $20 million over four years to improve PEOLC by shifting from hospital to community-based care; raising awareness of how and when to access PEOLC; developing effective caregiver supports; and establishing education, training and standards for health professionals. (3) The funds were entirely allocated as of 2022 and were not eligible for hospice societies’ operational expenses.
(3) https://rmalberta.com/resolutions/20-19f-policies-for-supporting-commun…
Non-profit hospice societies who are already operating in communities and working towards expanding these important services in Alberta have been left in budget purgatory. They are actively working towards a priority identified by the Government of Alberta, but reliant on fundraising for operational funding.
Correcting the disparity between the funding available to patients who choose to receive PEOLC in-home versus in a hospice suite is an immediate solution that could address these challenges while the economic analysis of reallocating health care financial resources in accordance with the shift from hospital to community-based hospice care is completed.
Municipalities must advocate for the allocation of financial resources to these valuable supports and services provided in their communities.