FSNA Sponsered Relocation Services Program

We have learned that even though the relocation program has been available to FSNA members for over 6 years, many members are still unaware of the program. We attach a brochures that may be of use to you in your branch. Click here.

Clarifying Rules On Above-Guideline Rent Increase

April 12, 2010 10:40 AM

To protect tenants, Ontario is clarifying rules governing how the HST will affect above-guideline rent increases.

Under current regulations, a landlord could apply for an above-guideline rent increase based on the HST on utility costs. A proposed change to the Residential Tenancies Act (RTA) would prevent tenants from being charged the HST in an above-guideline rent increase for utility costs.

As established by the RTA, landlords will continue to be eligible for annual rent increase guidelines based on the annual Consumer Price Index (CPI) increases

The proposed regulations have been posted online the government's website for 45 days to allow Ontarians to comment.

Still Further Ontario Health Issues

Pharmacy battle in Ontario heats up

There are suggestions the Ontario government may be prepared to put more money on the table to help pharmacies deal with sweeping drug reforms it proposed last week.

This follows strong reaction from two big pharmacy chains to the government’s recent decision to abolish rebates pharmacies receive from generic drug companies for stocking their products. The price of generic drugs is also being capped at 25 per cent of the brand.

On Monday, Shoppers Drug Mart announced that it was reducing operating hours at seven of its stores in London which also happens to be the area represented in the legislature by Health Minister Deb Matthews. As of next Monday, these stores will also be implementing a fee for delivery services.

On Tuesday, the Rexall chain announced that it too would start charging for deliveries next Monday. It is also instituting a hiring freeze for its head office including the cancellation of its pharmacy student and intern programs in Ontario.

Ms. Matthews has responded to these measures by accusing “Big Pharmacy” of holding patients hostage in its battle with government. She has also accused pharmacy groups of spreading misinformation designed to “worry patients unfairly.”

However, there are signs that the government may be willing to reach a compromise. Shortly before the Rexall announcement, Ms. Matthews said the government may increase a $100 million fund it has promised to compensate pharmacies for professional services they provide customers, like vaccinations and counseling for conditions like diabetes.

“Because they’re taking pressure off our family doctors, if they’re taking pressure off emergency departments, we want to compensate them for that,” she told the Toronto Star.

In addition to the $100 million fund, the government is providing $140 million for the MedCheck program which pays for people to have their prescriptions reviewed by a pharmacist. Dispensing fees are also going up a dollar to $8 and will increase by 2.5 per cent a year.

However, this falls well short of the $750 million which pharmacies stand to lose with the abolition of professional allowances from generic drug companies.

On Wednesday, Premier Dalton McGuinty acknowledged that the government’s new policy may hurt small pharmacies more than those which have diversified product offerings including groceries and cosmetics.

“That’s something we want to keep our eye on, of course, but remember the responsibility of our government is not to ensure that we have a particular kind of pharmacy industry in place,” he told Canadian Press.

Mr. McGuinty said the government’s job is to ensure Ontarians have affordable, quality drugs and as many pharmacies as are necessary to ensure they have access to these drugs. HE

Ideas for Ontario to save money on health care proposed

Ontario could shave $2.2 billion off its health bill if it were to spend at the same rate per capita as in other provinces for physician services, a new report released Thursday suggests. This would represent a drop of $842 to $672 per person.

The report, Ideas and Opportunities for Bending the Health Care Cost Curve, was produced by the Ontario Hospital Association, Ontario Association of Community Care Access Centres and the Ontario Federation of Community Health and Addiction Programs.

The report also says one per cent of the population accounts for 49 per cent of combined hospital and home care costs, and figures that every 10 per cent reduction on the $8 billion in expenditures used by this group would equal $800 million in savings. It recommends a comprehensive analysis of service utilization to select key priorities for initiatives to reduce these costs.

Another idea is to set up a single organization to drive the province’s Chronic Disease Prevention and Management Strategy. The report says every 10 per cent reduction in the $12 billion attributed to major chronic illness equals $1.2 billion in savings.

The report also counsels the implementation of leading practices in targeted areas such as wound care and palliative care, as well as the management of drug expenditures and implementation of selected hospital human resource initiatives.

Ontario goes after pharmacy earnings in new drug reforms

The Ontario government has taken direct aim at pharmacy profits in an attempt to lower its drug bill. It announced Wednesday that it will be abolishing a key source of pharmacy revenues, a move which the pharmacy community warns will see some services traditionally offered to customers disappear.

The government’s two-prong strategy will abolish rebates the province’s 3,306 pharmacies receive from generic drug manufacturers to stock their products, and lower the prices of generic drugs to 25 per cent of the brand.

It had taken similar but far less drastic action in 2006, recasting rebates as “professional allowances” that had to be used to fund patient services and limiting the amount collected to 20 per cent of the cost of the product. The price of generic drugs was also capped at 50 per cent of the brand.

These measures were implemented just for drugs reimbursed by public drug programs in the province, and the private sector ended up paying more as a result.

Of the $750 million which generic drug companies paid to Ontario pharmacists in 2009, over $600 million was applied to products purchased by cash-paying customers and through private drug plans. Instead of a 50 per cent price cap, they paid an estimated 70 per cent of the brand.

This is now changing. The measures are being instituted in the public sector as soon as legislation can be passed, and are being phased in for the private sector. By 2014, everyone will be paying the same.

The savings will be significant – the public sector alone expects to recoup over $500 million.

The government is offering pharmacists $150 million in funding to offset their loss in professional allowances, to be used for counseling and other direct services provided to customers.

Some of this money will be specifically earmarked for pharmacies in small communities who are likely to be the hardest hit by the new policies. Dispensing fees will also be bumped up a dollar from $7 currently and increased annually; they will go up $4 in rural and underserviced areas of the province.

Health Minister Deb Matthews says all of this will give pharmacies $246 million in relief – well short of the revenue that will be lost – but she underlined the government’s determination to weather the inevitable backlash.

“I have a simple message for big pharmacies – the days of artificial high drug prices paid on the backs of patients and taxpayers are gone, and they are gone for good,” she told Canwest News.

In media interviews Wednesday, she said the current system is being abused by pharmacists and suggested some people would call professional allowances “kickbacks.”

The reporting mechanism the government set up for how professional allowances were being used revealed that 70 per cent have gone to “fringe benefits, overhead costs and boosting profits instead of patient services as was the intent.”

However, the Canadian Pharmacists Association said professional allowances have been an established part of pharmacy funding for many years and the government has used them to subsidize services and minimize dispensing fees (which are the lowest in the country).

Pharmacists are painting a grim picture of what will happen as a result of their revenue loss.

“For neighbourhood pharmacies, the government’s cuts will mean reduced hours of operation, less staff, and fewer patient services,” Ben Shenouda, a community pharmacist in Brampton and president of the Independent Pharmacists Association of Ontario told reporters.

The government’s news release and background materials can be found at www.health.gov.on.ca/en/news/release/2010/apr/nr_20100407.aspx. HE

OMA rejects report saying physicians are overpaid

Ontario Health Minister Deb Matthews is trying not to be drawn into a debate between the province’s medical and hospital associations over whether physicians are being paid too much.

A report last week, co-produced by the Ontario Hospital Association (OHA) along with the Ontario Association of Community Care Access Centres and the Ontario Federation of Community Mental Health and Addiction Programs, presented a number of ways for the government to save money on health care.

Included was the suggestion that Ontario could save $2.2 billion if it paid the same rate per capita on physician services as other provinces.

The Ontario Medical Association called the figures "misleading" and said they do not account for differing patient volumes and demographics.

"The leadership of the OHA is out of touch with the rest of the province's health care providers, who are all working tirelessly to improve quality care for Ontario's patients," OMS President Suzanne Strasberg told Canadian Press.

Health Minister Deb Matthews would not comment on the report, saying the government is committed to the four-year contract it signed with physicians in 2008.

However, Ms. Matthews opened the door to speculation that the government may take a harder line with physicians in the next round by telling CP that targeting how doctors are paid is "not part of our plan right now."

Ontario Hospital Association President Tom Closson said physicians need to be subject to the same performance guidelines as hospitals.

“Hospital CEOs are going to be on pay-for-performance. It’s really important that we have doctors’ accountability and hospitals’ accountability aligned,” he told CP.
He suggested the new physicians’ contract could include expectations on patient volumes per physician and the number of hours they would be available. HE

No end in sight for war over Ontario drug reforms

The stand-off between the Ontario government and pharmacists over controversial drug reforms continued this week.

Both sides have ratcheted up the public relations battle to win public opinion. Pharmacists started a two-week advertising blitz, and the Ministry of Health has turned to YouTube to get its message across.

Government is saying it is trying to get lower drug prices for Ontarians, while the other side says government is trying to solve with its deficit issues on the back of community pharmacy.

So far no talks have been held to deal with the impasse, but the Independent Pharmacists Association has accused the government of shunning its proposals to save the drug plan $1.3 billion over the next four years.

These proposals include phasing out of professional allowances which are at the centre of the government’s new reforms.

Professional allowances are paid by generic drug companies for pharmacies stocking their products.

Pharmacy says government has to put more money on the tablet to offset the loss in revenues from professional allowances. Dispensing fees, instead of going up a dollar to $8, would have to double. HE

Ontario nurse practitioners could get new powers

Ontario is prepared to look at the idea of nurse practitioners admitting and discharging patients, something the Registered Nurses Association of Ontario has been after for some time. Premier Dalton McGuinty, speaking at the RNAO’s annual meeting this past week, said he is committed “to getting to work on that.”