Home dialysis patient in Vaughan seeks utility relief from city

Yorkregion.com
April 6, 2016
y Adam Martin-Robbins

Many Vaughan homeowners are feeling the sting of rising water costs, but Francesco Nardi is impacted far more than most people.

The 66-year-old Maple man’s utility bill has soared, largely because of increased water usage since he started doing home dialysis last November. And with water rates projected to continue rising by nearly 10 per cent a year for the next few years, it’s going to get even more costly for him.

“Some of my most recent bills were as high as $975 and $950 (every two months) for hydro and water, which is really, very high for this area,” he said noting that before he started home dialysis his utility bills ranged between about $540 and $665 every two months.  Nardi has polycystic disease, a genetic disorder that causes cysts to form in his kidneys rendering them unable to function properly.

As a result, he has to hook himself up to a dialysis machine, set up in his home office, for several hours every other day to do the work of his kidneys, which remove toxins from the blood.

The entire process, factoring in set-up time and cleaning up afterward, takes him about six and a half hours, Nardi said. And it uses hundreds of litres of water an hour.

“The machine, every two hours, it backwashes so the water runs very often,” said Nardi, a semi-retired electrical contractor who runs his own business. “And then when I do (dialyze) for six-and-a-half hours, the water is running steady.”

Despite all that, Nardi opted to do dialysis at home rather than driving to a clinic or the hospital because it gives him greater flexibility.

“I’d still rather do it at home because it’s in my own room and it gives me a chance to take care of things like work,” he said.  “If I’m an hour late (starting dialysis), I can still do it at home. At the hospital, you have to be there on time so it gives me a bit of freedom.”

By opting to do home dialysis, Nardi is also saving the provincial government thousands of dollars, in part, because it reduces the need for hospital space and requires fewer health-care workers.

The cost to provide dialysis in a hospital or at a clinic has been pegged at about $83,000 per patient, per year, according to information published by the Kidney Foundation of Canada in 2013.

By contrast, home dialysis costs between $30,000 and $60,000, depending on the type of dialysis.

Nardi says his decision to dialyze at home also benefits those who are unable to by freeing up space for them at clinics or hospitals.

Given all that, he’s hoping the city will seriously consider doing something to help people in his situation reduce their costs.

“I would like to see if, for patients like me, they could put in a flat (water) rate fee,” he said.

Nardi’s bid for financial assistance from the City of Vaughan has the support of at least one local councillor, so far.

Maple/Kleinburg Councillor Marilyn Iafrate, last month, asked city staff to investigate the best approach and potential costs of implementing some kind of rebate or grant program for people doing home dialysis.

“It’s not something that a resident can write off on their income taxes as a medical expense, but it is a lot money,” Iafrate said. “If there’s an opportunity, maybe, for us to do something - whatever it is - I think we should explore it. ...It’s not a lot of people, but I think it would help those who are in need.”

A report on the matter is expected to come back before city council for discussion later this year.

It’s rare, but not unheard of, for municipalities in Ontario to offer assistance to home dialysis patients.

For instance Clearview Township, just west of Barrie, provides residents a 90 per cent rebate on the amount of water their dialysis machine uses.

The City of Ottawa, meanwhile, has been providing annual grants ranging from $250 up to a maximum $500 depending on the amount of water used since 2007.

Last year, 13 people doing home dialysis in Ottawa received grants at a cost of $5,250 to the city.

Other Ontario municipalities have looked at implementing similar reimbursement or grant programs, but have rejected the idea, in part, on the grounds that health care falls under the provincial government’s jurisdiction.

Some of those municipalities have, instead, advocated for Queen’s Park to provide financial assistance to home dialysis patients to offset their higher utility bills including water and power.

Manitoba, reportedly, became the first provincial government in Canada to do that when it set up a reimbursement program late last year.