Toronto city council considering water rebate for at-home dialysis

Thestar.com
May 21, 2018
Samantha Beattie

When Jennen Johnson faced kidney failure two years ago she turned down the least intrusive form of home dialysis because it would require she pay for hundreds of thousands of extra litres of water a year.

The working mom and Toronto resident said she couldn’t afford what medical staff cautioned would be an expensive utility bill.

“I wasn’t working full hours because of my health,” said Johnson, 42, who works as an executive assistant “I didn’t want to take the little money I was receiving and put it into paying my water bill.”

This week, council will consider a water rebate program for home hemodialysis patients. Each patient consumes between 150,000 to 600,000 additional litres of water per year, said a staff report.

The rebates would range from $600 to $2,400 per patient, per year.

“If the city had a rebate program two years ago, I would’ve done (home) hemodialysis in a heartbeat,” Johnson said.

Hemodialysis would’ve flushed out her kidneys with water while she slept and not interrupted her daily life. Instead, for two years she resorted to either going to the hospital for hemodialysis for four hours, three times a week, or peritoneal dialysis at home.

When doing peritoneal dialysis, she’d wake up at 6 a.m., insert a toxin-absorbing fluid in her abdomen through a catheter and make sure to get home 12 hours later to repeat the process. She’d also do it a third time before she went to bed.

Because of the additional fluid in her body, Johnson said she was unable to exercise and could never do more than a relaxed walking pace, even when she needed to catch the bus. If she didn’t change the fluid in time, she’d experience nausea and other side effects.

This spring, Johnson underwent a successful kidney transplant and no longer does dialysis. And she has her energy back.

Dr. Ellen Greenblatt can attest to the financial burden of home hemodialysis.

She told the Star her son, in his early 20s, has relied on the life-saving process for about a year. In that time, her quarterly utility bills (for water and waste collection) have more than doubled -- from about $400 per bill to almost $1,000.

This cost, plus the electricity needed to run the hemodialysis machine, shouldn’t be borne by the patient, or the city, she said.

“Home hemodialysis is a tremendous cost saving to our provincial health care budget -- you don’t have to have nurses there. You aren’t using hospital space or resources,” said Greenblatt. “It’s downloading the cost, and the risk, to the patient.”

The Ministry of Health and Long-Term Care pointed to a grant it funds through the Ontario Renal Network, but Greenblatt said “it certainly doesn’t cover the increase in my costs, that’s for sure” and added that a city rebate program is needed to help make up some of the difference.

If approved, the rebate program will be similar to those already in place in Ottawa, Vaughan and Clearview, Ont., the report said. It will cost the city between $61,300 and $191,700 a year, which will be funded through water rates.

Also at council Wednesday and Thursday:

• Councillor Gord Perks has put forward a member motion for city staff to consider using $1.5 million to buy and renovate a rooming house that would be operated by a non-profit organization. The money would come from Section 37 community benefit funds the city receives from developers, said the motion.

• Councillor Joe Cressy, also through a member motion, is requesting the city create a naming process for the new wards. The names would be put into place next term to help future voters distinguish between the old and new numbering system, associate neighbourhoods with wards and continue a tradition established at amalgamation in 1998, the motion said.

• City staff are recommending it require fraternity and sorority houses to meet certain requirements in order for them to continue without a rooming house licence. It wants to address community concerns including noise, waste and behaviour issues, said a city staff report.