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Ford government making life easier for LTC operators

Posted: July 9, 2020

(July 8, 2020)

By: Keith Leslie, The Hamilton Spectator

COVID-19 devastated long-term-care homes in Ontario, but it also helped LTC operators get rid of some regulations, at least temporarily, that they’ve lobbied for years to have eliminated.

Last year, under the guise of “flexibility,” LTC homes asked to use less qualified staff to address a shortage of registered nurses and personal support workers, which they helped create.

The staffing shortage quickly became a crisis when COVID-19 hit, so the Ford government gave LTC homes what they’d been asking for, hopefully just for the duration of the pandemic.

The Ontario Long Term Care Association said homes shouldn’t be required to have at least one RN on duty 24-7, claiming a registered practical nurse could do the job, and also wanted to use untrained staff to do work done by college-trained PSWs.

The province approved both changes in the pandemic Emergency Act, allowing LTC homes to use any staff, or even volunteers, to do the “direct care and comfort” work of PSWs.

Premier Doug Ford this week denied cabinet had rejected two requests from Long Term Care Minister Merrilee Fullerton for extra funding for LTC staff. There was no money for more staff, but immediate regulation changes to allow LTC homes to use cheaper, untrained labour.

LTC homes call it a “human resources emergency,” but nowhere in their nine-page submission to the government’s red tape commission in 2019 do they admit that precarious employment is a key cause of the problem. They claim the “greatest challenge” to hiring staff is a “high administrative workload,” and a “punitive culture” created by regulations and inspections.

In reality, too many LTC staff are hired on a part-time, temporary or contract basis, without benefits, and work at two or three homes, or take agency work, to make ends meet.

Ontario was also slower than other provinces to tell staff to work in just one LTC home after COVID-19 hit, which forced some homes to rely more on agency staff, punching more holes in Ford’s promised “iron ring” of protection for 78,000 LTC residents.

When COVID-19 also ravaged short-staffed LTC homes in Quebec, that province quickly offered people three months training as a PSW at $21 an hour, with a guaranteed job at $26.89 an hour. Ontario has done little on the LTC job front beyond offering a temporary, $4-an-hour pandemic premium for front-line health care workers.

The Ontario Health Coalition and other advocacy groups say it’s hard to determine LTC staffing levels because of changing job definitions and weak compliance with reporting, especially from private homes. Public health advocates and unions use freedom of information to get the data, which are often incomplete, making comparisons difficult.

LTC homes also wanted fewer inspections, especially surprise resident quality inspections that take can days or weeks, and that each home was supposed to get once a year. The Health Coalition says it’s misleading for the government to claim complaint- and critical incident-based inspections are equal to an annual RQI.

Only nine of 623 homes received a full RQI in 2019, the year before the pandemic killed more than 1,700 residents and seven LTC staff in Ontario. Let that sink in.

Could the death toll in LTC have been reduced? That question may not be addressed by Ford’s promised inquiry into the long term care system’s pathetic response to COVID-19, but it could be answered in court if any of several proposed class action suits are certified.

The emergency deregulation measures for LTC homes must not become permanent. It would be heartless and dangerous to further reduce standards of care and protections for vulnerable LTC residents, especially after the horror show of the pandemic.

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