(June 3, 2020)<\/p>\n
By: Samuel Helguero, The Post Millennial<\/p>\n
For decades, long-term care homes have been operated by non-profits, municipalities, or for-profit companies. It was the Chair of Chartwell Retirement Residences, and former Premier, Mike Harris, that started the for-profit boom in Ontario.<\/p>\n
With Harris\u2019 introduction of a competitive bidding process for home care services what was a minority of homes being run for-profit became a majority by the end of the Harris government tenure in 2002.<\/p>\n
\u201cWhen Harris was in power and he decided to go to the competitive bidding process that\u2019s when we first saw the major move towards for-profit chains,\u201d researcher Pat Armstrong, an authority on long-term care, explained to The Post Millennial. \u201cThe competitive bidding process really favors the for-profits, the big companies.\u201d<\/p>\n
Ever since, major lawsuits and government reports have exposed the conditions in many privately run homes.<\/p>\n
In 2014, a Health Ministry\u00a0report<\/a><\/span>\u00a0accused Chartwell, one of Canada’s largest companies providing for-profit care, of \u201cneglect\u201d and \u201cinaction\u201d in the handling of an elderly woman. Her bedsores revealed \u201ca rotting ulcer [that] ate deep into her leg, exposing her shinbone through blackened flesh.\u201d<\/p>\n In 2018, Sienna, Revera and Extendicare, three industry giants, were involved in an unprecedented lawsuit brought by 200 families. One plaintiff\u2019s mother lived in an Extendicare home where a cockroach was discovered in her bed. The concerned daughter\u00a0told<\/a><\/span>\u00a0the media \u201c[my mother] was in diapers. She was always wet and dirty.\u201d<\/p>\n Another plaintiff\u00a0accused<\/a><\/span>\u00a0Sienna of allowing his father to develop bedsores. The ulcers were so severe that an Ontario hospital assessed them as being stage four sores, \u201cwith bone being visible.\u201d<\/p>\n \u201cMany for-profits are not providing appropriate care. We\u2019ve looked at scandals that have been made in the media. Almost all are in for-profit homes,\u201d recalled Armstrong of an earlier study.<\/p>\n Last fall, Inspectors sent to an Extendicare facility\u00a0found<\/a><\/span>\u00a0that residents were \u201cnot always getting bathed on a regular basis,\u201d pointing to a \u201cpattern\u201d of understaffing. Meanwhile, Sienna and Revera are among companies currently facing a $100-million class-action lawsuit started by those whose loved ones died during the recent epidemic.<\/p>\n These results anticipated a scathing military report which found several Ontario homes to be host to poor sanitary conditions and degenerating care for residents. The military observed cockroaches and flies, residents being allowed to soil their beds, and food being left in residents\u2019 mouths while they slept.<\/p>\n All five of the homes that had soldiers turn whistleblower were owned by for-profit companies.<\/p>\n The formal academic research has been equally damning. Two studies in 2011 found\u00a0lower staffing<\/a><\/span>\u00a0levels and\u00a0higher<\/span> rates<\/span><\/a>\u00a0of resident complaints in for-profit homes. A 2015\u00a0study<\/a><\/span> found residents in Ontario for-profits at a 10 per cent higher risk of mortality and at a 25 per cent higher risk of hospitalization.<\/p>\n During the epidemic, according to research released early May, the death rate in private, for-profit homes has been more than double that of Ontario\u2019s many municipal, publicly owned facilities.<\/p>\n According to Sarah, a personal support worker (commonly referred to by the acronym, PSW) who has worked through the COVID-19 epidemic, things were already bad in her home.<\/p>\n \u201cThere\u2019s been problems for years. But they just kind of turned a blind eye to it. Because they knew the job would get done,\u201d said Sarah, whose for-profit home struggles with low staffing levels. \u201cSo who\u2019s going to leave someone in a soiled mess and just go home. The job would get done. But you would have to cut corners somewhere.\u201d<\/p>\n Pay is also low at Sarah\u2019s home. The building is run by one of Canada\u2019s wealthiest long-term care operators. Yet, at the end of the month, almost all of the staff\u2019s salary is spent on rent.<\/p>\n \u201cA lot of PSWs work two or three jobs. We have a lot of part time people who probably work three jobs. I only work one. I can\u2019t handle two.\u201d said Sarah chuckling with her last comment. \u201cEven some of our full time people are working another job.\u201d<\/p>\n \u201cThis is a for-profit home. Honestly, it\u2019s money, money, money. Only so much money is allocated for each area. Years ago funding was so short so that had to go dip into their fund for overtime\u2026 Then we were really working short.\u201d<\/p>\n With the Pandemic, Sarah has had to help bag some of the dozens of residents that have died from COVID-19. This work used to be done by funeral homes who are no longer allowed to enter the building. Many of these residents she has considered family.<\/p>\n Morgane, a PSW in non-profit, described the experience of working in a home hit by the epidemic.<\/p>\n \u201cThese people become part of your family circle. You don\u2019t mean for it to happen. But, when you take care of someone day in and day out, and you know their family, and their family knows you by name. To watch them go through the end of life alone\u2014scared\u2014surrounded by strangers\u2026 it breaks you as a person\u201d Morgane said.<\/p>\n \u201cBecause we are strangers even though we\u2019re still family. We\u2019re not daughters, we\u2019re not sons, we\u2019re not grandkids, we\u2019re not husbands… They talk to the family over FaceTime. They say goodbye to the family over FaceTime…\u201d<\/p>\n For the surviving residents, says Morgane, things are equally grim. Many have gone into a depression after being forced to spend long-periods alone in their rooms.<\/p>\n \u201cSome of them are able to pick up the phones and make calls to their loved ones. But there are some with limited mobility who can\u2019t. So now they\u2019re stuck in their rooms sitting in front of the TV or the window and they\u2019re lost. They\u2019re just lost and broken.\u201d<\/p>\n Despite how bad things have become in her home, Morgane, who did a placement in Revera, is still glad she does not work in a for-profit. The crisis, according to her, has exposed the \u00a0real difference between the profit and the not-for-profit \u00a0industry.<\/p>\n \u201cThe people that do the most work are the most undervalued and underpaid. I have always said this. I will always say this,\u201d she concluded. \u201cThe crisis in long term care was really bad before the pandemic and then the pandemic happened and then it just absolutely destroyed all hopes of ever having any normalcy again. Which is why we need help.\u201d<\/p>\n Groups like the Ontario Health Coalition (OHC), which represents half a million people with 400 member organizations, have tried to shine the spotlight on long-standing issues in long-term care.<\/p>\n Yet, despite these groups widespread membership and wealth of research, they have had a difficult time getting their concerns through to the Ford government.<\/p>\n \u201cNormally, we\u2019ve met with every health minister and every premier.\u201d Natalie Mehra, Executive Director of the OHC told The Post Millennial. \u201cWe have not been allowed to meet with Doug Ford or Christine Elliot. We talk with MNA\u2019s when we run into them. Formal meetings, however, generally, they\u2019ve just ignored our correspondence or are just not responding.\u201d<\/p>\n On the other hand, numerous lobbyists are hired by these for-profit companies and by the Ontario Long-Term Care Association (OLTCA) which represents their interests. These lobbyists target offices like that of the Minister of Health, the Premier, his Cabinet, and the Attorney General, with phone calls, meetings, and presentations.<\/p>\n Frequently hired through a public affairs agency, these consultants are often connected to the Conservative party. Andrew Brander who has lobbied for the OLTCA, was the director of communications of Ford\u2019s current Minister of Finance and is\u00a0described<\/a><\/span>\u00a0by his agency as being \u201c[f]resh off role in Ford Government.\u201d Christopher Chapin, who\u2019s done lobbying for a large Ontario for-profit, was the Deputy Digital Director for the 2018 Conservative election campaign.<\/p>\n Other lobbyists have been senior advisers, heads of strategic communications, and campaign directors for the Ontario PCs.<\/p>\n For Mehra, this is evidence of a different story going on behind closed doors: \u201cFor family members, and for organizations like ours, trying to get in the door is very difficult. Obviously people who have close relationships\u2014who have closely worked with politicians, or have been at the head of political parties, or at the head of governments\u2014have the\u00a0ability<\/em>\u00a0to get into the door instantly, and have the\u00a0ability<\/em>\u00a0to get listened to by the government.\u201d<\/p>\n Indeed, the OLTCA publicly\u00a0publishes<\/a><\/span>\u00a0its demands to the government. In 2019, the organization was asking that owners receive increased \u201cflexibility\u201d with staffing. Specifically, they wanted the removal of the requirement for an on-site registered nurse 24\/7.<\/p>\n Moreover, because these facilities, which can sometimes face serious lawsuits or damning reports, \u201cfeel over-scrutinized by the public, the media and by Ministry inspectors\u201d the OLTCA is pushing for an end to \u201cpunitive approaches to compliance\u201d: namely, fines for repeated statutory non-compliance. They also ask that the government \u201crevise\u201d its decision to hire 100 inspectors who inspect homes annually.<\/p>\n \u201cAll of these things are not in the public interest,\u201d says Mehra. \u201cIt is absolutely\u00a0not<\/em>\u00a0in the public interest to not even have one RN on staff in the homes. It is\u00a0not<\/em>\u00a0in the public interest to cancel annual, unannounced inspections. It\u2019s\u00a0not<\/em>\u00a0in the public interest to not have an effective enforcement regime. But that\u2019s what they have been lobbying for.\u201d<\/p>\n When the Ford government came to power they eliminated annual unannounced inspections. Despite the protests of groups like the OHC and Ontario unions, Ford is yet to put in place minimum care standards for residents. Funding increases for long-term care were also placed below inflation.<\/p>\n Mehra described what she called the \u201crevolving door\u201d that has developed between for-profit long-term care and Conservative politics. Conservative politicians and insiders routinely turn from the party and government payroll to for-profit companies. Mike Harris is not the only premier to have gone on to sit on the boards of these large companies. Conservative premiers Ernie Eves and Bill Davis have gone on to sit on the boards of major for-profits.<\/p>\n Others, like Shelly Jamieson and Donna Duncan worked in Conservative politics before they started earning a salary from Extendicare and the OLTCA respectively.<\/p>\n For-profit Corporations and their lobby have also made good on paying the Ontario PCs at least\u00a0$340,477<\/span><\/a>\u00a0in political donations since 2007.<\/p>\n According to Unifor, which has almost 15,000 members in long-term care, the major concerns that ought to be dealt with relate to low wages and better working conditions. The OLTCA\u2019s members, who negotiate collectively with Unifor, have apparently been less charming in these matters.<\/p>\n \u201cArbitrated settlements have not been good to Personal Support Workers (PSWs) over the last decade and, in fact, included a two-year wage freeze if you can believe it,\u201d explained Katha Fortier, Unifor\u2019s Ontario Regional Director. \u201cSo they\u2019ve fallen below inflation.\u201d<\/p>\n \u201cBefore ten years ago we were bargaining wage increases like %2.6, %2.75. Not that things were perfect but people were staying. It was a decent job and now, relatively speaking, it\u2019s not.\u201d<\/p>\n At one facility with degenerating staffing levels, one employee Fortier cited as an example, left for better pay at a Booster Juice for $16.50 an hour. When Unifor took its staffing concerns to the Minister of long-term care they received the following response:<\/p>\n \u201cMinister Fullerton told us that she was aware of the issues around personal support workers… The response was essentially to tell us that she would be creating an advisory group which of course, our union or any other union is not a member of. In fact, there\u2019s not a single PSW on the advisory group to talk about a staffing plan.\u201d<\/p>\n Unifor later learned that the staffing advisory group did include industry leaders like James Schlegel. The Schlegel family has donated at least $70,000 to the Ontario PCs. They were\u00a0recently<\/a><\/span>\u00a0in a bargaining dispute over short-staffing levels. Moreover, their homes have collectively had one of the highest death tolls among major Ontario chains since the COVID-19 epidemic started.<\/p>\n To date, across Ontario, at least 261 people have died in Revera homes. 79 elderly Ontarians have died in Schlegel Villages facilities. At Extendicare homes and subsidiaries, 66 passed. At Sienna, two workers, one in their fifties, another, a Hatian man in their 60s, have also died, along with 43 residents.<\/p>\n With the high death tolls, there have been calls from unions and civil society groups for the government to take over for-profit homes as they have done in BC and elsewhere. There have also been\u00a0demands<\/a><\/span>\u00a0for a public inquiry into the crisis in long-term care. A public inquiry would allow for warrants and the summoning of witnesses to investigate the long-term care industry.<\/p>\n COVID-19 has otherwise been accompanied by a spurt in lobbying. A study conducted by The Post Millennial of Ontario\u2019s lobbying registries over the past two months shows at least 17 different representatives or consultants have registered as active lobbyists for for-profit long-term care companies or for the OLTCA.<\/p>\n Of those newly registered lobbyists at least five have previously worked for the Ontario Progressive Conservatives.<\/p>\n Lauren McDonald registered May 7 to represent Revera. Revera\u2019s Ontario homes have seen the most deaths among for-profit Ontario chains. McDonald worked in the Office of Premier Ford and was the premier\u2019s director of marketing in the opening months of his administration.<\/p>\n Michael Wilson is another recent lobbyist for Revera. He was Conservative Ontario Attorney General Doug Downey\u2019s \u201cgo to<\/a><\/span>\u201d (as Downey called him) when he was being paid to be Downey\u2019s chief of staff.<\/p>\n There is also Leslie Noble, registered for Chartwell, a for-profit whose revenues neared one billion in 2019. Noble is\u00a0described<\/a><\/span>\u00a0by her government relations firm as being \u201cwell-known in Conservative circles\u201d after serving as strategic advisor on numerous political campaigns. She frequently comments in national outlets on industry and Conservative politics.<\/p>\n In the same boat as Noble, Carly Luis is earning money through Chartwell and previously served as director of strategic communications for the Ontario PCs. She has worked in the office as an adviser to the leader of the PC\u2019s when Patrick Brown was holding the reins.<\/p>\n“Undervalued and underpaid”<\/h3>\n
A \u201crevolving door\u201d<\/h3>\n
Getting out \u201csmelling like roses\u201d<\/h3>\n