Health Coalition seeks progress on Safe Long-Term Care Act in 2022 Budget

Posted by on March 08, 2022

Initially posted by the Canadian Health Coalition. View original, posted on February 16, 2022.

The Canadian Health Coalition has delivered the following letter to Health Minister Jean-Yves Duclos, calling for the introduction of legislation with national standards for long-term care that is funded – and enforceable.

“People in Canada deserve equal access to quality care and quality working conditions,” said Pauline Worsfold, RN, the coalition’s chairperson. “We need the government to move forward with developing national, enforceable standards through a Safe Long-Term Care Act, including removing for-profit companies from long-term care.”

The Canadian Health Coalition was founded in 1979 to support public health care, and comprises unions representing frontline health care workers, community groups, and experts.

The letter from the Canadian Health Coalition follows (and in PDF format):

Canadian Health Coalition / La Coalition canadienne de la santé
Rue 116 Albert St., 300
Ottawa, ON K1P 5G3

The Honourable Jean-Yves Duclos, P.C., M.P.
Minister of Health
House of Commons
Ottawa, Ontario
K1A 0A6

February 16, 2022

Dear Minister Duclos,

The Canadian Health Coalition (CHC), comprising community organizations and unions representing frontline health care workers, is writing to urge accelerated efforts to help solve the crisis faced by residents, families, and workers in long-term care.

The Prime Minister has mandated you, as Health Minister, “to develop national standards and a Safe Long-Term Care Act to ensure seniors get the care they deserve.” The CHC and its members have called for the introduction of legislation with national standards for long-term care that is funded – and enforceable.

The next federal budget will be an important opportunity to fulfil your government’s election promise to work collaboratively with provinces and territories to support seniors and long-term care through an investment of $9 billion over five years.

Now is the time to repair the damage caused by chronic underfunding and profit-based health care. We urge you, Minister, to commence negotiating agreements with provinces and territories for conditional long-term care funding promoting adherence to the principles of the Canada Health Act.

The Health Standards Organization (HSO) and the Canadian Standards Association (CSA Group) have developed two new national standards for long-term care. These accredited non-profit organizations are independent of the government. Still, the standards have been federally funded and the process was recognized and welcomed by the federal government in Budget 2021. Both draft standards are in the requisite 60-day public comment period.

Upon review, we find the draft CAN/HSO 21001:2022 (E) Long-Term Care Services standard is an improvement over the previous and inadequate HSO 21001:2020 standard. The foundational principles reflect the CHC’s view; the conditions of work are the conditions of care, systemic racism must be addressed, and federal and provincial legislation must include accountability mechanisms to enable these standards for LTC.

The CHC and its members have also identified several very concerning gaps and will provide the HSO and CSA Group with further comments on their draft standards. If not addressed, some of these omissions could render these standards an ineffective attempt to address the crisis in Canada’s long-term care sector.

For example, there is no standard for a minimum number of hours of direct care for residents, which should be at least 4.1 hours. Likewise, many stakeholders have recommended a more stable and cohesive workforce with 70% full-time employees. In addition to the importance of benefits, portable pensions and minimum sick days available to workers should also be included in the standard.

Overall, the vague language of these standards, combined with the dearth of clear metrics by which to judge compliance, does not provide us with confidence in these draft standards as currently written.

Especially concerning is the fact the HSO has not adequately responded to grave concerns from stakeholders about the impact of for-profit companies in the ownership of LTC homes and the provision of services.

What We Heard Report #1: Findings from HSO’s Inaugural National Survey on Long-Term Care, based on over 16,000 submissions to the HSO, acknowledged, “many survey respondents felt that abolishing for-profit long-term care was the most important issue to address within LTC.”

However, the HSO does not take the opportunity to place conditions or limits upon for-profit companies in the draft CAN/HSO 21001:2022 (E) Long-Term Care Services standard. Instead, the HSO deflects the issue as the responsibility of provincial and territorial governments.

In our view, this is an incorrect conclusion. Standards must be based on evidence, and the evidence is clear residents of LTC homes owned by for-profit companies faced far higher rates of infection and death during the pandemic than LTC homes owned by non-profit organizations or governments.

If the matter of ownership of LTC homes by for-profit companies is left to provinces and territories, as the HSO suggests, then your mandate as Health Minister to create national standards to “ensure seniors get the care they deserve,” cannot be achieved.

Our goal is to ensure the patchwork of standards, regulations and structures is not allowed to persist across jurisdictions. People in Canada deserve equal access to quality care and quality working conditions.

We acknowledge the phase-out of for-profit ownership in the LTC home sector will not be achieved overnight, and concern by families that such structural changes may reduce the number of available beds needs to be addressed.

We urge you and your Cabinet colleagues, the Minister of Seniors and the Minister of Employment, Workforce Development and Disability Inclusion to move forward with developing national, enforceable standards through a Safe Long-Term Care Act, including removing for-profit companies from long-term care.

Budget 2022 must provide sufficient conditional funding to implement the Safe Long-Term Care Act with enforceable national standards, and other critical workforce measures your government has committed itself to achieving.

Yours sincerely,