RTOERO Advocacy Issues
Marie DellaVedova, Political Advocacy Representative District 3 RTOERO, sent the following advocacy letter to both Minister Ross Romano and MPP Michael Mantha regarding the state of Long Term Care Homes in Ontario. Marie’s letter is accompanied by responses from the offices of Minister Romano and MPP Michael Mantha.
According to many medical and scientific experts, we have now entered the third wave of the Covid-19 pandemic. Throughout the first two waves approximately 4000 people died in long-term care homes in Ontario.
The pandemic experience for long-term care residents in Canada has been especially brutal. Compared to the rates in other OECD countries Canada has had the highest proportion of deaths occurring in long-term care.
Most of these deaths were preventable. While many long-term care residents died due to Covid-19, many also died due to inadequacies of care. Now, even though most long-term care residents have received at least the first dose of the vaccine and Covid-19 cases in long-term care are decreasing, the conditions in long-term care homes that allowed Covid-19 to spread are
still the same. Until those conditions are rectified, long-term care residents will continue to suffer and die, if not from Covid-19 and its variants, then from repercussions of the horrific conditions that have long persisted in long-term residential care.
The acuity levels of long-term care residents have increased dramatically over the years. More residents now have complex health care needs, including dementia and behaviour concerns. Because of staff shortages, in many long-term care homes there are simply not enough staff to feed and bathe people and keep them safe. Personal support workers are working in
stressful conditions and many are forced into part time employment. Part time work has been shown to foster the spread of sickness. Also, because staff are overwhelmed, it is difficult to establish the kind of personal relationships that are important to maintaining the dignity and happiness of residents. The elderly have borne the brunt of health care policies that have cut the number of hospital and long-term care beds, staff and resources.
It is time for a complete overhaul of our long-term care system. There is a need to confront ageism which is pervasive in our culture and rampant in long-term care. Ageism undoubtedly accounts for the entrenched reluctance to fix a system that is obviously rife with injustices. We need national long-term care standards to replace the patchwork approach that exists across the country. After all, long-term care is an essential component of our health care system.
A national high-quality, public and not-for-profit long-term care system that values the rights and dignity of the older person would have resident care as its priority, not profit making. It would have enough trained front line care workers to maintain an adequate minimum standard of resident care and those frontline health care workers would have full time employment with pay commensurate with the importance of their work. And it would be accountable to the Canadian public.
It will take political will to create such a system.
The question is: Canada needs a national plan for long-term care homes with national standards and processes for robust accountability. How are you and your government collaborating with other levels of government to work towards this goal?
Political Advocacy Representative
District 3 Algoma, RTOERO
Thank you for contacting the office of MPP Ross Romano.
Please accept our apologies for the delay in responding to your correspondence. We have been receiving a high level of constituent engagement and we certainly express our regret that we were unable to return a response to you in a more timely manner.
Since day one, our government has been committed to building a long-term care system that meets the needs of residents in the 21st century, after decades of neglect from previous governments. Before and during the pandemic, we have taken steps towards an aggressive modernization agenda that addresses long-standing needs like improved staffing, upgrading
existing homes to modern design standards, creating new capacity and limiting crowding.
While there has been a broader discussion happening on national standards, our focus is on improving long-term care in Ontario. We have been clear that we are willing to work with any partner who can help us achieve our goals and we are backing them with real dollars.
For example we have partnered with public colleges on the Accelerated PSW Training Program with an investment of $115 million to train 6000 new PSWs and 2200 currently finishing the program. We have partnered with Willis College with an investment of $2.4 million to train 300 PSWs in the Ottawa area, and we have partnered with private colleges and district school
boards with an investment of $86 million to train 8000 additional PSWs.
These partnerships are part of our $4.9 billion investment over 4 years to increase daily direct care from the 2.75 hours where the Liberal government left it to the 4 hours our residents deserve. This is the most ambitious target in the entire country and will make Ontario the leader in direct care in Canada.
Thank you for your continued advocacy.
Office of Ross Romano, MPP
Dear Ms. DellaVedova,
Thank you for contacting the office of MPP Michael Mantha and sharing your concerns regarding Ontario’s Long-Term Care system on behalf of RTOERO District 3. MPP Mantha and the Ontario NDP absolutely agree with you.
The spread of COVID-19 among Ontario’s most vulnerable citizens and the front-line staff who care for them, has been shocking. The sheer number of deaths of residents – often alone because family members are not permitted to be by their sides – is heart-breaking. The current chaos in LTC is a provincial and a national tragedy – but it didn’t have to be this way.
Successive studies have revealed chronic underfunding of the LTC system by Liberal and Conservative governments, the most recent being “Caring in Crisis: Ontario’s Long-Term Care PSW Shortage,” released in December of 2019. These studies reveal a worsening of staff-to-resident ratios at a time when more health care workers are needed in LTC; reduced hours of hands-on-care per resident per day when residents have higher needs than ever before; and juggling of shifts by casual and part-time workers, between 2-3 different homes, just to make financial ends meet. Nothing was done to deal with underfunding and all its consequences.
New Democrats have a much different response for the crisis in LTC. On March 12, 2020, we called on the government to adopt the precautionary principle with COVID-19 to ensure all health care workers get the PPE they need, based on their own judgement, including at least N-95 respirator masks, with necessary training and drilling in safe use, donning and doffing, to protect themselves, patients and the residents they care for. We’ve demanded an end to staff working at multiple LTC sites which increases the risk of spread; a robust testing regime for all residents and staff; an investment in LTC base funding so workers restricted to a single home are not monetarily penalized, and so there are more staff on each shift in every LTC home; provincial funding to provide full-time jobs to every LTC worker who wants one; a minimum increase to $22/hour for Personal Support Workers (PSWs) and Registered Practical Nurses (RPNs) to attract and retain them in LTC; and the inclusion of LTC agency staff in this restriction too so they don’t spread the virus either.
We’ve written the Minister of Long-Term Care to highlight our serious concerns with the recent de-regulation of important hiring, screening, training and staffing policies in LTC. Most recently, we called on the Ford government to follow British Columbia’s lead in developing criteria to determine when Public Health will take over management of individual LTC homes and group housing for other vulnerable people. Finally, our Leader Andrea Horwath has said that once this terrible crisis is over, Queen’s Park must ensure we don’t return to the patchwork of privatized, underfunded and poorly-regulated seniors care, so under scrutiny in Ontario today.
As you might know, the NDP also released in early October our full plan for a new, public and non-profit home care and long-term care system.
The NDP plan includes:
Thank you for reaching out to us and sharing your thoughts. Please let me know if you have any question or comment.
Adjoint législatif / Legislative Assistant
Bureau du député Michael Mantha / Office of MPP Michael Mantha Algoma-Manitoulin
Long-Term Care and Human Rights
The number of long-term care Covid-19 cases in the second wave has surpassed the number in the first wave by approximately 50%. And it has been deadlier. From January 1 to February 9 there were 5,824 LTC residents and staff infected and 962 deaths. (OHC, Feb.17, 2021) Many of the deadliest Covid-19 outbreaks in long-term care can be traced back to preventable error and staff shortages. Now the Covid-19 vaccination program is rolling out and most long-term care residents have received at least the first dose of the vaccine. Does that mean that the long-term care crisis will soon be over? Sadly, the answer is no.
There are several Covid-19 variants spreading across the province and proving to be much more infectious than the original virus. The efficacy of our vaccines against emerging variants remains to be seen.
But more importantly, the conditions in our long-term care homes that allowed Covid-19 to spread and kill so savagely are still the same. Until those conditions ar
e rectified, long-term care residents will continue to suffer and die, if not from Covid-19 and its variants, then from repercussions of the horrific conditions that have existed in long-term care, well before the pandemic.
Dr. Tamara Daly, Director of York University Centre for Aging Research and Education, has done extensive international research on long term care. in a recent RTOERO webinar entitled, Rights of Older Persons: Support, Ratify, Demand Now, Dr. Daly points out the impact of staffing shortages on the quality of care. Because of staff shortages, in many LTC homes there are simply not enough staff to feed and bathe people. PSWs are working in horrible conditions and many are forced into part time work. Also, because staff are overwhelmed, the relationships that are important to maintaining the dignity and happiness of residents are not established. Ontario’s very complicated long term care system with both public and private ownership and so much contracting out of services, leads to less transparency and accountability from those whom Dr. Daly calls “bad apples.” Dr. Daly advocates for public not-for-profit long term care homes which are more transparent and accountable. Profit taking is associated with poorer quality of care and buildings in disrepair. Dr. Daly says that public funds should not be going to privately owned long-term care homes. Approximately 60% of LTC homes in Ontario are private-for-profit homes. She is critical of the Ontario government which has received a lot of federal money but has directed very little of it to front-line long-term care workers. Both Quebec and British Columbia have done much better after the first wave to train and employ additional PSWs and pay them more. Dr. Daly also articulates a need to address gender equity in front line health care. LTC staff are predominately women. Their work is undervalued and underpaid even though it requires a high level of skill.
Recently Premier Ford announced that Ontario will adopt a 4-hour minimum care standard as advocated by his long-term care commission. However, Ontario would not commit to implementing it until 2024-25. The timeline is so long that it is meaningless for the people who are suffering and dying in long-term care now.
Dr. Daly is advocating for national long-term care standards to replace the patchwork approach across the country. She sees a need to confront ageism which is rampant in long-term care. This attitude likely accounts for the entrenched reluctance to fix a system that is obviously rife with injustices.
Margaret Gillis, President of the International Longevity Centre Canada, has called the horrors in long-term care human rights abuses. In the same webinar, she explains that the Universal Declaration of Human Rights has been expanded over time to include conventions to protect the rights of groups such as women, children, and persons with disabilities. Gillis says that now is the time to call for a convention on the rights of the older person. This pandemic has shown the necessity of such a convention. Human rights must be seen as life-long rights but they need to be grounded in convention if they are to be enforced. A convention would provide a stable complaints mechanism, not dependent on governments, and therefore able to provide accountability and continuity. The International Human Rights Council would have the authority to respond to complaints and issue recommendations.
Asked what we can do now to support their work and recommendations, both Dr. Tamara Daly and Margaret Gillis advised that citizens must DEMAND better accountability from ALL levels of governments. We must fight against ageism which is pervasive in our culture.
Both insist that we have to demand a complete overhaul of the LTC system. Gillis says that we must start screaming for change. We have to get the attention of politicians. It is only through political will that the changes will be made that can truly save lives. Suggestions include contacting the premier, the ministry of long-term care, federal and provincial representatives, and making sure that all know that what is happening in long-term care is an election issue. The District 3 website has a link to a personalized copy of the RTOERO form letter that members can send to elected representatives. Long term care residents are unable to advocate for themselves and many community members are still unaware of the conditions. Thankfully we have front-line care workers who, with the support of their unions, have spoken out to enlighten the public. Many unions have campaigns to reform Ontario’s LTC conditions including establishing minimum care standards. ONA, CUPE, CARP, UNIFOR and the SEIU Healthcare Union are some organizations with information and/or campaigns (including petitions) to improve long-term care. We can become involved in these campaigns and those of health care advocacy groups such as Doctors for Justice in Long Term Care and the Ontario Health Coalition, another grassroots group that has long advocated for reform in LTC.
These organizations and others have websites that you can find with a quick google search.
And of course, each one of us has the right and responsibility to vote. When we do, we can keep long-term care front of mind. Vulnerable seniors need us to step up for them. And SCREAM.
Submitted by Marie DellaVedova, Political Advocacy Representative
A Humanitarian Crisis – Here in Ontario
A humanitarian crisis is unfolding here in Ontario, one that could have been prevented. If thousands of children had died in institutions during the course of this pandemic, the institutions would have been closed down and criminal charges likely would have been laid. But the majority of deaths have been seniors in long-term care homes. And little has been done to quell the growing numbers of infections and deaths in long-term care. During the first wave of the Covid-19 pandemic the International Longevity Centre for Canada reported that 82% of all Covid-19 deaths in Canada occurred in long-term care homes. It was reported that death rates were especially high in private for-profit long-term care homes. Despite accounts of negligence, in Ontario not one long-term care home has been fined. Not one long-term care home has lost its license.
Now, as predicted, the second wave is becoming worse than the first wave. Our friends and family members living in long-term care homes continue to get sick and die in ever increasing numbers. Those who are in desperate need of hospitalization may be unable to access a bed as many hospitals in the province are reaching ICU capacity.
Reports of insufficient care have been the norm in Ontario’s long-term care homes for decades. Last year the Armed Forces provided a disturbing assessment of intolerable conditions in long-term care homes. There has been inadequate action to address the inhumane conditions and the growing number of deaths. This is undoubtedly a reflection of a most heinous form of ageism. Covid-19 has made it clear that Canada needs a national not-for-profit plan for long-term care homes with national standards and processes for robust accountability.
For years there have been calls for a four-hour minimum care standard in Ontario’s long-term care homes. The recent response of the Ontario government to institute such a policy, but only in several years, is not helping our vulnerable seniors now. The vaccination process has begun but so far, the roll out has been dreadfully slow. According to Dr. Samir Sinha, Director of Geriatrics at Mount Sinai Hospital in Toronto, speaking on January 4th, there are presently 100,000 doses of vaccine, 71% of the total, waiting in freezers. They will do no good until they are administered.
In order to increase resident care and infection control we must increase staffing levels and the use of appropriate PPE. We need more personal support workers (PSWs). They are the backbone of our long-term care system. They are overworked, underpaid and leaving the profession in droves. The government could begin a serious recruitment drive for PSWs specifically for long-term care. It could pay them for fast tracked training and provide them with full time work and improved wages and working conditions. Quebec did that and has greatly increased its long-term care staffing levels.
On January 3, 2021 the province reported Covid-19 outbreaks in 207 long-term care homes and a total of 1,140 confirmed active cases of positive residents. With 2,781 resident deaths in Ontario long-term care homes, it is time again for military intervention. It is also paramount that the 500,000 vaccines that will have been delivered to Ontario by the end of January be administered right away. Every missed opportunity is a potential loss of life.
District 3 Algoma is a branch of the Retired Teachers of Ontario (RTOERO). As a seniors’ group we consider health care a priority. We are concerned that Covid-19 cases are dramatically increasing in our district just as they are across the province. District 3 RTOERO implores the Ontario government to act immediately to stop the rising number of Covid-19 cases in long-term care homes and the mounting death toll among long-term care residents. Not to do so will fuel speculation that seniors are considered expendable in Ontario.
Political Advocacy Representative, District 3 RTOERO
RTOERO Long Term Care Advocacy Form
RTOERO’s 3 Advocacy Issues
Letter to the Minister of Long-Term Care, Ontario from RTOERO
Click the document to download / view.
RTOERO has identified three advocacy issues this year
The three issues are: A National Seniors Strategy, Environmental Stewardship, and Geriatric Healthcare.
A coordinated seniors strategy is necessary to remove barriers to seniors’ independence and to the essential role seniors play in vibrant, healthy communities and economies. There is a need for a national seniors strategy that will tackle the gaps that exist in health care and social policies. That will require dedicated funding and accountable goals to meet the changing needs of seniors who are Canada’s fastest growing demographic. Challenges include income security, universal public pharmacare, social isolation and aging at home.
It is important for us to maintain the viability of our ecosystems for ourselves and for future generations. We must improve in all areas that are critical to a sustainable future. That includes a responsible use of resources, conservation and protecting our air and water. Everyone has a part to play in environmental stewardship-individuals, companies, industrial groups and governments. Challenges include a ban on single-use plastics, common recycling standards, environmentally-sustainable transportation and safeguarding the water supply and drinking water.
Geriatric Healthcare: Physical and Mental Health for Older Adults
Canada’s population is aging. In 2020 more than one in six Canadians is now a senior. By 2030 it will be nearly one in four. Our health care system, which has tended to address acute care needs, has had less focus on home care and community care. The rising needs of the growing senior population means that our health care system and social systems need to develop ways to address the new reality in order to meet those needs.
Challenges include geriatric training, healthy aging, long-term care and elder abuse.
If you would like more information about RTOERO’s advocacy issues please go to the website: www.vibrantvoices.ca.
There you can also add your voice to the voices of fellow RTOERO members in urging government to improve the tragic conditions that presently exist in long-term care.
Click the Summary Sheets, below, to view/download.
Below are the complete booklets for each Advocacy Issue.
Click to view/download.