Fund homes to truly meet residents needs: OLTCA

Wednesday, January 17, 2007 -- John Driscoll

The Ontario Long Term Care Association (OLTCA) is calling on the provincial government to amend the proposed, Long Term Care Home Act (Bill 140) to strengthen its overall commitment to fund homes to truly meet resident needs.

The provincial Standing Committee on Social Policy is currently holding public hearings on the controversial legislation.

Karen Sullivan, OLTCA executive director, was scheduled to speak during the second day of hearings Tuesday in Toronto. Other hearings are scheduled for Jan. 22 in Kingston, Jan. 23 in Sudbury and Jan. 24 in London.

Representatives of the long terms sector including operators, residents, families and others have been raising concerns at the hearings about the legislation and its impact on the future of long term care services in Ontario.

They are also presenting workable solutions to the committee.

While welcoming the increased emphasis on resident safety, zero tolerance for abuse and whistleblower protection in the proposed Bill, they had hoped the new legislation would provide the foundation to address the reality of staff being "run off their feet" to meet resident needs, the OLTCA states.

"These hopes were dashed with the discovery that instead, Bill 140 poses risks to existing care and service levels, fosters institutionalization and provides no commitment to support homes to implement even the provisions included in the Bill."

As currently proposed, the Bill will require additional paperwork and administrative processes that will reduce existing resident care time, according to the OLTCA statement.

"Even if more funding is provided, homes, residents and families want it to go toward more care not to help fill out more forms. Yet Bill 140 introduces a doctrine of absolute compliance which will give homes no choice but to comply."

The Bill can be amended to be more realistically implemented while still allowing government to effectively monitor homes, states the OLTCA.

The sector has long advocated for a risk-based graduated sanctions process to enhance resident care and safety standards, the OLTCA states. "Such a process would provide a clearly understood approach to compliance, an early risk identification and response capacity and, if required, the consistent application of appropriate remedies of increasing severity to secure resolution."

The process outlined in Bill 140 provides no requirement for graduated implementation. Instead the government will be able to unilaterally decide what remedies to apply in any situation, thus continuing the inconsistency that everyone agrees reduces the effectiveness of the existing Compliance program, the OLTCA states.

If the Bill remains unchanged, inspectors will have unfettered authority to issue homes with Work and Activity Orders for everything from additional staffing to building renovations, leading to standards varying from home to home and region to region, according to the OLTCA statement.

"Even more concerning is the fact these Orders will be able to be issued without reference to Ministry funding levels or a home’s financial capacity," the OLTCA states.

"Bill 140 specifically states that ‘lack of government funding’ is not a legitimate reason for appeal of the Orders, and, at the same time empowers government to withhold or claw back a home’s funding for non-compliance."

"If government reduces a home’s funding, it also reduces its care and service delivery capacity. We fail to see how this will benefit either resident care or safety."

A more effective and resident-centre solution is to amend Bill 140 to provide a graduated and consistently applied sanctions process, the OLTCA states. The Bill should replace Work and Activity Orders and funding penalties with remedies that also maintain care and service levels, such as the power to impose external managers at the operator’s expense.

"Everyone agrees that long term care needs more funding," the OLTCA states.

The Ministry’s own data shows homes provide an average of 2.5 hours of care per resident per day in Ontario whereas most other jurisdictions in North America provide three hours or more for residents with similar needs.

"We fully understand that more funding is a budget issue," the OLTCA states. "The fact that Bill 140 asks long term care homes to do what is impossible, however, is a legislative issue."

Reassurance in the government’s commitment to fund an appropriate provincial long term care program is further lowered with the fact Bill 140 proposes the government "may" provide funding to met resident care needs. The funding commitment in the existing legislation uses the word "shall", the OLTCA point out.

"Government can help restore this reassurance by amending Bill 140 to strengthen overall commitment to truly meet resident needs."