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Comments
on the Plan for Long-Term Care in Ontario
June 2004- On May 11, 2004,
Health Minister George Smitherman presented and endorsed a far-reaching
report on long-term care in Ontario. The report was prepared by parliamentary
assistant Monique Smith after a two-month review of long-term care facilities,
during which she made unannounced visits to over 20 homes and consulted
with close to 100 interested groups and individuals.
Mr. Smitherman also announced $191 million a year in new money to hire
2,000 new staff, and promised funding and legislation to support the
establishment of autonomous family councils in every home.
Concerned Friends is very pleased with the overall philosophy of this
report. Many of the recommendations are reforms that we have advocated
over the years. The report focuses on five areas for government action
in the long-term sector:
• improving quality of life,
• ensuring public accountability,
• developing clear, enforceable standards with tougher inspection
and enforcement,
• improving staffing and system administration,
• amending legislation and reviewing the funding formula.
The report describes the critical role of the facility administrator
in setting an exemplary standard of care, and the importance of qualifications
and training for this position. Appropriate staffing levels and well-trained,
full-time staff has always been a top priority for Concerned Friends.
This report recommends much needed improvements in these areas.
The role of volunteers, including family and residents’ councils,
is emphasized and ways of encouraging a home-like environment are described.
As an example, the report notes the importance of access to telephone
and cable TV to many residents. However, Concerned Friends is aware
that residents who receive the Comfort Allowance of $115 a month (increased
by 3% in the June 2004 provincial budget from $112, but still not enough)
are often unable to afford these basic necessities.
Public accountability is a key area in need of reform. Concerned Friends
strongly supports more public access to user-friendly information including
profiles of each long-term care facility, both on a website and available
from local Community Care Access Centres. The issue of an independent
advocate for long-term care is one that needs full study, including
consultation with the public and relevant stakeholders, in order to
develop the most effective and cost-efficient solution.
Tougher enforcement of clear, measurable and resident-focused standards
is critical. The separation of the roles of inspectors and compliance
advisors is helpful, and ongoing training for these roles is imperative.
Financial accountability is also critical. The public confidence has
been severely shaken by reports of mismanagement and misappropriation
of public funds intended for the care of residents.
Of special interest is the suggestion that the government re-examine
the new bed allocations with a view to stopping the building of those
not yet in the ground and redirecting the savings to other areas.
We suggest affordable group homes or apartments, designed to meet the
needs of seniors who require home support services and some (but not
24-hour) medical services. These seniors could be served by non-profit
community support agencies such as Sprint and Senior Link, who provide
a full range of supports, including housekeeping, shopping and food
preparation, nursing and personal care.
Seniors overwhelmingly prefer to age in one place, and the success of
supportive housing projects (such as Ewart Angus Home for individuals
with dementia) indicate that at the very least these programs are able
to delay institutionalization. In addition, some of these small residential
settings could be designed and staffed to accommodate “hard-to-place”
seniors with special needs who are not appropriate for placement in
long- term care facilities.
There are many interesting and innovative ideas put forth in this report.
Concerned Friends would like to see some of them implemented immediately.
Others may take longer, but initial pilots could begin. We strongly
recommend that an implementation task force be set up, with representation
from seniors’ organizations and advocates for elder care issues,
to monitor the process.
To access Commitment
to Care: A Plan for Long-Term Care in Ontario, visit the Ontario
Ministry of Health and Long-Term Care website, or call your local regional
health office or M.P.P.
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