May 16, 2007

ORDERS OF THE DAY LONG TERM CARE

Mr. Ernie Hardeman (Oxford): I rise today to speak to Bill 140, which is a bill, of course, that was supposed to deal with improving the lot in life for our seniors, to upgrade and to provide, as the minister opposite said, quality care for our seniors.

The bill doesn't seem to have achieved the goals that the government themselves set out to achieve. Of course, you would know that in the campaign document-and you know that very well, Mr. Speaker-the government promised to spend and to provide $6,000 more per resident in the long-term-care system in order to provide that quality care. They were going to upgrade the quality of the homes. The previous government funded 20,000 new long-term-care beds which were going to be used to alleviate the backlog of people who were waiting for beds. We spent money on 16,000 beds that were D facilities that were moved up to A facilities. The government of today-I would have thought there would have been something in this bill that would help facilitate the process of taking the C beds and turning them into A beds so everyone would get the quality care and a similar level of care to what their neighbours and their friends get. There's nothing in the bill that does that, and I think that's of great concern.

I had the opportunity to attend some of the public hearings, and what I found interesting was that it didn't seem to matter what group was presenting; there was no one who came in and presented and said, "We like this bill the way it is." Everyone who came in had certain things they liked about the bill, but all had serious problems with it. I would just like to very quickly go through some of the areas.

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At the public hearings in London-of course, as you would know, that's rather close to my riding, so that was an opportunity for some of the people who provide long-term care in my riding, some of the people who represent the associations, the resident councils and so forth in long-term-care facilities, and the labour people who provide the care in the homes for long-term care. I just want to go through some of the things that they told us were wrong with the bill and where they were concerned.

I'll start with the Oxford Health Coalition, which presented to the committee. I wouldn't think of reading through their whole presentation-we would be here for the whole day-but there is one paragraph I do want to read. I think this was fairly consistent with all the presenters who represented the labour that provides the service in the homes.

This is Shawn Rouse, who is chair of the local for the workers in the long-term-care facility:

"Where the act does fail the residents and their families is in what is missing in the act. What we see as a root issue in many of the continuing problems plaguing resident care is the missing language surrounding a minimum care standard. An interesting issue has arisen in the presentation of an actual regulation reported on the long-term-care website that speaks to a minimum requirement for staffing levels in the dietary department of 0.42 hours per resident meal day. There is a formula to amend the number if the dietary department is shared with a retirement home or a hospital. Imagine that there are no minimum staffing levels in nursing, but there are in dietary. Compliance staff will be enforcing this and may request staffing schedules, records of resident meal days and duty rosters, among other things. Dietary standards are outlined in seven pages, and nursing standards are outlined in four."

I think I would have to agree with him that in fact there seems to be a bit of a problem there, that we are more interested in looking at what is happening in the operation of the facility in the kitchen than we are in what is happening with the actual care for the people living there. I think that's a sad commentary. He brings that out because that's what is in this bill. That's what this government is proposing to do with this legislation that they said was going to provide quality care and improve that quality care for our seniors.

As I said when I started, everyone who came to present had some concerns with the bill. The minister opposite mentioned that this was designed to help the not-for-profit organizations. One of those not-for-profit organizations is the municipal home for the aged. Again, I've had the pleasure and privilege of sitting on the board of our local Woodingford Lodge and the long-term-care facilities in the riding. The warden of the county made a presentation. I just want to point out some of the concerns that they had with the legislation. Again, they were trying to deal with these issues, and it seems that they've come up short.

"A paramount concern of the county of Oxford related to this piece of legislation deals with the failure of the province to make a commitment to ensure that there will be sufficient long-term-care beds available in Ontario in general, and in Oxford county in particular, to meet the future long-term-care needs of the residents of our communities."

Again, there is nothing in this piece of legislation that provides for increasing the number of beds and, furthermore, improving the quality of the beds that exist.

This is another problem that we found in Oxford county and in all municipal homes for the aged: "The county of Oxford contributes some $5 million per year to the cost of resident care and services at Woodingford Lodge to meet the current standards. It is becoming progressively more difficult to maintain this level of subsidy due to the capital financing commitments. Unless the government provides additional funding, Woodingford Lodge will be forced to apply even more of its limited resources to meeting all the new administrative requirements of the act."

Again, there are a lot more administrative things in this act that need to be done. There is absolutely nothing in this act that will help the operators of the facilities to pay for that service.

Number three was "a requirement to establish and maintain a home. Under section 117 of Bill 140, southern municipalities will continue to be required to establish and maintain a long-term-care home or joint home or help maintain a home or joint home with the ministry's approval." Again, of course, there's an exemption for northern Ontario. The problem that arises is that they mandate that the municipality must do it, but there is no funding applied to it. Furthermore, this bill increases the standards that are required.

When they got through with their presentation and I thanked the warden, I said, "The number one issue in the whole presentation appears to be that we can make these changes, and a lot of the changes are good for the system, but what we need is funding to go with it. So we'll leave the funding as the number one priority," and the warden agreed with that. "As the second priority in your presentation, what would you say if we could convince the government to make a change, but only one? What would it be in the bill that would make this a better bill as it relates to long-term care and the county's operation of Woodingford Lodge?"

The warden said, "If I could maybe turn that over to Mr. Orvidas, who, as I mentioned, is the director and has a little more day-to-day interaction with staff, the residents and also family members."

Again, it's so important that we hear from the people who actually operate the facilities and whether this legislation will do that.

"I think enhanced funding is a critical component. However, I think that's so closely tied to operational funding that one goes hand in hand with the other."

Again, it comes down to-it's wonderful to make all kinds of rules and regulations and set standards, but you have to put funding in.

"An area that we have particular concern about, as has been mentioned, is the prescriptive regulations and the need for staff to spend so much more of their time, then, to meet those requirements rather than doing what they do best, which is bedside nursing."

Again, he is very concerned that there is no mandate and no funding there to help with more people to look after the bureaucracy. Of course, it's going to be more and more difficult for them to meet the needs in the bill-and absolutely no improved services for the residents.

The last one I wanted to just quickly touch on was the presentation that was made by Mr. Brent Gingerich, who is the operator of PeopleCare in Tavistock. I won't go through the whole thing, but there's just one section of it here that I found rather helpful as we decide whether this bill meets the targets that were set.

"This act could be win-win for the government, could be win-win for the clients and public, could be win-win for the staff and operators and could be win-win for owners and financers. This is why the Ontario Long Term Care Association has proposed some 95 in-depth and detailed amendments. I'd encourage you to adopt these amendments as presented." Of course, they had been presented to the committee before.

He goes on to say further down, "With Bill 140, there's still no workable plan"—should    
maybe read the paragraph before that's so critical: "PeopleCare's three homes are classified as C by the Ministry of Health, which means the physical structures, the bricks and mortar, comply with 1972 nursing home standards but do not meet the newly introduced 1998 standards. My colleagues in the association and I have been advocating the government since the 1998 standards were introduced to develop a workable plan to get these 1972 C homes, which represent about 50% of the homes in the province, to standards more acceptable to today's residents and their families. Unfortunately, a plan has never been introduced.

"With Bill 140, there's still no workable plan for the future. According to Bill 140, I may get notification by the ministry informing me if I'll get to remain open after seven years. In the absence of such notification, I can expect to be closed." The minister said that this wasn't going to happen, but in fact, the people who are running the homes believe that it is going to happen. "That's the level of planning for capital in this act. For a long-term-care organization with an outstanding reputation that has been a model provider of long-term-care services for 40 years, this has caused a tremendous amount of uncertainty regarding our future existence"-not only for the homes but for the residents in those homes, because if they cannot get their licence extended, those people will have to find new places to live.

"The worst thing is, Bill 140 does not even identify what we need to do in order to keep our licence after seven years." They have amended the bill to now make it, I believe, 15 years. "My bank is not optimistic. My banker calls this cloud of uncertainty `risk,' and he indicates that banks don't like risk. Unfortunately, I have to worry a lot about what my banker thinks, because part of our extended family's succession and transition plan for me required that I take out a mortgage. Now, because Bill 140 does not outline a workable plan for C homes, our mortgage rates have gone up-my payments have gone up considerably. There is less money in the budget to do the cosmetic upgrades and repairs to our home. But the worst thing-the absolute worst thing-is that we may not be able to renew our mortgage in four years-bottom line. Talk about uncertainty. Is it acceptable to create that type of environment in this sector?"-and again, not only for this sector owning the home but the people living in it. I think that's the position of the people who spoke to us, the providers of the service and the seniors.

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I haven't talked much about the seniors, and I think it's so important. I'm going to touch on it just for a moment. Last Friday, we had a group of people in who represent the seniors in Oxford county. Their number one concern was how we go about making sure that the level of service that is being mandated is in fact being provided. The only thing that's out there to make sure it's happening is inspectors from the ministry who come in from time to time, always with a phone call to say they're coming. So how can the people be assured that their family members in the home are being cared for? Their request was that an ombudsman position would be created-which had been promised by the government-that in fact they would be able to report to without notice, and that he could check to make sure that all the people in the home were getting the quality care they were entitled to.

With that, I've touched on the areas that I think are of great concern. I think the bill falls far short of what the government said they were trying to achieve, and it falls far short of what the seniors, the operators of the facilities, and the public and the people of Ontario have a right to expect from a bill that deals with long-term care. Again, I thank you very much for your time, and I look forward to being able to oppose this legislation on behalf of the constituents I represent.