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June 16, 2020 - No. 41
The Need to End Private-Profit
Arrangements in Long-Term Care
Governments Must Be Held to Account!
• Profit Motive and
Unaccountability -- Culprits for Deficiencies
in
Long-Term Care - Diane Johnston
• National
Union Calls on Public Service Pension
Investment Board to Pull Out of the Business
of Long-Term Care
• Alberta
Government's Subsidies to Private Seniors'
Care
Operators - Peggy Morton
• Alberta Federation of
Labour Statement
• Ontario Registered
Nurses Association Sets Standards for
Long-Term Care
• Rally to Support
Extendicare Guildwood Residents in
Scarborough, Ontario
• Quebec Government's
Callous Disregard for Life, Health and
Dignity - Pierre Soublière
- Diane Johnston -
Long-term care is not available to Canadians on
a universal basis. They are largely left to fend
for themselves with regard to ensuring that
their long-term care needs, and the costs
associated with them, are met.
 
In reference to the glaring deficiencies in
long-term care, in a recent interview on CTV's
Question Period, Sharleen Stewart, the President
of the Services Employees International Union
(SEIU) Healthcare, a union representing over
60,000 frontline workers in Canada,[1] said: "We've
been [tolling] on the alarm bells for decades on
this and just recently over the past couple of
months with the pandemic, constantly we've been
asking, announcing, and reporting what we were
hearing in real time off the front lines that
our members were reporting to us."
 "There has to be accountability
to any money transferred from anybody's hands,
whether it be federal money to the provinces or
provinces to those homes," she noted.
Stewart also said that Canada must put an end
to privately-owned facilities, "who[se]
priorities are based more on paying out
shareholders rather than making sure that the
proper and adequate care is given."
On June 2, Stewart wrote a letter to Ontario
Premier Doug Ford, regarding his announcement of
pandemic pay for eligible frontline health care
workers, effective for 16 weeks from April 24
until August 13.
In her letter, she points to the fact that
"tens of thousands of frontline health care
workers were wrongfully excluded, which showed
your government's clear lack of understanding of
the critical roles so many are playing during
these unprecedented times."
"Along with over 8,000 of our union members who
have signed our petition demanding the expansion
of pandemic pay," she writes, "I am calling on
you to immediately ensure that pandemic pay is
applied to ALL non-management frontline health
care workers. We are also asking you to make
Pandemic Pay retroactive to the start of this
pandemic, instead of the April 24 date that was
arbitrarily chosen."
Concluded the SEIU Healthcare President, "It is
long overdue that all frontline health care
workers, who are risking their lives each and
every day during this pandemic, are properly
supported and respected."
The pandemic has made it glaringly clear that a
new direction is needed in the care of seniors
and the health care sector generally. In order
for that to happen, the most urgent need is for
a credible public authority.
SIEU continues to hold rallies at Ontario
seniors' care homes, thanking the healthcare
workers. This one, at Westgate Lodge in
Belleville, honours those who have died of
COVID-19.
For such an authority to be credible,
legitimate and accountable, it must have a
direct connection with the working class with
regard to determining the direction of the
economy, as it is the working class that creates
all the value produced in the society. That
value must be placed towards responding to the
needs and well-being of the society in general.[2]
Notes
1. SEIU Healthcare
members include clerical support, developmental
support workers, dietary aides, housekeepers,
lab technicians, maintenance workers,
paramedics, registered nurses, personal support
workers, registered practical nurses and social
workers
2. "The
Necessity for a Credible Public Authority," TML
Weekly Supplement, May 30, 2020.
A May 26 press release from the Public Service
Alliance of Canada (PSAC) informs that National
President Chris Aylward has called on the Public
Sector Pension Investment Board (PSP
Investments) "to end its investment" in the
long-term care provider Revera and instead "put
the second largest Canadian network of
for-profit long-term facilities under public
ownership and control."
Revera is a wholly-owned subsidiary of PSP
Investments, a federal Crown corporation[1] which PSAC
points out, "manages the investments of the
pension plans of the federal public service, the
Canadian Armed Forces, the Royal Canadian
Mounted Police and the Reserve Force. As the
bargaining agent for members of the federal
public service and federal agencies, PSAC
represents a large proportion of the
contributors and beneficiaries of federal public
service plan."
PSAC notes that it made the call for a change
in ownership of Revera as a result of "mounting
evidence that the incidence of deaths and
illnesses attributable to COVID-19 is
disproportionately large in private, for-profit
long term care facilities. Also, a class action
lawsuit by family members of deceased former
residents of Revera Inc., has exposed the risk
that comes with owning the long-term care
chain."
In a letter sent on May 11 to the pension
fund's president and CEO Neil Cunningham, PSAC
President Chris Aylward wrote: "Regrettably, in
the midst of this unprecedented global pandemic,
we find ourselves having to write to you again
on behalf of the approximately 140,000 members
of the Public Service Alliance of Canada (PSAC)
who currently contribute to [the] Federal Public
Service Pension Fund pursuant to the provisions
of the Public Service Superannuation Act
(PSSA). As we have advised previously, the
objectives of our organization include a
commitment to ensure that quality services are
provided to the Canadian public and that the
compensation and working conditions of employees
are conducive to fulfilling this
responsibility."
Aylward then highlights the issue of "the
mounting and overwhelming evidence of an
extremely disproportionate incidence of COVID-19
related deaths and illnesses amongst residents
and employees of Long-Term Care (LTC)
facilities," which he notes, "raises a number of
troubling concerns. In this regard, and as you
are aware, Revera Inc., as a wholly owned
subsidiary of PSP Investments, operates the
second largest network of for-profit LTCs in
Canada."
"Our organization has previously had to
intervene with both yourself and your
predecessors regarding the operations and
conduct of Revera Inc. towards both residents
and staff. The responses provided by PSP
Investments have, quite frankly, been inadequate
and dismissive." With regard to media reports
about a class action lawsuit initiated in
Ontario by family members of deceased former
residents of Revera facilities which cite the
lack of proper sanitation protocols and testing
procedures in the face of the pandemic, Aylward
notes that PSAC "suspects the foregoing is the
first of many forthcoming on the horizon."
Stressing that PSAC has long warned PSP
Investments "that the continuation of business
practices without addressing the concerns of our
organization would not only be detrimental to
the residents and employees" of Revera, he adds
that such practices "could also pose long-term
consequences for the contributors and
beneficiaries of the Federal Public Service
Pension Plan."
"As a consequence of all of the foregoing, and
in the interests of the residents, employees and
stakeholders in Revera," Aylward concludes, "the
PSAC membership is requesting that your office
initiate immediate and formal comprehensive
consultations with federal and provincial
governments for the transition of the management
and control" of Revera's operations, "to the
corresponding provincial health authorities" in
jurisdictions where Revera operates.
A copy of that letter was sent to Treasury
Board of Canada President Jean-Yves Duclos, to
whom PSP Investments reports.
Note
1. "Taking
Advantage of the Most Vulnerable and Then
Passing the Buck," Diane Johnston, TML
Weekly, May 30, 2020
- Peggy Morton -
The Alberta government announced on May 20
that it would provide $170 million to private
operators of long-term care facilities,
designated supportive living facilities and
seniors' homes across Alberta. The government
stated that the funding was "to help support
vulnerable seniors in Alberta amid the COVID-19
pandemic" and would go towards enhancing
staffing, providing more cleaning supplies, and
addressing lost accommodation revenue.
 The funding is
retroactive to March 15 and is only available to
"contracted operators," not to publicly-owned
facilities or those managed by Covenant Health
(Catholic hospitals and continuing care
facilities). United Nurses of Alberta, the
Alberta Union of Provincial Employees, the
Canadian Union of Public Employees, the Alberta
Federation of Labour, and Friends of Medicare
all denounced the decision to guarantee the
profits of the private operators, while refusing
to recognize the contribution of all staff
working in seniors' care.
The Alberta Union of Provincial Employees
(AUPE) called for a suspension of profits and
executive bonuses at continuing care facilities,
saying that "profitable corporations should not
be rewarded for their pandemic failures."
"During the announcement, Health Minister Tyler
Shandro acknowledged more than 70 per cent of
Alberta's COVID-19 deaths have been in
continuing care," says Kevin Barry,
Vice-President of AUPE. "What he left out was
that a disproportionate majority of those deaths
and outbreaks have occurred in for-profit
centres.[1]
Providing this money while still allowing
multi-million dollar corporations like Revera
and Chartwell to run a profit is rewarding them
for their failures..."
"Residents and staff have had to sacrifice
their safety during the pandemic, and to do
right by those residents and staff, for-profit
providers should have profits suspended and to
dip into their revenues to manage this crisis
instead of expecting a publicly funded bailout,"
says Barry.
United Nurses of Alberta (UNA) said the
announcement showed the failure of seniors' care
operated for private profit, which the United
Conservative Party (UCP) government has
announced it will expand. "While the money is
necessary as an emergency measure to protect
vulnerable residents of private long-term care
facilities that have been hit hard by COVID-19,
it amounts in many cases to a bailout for
businesses with a conspicuously bad record of
protecting the people trusted to their care,"
UNA President Heather Smith said. "In essence
the government is rewarding private operators
who have diverted public funding to profits
instead of paying fair wages and ensuring
adequate staffing."
Speaking to the fact that the majority of
deaths in seniors' homes across Canada are
linked to privately owned facilities, Smith
stated, "In most cases, these were needless,
preventable deaths. The current system is broken
and the Alberta government's priority should be
to fix it by returning it to the public sector,
not by shoring up for-profit private operators
with public funds for ideological reasons."
The Alberta government has promised funding for
a $2 an hour raise only for personal support
workers or nursing aides in private and
not-for-private-profit facilities. All
other staff, including licensed practical
nurses, housekeepers, food services workers,
maintenance, and clerical workers will receive
nothing, and even the aides in public facilities
and those managed by Covenant Care have been
excluded. The fact that they all have risked
their lives to provide care and services to
patients is not recognized, the unions point
out, nor the fact that staff who do not normally
provide direct patient care have been doing so
during the pandemic.
Several private operators have withheld funds,
including Chartwell and Rosedale Development,
claiming that they are only required to pay for
hours worked in publicly funded beds. "This is
utter nonsense, of course," says AUPE
Vice-President Susan Slade. "All these residents
live side by side in the same units. The work
these HCAs do, and the risks they are taking,
are exactly the same. The pay they get should be
the same."
One particularly obscene aspect of the
announcement was that operators who have empty
beds in their facilities as a result of patient
deaths would be compensated for the loss of
revenue from "accommodation fees." When
private operators' negligence, greed and
indifference to the seniors under their care is
rewarded by government, it shows there is no
governing authority fit to rule. Money given
retroactively to facilities for extra cleaning
due to the pandemic, all goes into the hands of
the private operators, not housekeeping staff
and others who have risked their lives to keep
the seniors' care homes clean.
While Albertans, together with all of Canada
and Quebec are calling for increased funding for
social programs and an end to privatization, the
Alberta Health Minister's obsession is to
guarantee the profits of the wealthy owners and
shareholders. It is, as the workers and their
organizations point out, one more compelling
reason why the Minister should resign, and why
the UCP government has shown itself unfit to
govern.
Note
1. Of the 102 deaths
identified by Alberta's Medical Officer of
Health in long-term care and seniors'
residences, the facilities are not identified in
five deaths. Seventy-one of the remaining 97
were in for-private-profit facilities.
On April 20, Health Minister Tyler Shandro
publicly promised a $2 per hour wage top-up for
Health Care Aides working in private continuing
care facilities. Shortly after the government
also announced a new provincial order of a
one-site policy, which would restrict some care
workers from working at multiple long-term care
facilities. Both of these policies left
non-profit community care agencies and group
homes in the lurch.
"Many care workers are forced to work multiple
jobs just to make ends meet. This often means a
worker in a private continuing care facility
will also work in home care, a group home or
elsewhere to make a living," said Alberta
Federation of Labour President Gil McGowan. "By
restricting the provincial policies to only
certain continuing care facilities the UCP
government is now causing staffing concerns for
the other community agencies and workplaces
where these workers also work."
Non-profit agencies providing care for
society's most vulnerable are receiving no extra
PDD [persons with developmental disabilities]
funding or support for staffing from the
provincial government. With many workers
restricted to one workplace, and receiving
higher wages if they choose to work at other
facilities, these agencies are left without the
support required to compete for, or retain
staffing.
"The federal government announced support for
provinces to boost care worker wages, but the
UCP have chosen not to expand their wage top-ups
to help support these crucial non-profit
agencies caring for some of our society's most
vulnerable," said McGowan. "This exclusion is
leaving many group homes in a constant struggle
to provide adequate staffing levels or support
for their residents."
"The COVID-19 pandemic has highlighted that
care workers are crucial all of the time and
have always deserved to get paid more than the
lowest legally allowed wages," said McGowan.
"Unions representing care workers have
repeatedly requested to be at the table for
these discussions to help this government
implement better policy decisions during this
pandemic. So far the Kenney government has shown
no interest in involving workers in decisions
and as such they are missing the mark for
ensuring society's most vulnerable are protected
and cared for during this pandemic."
The Alberta Federation of Labour has joined
with LIUNA 3000 to co-sponsor a petition calling
on the UCP government to act on these issues.
The petition can be found here.
Memorial established by families of residents
who had died of COVID-19 at the Camilla Care
Community, a long-term care home in
Mississauga.
On June 5, the Registered Nurses Association
of Ontario (RNAO) threw down the gauntlet to
the government of Ontario, setting out
standards of care that the RNAO deems
necessary for residents of long-term care
facilities. RNAO also declared there is no
need to look any further into what is needed
than the dozens of reports that have already
been written over the past 20 years. The RNAO
statement is posted below.
If the Ontario government is serious about
fixing the long-term care (LTC) system, it must
adopt evidenced-based solutions documented in
numerous reports that have examined the sector's
failings.
RNAO today released a list detailing dozens and
dozens of recommendations in the areas of
staffing and funding made in 35 reports as well
as a public inquiry and a coroner's inquest
looking into the problems in LTC over the past
20 years. The recommendations in these reports
call for more staffing in LTC homes, the proper
skill mix of regulated and unregulated staff to
meet the increasing acuteness, and a funding
model that responds to growing needs.
RNAO compiled Long-Term Care Systemic
Failings: Two Decades of Staffing and Funding
Recommendations[1]
because we are among those who have examined
this issue for years. "We implore the Ministry
of Long-Term Care, the Ministry of Health and
the premier to act NOW. It is disheartening,
exhausting and expensive to continue to study
problems that are known and understood and where
the missing factor is the political will to act
decisively rather than, once again, kick the can
down the road with more commissions and more
reports," says Dr. Doris Grinspun, RNAO's CEO.
"Enough of over-studying and under-acting in
this sector -- we know and the government knows
what needs to be done to improve and save the
lives of LTC residents."
"Premier Ford has vowed to fix the system. He
says there will be accountability. However, as
much as I want to believe him, I have heard
heartfelt words from political leaders before.
Accountability begins at the top and must be
delivered with swift actions. Residents living
in long-term care, along with their families,
and staff can't wait any longer for change. No
study and no words will deliver better care for
residents, only better funding and better
staffing will," Grinspun insists.
RNAO has proposed a staffing formula that
builds on earlier reports and studies and
addresses those needs. It wants each LTC home
resident to receive at least four hours of
direct nursing and personal care per day, based
on a skill mix of regulated and unregulated care
providers. Of those four hours, 0.8 hours (48
minutes per day) should be provided by a
registered nurse (RN), 1 hour (60 minutes per
day) by a registered practical nurse (RPN), and
2.2 hours (132 minutes per day) by an
unregulated personal support worker (PSW). In
addition, each home should have one nurse
practitioner (NP) for every 120 residents as
well as a nurse specializing in infection
prevention and control.
RNAO explains such a formula is necessary
because about 55 per cent of LTC residents are
85 years or older and 90 per cent of all
residents have some form of cognitive
impairment, including dementia. The majority of
residents in LTC also have complex health needs
including chronic conditions such as heart
disease, diabetes or arthritis -- needs that
require the expert care and skill mix NPs, RNs,
RPNs and PSWs provide.
RNAO's President Dr. Angela Cooper Brathwaite
says a critical deadline is looming. "July 31,
2020 is an important date on the government's
calendar. It's the deadline Justice Eileen
Gillese gave the government to table in the
legislature a detailed report on the adequacy of
regulated staffing in LTC. It was a key
recommendation in her report The Long-Term
Care Homes Public Inquiry (2019)."
"The July 31 government report gives the
opportunity to Premier Ford to demonstrate he
means action. We need to address staffing and
funding issues in LTC immediately. We don't need
more studies, as the list released by RNAO today
demonstrates. Let us get on with improving the
lives of people, in real ways. We owe residents
in LTC a debt of gratitude for the contributions
they have made during their lives. They should
be able to live with dignity, comfort and love,
and they and their staff should be better
equipped and protected, especially when the
second wave of the pandemic hits," adds Dr.
Cooper Brathwaite.
The Registered
Nurses' Association of Ontario (RNAO) is the
professional association representing registered
nurses, nurse practitioners, and nursing
students in Ontario.
Note
1. To view the full
report, click
here.
Friends and family members of residents at
Extendicare Guildwood long-term care home in
Scarborough are calling on the Ontario
government to step in and take control of that
facility. On Friday, June 12, they held a
protest rally in front of the home. They have
also started a Facebook page and issued a
statement on the appalling conditions at the
facility.
The Guildwood Extendicare Family Support Group
came out in full support of the Service
Employees International Union's (SEIU) call for
government to take over long-term care services
in Ontario. In fact, the SEIU, citing a more
than $10 million dividend that Extendicare
recently voted to pay its shareholders, issued a
demand that dividend payments to long-term care
operators should come to an end given the state
of affairs in long-term care facilities across
the country. SEIU Healthcare President Sharleen
Stewart said at the time: "What I heard today
from Extendicare was both alarming and an
affirmation of a truly ugly long-term care
system. Residents are getting sick and dying.
Workers are getting sick and dying. Enough is
enough. Corporate dividends from companies like
Extendicare, Chartwell, and Sienna, can no
longer be a part of the delivery of health care
equation."
 
Rally at Guildwood Extendicare, June 12, 2020.
The conditions at Extendicare Guildwood in
Scarborough are completely opposite to the way
the Ford government characterizes the situation
in long-term care. Premier Ford announced on
June 11 that because "progress" has been made
containing COVID-19 outbreaks in long-term care
facilities, families would soon be able to visit
their loved ones, with strict distancing
requirements in place. There is absolutely no
sense of shame or accountability for what has
happened to seniors in long-term care.
The Guildwood Extendicare Family Support Group
paints a very different picture, one so dire
that it is enough to make one weep. Their
statement reads:
"As of June 10, there have been at least 54
deaths at the facility since the outbreak began
there in April. There were 159 residents before
the outbreak began which means a third of all
residents have died while 86 per cent of
residents have tested positive for COVID-19.
Forty-two staff members have also been
diagnosed. By any objective measure, Extendicare
Guildwood is in crisis.
Family of seniors in Guildwood held an earlier
picket May 26, 2020.
"Attempts to contain the virus to a single wing
of the facility failed. Uninfected residents are
still living in close quarters with those
infected as the virus continues to infect all
those within the building. Families are
terrified for their loved ones. Both the
Administrator and Director of Care of Guildwood
Extendicare contracted the virus in the early
days of the outbreak and have not yet returned
to work. At this time, it is unclear who is in
charge at Extendicare Guildwood. Management have
turned away an offer of assistance from the Red
Cross. Enhanced protective measures have not
been adopted. The lockdown has failed.
Their statement concludes:
"COVID-19 has shed light on numerous problems
with Ontario's care facilities for the
vulnerable. Changes to these facilities are
critical to all Canadians, as many face the
reality of placing beloved family members in
long-term care or entering such a residence
themselves. Please help us save our loved ones!
"We stand together to support one another and
our loved ones who depend on us to be their
voices."
- Pierre Soublière -
 The Integrated
Centre for Health and Social Services for the
Outaouais region (CISSSO) recently revealed that
in one long-term care centre (CHSLD),
Lionel-Émond, a public institution, there had
been 30 infections and six deaths among the
residents and 21 cases among the health care
workers. On the other hand, in a private CHSLD,
Champlain de Gatineau, belonging to the Toronto
company All Seniors Care Living Centres, there
are active cases but, in spite of that, the
CISSSO recently told a local newspaper that it
had decided not to divulge the number of cases
"out of respect for the owners." In Quebec's
daily count, how many such cases are not being
made public?
In some cases, people are presently resorting
to legal action. For example, on April 17, a
class action suit was launched against the
Herron CHSLD in Dorval where 31 people lost
their lives. The litigants are seeking punitive
damages for the inhuman and degrading treatment
of the seniors who live there. The action is
being taken for the 130 residents because of
everything they have been through. The Kasata
Group, the owners of Herron, are being held
responsible for not having given their health
care workers the proper personal protective
equipment, nor ensuring that the surroundings
were safe and had adequate sanitary conditions.
They are also held responsible for having
abandoned their residents with the most callous
disregard for their life, their health and their
dignity by treating them in an inhuman and
degrading way. On one specific day, the
claimants point out, there was one nurse and two
aides for the 130 residents.
Long before the pandemic, the situation was
such in the seniors' homes that in July 2018,
the Conseil pour la protection des malades took
up a similar class action in which it gave many
examples of degrading living conditions. It
denounced the systemic negligence and ill
treatment of patients in the CHSLDs. The class
action involved no less than 34,000 people who
had experienced such conditions since July 2015.
It raised the lack of personnel and work
overload for health care workers as being a part
of the problem. The government at the time tried
to quash the lawsuit, under the pretext that a
"living environment" as raised by the claimants
was "difficult to define." The judge upheld the
class action in 2019 on the basis that matters
of living conditions and those of adequate
quality of health were identical, rejecting
the government's argument. This is just one
of many instances where governments, which are
supposed to defend the public good, instead,
acting on behalf of private interests, attempt
to quash collective legal efforts to defend the
rights of workers and Indigenous peoples.
Now, on May 26, in the midst of the pandemic,
the Quebec government made a "global offer" to
various health care workers' unions in
negotiations for new contracts that embodies
this callous disregard for the life, health and
dignity of the workers and people. None of the
workers' demands for working conditions that
ensure their health and safety, and the
well-being of their patients, are addressed.
Consequently, the offer was rejected with
contempt. Not only do such offers refuse to meet
the needs of public service workers, they
pointed out, but the hardships the workers and
people are going through at this time are
precisely a result of this refusal.
(To access articles
individually click on the black headline.)
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