OPEN LETTER: Open Letter to Doug Ford signed by over 200 organizations & almost 2 million Ontarians – LTC commission & immediate measures

Posted: June 30, 2020

(Updated: June 30, 2020)

The Ontario Health Coalition sent an open letter to Premier Doug Ford signed by family councils, health professionals, social organizations, cultural organizations, seniors’ and retirees’ groups, health coalitions, legal clinics, and many others who collectively represent almost 2 million Ontarians. The letter is below. If your organization wants to sign on it isn’t too late; please email us at ohc@sympatico.ca with the subject line “Open Letter”. Individuals who do not represent an organization can help also. You can use this letter as a template to write your own and email it to premier@ontario.ca and please cc us in.

Ontario Health Coalition

Open Letter to Premier Doug Ford

May 28, 2020

While we are pleased that your government has committed to independence, non-partisanship and transparency with regards to the commission into long-term care and COVID-19, we are seeking some assurances regarding both this commission and the immediate measures needed that cannot wait for a commission. In addition, we believe that it is imperative that Ontario hold a full public commission or inquiry into the province’s overall response to COVID-19, like the SARS Commission, as there are many lessons to be learned from this experience beyond the long-term care sector.

To be clear, the Ontario Health Coalition called for the commission into long-term care to be under the Public Inquiry Act. You have voted against this in the Legislature. Failing that, Premier, we must state in the clearest possible terms that it will be unacceptable to the public if the commissioner(s) and any supporting staff are not fully independent of long-term care operators. Any long-term care commission must have unimpeachable credibility and operate in the public interest. This means it cannot be led or controlled by any partisan (political party) interests or by long-term care owners and operators. It must be transparent and open, not by invitation only. Access to the Commission must be equitable and it must allow for voices from families, residents, staff and their associations and unions, public interest groups and advocates who have worked closely on these issues. Care workers and professionals must be protected to speak on the record about conditions in the homes. Testimony and research must be on the record and fully available publicly as with formal commissions and inquiries in the past, and the commission must report as quickly as possible.

Further, this commission cannot delay immediate action being taken to stabilize and support the workforce to stop the COVID-19 outbreaks that continue to spread in long-term care homes across significant parts of Ontario. We need a coherent plan from your government to stop the spread of COVID-19 in long-term care and retirement homes, including concrete measures to improve PPE supply, workplace safety and infection control, and to stabilize the workforce. We urgently need your government to take leadership and concrete coordination measures to immediately address critical staffing shortages that mean even basic daily care like feeding, bathing, hygiene, human contact are not able to be done; that palliative care needs are not being met; that care for the gravely ill is less than what is needed, as follows:

Understaffing in long-term care is critical and must be addressed. The provincial government cannot rely on long-term care homes in crisis to get themselves out of crisis. There must be a coherent plan, led by our government, to step in with a set of coordinated, concrete measures to get staff into the homes that have lost staffing levels due to sickness, having to choose one part-time job, staff leaving etc. Leaving it to the providers to forge voluntary arrangements among themselves is not sufficient. Staff need a permanent improvement to their wages and access to full-time hours. This cannot be voluntary and there is no path to stability without the provincial government undertaking these measures. In addition to the permanent improvements to wages and access to full-time work, measures are needed while homes’ operations remain under the emergency directives. Many staff have lost significant hours of work (and thus income) as a result of the requirement to choose one work site. They are risking their health and their families to go into the homes to do care work and the loss of hours is not offset by the pandemic pay increase. Yet some homes are bringing in PSW aides, nurses and others without giving their part-time staff any increase in hours. To address this, long-term care homes must be required to increase their pay for part-timers who have been required to give up part-time work in other homes to be equivalent to full-time pay and benefits, so as not to maintain the operator’s economic incentive to limit the proportion of care delivered by full time staff. Further, the Minister of Long-Term Care must use her powers to revoke licences and appoint new management in long-term care homes that have uncontrolled outbreaks and evidence of negligence and poor practices.
Infection control practices, workplace safety and access to PPE must be improved. Reusing surgical masks patient after patient, resident after resident, would have been totally unacceptable before COVID-19. Insufficient access to N95 masks continues to be a problem and there are shortages of other equipment. There needs to be a clear plan from the government to improve the supply of PPE or develop our own. Leaving it to industry to do voluntarily has so far been insufficient. Standards for infection control and workplace safety must be improved. Staff need the appropriate equipment, enough supply and training in order to comply with them. Staff who are infected must be supported to isolate at home. The directive allowing health care facilities to require staff to work who have tested positive for COVID-19 but are asymptomatic is dangerous and should be changed as should the loopholes that fail to stop agency staff from working at more than one location. Ongoing training and support for infection control regarding the use of PPE are needed. Testing of all residents and staff must be ongoing in long-term care homes, and completed in retirement homes and congregate care facilities (and shelters). Testing, tracking and isolating people who test positive is shown to have stopped the spread of COVID-19 in other countries. It must happen here. Access to PPE using the precautionary principle must be implemented in long-term care, hospitals, home care and across the health care system as soon as possible.
Testing, contact tracing and isolation must be improved using our province’s full public capacity. Public hospital laboratories that are not currently doing COVID-19 testing and have unused capacity should be ramping up testing. We need a clear honest plan from the provincial government that assesses our full capacity to test (including all the public hospitals, not just those that are currently testing) and immediately ramp up to our province’s real full capacity the testing, tracking and isolating to stop the spread of COVID-19. There must be a coherent plan and immediate action to get the supply or develop it for testing kits, swabs and reagents, and transparency about what is happening with this.
Transfers to hospitals. Where there are long-term care homes in crisis without sufficient staff to provide proper palliative and end-of-life care, as well as being unable to address the general care requirements of the residents, residents should be considered for transfer to public hospitals, which are not in crisis, for safe and proper care, subject to their right to consent.
Bring in family caregivers and volunteer nurses as soon as possible: As soon as testing/contact tracing capacity and PPE supply are stabilized enough to do so, and as soon as training in infection control can be properly conducted, primary family caregivers need to be able to be involved as partners in their families’ care. The pool of nurses that the RNAO has recruited to help should be utilized if they have not already been.
Institute a minimum care standard in long-term care: There has been deep consensus for decades that the rising acuity (complexity and severity of the care needs) of long-term care residents requires more care. This cannot be left to operators to do on their own, and resources — both financial and human — need to be provided to support this. There cannot be further delay in beginning to move to a 4-hour average minimum care level for residents in long-term care to protect their safety and the safety of staff.

Premier, we are also deeply concerned about our research finding that the death rates in for-profit homes are significantly higher than in non-profit homes. It is imperative that your government halt any expansion of for-profit long-term care. We will follow up with your office regarding these issues and look forward to your response.

Cordially,

Natalie Mehra Ross Sutherland

Executive Director Chairperson

Please see the following list of more than 200 organizations representing almost 2,000,000 Ontarians that have signed onto this letter in support in the following pages.

The following organizations representing almost 2,000,000 Ontarians have signed onto this letter in support:

Action Not Words

Advancement of Women Halton

Advocacy Centre for the Elderly (ACE)

ARCH Disability Law Centre

Amnesty International Groups as follows:

Amnesty International Group 9 (Kitchener-Waterloo)
Amnesty International Group 125 Kingston

Antler River Watershed Social Justice Network

Bowmanville Nurses Association

Canadian Association of Retired Persons (CARP)– Essex Chapter

Canadian Federation of University Women (CFUW) chapters as follows:

CFUW Brantford
CFUW Stratford

Canadian Health Coalition

Canadian Office and Professional Employees Union (COPE) Ontario and locals as follows:

COPE l. 96
COPE l. 468

Canadians Against for Profit Care and Support Group for the Elderly

Canadian Union of Public Employees Ontario (CUPE Ontario) and locals as follows:

CUPE Retirees’ Association
CUPE l. 57 Guelph General Hospital
CUPE l. 87
CUPE l. 786
CUPE Council (Niagara Region)
CUPE l. 2225
CUPE l. 4207
CUPE l. 6364

Canadian Union of Postal Workers – Ontario, Toronto and Central Regions

Care Watch Ontario

Child Care Now (Ottawa)

Citizens United for a Sustainable Planet

Committee on Monetary and Economic Reform (COMER) Kingston

Community Elder Abuse Prevention Committee of Thunder Bay

Concerned Friends of Ontario Citizens in Care Facilities

Congress of Union Retirees of Canada (CURC) and chapters as follows:

CURC Hamilton Burlington Oakville
CURC Sarnia Council
CURC South Central Ontario Branch
CURC Thunder Bay
CURC Toronto and York Region Council

Council of Canadians and chapters as follows:

Council of Canadians – Guelph Chapter
Council of Canadians – Hamilton Chapter
Council of Canadians – Kitchener Waterloo Chapter
Council of Canadians – London Chapter
Council of Canadians – Windsor Essex Chapter

Council on Monetary and Economic Reform (COMER) Kingston

Decent Work and Health Network

Downsview Community Legal Services

Elementary Teachers’ Federation of Ontario (ETFO)

Empowerment Council

Family Councils as follows:

Algoma Family Council Coalition
Cedarvale Lodge Retirement Community, Keswick
Champlain Region Family Council Network
Clarion Nursing Home Family Council
Family Councils Collaborative Alliance (FCCA)
Family Council for the Henley House
Family Council McGarrell Place
Family Councils of Region 4 Advocacy Committee
Fieldstone Commons Family Council
Guildwood Extendicare Family Council
Grand Family Council of Greater Sudbury (GFCGS)
Idlewyld Manor Family Council
Iler Family Council
John Noble Home, Brantford
Linhaven Family Council, St Catharines
Macassa Lodge, Hamilton
Northeast Family Councils Network (NEFCN)
Park Lane Terrace Nursing Home
Shepherd Lodge Family Council
Shalom Village
Peter’s Residence at Chedoke Family Council
Village of Humber Heights

Free Transit Ottawa

Friends of Kingston Inner Harbour

Guelph Wellington Coalition for Social Justice

Hamilton Community Legal Clinic

Health Providers Against Poverty

Horseshoe Falls Regional Council, The United Church of Canada

Horton Street Seniors Centre Advisory Committee

Image Promotions Inc.

Indo Canadian Workers Association

Interfaith Social Assistance Reform Coalition (ISARC)

International Association of Machinists and Aerospace Workers (IAMAW)

International Brotherhood of Electrical Workers (IBEW) l. 636

Just Voices- Ottawa Community Choir

Kingston Faith and Justice Coalition

Kiwanis Club of Ingersoll

Latinx, Afro-Latin-America, Abya Yala Education Network (LAEN)

Latin American Canadian Solidarity Association

London Injured Workers Group

Making Waves Windsor Essex Pelee Island

Municipal Retirees Organization of Ontario (MROO)

National Pensioners Federation

Neighbourhood Legal Services London and Middlesex

Network of Women with Disabilities (NOW)

Niagara Poverty Reduction Network

Noor Cultural Centre

Northumberland Coalition for Social Justice

Nurse On Board Canada Inc.

OHIP for All

Older Women’s Network (OWN)

Ontario Council of Hospital Unions (OCHU)

Ontario Disability Support Program (ODSP) Action Coalition

Ontario Health Coalition (OHC) and chapters as follows:

Chatham-Kent Health Coalition
Guelph Wellington Health Coalition
Hamilton Health Coalition
Kawartha Lakes Health Coalition
Kingston Health Coalition
London Health Coalition
Niagara Health Coalition
Northumberland Health Coalition
Ottawa Health Coalition
Peel Health Coalition
Peterborough Health Coalition
Sarnia Lambton Health Coalition
Sudbury Health Coalition
Thunder Bay Health Coalition
Toronto Health Coalition
University of Toronto Health Coalition
Wallaceburg-Walpole Island Health Coalition
Waterloo Region Health Coalition
Windsor Health Coalition

Ontario Federation of Labour (OFL) and affiliates as follows:

Kingston and District Labour Council
Lindsay and District Labour Council
London and District Labour Council
Niagara Regional Labour Council
Northumberland Labour Council
Ottawa Labour Council
Peel Regional Labour Council
Peterborough and District Labour Council
Quinte Labour Council
Renfrew and District Labour Council
Thunder Bay & District Labour Council
Waterloo Region Labour Council
Windsor and District Labour Council

Ontario Federation of Union Retirees (OFUR)

Ontario Medical Association (OMA) Section of General and Family Medicine

Ontario Network of Injured Workers Groups

Ontario Nurses’ Association and locals as follows:

ONA l. 75

Ontario Public Service Employees Union (OPSEU) Region 4 Retirees Division

Ontario Secondary School Teacher’s Federation and chapters as follows:

OSSTF – Association of Retired Members (ARM) Thames Valley (Chapter 11)
OSSTF ARM Toronto (Chapter 12)
OSSTF ARM Durham and York (Chapter 13/16)
OSSTF ARM Niagara (Chapter 22)
OSSTF ARM Kitchener Waterloo (Chapter 24)
OSSTF ARM Limestone, Ottawa-Carleton, Renfrew, Upper Canada (Chapter 25)
OSSTF ARM Waterloo (Chapter 74)
OSSTF ARM Sudbury & Manitoulin (District 3)
OSSTF Limestone District 27, Teachers’ Bargaining Unit

Ontario Society of Senior Citizens Organizations (OSSCO)

Oxford Coalition for Social Justice

Oxford County Voices for Education

Public Service Alliance of Canada (PSAC) Ontario region and chapter as follows:

PSAC- National Capital Region

Peel Poverty Action Group

POOF Protecting ODSP OW Funding

Poverty Free Thunder Bay

Raging Grannies chapters as follows:

Raging Grannies Toronto
Raging Grannies Ottawa

Ralph Thornton Community Centre

Retired Teachers of Ontario (RTO/ERO) District 14 Niagara

Royal York Road United Church (RYRUC)

Seniors’ Health Advisory Committee Sault Ste. Marie and Algoma District

Senior Pride Network Toronto

Shelter and Housing Justice Network

Socialist Project

Social Justice & Advocacy Committee of the Anglican Diocese of Toronto

Social Justice Network of Antler River Watershed Region

Social Justice Network of the Ontario Regional Councils (SJNOR)

Society of Saint Vincent de Paul, Ontario Region

St. Athanasius Anglican Church Orillia

St Paul’s United Church, Midland

Street Nurses Network

The Committee of Progressive Pakistani-Canadians

The Ministry for Social Justice, Peace, and Creation Care of the Sisters of St. Joseph of Toronto

Thunder Bay and District Injured Workers’ Support Group

Toronto Board of Rabbis

Trillium United Church Social Concerns and Outreach Team

Unifor and local unions as follows:

Kitchener, Waterloo, Brantford, Cambridge, and Guelph Unifor Retired Workers Area Council
Unifor l. 27
Unifor l. 195
Unifor l. 199 Retiree Chapter
Unifor Local 200 Retirees’ Chapter
Unifor l. 222
Unifor l. 222 Retired Workers’ Chapter
Unifor l. 240
Unifor l. 302
Unifor l. 673 Retirees
Unifor l. 1325 Retirees
Unifor l. 1451 Retirees