RELEASE: Action Plan to Stop the Spread of COVID-19 in Long-Term Care Inadequate: Ford government must match rhetoric with stronger, concrete measures to protect residents and staff

Posted: April 16, 2020

(April 16, 2020)

Toronto – The Ford government’s Action Plan to address COVID-19 outbreaks in Ontario’s long-term care homes is still less than what is needed stop the spread of the virus and stabilize the workforce, warned the Ontario Health Coalition today, and is inconsistent with the “iron ring” rhetoric and promises for widespread testing from the Premier.

“We are increasingly frustrated with the disconnect between the statements of the Premier and what is actually being put into the regulations, directives and guidance issued by his own government,” said Natalie Mehra, executive director. “Yesterday’s announcement was mostly a rehash of measures already announced, many of them less than what has been stated in daily press conferences by the Premier. More importantly, the measures that are being taken are too little and too slow, and the Ontario government appears to be relying too much upon isolation to contain the spread of the virus, which is not practically possible in many long-term care homes.”

“We are inundated with calls and emails from families with loved ones in long-term care and staff in the homes, crying, afraid, furious about the lack of testing, even in homes with outbreaks,” Ms. Mehra reported. “Staff are contacting us because they are being required to work, even when they test positive, and they are afraid of infecting others. Workers are angry and they are frightened and the many family councils we work with share their anger. They are taking risks to provide care but feel they are being blamed for the outbreaks, have been required to give up part-time jobs, but still nothing has been done to address their longstanding grievances about poor pay, heavy careloads, and conditions of work.”

The Coalition called on the government to revise the Action Plan to require the following:

• What is required: All staff, volunteers, third-party caregivers, management and residents going into or living in long-term care homes must be tested for COVID-19 and the Ontario government must come into compliance with the World Health Organization’s recommendation issued on February 24 that countries, “prioritize active, exhaustive case finding and immediate testing and isolation, painstaking contact tracing and rigorous quarantine of close contacts.”
  • What is happening: Premier Doug Ford said mid-week last week that everyone should be tested. Yet the directive and guidance issued by the government only slightly widened the list of symptoms that long-term care residents and staff need to demonstrate in order to be tested.  In addition, some asymptomatic residents in the same room, adjacent rooms or in the same unit may be tested in homes where there are outbreaks. However, even this is left up to local decision-making, and there is no requirement to test all residents, staff and people going into the homes, even in homes with outbreaks. Families are telling us testing is not happening.
• What is required: Staff who test positive cannot be required to work in the homes, they should, as above be under quarantine with support.
  • What is happening: The Coalition is hearing from staff who have been required to work even though they have tested positive for COVID-19 and are afraid of passing on the virus to other staff and residents. As revealed by Global News yesterday, the government’s directive allows long-term care homes to require staff who test positive to work in the long-term care homes under “self-isolation” measures that are inadequate and impractical, and those staff are required to travel to and from work in the community, when people who test positive are should be required to stay home under quarantine with support to do so.
• Testing of new admissions must be done prior to admission. No people who test positive for COVID-19 should be admitted to a long-term care home. Hospital patients who test positive for COVID-19 should not be allowed to be transferred into long-term care homes or other residential care facilities.
  • What is happening: The new directive only requires new admissions into long-term care to be tested within 14 days of admission which is far too slow, and hospital patients transferred into long-term care are required to be tested under the new guideline, but transfers of COVID-19 positive patients are expressly allowed.
• Immediate measures must be taken by the provincial government, which is responsible for funding and regulating long-term care, to support and stabilize the long-term care workforce. The critical shortage of Personal Support Workers that has emerged over the last two years is a result of poor pay and conditions that have fallen far behind, as well as too-high acuity among residents for the care levels provided. Heavy workloads and punitive conditions must be addressed as we outlined in our report on the PSW Crisis released in January. Improved wages and benefits, full-time employment, a regulated care standard that would provide a minimum of 4-hours of staffing time to provide daily care for residents must be implemented.
  • What is happening: The provincial government has passed a regulation requiring some (but not all) workers to limit their work to one home (see below for details). But it has still not undertaken any concrete measures to support the workers, leaving it up to the homes to voluntarily top up hours for workers who are now required to give up one or more part-time jobs in order to choose one primary workplace. Provincial legislation prohibiting wage increases above 1 percent in public and non-profit homes has still not been rescinded. The province has temporarily allowed hospital and other health care staff to be redeployed to the homes in the emergency while being employed by their other employers, but there are no measures being taken in tandem to support and stabilize the long-term care workforce now or going forward. The deregulation of existing staffing standards and the allowance of untrained staff and volunteers under a regulation passed under the province’s emergency legislation continues. The province is now waiting for the federal government to release its program for wage top-ups during the emergency.
• What is required: Isolation in long-term care is a significant problem. Isolation of COVID-19 residents is not physically possible in many of the homes. Larger homes have elevators that all staff, residents, visitors and volunteers use. Smaller homes lack the physical space for separation. There are not separate entrances. Many homes have shared rooms or shared bathrooms. Residents are still eating in group settings. There is no easy solution but the provincial government cannot rely on isolation as the primary means of containing the spread of COVID-19 in long-term care given the reality of the homes. A much better plan must be developed to provide safe, compassionate isolation measures.

In addition, a CBC investigative report revealed yesterday that since the Ford government was elected, annual unannounced inspections of long-term care homes have ceased. The Coalition is calling for the government to reinstate annual unannounced inspections.

The new regulation requiring that staff choose one workplace and temporarily take a leave from their additional part-time jobs in long-term care homes was passed yesterday. It covers PSWs, RPNs, RNs, housekeeping and dietary employees of long-term care homes. It does not cover hired-in caregivers that families have employed, temp agency staff, management, retirement home staff, other jobs outside of long-term care, and staff not listed in the regulation. It does not provide full-time hours for those staff who lose hours at another part-time job as a result of the directive. It does not improve staff wages, provide benefits or other supports for the workforce to be able to do this.

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