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Liberals should legislate long-term care standards to fulfil pledge in pact, says NDP

OTTAWA — The Liberals must enshrine new standards for long-term care homes in law to fulfil a pledge in the confidence-and-supply agreement that would help keep their minority government in power, the health critic for the New Democrats said Tuesday.
A panel of experts with the Health Standards Organization has developed updated guidance for how care homes should operate in light of the deadly and tragic toll the pandemic took on Canadian residents and their quality of life. A man looks out the window at the Camilla Care Community centre overlooking crosses marking the deaths of multiple people that occurred during the COVID-19 pandemic in Mississauga, Ont., on May 26, 2020. THE CANADIAN PRESS/Nathan Denette

OTTAWA — The Liberals must enshrine new standards for long-term care homes in law to fulfil a pledge in the confidence-and-supply agreement that would help keep their minority government in power, the health critic for the New Democrats said Tuesday.

A panel of experts with the non-profit Health Standards Organization released updated the guidance for long-term care in Canada on Tuesday, in light of the deadly and tragic toll the COVID-19 pandemic took on residents and their quality of life.

The new standards, which are not currently enforced, recommend that residents should get at least four hours of direct care every day, and that those who work with them must be paid more.

The Liberals committed to legislate safety in long-term care as part of the confidence-and-supply deal the parties signed last March, which would see the NDP support the minority government through crucial parliamentary votes until 2025, in exchange for action on key priorities.

NDP MP Don Davies, the health critic for his party, said these new standards must provide the foundation for that promised legislation.

"If it's going to be safe, then those standards have to be in the legislation," Davies said outside of the House of Commons Tuesday.

The Liberal government has so far not committed to legislating the standards, but federal Health Minister Jean-Yves Duclos says consultations on the new long-term care bill will begin in the "coming months."

It is tricky ground for the federal government to tread, since long-term care falls under provincial jurisdiction. 

Prime Minister Justin Trudeau said Tuesday that he recognizes the provinces are responsible for delivering and regulating the care, but all Canadians want to see seniors' care held to the highest standard possible.

"That's what we're going to continue to work on," Trudeau said on his way into a meeting with his cabinet ministers.

Experts with the Health Standards Organization said the new standards will only help if the government puts them into practice and makes sure they are followed.

"These standards are only useful if … they become the basis of enforcement and accountability measures, not only accreditation measures," said Dr. Samir Sinha, the chair of the technical committee that developed the updated standards.

He suggested the standards could become the basis of provincial legislation, policy, or some other means of accountability. 

For now, every province makes its own rules about the accreditation, operation and inspection of long-term care, creating a patchwork system across the country that governs how the homes should be designed, operated and maintained.

Trudeau promised in the 2021 election to legislate safety in long-term care across the country, and doubled down on that promise in the pact with the NDP, but the government has not said what that law would entail.

"We’re going to continue to work with provinces and territories in their efforts to support those long-term care standards in their own communities," Seniors Minister Kamal Khera said Tuesday after the cabinet meeting.

Duclos suggested the government might sign bilateral deals with individual provinces to enforce the new standards.

The government set aside $3 billion in the 2021 budget to help provinces and territories apply standards to long-term care, top up wages, and improve staff to patient ratios.

"Now, we are looking forward to sign agreements with provinces and territories to see how they can use those dollars to further meet these new standards," Duclos said.

Much more money will likely be needed to implement the standards.

In 2021 the parliamentary budget officer estimated it would cost an additional $4.3 billion per year just to expand the number of hours of daily care to the four hours listed by the Health Standards Organization.

Davies said the NDP would likely be flexible about how the standards are enforced.

"I think what Canadians are really interested in is making sure that their relatives or seniors are being properly cared for long-term care homes," he said. 

"I don't think they really care so much about the framework."

Some provinces already require long-term care homes to be accredited according to the organization's standards, while other homes seek accreditation voluntarily.

The Health Standards Organization expects about 68 per cent of long-term care homes will be accredited on a voluntary or mandatory basis using the updated standards.

But Sinha said accreditation will not be enough without enforcement.

New guidelines for the design of long-term care homes and practices to prevent infection were developed in tandem with the updated care standards. They were released last month by the CSA Group, formerly known as the Canadian Standards Association.

The CSA Group standards cover everything from the number of residents who should share a room to the materials used to construct the building.

The CSA Group standards are strictly voluntary at this point, but the experts who developed those building standards hope they will be adopted into regulationsor legislation quickly.

"Time is of the essence as there are plans across the country, in various provinces and territories, to build new long term care homes," said Alex Mihailidis, who chaired the CSA Group committee.

"Our hope is that they will be looking at our standard for before the shovels are in the ground."

Mihailidis believes if the standards were in place when COVID-19 struck in 2020 fewer things may have fallen through the cracks, but until the new guidelines are in place and enforced, he said it's still a matter of waiting to see.

"It's definitely a big step in the right direction," he said.

Khera said the new standards were developed from extensive consultations, including with seniors and organizations that work with seniors, and she believes they will improve long-term care.

Khera said that as a nurse who volunteered at a long-term care home in her community during the COVID-19 pandemic, she can say "these are going to make a huge difference."

This report by The Canadian Press was first published Jan. 31, 2023.

— With files from Mia Rabson

Laura Osman, The Canadian Press

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