After thousands of pandemic-related deaths in the province’s long-term care sector, Ontario’s Progressive Conservative government introduced a bill that doubles the maximum fines levied on homes that break the law.
The Providing More Care, Protecting Seniors, and Building More Beds Act, 2021 will increase the power of long-term care home inspectors by allowing them to issue compliance orders on the spot and allows the ministry to put in place a long-term care home supervisor to run a home.
In an interview with CBC News Wednesday, Long-Term Care Minister Rod Phillips said the government wants to better protect residents through greater accountability, stronger enforcement and increased transparency.
“We expect most of the operators, in fact, the vast majority of operators to operate within the rules. But it’s important that there be consequences when they don’t. The highest fines in Canada will ensure that operators understand that there are financial implications if they don’t play by the rules,” Phillips said.
The bill comes after the deaths of more than 3,800 long-term care residents in Ontario during the COVID-19 pandemic, and it follows a widely criticized move by Premier Doug Ford’s government to scale back comprehensive, annual inspections of long-term care homes in 2019.
Phillips said the legislation is intended to provide not only more oversight but also to restore confidence in the long-term care sector. It would legislate direct care targets, includes provisions on integrating a palliative care philosophy into homes and would require homes to have a dedicated person in charge of infection prevention and control.
Ontario’s Long Term Care Association (OLTCA), which represents 70 per cent of the province’s long-term care homes, welcomed the introduction of the bill.
CEO Donna Duncan said in a statement that the legislation “lays the foundation for a modernized long-term care system focused on residents, their needs, and their quality of life.”
“The Ontario Government has made unprecedented investments in staffing and rebuilding and expanding long-term care homes to correct decades of systemic neglect by successive governments and provide much-needed supports for Ontario’s seniors and other residents of long-term care homes,” she said.
“It is our hope that the new legislation will help to create a climate of stability and confidence among residents, families, staff, and the public.”
Phillips previously announced that the province will spend $20 million to double the number of long-term care home inspectors, with plans to hire 193 new inspections staff by next fall.
“Increasing the number of inspectors puts in the capacity for the ministry to make sure that homes are held accountable, including significant financial penalties if they don’t meet their obligations to protect the safety of their residents and protect their quality of life,” Phillips said.
Under the legislation, maximum fines for provincial offences under the act will be doubled:
- For individuals ($200,000 for first offence, $400,000 for second offence).
- For corporations ($500,000 for first offence, $1,000,000 for second offence).
- For board members (for-profit licensees: $200,000 for first offence, $400,000 for second offence; not-for-profit licensees: $4,000).
The bill would empower inspectors, not only directors, to issue compliance actions. It would allow the director of a home or the minister to suspend a licence and have a long-term care supervisor installed to take over the operation of a home without having to revoke a licence and close the home.
A long-term care supervisor would allow the ministry full control of the home until the suspension is lifted, licence expires, revocation of the licence occurs or another solution is found. This function currently exists for government oversight of hospitals and school boards.
The bill would also prohibit any person convicted of an offence under the new act, or found guilty of professional misconduct detailed in regulations, from working for, volunteering for or sitting on the board of a licensee or long-term care home.
Phillips said he is pleased that bill would legislate the province’s commitment to increasing direct care for long-term care residents to an average of four hours per day by 2025.
“My experience visiting homes has educated me to the vital role that staff play, and 27,000 more people working in long term care homes four years from now is going to make for much better quality of life and much better quality of care,” he said.
The bill would also legislate the province’s commitment to specific direct care targets for each year, which is three hours by March 31, 2022, three hours and 15 minutes by March 31, 2023, and three hours and 42 minutes, by March 31, 2024.
Under the legislation, the minister will now be accountable for annually reporting on each target, and if the target is not met, producing a public plan that explains why the target was not met and how the next target will be achieved.
The bill would require homes to incorporate a palliative care philosophy into their care and services.
Phillips said each home, under the bill, would have a mandate to have an infection prevention and control (IPAC) dedicated staff person who is responsible for the IPAC program as their primary responsibility. This person would have to take specific training. Inspectors will be required to audit IPAC programs.
In terms of transparency, the bill includes a section on quality of care and quality of life and that would mean requirements for mandatory quarterly public reporting, including standardized annual resident and family surveys. It will also have regulations that define the role of caregivers and medical directors in delivering care.
And the bill would allow for appeals to the minister in the licensing process and enable the creation of a long-term care quality centre that would disseminate best practices through training and research.
The bill will repeal the current Long-Term Care Homes Act, 2007, create the Fixing Long-Term Care Act, 2021 and amend Retirement Homes Act, 2010.