As of April 29th, the media reported that 79% of all deaths in Canada from COVID-19 are occurring in seniors’ and long-term care homes. The Public Health Ontario statistics, as of May 3rd, indicate that 75% of all COVID-19 cases in Ontario’s health care facilities (hospitals, retirement homes and long-term care homes) are in long-term care homes (residents or staff), with approximately two thirds of that figure representing residents and one third representing staff. It seems that pandemic planning prevented hospital surges that could have crippled them; but long-term care may have been an inadvertent casualty during the planning process.
Long-term care homes are facilities for individuals who require 24-hour nursing care; we usually think of these individuals as the frail elderly but young people may also qualify.
For those of us fortunate enough to practice health care law, the problems in the long-term care sector that are highlighted by this pandemic – staffing shortages and inadequate funding, to name only two – are well-known and have been the subject of reports seeking change for the past two decades. An Ontario Health Coalition report dated as recently as Feb 13, 2020 highlighted a critical shortage of personal support workers in long-term care. The July 31, 2019 report on the Public Inquiry into the Safety and Security of Residents in Long-Term Care Homes (the 2019 Report) recommended an increase in funding to the nursing and personal care envelope that would allow homes to hire a broader spectrum of staff, bridging and laddering programs to enable homes to retain and develop their most promising and dedicated staff members, and increased funding to ensure adequate training and knowledge for everyone working in such homes. The 2019 Report also required the Ministry of Health and Long-Term Care to report to the legislative assembly in July of 2020 about improvements and increased funding. And in April of 2019, the Ontario Long Term Care Association noted the need for more staff and highlighted a shortage of personal support workers.
The implementation of the Long-Term Care Homes Act in 2010 reinvigorated the sector and new programs were introduced thereafter that directly improved resident care. According to a March 25, 2020 news release from AdvantAge Ontario, the government injected $243 million into the long-term care sector on March 25, 2020 for “surge capacity and 24/7 screening, supplies and equipment…and $80 million to enhanc[e] the quality of care and overall resident experience in long-term care homes, along with $23 million for a minor capital program for upgrades and repair”. However, the staffing problems remain.