SoVote

Decentralized Democracy

Ontario Assembly

43rd Parl. 1st Sess.
August 24, 2022 09:00AM
  • Aug/24/22 9:50:00 a.m.
  • Re: Bill 7 

It is my privilege to rise in the House to speak to the debate on Bill 7, the More Beds, Better Care Act, 2022. This bill, if passed, will make amendments to the Fixing Long-Term Care Act, 2021, as part of our government’s larger Plan to Stay Open: Health System Stability and Recovery. This five-point plan aims to provide the best care possible to patients and residents while ensuring the necessary resources and supports are in place to keep the province and the economy open. The plan further bolsters the Ontario health care workforce, expands innovative models of care, and ensures hospital beds are there for patients when they need them.

As everyone in the chamber knows, health care systems around the world are facing unprecedented challenges lately, and Ontario is no different. In order to address these pressures, make more progress with the surgical backlog, and be properly prepared for a potential winter surge, we need to do more. If we keep the status quo, we could see a 2,400-hospital-bed shortage by the peak of the potential flu and COVID waves later this year.

Over the last few weeks, our government has been actively engaging with front-line partners, hospitals, long-term care, union leadership and the best experts available to identify concrete, actionable solutions to respond to urgent pressures as well as prepare for any potential surge in the winter months. Our government is looking at every possible option as we look for ways to address the challenges facing our hospital capacity, avoid overstraining the health care system, and establish better models of care.

One of the main ways we help with hospital capacity challenges is to ensure that patients are getting an appropriate level of care in an appropriate setting. Across the province, there are many patients whose care needs could be better met elsewhere. These patients are sometimes referred to as alternate-level-of-care patients, or ALC for short. ALC patients in hospital no longer need to be there, and many would have better quality of life in a long-term-care home. At the same time, moving these ALC patients out of hospital and into long-term care frees up much-needed space in hospitals for patients who require hospital treatment.

Our government’s priority is for people to live and receive care where they have the best quality of life, close to their family and loved ones and their community. With this bill, we would add a new provision to the Fixing Long-Term Care Act, 2021, to ease the transfer of patients in ALC into long-term care.

ALC pressures are not unique to Ontario. Several provinces, like BC, Alberta and Nova Scotia, have similar policies which encourage the movement of patients into temporary care settings while they wait for their preferred bed.

In Ontario, there are approximately 1,900 ALC patients on a long-term-care wait-list or in need of long-term care. Some patients can spend up to six months or longer in hospital waiting for a space in their preferred home to open up, even though they no longer need hospital services. When they cannot be discharged, these patients continue to receive care, but in the wrong setting. These patients contribute to backlogs in acute-care services in hospitals because they occupy beds that other patients urgently need.

The More Beds, Better Care Act will enable the movement of these patients to a more appropriate care setting that can better support their quality of life and better meet their needs. ALC patients who are placed in a long-term-care home that was not selected by them will be there temporarily, until they can be placed in their preferred home.

As members in this house surely know, the wait-list for long-term care is sizable, thanks in large part to the neglect of the former Liberal government, who, from 2011 to 2018, only managed to build 611 net new beds across the province—611 net new beds while the population of Ontarians aged 75 and older grew by over 176,000. This blatant neglect of the sector left our government with a wait-list of over 40,000 patients.

Speaker, I am sure you know that our government wasted no time in developing new long-term-care beds. Since 2018, we have invested $6.4 billion into the development of new beds and new homes, and we currently have over 30,000 new and more than 28,000 existing beds to be upgraded in the development pipeline. Despite all of that, we still have a long wait-list for long-term care in Ontario, so I am sure everyone is wondering where we are going to place all of these ALC patients.

Well, as we have done since the beginning of the pandemic, we are working on the advice of the Chief Medical Officer of Health, and we are taking immediate action to increase bed capacity in long-term-care homes by right-sizing the number of COVID-19 isolation beds, based on community demand and COVID-19 risk levels. By the end of the summer, approximately 300 long-term-care beds that were set aside for COVID-19 isolation will be safely available for the people on wait-lists, with a potential of 1,000 more beds available within six months.

I am sure some members in this House are wondering, if we eliminate isolation beds in homes, are we putting long-term-care residents at risk of contracting COVID-19? That is a very good question. Isolation beds were implemented at the onset of the COVID-19 pandemic as a way to protect residents from contracting this highly contagious virus. Since that time, long-term-care homes have implemented enhanced infection prevention and control practices, personal protective equipment is more readily available, and a large majority of residents and staff have been vaccinated. Because of these factors, isolation beds are no longer as necessary as they were in the early days of the pandemic.

Over the course of the last couple of days, I have heard some members of the opposition suggest that the homes that ALC patients would be sent to could be in outbreak, or experiencing staffing shortages. However, I would like to remind those members that, as set out in the Fixing Long-Term Care Act, 2021, long-term care licensees must approve the applicant’s admission to the home unless the home lacks the physical facilities necessary to meet the applicant’s care requirements, or the staff of the home lack the nursing expertise necessary to meet the applicant’s care requirements. In the case of an outbreak, homes must follow guidelines and direction from their local public health unit with respect to any additional measures that may be implemented to reduce the risk of transmission in the home. All this to say, if the home does not have the capacity to take on additional residents, they will not be asked to do so. One thing that we should make clear is that this would not apply to all patients in ALC. It would only apply to ALC patients who have been deemed by a medical professional to no longer need to be in a hospital and who may benefit from receiving care in a long-term-care home instead, but are either waiting for a preferred long-term-care bed or do not consent to apply to a long-term-care home suitable for their needs.

By allowing a placement coordinator to access and authorize an ALC patient admission to a long-term-care home, this amendment, if passed, will allow seniors, their families, caregivers and clinicians to shift the conversation from where a person’s needs can best be met to where a person’s quality of life would be better. The focus should always be on providing the right care in the right place.

Speaker, now I would like to spend a few minutes talking about some of the landmark changes our government has made in long-term care to make sure that seniors receive the care they deserve. When it comes to long-term care, our government saw the status quo that was left behind. We saw a system that had been neglected by the previous Liberal government, with out-of-date homes, understaffing across the sector, and little accountability measures. We knew that we would have to work quickly and that we would need to come up with innovative solutions to accomplish what needed to be done in the sector.

When the Premier promised to build 30,000 net new beds in the province, we acted quickly. In four years, we have had more than 30,000 new beds allocated across the province and another 28,000 existing beds that are being upgraded to modern standards. This means no more four-bed ward rooms with poor ventilation designed to outdated standards.

This includes the brand new 320-bed Lakeridge Gardens home in my riding of Ajax, which was built as part of our accelerated build pilot program. Launched in July 2020, this program uses hospital-owned land and accelerated procurement and construction methods, and aims to deliver new long-term-care beds up to two years quicker than the traditional pilot program. Our government recognized that large urban centres are areas of high service need. The need for additional long-term-care capacity is critical, but it’s often difficult to build due to issues like availability and cost of land. This program leverages the expertise of Infrastructure Ontario to accelerate construction. In addition to the Lakeridge Health home in Ajax, this program will also see the building of two homes with a total of 632 beds in Mississauga by Trillium Health Partners, and another 320-bed home developed by Humber River Hospital in Toronto. This is just one more example of how our government changed the status quo on building long-term-care homes.

For years, the status quo with the Liberal government was reading reports about the need for more staff to deliver more care to residents, and ignoring those reports. From 2009 to 2018, they only managed to increase direct care to residents by 21 minutes. That is a 12% increase over nine years in government, or slightly more than two additional minutes of direct care per resident per year.

Our plan includes a historic investment of $4.9 billion over four years to increase direct care to an average of four hours per resident per day. This plan will require hiring 27,000 support workers and nurses to work in long-term care. But we all know that these highly skilled workers do not just appear. That is why we invested in programs to train these workers. Partnering with our publicly funded colleges, we invested $121 million to accelerate the training of 9,000 PSWs. We invested another $86 million to train up to an additional 8,600 PSWs through private career colleges and district school boards. But we weren’t done there. We invested a further $35 million to increase enrolment in publicly assisted colleges and universities to introduce 2,000 nurses to the health care system.

Training and hiring new staff is one thing, but retaining that staff is a completely different thing altogether. That is why we invested $100 million to add an additional 2,000 nurses to the long-term-care sector by 2024-25 by supporting the training of thousands of support workers and nurses who want to advance their careers in long-term care.

The first program we launched is the Bridging Educational Grant In Nursing—or BEGIN—initiative. Partnered with WeRPN, eligible PSWs will receive $6,000 a year to pursue further education to become registered practical nurses, and eligible registered practical nurses will receive $10,000 a year to become registered nurses.

The second program: We partnered with Colleges Ontario to increase access to nursing programs at publicly assisted colleges through:

—the introduction of hybrid online and in-person models in practical nursing and bachelor of science and nursing programs to provide students with greater flexibility and choice;

—the creation of an additional 500 enrolments in bridging programs for the 2022-23 academic year, designed to give applicants the skills and credentials they need to move to the next stage of their careers; and

—providing up to $6,000 a year in financial support to internationally trained nurses to gain the credentials required to work in Ontario.

Speaker, when it comes to ensuring Ontarians receive the care they require, our government continues to go beyond the status quo and find innovative solutions. That is why we are listening to experts and stakeholders from across the health care and long-term-care sectors. That is why we’re listening to seniors, their families and caregivers. We’re listening to nurses, PSWs and front-line health care workers as we move forward with our plan to fix long-term care. The feedback and insights that we receive from people on the ground in long-term care is invaluable and helps to shape the solutions and direction our government pursues. This will continue to be this government’s approach as we continue to go beyond the status quo to innovate and evolve the long-term-care and health care systems in Ontario.

We all know that this is a critical time for action in Ontario, and I am proud to be part of the government that is taking real steps to fix long-term care and evolve our health care system. With the proposed amendments in the More Beds, Better Care Act, 2022, and our five-point Plan to Stay Open: Health System Stability and Recovery, we are taking actions to solve the challenges and alleviate pressures facing the health care system. I am proud to support this bill, and I hope the members opposite will join us as we ensure that every Ontarian has access to care when and where they need it.

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  • Aug/24/22 10:40:00 a.m.

That question is completely contrary to the question he just asked before.

What he is admitting, and what his party is admitting, is that there has been a tool in the tool box for decades in this province.

But what he doesn’t want to talk about is the fact that, because of the investments that we have made in long-term care, the investments that this Premier and this government and this cabinet and this caucus have made in every part of this province, we are able to be part of a solution to the acute-care bed shortage that has existed in this province for decades. We are talking about making 2,500 additional beds available. We are talking about better quality of care for people who are actually waiting for long-term care. Experts agree, doctors agree, hospital administrators agree that the best place for you to get the care you need if you’re waiting for a long-term-care bed is in a long-term-care home. That’s why we are providing millions of dollars in support to make the system even better. They voted against all of that. But we will not stop improving the system.

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  • Aug/24/22 11:10:00 a.m.

We know that every job that sits unfilled hurts Ontario’s economy. These are paycheques waiting to be collected. There are thousands and thousands and thousands of jobs waiting to be filled in Ontario, but many of those jobs require special skills.

My question, again to the minister: What are we doing to close the gap in the labour shortage, and what is being done to give incentives for training and skills development in these critical sectors?

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