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

OTTAWA — Liberals must legislate new standards for long-term care homes to fulfill a promise in the Confidence and Care Agreement that would help keep their minority government in power, the New Democrat health critic said Tuesday.

A panel of experts from the nonprofit Health Standards Organization on Tuesday updated guidance for long-term care in Canada, given the deadly and tragic toll the COVID-19 pandemic has taken on residents and their quality of life.

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

The Liberals pledged to enshrine long-term care safety in law as part of the Confidence and Care Agreement the parties signed last March, under which the NDP would back the minority government through crucial parliamentary votes until 2025 in exchange for action on major ones Priorities .

NDP MP Don Davies, his party’s health critic, said those new standards must form the basis of the promised legislation.

“If it’s going to be safe, those standards need to be put into legislation,” Davies told the House of Commons on Tuesday.

The Liberal government has not yet committed to enacting the standards into law, but German Health Minister Jean-Yves Duclos says consultations on the new long-term care law will begin in the “coming months”.

It’s tricky territory for the federal government, as long-term care falls under the jurisdiction of the states.

Prime Minister Justin Trudeau said on Tuesday that he recognizes that the provinces are responsible for providing and regulating care, but all Canadians want care for the elderly to be kept to the highest possible standard.

“We will continue to work on that,” Trudeau said on the way to a meeting with his cabinet ministers.

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

“These standards are only meaningful if … they become the basis of enforcement and accountability actions, not just accreditation actions,” said Dr. Samir Sinha, the chairman of the technical committee that developed the updated standards.

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

Currently, each province enacts its own rules for licensing, operating, and inspecting long-term care, creating a statewide patchwork system governing how the homes are to be designed, operated, and maintained.

Trudeau vowed in the 2021 election to enshrine long-term care safety in law across the country and doubled that pledge in the pact with the NDP, but the government hasn’t said what that legislation would entail.

“We will continue to work with provinces and territories to support these long-term care standards in their own communities,” Senior Minister Kamal Khera said Tuesday after the cabinet meeting.

Duclos suggested the government could sign bilateral agreements with individual provinces to enforce the new standards.

The government has allocated $3 billion in the 2021 budget to help provinces and territories apply long-term care standards, increase wages and improve staff-patient ratios.

“Now we look forward to signing agreements with provinces and territories to see how they can use those dollars to further meet these new standards,” Duclos said.

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

In 2021, Parliament’s budget officer estimated it would cost an additional $4.3 billion a year just to increase the number of hours of daily care to the four hours listed by the Health Standards Organization.

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

“I think what Canadians really care about is making sure their relatives or seniors in long-term care homes are getting the right care,” he said.

“I don’t think they really care that much about the frame.”

Some provinces already require nursing homes to be accredited to the organization’s standards, while other homes seek accreditation voluntarily.

The Health Standards Organization estimates that approximately 68 percent of long-term care homes will be accredited using the updated standards on a voluntary or mandatory basis.

But Sinha said accreditation without enforcement will not be enough.

Alongside the updated standards of care, new guidelines for long-term care home design and infection prevention practices have been developed. They were released last month by the CSA Group, formerly known as the Canadian Standards Association.

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

CSA Group’s standards are strictly voluntary at this point, but the experts who developed these building standards hope they will quickly be adopted into regulation or legislation.

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

“Our hope is that they will look at our standard before the shovels are in the ground.”

Mihailidis believes that if the standards were in place when COVID-19 hit in 2020, fewer things might have fallen through the cracks, but until the new guidelines are in place and enforced, it’s still a matter of waiting.

“This is definitely a big step in the right direction,” he said.

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

Khera said that as a nurse who has volunteered at a nursing home in her community during the COVID-19 pandemic, she can say “these are going to make a huge difference.”

This report from The Canadian Press was first published on January 31, 2023.

— With files by Mia Rabson

Laura Osman, The Canadian Press