Long term care homes were seeking over $500 million more a year in operating funding in order to provide an acceptable and adequate level of care for residents. Instead, the Ontario government has allocated just $107 million over three years to hire 2,500 personal support workers and an unspecified amount for 2,000 nurses.

"Earmarking money for specific positions forces homes to hire when they can't maintain the staff they already have. It becomes a shell game if homes are laying off at the same time as they are hiring," said Donna Rubin, CEO of the Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS).

Today's announcement means that the level of care in these homes will actually decline this year as inflation, wage adjustments and other operating costs outstrip the dollars toward new hires. As the funding shortfalls continue to mount, the situation will continue to deteriorate.

"We're slipping backward, not moving forward, and that's bitterly disappointing for the 76,000 long term care residents in this province who were expecting more," said Rubin. "This is certainly not going to make Ontario a leader in helping its most vulnerable citizens."

In the not-for-profit sector, which includes municipal and charitable long term care home and non-profit nursing homes, the supporting organizations are doing everything they can to address the situation. Charitable foundations and municipalities are topping up government funding by more than $150 million a year to maintain a level of care that the province has been unable to support.

"But I don't know how long they can continue to make up the shortfall," Rubin warned.

The budget also includes $278 million for 'various programs'. "This sounds like a big figure, but this funding will not flow directly to resident care," said Rubin.

In December last year, OANHSS sent an open letter to George Smitherman, Ontario Minister of Health and Long-Term Care, in which it identified what it believes are the most important objectives to be achieved over the next four years. It said it would measure the government's progress by these benchmarks. (See attached letter.)

Based on today's budget, OANHSS members will be disillusioned about this government's real commitment to long term care. The lack of adequate funding means that Ontario will continue to lag behind other progressive jurisdictions in the level of care provided to those living in long term care homes. OANHSS acknowledges some positives in this budget for not-for-profit long term care, including a review of the property tax treatment of homes established under the Charitable Institutions Act. The Association was also pleased to see the broadening of the OSIFA infrastructure loan program to include social housing, the re-confirmation of the Aging At Home Strategy, funding to support the capital re-development of B and C homes, and the 2 per cent increase to the comfort allowance for long term care home residents.

OANHSS is the provincial association representing not-for-profit providers of long term care, services and housing for seniors. Members include municipal and charitable long term care homes, non-profit nursing homes, seniors' housing projects and community service agencies. Member organizations operate over 27,000 long term care beds and over 5,000 seniors' housing units across the province.

December 4, 2007

OPEN LETTER TO GEORGE SMITHERMAN: LONG TERM CARE OBJECTIVES FOR THE NEXT FOUR YEARS

Hon. George Smitherman
Minister of Health and Long-Term Care
80 Grosvenor Street
10th Floor, Hepburn Block
Toronto, Ontario
M7A 2C4

Dear Minister Smitherman:

On behalf of OANHSS and its members that operate more than 27,000 long term care beds and 5,000 seniors' housing units across the province, congratulations and best wishes on your reappointment as Minister of Health and Long-Term Care. We look forward to continuing to work with you in order to improve the care and quality of life of Ontario's frail elderly.

In this open letter, we identify what we believe are the most important objectives to be achieved over the next four years. We recognize that adjustments may have to be made in response to unforeseen circumstances, but generally these are the benchmarks by which we will measure progress in our sector during your government's second mandate.

We trust that your Ministry will remain focused on these objectives as it develops funding and policy positions. For our part, we are ready to implement the needed programs and services.

Minimum Level of Care
OANHSS wants to see the level of care increased to an average of three hours per resident per day - whether or not a specific care standard is mandated in legislation. By achieving such a benchmark, Ontario will be catching up to other progressive jurisdictions in the level of care provided to those living in long term care homes.

Mental Health

As reported recently in the media, instances of violence and abuse are on the rise because of the changing needs of the residents. Today, they are older and require more complex care than even a decade ago. Today, 68 per cent of residents suffer from dementia or some other form of cognitive impairment. Yet funding and staffing have not kept pace with these demands. The homes are finding it increasingly difficult to cope, especially with volatile and aggressive behaviour for which they are not adequately trained or resourced.

We need a system-wide, comprehensive strategy to address this growing problem. Currently, there are few alternate care locations where potentially violent residents can be transferred. We need specialized units that can care for those with aggressive behaviours so that other residents and staff in our homes can live and work in a safe environment.

In addition, work needs to begin to address other special populations such as those with developmental disabilities and those with acquired brain injury (ABI), Huntington's disease and substance abuse issues.

Aging in Place

Continuums of care, or campus-like settings that include housing for seniors in addition to a long term care home were developed with the encouragement of government, to allow seniors to "age in place" or move to a higher level of care as their needs require.

But sadly, this is not always the case under current rules and some are forced to relocate to another long term care home away from their friends and even their spouses.

The province must address this issue in regulations under the new Long-Term Care Act. Specifically, we are requesting higher priority ranking for long term care applicants who currently reside on the same campus as the home.

New Regulatory Framework

We are committed to working with the government and your Ministry to develop the regulations to accompany the Long-Term Care Homes Act. We certainly support all efforts to enhance standards and ensure full accountability for the sector, but this should not become such a 'paper burden' that it has a negative impact on the amount of staff time available for resident care.

Support for Not-for-Profit Providers

Not-for-profit providers have a long history of bringing added value to long term care and community services in Ontario. Yet there has been a noticeable erosion of our sector over the last few years, and we will be looking for concrete action on your government's stated support for not-for-profit delivery.

For example, charitable homes that have typically not paid property tax are starting to attract tax as they have redeveloped. We are seeking an amendment to the Assessment Act to exempt all not-for-profit homes from paying property tax, and we would appreciate your support in this effort.

Capital renewal is another area where we see an immediate need for special consideration and assistance to support not-for-profits looking to rebuild under the B & C program and we appreciate your government's acknowledgement of this need in the program design.

Much has been accomplished over the past four years, and there is much still to do. If we can make meaningful progress on this proposed agenda, we're certain that together we can achieve significant gains for the 78,000 residents in long term care over the next four years.

Sincerely,

Donna A. Rubin
Chief Executive Officer