Re: Campaign to fix LTC (January 13, 2021)

January 13, 2021

Mr. Paul Rivett
Chairman and Co-Proprietor of Torstar

Mr. Jordan Bitove
Publisher of Toronto Star and Co-Proprietor of Torstar

1 Yonge Street
Toronto, ON
M5E 1E6

Dear Mr. Rivett and Mr. Bitove,

I am writing on behalf of AdvantAge Ontario in response to the launch of your recent campaign to encourage Toronto Star readers to sign an open letter calling for urgent action to fix the province’s failing long-term care (LTC) system.

AdvantAge Ontario is the only provincial association representing the full spectrum of the senior care continuum and has been the trusted voice for the sector for over 100 years. Our members are over 400 charitable, municipal, and non-profit LTC homes, seniors’ housing and community service agencies serving seniors in communities across the province. The residents, families, and staff who live and work in these organizations have been at the forefront of this devastating pandemic since it began.

As Ontario continues to grapple with the second wave of COVID-19, nothing is more important to us than the health and wellbeing of our residents and staff. We have continually advocated over the years for increased funding to address the longstanding staffing and resource challenges facing the sector.

We want to acknowledge that this government has responded to the crisis in LTC with significant funding announcements last fall to support the sector during the second wave, including $540 million as part of the LTC preparedness plan, $461 million in temporary wage enhancements for personal support workers (PSWs), the up to $1.9 billion in annual funding to provide a provincial average of four hours of direct care per resident per day by 2024-25. A further $398 million in second wave pandemic support for homes was announced last week.

However, COVID-19 is a powerful and devastating force and there is much more that still needs to be done. To this end, we want to express our gratitude to you for drawing attention to the issues facing the LTC system and for championing policy solutions to improve the quality of care in homes across Ontario.

We would like to address the specific solutions raised in your open letter and provide further recommendations based on our expertise and the experience of those on the frontlines throughout pandemic to ensure residents stay safe and receive high-quality care.

1. Rapid Testing and Vaccinations

We strongly support your call for rapid COVID-19 testing to be deployed to LTC homes to test residents and staff. Since the advent of rapid antigen testing, AdvantAge Ontario has been advocating for this innovation to be deployed in LTC for use with residents and staff, as well as caregivers and visitors. Rapid testing is a critical measure for reducing the risk of COVID-19 in our homes.

That is why we were pleased to see that on January 8, 2021, the Ministry of Long-Term Care (MOLTC) expanded its Directive to allow surveillance testing using antigen tests (Panbio rapid test) and encouraged homes to transition to this test as soon as possible.

As your open letter identified, this new testing approach brings additional administration and operational requirements, and homes must be supported by the province to ensure they have the funding and personnel to meet the rapid testing frequency required by the government.

We would also like to thank you for calling on the government to vaccinate all LTC residents and staff by February 15, 2021. Government has told us that this is their target as well. It is important to note, however, that while a public tracking system is operational to record and report vaccinations, this system still requires appropriate guidance and standardization to ensure the data being collected can be accurately interpreted.

2. Mandatory Inspection Regime and Public Reporting

Your letter raises several important issues surrounding the inspection of LTC homes. We believe inspections play an important role in ensuring the health and safety of residents and staff, and therefore agree with your finding that the province should reintroduce annual, proactive RQI inspections and require reactive inspections that include an IPAC program review.

We also believe the MOLTC should focus on coaching operators and their staff so that they provide the best and safest care and have recommended that the province move towards a risk-based oversight system that includes coaching for compliance.

However, it is important to recognize the critical funding challenges facing homes and acknowledge that they require more resources to meet additional inspection requirements.

Inspections alone are not the answer. They must be supported with additional resources for homes to fully comply with all regulations under the Long-Term Care Homes Act. Increased provincial funding is needed to assist homes with compliance issues and help keep residents safe.

3. Emergency Funding for Staff

LTC homes were chronically understaffed long before the COVID-19 pandemic. One of the leading reasons for this is that staff working in LTC are paid considerably less than their counterparts in the acute care system.

We saw the positive impacts on staff recruitment and retention generated by the temporary PSWwage enhancements announced earlier this year that helped close that gap.

Despite that important step, we continue to see homes facing staffing issues during the second wave and are concerned about the impacts of the temporary nature of the enhancement as well as its limitation to only one type of health care worker.

That is why it is critical that government permanently increase wages in the LTC sector to match acute care settings and ensure that it includes all positions, including supervisory staff. All those who work in LTC are integral to the functioning of homes and should have be included in the wage increase in recognition of their efforts and contributions toward resident care.

4. Establish Emergency Rapid Response IPAC Task Force

In its Wave Two Preparedness Plan, the government committed to developing rapid response teams comprised of IPAC specialists. While we applaud this approach, deployment on the ground has been slow, and we support your call for a greater emphasis to be put on developing these critical resources.

Additionally, we believe all homes should be equipped with internal expertise to effectively enact IPAC protocols. This expertise is critical to containing and preventing the spread of COVID-19, avoiding unnecessary hospitalizations and emergency room visits, and reducing the risk of death among residents. The government has committed $30 million in funding for IPAC resources, however, an additional $49.6 million annually is required to strengthen internal capacity through dedicated IPAC staff and training for every LTC home.

5. National Long-Term Care Standards

The COVID-19 pandemic has exposed chronic issues that have existed for years, but that previous governments have ignored. It is critical that we not turn away from this reality but instead face it head on and seize this moment to build a new vision for seniors’ care in Ontario. The government has taken important actions throughout the fall to begin this work but collectively there is more to do.

Several significant and longstanding issues, most notably underfunding and understaffing, severely challenged the ability of homes to prevent, identify, contain and manage COVID-19 outbreaks. These settings are residents’ homes, and are where residents should feel and be safe, comfortable and well cared for.

We have the opportunity – and an obligation to our residents and our staff – to act on the tragic lessons learned over the past year and do everything possible to both address the immediate issues still facing the sector today, while also building a more resilient system for the 21st century.

We support the principle of national standards for LTC as long as they are developed in consultation with the sector and are accompanied by funding.

In conclusion, we thank you for your focus on this incredibly important issue. We are optimistic that with our collective continued efforts, and with a vaccine now being administered, we will get through the dark days of this pandemic and emerge with a system that is stronger than before.


Lisa Levin

Chief Executive Officer
AdvantAge Ontario