Experts warn that the new long-term care standards will stabilize without funding or implementation

Experts warn that the new long-term care standards will stabilize without funding or implementation



The federal government will spend 3 billion Canadian dollars in five years to establish new standards to improve long-term care in Canada. Proponents say that money alone is not enough-they want to take steps to ensure that the new standards actually provide better care for the elderly.

Now, the new standards developed by the Health Standards Organization (HSO) and the Canadian Standards Association (CSA) have high hopes. This work will take at least 20 months, but relevant people said they hope that the new standards can help prevent the severe conditions that cause high epidemic mortality in the long-term care sector.

In the first wave of the pandemic, long-term care facilities accounted for 80% of all COVID-19 deaths in Canada. Outside of Quebec and Nova Scotia, the number of long-term care deaths in the second wave actually increased.

But experts warn that the new standards alone will not solve many problems in the field of pandemic exposure. They said they worry that after decades of government indifference to long-term care, as the pandemic wanes, public pressure to address these issues may diminish.

Alex Mihailidis, chairman of the CSA Technical Subcommittee, said: “I don’t want these standards to be put on hold and not to be used.”

“If we can take any positive measures from this pandemic, and everything that happened… I think we are at a tipping point, which will really push the political will and social will forward and ensure that these standards are met. handle it seriously.”

What is the new standard?

Experts say that the long-term care sector needs to improve the delivery of care and the operation of facilities. From the number of hours of direct personal care of residents to the ratio of employees to residents and infection prevention and control measures, this involves everything.

It also includes the technical use of ventilation systems, ducts, medical gas systems and facilities. All of these things may depend on possible new infrastructure standards, which may determine how new long-term care homes should be built, how many residents can be placed in a room, and how common areas and isolation areas should be built.

HSO and CSA must also determine how infrastructure standards will be applied to existing buildings.

“We are trying to use everything we have learned so far, and everything we have learned about the state of long-term care in Canada, to basically say how these actual new standards can prevent us from pandemics?” Sinai Health and the University of Toronto Health Network Said Dr. Samir Sinha, Director of Gerontology. He is leading the HSO Technical Committee.

On Monday, December 7, 2020, during the COVID-19 pandemic in Toronto, medical staff took a person from the Revera Westside long-term care home. (Nathan Dennett/Canada Press)

HSO has established standards for long-term care homes. The pandemic proves that they are clearly insufficient. Throughout Canada, nearly 70% of long-term care homes are recognized by HSO standards or equivalent standards in the United States.

In Quebec, 100% of houses require certification. But Quebec’s long-term care home is one of the most severely affected by the pandemic.

Dr. Sinha admitted that waiting 20 months is a long time to wait for the new standard, but this work takes time.

“Actually, this is ultimately your way of setting high-quality standards. Or are you just trying to gain the upper hand politically and get more of the same thing?” he said.

“Frankly, because everything we have done so far has not been done well, and now everyone is paying attention to this, I am determined to make sure we do it.”

Public opinion

Usually, in the standard setting process, a technical committee composed of stakeholders and experts is responsible for formulating a draft standard and then submitting it to the public for comments and review at the end of the process.

However, the number of deaths in the long-term care sector during the pandemic has aroused widespread public concern in this process, especially among people who have lost their loved ones in long-term care.

It is expected that HSO and CSA will take into account the results of public surveys on long-term care standards, and will convene city halls for comments starting this summer. The components of the HSO Technical Committee are formed through an open application process.

Will the new standard make a difference?

The answer to this question depends on what the provinces do. Provinces primarily responsible for long-term care will be required to spend the necessary funds to meet these standards and make up for the severe shortage of personnel.

Experts also said that the effectiveness of the new standards will largely depend on whether they are mandatory and whether facilities found to violate these standards will be punished.

Laura Tamblyn Watts, CanAge’s chief executive officer, said: “Unless they are mandatory, they are just a wish list that we consider important and will not really undergo substantial changes.” University of Toronto.

“So it is important that these standards have some legal effect, and to break them [has] Some kind of deep punishment for them. “

Tamblyn-Watts said that long-term care homes almost never lose their licenses for violating standards, and the fines they face are “almost ridiculous.”

Technically, the federal government can formulate its own laws and regulations to make standards mandatory. Experts say this is unlikely.

Health Minister Patty Hajdu listened to a press conference on the COVID-19 pandemic in Ottawa on Friday, December 4, 2020. (Tang Poetry/Canada Press)

Nonetheless, in an interview with CBC in March, Health Minister Patty Hajdu believed that law enforcement is the key.

She said: “For me, having standards is not just a problem. It also involves a commitment and a way forward to implement or adhere to these standards.”

“Of course, because certain provinces and regions do have standards, it does not necessarily alleviate the tragedies of those provinces and regions. Therefore, this is to clarify the requirements of the standards. Then, the separate process is how you ensure that the implementation of these standards is consistent. Yes, so people who rely on care are indeed safe in those places.”

How much does it cost?

The Canadian Standards Council said it plans to donate 340,000 Canadian dollars to fund work on long-term care standards.

Of course, the real price tag is ultimately used by the federal and provincial governments to ensure standard fees Stingy something. Critics say that the $3 billion that Ottawa has provided to the provinces in five years is simply not enough.

Terry Lake, chief executive officer of the British Columbia Association of Medical Service Providers, said: “This is about six to seven dollars per resident per day.” The association represents 400 long-term care and assisted housing. Lake is the former provincial health minister.

“Because health care is under provincial jurisdiction, these provinces must be enforced. Because there are carrots and sticks, and carrots are of course funded by the federal government. I think some provinces may be reluctant to set standards without more funds to motivate these standards. It can be executed under the circumstances.”

On Tuesday, December 29, 2020, during the COVID-19 pandemic in Scarborough, Ontario, people protest outside the Tendercare Life Center long-term care facility. (Nathan Dennett/Canada Press)

There are already some provincial governments Irritated the idea of ??taking any direction from Ottawa, Rich or no money.

Tamblyn-Watts said: “I think these prime ministers misunderstood their populations. These jurisdictions have produced very bad results in long-term care, and many of them are preventable.” “As voters feel how much of this Anger and annoyance, sales promotion measures keep pace with the times.”

However, recently some provincial budgets have invested money to build new houses or increase existing houses, but they have been criticized because even under the strong pressure of public reforms, they have not set aside any needed funds.

Advocates say they worry that this is not a signal of political will to ensure that the thousands of people who die in long-term care homes during the pandemic are not in vain.


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