Procedure and House Affairs Committee on Nov. 12th, 2020

[The Chair, Liberal, Ruby Sahota]

I call this meeting to order.

Good morning, everyone. Welcome to meeting number nine of the House of Commons Standing Committee on Procedure and House Affairs.

I would like to start the meeting by providing you with some information following the motion that was adopted in the House on Wednesday, September 23, 2020.

The committee is now sitting in a hybrid format, meaning that members can participate either in person or by video conference. Witnesses must appear by video conference.

All members, regardless of their method of participation, will be counted for the purposes of quorum. The committee’s power to sit is, however, limited by the priority use of House resources, which is determined by the whips. All questions must be decided by a recorded vote unless the committee disposes of them with unanimous consent or on division.

Finally, the committee may deliberate in camera provided that it takes into account the potential risks to confidentiality inherent in such deliberations with remote participants.

Today’s proceedings will be made available via the House of Commons website. As a reminder, the webcast will always show the person speaking, rather than the entirety of the committee. To ensure an orderly meeting, I would like to outline a few rules to follow.

For those participating virtually, which is basically everyone today, members and witnesses may speak in the official language of their choice. Interpretation services are available for this meeting. You have the choice, at the bottom of your screen, of either floor, English or French. Before speaking, click on the microphone icon to activate your own mike. When you are done speaking, please put the mike on mute to minimize any interference. As a reminder, all comments by members and witnesses should be addressed through the chair.

Should members need to request the floor outside of their designated time for questions, they should activate their mike and state that they have a point of order. If a member wishes to intervene on a point of order that has been raised by another member, please use the “raise hand” function at the bottom of your screen. When speaking, please speak slowly and clearly.

Unless there are exceptional circumstances, the use of a headset with a boom mike is mandatory. Should any technical challenges arise, please advise the chair. Please note that we may need to suspend for a few minutes to ensure all members are able to participate fully.

With that, we will begin the first panel. We have three panels today and a three-hour meeting. We will be going until two o'clock. Ideally, I'll be trying to end the panels five minutes before the hour so that we have time to transition into the next panel. We'll try to be as efficient as possible with our time.

For our first panel, I would like to welcome—

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

I have a point of order, Chair, before we get started. Sorry about that.

I just want to bring forward what we talked about the other day. Perhaps you can give clarification.

We talked about time frames and timelines and looking at when we're going to start the next study. I didn't see it in the notes or see any business opportunity for this today, with these three panels. When are we going to be able to have the discussion on the next study?

[The Chair, Liberal, Ruby Sahota]

It's not possible in today's meeting, that's for sure, because we have three panels and we already have extended the hours for this meeting, but we are looking. There are upcoming meetings, and I can discuss it at the end. We have a meeting on November 17 with Minister LeBlanc on the main estimates and a meeting on November 19 with Elections Canada on the main estimates, and then we have a meeting on November 24. That one is with the Speaker and the House administration, including PPS. Those are the next three meetings.

All of those meetings have to get done because we have a deadline for the main estimates, but I did say in the last meeting that I will squeeze in committee time before the winter break so that we can plan out our next study, have a discussion as to how long we want that study on prorogation to be and what witnesses we might want. I'm working with Justin Vaive, the clerk, to fit in a committee business portion where we have half an hour or more to discuss that.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Okay. Excellent.

I will be following that up, because I do think this study should be starting prior to the Christmas break. Hopefully, we'll be able to have a meeting before then, so that this is not held off until mid-December.

Thank you very much.

[The Chair, Liberal, Ruby Sahota]

Ms. Vecchio, did you say the study should start prior to the winter break?

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

We would hope that we would already have something sorted out with plans before the winter break. If we can make sure that we have this all planned.... I would hope that we would not be seeing a meeting in the second week of December to discuss this committee business, and that we actually do it much earlier than that.

[The Chair, Liberal, Ruby Sahota]

Okay. We would discuss the committee business and the study before the winter break, but we wouldn't be able to begin the actual study before the winter break.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Perhaps we can look at what options are available—that would be awesome—and we can go on with today's panels.

I just want to plant that seed. Thank you.

[The Chair, Liberal, Ruby Sahota]

Thank you, Mrs. Vecchio.

I'd like to continue by welcoming the two witnesses we have with us today. Jason Lee is from the Canadian Association for Long Term Care. Donna Duncan is the chief executive officer of the Ontario Long Term Care Association.

Welcome to both of you. Thank you for being with us today.

We will start with opening remarks by the two of you. You have five minutes each for opening remarks. Those will be followed by rounds of questions from all of the members, and that should take us to 11:55 or close to 12 o'clock.

Mr. Lee, would you start, please?

[Jason Lee, Treasurer, Canadian Association for Long Term Care]

Thank you, Madam Chair.

I want to thank the members of the committee for inviting me and CALTC to appear before you today.

We're here to discuss seniors living in long-term care and the support needed to ensure that residents can participate fully in our democratic process during the COVID-19 pandemic.

My name is Jason Lee and I'm here today as the treasurer of the Canadian Association for Long Term Care, also known as CALTC. As the leading voice for quality long-term care in Canada, CALTC members advocate on behalf of our residents at the federal level to ensure that seniors can age and live with dignity.

I would like to take a moment to acknowledge that yesterday was Remembrance Day and that this conversation aimed at ensuring accessible and safe voting for our seniors, who built this nation, could not be more appropriate or important.

During a federal election, Elections Canada has the responsibility to ensure that all eligible voters are able to exercise the right to vote, and it is our collective responsibility to accommodate them to do so. Many of the normal voting procedures used to assist residents in long-term care have significant health risks in the context of the ongoing COVID-19 pandemic, some of which I will outline.

Outside visitors to long-term care homes must continue to be restricted to essential caregivers and workers, for the continued health and safety of residents and staff. While election workers could fall into the category of essential workers, it is not safe at this time to have an election worker go into a home, facilitate a mobile voting station and then move from home to home. This is especially true as we continue to see more homes go into outbreak or suspected outbreak across the country.

Additionally, any procedures in place that support seniors in leaving their long-term care homes to go to a polling station are simply not feasible, as COVID-19 continues to increase rapidly in communities across the nation. Any staff members who might normally assist seniors in going to a voting station are hindered not just by the risk of transmission, but by the increased staffing pressures in care homes as they continue to carry out new and ongoing infection prevention and control measures on a daily basis. There is simply not enough staff or personal protective equipment to ensure a safe trip outside a home to vote or to have an election worker enter multiple homes.

In my home province of Prince Edward Island, we normally use our long-term care homes as polling stations. I've already been in contact with the election officials for the riding where some of our homes are located, and it has been communicated to me that the polling stations will be moved to other sites. This is completely understandable and necessary, but it also further isolates our seniors from the community. While our seniors would normally be able to walk down to the lobby and vote with others from their riding, they will not be able to do so in the current environment.

However, we must not let this virus interfere with seniors having their voices heard or ensuring that seniors living in long-term care are appropriately engaged in the voting process.

As you know, three provinces have been through provincial elections during the COVID-19 outbreak, including New Brunswick. There are some lessons learned and considerations that I would like to share with you today, and they may help inform the committee and Elections Canada in addressing the challenges and circumstances of the current moment.

In New Brunswick, an alternative voting method was put in place that included the returning officer sending a letter to long-term care homes that outlined the instructions for a modified vote-by-mail process. This was a time-consuming process that required two weeks to coordinate and carry out the actual voting, along with many weeks of consultation beforehand. In this instance, administrators or other staff in the homes were deputized and trained to collect and return the mail-in ballots.

Any process put in place for a federal election will need to be cognizant of the time frame, effort and resources needed to assist residents in voting.

In closing, staff not being able to accompany residents outside the home to vote, given COVID—19, the dangers of having a mobile election worker going from home to home and the inability to hold voting stations in long-term care homes mean that seniors living in long-term care will be very disconnected from this process and homes will require support and guidance to ensure they can appropriately engage residents in the democratic process.

I thank you for your time. Obviously, I'm happy to answer any questions.

[The Chair, Liberal, Ruby Sahota]

Thank you, Mr. Lee. We appreciate your statement.

Next we have Ms. Duncan, please.

[Donna Duncan, Chief Executive Officer, Ontario Long Term Care Association]

Thank you very much, Madam Chair and committee members.

It's a privilege to be here with you today, as per Mr. Lee's comments, on the day following Remembrance Day, when we recognize so many of our residents.

We are grateful to the committee for recognizing the importance of ensuring that voting privileges are available to residents of Canada’s long-term care homes during this pandemic. To set the context for today’s discussion, I would like to provide an overview of Ontario’s long-term care homes.

More than 79,000 people live in long-term care in Ontario in 626 homes, with more than half of our residents being over the age of 85. Approximately one resident in six is younger than 75.

In Ontario, we have stringent criteria for admission into long-term care. Most people are not eligible until they are experiencing significant impairment due to physical frailty and/or cognitive impairment. Ninety per cent of residents have some degree of cognitive impairment, ranging from mild to severe, caused by conditions such as dementia or stroke.

In prior elections, it has been common practice to establish polling booths in the lobbies or other common areas of long-term care homes to enable the resident population to vote, as well as the neighbouring community members. This is not possible during COVID -19 due to Ontario restrictions around access to long-term care homes and the extreme vulnerability of our residents to outbreaks of COVID–19. In most cases, as per Mr. Lee's comments, escorting residents from long-term care homes to voting booths elsewhere is also not possible due to a number of different factors.

First, under our provincial directives and now-evolving regional directives, non-medical absences from the home are not possible at all during an outbreak or in a region that is considered at high risk or a hot zone for community transmission. As of November 10, 15% of Ontario’s homes are in COVID outbreak. Several major urban areas remain areas of higher risk and outings are not permitted.

Second, if neither of those factors is in place, non-medical absences need to be approved by the home based on a case-by-case risk assessment, recognizing the risk to our residents is extremely high and we do not recommend absences.

Third, if an outing is approved, most homes do not have the staffing capacity or support to take residents out of the home to vote. While some residents may have families that can assist, many residents do not have these supports readily available and would be reliant on staff for transportation to the voting site. Our long-term care homes are experiencing a critical staffing shortage that predated COVID and has only been exacerbated by the pandemic. This has implications for staffing capacity to support resident voting either in or outside of the home.

Despite the challenges of COVID, it is vitally important to ensure that voting privileges are available to residents of long-term care. Mail-in ballots may be the simplest option for residents to manage and for staff to facilitate, as per Mr. Lee's comments. We are open to discussions on processes that could facilitate that. There may be other options the committee is considering, including electronic voting in the homes. We'd be pleased to bring that back to our members for review and feedback to support successful implementation.

We are committed to helping our residents exercise their right to vote.

We would again really like to thank you for recognizing the importance of this issue and exploring solutions during the pandemic.

Thank you.

[The Chair, Liberal, Ruby Sahota]

Thank you, Ms. Duncan.

We'll start our first round of questions with Ms. Gladu. It's an honour to have you on the committee today substituting in. It's nice to see you again as well.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you, Chair.

Thank you to the witnesses.

We all know about the tragic deaths we've seen in long-term care facilities. I am the chair of the status of women committee and we've just had testimony on long-term care facilities and how understaffed they are. The federal government, in my view, has really abdicated its responsibility to come alongside and help. I worry that if the Liberals force an election in a pandemic, that is going to exacerbate an already concerning situation.

The points you've made about protecting people who are in long-term care facilities, as well as the workers, are important.

One of the concerns I have is trying to make sure that there isn't undue influence. My mother just recently passed away and she was in long-term care. She was as sharp as a knife normally, but she did have days when she was mentally confused or whatever, so I am interested in any suggestions you have on how we can make sure that someone who is deputized is not voting their personal preference through those who are maybe not able to decide.

[Donna Duncan]

I'll start.

I think it's a great question, especially as we look at how so many of our residents do suffer from advanced dementia and cognitive impairment. Certainly training is very important, including working through Elections Canada to establish parameters in training and ensuring neutrality as we support our residents. How we work with substitute decision-makers as well will be very important for us. Certainly, the right to vote is paramount but I certainly appreciate your comments around the potential for coercion or influence.

I would certainly welcome Mr. Lee's comments, because I know he has been speaking to his eastern Canada colleagues around this as well.

[Jason Lee]

Thank you.

It's a good question and it's actually a topic that I think comes up in every election, not just one around a pandemic.

If a person is unable to physically mark their ballot, they can receive assistance to mark their ballot. There is a process whereby the person has to solemnly declare that they will mark the ballot in the manner in which they are directed. It's a very serious oath and commitment to make, and we expect people to honour a commitment or an oath like that.

We want every Canadian who wishes to vote to be able to vote. I know first-hand, having seen elections take place in our homes, that the staff take a lot of time to be trained on elections and to understand the very complex and thick Canada Elections Act. I think they do an excellent job of making sure people vote, and hopefully the exceptions are very few.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Mr. Lee, to your point, we talked about the amount of time it would take to train somebody to be deputized. One of my ideas is to have rapid testing for the Elections Canada people, who could have a rapid test and receive a negative result before they entered a home, and then not go to different homes. There would be someone different assigned to each one. Do you think that is a feasible option?

[Jason Lee]

Doing that for one home would work, absolutely. Your team would have to be aware of where they were going to be working and why it would be so important that they be healthy, so the testing would certainly be a part of the solution for that.

Of course in a federal election you're looking at a massive scale. I am not aware of rapid testing even being in place here in Prince Edward Island. It may be more common in other parts of the country, but I don't see why it can't be part of the conversation or the solution.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

You're right that the rapid testing is not where it needs to be.

I have one other question. Normally in an election the candidates get to go into the long-term care facilities and they can hand out their brochures and leave them all over the place so everyone will vote for them. I can't see that happening in a COVID-19 situation, so do you have recommendations about how the residents will be able to be informed about the issues and the candidates in the campaign?

[Donna Duncan]

Communications certainly have been key. As we've been navigating this COVID-19 environment, certainly in Ontario we've been taking advantage of the benefit of our residents' councils. Our homes and front-line staff have been working very closely with residents' councils to share the information, even today around changing directives and around infection outbreaks and communicating around visits. We're working with the family councils as well and ensuring that everybody is well educated.

We have been sharing information from our local representatives through those councils as well and making sure that every home is meeting the test of communication and how information is posted and shared in each home. It certainly was a challenge early on in wave one, I have to confess, as we tried to navigate that, but we have far better processes now, I would argue, including how we use technology to communicate with our residents through our front line and our volunteers.

[The Chair, Liberal, Ruby Sahota]

Thank you, Ms. Duncan.

Next up for six minutes we have Dr. Duncan, please.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Madam Chair, and thank you to our witnesses this morning.

I would like to begin by saying thank you for providing care during a pandemic and how difficult that is. I am deeply concerned about the impact of COVID-19 on long-term care and doing everything possible to protect resident and staff health and safety while ensuring residents' right to vote.

Ms. Duncan, if I could begin with you, I have limited time, so in many cases I'll be asking for a number or a yes or a no, please.

How many Ontario long-term cares are currently in outbreak?

[Donna Duncan]

We have 94 in outbreak right now.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

How many staff COVID cases at this time are there, please?

[Donna Duncan]

Currently, we have 435 staff cases.