Human Resources Committee on May 13th, 2021

[The Chair, Liberal, Sean Casey]

I call this meeting to order.

Welcome to meeting number 34 of the Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities.

Today's meeting is taking place in a hybrid format, pursuant to the House order of January 25, 2021. The proceedings will be made available via the House of Commons website, and the webcast will always show the person speaking rather than the entire committee.

Pursuant to Standing Order 108(2) and the motion adopted by the committee on Tuesday, February 2, 2021, the committee will proceed to its study on the impact of COVID-19 on seniors.

I would like to welcome our witnesses, who will begin our discussion with five minutes of opening remarks. These will be followed by questions.

We have with us today, Laura Tamblyn Watts, president and chief executive officer of CanAge; and Miranda Ferrier, chief executive officer of the Canadian Support Workers Association.

For the benefit of our witnesses, I would like to offer a couple of additional comments.

Interpretation in this video conference is at the bottom of your screen. You have the choice of floor, English or French. When you're speaking, please speak slowly and clearly, and when you're not speaking, your mike should be on mute.

You may notice that with about one minute to go, I will hold up one finger to signal that. I will probably incessantly interrupt you, so please forgive me. I apologize in advance. It's my job to try to keep everything on schedule and ensure that the time is allocated fairly among members.

With that, we're going to start with Ms. Tamblyn Watts.

Welcome, You have the floor for five minutes.

[Laura Tamblyn Watts, President and Chief Executive Officer, CanAge]

Thank you for the opportunity to address you today about the pressing issues facing Canadian seniors.

My name is Laura Tamblyn Watts and I'm the president and CEO of CanAge, Canada's national seniors advocacy organization. We are a pan-Canadian non-partisan not-for-profit organization. We work to advance the rights and well-being of Canadians as they age, and ensure that older Canadians live vibrant and connected lives. In the time of COVID-19, however, that has been far from the current reality.

I would like to focus my submission on three specific areas: elder abuse and neglect, long-term care and seniors care reform, and social inclusion.

First is elder abuse and neglect.

I'd like to tell you Mabel's story. When COVID-19 hit, Mabel followed all the rules. She stayed home. She worried. Her adult son lost his job and moved into her house. Soon Mabel was pressured to a make a power of attorney, add him to her bank accounts and eventually put him on as co-owner of her house. Within 12 months, Mabel went from living a safe, socially connected life to living one of fear, abuse and poverty.

Mabel's story is not unique—far from it. Prior to COVID-19, approximately one in five older Canadians experienced abuse and neglect. Since COVID-19, responding organizations, such as Elder Abuse Prevention Ontario and others, are signalling a 250% increase in abuse and neglect of seniors.

We were pleased to see elder abuse mentioned in the budget—along with some other forms of abuse—and the investment, but there is much to be done. We recommend that the government do two things to address this. One, designate on an ongoing basis a similar amount of funding and support for preventing and responding to elder abuse as is given to domestic violence supports. Two, create a pan-Canadian committee on abuse and neglect.

Our second area is long-term and seniors care reform, the one we've been speaking about most during this time of COVID-19.

I want to tell you the story of Stanley. Stanley called me, weeping. He was a resident at a long-term care facility in Ontario. He lived through the first wave and was in a shared room with other sick residents. At one point, he was left alone next to a friend who had passed away from COVID-19, but the remains of the deceased had not been removed.

He was living locked up in a 100 square foot room for months on end. He was not bathed, fed or changed sometimes for days on end. He had not had a breath of fresh air for months. When he called me, he was asking how to get medical assistance in dying, not because of his health status but because life in long-term care during COVID-19 was, in his mind, not worth living any longer.

I cannot emphasize enough the tragedy that has unfolded in long-term care. However, if you ask any experts in the field, they'll tell you that the situation prior to COVID-19 was at the breaking point and that it's only gotten worse.

However, the good news is this: We know exactly what needs to be done. There's very broad expert consensus. We need dedicated long-term care funding, increased staffing, infrastructure development, improved infection control measures and a national adult vaccination strategy.

We need national standards. However, we need to make sure that we are working beyond the accreditation level with provincial and territorial governments to embed standards in regulation, and include innovation, age-tech and digital advances in seniors care as part of that.

We need to fix the buildings. We need to provide transformative investment in long-term care. The outcomes are overwhelmingly worse in older homes, and we know that HVAC systems in many cases, including in Ontario, don't even live up to 1999 standards.

We know—and my colleague will speak more about this—that we need to fix staffing and the conditions of work. The conditions of work are the conditions of care. We need an aging sector health and human resources strategy at the federal level. There should be training incentives and programming, and we should be putting immigration priorities to work.

We know that most people—overwhelmingly, 92% of seniors—will always age at home. We need to do much more by having a federally supported home and community care strategy.

We need a national adult vaccination strategy. Right now only about 3% to 10% of Canadian seniors have the basic vaccines they need. We need to make sure that we are moving forward and building on the successes of the senior-specific flu vaccines for long-term care and COVID.

Last, I want to talk about social inclusion.

I want to tell you about Manon, who is 85 and lives in Nova Scotia. She fell and broke a hip a year ago, which stopped her from driving and getting around. When we talked to Manon, she told us that she had not seen or spoken to anyone in more than a month. She was depressed, disconnected and lonely. This story is really common. A StatsCan report found that 20% of seniors didn't have a single person to reach out to in an emergency.

To conclude, we recommend the following three things: increase investment in community-based programming for seniors, including intergenerational programming and activities; invest in sector supports for digital inclusion and innovation; and last, create a federal office of the seniors advocate to consistently include older people and plan for an aging population.

Thank you. Those are my remarks.

[The Chair, Liberal, Sean Casey]

Thank you very much, Ms. Tamblyn Watts.

Next we're going to hear from the Canadian Support Workers Association.

Ms. Ferrier, you have the floor for five minutes.

[Miranda Ferrier, Chief Executive Officer, Canadian Support Workers Association]

Good afternoon and thank you very much for having me here today.

As was just said, I'm Miranda Ferrier. I'm the CEO of the Canadian Support Workers Association. We represent over 67,000 personal support workers and support workers, which have different names in almost every province, across our wonderful nation.

Seniors and disabled Canadians in Canada have never been at greater risk to their overall safety both financially and societally. These risks are unusual in that they transcend socio-economic and cultural classes. Across Canada our ability to provide care to this demographic has come into question, as the most vulnerable members of our society are made to bear the burden of years of collective mismanagement.

This absence of foresight can best be seen in the inability of our nation to adequately staff personal support workers, who provide the basic needs for these vulnerable Canadians. Personal support workers are often the main point of contact for these individuals and are responsible for their care and emotional and societal supports. However, these relationships are precarious at best and at worst are criminal.

Most of us hope for a long and rich life. However, many of us may think twice about this wish based on the reality of life for thousands of seniors and disabled Canadians in this country who are dependent on personal care. Seniors and disabled Canadians in long-term care and community care often experience traumatic levels of isolation, which quickly erodes independence and quality of life.

As we all journey towards our senior years, our needs will grow more complex and require a robust and stable workforce. Unless we make significant changes and work towards a national standards model, many of us will not have the personal support workers needed to help us participate fully in our lives.

Seniors and disabled Canadians and health care issues are often discussed in tandem, and the reasons are not hard to see. For many seniors and disabled Canadians, it is their own health issues that isolate them, often leading to depression and many other health issues. In other words, as these seniors and disabled Canadians become lonely, their exposure to physical, emotional, verbal, sexual, racial and financial abuses increases greatly.

Of all the possible abuses endured by this vulnerable population, one not often spoken of is financial abuse. Over the last three years, the Canadian Support Workers Association, along with our chapter in Ontario, the Ontario Personal Support Workers Association, has dealt with a growing number of incidents involving the attempted seizure of entire estates by health care workers. Without a professionalized health care workforce, especially in community care, this population is at serious risk of quickly having their financial assets stolen, mortgaged and spent.

I look forward to answering all your questions today. Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Ferrier.

We're going to proceed to rounds of questions now, beginning with the Conservatives.

Go ahead, Ms. Falk, for six minutes.

[Rosemarie Falk, Conservative, Battlefords—Lloydminster, SK]

Thank you, Chair, and thank you, Laura and Miranda, for coming today and sharing your wisdom and experience with the committee.

I'm going to start with Miranda.

In advance of Ontario's Personal Support Worker Day, which is next week on May 19, I want first of all to extend my gratitude and thanks to you and through you to support workers across the country for their dedicated and tireless work to care for their patients. Support workers have shown courage and commitment on the front lines throughout the pandemic, and I know that the work support workers does is not easy and takes a certain skill set. It's emotionally, physically and mentally demanding, and has been undoubtedly even more so during this health crisis.

I'm wondering, Miranda, if you could share with the committee the level of professional recognition that support workers have across the country and how this affects the workers and their patients.

[Miranda Ferrier]

Absolutely. Thank you very much MP Falk. It's nice to see you.

Personal support workers across our nation are called something different in almost every single province. In Nova Scotia they're referred to as continuing care assistants. In New Brunswick they're PSWs and health care aides. In Saskatchewan they're continuing care assistants. In Ontario we're personal support workers. I'll refer to them as PSWs moving forward.

In every single province we are unregulated. Two provinces do have registries in place for their workers, but they're employer-driven registries, which does nothing for the worker.

One thing the association has been doing on a provincial level in Ontario for over the past 10 years is lobbying quite hard for the regulation of personal support workers. We know that with title protection, regulations, accountability and oversight put in place, our most vulnerable would be much safer. Right now, to be honest, do you know who's knocking at your door? We don't know who is a personal support worker. There's no way, other than with our association, for them to identify themselves as such. That's a huge concern.

The level of abuse in elder care that's happening right now has been happening forever. A personal support worker working in long-term care, home care, a retirement home or wherever can be accused of abuse, be fired from their job, walk down the street and get a job at another long-term care facility, home care company or whatever, because no one's following them in their jobs. That is where elder abuse really starts.

I am happy to announce that the Province of Ontario has put a bill forward to regulate personal support workers in Ontario. It's currently in its public consultation process. It's Bill 283, if anyone's interested, in Ontario. Hopefully it will be an authority that oversees accountability and protections for the public regarding personal support workers.

PSWs, as you know, are unregulated, so we're not taken seriously in the job in a lot of places. We bring a lot to the table. No one else does personal care; only the PSW does.

[Rosemarie Falk, Conservative, Battlefords—Lloydminster, SK]

I have one more quick question for you, Miranda.

In previous meetings at this committee, the Minister of Employment, Workforce Development and Disability Inclusion suggested that the Minister of Seniors and the Minister of Health are working with the sector to standardize credentials for support workers. A follow-up from the department suggested that their work to develop occupational standards was expected to begin this spring.

I'm wondering if the Canadian Support Workers Association has been consulted on occupational standards.

[Miranda Ferrier]

No, not at all.

[Rosemarie Falk, Conservative, Battlefords—Lloydminster, SK]

Laura, I'll scoot over to you. Off the top, I want to thank you for the steadfast advocacy you have for an age-inclusive Canada.

In the breadth of CanAge's work, I know that you have valuable insights on a range of issues facing seniors and on the impact that COVID-19 has had on seniors. We know the pandemic has been particularly isolating for seniors and that they have missed out on celebrations, holidays, milestones and even day-to-day contact, like seeing somebody smile, holding a hand or sometimes just sitting beside someone.

I'm wondering if you can share with the committee this afternoon what impact social isolation has had on seniors and the impact that restricted interactions have had during the pandemic.

[Laura Tamblyn Watts]

It has been a misery for older people across this country, whether they are the individuals left in their own homes and socially isolated from family, friends, neighbours and faith communities, without exercise and daily connections, or at the most extreme level, those in long-term care like Stanley, whom we spoke about. He was restricted not just to his long-term care facility, but to his room.

Older people are suffering untold amounts of physical deterioration. In long-term and residential care facilities, we've been able to measure it, so we know that their bodies are getting less strong. We also know that cognitive impairment has been significantly affected. People who were more able mentally before are now less able mentally. That can be measured on dementia scales or on other scales for cognitive impairment.

We know that mental health has deteriorated enormously. For some people, particularly those in long-term care, where the average length of stay before a person passes away is 18 months, this has been almost the rest of their lives, so it has been devastating.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Tamblyn Watts.

Thank you, Ms. Falk.

Next is Mr. Dong, please, for six minutes.

[Han Dong, Liberal, Don Valley North, ON]

Thank you very much, Chair.

Good afternoon to Miranda and Laura.

First of all, I want to say thank you for taking time out of a busy schedule to respond to the invitation of the committee. Also thank you for all your members' hard work during the pandemic. I have six long-term care facilities in my riding of Don Valley North. I have visited them a few times while organizing PPE donations. I've seen first-hand how hard they work. They treat the residents like members of their family. That's the reason most of them are willing to put their safety on the line to provide the support for them. So thank you and, through you, thanks to all your members and your colleagues for doing that.

That being said, reading the most recent report provided by the Canadian military, I got really upset, to be honest, that lives were lost purely due to neglect. I couldn't imagine that this kind of stuff would happen in our country. Also, some of the reports since 2018 have noted that the random checks on long-term care facilities have been suspended, and that kind of feeds into the really terrible picture right now.

I think that's part of the reason we've heard a lot of calls for the federal government's increased involvement in the long-term care sector. We've seen that the throne speech talked about looking at perhaps more severe penalties for perpetrators. We've seen in the budget the $3-billion investment over five years. That leads to a bigger question, which is my first question for both of you.

What's your suggestion for how all levels of government can work together while respecting each other's jurisdiction? I heard my colleague mention occupational standards, which traditionally, I believe, have been a provincial responsibility. Obviously there is a lot of negotiation between the federal government and the province.

What's your vision of how all three levels of government can work together to improve the situation?

[Laura Tamblyn Watts]

Of course our division of powers was not meant to promote finger pointing. It was meant to make sure that governments work together. In this particular shared area, we're very pleased to see the federal government reach in with open arms and make profound changes and make significant investments, but we need to do more.

For full disclosure, I am part of the national long-term care standards technical working group, and I know that members will hear from the leaders of those technical working groups next.

From a legal point of view—this is where the lawyer comes out—we feel that it might be very helpful to move forward with standards but then to work collaboratively with our provincial and territorial counterparts to embed those standards in regulation. Our organization, CanAge, would like to see funds tethered to those national standards.

The $3 billion over five years across this country is a good and significant movement and signal about the importance of implementing national standards, but it's not transformative money. We need to make sure that there are specific amounts of money tied to those standards. It will be an agreement between provinces and territories. We hope very strongly that provinces will look at this not as a political football and an opportunity for grandstanding but rather as an opportunity for transformative change for seniors.

[Han Dong, Liberal, Don Valley North, ON]

You mean having not a giant envelope but perhaps a specific envelope of funding that targets....

Okay.

Miranda.

[Miranda Ferrier]

I would have to agree with Laura. Laura and I are friends outside of this as well, so we see things eye to eye on a lot of different issues, which is great.

I would agree about having the individual envelopes. I think one of the ways we really have to look at this from the federal level looking down into the provinces, especially Ontario, is that one area they just won't touch is ratios in long-term care. This might not play into what you're asking, but I worked as a personal support worker for eight years in long-term care, so my background is all personal support worker, home care, long-term care, hospital. I will tell you that from 2006 forward, I never worked a fully staffed shift. That was starting in 2006 and moving forward. That's scary if you think back that far.

I find that provinces are almost leery of having set ratios. If you have one PSW to eight residents on a floor just to start with and then decrease that as it moves on, that would make such a huge impact. The burnout rates would go down, and you'd actually be able to give the residents better care. I think the federal government could be really influential on the ratios aspect.

[Han Dong, Liberal, Don Valley North, ON]

I'll try to get one more question in.

Speaking of the standards, there are two things being considered: the national long-term care services standard and a new national standard focused on operations and infection prevention.

Is there a role for the federal government in ensuring long-term care workers are given adequate training, work conditions and wages?

[Laura Tamblyn Watts]

Very briefly, yes. I don't want to speak over Miranda—

[Miranda Ferrier]

I was just going to say yes.

[Laura Tamblyn Watts]

—but we feel there's an opportunity for incentivized grants; training and education supports; immigration, with the immigration priorities in these areas; and setting out different incentive-based capacity-building programs.

[Han Dong, Liberal, Don Valley North, ON]

Miranda.

[Miranda Ferrier]

I totally agree. I have nothing to add.

[Han Dong, Liberal, Don Valley North, ON]

Great.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Dong.

Ms. Chabot, you have the floor for six minutes.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

Thank you, Mr. Chair.

Good afternoon.

Thank you, witnesses, for your testimony and opinions. As you know, we're embarking with you today on a study on seniors. All aspects of this study are important, including the financial, social and health aspects.

The consensus around the table is that the pandemic crisis has hit our most vulnerable people, including our seniors, particularly hard.

I listened to Ms. Watts and Ms. Ferrier. My question is for both of them.

You focused heavily on the reality in some provinces. That's fine. However, I want to bring up one point, with regard to national standards. You seem to agree on these standards, which you're focusing on.

In Quebec, personal support worker training is qualifying training and it's considered very important. In terms of staffing ratios, this falls very much under the purview of legislation. It seems far-fetched to try to establish uniform standards in all our care systems and in all the provinces.

Moreover, in Quebec, the National Assembly wasn't really considering national standards, since there are already many established standards. Instead, it focused on the idea that the Canadian provinces need proper funding for the health care system on a permanent, sustainable and structural basis. That's why all the provinces and territories in Canada are calling for a substantial increase in the Canada health transfer to meet their needs.

Do you agree with this demand from the provinces?