Human Resources Committee on March 21st, 2022

[Ian DaSilva]

Data is a huge a problem for frontline health care. As we said, there is no title protection, so there's no corresponding professional college in which to accumulate or restore that data. It's very much a complete [Technical difficulty—Editor]. About a year ago, the Canadian Support Workers Association actually took it upon itself to invest money in developing a national competency and data measurement assessment tool that will work, and that works already, designed first to determine interprovincial competencies between provinces to allow for PSWs to move between provinces more easily. For example, PSWs can come to Ontario and work, and there's no problem with the Ontario PSW Association, but Ontario PSWs can't go out and work in other provinces. We want to end that, so we developed a tool already and we're happy to share it with the government, of course. The money has already been spent, so the tool exists. The tool will not only measure competencies but be an initial step to actually begin to gather some of these data points that we simply do not have access to.

It will require, from this committee, some endorsement of the idea that we need title protection, so that we can at least start creating mechanisms, as Ms. Hall was saying, to collect the information. Since this meeting began, just bear that in mind the number of terms we've used to define the personal support worker. We've called them community care assistants, personal care aids, community care aids; it goes on and on. We really need to settle on one title nationally, allow the provinces to start housing that data provincially, but then also use this interprovincial competency tool to conduit that data to a national level.

It's all there. It's ready to go. We're ready to use it. I hope that answers it. We also grandfather nurses in Ontario as well, to work as PSWs, and we've been doing that since 2019, so we have mechanisms in place to move IENs into this province. There's no problem, in Ontario at least.

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Thank you.

Madame Bisanz, I think we have just under a minute.

[Christina Bisanz]

I just have to echo that the challenge is around ensuring that in data collection we're very clear on how we define the roles. There is a lot of intermingling with regard to how we use such terms as personal support workers, home support workers and community support workers. To enable us to really reflect what the numbers are, and the statistics, it would have to be clearly defined. For example, we had a situation in the past where the Province of Ontario offered increased wages in short amounts, but it covered PSWs who did certain functions and not PSWs who did other functions.

If we're going to collect meaningful data—and I fully support the need for that—I think in our own workforce planning, we need to be aware of what the data tells us. It's important to underscore that we define the roles as opposed to defining the titles in collecting that data.

[The Chair, Liberal, Bobby Morrissey]

Thank you, Ms. Bisanz.

Madam Zarrillo, your time is up.

We'll now go to Mr. Ruff for five minutes.

[Alex Ruff, Conservative, Bruce—Grey—Owen Sound, ON]

Thanks, Chair.

I have a few questions, but my first questions will be to Mr. DaSilva and Ms. Hall. It's really around the challenges with PSWs and part-time versus full-time work.

I'm interested in your feedback on how we can solve this challenge. I recognize that this delves into some provincial jurisdiction as well, but there are so many PSWs having to take jobs in multiple long-term care homes in order to make do. What are some solutions to resolve this?

[Ian DaSilva]

Ms. Hall, do you mind if I go first? Thank you.

Essentially, the [Technical difficulty—Editor] that the dignity element is the key, and the dignity element is tied to that professional title. The reason we have seen a lot of these jobs go from full-time to part-time, and it is a member issue on a large scale for us right across Canada, is simply that employers have the flexibility to hire other titles to replace that personal support worker. They can do so at leisure. Because there's no regulatory or title protection around that, it's making the job of trying to secure full-time PSW work extremely hard.

Once you start establishing that you want to hire a PSW full time, you ask, what is a PSW? Who defines that? There's no college. There's nothing other than the Canadian Support Workers Association. The first role is that you need to standardize the title, and then you're going to see some ability to....

That goes right across home care and long-term care. If you standardize that title, so that personal care is personal care right across the board, then in theory you should start seeing those part-time jobs go away. Right now there's no incentive—none—to hire full time.

[Alex Ruff, Conservative, Bruce—Grey—Owen Sound, ON]

Go ahead, Ms. Hall.

[Jodi Hall]

Thank you.

I would add that long-term care homes are 24-7 operations. Within that model, a certain number of staff members will always be required to be on a part-time or on-call basis. That is essential to the model.

I will note that in terms of the number of hours that are available to create full-time and part-time positions, that comes back to the hours of care. It's the hours of care in a home that really drive how much time a care provider spends at the bedside of a resident. Those hours then translate back into the number of positions you can create. With a 24-7 operation, the employer decides what they need in terms of full-time and part-time staff to keep the home running.

That's all part of that piece. We see that provincial governments are now taking steps to increase the hours of care and are establishing targets for that. Of course, it then comes back to what we're talking about here today, which is the staffing shortages. We can increase hours of care and we can make those resources available, but at the same time we need to be extremely diligent in continuing our efforts, with urgency, to increase the actual pool of people who are available to work in our homes and in all of long-term care.

[Alex Ruff, Conservative, Bruce—Grey—Owen Sound, ON]

Thanks, Ms. Hall.

My final question is for you, Ms. Bisanz. It's more about rural Canada and even the Arctic, to some extent, because there's a lack of long-term care homes, obviously, in the north. Specifically, what can the federal government do to support rural long-term care access and aging at home?

In particular, one of the challenges I'm hearing about from PSWs in my riding of Bruce—Grey—Owen Sound, which is the second-oldest demographic in Ontario, is that there are no workers. Another part of the reason, even if they can get work, is that there's no place for housing. If you're going to stay at home, there's no Internet access, etc.

Ms. Bisanz, can you expand a bit on the importance of housing and Internet access, and on how this all ties together for rural Canada and even the Arctic?

[Christina Bisanz]

That's a great question. First and foremost, I think we really need to recognize that [Technical difficulty—Editor] services are part of the continuum of care and must be reflected in our national health policy and delivery of health care.

The federal government should [Technical difficulty—Editor]. Canadians have overwhelmingly told us that their desire is to age in place, as you've indicated. Funding and policies need to mirror those wishes.

It's time the federal government committed to including community services in the Canada Health Act. Right now the only place Canadians are guaranteed health services is in hospital. As long as we have that paradigm in place, we'll continue to undervalue home care supports and community services, require [Technical difficulty—Editor] CHATS to operate on a shoestring and expect our workers to drive from client to client and not be fully compensated for the time it takes or for the cost of gas.

We have many examples of supports that are actually provided 24-7. Our assisted living program provides support to seniors who live in areas where personal support workers are co-located in buildings. In cases in which clients are living in the rural community, the PSWs will go out and do visits to them on both an unscheduled and a scheduled basis.

A lot of services are being provided that are unrecognized and undervalued. If we continue to do that, the resources necessary to serve the clients in those rural and northern communities are going to be lacking and they will continue to be underserved.

The housing—

[The Chair, Liberal, Bobby Morrissey]

You may be able to finish that with the final questioner.

We go to Mr. Van Bynen for the final five minutes.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Thank you, Mr. Chair.

I want to thank all the witnesses for taking the time to give us the benefit of their perspective on delivering service at the grassroots level. In particular, Christina, you have a busy schedule, not only through CHATS, but also through being a councillor with the Town of Newmarket. I appreciate your taking the time to join us.

My question is for Ms. Bisanz.

I understand that one of the core aspects of the New Horizons for Seniors program is promoting volunteerism among seniors. Do you feel that the federal government has any role to play in increasing the organizational capacity of volunteer-based seniors-serving community groups? Are there any tools that could help address those gaps in the labour market?

[Christina Bisanz]

Thank you, Mr. Van Bynen, for [Technical difficulty—Editor].

First of all, I want to thank the federal government and the New Horizons program for having funded a number of initiatives that CHATS was able to deliver to increase support to our clients—to seniors and their caregivers. The value of those programs can't be understated. Funding was available through the pandemic to enable us, for example, to quickly switch from our in-person programming to offering virtual programming, Internet connections, tablets and literacy training to keep seniors connected through the time of the pandemic. We would not have had the resources had it not been for that special funding.

Moving forward, we know that we rely on volunteer support for a lot of the services we provide. Were it not for volunteers, we couldn't possibly reach and serve as many seniors and their caregivers as we do.

It's not the only solution. Often this funding is provided one time. We can set up a program but we need to be able to continue to operate it, especially once we've developed expectations among our clients that the program will be available to them. The question of capacity needs to be built into the way the program funding is structured, with a recognition that the ongoing operating costs must be factored in as well.

We know that volunteers are a very important resource to us. The pandemic showed us that when we had to appreciate that our volunteers—many of whom are seniors themselves—had to shutter for a long period of time. That resource wasn't available to us anymore, but the expectation and the need for the services to continue was still there.

From a capacity standpoint, we appreciate the one-time funding, but we also need to look at how we can sustain the resources and the capacity to continue to offer those services.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Thank you.

I noticed in your earlier comments your concern about the propensity for, or the prioritization of, institutional care for the elderly, as opposed to aging at home, which we intuitively know is more cost-efficient. We also know it's a more effective method of health care and a better quality of life.

Is there any evidence, or are there any studies you could submit to this committee, that could show the effectiveness of aging at home compared to institutional care?

[Christina Bisanz]

Yes. I would have to look into the specific studies, but I think there's a wealth of evidence that supports this. That's not to undermine the need for other forms of care, depending on the complexity of the individual, their access to caregiver support to help them stay in their home and, of course, their access to home and community services. Where they live, as the previous member indicated, has a huge bearing on their access to services and their ability to remain in the home.

We know, and the evidence supports this, that we can do better. If we look at jurisdictions outside of Canada—Denmark, for example—they demonstrate that home care support can keep people in their own homes much longer and in fact out [Technical difficulty—Editor] has been well established and well proven. I think we just need to shift our paradigm and shift the way in which we culturally view aging in our society and the importance of recognizing quality of life, choice, and the dignity of that choice for individuals, where possible.

[The Chair, Liberal, Bobby Morrissey]

Thank you, Mr. Van Bynen and Madam Bisanz.

With that, we conclude our witness list for the second round. I want to thank the witnesses, Madam Hall, Madam Bisanz and Mr. DaSilva for their very good testimony.

While they're leaving, I need direction from the committee on two items. To the witnesses, thank you for your contribution and testimony today.

While we're doing that, Ms. Gladu referenced in her comments a previous committee report. She wants permission to have it circulated.

Do you want to speak, Ms. Gladu?

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

Thank you, Mr. Chair.

I was going to suggest that, with the committee's approval, the parliamentary analyst forward those reports to you for your consideration. It could inform the study. One was on unpaid work and the other was on working conditions in long-term care.

[The Chair, Liberal, Bobby Morrissey]

I think they would find that very informative. That's something we'll be able to do. Thank you, Ms. Gladu.

I have a request. I need direction from the committee on one item of committee business.

Ms. Zarrillo, please go ahead.

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

I just have one request, too. Mr. Van Bynen asked last time that any reports that are referenced in witness testimony come to the committee, but I wanted to ask specifically about the construction trade.

Today it was mentioned that the construction trade has a Canada-wide strategy. I'm wondering if that strategy could come to the committee as a template or an idea. I say that, too, because Ms. Nord from the Canadian Chamber of Commerce mentioned, in her last testimony, that she can tell us the age distribution of the construction workforce—how many women, indigenous people and new Canadians work in those trades—and she can break down those numbers by jurisdiction. I'd love to see that as a framework for what could come to health care and the care economy.

Thank you.

[The Chair, Liberal, Bobby Morrissey]

Thank you, Ms. Zarrillo.

Our next meeting will be on Thursday. Minister Qualtrough will appear on two items: the main estimates and her mandate letter. The minister has requested to extend her opening comments from the normal timeline to up to maybe 10 minutes, given that she's speaking on two issues. She has also indicated to the chair that she would extend her time for committee members to question her.

I need direction from the committee. Is it agreeable that she prepare an opening statement of 10 minutes?

[Some hon. members]

Agreed.

[The Chair, Liberal, Bobby Morrissey]

I see a consensus. Thank you, committee members.

I apologize. I forgot to officially welcome Ms. Gladu to the committee. Thank you for your participation today.

The meeting is adjourned.