Big holes in Ontario retirement homes bill, advocates say

Posted on May 31, 2010 in Child & Family Debates

Source: — Authors: – News/Ontario – Private homes legislation creates a lesser tier of long-term care beds with lax public oversight, health coalition says
Published On Mon May 31 2010.   By Tanya Talaga, Queen’s Park Bureau

Ontario is poised to bestow enhanced powers on private retirement homes that will allow them to self-regulate, medicate residents and become “de facto” long-term care facilities, critics charge.

The act to regulate retirement homes, Bill 21, poses “significant questions” in its ability to respect “fundamental human rights”, according to Sack Goldblatt Mitchell, lawyers retained to analyze the bill by the Ontario Health Coalition — a healthcare watchdog group.

The legislation is expected to go to third reading this week before the House rises for summer break. Third reading is the last step before a bill receives Royal Assent and becomes law.

But Ontario’s Minister Responsible for Seniors, Gerry Phillips, said the legislation is not rushed, 800 groups and individuals were consulted and that all three parties have supported it’s creation. “The bill reflects those consultations,” he told the Star.

For decades, advocates have called for the regulation of privately run retirement homes after horror stories of resident neglect, abuse and lax standards of care. There are approximately 628 retirement homes across Ontario housing 43,000 residents.

Some argue the bill gives private homes the ability to provide medical and nursing care similar to those in provincially regulated long-term care homes and even public hospitals. They say this creates a second-tier of lesser-regulated long-term care facilities in Ontario.

“I’m afraid we’ll be stuck with a piece of legislation that will be quite dangerous for residents of retirement homes,” said Natalie Mehra, the health coalition’s director.

After years of waiting, this legislation is disappointing, said NDP MPP France Gélinas (Nickel Belt). Gélinas brought forward 92 amendments to the bill and 91 were defeated. “This is the worst bill I’ve seen since I’ve been there,” she said. “We have been asking for regulation because of a critical mass of frail, elderly seniors who live in these homes. History already tells us people can abuse them — from physical abuse to starving them to stealing from them.”

For the owners to self-regulate simply “adds insult to injury,” Gélinas said.

But others say this legislation is desperately needed and that Ontario has lagged behind other provinces in regulating the industry for too long.

“You have to have a system that will deal with bad actors,” said Gord White, CEO of the Ontario Retirement Communities Association. “There has to be assurances of safety for residents of retirement homes and we don’t have that now,” said White. ORCA is a non-profit voluntary group that represents about 70 per cent of the beds in the retirement sector.

Without legislation, anything goes. For instance, White knows of an instance where a 12-year-old girl comes home from school and hands out medication to retirement home residents — because someone needs to do it and it’s not illegal. “When there are no rules, there are no rules,” he said. “This will bring consistency. It will ensure those operating retirement homes have a level of competency to do so.”

However, the bill allows for the industry to be virtually self-regulating — missing public oversight, critics say. The legislation creates a private oversight model called the Retirement Homes Regulatory Authority but it has limited public controls, according to Sack Goldblatt Mitchell. It’s unclear if stringent transparency and accountability measures in place to govern public bodies and agencies would apply, they add.

Phillips said the government oversight is there. The authority is not self-regulating as the government appoints the chair and some of its directors. “It’s clear the mandate of the regulatory agency is to protect the residents,” he said.

The health coalition fears what is really happening is the government is using retirement home beds to take elderly hospital patients. The government claims retirement homes taking these patients have to follow provincial standards but they don’t have the physical facilities needed or the trained staff, Mehra said.

“These are private, for profit institutions,” she said. “Retirement homes are taking heavier care residents and are increasingly being seen as some sort of health facility.”

As Ontario continues to struggle to care for its growing elderly population and deal with a shortage of alternate level of care beds in hospitals — retirement homes should not be used as a substitute, Mehra said.

Allowing this to happen “flies in the face” of decades of work to improve conditions in long-term care homes and could mean worse care and poorer health outcomes for the province’s seniors.

Another major problem is that seniors could be at risk of being put in secure units or restraints, according to Sack Goldblatt Mitchell. “The protections contained in the bill are simply inadequate to ensure that such restraints or confinement will be imposed in the best interest of the resident,” the legal opinion states in a letter to the Ontario Health Coalition dated May 27, 2010.

However, Phillips said the bill has been recently amended to clarify the use of restraints, in fact, it goes out of its way to state they are prohibited.

Still, seniors groups aren’t impressed. The retirement home changes need to go immediately back to the drawing board, said Judith Wahl, executive director of the Advocacy Center for Elderly, a clinic which provides legal services to low income seniors.

“I wish they’d put the brakes on it and listen to the comments that are coming in,” she said. “We are saying, wait a minute, this isn’t the best model, they can do better. Everyone wants regulation in this sector but this isn’t it.”

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