Bob Hepburn’s commentary (Toronto Star. Aug. 4, 2016) [1] laments that raising the minimum wage for Personal Service Workers (PSWs) in the home care sector has resulted in reduced hours of service for clients and lower take-home pay for workers.  PSWs, who are paid on a piece-work or hourly basis, are now allowed to spend only 45 minutes per hour with clients, regardless of the client’s needs or the amount of work to be done, and are being assigned fewer clients.  The result for the PSW is less take-home pay, fewer or no employment benefits (e.g., sick, vacation or holiday pay), continued precarious working situations and increasingly rushed and frustrated clients.  The result for the client is less service and, for those with complex health problems, an increased likelihood of requiring more expensive hospital services.

Care Watch wonders why anyone is surprised.

The majority of home and community care workers are employed through private agencies; they are not “government” workers. These agencies must cover their overhead costs, and, in the case of for-profit agencies, their profit margins, through the budgets contracted via the CCACs. The obvious response was to cut back on hours of work and service provision.   The CCACs’ defense that services are based on need is disingenuous and not credible.

Back in June 2015, the Globe & Mail [2] reported that the Ministry of Health and Long-Term Care responded to a litany of complaints by providing guidelines to the LHINs intended to address inequities in the implementation of the phased wage increase and to deny any new business to agencies that would not agree to accept the raise. It appears that they failed to also address the usual strategy of reducing working hours and services as a response to increased costs that cannot be passed on to the client.

At that time, Minister Hoskins acknowledged that problems arose because his department did not know enough about PSWs in the home care sector. A year later, they should have learned a lot more and be in a better position to mitigate the problems that are arising.

Via the 2015 Patients First Roadmap [3], the province committed over a three-year period to raising investment in home and community care by $750 million (or $250M per year); increasing nursing visits a patient can receive at home above current maximums to avoid hospital or long-term care home admission; develop measures to create more permanent and less casual employment for PSWs (stabilize the work force); and address the challenges affecting recruitment and retention of PSWs.   The 45 minute hour and continued poor working conditions for PSWs are not meeting this commitment. Ontarians, and PSWs, deserve better.

[1] Toronto Star, Aug. 4, 2016. https://www.thestar.com/opinion/commentary/2016/08/04/how-a-pay-raise-turned-into-a-nasty-pay-cut-hepburn.html

[2] Globe & Mail, June 11, 2015. http://www.theglobeandmail.com/news/national/ontario-tightens-wage-increase-rules-for-personal-support-workers/article24921222/

[3]  Ministry of Health and Long-Term Care.  A Roadmap to Strengthening Home and Community Care.  http://www.health.gov.on.ca/en/public/programs/ccac/roadmap.pdf