Care Watch 2022 Annual General Meeting: Report from the Co-Chairs

December 2022

The pandemic isn’t yet behind us. Hospitals and long-term care homes are stressed, and there are too few people to care for older adults. High quality, equitable, and affordable home and community services remain what older Ontarians want and the system needs. Care Watch’s mandate – to advocate for these services – becomes increasingly important. Throughout 2022, we have sought opportunities to carry out this mandate.

We continue to learn some hard lessons. Older adults and many of their caregivers were hit particularly hard – both by disease and by the system. Their deaths and their suffering show us that care should not be linked to profit and that ageism needs to be eliminated. Discrimination by age is no more acceptable than discrimination by ethnicity, gender identity, or level of ability. Care Watch views all policies and programs through the lens of ageism, which affects how people think (stereotypes), how they feel (prejudice), and how they act (discrimination). We resist it in all its forms.

Care depends on the people who provide it, and we continue to advocate for both the paid and unpaid ones. Our communications reinforce the need for home and community care workers to earn as much as those in hospitals and long-term care homes. When they cannot earn what they deserve, they leave the community for jobs in other settings. Many have already left, and the number is growing. When there aren’t enough people to provide care in homes and communities, clients are forced into institutions they could have avoided, with emotional and financial costs to them and to the system. We also can’t forget how much of the care in homes and communities comes from people who aren’t paid. These unpaid caregivers are equally deserving of recognition and support. 

Communication with Decision Makers

Our pre-budget submission in January called on government to: 1) commit to a home and community-centred system of care for older Ontarians; 2) fund long-term care as a comprehensive system; 3) make both initial and stable ongoing investments in home and community care; 4) recruit, train, and retain staff to work in the community and pay them the same as those in hospitals and long-term care homes; and 5) remove legislative and regulatory barriers to improving salaries.

We worked closely with the Alzheimer Society of Ontario and the Ontario Community Support Association on this submission to align our position and our numbers with theirs. These collaborations are ongoing.

In September, we wrote to government about Bill 7, the More Beds, Better Care Act, 2022. This act (passed without public hearings) permits a placement coordinator to assess a hospital alternative level of care patient, select a long-term care home, give the patient’s personal health information to the home, and then admit the patient to the home – all without consent. As of November, hospitals must charge patients who resist this placement $400/day. We expressed concern about suspension of rights, financial abuse, and populating substandard long-term care homes with unwilling residents. We asked how government would insist long-term care homes meet care and safety standards, how they would build community capacity to care for older adults, and how they are using the $1 billion promised for home and community services and the unspent $1.8 billion in the health care budget.

Understandably, there have been legal challenges to this act and what it permits. As these challenges make their way through the courts, we observe with interest.

Elections

It was a notable year in Ontario, with both provincial and municipal elections. Care Watch does not endorse parties or candidates, so we concentrated on engaging and informing voters.

Before the June provincial election, we reviewed parties’ platforms and policy documents, with particular attention to what they said (or didn’t say) about investment in home and community care services; workforce capacity; accountability and standards; and privatization. We posted our analyses on the Care Watch website.

We wrote to party leaders and candidates asking what their plans were for: 1) increasing investment in home and community services; 2) setting and enforcing Ontario-wide standards for home and community care; 3) attracting and keeping community-based personal support workers and giving them the same wages and benefits as those in hospitals and long-term care homes; and 4) supporting unpaid caregivers.

Not everyone responded to our letters, but the three primary opposition parties were generally supportive of Care Watch’s positions.

Municipal elections followed in October. A large part of our work was raising awareness of just how much municipalities contribute to health services and healthy communities. We wrote to mayoral candidates throughout the province asking them how they would: 1) help older adults remain safe, independent, and productive; 2) support public health, particularly for older residents; 3) promote affordable housing and high quality home and community care delivered by not-for-profit community-based organizations; and 4) advocate to the provincial government for wage equality for home and community support workers.

We posted their answers on our website. We were heartened by those that reflected an understanding of the importance of home and community services to older Ontarians. Other candidates seemed less aware of the strong influence of municipalities on older adults’ health. They showed us that we still have some work to do.

Throughout both elections, we issued bulletins and tweets. We encouraged readers to ask our questions, add their own, and vote for candidates who had earned their votes. We were, however, disappointed in the low turnout and voter numbers for both elections. We hope future elections will inspire more participation.

Office Arrangements

Throughout 2022, we continued to work remotely, and our comfort with Zoom grew. In 2023, we expect some changes. We now have a new physical space. SPRINT, which provides a home for our office, is moving to a new location – 130 Merton St., just next door to its previous location, which will be redeveloped over the next three years. At some time in 2023, we may be able to hold in-person meetings. The experience of the past two years, however, has shown us what we can accomplish even when we’re not physically occupying the same space, so we will probably continue to offer a Zoom option. This option will allow people to participate according to their own feelings of safety. It also allows us to involve people in areas outside Toronto, enabling us to expand the reach of advocacy throughout the province.

Other Activities

2021 Annual General Meeting: At the AGM, our business meeting included reports from the chair and treasurer. We welcomed new board members and recognized the contributions of several retiring ones. Our guest speaker was Deborah Simon, Chief Executive Officer of the Ontario Community Support Association. Deborah called attention to the large impact of home care and community support services and the relatively small amount of funding they receive. She noted several conditions that hamper home and community services – their relative invisibility in relation to other health services, the lack of understanding of their capacity and what they can do, and the limited research and data on home and community care and its outcomes. She added that home and community care needs to be on an equal footing with other elements of the health care system. It also needs greater government investment, stabilization of its workforce, and attention to the voices of clients.

Website: We have been updating and modernizing the Care Watch website to make it more intuitive to follow and to provide clear pathways to all the information we post. We are in the final stages and look forward to sharing the new website with you.

Partnerships and collaborations: Care Watch is represented on the Ontario Ministry of Seniors and Accessibility Seniors Liaison Committee and the Toronto Seniors Strategy Accountability Table. Our participation gives us opportunities to work with other organizations and provide input to government.

We also collaborate and share ideas with additional organizations, for example, the Alzheimer Society of Ontario, Ontario Community Support Association, and Ontario Health Coalition. Adding our voice to theirs strengthens our message.

Care Watch is a partner organization for a seven-year research project, “Imagining Age-Friendly ‘Communities within Communities’: International Promising Practices,” which was launched in June 2018 and is funded by the Social Sciences and Humanities Research Council. A team of researchers, led by Dr. Tamara Daly of York University, is examining age-friendly practices in cities in Canada and in  Australia, Denmark, New Zealand, Norway, and Taiwan. We have submitted a letter of support for an additional project – one from the University of New Brunswick Centre for Research on Integrated Care on regulatory approaches to the assisted living/ retirement home sector in Ontario and British Columbia. If that project is funded, Care Watch expects to participate

Looking Ahead

Elections are behind us – at least, for now – but the issues they highlight persist. There are still significant gaps in home and community services, too few people to work in those services, and a lack of accountability and standards. In 2023, Care Watch will continue to monitor and comment on legislation, policy, and practices with the ultimate goal of advocating for more and better home and community services for older Ontarians.

We also eagerly await some answers. Government has pledged an additional “up to an additional $1 billion” for home and community care. We don’t yet know how this funding will be allocated, who will control it, what services it will provide, and which people it will serve.

We have had several discussions with Ontario Health and look forward to sharing perspectives and ideas. We are eager to see how the Ontario Health Teams evolve and how home and community care services and funding will work under new umbrellas. Our goal is to protect and promote these services within whatever structures the province adopts.

We have a great deal to do and to look forward to. We wish our members and supporters all the best for 2023.