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Personal Support Worker Registry of Ontario

As mentioned in November 2017, a “PSW Registry” [1] is being redeveloped and re-introduced. The redevelopment is being led by the Michener Institute for Applied Health Sciences for implementation in phases over the next three years, culminating in a comprehensive, mandatory registry by 2019 [2]. Apparently, the PSWs hired by the SDCO will have to be registered.

Although there is relatively little information on the Registry’s website, the initial phase of the PSW Registry is intended to start with the following:

  • Verification of a PSW’s credentials and additional certification (NOTE: This process was grossly underfunded in the previous registry, leading to significant difficulty in verifying foreign credentials and Ontario equivalency, and thus a lack of credibility. Information on the Registry’s budget is scarce);
  • A registration process for qualified applicants;
  • A Code of Ethics (http://www.psw-on.ca/assets/documents/policies/code-of-ethics.pdf) (although a good start, a code of ethics is not the same or as enforceable as professional competency standards);
  • A transparent interim complaints process; and,
  • An employer portal to assist in the filling of vacancies.

Also according to the website, the Registry will be open to all PSWs of Ontario; however, registration will be done in phases. The Registry will start with a small “sample of graduates” from an Ontario PSW Certificate Programme, who graduated in June 2016 or later, to allow the Registry to test and gain valuable feedback for the eventual mandatory comprehensive Registry. The Registry will gradually invite the remaining PSW population to enrol through expanded eligibility processes.


[1] A prior registry was closed in 2016 following complaints.

[2] Until then, current information available suggests that registration is voluntary.

Open Letter to Honourable Jane Philpott, Minister of Health, Canada, and Honourable Eric Hoskins, Minister of Health & Long-Term Care, Ontario

January 13, 2017

Honourable Jane Philpott, Minister of Health, Canada
Honourable Eric Hoskins, Minister of Health & Long-Term Care, Ontario

Dear Ministers:

Care Watch is a not-for-profit volunteer-run advocacy organization led by senior citizens. Our organization, which is comprised of and led by senior citizens, is focused on ensuring that ageing Canadians receive the services they require to remain living at home, thriving in their communities.

Canada’s population is ageing. Older Canadians need programs and national standards that provide needed in-home and community support services that will ensure our continued health and independence, and prevents premature entrance to the acute care system. Care Watch is writing this OPEN Letter to urge both levels of government to develop and enact a National Home and Community Care Framework. We beseech you to move beyond political maneuverings to realize this goal.

Canada’s seniors appreciate that the demands on health care budgets are fierce and competitive, and that money is not available to simply grow the provincial health budgets. However, within the dollars available, Canada’s leaders must protect funding in support of in-home care and community support services because senior citizens across Canada – millions of us – will and must age at home. Private sector retirement homes are financially out of reach for many of us, and the availability of beds in publicly funded long-term care homes across Canada is limited. So, for most of us, ageing at home is not only the desirable option, it is the only option.

Protecting funding for home care services makes good financial sense! Many of us are living longer and healthier lives. With the right supports, we can continue to live safely at home. Research has shown that care in the home is significantly cheaper than care in medical or institutional settings. It makes sense, therefore, for governments to fund home care and community supports so that seniors don’t prematurely seek more expensive hospital, rehabilitation and long-term care services.

Regardless of which government is providing the funding, the source of all funding is in reality, the Canadian taxpayer, many of whom are senior citizens, are caring for senior citizens, or will soon be senior citizens. Canadian taxpayers want and deserve a robust and lasting home and community care program.

Historically, increases to the health budget (whether by federal transfer payments or from provincial treasuries) have not resulted in increases to home care services that parallel the growth in population need. So something must be done to ensure and protect home care funding and to establish national home and community care standards. We entreat you to make this happen now!

Sincerely,

Josephine Grayson, Chair

Media contact: Michèle Harding, Director

This Hour has 45 minutes and PSW Pay Cuts

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

Let’s think about the new Patients First Act before jumping on or off the bandwagon!

Introduction of Bill 210, the Patients First Act, 2016 offers a key opportunity for Ontarians to assess the health system changes that Minister Hoskins proposes.  These changes will have a significant, long-term impact on the range and quality of health services Ontarians receive through our publicly funded Medicare system. They will affect our experience as users, providers and taxpayers.

The draft legislation will amend approximately 20 pieces of legislation in order to implement the proposed reforms.  The Bill is complex and the way it amends these other Acts requires careful analysis of the intent as well as effects or probable outcomes.

Care Watch has a longstanding commitment to advocate for better, more accessible home care for senior citizens.  It is through this lens that we will be watching and commenting on the proposals.

Several commentators, such as The Toronto Star’s Bob Hepburn, note that it is a “first step” in the reform and restructuring process to reduce bureaucratic barriers, improve coordination, access and geographic equity for patients; facilitate patient transitions from hospital to home care; and reduce wait times for home care services, all while re-directing spending from management to front line services.  These are high hopes indeed, but Ontarians are capable of amazing things given sufficient political will and resources!

Also, legislation alone will not change the less than healthy culture of our health care system – affecting both providers and patients – which underlies or exacerbates many current problems.  Long term improvements will require changes in the way we think of and use health services, in our expectations and requirements, and in the ethos of providers we employ.

In the short term, changes will need to be carefully synchronized with appropriate transitional funding and risk management.

There is a lot to ponder.  Care Watch encourages senior citizens to think about the proposals and share your thoughts with us.  We will offer advice to Minister Hoskins through the public legislative committee hearings that the government promises to hold.

Board of Directors, Care Watch