Building a Home and Community Care Workforce

May 26, 2022

The words don’t match the picture. We call personal support workers (or PSWs) essential, heroes, the backbone of the system, but the ones who work in home and community care are the lowest paid workers in health care. When the pay is too low and the conditions too hard, they leave. So we asked parties and candidates how they would attract, keep, and pay these PSWs and how they would support unpaid caregivers. Then we reviewed their platforms.

The Green Party platform (The Green Plan. New solutions to old problems) talks about “respecting and retaining” health care workers. After releasing their platform, the Greens responded to our questions in a letter. Our comments reflect both sources.

Some of the Greens’ plans would improve conditions for all workers. The platform also says, “If we are going to call nurses, PSWs and educators heroes, then let’s pay them that way.” Investments include:

  • Increasing the minimum wage each year, starting at $16, with top-ups for higher cost cities; providing 10 paid sick days and giving small businesses support for the increase; giving all workers employment rights and benefits; and working with the federal government for universal access to $10/day child care
  • Paying PSWs at least $25/hour, paying them for travel time between visits, offering “fair benefits,” and giving PSWs and other health care workers equal pay for the same responsibilities
  • Immediately repealing Bill 124 and parts of Bill 106 so health care workers can bargain collectively
  • Establishing a task force (including workers) on recruiting and retaining nurses and health care staff
  • Fast-tracking credential approvals for 15,000 international health care workers, including PSWs
  • Piloting a support program for unpaid caregivers as part of a basic income phase-in

Our thoughts: We are pleased that the Greens’ initiatives specifically include PSWs. Also, the minimum $25/hour wage appears to apply to all PSWs wherever they work. Giving employment rights and benefits to all workers would help keep PSWs in homes and communities. We also appreciate the Greens’ willingness to respond to us.  

The Liberal Party platform (A Place to Grow) notes that “… too many health care workers are leaving the field after feeling burnt out …” To improve conditions for all workers, “properly pay health care workers and prevent burnout,” and support unpaid caregivers, the Liberals propose to:

  • Repeal legislation limiting wages and collective bargaining; raise minimum wage to $16/hour with a living wage to match living costs; give all workers 10 sick days and benefits and compensate businesses; cover prescription drugs; top up parental leave, provide $10/day child care and $10/day before and after school care; raise the CARE credit; and forgive student loans for PSWs and other COVID-19 health care workers
  • Give PSWs $25/hour; deliver fair and consistent pay across home and community care, long-term care, and hospitals; and provide top-ups for short-staffed shift work
  • Hire 10,000 health care workers and remove roadblocks to hiring internationally-trained professionals
  • Make the Caregiver Tax Credit refundable, tax-free, and paid throughout the year

Our thoughts: We support giving all workers a living wage, paid sick days, and benefits. Repealing Bills 124 and 106 would improve compensation and working conditions for PSWs, as would amending employment standards legislation. Wages of $25/hour, along with better working conditions, would go a long way to expanding the pool of PSWs. However, it’s not always clear which other recruitment and training programs and incentives apply to PSWs, particularly those working in home and community care. In addition, although the Ontario Caregiver Tax Credit would be refundable and tax-free, tax credits favour only those who can spend first and recover costs later.

The New Democratic Party (NDP) platform (Strong. Ready. Working for You.) views the “caring sector” as important to its jobs plan. The NDP commits to:

  • Raising the minimum wage to $20 in 2026, with annual $1/hour increases; giving all workers 10 permanent emergency leave days and helping businesses support the transition; giving all workers high quality benefits; strengthening employment law; and removing barriers to unionization
  • Immediately begin hiring 10,000 PSWs and ending further cuts to health care workers
  • Increasing wages and giving PSWs a raise of at least $5 above pre-pandemic levels
  • Repealing Bill 124 and committing to good faith bargaining with the public sector
  • Recognizing foreign-educated workers’ qualifications
  • Instituting a $400/month means-tested provincial Caregiver Benefit Program for family caregivers

Our thoughts: We would like more detail about the strategy for the home and community care workforce and the caregiver benefit program. We commend increasing PSWs’ wages, but a flat $5 still leaves those in the community earning far less than those in other settings. We can, however, interpret references to fair wages, decent work conditions, and good faith bargaining as a willingness to pay community-based PSWs fairly.

The Progressive Conservative Party did not release an official platform, so we are treating its budget (Ontario’s Plan to Build) as a proxy. However, the Legislature hasn’t passed this budget and that the Conservatives, if re-elected, haven’t committed to reintroducing it.

Some initiatives apply to the general workforce. Others directly address recruitment and training. For example:

  • Increasing minimum wage to $15.50/hour; the CARE tax credit (from 2019); and a proposed LIFT Credit enhancement
  • Annual $1B for retraining and upgrading; additional $268.5 million through Employment Ontario for skills training and employment programs; $5 million for Better Jobs Ontario; additional $6.9 million for Women’s Futures; Jobs Training Tax Credit (previously introduced) for retraining; and new Learn and Stay Grant for students in priority programs (such as nursing) to work in underserved communities
  • Ontario Bridge Training Program to connect newcomers to in‐demand jobs in their communities; $15.1 million in Ontario Immigrant Nominee Program for applicants who match Ontario’s labour market needs; and proposed legislation and amendments to reduce barriers to foreign‐credentialed health workers

The Conservatives see adding health care workers as a “… key element of the government’s Plan to Stay Open,” so the budget includes $342 million to add over 13,000 workers, including 8,000 PSWs, along with a proposed investment to make the temporary raises for PSWs permanent.

Our thoughts: As we could expect from a governing party, some initiatives include funds previously spent, some are new investments, and others are “proposed.” It’s hard to know which ones include PSWs; references to “health care professionals,” “foreign-trained workers,” or “labour market needs” don’t tell us. Also, even if PSWs receive the “proposed” increase, if those in the community still earn less, they won’t stay in those jobs.

Our conclusions: All parties recognize the importance of PSWs. They aren’t as clear about how they will pay and support those who provide care in homes and communities. Will they earn as much as those in hospitals and long-term care homes? Until we can give them the pay and working conditions they deserve, we will keep losing them. We’ve added our thoughts and questions. You may have others of your own. Ask them when you can.

Now it’s up to you.

Ask, think, and then vote!