The province's decision to establish a team of investigators who can lay provincial charges against long-term care operators or workers is getting mixed reviews from advocates.
Minister of Long-Term Care Stan Cho announced on Monday the launch of a 10-person investigations unit that would be supported with a $72-million investment.
"Empowered as provincial offences officers, their specialized training will allow investigators to lay provincial charges for the 11 offences under the Fixing Long Term Care Act related to failure to protect residents from abuse or neglect, repeated or ongoing non-compliance, failure to comply with inspectors orders, suppressing and or falsifying mandatory reports and negligence of corporate directors," Cho said at Queen's Park, surrounded by the new investigators.
He said the establishment of the unit was part of the government's efforts to "increase accountability, enforcement and transparency."
The investigators' training, which spanned 19 weeks, included in-class training, self-study and in-the-field experience, with the government saying it covered "all aspects of the inspections program, the relevant legislation and regulation, investigative techniques such as interviewing, search warrant and report writing, as well as court procedures."
The government said that while inspectors target non-compliance under the legislation, the investigators will "determine if there are grounds that an offence under the Act has been committed, which if prosecuted could result in fines and/or imprisonment."
Fines could range from around $200,000 for first offence and go up to $400,000 for repeat offences, said Mike Moodie, director of the ministry's inspection branch, though imprisonment is also possible. Moodie, who is one of the new investigators, said a charge could target either an individual or the operator, including licensees or directors.
"Up until now our ministry inspectors were limited in how they could attempt to correct non-compliance. Thus, this new unit and its enhanced powers is a game-changer for what is already the toughest long-term care inspection and enforcement regime in Canada," said Cho. "It will also act as a proactive deterrent to keep any potential bad actors in check. It won't take long for word to get out. You do not want one of these investigators at your home."
Cho's announcement came on the same day court hearings began for residents and families who say long-term care homes failed to keep residents safe during the pandemic and are seeking to have a class-action lawsuit certified against hundreds of homes.
Jane Meadus, a lawyer with the Advocacy Centre for the Elderly, said she "absolutely welcome(s)" the launch of this unit, noting that while legislation has allowed for provincial offences for many years, "there hasn't been any ability for the inspectors to enforce that."
"It's definitely a long time coming, it's something we've been pushing for," Meadus said.
She said the new investigators are particularly important when it comes to abuse and neglect.
"Failure to protect our residents from abuse or neglect is an offence under the act and it has been, but the problem is that it hasn't lent itself very well to orders and things like that," she said. "There's homes that have repeated situations where they're not preventing abuse, not doing the right thing ... and so that doesn't protect the residents."
Meadus said they didn't see charges laid during COVID despite hearing about "horrific situations," and that one of the reasons was that inspectors weren't able to.
She now expects to see charges being laid, though said she is "wary."
"I'm always very wary because we hear a lot about things that they're going to change, and then we see them do the exact opposite," she said. "We'll wait to see is whether or not this section is utilized to the full extent that it can be."
Vivian Stamatopoulos, a long-term care advocate and Associate Teaching Professor at Ontario Tech University, said if the government was "trying to take negligence" seriously, it would have revoked Bill 218, "not keep a bill that enabled these bad actors to actually get away with higher levels of negligence."
She was referring to legislation the Ford government passed in 2020 to protect long-term care homes and others from COVID-related lawsuits except in cases of "gross negligence."
Stamatopoulos said the allegations referred to by the minister have been ongoing at long-term care homes for decades.
"He's talking about the potential allowance now of imprisonment for bad actors, but give me a break, they haven't done it yet and you could have, by the way," she said. "So forgive us if we sit here, very pessimistic that really anything is going to change when you had the power all along."
She said to improve the sector, the government needs to adequately address pay and working conditions.
"Those two things alone are going to reduce so much of the preventable harm and the negligence that is occurring in these facilities," she said.
The government has committed to boosting the average amount of direct care provided to residents by registered nurses, registered practical nurses and personal support workers to four hours per resident by March 2025 with a $4.9 billion investment. But Stamatopoulos said there should be a minimum at every home instead.
"An average is useless because it means that the good homes will have the higher averages and will effectively obfuscate and hide the data of the ... worst of the worst bad actors," she said.
Meanwhile, Donna Duncan, CEO of the Ontario Long Term Care Association, voiced her support in a statement included as part of the government's announcement.
"Ontario’s long-term care homes who are providers of affordable housing and specialized care are committed to the well-being of their residents and providing high-quality care. There is zero tolerance for abuse," Duncan said. "Major transformation is happening across the province as homes seek to replace older buildings and create new models of emotion-focused and person-centred care. We look forward to the province’s continued support in addressing long-standing systemic issues including a significant staffing shortage across the health care system and the need to rebuild Ontario’s older long-term care homes."
