The province’s new long term care act could lead to $1 million fines for home operators who don’t follow the rules.

The Ontario Health Care Coalition says the change has “potential” but in the last three years the Ford government hasn’t used the powers it already has to fine operators despite thousands of seniors dying during the COVID-19 pandemic because of poor procedures and lack of care..

Rod Phillips, the minister of long term care, introduced the legislation Thursday and said in a news release “the plan is built on three pillars: staffing and care; accountability, enforcement, and transparency; and building modern, safe, comfortable homes for seniors.”

One of the most anticipated pieces of the legislation is the enforcement of the act. During the pandemic, horrific conditions came to light when the Canadian army moved into long term care homes to help overwhelmed staff. The army wrote scathing reports of conditions where seniors were left in soil diapers, dehydrated and with bedsores from lack of care.

Phillips says the new act will establish new compliance and enforcement tools, including doubling the fines on the conviction of an offence under the proposed legislation. It also introduces a minister’s review of a director’s decision in the licensing process.

“After decades of neglect and underfunding by previous governments, we are fixing long-term care. This legislation, if passed, would protect our progress by supporting our commitments to increase staffing for more hours of direct care, enhance accountability, and build more modern beds,” says Phillips in a news release.

The health coalition, which has been a vocal critic of the government’s handling of long term care particularly during the pandemic, says Ontario already had the authority to issue fines.

“This government has for three years done nothing to hold any of the terrible operators to account despite already having the powers in the act to fine, have provincial offenses charged, suspend licenses, revoke licenses, appoint management to take over the homes and stop new admissions,” executive director Natalie Mehra writes after reviewing the legislation.

“Doubling fines sounds great but the existing hefty fines – $100,000 per home or penalties provincial offenses – have never been enforced and the Ford government has been sitting on them without enacting or using them since it took office.”

Phillips says the proposed act also establishes the commitment for four hours of care by 2035.

Mehra points out that in the legislation it is a “target.

“This was released in December 2020. The plan is back-end loaded to the last two years, after the next provincial election when there is little way for advocates to hold them accountable for it,” she writes. She writes it is not clear how the target could ever be enforced.

The province also plans to improve the Residents Bill of Rights to align with the Human Rights Code. The NDP has long been calling for a guarantee that residents would not be cut off from their family, however it is not clear if the improvement will provide that protection.

Phillips also says homes will be required to do a yearly survey of residents.

Mehra is disappointed the government didn’t do more. “What improvements that could have and should have happened are far more than the changes that they have made,” she says.

The health coalition says the act does call for all direct care to be done by RNs, PRNs and PSWs, but there is not a plan to get there.

And she says, the province did nothing to encourage a move to non-profit long term care homes. The health care coalition has been advocating for non-profit care.

“They have dropped the requirement that the government promote the delivery of long-term care by non-profit organizations. They added in “and mission driven” which are weasel words for for-profit owned facilities,” Mehra writes. “There is no definition of mission driven in the new Act.

“It is a gaping loophole that allows all the for-profits through, and of course we already know that the Ford government is mid-stream in awarding thousands of new beds to the same for-profit chains. This is a major loss and is not in the public interest.”

Mehra is also disappointed the government didn’t address the issue of absentee medical directors – the physicians assigned to the home to provide care who are not on site.

“Poor care, lack of accountability were major problems exposed in the pandemic and long predated the pandemic. There is no improvement — no change — in the language here.”