Proposed Reforms to Ontario’s Long-Term Care Legislation

By Jo-Anne Pickel

The Ontario legislature will soon begin third reading of the Bill 140, the Long-Term Care Homes Act. The Standing Committee on Social Policy held public hearings into the Bill and recently reported back to the legislature with an amended version of the Bill.

Bill 140 seeks to repeal the Nursing Homes Act, Homes for the Aged and Rest Homes Act, and the Charitable Institutions Act and replace them with the Long-Term Care Homes Act, 2006. The new Long-Term Care Homes Act includes a number of provisions that are aimed at enhancing resident care, as well as the enforcement of standards, and accountability of long-term care homes. The Bill includes the following provisions:

• Enhanced Residents’ Bill of Rights;
• Provisions concerning the prevention of abuse and neglect, including a duty on any person to report abuse and neglect;
• Whistleblower protection for those who report abuse and neglect;
• Requirement that at least one registered nurse be on duty and present in a home at all times;
• Provisions aimed at restricting the use of restraints to circumstances where it is necessary and with appropriate safeguards; and
• Provisions seeking to improve enforcement and compliance.

During the Committee’s hearings a number of organizations and unions were critical of the Bill and recommended various amendments including:

• Legislating minimum staffing standards and levels of resident care;
• Defining what constitutes abuse and neglect within the legislation rather than in the regulations;
• Expanded whistleblower protection that would cover disclosures to media or elected representatives;
• Improved health and safety standards and working conditions for long-term care staff;
• Strengthened inspection and enforcement mechanisms;
• Greater transparency and accountability of long-term care homes; and
• Explicit commitment to preserving and promoting the not-for-profit delivery of long-term care.

As well, several advocacy organizations and unions have stressed that any reforms to the long-term care sector will fail to meet their objectives unless accompanied by sufficient, consistent and predictable funding for the long-term care system.

The Committee’s amended version of the Bill addressed some, but not all of these concerns. The following are some of the more significant amendments to the Bill:

• Instead of legislating minimum staffing and care standards, it appears that these matters will be left to government regulations. A provision was added requiring every licensee of a home to ensure that the home meets the staffing and care standards provided for in the regulations;
• All homes will be inspected at least once a year. Exceptions to this requirement for certain classes of homes and homes recognized as having a good record of compliance were removed.
• The preamble to the Bill was amended to include a statement of the government’s commitment to the promotion of the delivery of long-term care home services by not-for-profit organizations; and
• The range of fines that may be imposed on a director or officer of a non-profit home for failing to ensure compliance with the Act was reduced. The fine for directors or officers in the for-profit sector is a maximum of $25 000 for a first offence and a maximum of $50 000 for a subsequent offence. The fine for directors or officers of non-profit homes is not less than $50 and not more than $1000.

After passing third reading, the Bill will receive Royal Assent and become law. Because of the broad scope of the Bill, it is likely that certain of its provisions will not come into force immediately upon Royal Assent but will instead be proclaimed into force at a later date.