Have you had to pay $1,570 per month in room and board for a shared room and bath with three other persons with only your bed and a dresser as your personal possessions?
You will by August of this year if you are one of some 60,000 elderly Ontarians residing in a publicly funded long term care facility - including municipally operated homes for the aged and private, for-profit nursing homes.
Just before the Ontario Legislature rose for the summer recess, with public attention focused on the Toronto municipal strike, the Government stealthfully announced that residents would on August 1, 2002 face an increase from $1,354 to $1,567 or $213 per month in user fees or co-payment for basic ward [more than two persons per room] accommodation.
The increase represents a 15.7% jump in the amount residents must contribute towards accommodation costs in these homes. Ministry of Health staff had recommended a typical 1 or 2% increase in March to cabinet but the Tories decided in late June to reject that proposal and instead raised fees in August by 15.7%
The 60,000 Ontarians residing in these homes are an average age of 86 with at least half suffering from dementia or other mental or behavioural disorder and the vast majority requiring assistance with daily activities of life such as dressing, grooming, toiletting and feeding. They are the elderly and vulnerable - predominately women - no longer able to live independently at home.
Until this increase kicks in August of this year, these residents faced co-payment increases linked to the quarterly CPI adjustments in the federal Old Age Security (OAS) and Guaranteed Annual Income Supplement (GAINS) payments. However, OAS or GAINS payments rose only 2.1% between June 2001 and June 2002 providing a maximum monthly increase of only $20 compared to the $213.50 increase in accommodation user charges soon to be levied by the province. The additional costs in excess of the OAS/GAINS payments must come directly from the resident's income or assets or be subsidized through the indignity of means-testing if they cannot afford the basic accommodation rate.
Despite an immediate and ever-growing angry protest from seniors as well as provider organizations [with one city that operates four municipal homes - Ottawa - already declaring it will not implement the increases until September] residents and their families and advocates will be unable to hold the Government accountable until the Legislature re-convenes on September 23, 2002.
Responding to the media about the increases, Premier Ernie Eves, formerly on the board of Canada's largest retirement home corporation before returning to provincial politics, commented that "it's reasonable" to raise some $50 million annually that could be invested into nursing and other long-term services on the principle that "those that can afford to pay more, should". Strange that his new-found logic never applied to the corporate tax reductions or personal tax cuts his government implemented.
In reality, for-profit operators of these nursing homes are most unlikely to sacrifice revenue from the accommodation side (the only area of operation where they are permitted to realize profits) by transferring monies to nursing and personal care (where unspent revenues must be returned to the province).
While the Ontario Tories seem to expect seniors in these homes to subsidize each other, they have been using public funds to subsidize an ever-increasing private, for-profit corporate sector. Out of some 20,000 beds recently awarded in a major expansion of the sector, two-thirds were awarded to for-profit corporations, with the largest number of beds (2,387 being awarded to Central Park Lodges - the nursing home counterpart of the retirement home corporation where Ernie Eves served on the Board.
In an unprecedented approach, both newly licensed and renovated for-profit nursing homes are eligible for a daily amount of funding of $10.35 for up to 20 years (or over $75,000 dollars per bed) to assist with their construction or renovation costs - a public subsidy costing billions as these corporations create or enhance their private capital assets.
Since April 2000, long term care operators were allowed to retain 100% of preferred accommodation revenue (for semi-private or private rooms) that flowed another $47 million of resident fees for accommodation potentially into the pockets of these operators.
Lat year, over $25 million in federal monies from the Medical Equipment Trust intended to re-invest in the technologies of our public medicare system has been directed by the provincial Tories into the long term care sector, including to private, for-profit corporations for the purchase of beds and other fixtures normally provided directly by operators.
Compared to this largesse, what has the government done to ensure adequate provision of nursing and personal care to Ontarians residing in these homes? Since 1993, while patient needs and workloads have steadily increased, while provincial funding has barely addressed inflation. In 1996, the government de-regulated the provision of care, removing a requirement to provide not less than 2.25 hours of care. A report in 2001 funded by the Ministry of Health found Ontario ranked last in 10 jurisdictions in meeting the needs of residents in nursing homes and homes for the aged. Ontario residents received the least amount of nursing and personal care (less than two hours per day); often having a bath only once a week.
In their pitch to the provincial government in advance of the 2002 Budget, both provincial associations representing the municipal homes for the aged and the for-profit nursing homes sought an eventual $25 per day increase in the government’s share of funding on a multi-year basis with an immediate infusion of 50% up front (or an increase of $12.50), and 25% in years two and three.
We need to force the Tories to rescind the resident co-payment increase and ensure proper funding based on resident needs is provided. We need to demand that government make nursing and personal care funding - the hands-on compassionate care that residents are entitled to - is indeed the priority. That also means complete disclosure and accountability by all operators to both government and the public, including the multinational for-profit nursing home firms, for the use of public and resident funds. And that means working to eliminate the for-profit motive in providing care to our most elderly and vulnerable citizens.