441-00612 (Health)

As we have seen throughout this pandemic, vulnerable populations have been greatly affected by the consequences of this public health crisis. COVID-19 has resulted in tragedies in long-term care facilities and nursing homes right across the country, and exposed long-standing issues affecting the sector.

The Government of Canada is committed to supporting Canadians, including seniors, through the development of policies, programs, and initiatives that promote the health, wellbeing, and quality of life of older adults, and through addressing issues in long-term care.

The provision of health care services, including long-term care, falls under the jurisdiction of the provinces and territories. Provinces and territories are also responsible for the establishment and management of hospitals and other facilities, including nursing homes. While a provincial responsibility, the Government of Canada is working collaboratively with provinces and territories to improve the quality and availability of long-term care, and to support training and better wages for personal support workers. The Minister of Health’s most recent mandate letter reiterates the Government’s commitment to ensuring seniors get the care they deserve. This commitment builds on past efforts to support long-term care throughout the COVID-19 pandemic.

To address significant challenges revealed during COVID-19, in the 2020 Fall Economic Statement, the Government of Canada announced the creation of a new Safe Long-Term Care Fund. This fund has transferred $1 billion to the provinces and territories to protect people living and working in long-term care. Provinces and territories are able to use this money to improve infection prevention and control in facilities, including to assess infection prevention and control readiness, improve infrastructure such as ventilation, and address workforce gaps, including hiring more staff or raising wages.

In addition, Budget 2021 announced a further $3 billion investment over five years, starting in 2022-23, to support provinces and territories in their efforts to ensure standards for long-term care are applied and permanent changes are made. This funding will help support workforce stability, including through wage top-ups and improvements to workplace conditions (e.g., staff to patient ratios, hours of work) and strengthened enforcement (e.g., enhanced inspection and enforcement capacity, quality and safety improvements to meet standards), including through accreditation and regular inspections. The Government of Canada will work collaboratively with provinces and territories to flow this funding as part of our collective efforts to make sure that seniors and others in care settings live in safe and dignified conditions.

The Government of Canada has also responded to COVID-19 in long-term care facilities in a number of other ways:

• $740 million to provinces and territories for vulnerable populations, including those in long-term care, as part of the Safe Restart Agreement in 2020.
• Workforce supports from the Canadian Armed Forces and Canadian Red Cross in long-term care facilities
• Public Health Agency of Canada Guidance on infection prevention and control and patient care in long-term care / home care during the pandemic.
• Enhanced supply and coordination of personal protective equipment
• Procurement and coordination support for rapid testing and vaccines
• Funding for Healthcare Excellence Canada’s LTC+ program, to share best practices across long-term care facilities and seniors’ residences.
• Program coordinated by Employment and Social Development Canada for training and work placements for personal support worker interns.

The Government of Canada also welcomed the news that the Health Standards Organization and the Canadian Standards Association (CSA Group) are conducting an independent process to develop new national standards for long-term care. Both organisations have conducted extensive public consultations, completed a 60-day public review of their draft long-term care standards, and expect to release the final standards by January 2023. This is an important step to improving care for seniors that will set the bar higher for safe and respectful care in these facilities.

The Government of Canada is supporting research and innovations to develop alternatives to traditional long-term care. In 2018, the Government of Canada invested $75 million for the Healthy Seniors Pilot Project in New Brunswick, to fund a range of applied research initiatives until March 2025 to better support seniors in their homes, communities and care facilities, while promoting healthy aging. The priorities areas of this project are:

• Improving social and built environments;
• Using community approaches to reduce health inequalities;
• Increasing independence and promoting healthy lifestyles;
• Developing innovative care pathways; and
• Supportive technology to foster healthy aging.

Projects are ongoing, and knowledge resulting from the Healthy Seniors Pilot Project in New Brunswick will be shared with jurisdictions across Canada.

The Government of Canada committed $90 million until March 2025, to the Age Well at Home initiative announced in Budget 2021. This new initiative will provide funding for seniors-serving organizations to pilot how volunteers can be leveraged to provide practical assistance with everyday tasks such as meals, housekeeping, and yard work to low income and otherwise vulnerable seniors in their communities to help them stay in their homes and communities as long as possible. Funding will also be available for regional and national projects to expand services that have already shown results in helping seniors stay at home. Age Well at Home will complement provinces and territories’ efforts by generating lessons learned about mobilizing seniors-serving organizations and volunteers to support seniors who want to age at home.

The 7-year National Research Council Aging in Place Challenge program was launched in April 2021 and aims to support older Canadians’ choice to age in place within their own homes and communities through technology and innovation.

Over the last five years, the Government of Canada invested over $153 million in research related to health care and services for aging individuals. In September 2020, Healthcare Excellence Canada and the Canadian Institutes of Health Research, in collaboration national and provincial partners, launched the Implementation Science Teams – Strengthening Pandemic Preparedness in Long-Term Care funding opportunity. This led to the investment of a total of $3.4 million to support 22 research teams as they collaborate with long-term care homes to support evidence-informed implementation, evaluation and sustainability of promising practice interventions and policies designed to improve pandemic preparedness within long-term care.

The Canadian Institutes of Health Research also recently launched The Transforming Health with Integrated Care (THINC)research initiative, which aims to improve our understanding of how to implement, evaluate, and spread and scale evidence-informed integrated care policies and interventions that encompass intersectoral collaborations within and beyond the formal health care delivery system to advance health equity. The THINC Initiative is currently accepting applications for its Implementation Science Teams funding opportunity and Policy Research for Health System Transformation funding opportunity both of which include aging in the right place as a research area. Additionally, prior to launching THINC, the Canadian Institutes of Health Research funded a suite of catalyst grants – Quadruple Aim and Equity Catalyst Grants - to mobilize the research community and the evidence base. Two relevant research areas within this funding opportunity were long-term care and primary, home and community-based care focused on older adults. Examples of several of the funded grants include:

• Workload management through understanding and addressing resident needs in long term care: A study to adapt, validate, implement and evaluate the Synergy Model
• ALLOCATE: A Long-term care Or Community care resource Allocation Tool for Equity
• Implementing and evaluating the ELEVATE innovation: an IntegratEd heaLth carE innoVation to engAge older patienTs and familiEs within their home and community
• Telemedicine in the care of people living with dementia and their caregivers in the rural and urban community of Canada during and beyond the COVID-19 pandemic
• Utilization-Focused Evaluation of Virtual Physician Care Use in Long-Term Care Homes Across a Regional BC Health Authority (ViP LTC Study)

Additionally, the Government of Canada supports knowledge mobilization activities. For example, in January 2021, the Canadian Institutes of Health Research, in collaboration with the Ontario Ministry for Seniors and Accessibility and the Ontario Ministry of Health, hosted a Best Brains Exchange on the regulation of the Ontario retirement homes sector. The purpose of the exchange was to examine the distinction between long-term care and retirement homes, gain deeper understanding of the research and implementation evidence related to the retirement homes model and assess current regulatory models to support future decision-making.

Canadians ultimately want to age at home or in their community, close to family and loved ones. That is why the Government of Canada is providing $6 billion over ten years – starting in 2017 – for provinces and territories to improve access to home and community care services, including palliative care. This investment is helping more Canadians receive the care and services they need so that they may remain at home longer.

Seniors deserve to be safe, respected, and live in dignity. The Government of Canada continues to work in collaboration with provinces and territories to ensure seniors get the care they deserve, foster aging at home, and increase the resilience of long-term care facilities in order to prevent and mitigate challenges, including COVID-19.