e-3206 (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 (LTC) facilities and nursing homes right across the country.

The provision of long-term care falls under the jurisdiction of the provinces and territories (PTs). The Canada Health Act (CHA) sets out federal requirements for the coverage of insured hospital and physician services that provinces and territories must meet in order to receive their full federal health transfers under the Canada Health Transfer (CHT). As an extended service under the Act, PTs are not obligated to insure LTC, but must cover the cost of physician services delivered at LTC facilities. All PTs have elected to provide additional public funding for long-term care. The Government of Canada will provide a record $43.1 billion in CHT funding for provinces and territories in 2021-22, with funding amounts growing year-over-year. The Government of Canada also announced a onetime $4 billion top-up to the 2020-21 CHT funding, acknowledging the pandemic’s strain on health care systems.

While the CHA establishes broad, national principles that govern the Canadian health care insurance system as a whole, the Act does not set standards for the delivery of specific services, including long-term care, which would go beyond the federal jurisdiction.

In the 2020 Speech from the Throne, the Government of Canada committed to work with provinces and territories to set new national standards for long-term care so that seniors get the best support possible. The Government also committed to look at further targeted measures for personal support workers, who do an essential service helping the most vulnerable in our communities. Canada must better value their work and their contributions to our society.

The government welcomes the news that the Heath Standards Organization and Canadian Standards Association are launching a process to help address the issues identified in long-term care facilities. The Health Standards Organization’s and Canadian Standards Association’s work with governments, stakeholders, and Canadians to develop national standards will help inform our ongoing discussions with provinces and territories on improving the quality of life of seniors in long-term care.

Budget 2021 proposes to provide $3 billion over five years to Health Canada to support provinces and territories in ensuring standards for long-term care are applied and permanent changes are made. The federal government will work collaboratively with provinces and territories, while respecting their jurisdiction over health care, including long-term care. This work would ensure seniors and those in care live in safe and dignified conditions. 

Budget 2021 also proposes to provide funding of $27.6 million over three years for my65+, a Group Tax-Free Savings Account offered by the Service Employees International Union Healthcare, to support incentives for personal support workers, home care workers and essential workers involved in senior care. In addition, the Budget includes $960 million over three years in funding for a new Sectoral Workforce Solutions Program to help sectors design and deliver relevant training, and connect up to 90,000 Canadians with the training they need to access good jobs. This includes sectors like health, including the need for more accredited personal support workers.

This is in addition to the 2020 Fall Economic Statement’s commitment of up to $1 billion through the Safe LTC Fund to support infection prevention and control through making improvements to ventilation, hiring additional staff, and topping up wages. The 2020 Fall Economic Statement also included funding to offer an accelerated training for up to 4,000 personal support worker interns to address critical labour shortages in long-term care facilities and home care.

To date, the Government has been working alongside provinces and territories to address the impacts of COVID-19 in a number of ways:

• The Government of Canada and provincial/territorial governments reached a Safe Restart Agreement in 2020. The Agreement involved investment of over $19 billion in federal funding to help provinces and territories restart the economy over a period of six to eight months, while making Canada more resilient for the future. This included $740 million in funding to support our most vulnerable populations, including infection prevention and control measures to protect those in long-term care, and those receiving home care and palliative care.

• The Public Health Agency of Canada released evidence-informed guidelines to help residents, seniors and health care workers in long-term care homes remain safe and healthy. Infection Prevention and Control for COVID-19: Interim Guidance for Long-Term Care Homes provides recommendations that complement provincial and territorial public health efforts to prevent and control health care-associated infections.

• Complementing this, the Public Health Agency of Canada released new guidance on the care of residents in long-term care homes during the COVID-19 pandemic. This guidance provides health care providers working in long-term care homes with interim advice on important aspects of care for all long-term care residents during the COVID-19 pandemic, and on the timely and safe supportive management of residents with suspected or confirmed COVID-19.

• Up to $3 billion in federal funding has been offered to provinces and territories to support increased wages of low-income essential workers, which can include front-line workers in hospitals and long-term care facilities.

• In collaboration with partners, Healthcare Excellence Canada has launched the LTC+ initiative to spread promising practices in preventing and mitigating the impact of COVID-19 on long-term care and retirement homes. With an additional $6.4 million from the Fall Economic Statement, the goal of the initiative is to better position participating facilities to prevent and manage any future outbreaks.

• Health Canada continues to work with the Canadian Red Cross to support provinces and territories facing outbreaks in long-term care. Specifically, the Canadian Red Cross is recruiting and training paid volunteers in order to support epidemic prevention and control, basic care for long-term care residents and long-term care site administration.

• The Government of Canada has also adapted the Investing in Canada Infrastructure program to respond to the impacts of COVID-19. A new temporary COVID-19 Resilience stream has been created to provide provinces and territories with added flexibility to use existing resources to fund quick-start, short-term projects, including health infrastructure, such as long-term care homes.

These targeted investments are in addition to annual CHT investments of $43.1 billion to provinces and territories, and the $6 billion over ten years for provinces and territories the Government is providing to improve access home and community care services, including palliative care. Although funding is not specifically targeted to facility-based long-term care, this investment is expected to help more Canadians receive the care and services they need so that they may remain at home longer, and also allow the provinces and territories to optimize the long-term care resources at their disposal. 

COVID-19 has exposed a number of issues and challenges in the way we care for seniors in Canada. With an aging population, increasing rates of chronic disease and cost pressures tied to new drugs and technologies, our health system must adapt if it is to deliver better care and better outcomes at an affordable cost.

The Government of Canada will continue to work in collaboration with provinces and territories to address issues in long-term care facilities, in order to help keep seniors safe and improve their quality of life, and ensure seniors and those in care live in safe and dignified conditions.