The Highlights and Lowlights of Ontario's 2021 Budget

On the day of Ontario's budget release, CLAC breaks down where it hits and misses on healthcare

The Ontario provincial budget includes significant investments into senior care under the heading "Fixing Long-Term Care." Overall, the budget serves up a strong response to the public’s mounting outrage to the conditions faced by those working and living in the long term care (LTC) system.

Most of the key spending commitments were announced gradually over the past week, and a summary of the major hits and misses can be found below. As always, if you have questions about these or any other developments, please contact your CLAC representative.

Temporary Wages for PSWs – Miss

Mostly notable among the budget announcements is the promise to extend the $3 per hour wage adjustment for personal support workers (PSWs) to June 30 and that the province will continue to review wages. This is welcome news for PSWs who are still working under emergency order conditions and for whom collective agreements are, in part, suspended.

But as a temporary measure targeted to only one classification of worker, it fails to recognize that all workers in long term care have endured incredibly challenging working conditions. In August, Premier Doug Ford acknowledged that these workers were “grossly underpaid” and that his government was “going to come up with a solution to help these people.” This temporary pay premium fails to live up to that promise.

CLAC responded swiftly to the news last week, saying we need more than a band-aid solution.

Beds, Beds, Beds – Hit

The province will be investing $933 million into 80 new long term care projects, including new builds and much-needed renovations of older facilities. During the pandemic, older homes, most of which are owned by for-profit operators, were particularly hard hit. This funding will generate 7,500 new beds and upgrade 4,100 more as the province continues to work toward its commitment to build 30,000 new beds by 2028. 

Four Hours of Care – Hit

Although announced in 2020, today the province committed $4.9 billion over four years to support the move toward a daily standard of four hours of hands-on care per resident, per day. This amounts to a 45 percent increase in nursing and personal (PSW) care hours and will cause a seismic shift in working conditions for frontline workers in long term care.
 
Staffing Task Force and Training Incentives – Hit
 
As frontline workers know all too well, staffing in long term care was in a crisis state before the pandemic. The staffing shortage contributed to the spread of the virus, as operators were forced to turn to agency and temporary staff to contend with outbreak conditions and single employer requirements.
 
With 30,000 new beds and a commitment to move to four hours of hands-on care per day, the province will need tens of thousands of new workers to keep up with the demand. To assist with that effort, a 16-member Staffing Supply Accelerator Group was struck last week and has been charged with four priorities:

• build an earn-as-you-learn PSW learning pathway that will include on-the-job education, on-site training, and microcredentialing;
• create bridging opportunities for PSWs who want to become registered practical nurses (RPNs) and for RPNs who wish to become registered nurses (RNs);
• increase enrolment and accelerate completion of existing training programs in support of the long term care workforce; and
• remove barriers to enable more internationally trained professionals to become qualified to practice in Ontario.

This comes in addition to another recent investment of $115 million to cover the tuition cost for as many as 6,000 PSWs.

While these initiatives will not provide an immediate fix, we are pleased that reducing education barriers to becoming a PSW or RPN are a focal point of these long term care staffing strategies. As CLAC has previously noted, a person on path to become a PSW or RPN should receive as much support from the province as those apprenticing to become electricians and carpenters. These announcements suggest that those concerns are being heard.

WSIB – Miss      

Completely ignored in this budget is any attention to Workplace Safety and Insurance Board (WSIB) coverage for retirement and group home workers. As COVID-19 has highlighted, workers in these sectors are exposed to the risk of workplace injury and illness because they are not protected by the same level of workplace insurance coverage as most workers in Ontario.

CLAC has been loudly calling on the province to extend WSIB to all frontline workers, and the failure to address it in this budget—and in doing so ignoring the recommendations of the province’s own 2020 WSIB operational review—is a big miss.