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Results: 1 - 15 of 190
Jennifer Lyle
View Jennifer Lyle Profile
Jennifer Lyle
2019-06-04 16:03
Thank you.
My name is Jennifer Lyle. I am the CEO of SafeCare BC and one of the founding members of NASHH, the National Alliance for Safety and Health in Healthcare. I am here today on behalf of CALTC, the Canadian Association for Long Term Care, as the NASHH-CALTC liaison.
CALTC is a national organization composed of provincial associations and long-term care providers that publicly deliver health care services for seniors across Canada. It also represents care providers who deliver home support services and care for younger adults with disabilities.
The National Alliance for Safety and Health in Healthcare, NASHH, is a national-level collaboration of workplace health and safety associations that works with health care organizations and workers across Canada to promote safer, healthier workplaces.
Mr. Chair, honourable members, our continuing care sector is in a state of crisis. Our care providers are understaffed, under-resourced and under incredible pressure to provide quality care to an increasingly complex population. This set of factors creates a toxic mix that not only leads to burnout but also to workplace injuries.
Consider the numbers. Nationally, time lost claims due to violence in health and social services have increased by over 65% in the past 10 years. In B.C. alone, health and social services account for over 60% of all workplace violence claims among major industry groups, according to WorkSafeBC, and yet this sector amounts to only 11% of the total provincial workforce of this group.
Overall, violence is one of the leading causes of workplace injuries in B.C.'s continuing care sector, and B.C. is not unique. Across Canada we all face the same challenge: how to address the root causes of workplace violence in health care.
In order to address the root cause of an issue, you first need to identify and understand it, and that leads me back to my earlier remarks about being understaffed, under-resourced and under pressure.
To understand the pressure care providers are under, you need to understand how those relying on the continuing care sector have changed over the past decade and where we're headed. Today 62% of long-term care and 28% of home care clients have some form of dementia, a number that's expected to increase. By 2031, over 937,000 Canadians will have dementia. That's an increase of 66% from the present day.
In addition to the trends we see around dementia, we're also seeing an overall increase in complexity of the needs of those being cared for in a community setting as we continue to move away from an institutional model of care. This includes people with psychiatric disorders and addictions who may also now be facing dementia as they age. These things are all risk factors for violence.
Violence is not a foregone conclusion in any of these instances, but too often our system puts care providers at risk because of how care is being delivered. That brings me to my next point—being understaffed.
In a recent survey conducted by SafeCare BC of the continuing care sector, 95% of respondents indicated that their organization was short-staffed. You might wonder what staffing shortages have to do with violence; in that survey, we asked. We asked how staffing shortages impact care provider safety, and what they told us is that staffing shortages lead to rushing, to fatigue, to feeling like you don't have time to ask for help. All of these things put care providers at risk.
Not only that, but when you're working with vulnerable populations—for example, seniors with dementia—it's vital that you have the time to understand their needs and their triggers, yet it's this time that's in such short supply for our care providers because of chronic staffing shortages.
Not only that, but just as staffing shortages lead to workplace injuries, workplace injuries lead to staffing shortages. Take B.C. as an example. In 2018 the equivalent of nearly 650 full-time positions were lost because of workplace injury. Imagine an organization—or several organizations, for that matter—losing that number of full-time employees. Imagine the impact. That's the cost of workplace injuries.
Beyond the numbers, there is the human toll. There is the care aid who is sexually assaulted by a home care client with dementia. There is the nurse who is punched in the jaw by a senior suffering from delirium. There is the personal support worker who doesn't know how she could possibly face going back to work. Finally, there is the senior whose care is impacted because the person they rely on, the person they have developed a relationship with, is no longer available to help because of workplace injury.
What can be done? One option is a renewed national health human resource strategy—one that incorporates a seniors care lens and a workplace safety lens, one that reflects the changing demographics of our society and the shift towards community-based care, and one that places both the physical and the psychological well-being of our care providers at its centre, because ultimately we're talking about people, people who are trying to do the very best they can with what they have.
That brings me to my last point: being under-resourced. This is a big topic, so for brevity's sake I'll focus on three key areas: infrastructure, education and data.
From an infrastructure perspective, research has proven the power of design, specifically dementia-friendly design. Dementia-friendly environments support the person with dementia and minimize the risk of responsive behaviours. Put simply, dementia-friendly environments are not only associated with better care, but they're also safer for the care providers.
However, we face significant challenges across the country. CALTC estimates that 40% of care homes need significant renovation. In B.C., the average age of a care home is 30 years. A lot has changed in 30 years. Our understanding of dementia and the power of smart design has increased significantly, and at the same time, seniors entering care homes have changed. Gone are the days when a senior would drive herself to the care home and unpack her own suitcase. The care homes in which these seniors live are no longer designed for their needs, and that absence of design affects both the quality of their lives and the safety of the care providers who support them.
The federal government has an opportunity to make an impact in this area. One opportunity is to build on the $6 billion in community health investments made in the Investing in Canada plan to include investment in care home infrastructure, because, make no mistake, these are not care facilities or hospitals: These are people's homes. Such investments could be used to incorporate the last three decades' worth of research and knowledge into retrofits and new builds that better support safe care.
Our care providers are also under-resourced when it comes to education. Presently there's no national standard on workplace safety core competencies for health care workers, and there's also significant variation between health care occupations as to what core competencies are required.
Part of our work at SafeCare BC has been focused on making inroads with this group for that very reason. Working in continuing care is a high-risk activity, and therefore all health care providers should be required to exhibit baseline workplace safety competencies prior to entering the field, yet we see that this is not the case.
Part of this stems from a lack of awareness, and therein lies opportunity. There is opportunity for a public-facing campaign to raise awareness of the issues of violence in health care and the tools and strategies available to mitigate it. There's also an opportunity to address the lack of standardization in education, such as by establishing a national task group to create guidelines on core competencies and workplace safety for care providers.
Finally, there's data. Data is how we make informed decisions. It's as much a resource as physical infrastructure, yet when it comes to national-level data, we struggle. There is no standardized national definition of “the health care industry”, and when it comes to workplace injury data, each province's workers' compensation board codes workplace injury data differently. That makes it difficult to do an apples-to-apples comparison of the data and identify national trends.
In this challenge lies opportunity again, such as taking a leadership role to create a national-level workplace safety data benchmark, as was done similarly in previous pan-Canadian projects such as the Canadian medication incident reporting and prevention system.
Understaffed, under-resourced and under pressure—there's no doubt that these are big challenges, but there is an opportunity for the federal government to drive positive change, and change we must. The future of the health care system depends on its people. If we don't take care of the care providers, who's going to take care of us and our loved ones when we need it?
Thank you.
Kulvinder Gill
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Kulvinder Gill
2019-05-16 17:01
The majority of Ontario's front-line physicians are actually in a private practice and have no benefits. If they do take time off work, not only are they still covering the overhead for their staff but they are also still covering the overhead for their clinic. Once they do come back, all the patients they had cancelled need to be rescheduled. Oftentimes, physicians have an increased burden once they return to work.
We also previously had OPIP, the OMA priority insurance program, which was very minimal coverage through the Ontario government. However, due to escalating cuts, the Ontario government has not only cut mental health coverage, but now it's only a few hundred dollars a year for each physician. There are new graduates coming into the program every single year, but the government hasn't increased funding accordingly, so there's a smaller pool being split among a greater number of people.
View Brigitte Sansoucy Profile
NDP (QC)
Thank you, Mr. Chair.
Mister Minister and Madam Minister, thank you for being with us today for our study on votes.
I was very interested in what you said about the anticipated increase for the new horizons for seniors program. I can actually see the benefits of this program in the riding I represent. However, I’m most interested in what is not in the votes.
I was in the House last week when we debated Motion M-201 for an hour. I was angry. I felt that wanting to take credit for a beneficial reform has its limits. In the past year, I have tried four times to introduce a motion that says essentially the same thing. Four times, what we saw earlier in that meeting happened again. The Liberals, who have the majority on our committee, asked for the debate to be adjourned so that we could not discuss it.
In the past year, our committee could have done the study on the 15 weeks of EI sickness benefits. Four times, the Liberals were not allowed to vote for the motion.
In recent months, we have studied benefits for bereaved parents, a topic we discussed earlier, episodic disabilities, and precarious employment. Each time, witnesses have told us that the employment insurance program needs to be reformed and the sickness benefits improved. Most organizations, most of the public and most unions agree that action must be taken now. There is a broad consensus. In the past year, the committee could have taken action and conducted that study.
You met with Marie-Hélène Dubé, who collected 600,000 signatures. Yesterday, I held a public session in my riding on this issue, which was very popular. The issue affects people. Last week, I asked you about the story of William Morissette, from New Brunswick, who, in addition to fighting cancer, has to fight the government for his benefits. That's outrageous.
This reflected the many accounts we heard from people in similar situations who have exhausted the 15 weeks of sickness benefits to which they were entitled. Some sick people, like William Morissette, are turning to crowdfunding to survive. This can be seen across the country.
Figures from your department indicate that 150,000 people need more than 15 weeks. Let me stress that we are talking about 150,000 people who have qualified for employment insurance. The distinction is important. As witnesses from your department who appeared before our committee indicated, 6 of 10 people do not qualify for employment insurance.
Mr. Minister, in 2016, you and the Prime Minister said on, Radio-Canada’s Téléjournal, that employment insurance sickness benefits should be improved.
Sick people are looking forward to hearing what you intend to do about those benefits. So let me ask my question again. Mr. Minister, when exactly will you be improving EI sickness benefits?
View Jean-Yves Duclos Profile
Lib. (QC)
Thank you, Ms. Sansoucy.
You know how much I like having these conversations with you. You are a member of Parliament who listens to everyone suffering and struggling to make ends meet, for reasons totally beyond their control in all cases. Not only do you listen, you can also relay the messages you hear, and that I hear too.
As I just said, we know full well that the employment insurance system is fundamental to the economic security of millions of families in Canada. There will always be more to do and always more to say.
However, over the past few years, we have introduced two new special benefits. There is the shared parental benefit, which gives an additional five weeks to families who need some time to take care of their—
View Guy Lauzon Profile
CPC (ON)
In a past life, I was in a management position in the public service. Out of curiosity, what would your sick-time rate be?
Heather Lank
View Heather Lank Profile
Heather Lank
2019-05-02 13:06
I do not have the answer to that off the top of my head, in terms of the number of sick days, on average. What kind of information are you interested in, Mr. Lauzon?
View Guy Lauzon Profile
CPC (ON)
I remember going into an office where we had a 14% sick-leave rate. When I went to seek more money from my seniors, they said, “Well, maybe you should do something about your sick rate.” All we did was mention to the employees that when they don't come to work, their colleagues have to pick up the slack. Surprisingly, our sick rate went down to 6%.
Through economy, could you not come up with 3.9% on the size of that budget? That doesn't seem like a terrible amount of.... Have you looked at that?
Heather Lank
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Heather Lank
2019-05-02 13:07
For sure, we have looked at it. We have looked very hard at it. Indeed, when I came into this role, I was very clear with my management team that any increases to our budget required a robust business case, after we looked to see if we had the capacity internally.
We have not put in anything beyond what we feel must be there, unless we cut service. Ultimately, that's what it comes down to. In order to provide librarians to you in the branches, and to serve through the various avenues we spoke about this morning, we need these resources.
If we had to cut—
Heather Lank
View Heather Lank Profile
Heather Lank
2019-05-02 13:07
We don't want to cut service to you, is what it comes down to. On the sick leave—
Heather Lank
View Heather Lank Profile
Heather Lank
2019-05-02 13:08
Can I just make one comment about sick leave—
Heather Lank
View Heather Lank Profile
Heather Lank
2019-05-02 13:08
—because I think it's really important. In my experience—
Heather Lank
View Heather Lank Profile
Heather Lank
2019-05-02 13:08
—on the Hill, our bigger problem is presenteeism, rather than sick leave. I cannot tell you the level of dedication of the library staff to be there for you when you are here, no matter how awful they are feeling. Sometimes, we have to tell them, “You must stay home,” because they want to be here for you.
While I don't have the numbers, and I'm happy to come back to you with that, I think the level of dedication of the library staff is extraordinary, and I'm extremely proud of the fact that they make themselves available to you at every opportunity.
View Brigitte Sansoucy Profile
NDP (QC)
Thank you very much, Mr. Chair.
Let me first make up for something I forgot, and thank each one of you for contributing to our committee’s work.
Mr. Stapleton, Mr. Prince, I agree with you that, if there were a guaranteed minimum income, we would be asking all these questions very differently.
I would like to go back to the longer sickness benefit payments that could result if the calculation were by day of episodic disability, not by week. Along the same lines, we talked earlier about employment insurance. Those figures are based on the fact that 60% of those who contribute to the employment insurance fund are not eligible for benefits. Another obstacle to the eligibility, which also applies to people with episodic disabilities, is that prerequisite of a 40% reduction in income. If we do an analysis by gender, we see that, right off the bat, 34% of women and 52% of men are ineligible for benefits. So, in my opinion, we first have to solve the eligibility problem. What is your opinion?
John Stapleton
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John Stapleton
2018-12-04 10:23
I'll start.
EI is a program that has a threshold of eligibility, and if you don't meet the threshold of eligibility, then you're not going to be able to get the benefits.
The reason I started out by mentioning 10 different disability systems, 10 different bureaucracies and 10 different definitions of disability—even multiple definitions within the programs—is that each of these various silos is very interested in what the others pay out.
As Deborah pointed out, she was going to receive benefits from the one, but they're not only interested in the definition, but also the pedigree of the disability. Did it take place in the auto accident, or did it take place on the job, or did it take place somewhere else? There are all these questions that get involved in the essential bureaucracy.
Again, in mentioning the idea of some sort of basic income, if we could somehow combine or disentangle these 10 different bureaucracies that came in at various times with different definitions and different concepts of what a disability is, there has to be, as part of that, at least some sort of reckoning, maybe some massive saving within the system, if we were able to disentangle ourselves from these definitions of pedigree, and each one that overlaps with and deducts from the other.
Going back to Deborah's testimony and the idea of getting CPP, if she finally does get benefits from the Ontario disability support program, then her CPP will be deducted at 100% from those payments.
There's often the idea that the programs, in the end—especially for people who are living in poverty with disabilities and with episodic disabilities—become destitution-based. When they're destitution-based, they're very, very complicated. I think the eligibility requirements, at a minimum, are overly complex.
Michael Prince
View Michael Prince Profile
Michael Prince
2018-12-04 10:26
Before we look at something like a national guaranteed annual income or basic income in our own lifetimes—and in your own terms as MPs—I think we need to look at things like the disability tax credit.
The idea that we do not have right now a clause under the legislation that exempts people from re-examination for permanent disabilities should be low-hanging fruit. CRA should work with medical practitioners and health associations to develop specific criteria for people who have lifelong conditions, and then figure out a way to embed that in the administrative decision processes of the CRA so people are not put through a humiliating and frustrating experience.
That should be at Veterans Affairs, at the CRA, and it should be elsewhere as well.
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