Ontario long-term care statute combines 3 acts but no 'revolution', critics say.

Ontario's 618 long-term care facilities will be governed by one statute, replacing the three laws which have governed these facilities for many years. The proposed Long-Term Care Homes Act will replace the Homes for the Aged and Rest Homes Act, Nursing Homes Act and the Charitable Institutions Act, and bring the facilities governed by these laws under one Minister, the Ministry of Health and Long-Term Care. (Formerly, the community services ministry regulated the charitable institutions.) "This is hardly the 'revolution' the health minister George Smitherman promised us three years ago," says Leah Casselman, President of the Ontario Public Service Employees Union. She called it mostly a formalization of policies that have already been put in place. The union and others complain that the new Act fails to set minimum staffing standards for long-term care homes.

The Act will enable the Ministry to:

* provide community services for people in their own homes and in other community settings;

* provide support and relief to relatives, friends, neighbours and others who provide care for a person at home;

* improve community services and to promote the health and well-being of persons requiring such services;

* arrange the management and delivery of community services, the importance of a person's needs and preferences;

* integrate community services that are health services with community services that are social services in order to facilitate the provision of a continuum of care and support;

* provide a framework for the development of multi-service agencies;

* promote equitable access to community services through consistent eligibility criteria and uniform rules and procedures;

* promote the effective and efficient management of human, financial and other resources involved in the delivery of community services;

* encourage local community involvement including volunteers, planning, co-ordinating, integrating and delivering community services and in governing the agencies that deliver community services;

* promote co-operation and co-ordination between providers of community services and other health and social services; and

* ensure the co-ordination of community services provided by multi-service agencies with those services offered by hospitals, long-term care facilities, mental health services, health care professionals and social service agencies, and to promote a continuum of health and social services.

Ontario Association of Non-Profit Homes and Services for Seniors welcomes the new legislation but complains that the statute does not contain a strong statement of support for the not-for-profit sector. OANHSS wants the legislation to commit the province to preserving, protecting and promoting not-for-profit long-term care. "This is needed because of the increasing imbalance in the system and the loss of choice such a shift entails lasting enhancements to the system."

The Ontario Government Employees union is urging the government to amend the proposed Act and introduce a minimum staffing standard of 3.5 hours of care per day, per resident--a recommendation widely agreed upon by labour organizations, seniors' advocacy groups, and the Ontario Health Coalition. The union is also concerned the Act does little to stem the shift to for-profit beds in the province.

The Ontario Nurses' Association says new legislation is missing key elements that are essential to safer long-term care environments: minimum staffing standards, improved working conditions and adequate transparency and accountability regarding how public funds are being spent.

"Many of the residents in long-term care are in need of complex nursing care," ONA President Linda Haslam-Stroud said. Some facilities have just one registered nurse responsible for the care of 200 or more residents, and this is not enough staff to provide this kind of care. These residents require the broader skill set that registered nurses bring, and without legislating minimum staffing requirements, care is not going to improve.

The proposed Long-Term Care Homes Act will include:

* promotion of zero tolerance of abuse and neglect of long-term care home residents;

* whistle-blowing protection for staff, residents and volunteers who report abuse or neglect;

* requiring that a registered nurse be on duty in the home 24 hours a day, seven days a week;

* restrictions on the use of restraints;

* definition of licence terms for long-term care homes of up to 25 years;

* revocation of licenses in cases of non-compliance.