IN THE MATTER OF THE HOSPITAL LABOUR DISPUTES ARBITRATION ACT

AND IN THE MATTER OF AN INTEREST ARBITRATION FOR A RENEWAL COLLECTIVE AGREEMENT

B E T W E E N :

CHIPPAWA CREEK AT BELLA CARE RESIDENCE, PARK PLACE SENIORS LIVING

(“the employer”)

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HEALTHCARE, OFFICE AND PROFESSIONAL EMPLOYEES’ UNION, LOCAL 2220, UBCJA

(“the union”)

BEFORE: John McNamee, Chair Harold Caley, Union Nominee E.C. Carla Zabek, Employer Nominee APPEARANCES: For the Employer: Bob Bass (Bass Associates) Ian West Veronica Swartz Christina Cunnington

For the Union: Mark J. Lewis (Counsel) Paula Randazzo (President) Tara Marenchin (Business Representative) Cindy Viele (Bargaining Committee Member) Laura Napper (Bargaining Committee Member) A hearing took place via Zoom on April 21, 2020, following which the parties filed written submissions. The Executive Committee met on June 9, 2020.

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A W A R D

The parties were unable to resolve all of the issues with respect to the contents of a collective

agreement to replace the agreement which expired on December 31, 2018, and therefore referred

to this board the outstanding disputes. There was no disagreement as to our jurisdiction to

decide these issues.

The parties did not agree on a term for the new agreement; however neither of them suggested

that, in the absence of an agreement, the Hospital Labour Disputes Arbitration Act did not apply,

to require a two year term commencing on January 1, 2019 and ending on December 31, 2020.

By way of background, this facility, previously using the name Bella Senior Care Residences

Inc. o/a Bella Senior Care Residence was, at the time when HOPE first secured bargaining rights,

a privately owned, for profit, long-term care facility located in Niagara Falls, Ontario.

Subsequently, during the term of the current collective agreement, in or about June 2019, the

facility was sold to Park Place Seniors Living (“Park Place”). Park Place is a “family owned and

operated” company based in Vancouver. It owns and operates more than 30 seniors’ residences

in British Columbia, Alberta and Ontario. There are approximately 160 residents at the facility.

The union, Healthcare, Office and Professional Employees Union, Local 2220, UBCJA is a

trade union within the meaning of the Labour Relations Act, 1995, that specializes in

representing workers in various health care settings including in long term care facilities. HOPE

was founded in November 2011. Since its founding, HOPE has secured bargaining rights for

groups of employees and now has approximately 3000 members whom it represents in various

bargaining units throughout the Province.

At this facility, the union represents a bargaining unit of service workers that currently includes

167 employees (107 full time and 60 part time (including casual)). These employees work as

cooks, dietary and programme assistants, housekeeping and laundry aides, personal care

providers, and Registered Practical Nurses.

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The union provided Notice to Bargain on December 18, 2018, and the parties met and bargained

throughout 2019, culminating in a No Board Report which issued on November 27, 2019.

THE CRITERIA

The Hospital Labour Disputes Arbitration Act mandates an interest board of arbitration to

consider any factor which it considers relevant, but requires it to include the following five

criteria:

a) The employer’s ability to pay in light of its fiscal situation;

b) The extent to which services may have to be reduced, in light of the decision or

award, if current funding and taxation levels are not increased;

c) The economic situation in Ontario and in the municipality where the hospital is

located;

d) A comparison, as between the employees and other comparable employees in the

public and private sectors, of the terms and conditions of employment, and the nature

of the work performed; and

e) The employer’s ability to attract and retain qualified employees;

The parties also argued that the replication principle should apply, and that we should consider

comparability to other employers and bargaining units, as well as total compensation and

demonstrated need. To that end, they provided the Board with a variety of economic data,

including summaries, and in some cases the text, of memoranda of agreement and arbitration

awards from within, and without, the long term care sector. We have considered all of the

statutory criteria, the economic data, the precedents, and the arguments placed before us.

The employer did not argue that it had an inability to pay. The union did submit that the

employer had had difficulty in attracting and retaining qualified employees.

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ISSUES

Aside from the normal run of issues regarding wage rates and other more commonplace

proposals regarding amendments to the terms and conditions of employment, the union

submitted two proposals which merit separate comment. It asked that, due to the onset of Covid

19, the wages of all employees who work(ed) during the period of declared emergency (which

commenced on March 18, 2020) be paid time and one-half for all hours worked, and that this

amount be increased to double time if the facility became “under outbreak”. The union pointed

out that employees were (are) at substantially more risk than normal of contracting a potentially

fatal disease and/or infecting their family members. Long term care facilities, it pointed out,

were (and still are) the most likely places for the disease to strike and take hold.

Further, as a result of the outbreak and the provincial government’s decision to prohibit

employees to work at only one home during the outbreak, the bargaining unit (which was already

short staffed) was further substantially reduced as many employees chose to work elsewhere,

became infected outside the home, or simply could not or did not attend work by reason of

concern as to the risk of infection.

The employer took the position that this proposal, which was submitted only five days before the

hearing was untimely, and could not be considered by the Board by reason that it exceeded the

Board’s jurisdiction. In light of our conclusions (below) we do not need to deal with this

objection.

The union also seeks a “working short premium” of $2.00 per hour for each hour worked by an

employee when his/her department, classification or function is short staffed.

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Ruling:

Both of these proposals address real issues of concern to employees, and matters which impact

many, if not all, nursing homes. At least, with respect to the Covid 19 issue, the federal and

provincial governments have recognized that they bear some responsibility, and have offered

some compensation. We believe that the various commissions which will be examining the

structure and workings of the entire LTC sector, as well as the provincial ombudsman, should re-

examine this issue and the amount of compensation afforded to employees who continued to go

to work and to take care of our most vulnerable citizens at great peril, not only to themselves, but

their families. We cannot expect employees to put their health and lives at risk without both

adequate safety measures and a reasonable return for the courage and loyalty. We therefore

defer this issue to the government and industry investigatory bodies and commissions charged

with overall responsibility for recommending and implementing change throughout the entire

LTC sector, including the proper treatment of employees.

Although Covid 19 is on everyone’s minds at the moment, the union’s complaints about working

short are equally, if not, more pressing, and the issue poses at least as great a risk as any

pandemic to LTC residents, in addition to over-burdening employees. In our experience,

working with fewer than the appropriate complement of employees is an endemic problem in

nursing homes, and is particularly acute with respect to PSW’s. The union’s proposal for a

premium in working short situations is well justified, but will not solve the problem. The fact is

that not enough people are being attracted into PSW training courses (which take a minimum of

600 hours of classroom and practical experience) in light of the wages they can expect; the

responsibility that they bear; and the exacting and often physical nature of the work. In the

result, we also defer this issue to those bodies which will be (hopefully) charting a new and

better course for the sector, with the strong recommendation that they concentrate on ensuring

that employees throughout the system, including but not limited to PSW’s, are compensated

appropriately in light of their value.

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In the meantime, the parties ought, at a minimum, to work together to try and minimize working

short situations, as well as to track all of those occasions when it occurs. The information so

gathered will, no doubt, be useful to the commissions and other who will be examining the

manner in which the LTC system should be improved.

ORDER

In light of all of the circumstances and submissions, the Board makes the following award. The

parties are therefore directed to enter into a collective agreement which consists of all of the

terms of the previous expired agreement, including any letters of intent or letters of

understanding, except as modified by the following:

1) Term – in accordance with the Hospital Labour Disputes Arbitration Act, January

1, 2019 to December 31, 2020;

2) Wages – All employee classifications

(a) retroactive to January 1, 2019, increase all wage rates by 1.5 percent; and

(b) retroactive to January 1, 2020, increase all wage rates by 1.5 percent;

3) The retroactivity amounts referred to in paragraph 2 above are to be paid by separate check or bank transfer to current employees within sixty days of the date of this award. Persons who worked in the period from January 1, 2019, onwards, but who are no longer employed, will also be entitled to payment of retroactivity. The employer is directed to send a letter within three pay periods of the date of this award to the last known address of each such ex-employee, advising them of their right to retroactivity. Ex-employees will have 60 calendar days from the date of mailing to claim payment. Ex-employees who fail to claim their payments within the 60 day period shall be deemed to forfeit any claim thereto;

4) Effective as of the date of this award; a) Increase wage rates by 1% for employees in the DHL and Cook categories; b) Amend Article 11.08 to include the following:

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“(d) Notwithstanding anything else containing in this Article, and in the event that a full time employee is unable to work as a result of serious medical reasons, the employer the employer will continue to pay its share of the cost of Health and Welfare benefits as described in Article 18 for a maximum period of 36 months, provided that the employee continues any cost sharing arrangements. Failure by the employee to deposit the full portion of their payment to the Employer by the first of each month, for the month in which benefit coverage applies, will result in the termination of the benefit coverage for the duration of the leave.”;

c) Amend Article 15.01 (first line) to replace the words “who otherwise qualifies under Article 15.02 hereunder” with the words “who has successfully completed the probationary period”, and include two floating holidays per year (to be taken by agreement between the employee and the employer) in the list of holidays. Delete Article 15.02, and re-number the remaining provisions in Article 15;

d) Amend Article 16.02 to provide for 5 weeks’ vacation after 27,500 hours worked, with vacation pay at 10%, and add the words “Except with respect to the fifth week of vacation” at the beginning of the last sentence of Article 16.01;

e) i) amend Article 18.01 to increase the annual limit for paramedical

services to $400.00;

ii) amend Article 18.01 to provide that a part-time employee who works less than 45 hours per week transfers to permanent full time status (i.e. a position which is regularly scheduled for at least 45 hours per week) will have a one-time option to be covered under the Health and Welfare plan and the sick leave plan after 225 hours worked as a full time employee. (For greater certainty, the employee will continue to be paid in-lieu pursuant to Article 18.05 until he/she has worked for 225 hours in the new position);

f) Increase weekend premium (Article 21.07) to $0.35 per hour; g) The in-lieu premium set out in Article 18.05 is increased to 70 cents per

hour. The language of that Article will not otherwise change; h) Provide a Letter of Understanding as follows: “The parties agree that it is undesirable for employees to work without a

full complement of employees in each position/department, and the employer will make all reasonable efforts to recruit sufficient new employees where the bargaining unit is below complement, it being understood that the employer is entitled to determine appropriate complements of employees.

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The parties will meet at least quarterly, either at labour-management meetings or at special meetings, to discuss working short issues and the possible remedies therefor. The parties will also to attempt to agree upon a workload tracking form.

We remain seized in the event of disagreement as to the form to be used.

5) Any other matter as agreed between the parties. The effective date of these items

will be the date of this award unless otherwise agreed between the parties.

Any proposal not specifically included herein is rejected.

The board retains jurisdiction over this award until a new collective agreement is executed.

DATED at Toronto, this 26th day of June, 2020.

________”John McNamee”___________ John McNamee, Chair I dissent in part as attached “E.C. Carla Zabek”___________ E.C. Carla Zabek, Employer Nominee I dissent in part as attached “Harold Caley”____________ Harold Caley, Union Nominee

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Partial Dissent of Employer Nominee This award is overly generous for a collective agreement with a two-year term and expiring in six months. It is also not reflective of the principles of total compensation and replication. In this current bargaining environment, the trend is not to negotiate or award such cost improvements, but to award modest compensation increases in addition to the standard wage increases. In the Long Term Care sector, the SEIU Extendicare Master Collective Agreement is used as a precedent for other nursing home negotiations and interest arbitrations. I submit that had this nursing home been within the SEIU Master Group, wage adjustments would not have been awarded. I would have limited the award to the patterned pay increases, the removal of the requirement to earn a float day, modest increases to weekend premium and in lieu, and a premium to certified Dietary Aides which would have been a more reasonable result in the circumstances. Respectfully submitted, E.C. Carla Zabek

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PARTIAL DISSENT OF UNION NOMINEE PART A: THE AWARD The Union sought to introduce a specific provision to the Collective Agreement, providing additional compensation to employees working during the COVID-19 pandemic; and a specific provision providing premium pay when employees are required to work short. It is important to set out the positions of the Union/employees; it is as follows: “L. PREMIUM PAY FOR WORKING DURING THE DECLARED EMERGENCY/ COVID-19 OUTBREAK UNION BRIEF PAGES 29-31.

87. It is undeniable that the COVID-19 pandemic is affecting long-term care facilities at greater rates than within other industries/parts of society. In fact, it has now become apparent that it is in long-term care facilities, and not in hospitals as was originally expected, where Ontario is seeing surges in infected people and, sadly, an ever-increasing significant number of deaths. Of Ontario's 626 long-term care facilities, 114 are currently reporting infections (a rate of approximately 14%) and with the ongoing spread of the virus, and increased testing, this number will be clearly expected to increase.

88. What is going on now is unprecedented and tragic. Premier Doug Ford has

remarked that, "The sad truth is our long-term care homes are quickly turning into the front line against this virus," describing the situation in long-term care facilities as a "wildfire".

89. The Government of Ontario first declared a state of emergency on March

17, 2020 to commence at one minute after midnight on the morning of March 18, 2020. This state of emergency was then extended on March 30, 2020 and again on April 14, 2020. As a result of this declaration of emergency, the Government of Ontario has issued a number of Emergency Orders which affect the manner in which long-term care facilities are operating. Specifically, under these various Emergency Orders: private sector employers, such as Bella, have been given broad, and essentially unregulated, powers to overrule the rights of their employees which would otherwise be protected by collective agreements. Such employer powers have included the right to fill vacancies, reassign employees, reschedule hours, reallocate/cancel time off, cancel leaves of absence and vacations, and unilaterally alter many other terms and conditions of employment. In this respect, the hard-won rights of employees set out in collective

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agreements, many of which rest on their seniority rights, are simply not available to long-term care employees right now.

Union's Book of Documents Tab 13

90. The employees in this bargaining unit are undeniably working under extreme conditions. They are now required by law to work extended hours, regardless of whether or not they receive adequate support. They are trying to provide the best care to Bella's residents, while working short, including without sufficient PPE supplies. In addition, conditions of employment have been fundamentally altered such that employees are not able to leave the facility during their shifts and/or to take in with them items which they would otherwise be permitted to use (including cell phones, at least during their breaks).

91. In addition to that, previously as a result of decisions made by individual long-term care facilities (pursuant to their new unfettered powers) and now as a result of a new Emergency Order, employees have been required to choose the one workplace in which they will work during this crisis. This has caused great distress to employees. Part-time employment is endemic within this industry. In recent years, at least, many employees have been forced to string together a number of part-time jobs at various long-term care facilities in order to accumulate an income on which they can live. Obviously, given the special terms and conditions of employment under which they work, this is no longer possible.

92. All of the above is, of course, in addition to the extraordinary stress and mental anxiety which every employee in this bargaining unit faces each time she or he steps foot within Bella. Every minute worked and every resident interaction is a potential threat to their health and the health of their families. These employees are being asked to put themselves (and their families) at great risk for the benefit of others. Luckily, there is no known confirmed case of COVID-19 amongst the residents and staff at Bella. However, it cannot be assumed that this will remain the case and should that occur the extreme working conditions, and extraordinary stresses and anxieties which exist for these employees will be greatly magnified.

93. Based on all of the above, it is HOPE's position that these employees

should be compensated for everything that has been taken away from them and everything they are going through in order to support the greater good. Therefore, the Union is seeking special premiums relating to the unprecedented conditions which these employees are working under

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due to the Declaration of Emergency declared by the Government of Ontario on March 17, 2020, consisting of the following:

NEW Article 14.08 For all hours worked under the declared emergency (retroactive to 12:01 a.m. on March 18, 2020), employees ·' "regular rate of pay" will be time and one half (1 ½) their normal base rate of pay. Should the facility be declared to be "under outbreak as a result of COVJD-19", employees' "regular rate of pay" will be two times (2) their normal base rate of pay for all hours worked while the facility continues to be under such outbreak.” The Employer in its Brief responded at pages 183-185 as follows: “EMPLOYER PROPOSAL Status quo. SUBMISSION The Employer is opposed to HOPE’s proposal on COVID premium for the following reasons.

1. This proposal is untimely. This proposal was tabled after conciliation. In fact, it was first presented to the Employer on April 17, four days before this Arbitration. This submission has been reviewed earlier in this presentation as a preliminary matter.

2. Government Role in this matter. Premier Ford has committed to addressing this issue of recognition of the valuable work provided by these employees at this Home and across the Province. In an interview on Friday, April 17 he answered a news reporters question saying he planned to address this issue of special COVID-19 recognition for LTC employees but wanted to see the full Federal Package before announcing his entitlement. The entitlement will likely be announced this coming week. As Chippewa Creek is a Long-Term Care facility, it will be provided with the same entitlement as the rest of the province.

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3. No Arbitral Precedent

Fortunately, this Home is Covid-19 free. Most collective agreement have already been resolved for the time frame of this award without any COVID-19 premium. Many of those facilities have a COVID-19 outbreak. There is no basis to treat this Home better that the hard-working employees in the other 760 Long Term Care facilities in this province. While the challenges have been great and those employees working are heroic, this is a matter best handled by the Province for all LTC employees”. A second proposal of the Union related to a LOU with a ‘working short premium’ as the employees in this home are often required to do extra work when there is a shortage of employees on a floor to care for the patients. COVID-19 also made this matter worse. This proposal reads in part: “3. A working short premium of $2.00 per hour shall be paid to all employees performing the work of more than one employee as defined by the working short contingency plan.” The Employer response to this proposal at page 154 of the Employer Brief reads in part: “In the SEIU Master most recent Arbitration, SEIU pursued a similar letter. Arbitrator Jesin awarded a Staffing Advisory Committee and a Working Short Letter. No premium awarded for working short. The Award can be seen at Exhibit 6.” It was subsequently confirmed that no premium was in fact requested in the above Arbitration. The Chair did not award the Union proposals; rather he choose to defer them. So far as I am aware this is the first occasion where an interest arbitration Board has considered a COVID-19 proposal, like the one advanced in this case. The reasons advanced within the Union proposal support it being awarded by this Board. The premium for working short proposal is based on the facts contained in the Union Brief; and where, as here, the evidence supports the proposal it should be awarded. Further at no time did the Employer assert an inability to pay.

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I regard the Chair’s refusal to deal with the Union’s proposals to be unreasonable and untenable. We are determining the terms and conditions of a collective agreement covering the two parties and the employees before us for the calendar years 2019 and 2020; the COVID pandemic is now. Our jurisdiction under HILDA is to “make a decision on matters of common dispute between all the parties” …”in order to conclude a collective agreement between the parties.” This is the one and only opportunity for the employees working under this collective agreement to assert a claim for a COVID-19 premium and premium pay for working short for the period of the collective agreement before us. In my view, the Chair is avoiding the statutory duty imposed upon us and is doing so to the extreme prejudice of the employees before us in this arbitration. Once again the result is more words without concrete steps to address the workplace issues the employees face and deal with on a daily basis. PART B: THE LTC HOME INDUSTRY – INTRODUCTION The two proposals of the Union require a short review the long-term care industry as it has been the subject of much discussion; many newspaper articles; and TV coverage. It is easy to say too much in a dissent; more difficult to say less and properly capture the right message; I tried to find the right balance; but clearly a lot more could be said. For the most part we have been fortunate, that in our lifetime, we have only had to respond to a national/international crisis on this one occasion; but it is our response to the crisis that matters. Exceptional times require exceptional responses; it is simply not possible to record the daily updates with respect to the institutional and systemic faults within the LTC system; some of which has been documented by the Canadian Armed Forces. It is acknowledged that conditions in some of the LTC homes are “horrific”; and account for 80% of the Ontario COVID-19 fatalities. Service workers in long-term care homes and retirement homes go to work each day with the uncertainty that they are entering a hazardous work zone; and after working

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return home each day to the further uncertainty that they may be transporting COVID -19 home to their family. The work stress and the home stress take its toll on the employees; coupled with the low compensation and staff shortages service worker caregivers are in an impossible situation; they deeply care for their patients; it is well past the time that we ignored their plight. Until there is a vaccine there will be no “new normal” for the caregivers in the nursing homes and retirement homes; until such time there will be real risk; and fear and anxiety in the workplace. As Dylan stated: “How many deaths will it take?”; hopefully the answer is not blowing in the wind. PART C: WHAT HAS THIS GOVERNMENT DONE FOR EMPLOYEES IN LTC FACILITIES? There is no doubt that the Provincial Government also bears responsibility for the low wages and working conditions of the service worker employees. As the Employer Brief at page 21 states: “While not arguing a “financial statement” inability to pay, the Employer respectfully submits that this Board cannot ignore, and indeed must be greatly influenced by, the current restraints confronting the Employer as a result of the current provincial funding structure, the constrained funding environment and their impact on these homes. It is not simply an issue of whether the Employer has the ability to pay, it is an issue of the impact of a compensation award on staffing levels. All relevant factors point to the need for compensation restraint.” and later at page 29: “If compensation increases above the rate of increase in funding, then hours of paid staff time must decrease, or the home will spend beyond its means. If compensation increases at the same rate as an increase to funding, then the home cannot increase its staffing levels without spending beyond its means.” Also consider the following points: First, On May 31, 2019, the Minister of Health announced that the funding increases for the Nursing and Personal Care envelope (the “Nursing Envelope”) and the Accommodation envelope for 2019 would be 1%.

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The Nursing envelope funds the nursing staff; and the Accommodation envelope funds the housekeeping/laundry/dietary/cook staff. Second, In November 2019 the Ontario Government passed Bill 124 limiting the total wage and compensation increases to employees in not for profit LTCs to 1% each year, for a period of three years. Third, In March 2020 the Ontario government passed Regulation 74/20 allowing employers to ignore significant provisions of collective agreements relating to staffing, work assignment, scheduling, vacations, leaves etc. and limiting part time employees to one home. Fourth, The Provincial Government did eventually announce a $4.00 per hour increase effective April 24, 2020 to August 13, 2020; plus, a lump sum payment of $250.00 for four months for eligible workers who work over 100 hours per month. Hazard pay and increased sick pay benefits should have been introduced immediately upon the Declaration of the State of Emergency on March 17, 2020. When Ontario government inspectors from the Ministry of Labour, Trade and Skills Development initially did not enter long term care homes out of fear of infection; how could this same Ontario government not immediately address the plight of the caregivers in these homes? Premier Ford is reported to have stated: “These people put themselves in harm’s way to care for our sick and vulnerable citizens.” And “The situation we’re all facing is unprecedented and is extremely serious. This crisis has clearly shown the deeply rooted, longstanding cracks in our long-term care system. We need to do better. And we will do better.” And “I wish I could have increased the pay from day one, the government didn’t have the capacity at the time.” – where there is a will there is a way. Employers assert that the Ministry of Heath provides the nursing home with staff funding on the basis of a set of funding envelopes; namely the Nursing envelope and the Accommodation envelope. Wages and benefits are paid out of these envelopes and so in a direct sense it is the government that funds (and effectively restricts and limits) the wages and benefits of the employees; and as already stated, funding directly affects staffing; less funding means less patient care and less staff. If the above mentioned envelopes are not sufficient to provide decent wages and benefits for the service worker employees it is up to the employers to demand more funding from the Government as currently, there is no ability on the trade unions to bargain directly with the entity that largely determines the level of compensation and benefits.

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Further, in the for-profit homes, like this one, additional pay should come from the profit envelope; as mentioned above this Employer did not argue an inability to pay, nor did the Employer produce any financial records. To limit the annual increase to the Nursing envelope and the Accommodation envelope makes employers the partner with the Ministry of Health in keeping the wages and benefits of the service worker employees depressed. More than ever this single act of the Government and the response of the LTC employers demonstrates the presence of a single common employer; namely the Ontario Government and the LTC homes. The Ontario Government should be a joint party to all the collective agreements in this sector; wages/benefits/staffing/safety are the guts of a collective agreement and matter the most to the employees; as we have seen the role of the Ontario Government on these issues is significant. PART D: SOME OF THE QUESTIONS

1. What are long term care homes? They are institutions/facilities like hospitals

The starting point is the Hospital Labour Disputes Arbitration Act, RSO 1990 where the definition of ‘hospital’ includes a long-term care home; they are “homes’ only to the extent that the caregivers strive to make the patients welcome and comfortable within an institutional setting. Service employees in a long-term care home are “essential” and do not have the right to strike; rather the parties can take their outstanding issues to interest arbitration; a system that is in serious need of repair. Present circumstances compel us to reexamine the terms and conditions of employment of the service workers in the long-term care sector. The service workers generally consist of RPNs, PSWs, Dietary, Housekeeping, Laundry, Servers and Cook staff. Understaffing of long-term care homes is not something new; COVID-19 has illustrated and exasperated the situation and as recently reported on the Toronto Star: “The personal support workers who are left are worked off their feet. They are exhausted. They don’t have enough time to properly care for my parents and other residents”. As of the writing there are 66 long-term care homes with reported or suspected COVID-19; 247 LTC homes with resolved outbreaks; about 5,400 nursing home residents having been infected; and most of the deaths (1,803) from COVID-19 have occurred in long-term care homes; almost 2,205 nursing home staff have been infected by COVID-19 as well; with 7 staff deaths

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2. Who do the LTCs care for? Patients

Since 2010 only persons with high care needs are eligible for long term care in Ontario with the result that seniors are entering long term care homes when they are older, frailer, and in need of more medical and personal care than ever before. More than half of the patients are over the age of 85. Other younger patients have experienced a brain injury, stroke, or other conditions that require 24/7 care. Long-term care homes provide 24/7 nursing care and supervision, primary medical care, help with daily activities and interests, and a safe caring environment. Like a hospital, there are 3 bed types: basic, semi-private and private; and the approximate number of beds in a facility can range from 25 up to 300; with an approximate average of about 135 beds. The Provincial funding for the LTCs consist of set payments per day for nursing and personal care; specialized therapies; raw food; and a set payment per resident. The patient pays a set rate for accommodation; depending on the type of accommodation. The Report This is Long-Term Care 2019 by the Ontario Long-Term Care Association states that long term care patients: 90% have some cognitive impairment; 86% need extensive help with daily activities such as getting out of bed, eating or toileting; 80% have neurological diseases; 76% have heart/circulation diseases; 64% have a diagnosis of dementia; 62% have musculoskeletal diseases such as arthritis and osteoporosis; 61% take 10 or more prescription medications; 40% need monitoring for an acute medical condition; 21% have experienced a stroke. Sure, looks like Hospital care to me.

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As part of the Employer Exhibit at Tab 7 states: “The Task Force believes that long-term care is a highly specialized area that focuses on the care of a diverse group of residents with complex conditions and needs. Long-term care requires specialized leaders and skilled staff to care for some of the most vulnerable people in our society.”

3. Who should operate long term care homes? primarily the government A report in 2010 indicated that of the 626 licensed long-term care homes in Ontario 58% are privately owned; 24% are non-profit/charitable homes; 16% are municipal homes. Long term care is part of the health care system of Ontario and is publicly funded on a cost-shared basis with patients. Patients are expected to pay for their ‘room and board’ in the long-term care home; and the Provincial funding pays for the nursing and personal care, programs, support services, raw food. Patients in hospitals are often moved to long-term care homes to continue their health care needs. The privately-owned long-term homes are operated to generate a profit. The need to return a profit; the need to satisfy shareholder demand for a return on the investment should be removed from the equation. 100% of the monies allocated to long-term care homes by the government and paid by the patient should be used for the benefit of the patients and staff in the homes. Profit should be removed from the equation.

4. What are the terms and conditions of employment? Should be better The shortage of PSWs in the long-term care homes is not a recent development; and it is likely that with the presence of COVID-19 and the low wages/benefits retention and recruitment of PSWs in LTCs will suffer. The largest group of frontline caregivers are the personal support workers (PSWs) and there is an acknowledged shortage of these workers; 80% of the homes that responded to a 2018 survey said they had difficulty filling shifts; and 90% experienced challenges recruiting staff. Homes work short staffed; staff are required to work overtime and

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shifts go unfilled. The report mentioned above states: “The situation has reached a tipping point”. In this Home the Union asserts that prior to the COVID-19 crisis, there were more than 30 open lines with no regular employees to fill these lines. Employees are regularly scheduled to work overtime; and employees are working short staffed; meaning the employees at work are required to perform additional duties. Specifically, the Award of the Chair in this case falls well short of addressing the needs of the employees in terms of the wages, benefits and working conditions of the caregivers. Clearly the working conditions for staff need significant improvement as fewer employees are carrying a load that should be borne by many more; and the amount of personal care followed by the paperwork to record the patient care and attention has increased. Currently the wages and benefits for the service workers in long term care homes are significantly less than the wages and benefits provided to comparable employees who work in Hospitals; while performing the same functions. Service workers in long-term care homes work just as hard as the comparable service workers in Hospitals. The difference in wages and benefits causes employees to seek the job opportunities to work in the Hospitals to the disadvantage of the patients in the long-term care homes. Many part time workers in long term care homes need to work in more than one home in order to survive financially; a recent government regulation has precluded this practice; resulting in serious financial hardship to many caregivers. During the three-year period 2019-21 most service worker employees will only receive wage increases from their employers of 1.5% in each year; this is lower than the increase in the cost of living. As indicated above others will only receive 1%. The Employer in this case sought: to reduce sick pay from 100% compensation to 85% compensation; and to limit the wage increases to 1% in each year; where the increases in the cost of living for 2019 is 1.9% and in 2020 is likely to be higher due to the anticipated increase in food prices.

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PART E: WHAT CHANGES ARE NECESSARY? The Toronto Star in a column dated June 3, 2020 made the following comments: “For decades, far too many of these facilities have been understaffed, underfunded, overcrowded, poorly managed and badly in need of repairs and upgrading. Ford insists he wants answers to what’s wrong with the system, adding “we need to get this fixed.” He also suggests it’s not his fault because he inherited a mess from the previous Liberal government. In fact, though, Ford has done little to improve conditions in these facilities since being elected on June 6, 2018. Indeed, in many cases his actions -or inactions – have actually worsened conditions.” And later in the same article: “Ford’s record with the long-term care system has been abysmal since he was elected. First, the Ford government dropped the mandatory annual inspections of all homes that was adopted by the previous Liberal government. Only 2,800 inspections were conducted in 2019, most of them related to specific complaints or to critical conditions. Second, Ford cut funding increases for the long-term care system to less than the rate of inflation. Third, there’s been no movement on any of the new long-term care beds that were approved before the 2018 election. Fourth, Ford made no move to address critical staffing issues, including the shortage of nurses and the low pay and lack of full-time work for personal support workers in these facilities. Fifth, his government was exceedingly slow in providing protective equipment to staff and testing staff and residents for COVID-19 -with much of it coming only after many deaths. Sixth, Ford cut some $1 billion over a decade to Toronto Public Health, funds vital for helping to ensure health safety in long-term care residences.” HEALTH AND SAFETY Protecting the health and safety of patients and staff is critical.

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STAFFING LEVELS/FUNDING The Employer Brief at page 32 states: “On May 31, 2019, the Minister of Health announced that the funding increase for the Nursing and Personal Care envelope for 2019 would be 1%. While the public announcement infers an amount greater, a detailed review illustrates the improvement is in fact only 1%”. and at page 30: “We remind the Chair that we are before you in a year in which the Government has provided the lowest increase in funding in the Nursing Envelope.” and later at page 31: “The largest cost in operating a long-term care facility is compensation: wages and benefits. To balance expenditures within funding levels there are really only two variables: the compensation paid and the number of staff who receive the compensation.” “The Employer is not alone in its desire to optimize staffing levels. Employers within this sector are joined in their efforts to petition the government for increased staffing levels to benefit resident care. Unions within this sector have lobbied the government extensively over the past several years to increase staffing levels in order to improve resident care. The one fact that Employers in this sector and all Unions have agreed upon is that staffing levels are not at an acceptable level in this sector. Unfunded compensation increases result in fewer staffing hours.” In a recent article in the Toronto Star, June 5, 2020, it is reported that CEO Donna Duncan of the Ontario Long-Term Care Association, which represents more than two-thirds of the long-term care homes in Ontario, in a written statement said: There is “a human resources emergency across long-term care that predated COVID-19: and that the staffing shortage – for all roles, but especially personal support workers – has affected all types of homes, regardless of ownership.” And “Seniors entering long-term care are more frail and medically complex that even five years ago. However, provincial funding and regulations have not kept pace with the

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higher care needs of this population, leaving homes underfunded and facing staffing challenges.” Funding to provide care for the patients; and decent wages and benefits to the caregivers is an urgent need. The ratio of full time to part time employees needs a significant adjustment; There should be mandated that a minimum of 75% of the employees be classified as full time. This would not only help the staffing levels but would result in consistent care for the patients. The ratio of staff to patients should be established and strictly enforced. Part time employees should receive the same total compensation as that paid to the full-time employees; this would reduce the incentive to use part time employees; rather than employing full time employees. In this home there are 107 Full time and 60 Part time employees; in many homes the part time compliment is significantly higher than the full-time compliment. Agency workers should not be allowed in a home except in the case of extreme emergency. COMPENSATION: WAGES AND BENEFITS Wages and benefits for the service workers should be at least equal to the wages and benefits provided to the comparable employees in Hospitals; no classification should have a start rate below $25.00 per hour; hazard pay and increased sick pay benefits must be provided. Instead of limiting full time employment; running short staffed; and depressing the wages of the employees it is time to aggressively rethink the wages and working conditions of these essential caregivers. FOR PROFIT LTC HOMES The profit equation should not be present when providing essential health care to the sick and elderly. Long-term facilities should not be privately owned but rather should be owned and operated by a Government run agency or by a not for profit/charitable organization.

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PART E: THE CONCLUSION In my view, the Award of the Chair is fundamentally flawed; and that part of the Award that defers the Union COVID-19 proposal and the “working-short premium” of $2.00 per hour should be reconsidered. For too long the service worker caregivers in long-term care homes, who are predominately female and visible minorities, have been undervalued. Until now many outside the sector have simply been unaware of their existence and their importance. These employees are now the “squeaky wheel” that needs attention; most are dedicated, hard-working female employees, largely radicalized, who have sat silently on the side lines; waiting for things to improve; while caring for the patients. The COVID -19 virus has now drawn attention to the work these employees perform for one of the most vulnerable groups in society – seniors and others who need essential health care attention on a 24/7 basis. COVID-19 exposes the personal health risk, the workload and low pay that have always been present in long term care homes. I suspect that the patients and family members who visit the homes were simply not aware of the shortcomings in the long-term care homes; no doubt because the service worker employees are dedicated hard working employees who put on a brave face. The categories of medical care are home care (that is care in your own home); long term care; and hospital care. Long term care is not provided in a ‘home’ it is provided in a facility. Long-term care “homes” is a misnomer – they should be called long term care “hospitals”, “centers” or “facilities” and the service worker caregivers treated in their terms and conditions of employment, at a minimum, the same as employees of a publicly funded Hospital. The time for talk is over. ALL OF WHICH IS RESPECTFULLY SUBMITTED THIS 26rd DAY OF JUNE 2020 Harold F. Caley, Union Nominee