By: Anastasia Volkov
There is little doubt that the COVID-19 pandemic impacted all of our lives. However, several snapshots released by Statistics Canada in late August report a disproportionate impact on individuals with disabilities. Unfortunately, the disability community frequently does not receive the attention it deserves. Yet, nearly 25 per cent of Canadians over the age of 15 live with one or more disabilities and are confronted with environmental, economic, social, and attitudinal barriers. These barriers were exacerbated by the pandemic.
Individuals with disabilities are a diverse group. But the reality is, they are generally at a higher risk of infection and/or of being affected by the isolation measures. Many were unable to access a range of required health services due to temporarily closures. But those living within the long-term care (LTC) sector faced the gravest reality of all. With such high stakes, it is time for a national policy response.
The LTC sector in Canada houses individuals living with disabilities for both short and long periods of time. It is a continuum of medical and non-medical services including adult day programs, client intervention and support, and convalescent care, among others. These are dedicated to help individuals with severe disabilities live safe and independent lives. While many individuals requiring LTC services are seniors, they are only one part of the story. Both long, and short-term disabilities can result in the need for around-the-clock care irrespective of age.
According to the COVID-19 in LTCs Tracker, 80 per cent of the deaths in Quebec and 73 per cent of the deaths in Ontario involved residents of public and private LTC homes. In fact, more than 80 per cent of all COVID-19 deaths across Canada are linked to LTC. No other OECD country has faired so poorly.
In Canada, LTC is not publicly insured under the Canada Health Act (CHA). This is because the CHA only covers services and procedures that are provided in hospitals and in doctors’ offices. Consequently, there is little consistency in how facilities are governed, the type of care they provide and the cost of services they offer. Funding models also vary. What is consistent, are the deteriorating conditions of LTC facilities neglected by policymakers for decades and revealed by the pandemic for all to see. These conditions can be largely attributed to the widespread reliance on the private market to meet the need for LTC services. Research has found that private facilities often implement the multiple occupancy model and rely heavily on part-time personal support workers (PSWs) to reduce the cost of operation. Coupled with poor regulatory oversight, the LTC conditions were ripe for the spread of infection.
In early April of this year, Global News Canada reported that an Ontario LTC home for adults with severe mental, physical, and developmental disabilities in Markham was in “dire need of help”. Staff faced with the COVID-19 outbreak within the facility walked off the job, leaving five managers to provide care for 42 residents. The City of Markham immediately issued an urgent call for support and the story gained national attention. Several LTC homes across Ontario and Quebec were in similar situations. Both provinces resorted to the support of the Canadian Armed Forces, who later released a report documenting the dire conditions found in these facilities. Ill-prepared for the novel Coronavirus would be an understatement.
The global pandemic sent shocks through our social, economic, and political institutions. All orders of government engaged in unprecedented emergency response measures. If we evaluate the effectiveness of the Canadian policy responses through the lens of minimizing mortality, flattening the curve, and mitigating socio-economic hardship – we fair relatively well in comparison to other countries. But this closer look reveals a troubling and shameful reality. The under-preparedness of our LTC sector resulted in unequal and preventable outcomes within Canada. Hopefully, the shocking effect of this reality on public consciousness will lead to actionable policy responses to address long-neglected issues.
The Star reports that “there is no overarching or comprehensive plan to address the needs of people with disabilities as a result of the COVID-19 pandemic”. But as our governments turn to address the problems within the LTC sector (known to workers and families for decades) there are calls for a federal LTC strategy. However, constitutional limitations pose barriers on federal jurisdictional authority. The lack of consistency in policies and organizational models across provinces will pose a challenge to coordination. If there is a solution, governments need to act in concert within the institutions of Canadian federalism, to foster robust regulatory oversight and to explore new funding schemes to incentivise cooperation. The pandemic spoke loud and clear – it is time to care about our most vulnerable.
Anastasia Volkov is a Master of Public Policy candidate at the University of Toronto’s Munk School of Global Affairs & Public Policy. Her primary interests are in urban and social policy. Anastasia holds a Bachelor of Arts (Honours) in Public Policy and City Studies from the University of Toronto Scarborough, and she currently serves as an Editor-in-Chief for the PPG+Review, and one of the Directors of the Consulting Careers Initiative @ Munk.