PSW registry up and running despite unresolved key issues

Health Minister Deb Matthews rose in the legislature to announce June 13 the new PSW Registry is up and running. Initially PSWs (Personal Support Workers)  in the home care sector are being asked to sign up, followed by those working Ontario’s long term care homes.

This is the same registry the Health Professionals Regulatory Advisory Committee (HPRAC) recommended against in 2006 after extensive consultations with PSWs, employers, clients and other stakeholders.

HPRAC instead recommended additional steps to be taken to “improve PSWs education and training, staffing and supervision, and to provide better access to satisfactory recourse for patients and clients as a means of addressing instances of abuse and misconduct.”

HPRAC felt the cost of establishing such a registry would be prohibitive compared to the benefits it could generate.

Of course, with Matthews’ strong commitment to evidence-based decision-making, she ignored HPRAC’s findings and decided to create the registry anyway.

The registry got back on the radar of the province after a series of media stories highlighting issues of abuse and neglect in Ontario’s long-term care homes.

Yet HPRAC did not believe that a registry would be effective in protecting the public from PSWs with a record of abuse.

HPRAC notes they were told “the high threshold required to prove abuse coupled with a desire for a speedy resolution to an incident often encourages employers to offer a ‘buy-out’ to an employee rather than follow the procedures that would lead to dismissal. The ‘buy-out’ would be accompanied by a confidentiality agreement.”

The HPRAC review defined the work of PSWs to include activities of daily living (light housekeeping, personal care, and transferring responsibilities, such as helping someone in or out of bed. PSWs also engaged in tasks defined as “instrumental activities of daily living,” which includes menu planning, shopping, meal preparation. PSWs can provide transportation or accompanying clients to and from appointments. In some instances, the report states, “PSWs are called upon to provide clinical care services where they measure a client’s blood pressure, temperature or pulse, take specimens or implement a rehabilitation program.”

HPRAC noted that they repeatedly heard that there is no definitive body of knowledge unique to the PSW occupation. Much of the work they do is also under the supervision of a registered health professional.

None-the-less, some PSWs believe that a registry will give them long overdue recognition, some hopeful this will even translate into better wages and benefits. The Ontario PSW Association recruited a handful of PSWs to be present for Deb Matthews announcement.

France Gelinas, the NDP Health Critic, told the legislature that she thought recognition could go much further than the registry.

“If you look at all of the 26,000 PSWs working in the home care system, most of them make wages barely above minimum wage. Minimum wage in Ontario is $10.25. You will see many PSWs who don’t make $2 more an hour than minimum wage.”

The odd thing is, while PSWs in home care are signing up for the registry, the steering committee responsible for it has yet to determine how individuals qualify to go on the registry, or what it would take to remove someone from it. There is no agreement on who would be grandparented onto the registry, what educational requirements are needed to qualify a new PSW, nor what the process would be to take an individual off the registry. Nor is there agreement on how the registry will be permanently run.

In BC the PSW registry has a joint advisory committee of labour and health care providers.

In Ontario there are only four union representatives on the 24-member steering committee.

OPSEU is not on the steering committee, but has maintained contact with labour representatives who do participate on it.

It is understandable that PSWs would see this as an opportunity to gain respect. But it could also turn into a colossal boondoggle that may make the shortage of available PSWs worse.

The Steering Committee is expected to meet again next week. The number of issues in their “parking lot” is lengthy, especially now that Deb Matthews has started the meter running.

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