PSW Registry – Many issues unresolved despite impending deadline

As the deadline approaches for home care personal support workers to register with the government’s new PSW Registry, key issues remain up in the air and are unlikely to be resolved soon. PSWs may very well ask what they are registering for?

Home care employers like the VON are telling their PSWs that they must be registered by the end of the month, but the government anticipates that only 70 per cent of the estimated 26,000 publicly funded home care PSWs will meet that deadline.

What happens to the 8,000 unregistered PSWs is anybody’s guess. The PSW Registry Steering Committee does acknowledge it hasn’t worked through the implications of mandatory registration or how it will be enforced. No kidding.

CUPE announced last week that they are departing from the steering committee, calling the Registry “a dollar-store form of regulation, which benefits the province at the expense of the rights and dignity of personal support workers.”

The Ontario Federation of Labour also announced it was departing the steering committee, leaving the Ontario Nurses Association and the Service Employees International Union as the only labour representatives on what was a 25-member group.

The decision-making process on the steering committee has never been clear. Instead of providing direction to the Ministry of Health and Long Term Care, the marching orders appear to be coming directly from the Minister’s office. The website refers to the steering committee as an advisory body only.

Rather than first consult with employers, families, PSWs, and other health care stakeholders, Health Minister Deb Matthews set out the objective of the Registry in advance, then asked an employer group, the Ontario Community Support Association (OCSA) to get the Registry up and running. OCSA in turn assembled the steering committee with representatives from various stakeholder groups, including labour.

These objectives for the Registry were set out in an April 11, 2012 letter from Health Minister Deb Matthews.

In it she said all publicly funded health-care employers will have to hire PSWs from the Registry. Critically, Matthews states “to maintain public safety, the Registry will establish a process for reviewing, suspending or terminating PSW registration.” This is even though the Registry makes clear it is not a college, governing or regulatory body.

Nor is the Registry set up to take complaints, a function the province has already entrusted elsewhere.

It is this objective that remains in doubt as the steering committee has failed to work through a fair process for PSWs charged with neglect or abuse, particularly if employers continue to run the Registry. One option under consideration is to simply allow employers to decide if an employee has abused a resident(s). For PSWs with no union grievance process, they could lose their career based on an employer siding with a witness who may be less than reliable, such as a resident with advanced dementia. While there is talk of an appeal process, should a PSW get taken off the registry, there is no resolution as to how that would work.

The OCSA was supposed to hand over the Registry to a more appropriate body at the end of August, but there has yet to be any resolution as to what that would be. There is no agreement to the future governance or operation of the Registry. ONA has suggested, for example, that Health Force Ontario would be a more appropriate body to host the Registry.

If OCSA continues to run the Registry questions also get raised about information privacy, given OCSA is not covered under the Freedom of Information and Protection of Privacy Act.

At present the Registry is capable of telling the public whether or not a PSW has registered. That’s it.

The steering committee favours tiered access to information, given the Registry was also intended to serve as a recruitment tool for employers. Families looking to hire a PSW would be given access to detailed personal information under that scenario.

At present the registration process includes declarations around education, including whether the PSW graduated from a relevant academic program or whether they learned on the job. The PSW has to declare their employment status, including whether or not they are presently employed. They have to state their current employer, including whether they work for multiple employers, and whether there are any gaps in their employment. Optional questions, intended to put the PSW into an employment marketplace, include their contact information, availability for work, special experience and where they would agree to work (by LHIN).

Despite the questions, the committee appears to be tilting more towards an on-line job board posted on the registry site given thorny privacy concerns raised by opening such individual information to the public.

Additional optional questions are intended for health human resources planning, including whether the PSW plans to change jobs, return to school, or retire. This last section may make PSWs particularly queasy knowing the Registry is presently in the hands of their employer’s association. The Registry claims that this information will be provided to the government for HR planning with the PSW’s identity stripped out.

While employers are asked to hire from the Registry, there is no penalty for seeking a PSW from elsewhere. Would the province really want to contest the hiring of a PSW from out of province who has all the requirements to be on the list but doesn’t presently live in Ontario?

The present set up also calls into question the accuracy of the information on it. The prospect of verifying information given to them by as many as 100,000 PSWs would be daunting (all PSWs will eventually be required to register, not just those in home care).

The Registry does not reflect at all on the issue of competence, nor is it designed to. It presently has no process to remove anyone for reasons of abuse or neglect, and as such, cannot meet its claim that “it will go a long way to in providing peace of mind to clients and their families that was PSW listed on the Registry does not present a known risk to public safety.”

While the Registry has been sold as a way to recognize PSWs, it seems the workers get little more than having their name placed on a list and their privacy potentially put at risk.

What is clear is the Registry is not ready. Too many issues remain unresolved. Health Minister Deb Matthews should suspend the deadline until PSWs at the very least have an opportunity to understand how the Registry is to be used and what safeguards are in place.

The PSW Steering Committee is meeting again today.

The PSW Registry is located at www.pswregistry.org

Read our June story which describes earlier advice the government received suggesting the costs of the registry would outstrip any real benefit.