Category Archives: Uncategorized

Low wages and benefits makes interprofessional primary care a hard sell

Stock photo of a nurse with a tablet used to illustrate a shortage of nurse practitioners and other professionals in the pimary care sector.

Family Health Teams and other interprofessional primary care providers are having difficulty retaining and recruiting health professionals due to poor compensation. One in five nurse practitioner positions are vacant according to a report issued last year. (Canstock Photo)

The Ontario government would like every dollar of funding increase to be used to increase the volume of care. In their world, nothing would go to the increased cost of wages, benefits, drugs, energy, equipment, or any other cost pressure that health providers regularly experience.

We are told there is money for volumes, but nothing for base budgets.

While simplistically laudable, it’s not realistic and may be doing harm to the sectors the Wynne government wants to transition more of the health system.

Last year three organizations representing all of Ontario’s interprofessional primary care organizations quietly submitted a report to the Ministry of Health highlighting how the compensation structure for their sector is driving away the professionals they need.

It’s the same low wage strategy that personal support workers have been trapped in, creating high levels of turnover and undermining continuity of care. The big difference is there isn’t a large pool of professionals to continually draw from, leaving significant vacancies.

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ParaMed Strike: Are Canadian workers paying the price for Extendicare’s U.S. losses?

Photograph of striking Renfrew County home care workers and their supporters picket outside of ParaMed's Ottawa office on Monday.

Striking Renfrew County home care workers and their supporters picket outside of ParaMed’s Ottawa office on Monday.

As privatization creeps further into Canada’s health system it’s fair to ask whether decisions are being made based on private profit or health care needs?

As contract health providers become multinational, the interests of Canadian patients may also take a back seat to corporate priorities in other countries.

Extendicare is a Markham-based for-profit company that operates on both sides of the Canada-U.S. border. About 37 per cent of its revenue comes from the company’s operations in Ontario, Manitoba, Saskatchewan and Alberta. CEO Timothy Lukenda lives in Pewaukee, Wisconsin, not far from the company’s U.S. headquarters in Milwaukee. His father is a well-known dentist in the Sault and owns the junior hockey franchise in that city. Prior to getting the top job at Extendicare, Lukenda was an investment banker.

Extendicare’s business involves assisted living centers, nursing homes, health technology services, outpatient therapy and home health care. Overall they have 35,000 employees, making them one of the largest private long-term care providers in North America.

Extendicare’s home care subsidiary, ParaMed Home Health Care, is presently involved in a bitter strike in Renfrew County, northwest of Ottawa.

It’s fair to ask whether the hard-line ParaMed is taking at the bargaining table is motivated by priorities on the other side of the border?

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Some employers balk at mandatory PSW wage increase

PSWs are among 110 striking ParaMed Home Health Care workers in Renfrew County. The government gives, the agency takes away.

PSWs are among 110 striking ParaMed Home Health Care workers in Renfrew County. The government gives, the agency takes away.

In the wake of the Red Cross Care Partners strike last December, it was clear the province needed to quickly improve the working lives of its personal support workers. Home and community care agencies were losing significant numbers of staff due to poor compensation prevalent in the sector. The government’s austerity agenda was only making the situation worse.

The result was the Ministry’s Personal Support Worker Workforce Stabilization Strategy which includes the much talked about $1.50 an hour wage increase retroactive to April 1, 2014.

Now some employers are actually balking at the funding the government is flowing to them for the purposes of improving PSW wages, including the March of Dimes which already bruised its public image after locking out 30 Oakville workers last fall.

The reason has to do with employer payroll costs and a flattening of wage structures.

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Strike pits corporate behemoth against $12.88 an hour home support workers

Picture of a hand-written sign saying the ParaMed Office is closed. Thos who need assistance should call 1-800-565-3393.

Sign on the door Tuesday at of one of ParaMed’s Renfrew County offices.

Renfrew County doesn’t usually generate a lot of headlines.

In a very conservative part of the province the plight of a 110 striking home care workers is generating some sympathy as they take on a corporate behemoth. It’s a David versus Goliath story that pits the millionaire Extendicare CEO against the $12.88 an hour home support worker.

The striking front line staff at ParaMed Home Health Care’s Renfrew County operations are a mere drop in the bucket in Extendicare’s universe. Extendicare, which owns ParaMed, employs about 35,000 workers in Canada and the U.S. Its international headquarters are in Markham, Ontario.

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The power a company that size is being used to grind down the small Renfrew group. It’s been 21 months since their collective agreement expired and ParaMed has shown little interest in coming to the bargaining table or shifting from its hard-line position.

Of course, for Extendicare, there is little at stake beyond the profits generated from this small corner of the province and some public relations value. This is hardly showing Extendicare in a good light, but it may be the least of their concerns. Extendicare recently announced a $42.2 million legal settlement with the U.S. Department of Justice and the Office of the Inspector General of the U.S. Department of Health and Human Services after a 2010 investigation regarding undisclosed claims in alleged violation of the U.S. Social Security Act. The company also has to undergo a five-year corporate integrity agreement, not that Extendicare admits to having done anything illegal.

Back on the streets of Renfrew County the concerns are very different.

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For ParaMed Tuesday’s impending Renfrew strike is just business

Photograph of demonstration outside of ParaMed's Ottawa offices. Support came from across the region as ParaMed's Renfrew workers travelled to Ottawa to picket the company's offices. The workers will almost certainly be on strike next Tuesday.

Support came from across the region Wednesday as ParaMed’s Renfrew workers travelled to Ottawa to picket the company’s offices on Hunt Club Road. The workers will almost certainly be on strike next Tuesday.

Wednesday Renfrew County workers for ParaMed Home Health Care held a surprise picket outside the company’s Ottawa offices supported by a number of regional labour activists.

ParaMed has expressed remarkable indifference to an imminent strike that will sideline 110 nursing and home support workers in the region. Most of these workers are low-wage women.

The company has sent many mixed messages to these workers.

They say they want a deal, but refuse to offer any more bargaining dates until three days into a strike. That makes any last minute agreement to avert disruption to service impossible.

They say that in the event of a strike referrals will go to other home care agencies, but then irresponsibly tell workers that they can cross the picket line if they should choose to continue working.

They have also suggested they may shut down permanently.
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Elopement poses urgent questions about Waypoint’s new $474 million building

Photograph of the fences scaled by a maximum security patient August 23 at Waypoint Centre for Mental Health Care.

Fences scaled by a maximum security patient August 23 at Waypoint Centre for Mental Health Care.

A new building is often seen as a solution for the updated delivery of health care.

It’s true they usually reduce energy costs. If designed correctly and collaboratively, they can also contribute to higher operational efficiency.

Ontario invested heavily in new hospital buildings under former Premier Dalton McGuinty. At one point we counted about 100 major hospital infrastructure projects in the works – about a third developed as public-private partnerships.

Many of these buildings are now open or will be shortly. After moving in, administrators and staff are discovering the shortcomings that often aren’t evident in the planning stage.

One of them is Waypoint Centre for Mental Health Care in Penetanguishene. Waypoint moved both medium and maximum security units into its new $474 million building in May.

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Home Care: Giving and taking away

Photograph of ParaMed staff picketing outside of their Pembroke offices in July. 140 Renfrew County home care workers could be on strike as soon as September 2.

ParaMed staff picket outside their Pembroke office in July. 140 Renfrew County home care workers could be on strike as soon as September 2.

The government gives, the home care agencies take away.

Many of OPSEU’s home care agencies are presently at the bargaining table.

You’d think this would be the best of times for the professional and support staff that conducts the often difficult work of caring for Ontario’s homebound frail and elderly. Retaining this group of workers is also important to government bean counters who can add up the cost of lengthy stays in hospital by alternative level of care patients waiting for home care access.

Clearly of all sectors, home care has also become central to the government’s strategy to migrate services into the community.

So why can’t they get it right?

Ontario did recognize there is a significant problem with recruitment and retention in home care, taking what appeared to be a bold step towards increasing specific funding for the sector’s personal support workers (PSWs). PSWs delivered 72.3 per cent of all home care visits in 2012/13 and that percentage is growing as visits by licensed health professionals (nurses, dietitians, social workers and therapists) have been in decline over the past decade.

As we noted yesterday, the turnover is so high among home care PSWs that often the entire staff of an agency can change in less than two years.

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Two-thirds of Ontario PSWs excluded from wage adjustment

Photograph of former Health Minister Deb Matthews with Finance Minister Charles Sousa announcing the breakthrough increase for PSWs in April.

Former Health Minister Deb Matthews with Finance Minister Charles Sousa announcing the breakthrough increase for PSWs in April. (Photo: Ontario Government).

It was clear from the start that the much applauded increase for Ontario’s Personal Support Workers was not going to apply to all.

Back in April the government noted that “more than 34,000 of Ontario’s PSWs deliver care, assistance and support to seniors and other people with complex care needs in their own homes and communities.”

That was the target group for Ontario’s new funding aimed at bringing stability to a workforce that was turning over every two years or less. Given the emphasis on continuity of care as a measure of quality, this high level of turnover was evidence of colossal failure the Wynne government couldn’t ignore.

These 34,000 represent only about a third of the PSWs in the province. That means for two-thirds, there will be no additional adjustment outside of their existing collective agreement or individual non-union contract.

Only these 34,000 PSWs will receive the $1.50 an hour increase retroactive to April 1st of this year. Those wage adjustments and retroactive pay are expected in September.

The government has committed to increase the hourly rate for this group by a total of $4 an hour by April 1, 2016. By 2016 the new minimum wage for PSWs will be $16.50/hour.

Given the scope of the plan issued in April, it was no surprise that PSWs working in hospitals and long-term care homes would be excluded by the government from this new funding.

What is surprising is news that the government has arbitrarily excluded a significant group of PSWs who do work within the home and community sector. According to a brief released by CUPE, the government is denying the same increase to those who exclusively provide homemaking and work in community mental health/supportive housing. Earlier descriptions suggested these PSWs would likely be in the target group.

In some cases, these excluded workers are often employed by the same agencies that will be passing on increases to their colleagues who provide personal care.

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One helluva story

Photograph of Glenn French, President and CEO of the Canadian Initiative on Workplace Violence.

Glenn French, President and CEO of the Canadian Initiative on Workplace Violence.

Glenn French has a helluva story to tell.

The President and CEO of the Canadian Initiative on Workplace violence provided the keynote speech after two days of meetings by OPSEU’s Mental Health Division.

He spoke about a cleaner in a long-term residential facility in Newfoundland.

The man was well-liked and enjoyed his work.

One day he was struck with a lamp by a resident in a senseless act of violence.

While his colleagues quickly attended to the perpetrator of the act, nobody attended to the cleaner, who took himself off to what he perceived would be a safe place. It was an hour before anyone had thought to give any attention to the victim.

French says that when violence happens in the workplace it has a ripple effect, like a stone being thrown into a pond.

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Mental Health: No easy answers, but there are still answers

Photograph of Nancy Casselman, TEGH's Director of Human Resources and Organizational Quality, Safety and Wellness.

Nancy Casselman, TEGH’s Director of Human Resources and Organizational Quality, Safety and Wellness.

There are no easy answers, but that doesn’t mean there aren’t answers.

We’ve been meeting in downtown Toronto to try and tackle the issues behind the injuries front line professional and support staff are sustaining by simply going to work to help others recover from or cope with a mental illness.

We know that individuals with a mental illness are no more likely to physically and verbally strike out than anyone else.

The evidence is clear — this is not even a debate.

Queen’s University professor Dr. Heather Stuart pointed out that only three per cent of violent crimes are committed by individuals with a serious mental illness. There’s another seven per cent committed by those with addictions.

Yet in popular culture that perception is much greater. Stuart points out that in the world of popular fiction that rate is closer to 20 per cent. When one in five violent crimes are committed on TV by fictional mentally ill people, what does that tell us? How does that shape our view?

Academics, clinicians, and other experts – including our own members – have been spending the past day trying to solve the riddle poised by the very real injuries these front line workers are sustaining. On paper this is not supposed to happen – at least not to this extent.

Nor is it exclusive to this one corner of health care.

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