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January 11, 2022
Standing Committees
Meeting summary: 

Via Video Conference
Impacts of Staffing Shortages in Long-Term Care
Department of Seniors and Long-Term Care
Paul LaFleche, Deputy Minister
Kim Silver, Acting Senior Executive Director of Continuing Care
Katelyn Randell, Director of Long-Term Care
Nova Scotia Nurses’ Union
Janet Hazelton, President
Canadian Union of Public Employees – Nova Scotia
Nan McFadgen, President

Meeting topics: 

















Tuesday, January 11, 2022







Impacts of Staffing Shortages in Long-Term Care









Printed and Published by Nova Scotia Hansard Reporting Services








Trevor Boudreau (Chair)

Kent Smith (Vice-Chair)

Chris Palmer

John White

Danielle Barkhouse

Hon. Zach Churchill

Rafah DiCostanzo

Susan Leblanc

Kendra Coombes


[Danielle Barkhouse was replaced by John A. MacDonald.]




In Attendance:


Judy Kavanagh

Legislative Committee Clerk


Gordon Hebb

Chief Legislative Counsel





Department of Seniors and Long-Term Care


Paul LaFleche, Deputy Minister

Kim Silver, Acting Senior Executive Director, Continuing Care

Katelyn Randell, Director, Long-Term Care


Nova Scotia Nurses’ Union


Janet Hazelton, President


Canadian Union of Public Employees – Nova Scotia

Nan McFadgen, President










1:00 P.M.



Trevor Boudreau



Kent Smith



THE CHAIR: I call the meeting to order. This is the Standing Committee on Health, and my name is Trevor Boudreau. I am the MLA for Richmond and the Chair of the committee. Today, we will be hearing from witnesses on the topic of impacts of staffing shortages in long-term care.


Because of the rise in COVID numbers and in the interest of public health, this committee agreed unanimously in an email poll to hold this meeting by video conference. I thank you all for joining us today.


Members, witnesses, Committee Clerk, and Legislative Counsel should keep their video on throughout the meeting so that I can see you with their microphones on mute unless I call on you to speak. Please turn on your own mic before speaking, and then put it back off afterwards. All other staff should have their audio and video turned off.


If you have another device with you, such as a phone, please put it on silent. Please try not to leave your seat during the meeting unless it’s absolutely necessary. If you do, please leave your camera on but with your audio muted. That way we will know if we have quorum and know whether you are present if a vote is called.


If I need to confer privately with the clerk or Legislative Counsel, or if members wish to confer before a vote, I may call a brief recess. If any members have technical problems, please phone or text the clerk.


Right now, I’ll ask committee members to introduce themselves for the record by stating their name and their constituency. In our emails from the clerk, there was a committee membership list, and we’ll just go in that order, starting with Kent Smith.


[The committee members introduced themselves.]


THE CHAIR: At this time, I would also like to recognize the presence of Chief Legislative Counsel Gordon Hebb and Legislative Committee Clerk Judy Kavanagh. Thank you all for being here and certainly the other staff who put all this together for us online so that we’re able to hold these committees in the state that we’re in.


As I stated before, the topic today is the of impacts of staffing shortages in long-term care. I’d like to welcome all the witnesses. We have three different groups, so maybe they can introduce themselves and at the same time give opening remarks.


We’ll start with the Department of Seniors and Long-Term Care and I’ll let Deputy Minister LaFleche do some introductions and then maybe do some opening remarks as well.


PAUL LAFLECHE: I’m pleased to be here today. I’ve got a couple of colleagues with me. One is Kim Silver, who’s the Acting Senior Executive Director of Home and Continuing Care, and I’ll get to that in my speech why that is. The other is Katelyn Randall - Katelyn, can you raise your hand? Katelyn is a manager with us in Seniors and Long-Term Care.


Do you want me to go right into the speech, Mr. Chair?


THE CHAIR: That would be great, thank you.


PAUL LAFLECHE: Well, first of all, thank you, Mr. Chair and the members of the committee, for inviting us here today to speak about the impacts of staffing shortages in long-term care. We’re very pleased to be here. I am rather embarrassed in that I know the four Opposition members fairly well, but I’ve never met the five government members in person - I’ve met a couple of you on the phone. Nice to meet you, and hopefully over the next few years we’ll get to meet all of the new MLAs who, because of COVID, we haven’t had the chance and opportunity to meet in person.


It’s really a privilege to be here in my role as Deputy Minister of Seniors and Long-Term Care. In fact, I might really say it’s a privilege to be in the Public Service. Every day I wake up and I say, “I’m a lucky guy. I get to serve the people of Canada, the people of Nova Scotia.” That’s a great thing. I know all of you are in the same situation. Sometimes we’re no longer needed - and that day will come for me and everybody else. But right now, we’re very lucky to have the jobs we do and to be able to work in these jobs.


I’d like to spend a couple of minutes off the bat talking about where we are in the sector. I’ve been four months in this position - I also have another position, Deputy Minister of Municipal Affairs and Housing. In no way am I an expert, but hopefully I have the right staff with me to answer all of your questions.


I have a background, as some of you would know, in education, as a professor and as vice-president academic - the first one - of the community college over 20 years ago. So I have a background in education and training and in employment staffing, and one of the first things I noticed is, we’ve got a staffing shortage issue in this sector. That’s what we’re here to talk about today, and that’s something I’ve worked in and am very passionate about.


We’ve also got staffing shortages in many sectors across the county. It’s very acute because of COVID, and it’s very serious in long-term care - more serious in other sectors because of that - and because we care for the people who are in our care in these facilities. In my other portfolio, for instance, if any of you want to leave your public life and become a building inspector, just give me a call. We’ve got staffing shortages in everything we do.


We’ve got to do something about that, but particularly, we’ve got to do it quickly in long-term care. We had to spring into action, and my staff will be prepared today to answer questions concerning just how we’ve done that in three to four short months, and where we think we’ll be as we get further along in the agenda.


To create a continuing care assistant, a licensed practical nurse, a registered nurse, a nurse practitioner, or even a doctor who tends to people in the facilities is not an instant job. It takes time. But we do have a sense of urgency embedded in us to get this done, and we’re working closely with Dr. Kevin Orrell, who is the Deputy Minister of Healthcare Professionals Recruitment.


The pandemic has really strained a long-term care system that was already under strain. I had some experience in the system when I joined government in 2002 in terms of funding, a little later in terms of approval of facilities, and a little later when I worked at what is now called Public Works in the standards and the building of facilities.


We’re in a situation now where we’ve got a sector that probably has not had the degree of public care and tender that it should have over the last 20 to 30 years. Then we got hit by COVID, and then we got hit by staffing shortages.


First of all, I want to say that I’m very grateful for the work of all the health professionals who have worked so hard during this pandemic to ensure that our long-term care residents are as safe as they can be. It’s a very stressful situation for them, as you know. Many of those workers have gotten COVID themselves, therefore we’re short staffed. Enrolments are down at some of our training programs, therefore we have staffing shortages. There are issues with the career of a continuing care assistant, such that it’s not as attractive as it used to be.


When I was at the community college, the program was packed. There were oodles and oodles of people on wait-lists to get in. Now there are vacant seats at the Nova Scotia Community College in these programs. We’ve got to do something to change that. These are the problems.


On the other hand, we have opportunities. We have opportunities to look at changes in this sector. We’re doing 29 new and replacement builds that have been approved over the last year. These opportunities - and more will come in the future - present themselves to us at a very good time because we can build the right facilities for the future with the right staffing levels, the right equipment, and the right flexibility to adapt to future needs.


In the first four months this government has been in, they feel - and we as staff would agree - that we’ve put in place a foundation which will bear fruit over the next couple of years in terms of long-term care. In the meantime, we’ve got to deal with COVID and the issues we have before us. Last month, Minister Adams announced a $57 million commitment to long-term care. I’ve got a long list here - I know we’re not allowed props, but I can hand this out and we can send this to committee members - of the actions taken, let alone in the last two months. There’s a long-term care booklet detailing these, which is available on the website.


More is coming. We promised a Continuing Care Act - that will be coming, hopefully in the Spring or the Fall. We promised things around the registration of continuing care assistants - that will be coming. We promised to get the builds underway and done quickly. A couple have already started, others are in the early stages of project management. You may have seen recent tenders for project managers.


Then we have the issue of staffing. We have about 180 collective agreements between the various long-term care institutions and their staff. That’s a lot of collective agreements that have to be negotiated. One hundred and fifty-seven of these agreements are currently expired, and discussions are underway for 27 of them. We need discussions to come about with more of them. We’re hopeful that will occur between the employer - that being the board of the institutions - and the bargaining units in the near future.


Much has been made about the issue of higher wages. Higher wages are a part of the equation, but also is having the continuing care career as a vibrant career that has upward potential, where people can grow in the job and maybe move to different jobs, change over time, or even experience a great long-term career as a continuing care assistant. Those are things that are really important to creating an attractive career. We’re working with the NSCC, with private colleges, with the associations, to ensure that we can make this career more attractive.


We literally need thousands of additional health-care workers and more than a thousand continuing care assistants in the near future. The first attempt we’ve made to accelerate the training of these is the work-and-learn model. Until now, most of the training in recent years has been a ten-month program at a business college, community college, et cetera. We’ve introduced a work-and-learn program where you can go to school for one month, get an initial introduction, and then you go onto a three-day work, two-day school program until you finish your diploma as a continuing care assistant.


This dramatically accelerates the ability to get people into the workforce. It also allows people of a more mature age with parental responsibilities, or other responsibilities in life to be able to afford to go back to school - maybe when they’re in their mid-20s or later - and pursue this career. The full-time program is great for people coming out of high school, but we were told by the industry it didn’t appeal.


So, in very rapid order, within about a month, the minister put together a team to introduce a new program in cooperation with the Cape Breton Business College. That program already had its first cohort. Hopefully, that cohort will be entering the workforce in the near future on the work-and-learn model. Those are some of the things we’ve done to hopefully increase interest in the profession, to speed entry into the profession. We’ve got a lot of other work to do.


I want to give a shout-out here to my union colleagues. I know that Janet Hazelton is there. Janet wouldn’t remember, but when I was vice-president of the community college, she and I met in the year 2000 with Kelly McKnight. That was when I was in charge of licensed practical nurse training.


I haven’t seen you since, Janet, but happy to see you here. I know what a great partner your organization has been. We’ve listened to many of the things you’ve told us about the professions under your jurisdiction. Hopefully we’re making the right moves to implement what needs to be done to increase the supply and make life better for those workers.


I also want to give a shout-out to Nan McFadgen of CUPE. Some of you will know - I know Mr. Churchill will know - that for many years I was the only one in government who had a lot of CUPE employees at Public Works. I’ve worked for many years with CUPE, almost a decade, and glad to be a partner with you. Hopefully we’ll get to a good spot in terms of where we’re going in collective bargaining, but also in all the other things that we could learn from CUPE members in terms of how we need to create a better profession for continuing care assistants.


The government has been clear about what it would like to do. In only four months, it set out an aggressive agenda and made many announcements - more to come. We’re not going to fix a 30-year problem in four months, especially during COVID, but we’re going to take a big step toward fixing this problem - a step which hasn’t been taken in a long time. We’re going to take that step. We’ve started, we’ve taken the first step, we’re going to take the second and third. We’re eventually going to get to a better sector here with new facilities, single rooms, 4.1 hours of care - all sorts of things like that that will benefit the sector - and a better career for CCAs. I will be back hopefully a year from now with a good story to tell you.


That’s my opening speech. I do want to mention two things. My staff here today are, to some extent, pinch hitters. Tracey Barbrick, the Associate Deputy Minister who has worked in Health and Wellness and Community Services for many years, agreed to do a one-month assignment to set up the new booster shot vaccine centres. She’s off today and she’s replaced by Kim Silver. Vicky Elliott-Lopez, who was the long-time Senior Executive Director of Continuing Care, was stolen by the Honourable Geoff MacLellan to be the CEO of the housing task force and Housing Nova Scotia.


We’ll do all we can to answer the questions. If there are any questions we can’t answer, we’ll of course, as usual, be able to write back to the committee and give you answers. Any committee member who has personal questions at any time can reach out to me - as many of the veteran members of the Legislature would know that - or my staff and have a chat with us.


Thank you very much. I’ll pass the baton on to the next presenter.


THE CHAIR: Next we’ll have Nova Scotia Nurses’ Union President Janet Hazelton. You can introduce yourself and give us some short remarks as well.


JANET HAZELTON: Good afternoon and thanks for having me. My name is Janet Hazelton. I’m the current President of the Nova Scotia Nurses’ Union and have been the president since 2002. I am a registered nurse, graduated a few years ago from St. FX University, and I also have a Masters from Dalhousie.


I have the privilege of representing the majority, if not all, of the registered nurses who are working in long-term care, and some of the licensed practical nurses who work in long-term care as well. The mandate of the Nurses’ Union is that we can only represent nurses, so the three titles, if you will, would be: nurse practitioners, licensed practical nurses, and registered nurses.


We have four unions representing various classifications of nurses in this province: NSNU, along with CUPE, Unifor, and NSGEU represent all nurses through all sectors. I have the privilege, as I said, to represent licensed practical nurses, registered nurses, and soon to be - I hope - nurse practitioners working in long-term care.


Almost a year to the day today, I spoke before this Standing Committee on Health about staffing in long-term care. Not much has changed except for the recent and most contagious wave of COVID-19. Omicron has had a crippling effect on staffing, particularly in long-term care. Needless to say, Omicron has made a bad situation even worse - especially now when nurses are being put in increasingly unsafe work situations.


Since I last appeared before this committee on this matter, the legislation was written but it has never been tabled. This current government has also made a commitment to increase hours of nursing care. This, again, has yet to be realized, and we look forward to it.


Nurses need to see a plan and need immediate relief. Nurses are being put in increasingly unsafe situations with unreasonable expectations to keep our long-term care system functioning. Nurses fear that allowing the system to continue functioning the way it is, with staffing constantly bordering on crisis, jeopardizes safe nursing care. My presentation will have a familiar ring to many of you, simply because we’ve been talking about staffing issues in long-term care for a very long time.


Staffing ratios, or legislative ratios, have not changed since 1989. In those days, when residents came, many were driving vehicles. I say to lots of people, I went to a barbeque at a facility, and they had this huge parking lot in the back. It was in Dartmouth. I said to the administrator, wow, look at all the staff parking you have. He said, Janet, that parking was put in place for residents.


So, when we built this place, those parking spots were residents. They went out to church, they went to get their hair done - they did all kinds of things outside of the home. We know that that is not the case. We’ve done a very good job of keeping people in their home, so when they do go to long-term care, they’re there for that - care. They’re there for care from our hardworking CCAs, as well as our licensed staff.


But yet, changes have not been made since 1989. The state of the Nova Scotia long-term care system remains a long-standing concern of the membership, as well as the leadership, of the Nova Scotia Nurses Union. These concerns were articulated and validated in our 2016 publication called Broken Homes, which if you haven’t read, you really need to. We did a lot of research - both nationally and internationally - to make this publication called Broken Homes with a series of recommendations that we truly believe will help if they’re instituted.


We called for a lot of reforms in that, many of which are being worked on, we hope. We were very pleased to see with the previous government - when we would go to our finance lockup - they had a line in the long-term health budget that said Broken Homes Money. That was out of a recommendation. We’re very proud of that. We’re very proud that it was so well done, and that people are taking it seriously.


There has been progress on several fronts. The single most important recommendation for that publication - the one that would do the most to improve the quality of life for residents and working conditions for all the health care providers - remains unchanged. This is a call for explicit, evidence-based staffing standards. At a minimum, this would mean an average of 4.1 hours of care per resident per day, including 1.3 hours of nursing care. That would be provided by either an RN or an LPN or a combination of both. I realize that there are discussions about 4.1 hours of care, but the Nurses’ Union wants and demands that this be specific in legislation and that the legislation says that 1.3 hours of that care is being provided by either an RN or an LPN. That is paramount.


It has to be baked into legislation. The reason for that is when it’s in legislation, it has to happen. When it’s a suggestion, it may or may not happen. We implore you to make sure that it’s 4.1 hours of care, minimum. We’d be happy to have more - and we believe we need more - but if we get 4.1, it would be more than most other provinces. Just as importantly as the 4.1 - and again I stress this - 1.3 hours of that has to be provided by a nurse, whether it’s an RN or LPN or both.


In 2018, the Minister of Health and Wellness established an expert panel to look at ways to improve the quality of long-term care in Nova Scotia. In its terms of reference, the panel was tasked with recommending appropriate staffing levels, staff complement, and skill mix for long-term care facilities. The panel’s report made important recommendations, including many that were previously made by the Nurses’ Union in our Broken Homes report. Unfortunately, it did not live up to its mandate with respect to staffing ratios.


We think the Nurses’ Union saw that as a missed opportunity, and we were very disappointed. In our view - and in the opinion of experts we consulted - there is more than enough evidence to establish minimum staffing standards for Nova Scotia, even if it’s based on best-case scenarios. For many of you who may not be aware, that expert panel said that there needs to be more evidence, that there wasn’t enough evidence to warrant the 4.1 hours of care. There are mountains of evidence. There may not be enough evidence in Nova Scotia, but there are mountains of evidence all over this country, and in fact, the world.


After the expert panel, we once again went out and commissioned an expert to verify that there is, indeed, enough evidence to warrant the 4.1 hours of care. Never mind just talking to the people on the ground who are doing the work, that is all the evidence you need. We’ll talk about that briefly in just a second.


We hired a specialist. Her name was Dr. Harrington, and she came to us from California. She was an expert on long-term care and staffing. She agreed - and she provided loads of evidence available to you if you want - that residents needed at least 4.1 hours of care, including 1.3 hours of nursing care provided by an RN and LPN.


The expert panel said there wasn’t enough evidence. The Nurses’ Union took it upon themselves to go get verification that there was indeed enough - so I think we can put that to bed. There is enough evidence. This government has agreed that they will do 4.1 hours of care. The next step is to make sure that 1.3 of those hours are provided by nurses.


The issue of understaffing in long-term care and the COVID-19 crisis in this sector are intimately related. Long-term care has been chronically underfunded for decades. Staff are struggling every day to meet the needs of the clients and the residents that they care for. We need to stop designing systems around providing the bare minimum of care, when we have learned through painful experience just how easily the system can crack and crumble under the weight of the challenges that long-term care now face.


We also recognize that federal work is under way to establish national standards for long-term care in Canada through both the Health Standards Organization and the Canadian Standards Association. This is important work undertaken by experts in the field, but unless the standards they develop are written into legislation, we fear there will be very little change. The federal and provincial governments must also realize that no amount of creative and innovative thinking will replace care hours and funding to cover a deficit that has been decades in the making.


[1:30 p.m.]


We understand that it is decades in the making and we understand that it’s not going to take four months to fix, but we need to stop talking about fixing it and start to fix it. We need to stop studying the fixing and start doing the fixing. Nurses are tired of being surveyed, being studied, being watched, being followed around. We are done with that. We need action. We need it now. It is only by the grace of God that we have such a dedicated group of employees in our long-term care system. We have a shortage of nurses and others throughout the entire system. We have somewhere around 600 or 700 registered nurse vacancies in our acute care system, where the staffing, although not great, is definitely better.


We are so lucky that we have registered nurses, licensed practical nurses, and CCAs who are so dedicated to this broken system that they stay. They can easily cross the street and go get a job at any acute care facility anywhere in this province. They’re staying because they love what they do. They’re staying because they love their residents.


I get emails every day from long-term care nurses - one this morning saying, “This is bad. This is really bad. This is the worst I’ve ever seen it for staffing, because we have people out now that are either positive or are isolating.” Our system within long-term care has never been this bad. I have a very seasoned nurse who works nights for one of our bigger long-term care facilities. She came off her third 12-hour night this morning and said, “I have never worked in long-term care in a system that’s this bad. We could barely keep our heads above water last night.”


It’s got nothing to do with anything other than the minimum staffing was too minimum, and now when people aren’t there, it’s way below minimum. We don’t have the staff in long-term care because of the staffing levels. If we had decent staffing levels, we might be able to weather this storm, but we don’t, and we can’t.


I thank you for your interest in this issue, but again, I know that there are all kinds of good initiatives coming - for example, nurse practitioners in long-term care. We’ve been asking for that for a long time. They’re in primary care and long-term care. My concern is I don’t want them pulled out of the long-term care. I’m supposed to work today at X Long-Term Care Facility, and all of a sudden there’s a wait-list in the primary care system and people don’t have doctors. Eventually, that nurse practitioner, because she’s a primary care practitioner, gets pulled back into primary care - then long-term care once again suffers because the 40-year-old person with angina seems more immediate than the 97-year-old who has a urinary tract infection.


We just have to prioritize them. I guarantee you, we don’t have children at the IWK waiting 20 minutes or 30 minutes or longer to get bathed or fed. It doesn’t happen. But it does in long-term care. Does that show our respect for these individuals? I hope not, but I think we have an opportunity - unfortunately, COVID gave it to us, because the whole world’s talking about long-term care. We have this opportunity to make it better, and we need to make it better, or shame on all of us.


Thank you for your time. Those are my comments. Sorry if I went over.


THE CHAIR: Thank you very much, Janet Hazelton. Thank you for your comments.


We’ll move on to the Canadian Union of Public Employees for Nova Scotia and Nan McFadgen, president. Nan, you can take it from here.


NAN MCFADGEN: Thank you. My name is Nan McFadgen, and I am president of CUPE Nova Scotia. I’m pleased to be here today representing over 19,000 CUPE members - 4,700 of whom work directly in long-term care. I thank the committee for looking into the problem of staffing shortages and for inviting me to speak.


I bring you a simple and clear message from CCAs, dietary aides, housekeepers - the full range of workers who work in long-term care. They are overworked and underpaid. You may think that being overworked and underpaid are two separate problems to have, but long-term care workers want you to know that they’re intimately connected.


One reason they’re overworked is because there are not enough workers to fill vacant positions. They suffer from overwork when they can’t get a vacation or are forced to work overtime or work short-staffed because the workforce has been eroded by injuries, retirements, and resignations. Why aren’t there enough workers to fill the vacancies? In one word: pay.


The word is out that care work is hard work, and the pay isn’t great: systemic undervaluing of care work, which generally equates to women’s work. It’s an unfortunate fact that in Nova Scotia, the longer you work in long-term care, the less you can expect to make. You heard that correctly. When you take inflation into account, our members have seen their real take-home pay cut every year over the last eight years. Poor pay has led to many experienced long-term care workers leaving. Young workers can find better-paid positions, in- or out-of-province, that also provide better work/life balance. The result is that there are not enough workers available at the current level of pay, and that increases - wait for it - overwork and the exodus from this sector. You get the picture.


I think we all know the solution to the long-term care staffing problem: increase the pay and hire more staff. What is not yet known is whether this government will take the tough steps needed to solve this problem. It requires compensation increases to retain existing staff and attract new staff, and there needs to be a very significant investment in new positions.


In the remaining time, I want to direct my comments to the specific question of increasing staffing levels in long-term care. If there is a second message my members want me to deliver today, it’s this: give us the time to care. What we mean by having the time to care is that long-term care facilities need to have a ratio of care hours that is legislated at 4.1 hours of hands-on care per resident per day.


It has been 20 years since CUPE bargained the ratio of care. It remains in place as we speak. Twenty years ago, some of our residents would drive themselves to a nursing home. Now they are more often than not brought in by ambulance. Acuity of care has increased, but the time to care has not followed suit. What would we see if the government funded and legislated staffing levels at 4.1? Well, we would see staff who are not exhausted and injured by their workload, staff who can call in sick without condemning their workers to working short that shift, and staff who can, again, experience the joy that first drew them to the profession: caring for a person in need.


These issues are at the root of why long-term care workers are being burnt out and leaving the jobs they love. I have heard directly from hundreds of long-term care workers, and saw these problems grow first-hand during my 20 years as an LPN in long-term care.


In January 2020, CUPE CCAs working at a nursing home in Pictou County participated in an experiment to see what 4.1 hours of hands-on care per resident would look like. Our members came in on their days off to bring the resident/staff ratio up to 4.1 hours of hands-on care from a funded level of 2.45. The impacts were incredible. Staff had time to talk to residents or maybe even curl their hair. There were no falls during that period of the fully-staffed experience and no behavioral incidents.


Most telling, our members told us how even that short period of being able to have the time to care, rekindled the love that they have for their profession. The effect of investing in higher levels of staffing is that it will bring our seniors the high quality of care they deserve.


To conclude, I haven’t even mentioned the word “pandemic” until now. The past two years have been extremely difficult for everyone, and in particular, for residents and workers in long-term care. There have been a lot of things said about the importance of the work our members do. CUPE is currently beginning bargaining for their long-term care sector workers. Both issues I’ve spoken about today - staffing levels and compensation - can be addressed in that form. It remains to be seen whether long-term care workers will be recognized in more than words for the critical care work that they do.


I thank you very much for your time.


THE CHAIR: Thank you very much, Ms. McFadgen. That will conclude our opening remarks. They went a bit longer than we anticipated, but that’s okay. That was some good information.


What happens now is each caucus gets 20 minutes to ask questions, starting with the Official Opposition, then the third party, then the governing party. Usually, if there’s time at the end, some call it a rapid round where there’s extra time. I was hoping to have questions done by 2:40 p.m., which gives us 20 minutes each with no rapid fire at the end, but we’ll see how those things go and if we have some time for that at the end.


What I would ask is when members are asking questions, make sure you let me know who you’re directing them to - who the witness is you would like to answer them. I’ll try to play in between as we go along, if that’s all right with everybody.


I would ask the Liberals - Ms. DiCostanzo, you’re going to start. I see your hand going up. We’ll start your 20 minutes, and you can ask your questions. You can go right ahead.


RAFAH DICOSTANZO: Thank you everybody for your opening remarks. It was really hard to hear. Janet saying that this has been the worst it has ever been was like a knife in the heart. I worked in health for 20 years as a medical interpreter. I have two daughters in health, and it’s true - it is one of the most difficult times for all health workers. We all have to thank them so much for what they’re doing and how they’re caring.


I’m going to start with a couple of questions mainly to get more information - information that used to be supplied on a regular basis that we are not receiving. I would like maybe either Mr. LaFleche or Ms. Silver to see if they can update us on, for example, how many nursing homes are closed to admissions at the moment. I know we have over 133, and the last thing that we heard was about two months ago or more that 17 or 18 were closed. Do we have any updates on those numbers?


PAUL LAFLECHE: I’m going to refer those technical questions on long-term care facilities each time to Katelyn Randell. That’s the best person to answer the statistical-type questions - not that Kim Silver and I are ducking here. We can talk all you want, but maybe Katelyn can do that.


THE CHAIR: Ms. Randell, maybe you can answer that question.


KATELYN RANDELL: Thank you, Chair and Deputy. Hi, everyone. Yes, I’m Katelyn Randell, Director for Long-Term Care. It’s nice to see everyone today.


For workforce shortages, it has been very fluid. Some of the numbers that were mentioned were previous numbers. It’s important to realize that those numbers change almost daily. As of today, we have 25 homes that have paused to admissions. It’s important to realize that some of these homes aren’t fully closed, but they’ve taken the steps to recognize where they have gaps in staffing. They are allowing for those vacancies to optimize the staff they do have in the house. Some are closed but are still taking admissions past a certain number, so 25 is our number for today.


THE CHAIR: Ms. DiCostanzo.


RAFAH DICOSTANZO: Thank you, Ms. Randell, for that information. I’m sorry - you said they’re taking steps. Are these going to be open soon? What is “taking steps?” What practical steps are they putting in that these will be open, and how is it affecting the people who are waiting on the waiting list?


[1:45 p.m.]


KATELYN RANDELL: Absolutely, yes. We don’t take a one-size-fits-all approach, of course. Our service providers, our homes, are very unique. We work with every home on a case-by-case basis to assess their situation and support them in the areas where they need support. That can look like helping them access agency staff, deploying travel nurses to them.


For some, they’re closing just for a couple of weeks, knowing that they’re onboarding new staff and it takes time to orient and support them. Others, it’s a little bit longer where they have bigger gaps. We are really supporting them, we are working with them, and we recognize that they know what’s safe. We’re listening to them and understanding that what works for one may not work for the other. I think it’s really important that we highlight the fact that they know those facilities.


To Janet’s and Nan’s points, they’ve been in the industry, they care so much, so when they request that pause in admissions, we’re collaborating with them, looking at options, and supporting them continually. That involves frequent communication and touching base to look to the future, but currently we have deployed over 19 nurses to some of these facilities.


RAFAH DICOSTANZO: Do we have numbers of how many people are waiting? The last time we heard was two months ago. Actually, the minister herself promised that we will have that information in December - by the end of the week - those numbers of how many people are on the waiting list to get in.


I want to tell you that I’m witnessing it - my father-in-law who’s 95 years old, and literally needing 24-hour care. My sister-in-law and my husband - my family are struggling because we are not nurses. We have four private people who are going in just to help them because he can’t get into one of those long-term care homes. He is almost palliative. We don’t know what to do.


What are you doing for those situations? I’m sure there are hundreds of them. It just happens that I’m witnessing one within the family right now, and it’s very difficult on everybody. He fell twice. We don’t know how to help him and there is no hope of him getting into a home at 95 years old. Tell me what we can do temporarily until things get better.


KATELYN RANDALL: Thank you for sharing that. I know that’s a very personal story and I appreciate that there are many other Nova Scotians in similar situations. We do have 1,800 on the wait-list between community and hospital. It’s important to recognize, with the pandemic, that we have had to take steps with the Nova Scotia Health Authority to put some hospital variants in place to ensure that we’re optimizing access and flow in our acute care.


It’s been very difficult seeing people waiting in community for long-term care. That’s why we have such a robust home care as well. Home care and long-term care, as you know, is a continuum in support so absolutely, getting in touch with your care coordinator would be essential to look at any wraparound supports.


With the facilities themselves, like I said, we’re working with them very closely. We trust it’s the case when they say that it’s not safe and we need to pause on a few beds, but we also recognize that they’re working so incredibly hard to open those beds. Like I said, some may close five or six beds, but as soon as they get past that number, they’re still open.


We’re still seeing movement at many of these 25 nursing homes. It’s not like they’ve just completely stopped; it’s just giving them a little bit of the breathing room. I appreciate that’s still very difficult for your situation and many other Nova Scotians. That’s why we’re working so hard with the recent investment of $57 million to build up that workforce so that we don’t have these vacancies.


RAFAH DICOSTANZO: I know it’s personal, but I have experience with my family in Ontario getting home care and my in-laws getting home care here, and it’s quite different. I hope with the plans that this government is bringing that there will be change in home care and the way it’s delivered here.


We have people changing constantly. When you have one who is 91 with dementia, and another one - his cognitive is good, but he physically has so many issues that he should be in hospital or long-term care, and they’re having to explain the same thing over and over. Because a different person comes home every time, it’s not consistent with the same person. That’s home care, that’s not long-term care, but it has not worked. We had to give up on home care because of that. That is an issue that needs to be addressed.


I will bring it up as well when we talk about home care. It has to be addressed that the same person needs to go back in. When you have people who have dementia, who have issues, you’re literally explaining the same situation over and over. They have hearing problems, they have dementia problems, and they have language problems, and they have a different person going in every day. How does that work?


That was one. I’m just saying - and I love home care. I would love to be able to have both stay at home for as long as possible. I’m all for that, but we have a system issue that needs to be addressed as well.


The other thing actually, before I go - sorry. I think I took enough time. I wanted to make sure - because we’re not getting a second - to let my colleague, Mr. Churchill, take it over from here. If he has extra time to leave me, then I’ll have something else.


Thank you, and I’ll give it Mr. Churchill to take over.


THE CHAIR: Mr. Churchill.


HON. ZACH CHURCHILL: Thank you so much, and to the presenters. Deputy LaFleche, I’m happy to see that you’ve landed in such a critical portfolio. You’ve served governments of all three political stripes with a high level of competence and effectiveness. I know that your skill set, along with that of your team, will be well deployed in this department.


To presidents Hazelton and McFadgen, it’s really good to see you today. It was a real pleasure working with you during my time in government, and I look forward to continuing that in Opposition. I want to thank you for being such passionate leaders in your fields. Even in moments of disagreement - I know when we were in government - we could develop a level of respect and always appreciated your level of passion and commitment to your members and to the province.


I will say that particularly during these last two years, you and your membership have demonstrated the highest level of courage, service, and commitment to the people of this province. Being in harm’s way, very directly, never once have either of you or your members suggested that you shouldn’t be there at work. You’ve taken on your critical role during these last two years heroically. Thank you, and thank you to your members as well for that.


I do want to pick up on a question to Deputy LaFleche that my colleague touched upon. On December 1st, Minister Adams did indicate that right away, the reporting on the wait-lists would be updated. This is of course something that our government did very regularly. We reported on what the wait-list was for long-term care. In the last, I believe, five or six months or so, that reporting has stopped. On December 1st, Minister Adams did say that those numbers would be updated right away, and it has been six weeks since that commitment.


Could Deputy LaFleche please tell us if he has received a directive from the minister to commence reporting on the wait-lists once again? This was happening under the previous administration.


PAUL LAFLECHE: First of all, thank you, Mr. Churchill. I want to apologize. Just looking at the elegantly dressed Honourable Zach Churchill, I realized that when I came into work - I came in with my sweatshirt with the old department name on it - and I forgot to put my jacket on, even though I have a dress shirt. I apologize. I might dip out for a minute and get the tie and jacket on after we’ve finished answering the question.


I’m going to give a chance to Kim Silver, whom I think would like to answer that question about the wait-list. Good question and I think she has an answer.


THE CHAIR: Ms. Silver.


KIM SILVER: Thank you, Deputy. We actually stopped reporting that wait-list from community in June of this year. The purpose of the reporting was really to help people in the community understand how long they could expect to wait before they got into long-term care. We have a hospital variance in place with the NSHA that supports moving people out of hospital into long-term care. People from the community are still getting in, but the reality is that’s in quite small numbers based on urgency. So posting the numbers won’t give people a reasonable representation of how long they’re likely to wait at this point.


The variance is in place until March 31st, so it’s unlikely we’ll have a lot of movement from community unless things improve significantly before that point. However, we are looking at how we might be able to report it in a different way that actually provides information that’s useful to individuals.


We’d also encourage any individuals to contact their care coordinator to talk about what the expected timelines are in their situation. As well, we’ve significantly increased the home care supports in terms of direct funding so that people have an option to be funded to purchase services privately as well. That’s being used by a lot of people who have more significant care needs, who aren’t able to go into long-term care at this point.


ZACH CHURCHILL: I just wanted to quote the Minister’s comments from December 1st: “We’ve been, frankly, busy trying to implement as many things from the Premier’s mandate as possible, but we do have up-to-date wait time numbers. They just have to be uploaded to the website,” Minister Adams said, “and she will ensure that those are updated right away.”


Just for the sake of the committee, I do want to point out that it’s been six weeks since those numbers were updated on the website. Later on in the meeting, Mr. Chair, I wouldn’t mind moving forward a motion in relation to this.


Before we get to that point, I do want to ask some questions related to staffing as well. The government did commit to Nova Scotians - in their election platform and, of course, in the mandate letter - that 600 new nurses would be hired for our long-term care sector. I’d just like to know - considering there’s a shortage everywhere, not just in Nova Scotia, but across the country - what the expectancy is from the public service on when they could meet that number of getting 600 new nurses into the system. If there is a timeline on that, please speak to any strategies that will be employed as well. I’m familiar with some that were developed and some that were implemented when we were in government, but if there are any new ones, that would be of interest, for sure.


Also, in relation to the government’s commitment of 2,500 new beds into the system, how many more nurses and how many more long-term care staff would we require in the system to actually staff those beds once they are built? Again, that was 2,500 new beds. What’s the staffing complement that would be required to staff those new facilities? Also, would there be an additional staffing pressure related to the 4.1 hours of care per resident? What is the amount of nurses and staffing complement that would be required to implement that directive and that commitment from the Premier of the 4.1 hours of care per resident?


PAUL LAFLECHE: I’ll start that off by saying we have about 6,600 full-time equivalent continuing care assistants in the system. We certify about 500 or 600 a year. Obviously, we will need more. We’re currently pledged to bring in about 1,400 incremental continuing care assistants, and as Mr. Churchill said, about 600 nurses. That is really Dr. Orrell’s area, but I’ll ask Katelyn Randell to take a stab at it.


KATELYN RANDELL: Dr. Orrell with the Office of Healthcare Recruitment is specifically looking at nurses and nursing recruitment and strategies, and actually recently announced that nursing grads for the next five years will be guaranteed employment within Nova Scotia. We’ve also announced recently that there will be relocation aid for nurses who are looking to move to different hard-to-recruit areas of the province, and so with the Office of Healthcare Recruitment, we’re working on the nursing.

When it comes to CCAs, we’ve just recently announced quite a big announcement. Part of that announcement involved our new HR innovation fund and professional development fund. Over the next two years, through our HANS partner, each fund will administer up to $2 million each to CCAs and nurses for both creative and innovative ways to recruit to hard-to-recruit areas. That could include accommodation, travel, relocation, as well as professional development. We recognize it’s extremely important to onboard and take care of our new staff, as well as provide them the tools to upgrade and learn. Those are two of a few.


[2:00 p.m.]


We’re also looking at our RPL program. We’re increasing from 300 to 600 to be able to move CCAs with prior experience who - similar to Rafah’s comment - have that significant experience caring for their loved ones. It’s to recognize that experience and help them get to a very rewarding and honourable career as a CCA, as well as supporting tuition.


It’s recognizing that there are many different people with many different requirements in life and children and things that come up. We need to support them where they’re at - whether that be a traditional model that we support them through, in a bricks and mortar, or whether they’re in a new work-and-learn program, where they work within a facility and learn as well as earning income to support their family.


We’re really excited about that. To the deputy’s points earlier, we’ve already got a class that’s coming out this month through CBBC, another 70 going through this month, and another 100-plus lined up to take the next round. I’ve heard from many administrators who have people in mind that would love to be part of that program, and are starting to gear up to be involved.


It’s very exciting. We have ambitious numbers for both nurses and CCAs, and we’re hopeful to get there. Nova Scotia’s a beautiful place. With the many promises in the mandate and the work that we’re doing, we’re going to build that foundation where CCAs, nurses, and the like will continue to be proud of what they’re doing and love the work and enjoy the work, and do sit down and spend that time with residents and play cards, as some of my colleagues here have mentioned.


In addition to that, we’re recognizing that there are students currently in the program, so we have another $3.1 million announced to support them. We have $2.1 million to look at international recruitment as well as out-of-province recruitment - so again we’re recognizing that a lot of people want to come home. They’ve moved out for other jobs. We have a lot of new jobs here now. We want them home.


We have also supported our facilities looking at what we call surge capacity, up to $8 million that we’ve provided to offer full-time employment to those who are casual or part-time, and another $1.4 million . . .

THE CHAIR: Time. The 20 minutes for the Liberals has expired. We move on to the NDP who will now have their 20 minutes. Ms. Leblanc, you can begin.


SUSAN LEBLANC: I just want to make a couple general comments before I ask my first question - mostly around Deputy LaFleche’s opening remarks, and actually what Ms. Randall was just talking about with the better career for CCAs. This all sounds wonderful, actually having a career in long-term care, the caring economy, the green economy - although some members of the government party have called me out for suggesting that caring jobs are green jobs. I will continue to debate that because they are, and it’s the type of work that we need to be investing in right now in Nova Scotia and the world.


It’s wonderful to hear this vision of a CCA who maybe has support in school, and maybe has support with child care. Also, let us not forget that we need to make a living wage. We need to make a good wage, especially with the rental and housing market that we are in in Nova Scotia - not just in the city but in all parts of Nova Scotia. Folks who are making less than $20 an hour just can’t make ends meet anymore.


If we’re talking about better careers for CCAs, then we need to be talking about higher wages. We need to be talking about at least $25 an hour. I don’t understand how we can have any of these conversations without just putting that on the table. All of the other things are important. I’ll be very clear. I’m not trying to be a Nelly naysayer or a Debbie downer, but we just have to be realistic about the amount of money that people need to make.


That being said, I also want to say that as a preamble to this first question, that the deputy in his remarks - I’m quite sure he said there was this, there was this, then there was COVID, and then there were staffing shortages. I would politely disagree with the deputy that that’s not the case. As we’ve heard from the NSNU and from CUPE, staffing shortages have been dangerously low long before the COVID-19 pandemic. Of course, COVID-19 just made a bad problem worse. Long-term care workers are getting sick, being exposed to COVID-19, burning out, and leaving the profession - literally doing back-breaking labour with no respite.


Vicky Levack, who is a disability advocate and a resident in long-term care in Halifax, has been documenting the staffing shortages where she lives, explaining how people will wait hours for medication or to be helped to bed. One evening recently on the floor that she lives on, that floor was down to one continuing care assistant for 19 residents. As she says, it’s no way for people to live or for staff to work. It would be hugely demoralizing for the staff in that situation.


I guess I’d like to ask Nan McFadgen from CUPE first: Can you talk about what you’re hearing from your members directly about what working in long-term care has been like in the last couple of months?

NAN MCFADGEN: Well, working in long-term care has been a challenge long before COVID-19. We had people with cancelled vacations and cancelled holidays, mandating overtime - that came before COVID-19. Anybody who works in long-term care has that clear understanding that that’s been a challenge for many years. It’s why when we bargained the 2.45 hours 20 years ago, we continued to try to improve on it each round, but we continue to fail because we’re still there.


Our members are broken. They’re tired. I don’t exactly know what it is you, the government, or you, society, want from them. They’re doing the best they can, they’re working so very hard, and yet no one is willing to step up and say we know all of these things. I mean, recruiting from out west and Ontario - very best wishes to you - where some of them will make $24 an hour.


Our CCAs - if you’re living in Halifax and you have only a CCA income, you are living in poverty. If you’re thinking that you’re going to attract young people to a CCA career so that they too can live in poverty - all the while they break their back before they’re 40 with high incidents of WCB - I just don’t know how that’s attractive. I just don’t. That is why when we put forward our thoughts, they were very, very basic thoughts.


We need our workers to be paid better so that when they go to the store, they can afford that $30 roast to feed their family, or the $40 roast. They need to make enough money to live, and they need to not be broken when they come home. That’s really not a lot to ask. I just don’t know why that’s so hard. It’s such a frustrating thing for them.


We have members leaving long-term care early - so they take a hit with their pension - so they go to Frenchy’s to work part-time to augment their pension rather than work in long-term care. These are people who love what they do and love going to work. So if that doesn’t explain to you that they deserve better and, by extension, our seniors, on whose backs we currently stand - they built what we’re standing on, right? I mean, I sound like a long-term care worker because it’s not that long ago since I’m out of long-term care doing this job I’m doing now.


It drives me absolutely bananas that nobody - the previous government or this government - is willing to say we are going to legislate 4.1 hands-on hours of care - boom, it’s done - and we’re going to pay you a wage where you can afford your groceries and to send your kids to hockey or dance or whatever the things are your kids want to do. Why is it we don’t want that for care workers in Nova Scotia who are predominantly women?


If I sound frustrated, I am. I’ve been, to some degree, bargaining and advocating for long-term care for probably 17 years, and here I am, sitting in front of this committee saying all the same things. I don’t know what it is you need from us, you need to hear from us, to understand that our workers need better pay, and we need more staff. They’re not going to come from Ontario or from out west. We need to grow them here. We need to grow our own staff. We need to have people at work who make a living wage - a living wage, which is not what they’re making now. Even though I referenced Halifax, I live in Pictou County. You would be hard pressed to be living by yourself as a CCA and have a meaningful living on the wages that they’re currently making.


Now I’m rambling. I apologize for that. I tend to ramble when I get frustrated, which is a lot when I’m discussing and defending long-term care. They deserve so much better. I know everyone’s talking about COVID - that is the straw that broke their backs, but they’ve been struggling for a long time. This is not a new story. We need to see that. We need to place the value on the work that it deserves, and the respect to the seniors who are in receipt of their work and their care.


SUSAN LEBLANC: In December, the government released a document called A Healthy Nova Scotia: Solutions for Long-Term Care. It says, “We need to urgently hire hundreds more Continuing Care Assistants, LPNs, RNs, and allied health professionals like dieticians and occupational therapists, and we need to better support the providers we already have.”


I’ll ask Ms. Hazelton this one. Given that quotation, can you explain what you think the government needs to do to accomplish that goal?


JANET HAZELTON: First of all, I think we need to take and treat long-term care like acute care, not necessarily for staffing but for infrastructure and supports. We saw that when COVID hit. The infection-control measures within our long-term care facilities weren’t there or were nonexistent. PPE was limited at best.


We need to make sure that the staff who are within our facilities have the same rights and privileges as their colleagues across the road at the QEII or the IWK or Colchester Hospital. We need to make sure that they have the access to what they need: psychologists, psychiatrists, social workers. What’s happening is that the facilities are being run by RNs, LPNs, and CCAs - that’s a fact. They may have some limited access to other professionals to help them do their job, but not near what we have in acute care. It’s not even close.


Again, I go back to expecting licensed staff to often take on a responsibility - well, I’ll read you an email, and I’m not kidding you - I got it this morning:


Hi, Janet. Today I send you this email because I understand you’re talking about long-term care staffing this afternoon. Recently I was told that there may be times that our 113-bed long-term care facility may have to function with no RN onsite at all, but on call, offsite. As per the Nova Scotia College of Nurses, this is within the LPN scope of practice. It may well be, but I don’t feel safe. We don’t feel supported in long-term care. Our nurses are tired of fighting for every little bit of help we need.

That was sent this morning at 8:50. This nurse probably came off nights last night, and she probably was an LPN who was looking after or responsible for - she wasn’t caring for, she had CCAs helping her, of course. It wasn’t her total responsibility - 113 residents. That is unreal. If one or two of them get sick, develop chest pain, have a cough - God help us if they fall, because if they fall, that is a ton of work - and I’m not trying to sound flippant. We’ve got to call an ambulance, we’ve got to assess them, we’ve got to call the doctor, we’ve got to call their family. This is all the work of the licensed staff, not to mention the rest of them who are out there who need their help.


That’s why I’m saying that it can’t just be bodies. It has to be qualified, licensed bodies. We need more CCAs, for sure. Nobody is going to ever argue that they’re underpaid and they’re overworked. Nobody is going to argue that. That to me is a given. That is a thing. They shouldn’t have to be looking after six and seven residents. Can you imagine trying to get seven people up, dressed, and ready for the day? I can’t do that in 10 minutes for myself, let alone seven people who need all that help.


[2:15 p.m.]


We also need licensed staff though - LPNs and RNs who can come down and help and assess and make sure that they’re on the right medications, make sure that they listen to their chest to see if they’re getting pneumonia, check their bodies for bed sores, or go help a CCA who says, I think there’s a little red spot and maybe you should come take a look before it’s a sore this big.


Those are the kinds of things we need to decide as a society. Do we value our seniors or not? If we don’t, let’s be done with it. Let’s stop talking about it, let’s stop saying, yes we do, yes we do, and then do nothing. That’s a crime.


We keep saying to people working in long-term care, here, we’re going to give you a raft, we’re going to give you care, we’re going to give you this - and then we never do. I’ve been doing this job. When I got this job in 2001, long-term care nurses shamefully made less money than their colleagues in acute care. We’ve fixed that, but their benefits are not necessarily the same. They don’t get retiree benefits like our acute care colleagues.


Not only are the residents in long-term care treated like second-class citizens, often the staff. There’s no wonder people are saying, I don’t want to go work there - I don’t get this and I don’t get that. I see you have your hand up, I’m not sure if that’s for me, Susan, or if you just - go ahead. I’m not the Chair.


SUSAN LEBLANC: I’m just conscious of the fact that we only have a couple minutes left, but thank you so much for that answer. I just want to ask one more question, this one to the deputy.


Deputy LaFleche, can you confirm that there will be legislation in the Spring session of the Legislature that will guarantee a minimum of 4.1 hands-on care per resident per day? Also, can you also confirm that everyone working in long-term care will be making a living wage?


PAUL LAFLECHE: On the first one, you’re going to get me into the same trouble that I got into several governments ago when I said, I can’t confirm anything because an asteroid might hit the Earth. I cannot really say what’s going to happen in the Legislature. That’s up to the Speaker, the House Leaders, et cetera.


I can tell you what the intent of the minister is. The intent of the minister and the intent of the government, and it’s in the mandate letter, is to legislate the 4.1 hours of care. Whether it gets done in the Spring, which we hope, or whether it gets done in the Fall, which is not at the top of our wish list, I can’t answer. We’re hopeful to get it done in the Spring.


We’re looking at it, we’re preparing legislation at this point, and the minister has many times, as well as even the Premier, stated we’re going to the 4.1 hours. I can’t give you much more hope than that. Any number of things could happen that defray things like that. We could go into a fifth or sixth wave, who knows what, but our intent is to get the 4.1 hours in the Spring.


Obviously, the 4.1 hours is staff dependent, so the budgets are available for 4.1 even now, if facilities want to go to 4.1 and can do it. My understanding is that we’re okay to fund facilities to 4.1 if they can get there, given the staff they have available. Remember, we’re short several hundred staff around the system, so it’s not easy to get to 4.1 when you don’t have the staff to get there, even if you have the budget.


With that disclaimer, if you will - and I’m not a lawyer as you know, Ms. Leblanc - we will get to 4.1 in the Spring hopefully.


SUSAN LEBLANC: I’d like to hand it over to my colleague, Kendra Coombes, and just say of course, you can get more staff if you pay them properly.


THE CHAIR: Ms. Coombes.


KENDRA COOMBES: I agree. A Freedom of Information request response from the Department of Advanced Education shows that the government is already aware of these issues regarding recruitment as well as our wages. In an internal memo, it says, “CCA participation and graduation numbers are shrinking each year. Issues may include lack of full-time work opportunities, salary and benefits, and transportation needs.”


Of course, wages will be an important part of the upcoming bargaining conversations, and we encourage the government to participate in that in good faith, but we know wages can be raised at any time. We’ve seen this with regards to - the previous Liberal government in Nova Scotia raised the wage floor for early childhood educators outside of the bargaining process. The long-term care shortage is a crisis, and an increasingly dangerous one.


My question is - it’s a yes or no: Has the minister asked you to act to increase the wages for the long-term care workforce straight away?


PAUL LAFLECHE: I think everybody here knows that collective bargaining is legislated. Not only is it legislated, it’s a cultural and moral tradition in Canada, and we’re going to go through collective bargaining. Those who have signed - I think there are three collective agreements that have been signed - there are 27 at the table right now. There are another 157 expired. When people come to the table and bargain, then I’ll be able to answer your questions like that. We don’t bargain in committee, we don’t bargain in the media - we bargain at the table. When that bargaining is successfully concluded, we’ll find out what wages everybody got.


KENDRA COOMBES: With all due respect, deputy, we’re not asking about the bargaining process. We are saying that outside the bargaining process, we are able to raise wages. We’ve seen it done at the previous level of government regarding early childhood education.


So my question, again, I’ll ask: Has the minister asked you to increase the wages for the long-term care workforce straight away?


PAUL LEFLECHE: The minister has not asked us to do anything because the Minister for Labour Relations is Minister MacMaster, and I have not had any conversations with him about wages. He respects the collective bargaining process. He respects the unions and their tradition, and he’s very willing to sit down at the table with his staff and bargain collectively with them.


THE CHAIR: That is the 20-minute time for the NDP. We’ll now move on to the government party. They have their 20 minutes. It will start now - John White.


JOHN WHITE: Thank you to the witnesses. You all bring an amazing amount of wealth and knowledge to this conversation, and to show up every day, as Janet Hazelton has said, in the face of this stuff is just outrageous. I really do truly appreciate your work and showing up every day.


In November, a survey conducted by the province identified 589 CCAs vacant in the province. What factors over the last number of years contributed to this? This is probably directed to the department - Deputy LaFleche, I guess.


PAUL LAFLECHE: There are many factors. I’ll ask Katelyn Randell who, by the way, is a registered nurse - a former ER and long-term care facility nurse - to answer that question.


KATELYN RANDELL: Thank you, deputy, and thank you for the question. Absolutely. I don’t think anybody knows exactly what causes the vacancies. I think, certainly, through collaboration with our unions - they know their members. We’re not here today to disagree. We have a shortage, and this government is committed to addressing those issues of why individuals have left the profession, or why we need more. We are a growing sector in a growing population.


Respecting and recognizing that this is a specialty - long-term care is absolutely a specialty. As the deputy said, as a nurse myself and from working in the long-term care sector, I completely respect the individuals. That’s nurses, that’s CCAs, but that’s also RTs, OTAs, physiotherapists, laundry staff, housekeepers. There are quite a few people as part of that puzzle that complete the picture.


For us as a government, understanding what we need to do to make the workplace safe where they can enjoy their work - we get that not every day is perfect. We get that, but the majority should be. The heart of the profession are those teams that are showing up every day. Through our work, our long-term care panel work, all the recommendations are either completed or actively under way. Looking at all the reviews that have been completed - and learning and growing is a key piece of our everyday here - I completely appreciate and agree, we have work to do.


As the deputy noted, we’re building that foundation. It’s only been a few months. We’ve already invested quite a bit in the last few months and we will continue to ensure that staff want to work in the profession and are recognized for the hard work they do. Truthfully, I don’t think thanks is enough. I know we say thanks. I agree. How do you thank the people who are truthfully out there, throughout the pandemic and before, caring for our loved ones? We all could be there someday, and I think that’s the key here. We all have a stake in this. Each and every one of us could have family there or could be there ourselves, so creating that system that we can be proud of is really important to this government.


JOHN WHITE: Thank you. That’s an excellent answer. Just a year ago, I unfortunately had to put my dad in a long-term home. I guess fortunately, I ended up with a fabulous facility. I probably shouldn’t mention that here, but they’re absolutely amazing, so I don’t see the impact of the shortage. I hear it - I do hear it - so I’m asking if you can give me, just briefly, the impact of such a shortage on the staff and what that does. I know I heard of a case where they can’t get holidays, can’t take their vacations, that kind of thing. Just briefly, if you can explain to me the impacts of such shortages.


KATELYN RANDELL: Absolutely. I appreciate hearing it, because there are many facilities like that, where the stories that come out are absolutely amazing. It really is the staff stepping in, especially through the pandemic, because we haven’t had visitors the way that we could, to protect both staff and residents. Staff have had to fill in for that role.


Although we’re seeing great things - and absolutely, we’re seeing great things - I know that the staff who are in there work incredibly hard to make that happen. They really pride themselves and they are going to hold that bar.


We recognize that’s not sustainable. We need to get them the help they need. We’re incredibly proud of those who are in there and working so hard. It’s great that we’re not always seeing the effects of that, and we can thank the staff for that, of course. That’s why we’re looking at this as building a foundation of investing in school, education, pathways to the profession.


We’ll respect the collective bargaining process and support those processes so that we can collectively build on all those pieces. It’s certainly not one thing to make this a specialty where people want to work, so that they don’t have to raise and hold that bar so high. There are other people around them to support them to do that.


It’s incredible that through experience you’re seeing the great things that they’re doing, even through these really trying times. Of course, that’s the staff, as well as management, administrators, and again, that full allied team that we see in there who really complete that puzzle to make that quality care.


JOHN WHITE: A CBC article recently announced that one in 10 nursing homes have their doors closed to admissions. That’s affecting even my hometown of Glace Bay at one point. What do you think could’ve been done better over the past few years to prepare for this and to recruit staff?


THE CHAIR: Who are you directing this to, Mr. White?


JOHN WHITE: Really, I’m not sure who’s in there because some of them are pinch-hitters, as they’re called, but they’re doing fabulously, so anybody on the department side.


KATELYN RANDELL: I think we have been very honest. We have work to do. We need to build this workforce, and this should have happened a while ago. We’ve been in office, this government, for a few months, and certainly I don’t think anybody - regardless of party - fully understood the impacts COVID and the pandemic would have. Our colleagues at the unions have indicated that there has been work for years toward the staffing. I think we can all now look back and say we should have done that, but I think we’re looking forward and we’re looking at what we can do now and how can we improve this.

It is going to take time. This is years of shortages and we now need to come up with solutions, but we’ll get there.


JOHN WHITE: I agree with you, actually. I’m not finger-pointing here - I’m not. It’s no good to make policies if they’re not going to go through. We have the professionals on air here now, so I wanted to ask you those questions. I really feel that we have intent, but we have to know where we’re going as well.


In the same article, Michele Lowe, the executive director of the Nursing Homes of Nova Scotia Association, said that long-term care administration began to worry in the Spring of 2021 that they might eventually need to stop admitting new residents and were looking for guidance to make decisions.


My question is: What steps were taken to ensure that the previous administration was aware of this looming threat?


THE CHAIR: Who are we directing it to? Mr. LaFleche.


PAUL LAFLECHE: I was going to say obviously I wasn’t here at the time. I’ve only been here in this position since the current administration. If you want to talk about roads in Glace Bay, we could have a chat, although as Geoff MacLellan used to say, I don’t think there are any provincial roads - or many - in Glace Bay.


JOHN WHITE: One bridge.


PAUL LAFLECHE: One bridge. How’s it doing? Okay?


JOHN WHITE: It needs work.


PAUL LAFLECHE: I don’t feel we can really comment on that, but I will comment on Michele Lowe. I did talk to Michele today, and our staff regularly talk to her. She represents obviously the homes themselves, the administrators. The administrators are on the forefront of this along with the workers. We’re connecting with them regularly to do whatever we can to make things better.


Just two weeks ago, they had some suggestions on the changes that could be made to the Public Health orders. The staff here did a great job - Kim Silver and others - to ensure that their voices were heard and whatever could be done was safely done within the scope of the Public Health order, and was discussed and communicated to Dr. Strang. I myself had discussions with him.


They’ve done a great job, I think, in informing the system and in helping us manage through. Dr. Strang has said he has confidence in this sector to do what needs to be done. He has confidence in the administration. He has confidence in the frontline workers of this sector, and they’re doing all they can to make it safe. I don’t know that I can comment - maybe pass it over to Katelyn. Katelyn came out of the private sector, so I don’t know how long she’s been here either, but maybe Kim Silver can tell us what happened a year ago when Michele may have made those comments.


THE CHAIR: Ms. Silver.


KIM SILVER: Certainly, COVID has been very challenging since the beginning for the sector. A lot of the time we were trying to figure out between different waves of COVID how we needed to do things differently. We have been communicating on an ongoing basis. During waves, we increased the frequency of those communications with the sector. We listened to what they need and have been working very hard to provide everything from supplies and additional funding for COVID to, as the deputy referred to, bringing things back and trying to understand how our public health measures can practically work in a long-term care facility.


I think we have been connecting with them on a regular basis. I understand from communications from Michele recently and from facilities that the sector is feeling supported. Certainly, we’re always open to anything we can do to help them and to support their staff.


JOHN WHITE: Before I pass it over to MLA Palmer for the questions, I would like to ask Nan McFadgen a question. I simply want to know: Nan, what’s the holdup with 157 contracts being expired? I ask that sincerely because I come from a union background. I was a member of the executive for NSGEU, and I just question what’s holding up contracts from being brought to the table?


THE CHAIR: Ms. McFadgen.


NAN MCFADGEN: Thank you very much for the question. Also, as an aside, I’m really excited to hear that this government has such a deep and abiding respect for bargaining. I’m expecting any day now to get notice that they’re going to drop the fight against Bill No.148, which is the largest piece of anti-bargaining legislation ever tabled in Nova Scotia. I can’t wait. I’m going to watch my mail.


Bargaining. CUPE coordinates bargaining with 50 nursing homes, and so we have a structure that’s not captured in legislation, but is that we have a provincial table. We’re dealing with government to coordinate that provincial table, then a lead home is selected. That lead home has to have finished the majority of its local bargaining proposals, and then be prepared for conciliation. Then we sit at the table with that facility, and the government sits in the closet and tells them through the closet door what kind of money is on the table.


It’s all a very convoluted sort of process. We have been relatively successful with it in the past. I can only speak for the 50 nursing homes that we represent. As for the others, I would not even presume to discuss anything about their bargaining.


We’re actually in that process now of having those discussions with government. I’m not sure what your portfolios are, but they are happening. I think we’ve narrowed it down to a home that will be a lead table. There’s a lot of behind-the-scenes work that goes into having that happen, and then we have to bargain separately those 50 collective agreements.


There’s a lot of work that goes into bargaining, and we’ve been doing a global pandemic at the same time. The people at the bargaining table are the CCAs and the environmental and dietary staff - plus they’re short-staffed and we have to book them off to bargain. You can see how COVID, being short-staffed, having to work with the previous government - which is not a slight to the previous government - and then a shift to a new government. There’s been a lot happening in the past year. That’s part of the reason why bargaining has slowed somewhat than it traditionally would have been in the past.


The checklist would be: global pandemic, short-staffed, people being off with COVID, trying to shift from one government to another. There are a lot of pieces that go into bargaining that are challenging, but we’re working on it and we’re closer to a provincial table than we’ve been in a while.


JOHN WHITE: Thank you, Nan. I appreciate it. Chris Palmer, are you taking over there?


THE CHAIR: Mr. Palmer, I think you’re next.


CHRIS PALMER: Thank you, Mr. Chair. Like my colleagues, I want to just acknowledge the wealth of knowledge here today by our presenters, and a great group of witnesses. You’ve definitely set the bar very high for future committee witnesses as they come along, so I want to thank you all for your great passion today and your knowledge.


My question is for Ms. Hazelton. You mentioned in your opening statement that unfortunately, things haven’t changed much in your time here before this committee over the number of few years. I’m very sorry to hear that. I also appreciate you saying it’s going to take a bit more than four months to fix a problem that’s been going on for a number of years and understand where we’ve been, and correct the decisions that were made in the past, and to learn from that.


You mentioned, in your report - the Broken Homes report from 2015 - and in that, a quote: “Long-term care (LTC) is in desperate need of resuscitation in order to prepare for the imminent and expansive growth in our seniors population. Our system is dangerously out of step with the times, desperately trying to keep pace but suffering from widespread malaise and neglect.”


Those are pretty weighty words to mention. I know you’ve mentioned a lot about staffing numbers and hours and different things, but which of the things in your report - if you could prioritize them, just to give us an idea of the most important things that were not addressed since that 2015 report.


JANET HAZELTON: Obviously, staffing - because that hasn’t been addressed yet. I haven’t heard anyone at this table, including the government, say 4.1 hours of care with 1.3 of licensed staff. That needs to be there because if it’s not baked in - if you say 4.1 hours of care, administrators and others with all good intentions can hire whatever staff they want. It may not necessarily mean that they hire licensed staff, so I need a commitment before I can even support the 4.1. I’m happy about it, but it needs to say licensed staff. The CCAs who are working so hard - there are limits to their education. There’s a reason why we have CCAs, LPNs, RNs, and NPs. Everyone has a different expertise and level of education with different responsibilities. CCAs’ responsibilities are not to do head-to-toe skin assessments to make sure that there are no ulcers under there. That’s the licensed staff’s job.


The licensed practical nurses don’t do the appropriateness of various medications - that’s the registered nurses staff. The registered nurses don’t write prescriptions. That’s the role of nurse practitioners. We need to make sure that we have the right mix in there so that everybody is practicing to their scope of practice and safely.


If you run a whole long-term care facility on licensed staff, I don’t think the care would be as good as it is now. If you run the whole long-term care facility on just CCAs, the care wouldn’t be as good as it even is now. We need to have the right combination. I will be very disappointed if we do not take this opportunity when the legislation is opened - because we all know it takes forever to get one opened, to get it amended, to get it to be what it is. It takes years.


I will be extremely disappointed if it’s not 4.1 with 1.3 of licensed staff. If I leave any impression on you here today, that’s what we need. I think you could ask any CCA out there: They rely on and depend upon the licensed staff to help them. They need that assessment. They need that guidance. They need it, so we need to have it. That is my number one ask.


Secondly, we need to make sure that we put structures in place around the staff to help support them to do their job. One sad commentary I heard from one of my nurses is: I go into one of our residents’ rooms and I ask, “How are you today, Mrs. MacDonald?” I pray to God she doesn’t say “I don’t feel good” - because then my whole day is going to be ruined. If she says, “Great, I’m fine, Janet,” then I can go off.


We need to make sure that we build in more supports for those seniors so that they can have activities, they can play cards, and they can do things that bring them dignity in the last few years of their life. Let’s face it, no one comes out of long-term care anymore. They are going there to die, and they need to die with dignity.


THE CHAIR: Ms. Hazelton, the time is up.


JANET HAZELTON: Not a surprise.


THE CHAIR: We have reached the conclusion of question and answer. We did take the 20 minutes each, and we’re now 15 minutes before the end of the meeting. I will ask if witnesses have very short or very brief closing remarks. If you do, I would appreciate a minute or two, and then after that we have a bit of committee business to take care of. At that point, witnesses, after your closing remarks you can leave the meeting if you so wish. I’ll start with Mr. LaFleche, and then Ms. Hazelton and then Ms. McFadgen.


PAUL LAFLECHE: Thank you very much for this opportunity. I think we’ve had a lot of great discussion here. We’re always open to further discussion and clarification. I noticed that Ms. Hazelton had a lot to say about how the 4.1 is broken down. She’ll have an opportunity to discuss that with the minister. I think Ms. McFadgen will probably also want to discuss how it’s broken down too. We’ll take that into council. We’ve just defined the 4.1 and we’ve committed to it. Haven’t broken it down into its component parts yet, so that remains to be seen. We’ll take your comments back to the minister on those areas.


I want to mention the wait-list thing. We were having a discussion while other questions were going on here about the wait-list. It seems like the real issue with the wait-list is that given the waves of COVID, the wait-list doesn’t become that meaningful, but what we heard today is people still want the wait-list published even if the next COVID wave blasts it out and makes it really irrelevant. The minister will endeavour to get the wait-list published ASAP.


I’m told we’re just somewhere just over 200 days now for the communities, and about 45 days for those in the hospital. Again, that’s totally dependent on COVID and the directives we get from Public Health on beds needed for COVID and other reasons.


Those numbers can’t be taken to heart. Nobody should go home and say, wow, 200 days, because if we get another wave or if this wave doesn’t end early, it’s not going to be 200 days. Maybe that’s a bureaucratic error, and I’ll apologize for that in not putting those numbers out. You’ll have the numbers, but there’ll be a big disclaimer on them saying they may not be achievable given other events that may happen.


I think, with that, looking at my colleagues, I’m good on my concluding remarks. I want to thank everybody, and I’m sure we’ll be talking again. As I said at the outset, don’t hesitate to call us or our staff. Usually, I have a business card to show you the cell phone number as a prop, but as you know, I’ve been banned from the props area for life by various Chairs of committees.


[2:45 p.m.]


THE CHAIR: Mr. LaFleche, I’m going to say that’s a great closing statement. We do have some committee business that we have to get to. I will stop you there but thank you for your thoughts.


Ms. Hazelton, do you have any kind of closing remarks, quickly?


JANET HAZELTON: Very briefly, I want to thank you, again. I think COVID has given us an opportunity. It has shone a light on long-term care, and if we miss this opportunity, that would be shameful.


I do want to say to government and the deputy that we are looking forward to starting meetings with your department. To date, we are one of the stakeholders as well. I heard you mention that you’ve met with a lot of stakeholders, but I’m looking forward to meeting with you to have some discussions about what the nurse’s union would like to see.


THE CHAIR: Ms. McFadgen.


NAN MCFADGEN: Thank you for this opportunity. This truly is a serious issue that get more serious with each passing day. It used to get more serious with each passing month, but now it’s each passing day. COVID is, in great part, responsible for the acuity of the challenges faced by workers every day.


We, too, are advocating for a seat at the table with the Minister of Seniors and Long-Term Care. So far, like the Nurses’ Union, we’ve failed at that. It’s disappointing that we have a Minister of Seniors and Long-Term Care who hasn’t met with the largest representative of labour in the province. We might have the odd thought or two that could have some value.


The 1.3 only allows for a 0.4 increase for CCAs - so I just can’t get myself there. Our workers in long-term care need to be paid a wage that will provide a living for them in Nova Scotia, and currently they’re not. It’s a problem. To the MLA - Mr. White, I think - who asked me about bargaining, we’re coming, not to worry. Be ready, because we are. Thank you.


THE CHAIR: Thank you, Ms. McFadgen. I guess that would be the end of the closing remarks. I would, again, thank you all for coming. We’re going through some challenging times, and we have been for the last number of years. Certainly, I appreciate everybody’s willingness to work with us virtually to meet here today.


Again, thank you. If you’d care to leave the meeting, that’s perfectly fine. We’re going to do our committee business at this point.


PAUL LAFLECHE: You’re not going to say anything bad about us while we’re gone, are you?


THE CHAIR: Oh, stay tuned.


PAUL LAFLECHE: Okay, bye. (Laughter)


THE CHAIR: Alright, committee members, we’ve got about 11 minutes here on the end of our meeting at this point. We do have a couple of items on the agenda. Mr. Churchill.


ZACH CHURCHILL: Mr. Chair, we’d like to present two motions from the Liberal caucus, as well.


THE CHAIR: Let’s try to get through all of these things in order. Ms. DiCostanzo.


RAFAH DICOSTANZO: You may need to add time.


THE CHAIR: I guess we can see how we get through the next 10 minutes and ask for that time at that point, if that’s okay.


The first item is the venue for the February 8th meeting. Thank you all for being able to go virtually this time. We’re talking about February could be a similar thing where we either need to do virtual or in-person, but Legislative TV can provide the service either way if they’re given enough notice. They’re not really looking to offer a hybrid model at this point because of the extra work and equipment needed, but it is possible to meet in the Legislature with distancing protocols. We’d have a maximum of 15 people in the room, which would mean four witnesses at most, and all legislative and caucus staff would have to sit outside the Chamber.


How would we like to proceed? I see Mr. White’s hand up.


JOHN WHITE: I move that unless Public Health restrictions allow for full in-person participation for MLAs and legislative staff, the February meeting be held in a virtual format.


THE CHAIR: We have a motion on the floor. Is there any discussion from the committee? I don’t see any hands up at this point. If there are no hands up, we can have a vote on that motion.


All those in favour? Contrary minded? Thank you.

The motion is carried.


We will target basically a virtual meeting unless we have the restrictions lifted that we can have a full in-person meeting at that time.


The second item on the list was about witnesses for meeting on the Office of Healthcare Professionals Recruitment. On December 9th, an email was sent from Dr. Orrell with respect to agenda setting, asking for both Dr. Orrell and Deputy Minister Lagassé to appear for that topic. They both jointly requested that only staff from Dr. Orrell’s office be required to attend.


We did send out a poll on email conducted between December 10th and 13th, and we did not reach unanimous agreement, but we can bring it back today for debate for a motion if that is chosen. I’ll leave that to the committee for discussion.


Mr. Palmer.


CHRIS PALMER: I would like to put a motion on the table regarding what you previously mentioned - that the witness be changed for our February meeting at the request of Dr. Orrell to include Dr. Orrell and Vimy Glass, the Executive Director for the Office of Healthcare Professionals . . .


THE CHAIR: Mr. Palmer, this is not necessarily the topic for the February meeting. That was a December motion. At that time, we were hoping for a January meeting, but that didn’t pass, so we couldn’t. That’s why we had the meeting we had today. If at the time that that topic can be posted, that would be what we’d be looking for, just for clarification.


CHRIS PALMER: Okay. How would I word that, Mr. Chair?


THE CHAIR: Instead of a motion for February 8th, just make a motion that when that topic is presented, that you’re requesting what you are requesting.


CHRIS PALMER: When that topic is brought forward, I move that the witness be changed at the request of Dr. Orrell to include Dr. Orrell and Vimy Glass, Executive Director for the Office of Healthcare Professional Recruitment, and to remove the Department of Health and Wellness and Deputy Minister Lagassé.


THE CHAIR: We have a motion on the floor. Is there any discussion or any questions from committee members? Hearing none, I’ll put the motion to a vote.


All those in favour? Contrary minded? Thank you.


The motion is carried.

The third item on our list that we have here in front of us is witnesses for the Auditor General’s 2017 recommendations re: mental health services in the province. Because of the demands of the COVID situation, the Department of Health and Wellness has requested that Associate Deputy Minister Kathleen Trott appear as a witness in place of Deputy Minister Jeannine Lagassé.


This is again for that meeting, and I do believe this is the one we are trying to get for February, but we’ll see how it all goes. It’s been challenging with the department at this time.


Mr. MacDonald, I see your hand up.


JOHN A. MACDONALD: I move that for the suggested topic entitled Auditor General’s 2017 recommendations regarding mental health services in the province, that at the request of the department, the Associate Deputy Minister and staff take the place of Deputy Minister Lagassé, and that Deputy Minister Lagassé be removed from the witness list.


THE CHAIR: We have a motion on the floor. Is there any discussion from the committee?


Mr. Churchill.


ZACH CHURCHILL: Mr. Chair, I know we spoke about this before, but I have to mention it again. It would make sense to invite the Auditor General to speak to the Auditor General’s reports and the recommendations. It’s the best way that the committee can get a fulsome understanding from the Auditor General’s Office on how well the department has done in terms of meeting the recommendations.


Therefore I move that the committee invite the Auditor General to that meeting.


THE CHAIR: Are you amending the motion that was put forward or are you putting a new motion forward?


ZACH CHURCHILL: I’ll move to amend to also invite the Auditor General.


THE CHAIR: Ms. Kavanagh, you wanted to reach out to me, I think?


JUDY KAVANAGH: I just want to ask Legislative Counsel whether an amendment can be brought forward. I believe that decision was already made . . .


THE CHAIR: That’s right. I apologize. Maybe that’s for Legislative Counsel, if that motion has already been defeated in a prior . . .


Mr. Hebb?


GORDON HEBB: I’m not remembering whether it was, but if that was the case, then it’s already dealt with, I think.


THE CHAIR: I do know that it was brought forward to add the Auditor General to our meeting and that it was defeated in a previous motion.


I see a hand up. Ms. Coombes?


KENDRA COOMBES: While we’re on the topic of the Auditor General, I just want to confirm, though, that we are going to be able to meet with the Auditor General prior to the meeting, with regard to the Auditor General’s recommendations. Isn’t that correct, that we agreed to that?


THE CHAIR: I do not recall that. I don’t want to say something out of turn, saying yea or nay. I see Ms. DiCostanzo’s hand up as well.


RAFAH DICOSTANZO: I believe that Ms. Coombes is correct, that we were going to meet with them a half hour earlier to ask the questions related to the report and then they will be there for the committee. Somebody has to check our Hansard, but I seem to remember the same as Ms. Coombes.


THE CHAIR: Ms. Leblanc, I see your hand up as well.


SUSAN LEBLANC: I’m just going to suggest that maybe we now make an extension of time for the meeting.


THE CHAIR: I will move that forward. Is there a desire for the committee to extend . . .


JOHN A. MACDONALD: Point of order, Mr. Chair. I don’t believe you can do a different motion when a motion’s on the table. You probably need to deal with this and then extend it, unless staff want to correct me. If you’ve got a motion on the floor, you’ve got to deal with that before you can ask for an extension.


THE CHAIR: Ms. Kavanagh or Mr. Hebb?


JUDY KAVANAGH: I think the committee can agree by consensus without doing a formal motion on it.


THE CHAIR: That was my understanding. Is there agreement to extend for, say, 10 minutes?


Let’s extend it until 3:10 p.m., and then we’ll hopefully get through what we need to in those 10 minutes.


Mr. Palmer, did you have your hand up previously as well?


CHRIS PALMER: Mr. Chair, I wanted to just recommend that we wait for staff or our clerk to just confirm from Hansard what was actually discussed at that previous meeting - the details of that - before we make any decisions.


THE CHAIR: Ms. Kavanagh.


JUDY KAVANAGH: I do have an answer on one of the issues. There was actually a motion that the committee invite the Auditor General to brief them in camera before the meeting, and that was defeated.


What I’m trying to find out now - and I think I have to go to Hansard - is whether the suggestion of bringing the Auditor General in on the topic was made as an amendment to the original motion, or if it was simply part of the discussion before the motion was made.


THE CHAIR: From my understanding, then, the AG is not coming for half an hour - or that was defeated.


JUDY KAVANAGH: That was defeated.


THE CHAIR: Okay. Thank you.


We’re still trying to figure out if we can have an amended motion to add the Auditor General as it was presented by Mr. Churchill. We’re investigating that as we speak.


Mr. MacDonald.


JOHN A. MACDONALD: Just a question: does it really matter on that? My understanding is that a motion can be amended at any time, it just has to be re-voted. We’ve actually spent probably more time trying to figure out if it could, whether we’d just have the motion and vote on it.


I guess I look for staff - even if a motion amendment is failed at another time, every time a motion is brought forward, it could still be amended. It’s just subject to a vote. Am I correct, or am I incorrect?


THE CHAIR: Mr. Hebb.


[3:00 p.m.]


GORDON HEBB: It’s not really an amendment; it’s a motion that runs totally contrary to it. You could rescind the previous motion and then pass a new motion, but I don’t see it as an amendment to the motion.


THE CHAIR: Ms. Kavanagh.


JUDY KAVANAGH: I’ve just looked at Hansard, and as far as I can tell, there was never an amendment to the motion, or a motion at all, on adding the Auditor General as a regular witness on this topic. It’s just something that the committee discussed and rejected before passing the motion to invite . . .


THE CHAIR: Okay, so this amendment can stand. Is there any discussion on the amendment to add the Auditor General to the list?


Ms. Leblanc.


SUSAN LEBLANC: I just want to say I agree, and I fully support the idea. I think it seems like it would be a difficult topic to discuss an Auditor General report without a briefing from the Auditor General.


THE CHAIR: Ms. Coombes.


KENDRA COOMBES: Yes, I agree. I said it before in the committee and I’ll say it again, when you’re talking about recommendations from an organization or a person, the best thing to do is have that person there to speak to them. I, too, am in full support of having the Auditor General come speak with us on the Auditor General’s recommendations.


THE CHAIR: Mr. White.


JOHN WHITE: My thoughts on that meeting are that the topic was mental health, and the Auditor General’s recommendations, how they would impact that - I really don’t see why we would need the Auditor General to tell us how these policies are going to impact the mental health of the province. Unless you can convince me of that today, I don’t think I can support this again. That was the reason I voted against it in December, I think it was, or January, whenever we last met. Unless you want to elaborate on that, that’s where I stand, folks.


THE CHAIR: Mr. Churchill.


ZACH CHURCHILL: I’m happy to try to convince the member. The Auditor General does take an interest in these matters because it’s within the mandate of the office. The Auditor General then makes recommendations to departments related to policy changes, budgetary changes, practices that can impact in a positive way outcomes in relation to the agenda of the departments.


The argument that we’re making is that in order to know whether the Auditor General is satisfied with the efforts to pursue those recommendations, we would actually have to speak to the Auditor General directly. There’s my best effort to convince the member that this is very logical and in line with the mandate of the committee.


THE CHAIR: Thank you, Mr. Churchill. Mr. Palmer?


CHRIS PALMER: I’d just like to echo my colleague, Mr. White. There’s an opportunity for the Auditor General to come in and speak to Public Accounts Committee. There’s always been transparency through that committee. The role of this committee is to examine the mental health services, and I think it’d be wise for us to allow the Auditor General to be called by Public Accounts Committee if that’s a concern to people at that point in time. I would echo the sentiments of my colleague, Mr. White.


THE CHAIR: Ms. Coombes.


KENDRA COOMBES: I am sorry - I just think this is ridiculous at this point in time. This is absolutely ridiculous. You want an argument about why the Auditor General should come to speak to committee about the Auditor General’s recommendations regarding mental health. The name of the topic itself is the argument.


There should be no argument about this. I don’t understand why the government’s side does not want to hear from the Auditor General about these recommendations and where we are on these recommendations. This is a conversation that’s rearing its ugly head from the last Health Committee meeting, and I just think it needs to be said again. You cannot say, I’d like to hear an argument as to why, when the argument as to why is in the name of the topic: the recommendations from the Auditor General’s 2017 recommendations. It’s right there in the report.


Again, this is ridiculous. We should be hearing from the Auditor General, and you can say we could hear from Public Accounts Committee, but it’s my understanding in Public Accounts, they often hear that same argument for all the other committees.


THE CHAIR: Mr. White.


JOHN WHITE: Just to answer the member’s question, it’s not about the recommendations. The recommendations are out there. We can read those. It’s really about the impact of mental health. As a counsellor myself, I’m concerned about mental health in the province. That’s why I’m on this committee, not because of recommendations. I’ll deal with those recommendations when I read them and ask questions. We had the opportunity to ask those questions prior to the meeting, so I don’t think I can support it.


THE CHAIR: Any further questions? There was an amendment to the motion that we’re voting on at this point, which was to include adding the Auditor General.


All those in favour? Contrary minded? Thank you.


The amendment is defeated.


We are now back to the original motion, which was to include Associate Deputy Minister Kathleen Trott to appear as a witness in place of Deputy Minister Lagassé. Any further discussion?


All those in favour? Contrary minded? Thank you.


The motion is carried.


I know that we have two items that Mr. Churchill wanted to have on as well, so we have three minutes left.


ZACH CHURCHILL: Mr. Chair, I’d like to make a motion.


Whereas in the last month, the wait-list for long-term care placement has increased by 300 individuals; and


Whereas the current government has stopped the practice of reporting these wait-lists publicly despite the Minister of Seniors and Long-Term Care’s commitment to doing so;


Therefore be it resolved that the Health Committee request the Department of Seniors and Long-Term Care to resume the practice of publicly reporting wait times for placement in long-term care by the next Health Committee meeting in February in line with the minister’s public commitment to do so.


THE CHAIR: We have a motion on the floor. Is there any discussion from members?


Mr. MacDonald.


JOHN A. MACDONALD: I just got the email with the list of the motions that seems to be about a half or a third of the words that the member used, so I’m just trying to get clarification. If we could just have a second. I looked at a short one, but they seem . . .


THE CHAIR: There are no seconders in motions. Maybe Mr. Churchill …


JOHN A. MACDONALD: I said a second, Mr. Chair.


THE CHAIR: Sorry. Does Mr. Churchill just want to repeat it again for the members,




Whereas in the last month, the wait-list for long-term care placement has increased by 300 individuals; and


Whereas the current government has stopped the practice of reporting these wait-lists publicly despite the Minister of Seniors and Long-Term Care’s commitment to doing so;


Therefore be it resolved that the Health Committee request the Department of Seniors and Long-Term Care to resume the practice of publicly reporting wait times for placement in long-term care by the next Health Committee meeting in February in line with the minister’s public commitment to do so.


THE CHAIR: We have one minute left. Is there further discussion?


Ms. DiCostanzo.


RAFAH DICOSTANZO: I’d like to put a motion to extend the time with another five minutes, because I have another motion as well.


THE CHAIR: I will say there are some of us who have another meeting in five minutes, so that would be - if the committee so chooses, that would be . . .




THE CHAIR: How does the committee feel? Are committee members okay with that? I’m seeing multiple nods. Okay, let’s carry forward with that. Five more minutes.


Mr. MacDonald.


JOHN A. MACDONALD: Just through you, Mr. Chair, to the member. Are we taking staff’s time into account on doing that? I just don’t know when this committee meets - I’m a sit-in for it - so the question is, if they’re unable to by the February meeting, are you going to get some latitude onto it? I’m just asking the question because I’m always - and I’m sure you are - relevant to staff’s time on getting stuff done.


HON. ZACH CHURCHILL: I’ll just remind the committee that on December 1st - this was six weeks ago - I’ll remind the committee of the Minister’s comments. I’ll read those verbatim to the committee, where the Minister, in relation to this question, about reporting on the wait-lists, said, “We’ve been busy trying to implement as many things as possible in the Premier’s mandate letter, but we do have up-to-date wait time numbers. They just haven’t been uploaded to the website.” That’s what Minister Adams said. “I will ensure that those are updated right away.” This was on December 1st. We are now six weeks later.


We’re actually giving more grace time for the department to execute on what seems to have been a ministerial directive to start the practice of reporting wait times again publicly. We know that transparency, allegedly, is really important to this government. They’ve talked a lot about it, but we’ve actually seen this government reduce the level of public reporting on major metrics, consequential metrics, in the health care system. We’re willing to give the department an additional four weeks after these six since the minister committed to doing this right away.


I would ask that this committee move forward with this motion. It is in line with a directive that’s been committed to publicly by the Minister of Seniors and Long-Term Care. I think this is critical information for the public to receive. Obviously, the arguments around transparency are evident.


THE CHAIR: Any further discussion on the motion?


Mr. Smith.


KENT SMITH: If I may just for two seconds - I know we’re nearing the end here. We just heard from Deputy Minister LeFleche that they’re committed to doing this anyway, so I’m not even sure why we need to formalize it into a motion. If we do formalize it into a motion, I’d like to see it reflect that contrary to our honourable colleagues saying that our government stopped reporting it, it actually stopped in June of last year, not after August.


I’d like to go ahead from there to say we’ll support it because we want to be transparent, we want to get the numbers out there, but we just heard Deputy Minister LeFleche say he’s going to anyway.


THE CHAIR: Thank you, Mr. Smith. Any further discussion? Okay. Hearing none, there’s a motion on the floor.


All those in favour? Contrary minded? Thank you.


The motion is carried.


Ms. DiCostanzo, we’ve got one minute.


RAFAH DICOSTANZO: I’ve got to read it fast. I have a motion as well. Mr. Chair, I move that the Department of Seniors and Long-Term Care provide details on staffing calculations that would achieve the 4.1 care hours per resident per day with 2,500 new single long-term care beds, as per the Minister’s mandate letter.


Do you want me to repeat it one more time?


THE CHAIR: If you can, actually, that would be helpful.


RAFAH DICOSTANZO: Sure. I move that the Department of Seniors and Long-Term Care provide details on staffing calculations that would achieve 4.1 hours of care per resident per day with 2,500 new single long-term care beds, because that was promised. Can that be taken into consideration as per the Minister’s mandate letter?


[3:15 p.m.]


THE CHAIR: Unfortunately, our time is up. We are at 3:15 p.m., and we had two extensions. At this point, maybe that’s something we can bring forward at another meeting, if you so choose.


Our next meeting is scheduled for Tuesday, February 8, 2022 from 1:00 to 3:00. The witness is the Department of Health and Wellness re: the Auditor General’s 2017 Recommendations re: Mental Health Services in the Province. That is what we’ll be looking forward to in February.


Again, thank you all for being here. At this point, I will say the meeting is adjourned.


[The committee adjourned at 3:16 p.m.]