LTC standards must be mandatory

The new national long-termcare standards are comprehensive and have incorporated important person-centred quality of life elements that are the product of extensive input from professionals and individuals with lived experience with long-term care. The standards have the potential to be the national touchstone for excellence of care for decades to come. Their implementation can ensure that we will never again see the suffering and deaths experienced during this pandemic. However, the standards will not make a difference unless federal/provincial governments allocate sufficient resources and align inspection and accountability systems with the national standards.

The Ontario Association of Councils on Aging (OACA) Board of Directors, which reflects the perspective of thousands of older adults across Ontario, requests the standards be mandatory and be supported with sufficient federal/provincial/territorial funding and by inspection/accountability systems that align accordingly.

Although the achievement of all the standards is predicated on the necessity of funding/inspection/accountability alignment, we will provide additional clarity with one standard related to governance, and one standard related to operations to demonstrate our point:

In Section 1.1.4, the governing body cannot meet the criterion if the provincial/territorial authority responsible for their respective LTC system does not allocate sufficient resources. A national standard for is not possible without corresponding sufficient federal/provincial/ territorial funding allocations that are systemic and sustainable.

Similarly, many of the standards and criteria relating to other identified objectives in the national standards (e.g., resident quality of care and quality of life, appropriate technology, equipment, and supplies) will not be met without the assurance of these funding allocations.

In section 9.1.1, the organizational leaders cannot meet this criterion if the provincial/territorial authority responsible for their respective LTC system does not set the staffing standard and allocate sufficient resources to enable a home to meet “appropriate and sufficient evidence-informed staffing levels.” A national standard will not be effective without corresponding sufficient federal/provincial/territorial funding allocations that are systemic and sustainable to support an identified sufficient staffing level standard, as defined by average hours of direct care per resident per day, staffing mix, and staff qualifications.

There is a pivotal opportunity for federal and provincial governments to agree on transformational health-care improvements. Much like the federal government successfully rolled out a national child-care system, we recommend the federal government seize this opportunity and roll out a similar effort to develop a national longterm-care system.

Anything less than a national mandate will relegate the national LTC standards to another well written document, like existing accreditation standards, statements on the rights of LTC residents and many other standards documents, without making a difference in the safety and quality of care of residents and the quality and sustainability of the long-term care system infrastructure.

With an increasingly aging population, and the ongoing need for a responsive longterm-care system, governments must address this issue for the benefit of today’s and tomorrow’s older adults and others living in long-term care, irrespective of anticipated improvements in home and community care and access to primary care.