Health

Ontario's long-term care workers still working at multiple facilities as B.C. clamps down

Families with loved ones in long-term care homes have been locked out for weeks as the facilities try to contain the coronavirus pandemic that has had a devastating toll on their residents. Yet new outbreaks continue to emerge, as staff members continue to work at multiple homes in some jurisdictions.

B.C. changed policy after outbreaks were linked to employee working at more than 1 site

The Lynn Valley Care Centre in North Vancouver, B.C., has seen 17 residents die since an outbreak of COVID-19 emerged in early March. The average age of a resident at the long-term care facility is 87. (Jonathan Hayward/The Canadian Press)

It was a tough lesson learned by the Lynn Valley Care Centre in North Vancouver, the long-term care home in British Columbia that was the first — and is still among the hardest hit — by a coronavirus outbreak in Canada.

The facility that recorded the country's first COVID-19 fatality has since seen 16 others die, and almost 80 staff and residents have been infected since the outbreak began in early March.

Officials now believe that the virus arrived at the home through a care worker with multiple employers. 

Contact tracing — which involves tracking an infected person's movements and identifying all their close contacts — showed that the Lynn Valley outbreak was linked to at least one other outbreak through a worker moving between multiple locations, according to Isobel Mackenzie, British Columbia's seniors' advocate.

"That care staff member worked at other facilities," she said. "We saw some link between outbreaks … back at that point when we were doing the contact tracing.

"That's what was revealed."

Isobel Mackenzie, the seniors' advocate for British Columbia, says contact tracing revealed links between COVID-19 outbreaks and care workers working at multiple homes in the province. (Maggie MacPherson/CBC)

Seniors homes across Canada have been devastated by COVID-19, with confirmed cases in at least 600 of the country's facilities. 

Families with loved ones in these long-term care homes have been locked out for weeks, with no one but staff coming or going, as the facilities try to contain the spread of the coronavirus. 

Yet new outbreaks continue to emerge.

B.C. restricts movement between homes

Soon after the outbreak at Lynn Valley, B.C. provincial health officer Dr. Bonnie Henry issued an order requiring all care staff to work in only one home; part-time employees would be paid full-time wages to make up for not being able to work in multiple facilities.

Although the strategy has been slow to roll out provincewide, according to Mackenzie, it has been implemented in the areas hardest hit by the virus and will continue across the rest of B.C. in the coming weeks.

That decision was made based on evidence that "care staff were potentially carrying the virus from one care home to another," said Mackenzie.

"I think it will really help us as we get through this pandemic."

Recommendations — but no rules

And while Ontario seems to agree that a single-employer model would be safer amid the ongoing pandemic, it has stopped short of mandating such a move.

The provincial government issued guidance last month squarely aimed at long-term care homes, stating that "employers should work with employees to limit the number of different work locations that employees are working at, to minimize risk to patients of exposure to COVID-19."

Yet only about half of the personal support workers who have multiple employers in Ontario have committed to just one home, said Andy Savela, director of health care for Unifor, a union that represents 30,000 of the province's health-care workers.

Savela said that at this point, the provincial government has only suggested that personal support workers stay at one home — and hasn't gone as far as B.C. to promise those workers a full-time wage.

With about 60 per cent of his members working part time at multiple homes, he said it's just not possible for many workers who still have bills to pay.

Andy Savela is the director of health for Unifor, representing some 30,000 care workers in Ontario. (Katie Pedersen/CBC)

"PSWs have to hold jobs at numerous employers in different locations so that they can try and make a living wage by piecing all of those jobs together," said Savela. "Unfortunately the coronavirus doesn't change that."

Cindy Hasler — a Unifor member and vice-president of its 504 division — works full time at a Hamilton-area home, but says a number of her co-workers are still working at multiple locations.

Some colleagues are coming from a hospital or another care home, then working shifts at her facility — and vice versa. This makes her especially nervous, she said, because while her facility hasn't yet recorded a case of COVID-19, there are outbreaks at other homes in her community.

CBC has agreed not to identify the home because Hasler is not authorized to speak on its behalf.

"I think it's disgusting," said Hasler about homes that still have workers moving between multiple sites. "I think they should have to work at one place only.… It's about the life and death of our residents and the safety of our staff.

"Everybody's very anxious and very nervous it's going to come to us," she said. "I would just really like to see the government step up to the plate here and mandate that you only work in one long-term care facility at one time."

Cindy Hasler, 53, is a personal support worker at a Hamilton-area home who would like to see Ontario formalize a directive about part-time workers moving between facilities. (Turgut Yeter/CBC)

Personal support workers in Ontario make between $17 and $21 an hour to provide direct care to residents in long-term care facilities; that includes things like changing, feeding and bathing residents, as well as providing most of their day-to-day social interaction.

Savela agrees that the one home per worker directive needs to be formalized.

"The government needs to put forward a compensation package … so they could pick their primary employer where they get the most hours and then they could get compensated to make up the difference," he said.

'We needed staff anyway'

At least one Ontario care home has managed to make that happen with the money already issued by the government.

St. Joseph's Lifecare Centre, in Brantford, Ont., has asked their employees to work at only one location, and offered full-time shifts to anyone who chose to stay with the facility. 

"We needed staff anyway because it's a very critical time. So we upped their shifts so that they can … compensate for the loss of some of their shifts in the other places," said facility administration Bidar Swamy.

To pay for the increased wages, Swamy said they've dipped into the emergency funds that the Ontario government has issued all care homes in the wake of COVID-19. 

"We did get some additional funding from the ministry to accommodate things, especially this crisis time," he said. "All homes have received some additional funding."

WATCH | Ontario allows staff to work in multiple long-term care homes during pandemic:

Ontario is still allowing staff to work in multiple long-term care homes despite numerous COVID-19 outbreaks at multiple facilities. The B.C. government quickly stopped allowing the practice after outbreaks in the province’s long-term care facilities. 1:49

St. Joseph's Lifecare Centre currently has a COVID-19 outbreak designation; a casually employed staff member contracted the virus in the community and was working in the home while asymptomatic. But 11 days after the case emerged, no one else in the home has shown symptoms and any tests so far have come back negative, Swamy said.

On March 30, about a week after the original directive, the Ontario government told care home administrators that despite its recommendation, facilities should not be giving their workers ultimatums, forcing them to choose between working at only their homes or being fired.

Swamy said St. Joseph's will respect the request should any worker wish to return to their old schedule, but so far, no one has come forward.

"It's better for them, because they don't want to get exposed to different homes," he said. "Even before [the directive], some of them were actually asking if they can work only for us.

"You have to engage and listen to them, because, you know, they are the eyes and ears of the residents. They know much better than anyone, I think."

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