Here you will find a selection of current news on continuing care in Alberta and other related issues, as well as a collection of stored information in the attached archives.

December 2007
  Citizens Watch on Continuing Care launches updates to website

May 2006
   Ex-physician to be sentenced for sexual assault of nursing home resident

April 2006
   Is Health and Wellness still lacking sufficient information for funding and policy decisions?

April 2006
  Growing uncertainty about RHAs’ ability to meet or sustain 3.4 care-hour standard

March 2006
  $42 million in 2006-07 budget for continuing care

March 2006
  No commitment to set new standards in legislation

February 2006
  Alberta government commits $36 million in new funding to long term care and supportive living

January 2006
  Fatality Inquiry report on the death of Jennie Nelson, Jubilee Lodge, Edmonton Alberta

December 2005
  Minister’s Response on Increased Care Hours

September 2005
  Task Force Initiative

MEDIA RELEASE December 27, 2007

Citizens Watch on Continuing Care launches updates to website

Alberta's Citizens Watch on Continuing Care has launched an updated website at www.continuingcarewatch.com to provide new information about Alberta's "long term care" facilities and services, now referred to as "continuing care."

Continuing care services include home care, supportive living and facility living, to provide Albertans with health, personal care, and accommodation services when they are no longer able to live independently. Care can be provided in public or privately accessed assisted living facilities, group homes, designated assisted living facilities, or nursing homes (continuing care centres) for persons with high care needs.

If you have a parent, spouse or friends requiring long term or continuing care services at home or in special settings this web site will provide you with information that will help you feel less alone and more able to advocate on behalf of your family and loved one.

The website provides a source for information about the changes in our continuing care system. Articles and reports document the important issues influencing affordable quality care for vulnerable and dependent Albertans - including the shift of costs and responsibilities to individuals and families, and the shortage of care facility spaces.

Despite the Auditor General's scathing report on Seniors Care and Programs in 2005 and the subsequent Government promises to implement the Auditor General's recommendations, and Premier Stelmach's commitments to transparency, accountability, and the quality of life of all Albertans, serious problems continue to be painfully evident in the province's continuing care system.

Updates to our website highlight some of these ongoing problems. They include:

• Links to CBC's recent investigation into the increasing use of antipsychotics in seniors with dementia, despite Health Canada's 2005 warnings of their harmful and potentially fatal effects in this population;
• New reports on the discrepancies in facility funding, the persistent shortages in staffing, the privatization of continuing care, and the redefinition of "hours of care";
• Reports about long term care insurance;
• A study of the conversion of the Hinton nursing home to an assisted living facility
• Additional links to information about seniors and drugs, legal resources, the ethics of care for older persons, and policy analysis.

Citizen Watch is a grass roots network of concerned citizens committed to providing information about and insight into the critical problems of the safety, care and quality of life of our most vulnerable seniors.

- 30 -

Ex-physician to be sentenced for sexual assault of nursing home resident

Cesar Guzman, a 72-year-old care aide who was a doctor in Peru before moving to Canada in 1998, pleaded guilty in Calgary provincial court May 26, 2005 to a charge of sexual assault of an 86-year-old resident at Wentworth Manor July 24, 2005. Guzman is scheduled for sentencing June 2, 2006. The victim’s family is proceeding with a civil action against Guzman and the facility owned and operated by the Brenda Strafford Foundation.

This is the third known sexual assault of a nursing home resident to come before Calgary provincial court in the last five years. In January 2005, caregiver Rex Okumu was ordered to stand trial for sexually assaulting a resident in her ‘90’s at Brentwood Care Centre (Intercare Group) July 2004. In an unrelated case, male caregiver Allan Gervais was sentenced on July 17, 2000 to 18 months imprisonment for the sexual assault of a resident at Cedars Villa Extendicare.

Despite the increasing crime of sexual assault in Alberta’s nursing homes and the fact that more than 325 allegations of sexual abuse have been reported to Protection for Persons in Care since 1998, it appears that no decisive action has been taken by the Alberta government to prevent abuse and criminal acts from occurring in the province’s care facilities.

Is Health and Wellness still lacking sufficient information for funding and policy decisions?

The May 2005 Report of Auditor General on Seniors Care and Programs reveals that, at the time of the audit, the Department of Health and Wellness lacked information for assessing the quality and cost-effectiveness of services in long-term care facilities and for making policy changes and funding decisions.

In the April 3, 2006 sitting of the Alberta Legislature, Ray Martin, NDP MLA Edmonton-Beverly-Clareview, asked Health Minister Iris Evans for information on the average public funding for a resident in long-term care, assisted living and designated assisted living. The Minister replied: “The department does not track the average cost of health care services in long-term care, assisted living, or designated living.”

NOTE: If Health and Wellness does not have current and sufficient information to determine the extent of residents’ individual needs for physician, nursing, dietician, rehabilitation and other medical services, how will the department ensure that funding allocations to Authorities are adequate?

Growing uncertainty about RHAs’ ability to meet or sustain 3.4 care-hour standard

In anticipation of the release of the Auditor General’s May 2005 Report, Health and Wellness directed Regional Health Authorities (RHAs) to increase the average paid hours of care per resident per day from 3.1 to 3.4. To assist in achieving that goal, at the end of March 2005, a one-time supplemental amount of $5 million was provided from the 2004/2005 fiscal year. In the
2005/2006 Alberta budget, $10 million in additional funding was earmarked for the same purpose. [Reference: Health and Wellness April 7, 2006 correspondence to CITIZEN WATCH member].

In a February 23, 2006 news release, the provincial government announced an additional $15.2 million to support RHAs in increasing paid hours of care per resident per day from 3.1 to 3.4.

On March 22, 2006, Alberta’s Finance Minister announced $42 million for continuing care in the government’s 2006/2007 budget with a portion of the funding allocated to increasing the number of hours of care per resident per day to 3.6.

Despite the millions in additional funding for more hours of nursing and personal care in long-term care facilities, there is growing uncertainty about whether all RHAs were able to meet or sustain the current standard of 3.4 care-hour standard, as demonstrated by the following examples.

Palliser Health Region Annual Business Plan 2005-2006
“In continuing care, we have allowed for the increase to 3.4 hours of direct nursing care to all our continuing care services. Our budget allows for this expansion for three of the twelve months and next year’s budget will require and additional $850,000 to annualize this expenditure.”

Northern Lights Health Region Business Plan 2005-2006
“NLHA is funded at a rate that is 36% less than the provincial average ($728/capital vs. average $1191/capita); making it the lowest funded Health Region in the province.” The Region’s strategy is “to meet or exceed the provincial set targets of 3.3 nursing care paid hours per resident day as of July 1st, 2005 and 3.4 nursing care paid hours per resident day as of January 1st, 2006 in Long Term Care Facilities.”

Peace Country Health Annual Business Plan 2005-2006
“Current Status: Average daily paid hours of nursing care per continuing care resident with case mix index of >100: 3.1
Targets 2005-06: 3.4"

$42 million in 2006-07 budget for continuing care

The following excerpts derive from the Alberta government 2006 budget document.

“In this year’s budget, $42 million is being provided to improve continuing care through changes such as:”
increasing the number of care hours per resident per day from 3.4 to 3.6;
increasing access to therapy;
implementing new health care standards, and;
improving care co-ordination

The $42 million is “on top of the $25 million provided in 2005-06”. [See Feb. 2006 News Update]

“An additional $30 million in funding will be used to implement the recommendations of the MLA Task Force on Continuing Care [which apply to home care programs, public lodges and assisted. Supportive living, as well as traditional long term care facilities (i.e. nursing homes and auxiliary hospitals)] A further increase of $20 million is budgeted for 2007-08.

By 2008-09, annual funding for continuing care will have increased by $127 million”

TRANSLATION: If the entire $67 million (2005/06 + 2006/07 budgeted
funding) was spent only on individuals in nursing homes and auxiliary hospitals, this equates to an approximate increase of $13 a day for each resident
[$67m ÷ 14,000 residents ÷ 365 days].

CITIZEN WATCH believes it is important for the Minister of Health and Wellness to clearly explain to the people of Alberta how much of that $13 increase is going toward:
1. administrative costs?
2. hands-on nursing/rehabilitative/medical care for
residents?
3. better quality and quantity of food; other?

Are residents in continuing care benefiting from the increased funding?
Please contact us to offer your comments and perspectives.

No commitment to set new standards in legislation

Through an ongoing search for information, CITIZEN WATCH has learned the Alberta government remains, to date, uncommitted to setting the proposed new Continuing Care Health Service and Accommodation Standards in legislation. The following statements by the Minister of Health and Wellness are on public record in Alberta Hansard, March 1, 2006.

Iris Evans, Minister of Health and Wellness: ““New health and accommodation service standards will be implemented this year for all continuing care facilities and services. … Whether those are carried further in terms of legislation I cannot commit to at this time.”

Please contact us to offer your comments and perspectives.

On February 23, 2006, the Alberta government issued a news release announcing $36 million in new funding “to respond to the most pressing recommendations” in the MLA Task Force report, Achieving Excellence in Continuing Care. Of the $36 million, Alberta Health and Wellness will use $26.3 million, Seniors and Community Supports $10 million.

Please write or e-mail us to offer your comments and perspectives.

Jennie Nelson, a 90-year-old resident of Jubilee Lodge, an Edmonton nursing home which is regulated and overseen by the Alberta government, suffered second-degree burns to both legs when she was place in a tub of hot water on January 2, 2004. Mrs. Nelson was transferred to the University of Alberta Hospital Burn Unit where she died nine days later.

A public fatality inquiry into the death of Mrs. Nelson was held in the Court of Queen’s Bench, (Edmonton) November 28, 2005 through December 2, 2005. The inquiry came before Provincial Court Judge, Lloyd E. Malin. His report to the Minister of Justice and Attorney General confirms Jennie Nelson’s death was “a direct consequence of the scalding injury received in the bathing procedure at the Lodge on January 2, 2004.” Click here to access the report.


If you wish to offer your perspectives on the report and/or the death of Jennie Nelson, please E-mail or write us.

Following the release of the Auditor General’s 2005 report, the Department of Health and Wellness instructed Regional Health Authorities to increase the average paid hours of care per resident per day from 3.1 to 3.4. Since little detailed information accompanied this announced increase, Bev McKay, member of the Citizen Watch Network, submitted a letter of inquiry on November 19, 2005 to the Honourable Iris Evans, Minister of Health and Wellness. Questions posed in the letter appear below with answers extracted from the Minister’s December 15, 2005 letter of response.


1. Did the Alberta government fund those additional hours or were RHAs responsible for funding them?

“To assist in achieving this goal, at the end of March 2005 a supplemental amount of $5 million from the 2004/2005 fiscal year budget was directed to the RHAs specifically to increase average paid hours of care per resident per day in long-term care facilities. In the 2005/2006 Alberta Budget, $10 million in additional funding was earmarked for the same purpose.”

2. If the funding came from government, what amount of money was allocated to each RHA to enable it to meet this requirement?

“RHAs are not required to spend specific amounts on long-term care, or any other sector. They have the discretion to determine regional care needs and to allocate resources accordingly. Each RHA determines the allocation of funds to long-term care facility operators based on the assessed care needs of the residents. This is not a set amount as resident care needs vary.”

3. If RHAs were responsible for the funding:
a) where did it come from?

“The RHAs are using both the population-based global funding and the additional funding outlined above to increase the average paid hours of care per resident per day in long-term care.”

b) what amount of money did each region spend to meet this requirement?
c) are some RHAs financially unable to meet this requirement? If so, what regions?

“All the RHAs were provided with written instructions to increase their average paid hours of care per resident per day in long term care form 3.1 to 3.4. Subsequently, my department has written to all the RHAs requesting details on how they plan to comply with the required increase. All the RHAs have responded and confirmed that they will achieve the expected average of 3.4 paid hours of care. Some regions have reported that they have already increased their average paid hours of care to 3.4. Once the 2005/2006 fiscal year comes to a close and the RHAs have submitted their audited statements we will know how much each RHA has spent to achieve this increase in paid hours of care.”

4. How will your Department ensure:
a) that each facility is complying with this requirement?

NO RESPONSE

b) that residents and their families are informed of facility compliance?

“With regard to your inquiry about residents and their families being informed of facility compliance, this is a matter for the RHAs and facility operators to discuss with residents and families.”

5. Regarding the 3.4 hours:
a) What exactly is included in those hours?

“This increase in hours of care is specific to the average paid hours of care per resident per day, which includes professional nursing care provided by registered nurses, and personal care provided by personal care aides.”

b) Does your Department or each Region specify what those 3.4 hours must include?

“… it is the responsibility of the RHAs and the facility operators to determine the specifics of what is to be included in those care hours based on the residents’ assessed needs and the case mix of the facility.”

c) How will your Department ensure that residents and their families know what to expect for those 3.4. hours per resident day?

“… what residents can expect from the average of 3.4. paid hours of care is a matter to be discussed with the RHAs and facility operators.”

d) How did your Department determine that the funding of 3.4 hours is sufficient to provide the level of care required by residents and to meet their assessed needs?

NO RESPONSE

e) Will this requirement become a legislated standard?

“The average of 3.4. paid hours of care per resident per day will not become a legislated standard.”

6. According to Health and Wellness 2003/2004 resident classification data, almost 75% of residents in traditional long term care facilities are within the highest categories of need. Given these high levels of acuity, what has your Department determined as :

a) the appropriate staff-to-resident ratios?

“My Department does not determine or prescribe staff ratios, staff mix or the number of registered nursing hours per resident. The needs of long-term care residents change over time and vary greatly within and between facilities, making it difficult to prescribe uniform staffing levels. It is in the residents’ best interest for long-term care facilities to perform individual assessments to determine the level and type of care required by each resident rather than the government implementing rigid staffing requirements. This allows facilities the flexibility to customize their staff ratios and mix to best meet the unique needs of their residents in a safe and effective manner.”

Please E-mail or write us to offer your perspectives on the Minister’s responses.

MLA Continuing Care Taskforce: Seniors Report
In response to the Auditor General’s damning report, Health Minister Iris Evan charged a three-member MLA task force with restoring public confidence in Alberta’s continuing care system by holding public consultation sessions throughout the province on the government’s draft Continuing Care Health Service and Accommodation Standards. The appointed task force members: Conservative MLAs, Len Webber (Calgary-Foothills) and Ray Prins (Lacombe-Ponoka) as well as Liberal MLA, Bridget Pastoor (Lethbridge-East).

The government’s decision to restrict consultations to invited-participants-only drew such harsh criticism that three open sessions were hastily added to the task force schedule. At the Calgary, Edmonton and Red Deer public meetings, task force members heard from a number of families whose stories of a loved one’s tragic experiences highlighted serious flaws and deficiencies within Alberta’s long term care system. Briefs by professional and advocacy organizations also identified several weak areas requiring significant improvement and change.

The September 2005 document, Seniors Report; What We Heard & Draft Recommendations is the outcome of the task force initiative. A supplementary report was provided by Ms. Pastoor. Among the many formal responses to the Seniors Report and/or the government’s draft standards are those listed below. CITIZEN WATCH wishes to thank these organizations for granting us permission to post or link their submissions on our website.

If you, or an organization you are affiliated with, submitted a response to the government’s draft standards and/or to the MLA Seniors Report and would like to offer it to us for possible posting, please contact us.



Alberta Medical Association

Multiple Sclerosis Society of Canada

Alberta College of Pharmacists

Alberta Committee of Citizens with Disabilities

Alberta Dental Hygienists’ Association

College and Association of Registered Nurses of Alberta