Alberta Health Minister Tyler Shandro had a deer in the headlights moment during a press conference this week.
He admitted that there had been no technical briefing for reporters on the 200-page detailed report on continuing care, leaving the journalists with no time to leaf through the document before having to ask questions about it.
It was an inadvertent oversight, said the minister.
A senior member of the press gallery called him on that, saying he “didn’t buy” that the experienced health department communication staff has made the “inadvertent” mistake.
Shandro called a hapless assistant deputy minister to the podium to explain. The explanation was almost as dense as the report.
If just holding the press conference was that hard, how tough is implementing the report going to be? Probably just about impossible.
Covid-19 highlighted the major issues governments have to grapple with in continuing care. Those issues led to heartbreaking death tolls and spotlighted a system right across the country with far too many fracture points.
To its credit, the Alberta government contracted consultants MNP to do the continuing care review leading to this report in February, 2020, a month before Covid raised its nasty head.
They were able to pivot and add the lessons learned over the past 14 months.
The review is thorough and sweeping. As the various stakeholders plow through the contents it will also raise some controversies.
Alberta has a mashup of public, not-for-profit and private care facilities. The report doesn’t call for a change to that mix, which won’t go over well with critics of for-profit private healthcare.
The report recommends that accommodation fees charged to the residents of facilities be increased annually and the the government “provide flexibility to increase fees beyond the core inflation rate for Alberta if required.”
There will likely be hard-pressed families willing to protest that suggestion.
But some recommendations line up with what we’ve been hearing for months about these institutions. The report found problems with staffing levels, the number of part-time and casual staff, and the dire need for mental health staff and support.
“Another issue with FBCC (continuing care) workplaces is a shortage of full-time employment with related benefits such as sick time, vacation, and other fringe and pension benefits. … Some employers prefer to provide part-time employment as it lowers the facilities’ operating costs by reducing fringe and pension benefits,” says the report.
Shandro was happy to announce some immediate needed, but relatively easy, fixes to the system at the newser.
Ward rooms with more than two residents will be eliminated by July 1, he said. Plus inspections and audits of facilities will be made publicly available.
And the province will work to ensure couples in care don’t get split up.
But the answers got pretty vague when he was asked about staffing changes, sick leave, new construction and just about anything that would cost substantial dollars. Shandro kicked the big ticket and regulatory items into the fall, when the government will come up with an “action plan”.
It’s pretty clear MNP was directed to come up with solutions which would be zero sum in terms of implementation. So the consultant includes strategies to push more clients to home-care by beefing up that cheaper alternative. In the long run that strategy would save provincial dollars.
But in the short run implementing report recommendations will cost both the province and the facility owners.
The very items that will actually improve the system are anathema to the general philosophy of the provincial government. Increasing wages, guaranteeing sick pay and benefits for healthcare staff will be a tough hurdle for a government that hangs its budget hat on reducing the ever increasing cost of healthcare in the province.
And a government staking its reputation on reducing red tape is going to balk at increasing monitoring and “benchmarking” of private nursing home facilities.
The report specifies an Oct. 31 deadline for coming up with a plan.
The question is whether the government will set aside its own campaign rhetoric and do the right thing to prevent a repeat of the horrors Alberta’s most vulnerable seniors endured in the past year.
By October reporters and all the many folks touched by the continuing care crisis will have had time to read that report and craft some pretty tough questions.
Photo Credit: Red Deer Advocate