Dr. Merrilee Fullerton On Long Term Care

MPP Fullerton is Minister of Long Term Care 

From the Ontario Legislative Debates Oct. 20, 2020

Kanata-Carleton MPP Merrilee Fullerton is Ontario’s Minister of Long Term Care. She has held this position since July 2019 when the Ford Government elevated the issues of long term care in the Province and established a stand-alone ministry. Since, the Government has focused on addressing the lack of action for seniors and the long term care community taken by the McGuinty and Wynne Governments. The Kanata-Carleton Ontario PC Riding Association is proud of our MPP’s determination and compassion to tackle the current problems in long term care. As Premier Doug Ford has said on many occasions, “There is nobody better suited to fixing long term care than Dr. Fullerton.” 

On October 20th, the NDP Opposition moved a motion critical of the Government’s long term care agenda. Below is the Minister’s — Dr. Fullerton’s — remarks in the Legislature. 


Several of my honourable colleagues have already outlined the flaws on this wrong-headed, politically motivated motion. The contrast speaks for itself. The opposition’s position is reactive, based on ideology, without any exercise in due diligence and without anywhere near a full understanding of the consequences of the actions that they have proposed.

We are confronting a new reality. We face an aging population. The average long-term-care resident is older, frailer and more medically complex than 10 years ago, let alone 15 or 20 years ago. The growth in the seniors population was not matched by any meaningful increase in capacity in long-term care.

The Financial Accountability Officer confirmed that the previous government ignored the long-term-care system in a report last year. That report stated that between 2011 and 2018, the number of long-term-care beds in Ontario increased by only 0.8%, while the population of Ontarians age 75 and over grew by 20%. That makes it clear that the previous government failed to act responsibly or proactively to deal with this problem. That 0.8% means they built 611 beds while the seniors population grew by 176,211 people. For a comparison, British Columbia, which is roughly a third of the size of Ontario, built over 900 beds between 2013 and 2017. Alberta, which is a smaller province than British Columbia, has built 1,227 net new beds.

The challenge of an aging population is a new one and has not been fully experienced by any other modern society in modern history. Added to the pre-existing strain on the sector, we have been confronted with the need to plan against a viral attack never before known to the world until now, and we’ve seen its tragic effect.

The previous government, supported by the opposition, set the stage for what we saw with COVID: the capacity in our long-term-care homes at 99%; the lack of building that had gone on with the previous government. I do sometimes wonder why no one noticed at that time, why no one acted at that time. We recognized the need to act quickly, and we have done precisely that. Our actions have been thoughtfully considered, informed by expert opinion and evidence against the backdrop of an evolving situation. We have taken a consultative approach; listened to sector representatives, residents and their families, front-line staff and their professional and labour organizations; and, through it all, acted as swiftly as possible.

We have listened. We have acknowledged the shortcomings in long-term care that accumulated over years of neglect, and we have recognized aspects and efforts that were done well and that contribute to the well-being of residents and staff. Before, during and after this pandemic, we have acted and will act to repair, rebuild and advance long-term care in Ontario.

Is any of this easy? Certainly not. The challenge is a daunting one, but we are hard at work, having committed more to long-term care than any previous government. Long-term care is a key priority for our government, and as Ontario’s aging population continues to grow, seniors and their families expect that when they move into a long-term-care home, they will receive the kind of care that is always mindful of their needs in a caring, comfortable and dignified environment. They expect that because they deserve to know that they can receive the care they need, when and where they need it.

That’s why, on June 20, 2019, the Premier announced the creation of a stand-alone ministry dedicated to long-term care in Ontario. Much work has been done since the creation of this ministry. That’s why we committed $72 million more to long-term care than in the previous year in last year’s budget. That’s why we invested an additional $80 million to improve and maintain the quality of care and the overall resident experience in long-term-care homes in the economic statement last spring.

We have worked diligently across government and with sector stakeholders, and we have visited homes across the province and talked with residents, their families, loved ones, staff and the organizations that represent them, to help inform a path forward in the development of a strategy to modernize our long-term-care sector into one that puts residents at the centre of care. We have been putting in the work to ensure that residents receive access to the quality care that they deserve, in a safe, home-like environment.

That’s what this has always been about: the residents. It has always been about the residents, and it always will be. The resident must be at the centre of the frame through which we view long-term care. Any attempt to look at long-term care through any other lens misses the point.

Everything we have done, everything we will do moving forward, has been to improve the quality of life and care of residents. Every action we’ve taken during the pandemic has been to protect residents and ensure long-term-care homes have the resources they need to provide residents with the care they need.

The reality of long-term care in Ontario is that homes were operating at 99% occupancy with over 38,000 people on wait-lists. From 2015 to 2018, the wait-list for a long-term-care bed grew by more than 10,000 people—10,000 people in just three years. The current wait time for a placement in long-term-care homes is an average 145 days—that’s almost five months—and, in some cases, more than that. All the while, the previous government, often supported by the opposition, sat idly by.

We committed to address the issues surrounding the wait-lists and the capacity issues, investing a record $1.75 billion to build new beds and redevelop existing ones to modern design standards.

In the 16 months since the creation of the Ministry of Long-Term Care, our government has been putting the work in to build a 21st century long-term-care system, and we’re seeing the results of that work come to fruition. In the brief period between the Legislature rising in July and returning back last month, we have seen the report back of an expert-led study on staffing in long-term care, knowing the crisis in staffing pre-existed our government. It will inform a comprehensive staffing strategy that will be announced by the end of the year, and as we develop this program going forward, we’re also acting urgently to address the needs of our long-term-care homes affected by the impacts of COVID.

It’s crucial to understand the problems that face long-term-care homes, and it’s crucial that we understand the growing need for long-term-care homes to be understood for their needs. Unfortunately, the previous government, supported by the opposition in many instances, did not act. They did not raise the issue. When people were dying in long-term care in large numbers over the last few years, there was nothing. There was no voice from the opposition or the previous government.

The change in care needs of residents has placed a huge strain on staff in homes. We are committed to addressing that. This government is dedicated to that. We announced a rapid-build project for homes that will account for 1,280 net new beds that will be ready for residents by the end of next year. We reported back on the Gillese inquiry, as Justice Gillese asked, and have 80% of her recommendations completed or under way. We took immediate action. As the Ministry of Long-Term Care, we listened to the sector. We heard from staff, we heard from families and residents, and we acted.

We made real progress in ensuring every long-term-care home is air-conditioned. In July, 360 homes were not fully air-conditioned, and as of the end of summer, 193 of those homes indicated that they had purchased and/or installed new air conditioning systems. A further 108 homes have indicated that they plan on making air conditioning upgrades in the next year. I can tell you that, as a family doctor, for almost 30 years this was never addressed. There were long-term-care homes across Ontario that languished in the heat. Residents, staff—never addressed; never, until this government put dollars behind it and committed to it. We are committed to modernizing long-term care and every action we’ve taken has put residents at the centre of that.

Just before the Legislature rose, we announced the creation of the modernized funding model that recognizes and addresses obstacles that have held up development, especially in mid-sized cities and large cities. Crucially, this will help develop and redevelop older homes with ward rooms where four residents share a room. The science has become clear that these rooms, built to standards from the 1970s, were a major driving factor in the spread of outbreaks.

I remind everyone here that COVID-19 was a new virus to the world. At the beginning of this pandemic, the science was pretty negligible. Over time, the evidence has evolved, and we have scientific experts providing evidence and understanding of what happened in wave 1 and informing us as we move forward.

Our work to ease and address the long-standing capacity problems in this sector is showing results. There are currently 129 active projects representing almost 9,000 new beds and almost 12,000 redeveloped beds. We are making progress, and we will continue to commit to making sure we drive forward to meet the needs of an aging population. This is a commitment our government has made and will continue to make. We have pursued innovative solutions to accompany that work.

Community paramedicine programs, in which paramedics use their training and expertise in non-emergency care roles, have been demonstrated through various areas across Ontario—and we are expanding that. They have been demonstrated to reduce 911 calls and avoidable emergency room hospital visits. I’d like to thank them for their work during the pandemic, their assistance at our homes, assisting with testing.

I value all the abilities and skills that all of our front-line workers have provided during this challenging time.

After much consultation and engagement with the sector and municipalities, our government has created an innovative, 100% provincially funded community paramedicine program for long-term care. We are looking to partner with several selected municipalities across Ontario that will build upon their existing community paramedicine programs to provide additional and appropriate care for seniors in their own homes. We know that for the most part, that’s where people want to be, but when they cannot stay home, we must be able to provide the resources for them. Again, our government began, as soon as we started as a new government in 2018, understanding that issue, and with a stand-alone ministry, we’ve taken swift action. We know that 24-hours-a-day care is necessary, seven days a week, and the community paramedicine programs can provide that through home visits and remote monitoring that is more responsive to changes or escalation in their health needs and conditions. The communities where this pilot project will run have not been finalized, but that work continues at a good pace and will be announced shortly.

All of that work has continued while the COVID-19 pandemic has unfolded. It’s been said many times before, but it has to be remembered, that this unprecedented global crisis has created challenges never before faced. During this pandemic, we have examined and used every option at our disposal in the fight to keep our most vulnerable residents safe. We’ve taken significant action since the outset of this pandemic to protect long-term-care homes as they face unprecedented challenges due to this virus. We have learned from and adapted to a constantly evolving situation.

We implemented our aggressive COVID-19 action plan for protecting long-term-care homes, including rigorous testing measures. Testing is a key to defeating COVID-19, and the sooner we can identify cases, the better positioned we are to contain them and save lives. The rapid tests are evolving, and the federal government’s assistance with processing those and making them available is very much appreciated.

Unfortunately, if we look back to where we were at the beginning of COVID-19, the global competition for tests and PPE was a challenge. But our government rose above those challenges and has developed processes for PPE and allowed manufacturing to be done here in Ontario. It is our government that is making this province self-sufficient in PPE production.

We have persisted, with every single challenge that we’ve met, to overcome them. It is that dedication, that commitment to residents, that commitment to our most vulnerable population—our elderly, our seniors—that drives the work we do in the Ministry of Long-Term Care and across government as we work with various ministries to accomplish our goal. We will get through this challenging time as we all work together to make sure that we do everything possible for our residents.

There are currently 86 homes declared in outbreak, and of these, 58 have no resident cases. I mention this because that was the reality that we were seeing—staff members contracting COVID-19, often with no symptoms, or asymptomatically through community spread, and bringing it to the home.

As I mentioned, in early days, global competition for testing made it challenging, but we rose above it, and we are processing record numbers of tests.

I’m so proud of the efforts that our government has made to make sure that Ontarians are safe and protected, particularly our most vulnerable residents in long-term care.

Surveillance testing works. It enables us to catch individual cases and take measures to prevent wider spread. It allows us to focus attention and resources on those homes and ensure that they have what they need to contain the virus and keep it out. Twice-monthly surveillance tests for all long-term-care home staff continue.

Besides implementing the COVID-19 action plan for protecting long-term-care homes, we issued four emergency orders, introduced three packages of amended regulations and announced $243 million in emergency funding to support the needs of homes in the spring—and we’ve never stopped. Just as we started as a new Ministry of Long-Term Care in the summer of 2019, we have never stopped preparing for the future, dealing with emergency situations with COVID-19 and acting swiftly and decisively in many measures, with every single tool being used and even creating more tools as we went.

Facing a resurgence in cases, a second wave, we must be continually aware that this global pandemic continues to evolve. We know more about this virus and its spread every day. Our government has made adaptability the cornerstone of our approach. When the global pandemic was declared, I spoke of the importance of being vigilant and adaptable, and that is still true, which is why, as part of our fall preparedness plan, we are investing over half a billion dollars to protect residents, caregivers and staff in long-term-care homes from a second wave of COVID-19.

My heart, compassion and gratitude go to our front-line providers, our personal support workers, our nurses, our doctors, our pharmacists, our technologists, our community paramedics—everyone who has done what we never thought imaginable, to persist during the most challenging of times. Their courage is inspiring.

The investments that we have made include $405 million to support operational pressures created by COVID-19, $61.4 million for supports to help improve infection prevention and control in the homes, $30 million for long-term-care homes to hire and train more infection prevention and control workers and, in addition, $461 million to increase the personal support worker wages, the backbone of our long-term-care homes—not only the backbone, but the heart of our long-term-care homes. This will provide $241 million in emergency funding to support the needs of homes in the spring.

I am grateful to all my colleagues, to all the committees and groups who have supported me, the ministry and our government through this process. It has really been a collaborative effort, with everyone rowing in the same direction.

Facing a resurgence in cases, a second wave, we must continually be aware that this global pandemic continues to evolve. Our government keeps adapting.

We are prioritizing early distribution of the flu vaccine to long-term-care residents and our vulnerable population, and working with every partner to get access to rapid tests.

I’ll quote Lisa Levin, CEO of AdvantAge Ontario, which represents many not-for-profit and municipal home operators: “We still have a long way to go in this battle, but we are very encouraged by the government’s willingness to put every option on the table to get through this and to do what is needed to build a better future for long-term care in Ontario.”

The response of the staff at homes across the province has been remarkable, and I want to acknowledge their valiant efforts. I know that the care that they bring every day, all of the people working to make things better in long-term care—I know that they all believe in the residents. They believe in the people around them. They believe in making things better, and they believe in being determined to accomplish the goals they set and to get to the other side of this horrendous outbreak.

We face a daunting challenge, but we will be continuing to use every option to fight COVID-19 every single day.


Access the full debate here: The Ontario Legislative Debates – October 20, 2020