Tuesday, January 18, 2022

Report on 'defunding' Halifax police recommends reforms, no specific budget cuts

HALIFAX — A committee tasked with defining how to defund Halifax-area police has instead produced a wide-ranging report recommending a shift away from a "reactive" enforcement-based policing model — but it includes no specific budget cuts.

© Provided by The Canadian Press

The report, prepared for the city's Board of the Police Commissioners by a 14-member subcommittee, was formally presented to the board on Monday by subcommittee chairwoman El Jones. It makes 36 recommendations on police practices, oversight and accountability.

But the subcommittee said it did not have enough data to recommend a specific amount to be cut from the police budget.

"We have tried to find a middle ground between the two extremes of just offering a definition (of defunding) versus prescribing, step by step, how to defund the Halifax Regional Police," the report said.

"We lay out a suite of reforms drawn from our public consultation. … In this way, our recommendations are designed to bring about a wholesale shift away from a reactive, enforcement-based model and towards a proactive, supportive model of community safety."

The police board tasked the committee to conduct its review in 2020, following the murder of George Floyd in the city of Minneapolis by a police officer. That incident caused a movement to "defund the police" in the United States, which influenced activists in Canada.

The subcommittee included in the report results from an online survey that received 2,351 responses. It said 56.8 per cent of survey participants indicated support for the idea of defunding the police, while 43.2 per cent of respondents did not. It noted that support for defunding was higher among women, gender-diverse people and people with disabilities, compared to men.

"There is not agreement on what defunding means," Jones said Monday during the police board meeting. "Some people that indicated that they did not support defunding nonetheless did support ideas such as removing mental health (response) from police."

Among its recommendations, the report called for "detasking," which would remove certain functions from the police, such as responding to mental health calls. Those calls would instead be given to teams composed of civilians. It concluded that the current model of mental health crisis intervention in the Halifax Regional Municipality is "outdated and no longer aligned with best practices."

Jones told the board that while police do not support the defunding concept, they recognize they should not be the first line of response for every incident. "In order to get there that is not just resting on the police … we also more broadly need to rethink about how we are constructing society," she said. "So, in order to shift away from policing, we also need to shift the way we resource other organizations."

The report said police should be "detasked" from other duties, including traffic enforcement and safety; third-party sexual assault reporting; and incidents involving homeless people, young people, gender-based and intimate-partner violence, drug overdoses and noise complaints.

The subcommittee called for a series of legislative and policy reforms to promote community safety, and it recommended tying police budgets to clear performance metrics. It also called for "participatory budgeting," which would involve members of the community and various organizations in helping to decide how to spend public funds.

As well, it recommended aligning the Halifax police budget with Canadian cities of comparable size, pointing out that the current level of $393 per capita is higher than the national average. "When we look at cities of a comparable size, we are in fact overfunding the police," Jones said.

The report also recommended the police board consider exploring ways of disarming some police officers, such as community response officers, and ways to minimize the use of firearms by police. It said the board needs to provide meaningful oversight of the use by police of special weapons teams, long guns, riot gear and other militarized equipment.

"Defunding the police is in many ways about reinvesting in fundamental and historically underfunded community resources," Jones said. The report recommended diverting some funds to areas such as mental health, substance abuse and affordable housing.

Board member and city councillor Lisa Blackburn said she would table a motion in a future meeting to direct the report to another subcommittee aimed at coming up with a working plan based on the recommendations.

"This report is everything that I wanted it to be and then some," Blackburn said.

This report by The Canadian Press was first published Jan. 17, 2022.

Keith Doucette, The Canadian Press
Quebec may never get the full story behind COVID-19 care home deaths, coroner warns

Quebec coroner Géhane Kamel said Monday that grieving families may never get the full story behind the thousands of deaths that occurred in long-term care homes during the first wave of COVID-19

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© Provided by The Canadian Press

Kamel expressed shock that after a yearlong investigation, there seemed to be no consensus from witnesses on the timeline of how the government responded to the health crisis or where blame should lie for the tragedy.

Her comments came after a former manager with the Health Department told the inquest on Monday that the Quebec government only became aware of the risk COVID-19 posed to long-term care homes in mid-March 2020.

Martin Simard's testimony backed up that of Seniors Minister Marguerite Blais, but it contradicted the testimony of other prominent witnesses, including the province's ex-public health director and former health minister, who both said the province knew of the risk in late January.

Simard said that written internal communication on COVID-19 preparation from January was aimed at the network as a whole and did not focus specifically on the care homes, known as CHSLDs.

Kamel has been examining the deaths of elderly and vulnerable people in seven residential settings during the first wave of the COVID-19 pandemic, as well as investigating the government's response to the outbreaks.

On Monday, Kamel said she was "flabbergasted" at the statements she had heard and at the inability of some witnesses to admit that care homes had been a "blind spot" in the government's response.

"It's been a year that what we've been told is, 'I can't tell you, I can't say, and it may not be our department or our group that was managing,'" she said.

"It seems to me that people should be able to tell us in all honesty: 'Listen, we may have had a little blind spot when it comes to CHSLDs.'"

Simard told the inquiry that the long-term care homes only became a "named issue" on March 11. He said it was the responsibility of then-public health director Dr. Horacio Arruda to highlight the risk to care homes.

He said his role was mainly one of co-ordination between departments and that he experienced no difficulties in that regard.

Kamel had previously expressed hope that Simard's testimony would prove to be the "missing piece of the puzzle." On Monday, however, she said that piece would probably remain missing and that bereaved families would likely be left without answers.

"We can't get to the bottom of this story … is it normal that to this day, we're not able to have a story that holds together?" she said.

"We can't even get this chronology, because it's different depending on which actor is in front of us."

After Simard concluded his testimony, the lawyer for six of the families who lost loved ones in the homes blasted the government response, and Arruda in particular.

Quebec public health reacted "at the same rhythm as the population" — instead of planning ahead when it was clear as of January 2020 that there was a threat to the population, Patrick Martin-Menard said.

He said the slowness of the response was even harder to explain given that the province had an influenza pandemic plan it could have deployed. "Due to this inaction, because of this confusion, this lack of clarity and leadership, we lost crucial weeks," Martin-Menard told the inquiry.

Martin-Menard said it was clear the province hadn't acted quickly, despite what some witnesses claimed, and that Quebecers in long-term care homes had paid the price.

"We let them die alone … in complete indignity, not because it was an inevitable situation, but because we didn't adequately prepare."

This report by The Canadian Press was first published Jan. 17, 2022.

Caroline Plante, The Canadian Press


CANADA
‘The System Is So Broken’: What It’s Like In Long-Term Care Right Now

LONG READ

Nora Loreto 
© Provided by Chatelaine An Illustration of a senior in a wheelchair with a much smaller middle-aged adult standing in the shadow
(Illustration: Sébastien Thibault)

Nizi calls her mother’s long-term care facility every night. During each call, she asks someone on staff if Maria, 83, has showered and what she’s eaten. In January 2021, for three nights in a row, Nizi was told her mother had only eaten breakfast. She immediately knew something was wrong. At the time, the facility was in the midst of a COVID-19 outbreak. Maria’s nurse practitioner said it was likely that Maria had COVID but had not been tested; first she had refused, and then Nizi says the doctor told her she didn’t want to administer the test, as it might “ruin her rapport” with Maria. On February 5, Maria fell and was hospitalized. In the hospital, she tested positive for COVID-19 and also got her first sponge bath in six weeks.

Maria, who has schizophrenia, has lived in this Toronto-area public facility since 2018. She is independent and spirited, and still a fashionista. She walks down the hallway of her residence as if it’s a catwalk whenever Nizi brings her a new outfit. Before COVID—which caused the deaths of more than 20 residents in her facility—Maria would participate in bingo, birthday parties, exercise classes and creative activities. Nizi would take Maria shopping and to get her hair done. These routines helped strengthen their bond as they navigated Maria’s new reality in long-term care.

When the home went into lockdown in March 2020—as provincial governments across Canada closed LTC facilities to essential caregivers as an infection-control measure—Nizi’s visits were reduced to standing on the other side of Maria’s first-floor window. “The lockdown put a big wedge in our relationship, because Mum thought I had abandoned her. But I didn’t. I just couldn’t get in,” says Nizi.

Without the activities and regular visits from Nizi, Maria became depressed and—like an increasing number of Ontario long-term care residents during lockdown—was prescribed antidepressants. Twenty months after the initial lockdown, Maria says their relationship has recovered, but it’s not the same.

Nizi desperately misses the friendship that she and her mother used to have; the one where she could talk to Maria about everything. She wants to tell Maria about the health problems that she’s having related to constantly needing to advocate for Maria’s care. But Nizi doesn’t want to stress her mother out: Living in a long-term care facility in Canada is stressful enough as it is. Nizi is Maria’s primary caregiver, and the role is grinding her into the ground. When I first talked with Nizi, she had recently been hospitalized for five days due to the stress of being an essential caregiver.

Before she entered long-term care, Maria lived briefly with Nizi’s family, but her schizophrenia was deteriorating, making caring for her more challenging. On four separate occasions, Maria left Nizi’s home in search of her deceased husband, hoping to find him at the intersection where they used to live. Three times, Nizi says that they needed help from police to locate her. The fourth time, Nizi found Maria with a packed bag. Every time Maria left, Nizi’s young son would start shivering with shock over the stress of her disappearances.

“I needed that 24-hour help . . . . It was a very, very hard choice to place Mum in a long-term care home,” says Nizi. She got the call that a spot had opened up at the facility on her son’s seventh birthday. Maria moved in three days later, first into a semi-private room and then into a private room so that she could have her own bathroom. In the beginning, the facility’s care wasn’t so bad, says Nizi. But in March 2020, triggered by the chaos and loneliness of the pandemic, Maria started refusing care from personal support workers (PSWs). As the level of care Maria was receiving deteriorated, Nizi found that making complaints to Ontario’s Ministry of Long-Term Care was her only recourse to ensure that her mom not only had regular baths but received other care, too. In total, the ministry has found 22 instances of non-compliance that Nizi says were related to Maria’s care­—including issues related to her diet and medication.

“I’m just fighting for basic care . . . and shouldn’t be,” says Nizi, exasperated. “These are things that the home should be providing.”
© Provided by Chatelaine An illustration of a broken, heart-shaped plate
(Illustration: Sébastien Thibault)

Canada’s 2,076 LTC facilities have been understaffed and underfunded for years, but the pandemic kicked the dysfunction into overdrive.

The average amount of reported daily direct care that LTC residents receive—one-on-one time that staff spend with residents to provide for their daily needs, whether that’s help eating, bathing, dressing or toileting—varies by province: In British Columbia, it’s 3.14 hours per day; in Ontario, it’s around two hours and 45 minutes. In 2021, Alberta’s Parkland Institute, in collaboration with CUPE Alberta, a provincial union that represents LTC staff, conducted a survey that showed how understaffing and underfunding have had profound impacts on resident care. Forty-one percent of the Alberta-based workers surveyed felt that current staffing levels were “seldom or never adequate to meet care needs,” and more than 40 percent said that understaffing led to injuries and delayed assistance with meals.

These are concerns echoed by Emily, a PSW at a not-for-profit long-term care facility in southwestern Ontario. On a day when her facility is fully staffed, it has four PSWs for every 30 residents. Each morning, she quickly assesses each of her eight to nine residents to see if anyone needs immediate help. After that, she deftly moves from room to room to get each resident dressed, bathed and into the dining room for breakfast. She only has six minutes with every resident. If one needs more time to do something, she has to make that time up somewhere else. If she needs to use a lift to help a resident out of bed, she runs down the hall to find another PSW to help with the two-person job. At the best of times, it’s a massive challenge to care for everyone.

But if one PSW calls in sick, it means that the remaining three have to do everything for even more people—in less time. “[Even] when we’re fully staffed, we’re running crazy,” says Emily. She has to calculate her actions down to the bowel movements, back washes and daily demeanour of each resident. Every single shift, says Emily—who makes about $21 an hour—you have to mentally prepare yourself to “just go.”

Palliative care physician Dr. Amit Arya has worked in various Ontario LTC facilities and sees this rush regularly. When medications are added to the mix, it can get even harder: If a resident is prescribed something that requires they be monitored every 30 minutes, that leaves very little time for a nurse—who may be caring for 30 other residents, if not more—to do other things, including calling a doctor if they need to discuss the resident’s reaction to the medication. “This is not a system that was ever even designed to look after people that live there, to accommodate their wishes, to provide them good care and to support their families,” he says.

Instead, long-term care homes rely on essential caregivers like Nizi: unpaid family helpers who regularly come into the facility to feed, bathe and provide companionship to their loved ones. This regular contact also allows them to see when protocols are not being followed, which places them in the spot of also being whistle-blowers. “Caregivers are a giant part of why LTC is successful,” says Emily, “because they know their loved ones better than we do.”

But in March 2020, that all changed. Overnight, the thousands of unpaid caregivers who help the long-term care system operate were shut out—with no indication of when they could return. There was no question, says Arya, that this decision would have dire consequences.

Bob is an optimistic guy. Sitting inside a car in a Tim Hortons parking lot beside his daughter Jo-Anne, he tells me over the phone that his current residence is comfortable. In long-term care, “you don’t have the agony of fighting with a construction company anymore,” he says, referencing life as a homeowner. When I ask the 94-year-old how hard it has been to live within the facility during the pandemic, he says, “Each day is a new day, and there’s nothing to fear about it if you know the platform on which you can build a happy environment wherever you are.”

Bob’s cheery demeanour doesn’t betray how difficult his past two years have been. In January 2019, he was hospitalized after several falls. By March, Jo-Anne says she felt pressured to take Bob home from the hospital early so that she wouldn’t lose home support from government-funded PSWs. She quickly assembled a team—PSWs, family members, a few friends—to help accommodate Bob’s return to the condo that he shared with Barbara, his wife of 68 years.

Then, in May 2019, Barbara had a stroke and was hospitalized for months. In September 2019, Bob moved into a long-term care facility west of Toronto as it became financially impossible for Jo-Anne to keep him at home with round-the-clock care. Barbara joined him at the facility that November. When Barbara moved in, she was given a room kitty-​corner to Bob’s, so they could see each other. But she couldn’t get out of bed.

When the pandemic started and residents were confined to their rooms, Jo-Anne estimates that Barbara was alone for 22 hours a day, going in and out of delirium and experiencing terrible, progressive arthritic pain. Jo-Anne says she followed up constantly about her parents’ care: issues like insisting that staff use a lift for Barbara in a way that didn’t hurt her and constantly reminding them to bring Bob to see his wife. During a window visit during this time, Jo-Anne heard her mother scream in pain, but there was nothing she could do. Jo-Anne says she was constantly advocating for the home to implement measures to ease Barbara’s pain—including changing the way her medication was administered—and keep her hydrated. Jo-Anne says that when she would ask staff about the latter, they would say that there was always a glass of water beside her bed (by then, Barbara was quadriplegic). During lockdown, Jo-Anne would call the home twice a day to check in on her mom. If she wanted to talk to Barbara, she needed staff to hold a phone to Barbara’s ear. But they were often too overwhelmed to assist with the calls. Barbara eventually asked if Jo-Anne was mad at her, as she wasn’t calling as often.

On the Friday before Thanksgiving in 2020, Barbara died. For weeks, Jo-Anne tells me through tears, she had tried to get an exemption from lockdown rules to be with Barbara. In September 2020, the Ontario government announced that each LTC resident could designate two essential caregivers for unlimited visits. (Prior to this announcement, there wasn’t a consistent caregiver policy in place across all Ontario homes.) But Jo-Anne says she never received any communication about this. (A spokesperson for the Canadian chain that operates the facility in question told Chatelaine that such news is communicated to family members via email or voicemail updates “as soon as possible after such changes happen.”) Jo-Anne was eventually able to see her mom again before she passed, but she can never make up for the time she lost not knowing the facility was open to visitors.

This facility operates on a for-profit basis, and is located in Ontario’s Halton Region. It has only single-occupancy rooms and as of press time did not have a single death related to COVID-19 per official figures. Jo-Anne asked me not to name it for fear that it could have repercussions for Bob’s care. Of the dozens of people with family in LTC that I spoke to for this story, this was an overwhelming concern.

All of the advocacy for Bob’s care falls on Jo-Anne’s shoulders. She says she has made complaints to the Ministry of Long-Term Care regarding both of her parents’ care, but she’s too overwhelmed to recall the outcomes. She says that the time she spends advocating for Bob has ruined her financially (she’s self-employed) and emotionally. “I’m just so done with it all,” she tells me. “I know most of the people I deal with are kind people, but the system is so broken and the disconnect between admin and front-line [workers] is so acute . . . . I’ve never been so exhausted in my life.”

***

There are two ways in which provincial governments oversee the quality of care that is delivered within long-term care facilities, regardless of whether they are public, private not-for-profit or private for-profit. The first is through routine, unannounced inspections. These allow inspectors to see what the day-to-day operations of an institution are like and make recommendations to improve them. They might look at how medicine is stored, if there are any fire hazards or safety lapses and if the facility is fulfilling its responsibility under various pieces of legislation or regulations.

The second form of oversight is triggered either by a complaint from a family member or other concerned party, or a critical incident. Complaints can be a frustrating, difficult and drawn-out process. In Alberta, for example, anyone with concerns about food, cleanliness or general upkeep of their loved one’s LTC are encouraged to first bring their concerns to their home’s resident-and-family council, which is run by family caregivers and attempts to resolve issues that arise between families and the home. If bringing a complaint to this group doesn’t result in a resolution, a person can lodge a formal complaint with Alberta Health’s Accommodation Standards. But by the time this process plays out, weeks or even months might pass. If a concern was pressing, like unclean living conditions or a problem with a resident’s meals, the resident and their family either must live with the problem in the meantime or find other ways to raise the issue. This process is similar in provinces across Canada.

Any time a patient is injured, harmed or killed by the unintentional actions of staff—and if the impact has nothing to do with an underlying health issue—it must be reported. That also triggers an inspection (albeit one that management is anticipating).

Unannounced, thorough inspections are the backbone of effective compliance, and the reduction of such inspections means family members are often left to pick up the slack. Take, for instance, what has happened in Ontario: Prior to 2018, each long-term care facility in the province had an annual, unannounced inspection. CBC News found that those inspections were nearly eliminated in fall 2018—a few months after Doug Ford’s Conservatives took office. (While most of Ontario’s 626 LTC homes received unannounced inspections in 2015, 2016 and 2017, CBC reports that only nine did in 2019.)

This meant that inspections triggered by complaints and critical incidents became even more important. Not only does this leave a large part of enforcing compliance on the shoulders of family members, it also resulted in less-thorough inspections: An Ontario ministry report from 2015 found that these thorough, unannounced annual inspections were the only kind that were able to consistently identify lapses in infection control. Once Doug Ford became premier, the number of violations of non-compliance found within Ontario’s system dropped by 30 percent. Did this mean that facilities were safer, or only that conducting fewer inspections yields fewer instances of non-compliance?

In 2020, there were zero proactive investigations, called resident quality investigations, conducted. Ontario’s Ministry of Long-Term Care told Chatelaine that it’s working on creating “an improved proactive inspections program” but that the pandemic “sidelined this work until early 2021.”

As a PSW, Emily says that staff rely on family complaints just as much as families do. When staff complain to management, she says, their reports are easy to brush off or delay. But when management hears from a family member, issues are taken more seriously. Complaints can be about anything, from minor issues that could be easily addressed by asking a PSW to do something specific to major ones that try to identify how a resident was harmed by a particular practice. But larger issues are often systemic, and a complaint can only highlight the acute expression of a generalized problem. So while a complaint might result in a specific resident receiving a bath more often, it certainly cannot change protocols within a facility to ensure that all residents have more frequent baths, because bathing is a victim of chronic short staffing rather than a momentary lapse in a staffer’s daily work.
© Provided by Chatelaine An illustration of two hands—one old, one younger—pressed against a window.
(Illustration: Sébastien Thibault)

In November 2020, Ontario’s Ministry of Long-Term Care conducted a complaints-driven inspection at Maria’s home, including issues raised by Nizi, and found numerous infractions. Some residents’ care plans, which outline the specific care a resident should receive, were not being followed. Facility management failed to ensure that staff were using safe transferring and positioning techniques, resulting in a resident’s fall, as well as other care-related issues. The inspection also found that facility management didn’t follow their own complaints protocol. As a result, the inspector gave the home’s management a written notification indicating that the facility was found to be in non-compliance with provincial regulations. The notice was posted publicly—and that’s it. A 2020 CBC Marketplace investigation found that, out of 10,000 inspection reports completed in Ontario between 2015 and 2019, there were 30,000 written notifications given. None resulted in more serious action. Revoking an operator’s licence is exceedingly rare. Since the pandemic began, in Ontario, just seven retirement residences—all owned by the same family—had their licences revoked. During the hearings held by Ontario’s Long-Term Care COVID-19 Commission in late 2020, commissioners heard that in the 20 years prior to the pandemic, just two LTC facilities had had their licences revoked.

In May 2021, another inspection triggered by complaints at Maria’s LTC home found that bed rails weren’t being used properly, after a resident fell out of bed, among other infractions. Two days earlier, there had been a critical-incident inspection after a resident attacked and injured two other residents. The result of the critical-incident inspection was a voluntary plan of correction, the next level of infraction after a written notice: The facility was compelled to develop a plan to manage and avoid violence. There is no public reporting about whether or not the facility actually developed or implemented this plan.

At Bob’s residence, there were critical-incident and complaints-triggered inspections in December 2020, and another critical-incident inspection in May 2021. During the December 2020 critical-incident inspection, the inspector found that a resident was improperly transferred, resulting in a fall, and that several residents’ needs were not met by their care plans. It was also determined that medication was given to the wrong individual. Two of these infractions also resulted in a voluntary plan of correction. Once again, there is no mechanism in place to ensure that this plan was made.

It’s unfair and unreasonable that regulation and compliance should fall on the shoulders of family members, but that is exactly what has happened. Arya sees families in desperate situations, like those of Nizi and Jo-Anne, all the time. “I have seen the most burnout and the most stress in caregivers when their loved ones are in long-term care—more than any other setting; more than hospice, hospital or home care,” he says. “The time that people have to give to their loved ones is a set-up for burnout.” He thinks the complaints process is essentially futile: “Perhaps it gives people an outlet, but I can’t see it accomplishing anything,” he says. That’s because the problems within the system are far deeper than one nurse or PSW—or one manager or one facility.

***

Nizi and Jo-Anne met last year through a support network that formed during the pandemic and that is anchored by someone they all call Dr. ​V: Vivian Stamatopoulos, a sociology professor at Ontario Tech University, who has, for the past 20 months and counting, been an outspoken advocate for LTC residents and their families.

With Dr. V’s help, a community of essential caregivers shares advice on how to advocate for their loved ones and bring concerns they have directly to politicians. She is stunned by what she has witnessed during the pandemic: “I’ve never seen this level of trauma, pain and injustice,” Stamatopoulos says. She says that the essential caregivers in her network have all developed “trademarks” of depression and trauma. And when families’ only hope for adequate care for their loved ones rests in the complaints process, they often find themselves even more burnt-out, trying to follow a drawn-out, bureaucratic process that seems specifically designed to not address underlying systemic problems.
© Provided by Chatelaine An illustration of an elderly woman sitting in a chair, encased by brick walls
(Illustration: Sébastien Thibault)

It’s clear that long-term care in Canada is not working; not for staff, not for residents’ family members and certainly not for residents. While much of the attention focused on LTC has been related to system reforms, there are many voices that are questioning its existence outright.

Seniors for Social Action Ontario (SSAO), a group that advocates for better care and supports for disabled and elderly Ontarians, is calling for institutional long-term care as we know it to be abolished. It wants LTC replaced with alternative approaches, including home care and community care, such as group homes. It references Denmark’s community-care model as one possibility; the country experienced fewer than half the COVID deaths in LTC that Canada did. (It’s worth noting that Denmark spends nearly equal amounts on home care and institutional care, and banned the development of new LTC homes in the 1980s. Canada, on the other hand, spends most of its long-term care funds on institutional and hospital care.)

Formed in spring 2020, SSAO comprises a group of seniors that includes policy experts, activists and retired professors. It is resolute in its position that the institutional model of long-term care reduces the quality of the care that residents receive. In a presentation to Ontario’s Long-Term Care COVID-19 Commission in December 2020, SSAO argued that “all human conditions get worse in institutions” and that “external environment and trauma create aggressive behaviour.”

SSAO has lots of ideas on what could replace the current institutionalized system of long-term care. Member Kay Wigle, who has since passed away, told the commission about one project that she was involved in 25 years ago. Residents of a group home in London, Ont., who had Down’s syndrome were developing early onset Alzheimer’s as they aged. Rather than looking toward long-term care as the solution, this community agency decided to change how they delivered care within the group home setting. As a result, the facility never had to transfer any of its residents to long-term care: “They’ve used community nursing when needed, but they were also able to do a lot of care that typically a long-term care [facility] may or may not be able to do,” Wigle described.

In its testimony, SSAO noted that implementing some of these changes would require breaking down silos that exist between the ministries of health, social services and long-term care. But there are also changes that could be imposed on the sector as it is that would make a big difference immediately. SSAO argues that LTC facility managers need to be legitimately fearful that they may have their licences revoked. Instead, some of the deadliest operators during the pandemic have recently been granted the right to expand their facilities. Take, for example, Southbridge Care Homes, which has 784 new beds and 1,200 redeveloped beds either under contract with Ontario’s Ministry of Long-Term Care or at various levels of approval within the ministry process. This is in spite of the fact that half of Southbridge’s 26 facilities had a total of 214 COVID-19 related deaths. This figure includes 70 deaths at Orchard Villa in Pickering, Ont.—which experienced one of the province’s deadliest LTC outbreaks and was also the subject of a military report on alarming conditions inside certain LTC facilities. [Editor’s note: Chatelaine’s editor-in-chief’s mother is a resident in a Southbridge home.] There’s no question that Canada needs more capacity to care for the elderly, but governments seem more interested in expanding the status quo rather than exploring alternatives that could be immediately implemented.

***

Ultimately, the sweeping changes that are required to fix the long-term care system require money, creativity, courage and, most importantly, political will. And any changes will likely come far too late for Bob and Maria.

For his part, Bob told me the change he would like to see most in the LTC system is more support for peer-to-peer interaction within his facility. He thinks that incoming residents should be connected with veteran residents to foster relationships that would ease the loneliness he says is common. Facilitating this type of socialization, however, would require more staffing—and as it stands, there aren’t enough staff members at most homes to meet residents’ basic needs, never mind to provide social support.

Since I spoke with Bob, things are going better for him—Jo-Anne describes his health as stable—though life is just as difficult for Jo-Anne. She still meets with either the director of care or the executive director of the facility each week to monitor Bob’s care and address any new concerns that arise. She tells me via email that she’s still exhausted.

Nizi also continues to regularly advocate for her mother’s care and has encouraged other family members at Maria’s residence to file complaints, too. She tells them that she honestly believes her complaints have had a positive impact on the care Maria is receiving, though she wishes it didn’t have to be that way.

The LTC system, as it stands, continues to rely on the unpaid labour of essential caregivers to ensure the delivery of basic care, and to raise the alarm, again and again, when it’s compromised. The trauma that this system perpetuates—for staff, for family members and, most notably, for residents—is a national crisis. And the only solution is a radical upheaval of the status quo. What will it take for our governments to enact one?
SASKATCHEWAN
Mandryk: Wilson's SHA appointment adds to political meddling suspicions

Murray Mandryk 
© Provided by Leader Post 
Accusations that SHA decisions during this pandemic are being made by political appointees are unsettling.


If former Saskatchewan Party candidate Raynelle Wilson’s appointment as a Saskatchewan Health Authority (SHA) vice-president was just a simple matter of political patronage, it would be less worrisome.

After all, we’ve grown used to that in this province.

In the waning days of the Allan Blakeney government 40 years ago, the then Progressive Conservative opposition loved to point out how many friends and family of New Democrats had government jobs, noting how many Koskies related to a former cabinet minister, the late Murray Koskie, there were in the government directory.

While vowing to do better, the Grant Devine PC government soon faced similar accusations of placing friends and family in both high- and low-patronage places. By the end of that government’s tenure, stories were emerging of PC MLAs sending out letters to their donors asking for names of sons and daughters for hiring to cushy summer jobs in the early 1990s.

Naturally, the then NDP opposition was appalled by this and also vowed to do better. But the end of its tenure in government in the mid-2000s, the Sask. Party was rightly indignant over the appointment of “commissars” to the Crown corporations — dyed-in-the-wool political partisans who had worked directly either for executive council or as ministerial aides seconded for reasons that seemed largely about reporting back to their political masters.

Fast-forward to more than 14 years into this Sask. Party government and we are again hearing the term “commissar” — this time, in regard to Wilson’s newly created appointment as vice-president of Enterprise Initiatives Support in the SHA to “provide executive leadership” that will strengthen collaboration and report “on priority enterprise initiatives.”

Report to whom and why? And what special qualifications does Wilson have for this specially created position? And why are the skills of a political operative now so coveted in a senior health administration position in the middle of a pandemic?

It is about here where concern about her appointment moves beyond the usual patronage accusations into something more.

New Democrats were quick to note, after the StarPhoenix’s Zak Vescera broke the news of Wilson’s appointment, her role as chief of staff to then-Crown Investment Corp. Minister Donna Harpauer to help a questionable land acquisition proposal at the Global Transportation Hub (GTH) move forward as a cabinet decision item. In an email obtained by the CBC, Wilson called it a “bit of goat” show.

No doubt, this required some skill on Wilson’s part, but maybe not exactly the skills the SHA now needs when it’s facing today’s record case numbers and looking down the barrel of contending with year-long waiting lists for postponed surgeries.

Arguably worse, Saskatchewan’s health system is already in a bit of a crisis with questions about whether this government is actually listening to individuals from support staff to nurses and doctors, existing administrators or medical health officers. Given Wilson’s political history, does anyone really think she’s there to promote a freer dialogue and exchange of ideas?

Her arrival with the SHA comes at a time when there is already excessive mistrust and speculation stemming from the sudden and still-unexplained November departure of former SHA chief executive Scott Livingstone.

We still don’t know why someone of Livingstone’s experience, talent and tireless commitment just suddenly steps down in the middle of a pandemic. We do know, however, his puzzling resignation came after the government arbitrarily decided to hand over much of the SHA’s administrative function during this pandemic to the Provincial Emergency Operations Centre and as government is pushing for more private surgeries.

And now we see Wilson, who does not have a background in health-care administration, placed in a newly created vice-president’s position few can explain or justify. Instead, we got the usual nebulous government excuses that always accompany questionable patronage appointments.

However, the difference is this patronage job is about people’s health and well-being.

The premier and the minister of health owe us full disclosure we are not getting.

Mandryk is the political columnist for the Regina Leader-Post and the Saskatoon StarPhoenix.



Zamboni explodes at local hockey rink in Kentucky

Thomas Williams 

What would you do if you were just enjoying a recreational skate down at your local hockey rink, when all of a sudden a sizeable explosion occurred down a nearby hallway? Well, that happened this weekend in Kentucky.

A hockey rink in Kentucky was rocked by a Zamboni explosion this weekend.

While a number of skaters were present, there was a blast at the Lexington Ice Center on Saturday night, close to one of their ice pads.

David Christopher, one of the rink’s owners, told WKYT on Sunday that it was caused by a propane leak when employees were replacing the tank on the Zamboni machine. Luckily no damage was done and no one was injured by the explosion.

The Lexington Ice Center has had a bad streak of luck recently, as this is not the only disaster to take place under its roof in the last six months.

In July 2021, a massive fire heavily damaged the second rink at the center, forcing a substantial rebuild to take place. Despite the blaze making the rink unusable, no one was hurt.



Maybe the hockey gods just really dislike any sort of ice existing in Kentucky.
Mälkki could be 1st woman music director of NY Philharmonic

NEW YORK (AP) — Her arms at her side against her glimmering, long black jacket and her blond hair pulled into a ponytail, Susanna Mälkki soaked in several minutes of applause after a thrilling Carnegie Hall debut. She had conducted the New York Philharmonic in a challenging program, perceived as a possible prelude to becoming the first woman music director of an orchestra that started in 1842.

“Of course, it’s always an honor to be mentioned in this kind of context,” she said during an interview with The Associated Press the day before the Jan. 6 performance. “It’s really, really fun to be with the orchestra. But the `l’actualité,′ as they say in French: This something that the orchestra will take their time. They will try out a lot of people.”

Musicians beamed as the audience erupted following the Philharmonic’s first Carnegie Hall appearance in six years, broadcast live on radio. Leelanee Sterrett, the acting associate principal horn, detected a “focused energy” that Mälkki brought to the podium and called it “one of those performances where in the concert everything was kind of taken up a notch, dialed up a notch.”

A native of Finland who turns 53 on March 13, Mälkki studied at the Sibelius Academy and London’s Royal Academy of Music, and she was mentored by Esa-Pekka Salonen.

She was principal cellist of the Gothenburg Symphony Orchestra from 1995-98, then left to concentrate on conducting. She served as music director of the Paris-based Ensemble Intercontemporain from 2006-13, became chief conductor of the Helsinki Philharmonic Orchestra starting during the 2016-2017 season and principal guest conductor of the Los Angeles Philharmonic for 2017-18. She announced last month she will leave the Finland post at the end of the 2022-23 season.

A woman has never been music director of what was long known as the Big Five: the New York Philharmonic, Boston Symphony Orchestra, Chicago Symphony Orchestra, Philadelphia Orchestra and Cleveland Orchestra.

Marin Alsop took over the Baltimore Symphony Orchestra in 2007-08, a tenure that ended last August, and Nathalie Stutzmann was hired in October to become music director of the Atlanta Symphony Orchestra in 2022-23.

Jaap van Zweden said in September he will leave the New York Philharmonic at the end of the 2023-24 season after six years as music director. Orchestra members know when a potential successor is leading them.

“Of course we’re conscious of that. How could you not be?” principal cellist Carter Brey said. “But I think that occupies a small corner of our awareness at the time. We’re just focused on making music as well as we can.”

Mälkki’s past as a cellist — she still plays but not publicly — influences her conducting.



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“She’s meticulous in the way she runs a rehearsal,” star violinist Gil Shaham said. “You just always feel positive. You never feel like, ‘Oh, we’re going to run out of time.’ She always plans the time in advance.”

Mälkki made her New York Philharmonic debut on May 21, 2015. When she made her Metropolitan Opera debut in December 2016, she was just the fourth woman conductor of a company that started in 1883.

“At first meeting, she can seem somewhat reserved, but she obviously is very passionate about her performance and about music,” Met general manager Peter Gelb said. “She may have the surface dryness or wryness of other Finnish artists I have known, but her passion quickly comes out when she’s on the podium.”

Mälkki is among five woman conductors at the Met this season. She is one of 21 to lead the Philharmonic, including four so far this season.

“I know for me as a woman, it’s extremely meaningful to have somebody on the podium who reflects my identity, and I feel that every time we work with a woman conductor,” Sterrett said. “So I think that as you see people breaking through, it just changes the whole dialogue around us. It changes the paradigm.”

Deborah Borda, who returned to the New York Philharmonic as CEO in 2017 after 17 seasons as CEO in Los Angeles, hired Mälkki as principal guest conductor.

“She has a very powerful and quiet charisma and what she brings is an emotional as well as intellectual connection to the music that is really unique,” Borda said.

Borda tries to say little publicly about the music director search.

‘It’s a very delicate procedure,” she said. “There are obviously various stakeholders involved within our community, but the guests, as well, and it is so important that we protect the confidentiality and sanctity of the process.”

Typical of conductors, Mälkki leads a peripatetic life. She has homes in Paris, where she keeps her scores, and in Finland. “Helsinki is good because I grew up there, My parents are there. It’s nice to have a pied-à-terre in Helsinki, but Paris is definitely home,” she said.

She will be back in New York in May to conduct Stravinsky’s “The Rake’s Progress,” and is signed-up for Beethoven’s “Fidelio” in a future season and Kaija Saariaho’s “Innocence” in 2025-26 after leading its world premiere last summer at Aix-en-Provence, France. She conducts Berg’s “Wozzeck” at the Paris Opera in March.

Known for her interest in late 20th century and contemporary compositions, she has committed to future performances of Puccini’s “Il Trittico,” Debussy’s “Pelléas et Mélisande” and Janácek’s “The Makropulos Case,’ and hopes in the future to lead Puccini’s “La Bohème” and Wagner’s Ring Cycle and “Tristan und Isolde.”

“It’s a shift that’s been actually sort of intended and planned already some time ago,” she said. “I’ve been speaking about my interest for opera and there have been more and more invitations. And then I’ve just been grabbing everything, and it’s really exciting. I love working with singers. There’s something of a storytelling quality that I love. I guess I can even say that I somehow identify myself with the singers. I would love to be one of them.”

Ronald Blum, The Associated Press
ALBERTA
'RCMP asks people for public feedback on 2022-23 policing priorities

The National Police Federation (NPF) launched their Alberta-wide tour advocating for keeping the police service in the province with a Tuesday stop in Fort McMurray.

Community leaders attending the meeting at the Radisson Hotel agreed with the organization’s arguments, but also argued there must be organizational and cultural changes within the RCMP.

The Keep Alberta RCMP tour is a response to the UCP government’s support for replacing the Mounties with a provincial police force.


“The community police initiatives, your rural crime watch, victim services, all of that kind of stuff… those large programs have taken many years to develop,” said NPF regional director Kevin Halwa. “Those things aren’t replicated easily and definitely not replicated quickly.”

A provincial report provided by the auditing firm PriceWaterhouseCooper estimates moving away from the RCMP to a provincial police force would cost $366 million during a six-year period. This force would then cost $734 million annually to operate.

To compare, the 2021 operating costs for the Alberta RCMP is $595 million, with 30 per cent coming from the federal government and 70 per cent covered by the province and municipalities. Halwa argued roughly $180 million in federal funding will be lost if a provincial police force is created.


“There is not a huge appetite to go down this road toward a provincial police service,” he said. “We’ve conducted three rounds of surveys and each one of those surveys indicated that the support for keeping the RCMP is in the neighbourhood of 80 per cent.”

Alberta Justice Minister Kaycee Madu has argued an Alberta police force would be more responsive than the RCMP, better integrate operations and train officers locally. Madu and Premier Jason Kenney have been quick to point out that Ontario, Quebec and Newfoundland and Labrador fund provincial police services.

“I am confident that it would be at the same amount or lower than what we currently spend on RCMP, but as a province, we do have a responsibility beyond the monetary implications to defend and pursue our province’s best interests,” Madu said in October after the PriceWaterhouseCooper report was published.

“If those provinces can establish their own police service and pay for them, then I have no doubt that Alberta is well suited to do the same.”

Bill Loutitt, CEO of the McMurray Metis, says he opposes switching to a provincial police service. However, he argues the RCMP needs leadership and cultural changes if it wants to continue policing communities. He is not a fan of the use of force that has been justified by officers at times. Loutitt wonders how well prepared officers are for situations caused by a mental health crisis or addiction.

“Spend your money there instead of spending it on something that is going to make it worse,” he said after the meeting.

Ward 1 councillor Funky Banjoko said she wants to see more cost and benefit analysis from the province on the issue. Mayor Sandy Bowman has also opposed the creation of a provincial police force and would need to see data, such as community input and funding models, to reconsider.

“I think taxpayers would like to know why we are going to pay that premium, why are we going to make that change, if at all? Hopefully we are not and if we are not, we have to do more to have more effective and fair policing,” said Bonjoko.


Ward 4 Councillor Jane Stroud also wants to see more information on a potential switch, especially around costs and any additional fees charged to the municipality.

The province announced in late October that public engagement meetings will be held with municipal and Indigenous governments, law enforcement organizations and public safety partners such as victim services organizations. A public survey from the government is expected sometime this year.

The NPF is also planning a report based off their sessions that will be presented to the province.

-with files from Laura Beamish, Lisa Johnson and Ashley Joannou

JeHamilton@postmedia.com

Jenna Hamilton, Local Journalism Initiative Reporter, Fort McMurray Today
UCP TREATS ADDICTION AS A CRIME
Alberta advocacy groups seeking emergency appeal hearing over supervised consumption site ID requirements

Anna Junker 

Alberta advocates are seeking an expedited appeal hearing to stop the province from implementing a policy that would require supervised consumption sites to ask users for personal health care numbers.

© Provided by Edmonton Journal The Safeworks supervised consumption site at the Sheldon M. Chumir Health Centre is shown in Calgary on Thursday, May 27, 2021.

Plaintiffs Moms Stop the Harm and the Lethbridge Overdose Prevention Society sued the Alberta government over the new rules asking for identification, in part alleging the measures breach the rights of substance users and argued that some clients will be deterred from using the sites, leading to an increase in overdoses and deaths.

They asked the court to delay the implementation of the identification requirements until the constitutionality of the measures could be decided.

On Jan. 10, Court of Queen’s Bench Justice Paul Belzil dismissed the injunction application against the province, meaning the identification policy is set to go into effect on Jan. 31.

Belzil wrote that although he believes some clients will experience “irreparable harm” by having an overdose — some of which may result in death — as a result of the new rule, it doesn’t outweigh the need for the provincial government to be able to make policy decisions.

In the emergency appeal application, lawyer Avnish Nanda wrote that Belzil’s decision was made on a number of errors that warrant the Court of Appeal of Alberta to intervene.

“This includes failing to apply the correct framework at the balance of convenience stage of the test for injunctive relief against state action, failing to apply the framework in an appropriate manner to the facts on record, and most critically, finding that preventing the deaths of marginalized, vulnerable Albertans did not provide a greater public benefit than delaying the implementation of the impugned state action,” Nanda said.

The plaintiffs are seeking an expedited appeal hearing of the decision before the policy is to go into effect “to avoid the preventable deaths that (Belzil) acknowledges will occur if the impugned state action is implemented,” Nanda said.

“The record tendered in support of the injunction applications establishes that a large number of people will die as a result of the impugned state action, leading to mass death that will exceed the current record overdose death rates in Alberta.”

The plaintiffs have also asked federal minister of mental health and addictions Carolyn Bennett to intervene . In an open letter, they asked Bennett to write to her Alberta counterpart to “assert federal jurisdiction over the regulation of supervised consumptions services in Canada … and amend class- and individual site-exemption letters issued to service providers to clarify that the mandatory collection of personally-identifying information is prohibited within federally exempted supervised consumption services.”

The groups are also asking Bennett to issue an immediate nationwide exemption on criminalization for simple drug possession, and for her to meet with the plaintiffs to discuss the matter.

ajunker@postmedia.com

Twitter.com/JunkerAnna
Employees locked inside office tower after single Omicron case in Beijing

Michelle Butterfield

Beijing's first reported case of the Omicron variant has prompted heightened COVID-19 measures, including locking workers inside an office tower, as the city rushes to contain the virus ahead of the Winter Olympics.

According to CNN, the workers inside a building in the city's west end were not given any warning they would be put into lockdown at their workplace after a female employee inside tested positive for the variant during mandatory testing Saturday.

The woman who tested positive for Omicron was the city's first recorded case of the highly transmissible variant.

Read more:
Winter Olympics tickets won’t be sold to general public amid COVID concerns

COVID control workers delivered pillows and bedding to the building, while security guards kept watch over the entrances.

After the woman's case was confirmed, the city imposed a snap lockdown and put widespread contact tracing and testing into effect. Many schools in the city moved to online learning. The city has closed several tourist areas and temples. The woman's entire community — located about 15 minutes from her office building — has also been sealed off, and no one is permitted to enter or leave the area.

China has largely avoided major virus outbreaks with a regimen of lockdowns, mass testing and travel restrictions, although it continues to fight surges in several cities, including the port of Tianjin, about an hour from Beijing.

Read more:
COVID tests and police escorts: What it’s like in Beijing Olympics’ ‘closed loop’

The Olympics organizing committee announced Monday that very few people will be permitted as spectators. The criteria is even more strict than what was imposed during last year's Summer Olympics in Tokyo.

In its statement, the organizing committee said its measures were intended to “create a pleasant environment for the holding of the Games.”

“Given the difficult and complicated work of controlling the epidemic, and to protect the health and safety of those involved with the Games, the original plan of offering tickets to the general public has been altered toward spectators from selected groups,” the statement said.

As of Monday, the city has yet to detect any other cases of the Omicron variant.

The Olympics, to be held in the Chinese capital and neighbouring Hebei province, will take place in a “closed loop” that will keep athletes and other Games personnel separated from the general Chinese public. Most participants will arrive on special charter planes.

Organizers have said they expect COVID-19 cases in the bubble, but added last week that they don’t plan any changes to their protocols unless there are many cases inside the loop. They declined to say whether or how many COVID-19 cases had been found among personnel who have arrived thus far ahead of the Games, which start on Feb. 4.

— With files from The Associated Press and Reuters
'Black Swan' author Nassim Taleb compared bitcoin to a disease, called it a speculative bubble, and warned it was worthless. 

Here are his 8 best tweets about the crypto.

tmohamed@businessinsider.com (Theron Mohamed) 
© Mohd Zakir/Hindustan Times via Getty Images Nassim Taleb. Mohd Zakir/Hindustan Times via Getty Images

Nassim Taleb has compared bitcoin to a disease and called it worthless in recent months.

"The Black Swan" author said the cryptocurrency is in a fragile, speculative bubble.

Bitcoin isn't a currency, store of value, inflation hedge, or haven for investors, Taleb said.


Nassim Nicholas Taleb has fired off a bunch of incendiary tweets about bitcoin over the past six months. The author of "The Black Swan" and "Antifragile" has compared the most-valuable cryptocurrency to an infectious disease, dismissed it as worthless, and argued it doesn't serve as a hedge against anything.

Last summer, Taleb asserted in an analysis dubbed the "Bitcoin Black Paper" that bitcoin isn't a currency, store of value, inflation hedge, or a haven from government tyranny or catastrophe. He has used Twitter to amplify his view that bitcoin is a fragile bubble built on speculation instead of genuine value.
Here are Taleb's eight best tweets about bitcoin, lightly edited for length and clarity:

1. "Bitcoin is a contagious disease. It will spread and its price will rally until saturation, when every sucker stupid enough to buy the story is invested. Bitcoin is not competing against 'fiat' currency. It is competing against the thousands of other sucker products that are born every year." (January 17, 2022)

2. "Almost nothing in financial history has been more fragile than bitcoin." (July 3, 2021)

3. "Bitcoin has been a magnet for imbeciles." — blasting critics who accused him of being too rigid in his views about bitcoin, even though he shifted from being excited about its potential to deciding it was worthless in 2020. (July 30, 2021)

4. "It may interest some for speculative purposes, but anyone who claims that bitcoin is a hedge against anything, financial or otherwise, is a certified fraud." (September 20, 2021)

5. "Bitcoin is no hedge for adversity, inflation, or deflation. Bitcoin is no currency. Bitcoin is nothing." (December 4, 2021)

6. "BTC is an awkward, clunky, and already obsolete product of low interest rates. It should collapse with inflation." (December 28, 2021)

7. "If you still think that bitcoin is a hedge against world events, or represents 'diversification,' you must stay out of finance. Take up some other hobby such as stamp collecting, bird watching, or something less harmful to yourself and others." (November 26, 2021)

8. "I am not 'bearish' on bitcoin. It is a tulip bubble (without the aesthetics and disguised as a 'currency'), hence it is as irrational to buy it as it is to SHORT it, perhaps even more. Gabish?" (October 21, 2021)