CONTENTS
Thursday 25 March 1993
Long Term Care Statute Law Amendment Act, 1993, Bill 101
STANDING COMMITTEE ON SOCIAL DEVELOPMENT
*Chair / Président: Beer, Charles (York North/-Nord L)
Présidente suppléante: Vice-Chair / Vice-Président: Daigeler, Hans (Nepean L)
Drainville, Dennis (Victoria-Haliburton ND)
*Fawcett, Joan M. (Northumberland L)
Martin, Tony (Sault Ste Marie ND)
Mathyssen, Irene (Middlesex ND)
*O'Neill, Yvonne (Ottawa-Rideau L)
Owens, Stephen (Scarborough Centre ND)
White, Drummond (Durham Centre ND)
Wilson, Gary (Kingston and The Islands/Kingston et Les Îles ND)
*Wilson, Jim (Simcoe West/-Ouest PC)
Witmer, Elizabeth (Waterloo North/-Nord PC)
*In attendance / présents
Substitutions present / Membres remplaçants présents:
Akande, Zanana L. (St Andrew-St Patrick ND) for Mr Martin and Mr Owens
Cooper, Mike (Kitchener-Wilmot ND) for Mr Owens
Hope, Randy R. (Chatham-Kent ND) for Mr Martin
Jackson, Cameron (Burlington South/-Sud PC) for Mrs Witmer
Jamison, Norm (Norfolk ND) for Mr Drainville
MacKinnon, Ellen (Lambton ND) for Mr Gary Wilson
O'Connor, Larry (Durham-York ND) for Mr Gary Wilson
Sullivan, Barbara (Halton Centre L) for Mr Daigeler
Wessenger, Paul (Simcoe Centre ND) for Mrs Mathyssen
Wiseman, Jim (Durham West/-Ouest ND) for Mr White
Also taking part / Autres participants et participantes:
Czukar, Gail, legal counsel, Ministry of Health
Wessenger, Paul, parliamentary assistant to the Minister of Health
Clerk / Greffier: Arnott, Douglas
Clerk pro tem / Greffière par intérim: Freedman, Lisa
Staff / Personnel:
Gottheil, Joanne, legislative counsel
Spakowski, Mark, legislative counsel
The committee met at 0934 in room 151.
LONG TERM CARE STATUTE LAW AMENDMENT ACT, 1993 / LOI DE 1993 MODIFIANT DES LOIS EN CE QUI CONCERNE LES SOINS DE LONGUE DURÉE
Consideration of Bill 101, An Act to amend certain Acts concerning Long Term Care / Loi modifiant certaines lois en ce qui concerne les soins de longue durée.
The Chair (Mr Charles Beer): Good morning, ladies and gentlemen. We convene the standing committee on social development. We're considering Bill 101, An Act to amend certain Acts concerning Long Term Care. We had concluded to the end of section 13 yesterday. We now go to section 14 and begin with government amendments; in fact we have two government amendments. Parliamentary assistant, if you would begin.
Mr Paul Wessenger (Simcoe Centre): I move that the definition of "record" in subsection 21(1) of the Homes for the Aged and Rest Homes Act, as set out in section 14 of the bill, be amended by adding, after "form" in the last line, "but does not include that part of a record that deals with quality management activities or quality improvement activities."
This is to exempt from inspection those records dealing with quality management activities or quality improvement activities. The ministry inspectors do not currently review records with respect to these activities.
Mr Jim Wilson (Simcoe West): Mr Chairman, as was the case during our review of the Charitable Institutions Act, I would like an assurance from the parliamentary assistant that the wording of this amendment, which speaks to quality management activities or quality improvement activities, does indeed include peer review activities.
Mr Wessenger: I would confirm that legal counsel have previously confirmed that in their opinion peer review is included within the quality management definition.
Mr Jim Wilson: Thank you.
The Chair: I would then put the question. All those in favour of the government motion? Opposed? Carried.
Mr Wessenger, you have the next one.
Mr Wessenger: I move that clause 21(2)(b) of the Homes for the Aged and Rest Homes Act, as set out in section 14 of the bill, be struck out and the following substituted:
"(b) may, if he or she has reasonable grounds to believe that records or other things pertaining to a home are kept in a place that is not in the home, enter the place at all reasonable times in order to inspect such records and other things."
This adds the requirement that an inspector should have reasonable grounds and conforms with what was done in the Charitable Institutions Act.
The Chair: Discussion? I'll put the motion then. Shall Mr Wessenger's motion carry? All in favour? Carried.
We then go to the Liberal amendment.
Mrs Barbara Sullivan (Halton Centre): I won't be placing this amendment as the government has accepted the provision of warrant in other places in the bill.
The Chair: The amendment that follows is also yours, Ms Sullivan.
Mrs Sullivan: I won't be putting this amendment either, for the same reason.
The Chair: Not moved. Mr Wilson, the next two are yours.
Mr Jim Wilson: I too won't be placing this amendment because I think the government's amendment puts further safeguards in place to ensure that inspectors do have a warrant and have a reason for inspection.
The Chair: Both of those motions then are not moved. We then come back to a Liberal amendment.
Mrs Sullivan: I move that section 21 of the Homes for the Aged and Rest Homes Act, as set out in section 14 of the bill, be amended by adding the following subsections:
"Exception, solicitor-client privilege
"(5.1) Subsection (5) does not override any solicitor-client privilege to which a record is subject.
"Exception, law enforcement
"(5.2) An inspector is not entitled to have access to a record or part of a record whose disclosure could reasonably be expected to produce one of the results described in subsection 14(1) of the Freedom of Information and Protection of Privacy Act (law enforcement).
"Exception, personnel records, quality review, etc
"(5.3) An inspector is not entitled to have access to a personnel record or to a record or part of a record dealing with,
"(a) quality review activities;
"(b) peer review or performance review activities; or
"(c) quality improvement activities."
While we have had the assurance of the parliamentary assistant that peer review activities are included in exempted records, I would rather see something that is more formal and included in the legislation and I would also prefer to see the solicitor-client and law enforcement provisions specifically included in the legislation. They are understood, we're told, but there is too much "understood" about this entire bill and the entire process here.
The Chair: I'll then put the Liberal motion. All those in favour? Opposed? Defeated.
We then move to a government motion.
Mr Wessenger: I move that the French version of section 14 of the bill be amended by striking out "À la demande de la municipalité" in the first line and substituting "À la demande d'une municipalité."
This is a correction to the French.
The Chair: Government motion, all in favour? Carried.
We have a Conservative motion.
Mr Jim Wilson: I move that section 21 of the Homes for the Aged and Rest Homes Act, as set out in section 14 of the bill, be amended by adding the following subsection:
"Limitation on inspectors' powers
"(5.1) Subsection (5) does not give an inspector the authority to conduct an examination or test on an individual."
Again, this is to ensure that the term "examination" as used in the original drafting of Bill 101 --
The Chair: Excuse me, Mr Wilson. I apologize.
Mr Jim Wilson: Wrong one?
The Chair: We just have a momentary confusion here. Did you have --
Mr Jim Wilson: I withdrew the previous one.
The Chair: Subsection 21(5.1)?
Mr Jim Wilson: Yes.
The Chair: That's me, the Chair's.
Mr Jim Wilson: No, I --
The Chair: You withdrew that.
Mr Jim Wilson: I withdrew 21(2.1).
The Chair: You withdrew both --
Mr Jim Wilson: Subsections 21(2) and (3).
The Chair: And 21(5.1)?
Mr Jim Wilson: No.
The Chair: Okay, then I'm in error. I'm sorry. I thought you had --
Mr Jim Wilson: I just withdrew the one, Mr Chair.
The Chair: Fine. The Chair apologizes. We are dealing with 21(5.1). Would you mind presenting that again, please.
Mr Jim Wilson: I move that section 21 of the Homes for the Aged and Rest Homes Act, as set out in section 14 of the bill, be amended by adding the following subsection:
"Limitation on inspectors' powers
"(5.1) Subsection (5) does not give an inspector the authority to conduct an examination or test on an individual."
Again, it's to clarify the terminology of "examination" used in the bill.
The Chair: Thank you. All those in favour of Mr Wilson's motion? All those opposed? Defeated.
Mr Wilson, if you would then go on to your next one, 21(12).
Mr Jim Wilson: I move that subsection 21(12) of the Homes for the Aged and Rest Homes Act, as set out in section 14 of the bill, be amended by inserting after "at the inspector's request" in the fourth and fifth lines, "and at a time that is mutually agreed upon."
Again, this is an attempt by my caucus to ensure that, first of all, in no way the requirements by health professionals to assist inspectors is in any way limited. On the other hand, we feel this would add some goodwill to this section of the bill to ensure that health care professionals' schedules are respected. I think it's reasonable that the inspectors, through this legislation, be asked to meet with health care professionals at a mutually agreed-upon time.
The Chair: Thank you. I'll put the motion. All those in favour of Mr Wilson's motion? All those opposed? Defeated.
Mr Wilson, the next one is yours, 21(12.1).
Mr Jim Wilson: I move that section 21 of the Homes for the Aged and Rest Homes Act, as set out in section 14 of the bill, be amended by adding the following subsection after subsection (12):
"Reimbursement of expenses
"(12.1) The minister shall reimburse the municipality maintaining and operating a home, the municipalities maintaining and operating a joint home and the board of management of a home for all extraordinary expenses incurred in the preparation, production and interpretation of records for an inspector."
The Chair: Thank you, Mr Wilson. This motion would be out of order under section 56.
A government motion next, 21.0.1.
Mr Wessenger: No, 21(15).
The Chair: Subsection 21(15). Sorry, right.
Mr Wessenger: I move that section 21 of the Homes for the Aged and Rest Homes Act, as set out in section 14 of the bill, be amended by adding the following subsection:
"Inspection report
"(15) Upon completing an inspection under this section, an inspector shall prepare an inspection report and shall give a copy of the report to each municipality maintaining and operating a home or to the board of management of the home, as the case may be."
Mr Jim Wilson: Did we not have a government 21(8) which dealt with the French version?
The Chair: Yes, we did and it was passed.
Mr Jim Wilson: How did I vote?
The Chair: Quickly.
Mr Jim Wilson: I was looking forward to Mr Wessenger's pronunciation of the French language.
The Chair: We all enjoyed it. Il était très bien.
Mr Jim Wilson: Je m'excuse, Monsieur.
The Chair: Pas de problème. Which takes us back to 21(15).
Mr Jim Wilson: Oui.
The Chair: Do you wish to comment?
Mr Jim Wilson: Non.
The Chair: I'll move the motion, then. All those in favour of the government motion? Opposed? Carried.
Now there's also a Conservative motion 21(15).
Mr Jim Wilson: I think it'd be appropriate to not introduce that motion.
The Chair: Okay, that is not moved. Government motion -- I think now we're at 21.0.1.
Mr Wessenger: I move that section 14 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act, after section 21:
"Warrant
"21.0.1(1) A justice of the peace may issue a warrant authorizing an inspector named in the warrant to enter premises specified in the warrant and to exercise any of the powers mentioned in subsection 21(5), if the justice of the peace is satisfied on information under oath that,
"(a) the inspector has been prevented from exercising a right of entry to the premises under subsection 21(2) or has been prevented from exercising a power under subsection 21(5); or
"(b) there are reasonable grounds to believe that the inspector will be prevented from exercising a right of entry to the premises under subsection 21(2) or will be prevented from exercising a power under subsection 21(5).
"Expiry of warrant
"(2) A warrant issued under this section shall name a date on which it expires, which date shall not be later than thirty days after the warrant is issued.
"Extension of time
"(3) A justice of the peace may extend the date on which a warrant issued under this section expires for an additional period of no more than thirty days, upon application without notice by the inspector named in the warrant.
"Use of force
"(4) An inspector named in a warrant issued under this section may use whatever force is necessary to execute the warrant and may call upon a police office for assistance in executing the warrant.
"Time of execution
"(5) A warrant issued under this section may be executed only between 8 am and 8 pm, unless the warrant specifies otherwise.
"Other matters
"(6) Subsections 21(4) and 21(6) to (15) apply with necessary modifications to an inspector executing a warrant issued under this section."
The Chair: Comments? Shall the government motion carry? All in favour? Opposed? Carried.
Ms Sullivan, we then have a Liberal motion. I believe it's the same --
Mrs Sullivan: I think we have some government motions before mine. Is that correct?
The Chair: Sorry, just one second.
Mrs Sullivan: I can tell you now that when we do reach my motion on the warrants, I will not be putting it forward, if that's of assistance to you.
Interjection.
The Chair: We have some confusion here.
Mr Wessenger: It's 21.0.2, Charles.
The Chair: Yes, sorry. We showed the one that is 21.1 as 21.0.1 on the warrant.
Mr Wessenger: That was ours.
The Chair: Yes, but the Liberal motion that reads, "Section 14 of the bill (section 21.1..." should read "21.0.1," and we should deal with it now, and I believe that's the one you said you would withdraw.
Mrs Sullivan: I'm not putting that motion forward.
The Chair: It's not moved and we then go to the government motion, which is 21.0.2.
Mr Wessenger: I move that section 14 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act, after section 21.0.1:
"Personal information
"21.0.2.(1) For the purpose of complying with sections 21 and 21.0.1, a head and an institution are authorized to disclose personal information to an inspector.
"Definitions
"(2) In this section, `head,' `institution' and `personal information' have the same meaning as in the Municipal Freedom of Information and Protection of Privacy Act."
This amendment authorizes the municipal home to disclose personal information to an inspector and this amendment ensures that the inspection provisions are consistent among all the homes under the Municipal Freedom of Information and Protection of Privacy Act. Municipal homes may not disclose personal information unless disclosure is expressly authorized in other statutes. In other words, this is to make the provisions the same for municipal homes as they would be for charitable institutions and nursing homes. If we didn't have this, there would be a differing standard.
Mrs Sullivan: I'd like some further discussion of this motion, because there is not a comparable motion under the Charitable Institutions Act, and I understand why. However, the government did refuse to accept my motion which referred to the provincial freedom of information act, which may well apply to the nursing homes and the charitable institutions with respect to the law enforcement provisions. I think we need additional explanation of this particular section, which is not included in either of the other two bills.
Mr Wessenger: I'll ask legal counsel if she can add anything to what I've indicated.
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Ms Gail Czukar: Gail Czukar, legal counsel with the Ministry of Health. The provincial Freedom of Information and Protection of Privacy Act would not apply to charitable institutions or nursing homes, because they're private facilities. The municipal freedom of information and protection of privacy act does apply to municipal homes, because they're operated by municipalities, and under that statute the municipality would not be permitted to disclose any personal information within the meaning of the statute to the inspectors. This section is intended to override that so that the inspectors will have access to the same kinds of information they do in charitable homes and nursing homes.
Mrs Sullivan: At what point then under the provincial law, because the inspectors are provincial employees, does the provincial freedom of information law kick in, and what protection is there for personnel of nursing homes or of charitable homes which are not protected by freedom of information laws that their records will not be disclosed? I know that I'm moving away from this particular section, but we have not discussed the protection of personnel records with respect to employees of homes in any circumstance.
Ms Czukar: Because they work for the ministry, any information that the inspectors collect or have access to or use would be covered by freedom of information and protection of privacy legislation, so they would be bound by that act to keep the information confidential and private and wouldn't be able to disclose it. The information will be able to go to the inspectors, but it will not be able to go further and that's the protection for the information that's gathered from the homes.
The Chair: I'll put the motion then. Shall the government motion carry? All in favour? Opposed? Carried.
Mr Wessenger, section 21.2.
Mr Wessenger: I move that section 14 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act, after section 21.1:
"Protection from reprisals
"21.2(1) No person shall do anything, or refrain from doing anything, in retaliation for another person making a disclosure to an inspector, so long as the disclosure was made in good faith.
"No interference
"(2) No person shall seek, by any means, to compel another person to refrain from making a disclosure to an inspector.
"Offence
"(3) Any person who contravenes subsection (1) or (2) is guilty of an offence and on conviction is liable to a fine of not more than $5,000 for a first offence and not more than $10,000 for each subsequent offence."
The Chair: Any comments? Shall the government motion carry? All in favour? Opposed? Carried.
We then move to the Liberal amendment, 28(1.1).
Mrs Sullivan: I move that section 28 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by adding the following subsection:
"Payments must be sufficient" --
Mr Jim Wilson: Mr Chairman, there is a PC motion prior to that, I think.
The Chair: Wait. We're into 17.
Mr Wessenger: So shouldn't we pass 14?
The Chair: Yes, sorry. Just before we do that then, we have dealt with all of section 14 now. Nothing has been deferred. Shall section 14 of the bill pass, as amended? Carried.
Let's then deal with section 15 of the bill. Carry? Carried.
Shall section 16 of the bill --
Mr Jim Wilson: Mr Chairman, I just want to make a comment. There were a couple of PC amendments to sections 16.1, 16.2.
Mr Wessenger: It might be a new section.
Mr Jim Wilson: It's a section not dealt with in the bill, so I suspect you may rule it out of order, but I just want to make a comment, if I may.
Mr Wessenger: We can deal with that, because 16.1 is a new section.
The Chair: I'm sorry, I don't have --
Mr Jim Wilson: It's just for the committee members' information. It was a couple of motions dealing with capital funding. My comments with regard to this topic when we dealt with the Charitable Institutions Act stand and I will not be introducing these two amendments.
The Chair: Just for the record, that's section 16.1, subsection 25(2); and section 16.2, section 27 of the Homes for the Aged and Rest Homes Act.
Mrs Sullivan: Just for background, we would not have supported them had they been introduced.
Mr Jim Wilson: If I may comment on that, it is a contentious issue, except that I remind everyone that the attempt there was to show both the Liberal Party's and the government's illogical approach to these matters. The whole intent of this bill is to have a level playing field now between the three home sectors -- the nursing homes, charitable homes and municipal homes -- yet we're going to continue to have a bias in favour of charitable and municipal homes and against nursing homes when it comes to capital funding. We think, as a question of fairness, that it is self-evident this is unfair. I'll leave it at that, Mr Chairman.
The Chair: We will then put section 16. Shall section 16 carry? All in favour? Opposed? Carried.
Now we move to section 17.
Mrs Sullivan: I move that section 28 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by adding the following subsection:
"Payments must be sufficient
"(1.1) The payments under subsection (1) must be in such amounts that the payments, together with any amounts for which residents are responsible, are sufficient to defray all the costs described in subsection (1)."
This amendment is put forward to ensure that the payments from the ministry which are to be applied --
The Chair: Excuse me, Ms Sullivan, this is out of order.
Mrs Sullivan: That's a shame, because it's an important amendment.
The Chair: You can move to your next amendment, which is 28(2).
Mrs Sullivan: I move that subsection 28(2) of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be struck out and the following substituted:
"Service agreement
"(2) No payment shall be made under subsection (1) unless,
"(a) the municipality, each of the municipalities or the board of management receiving the payment is a party to a service agreement with the crown in right of Ontario that relates to the home or joint home; and
"(b) the service agreement complies with this act and the regulations."
As was previously the case, this is an attempt to fix a drafting error --
The Chair: Ms Sullivan, this is also out of order.
Mrs Sullivan: I don't believe so, Mr Chairman. We passed it in the previous bill.
The Chair: Then I must be out of order.
Mrs Sullivan: I think the government's willing to accept it. It's to correct a drafting mistake.
Mr Wessenger: I think we need to correct some -- I must ask legal counsel to suggest some language changes in it.
Ms Czukar: Just as a matter of drafting, because this is the Homes for the Aged and Rest Homes Act and we have different entities operating homes, it should say, "The municipality, each of the municipalities or the board of management, as the case may be" and going on in the same paragraph, (2)(a) "receiving the payment is a party to a service agreement with the crown in right of Ontario that relates to the home or joint home, as the case may be."
I think legislative counsel would confirm that we need those words.
Mrs Sullivan: I would be pleased to add those words, depending on what the Chair would like.
The Chair: And I would be pleased to put it back in order.
Mrs Sullivan: Okay. Shall I withdraw the previous motion and re-read? Is that what you'd like for the record?
The Chair: Perhaps that would be best. Do you have that friendly amendment to read?
Mrs Sullivan: Yes, I do.
The Chair: Okay, go ahead, please.
Mrs Sullivan: I then withdraw the previous amendment, and I move that subsection 28(2) of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be struck out and the following substituted:
"Service agreement
"(2) No payment shall be made under subsection (1) unless,
"(a) the municipality, each of the municipalities or the board of management, as the case may be, receiving the payment is a party to a service agreement with the crown in right of Ontario that relates to the home or joint home, as the case may be; and
"(b) the service agreement complies with this act and the regulations."
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The Chair: Shall the motion carry? Carried.
We then move to the government motion, subsection 28(3).
Mr Wessenger: I move that subsection 28(3) of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by adding, before "the municipalities" in the third and fourth lines, "any of," and striking out "is or are in breach of" in the sixth and seventh lines and substituting "has breached."
This change takes into consideration the fact that a municipality may not be in breach of the service agreement. I think this is the one indicating the technical aspect of ensuring that there are no difficulties with respect to the legal aspects of prosecuting or determining that a breach has occurred.
Mrs Sullivan: Once again, we want it on the record that we will not be supporting this amendment because we feel there is too much uncertainty in the introduction of the words "has breached," which may refer to even a technical breach which occurred at some point in the past and about which there is no record.
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
We then turn to the Conservative motion, sections 28.1 and 28.2, Mr Wilson.
Mr Jim Wilson: I move that section 17 of the bill be amended by adding the following sections to the Homes for the Aged and Rest Homes Act after section 28:
"Notice before reduction or withholding
"28.1(1) Before reducing or withholding a payment under subsection 28(3), the minister shall serve on the municipality, the municipalities or the board of management, as the case may be, a notice setting out,
"(a) the minister's proposal to reduce or withhold a payment under subsection 28(3);
"(b) the proposed amount of the reduction or the amount proposed to be withheld, as the case may be;
"(c) the breach or breaches of the service agreement on which the minister relies for reducing or withholding payment;
"(d) the requirements set out in subsection (4) for entitlement to a hearing by the appeal board;
"(e) the minister's power under subsection (5) to carry out the proposal; and
"(f) the requirements set out in subsection (6) for obtaining an extension of the time for giving a notice requiring a hearing.
"Service of notice
"(2) A notice under subsection (1) may be served personally or by registered mail addressed to the municipality or the board of management, as the case may be, at its most recent address known to the minister.
"Deemed time of service
"(3) If the notice is served by registered mail, the service shall be deemed to have been made on the seventh day after the day of mailing.
"Entitlement to a hearing
"(4) A municipality or a board of management that is served with a notice under subsection (1) is entitled to a hearing by the appeal board if it mails or delivers to the minister and to the appeal board, within thirty days after being served, a notice requiring a hearing by the appeal board.
"Minister may carry out proposal
"(5) If no hearing is required in accordance with subsection (4) by the municipality maintaining and operating the home, by any of the municipalities maintaining and operating the joint home or by the board of management of the home, as the case may be, the minister may carry out the proposal described in the notice served under subsection (1).
"Extension of time
"(6) A municipality or board of management may apply to the appeal board for an extension of the time for giving a notice requiring a hearing, either before or after the time expires, and the appeal board,
"(a) may extend the time for giving the notice if it is satisfied that there are reasonable grounds for applying for the extension; and
"(b) may give such directions as it considers proper in light of the extension.
"Hearing
"(7) If a municipality or a board of management requires a hearing in accordance with this section, the appeal board shall appoint a time and place for and shall hold a hearing.
"Same
"(8) The time appointed by the appeal board for a hearing must be within ninety days after the day the appeal board received the notice requiring the hearing.
"Parties
"(9) The parties to a proceeding before the appeal board under this section are:
"(a) the municipality, municipalities or board of management requiring the hearing;
"(b) the minister; and
"(c) such other persons as the appeal board specifies.
"Proceedings
"(10) Subsections 19.2(3), (5) and (6) apply to the proceedings and decisions of the appeal board under this section.
"Powers of appeal board
"(11) After a hearing by the appeal board under this section, the appeal board,
"(a) may, if the minister has not yet carried out the proposal described in the notice served under subsection (1),
"(i) allow the minister to carry out the proposal;
"(ii) direct the minister to refrain from carrying out the proposal; or
"(iii) find that an amount lower than that specified in the proposal is reasonable in the circumstances and allow the minister to make a reduction or withholding under subsection 28(3) in such lower amount;
"(b) may, if the minister has carried out the proposal under subsection (5),
"(i) find that the proposal was reasonable in the circumstances;
"(ii) direct the minister to pay to the municipality, the municipalities or the board of management, as the case may be, the amount of the reduction or the amount withheld, as the case may be; or
"(iii) find that an amount lower than that specified in the proposal was reasonable in the circumstances and direct the minister to pay to the municipality, the municipalities or the board of management, as the case may be, the difference between the amount specified in the proposal and the amount that the appeal board found was reasonable;
"(c) may substitute its opinion for that of the minister; and
"(d) may make such other order as it considers just.
"Powers of court on appeal
"28.2 On an appeal to the Divisional Court from a decision of the appeal board under section 28.1, the Divisional Court,
"(a) may affirm or rescind the decision of the appeal board;
"(b) may substitute its opinion for that of the minister or the appeal board; and
"(c) may exercise all the powers of the appeal board."
The Chair: Any discussion?
Mr Jim Wilson: Again, Mr Chairman, as was the case during our review of the Charitable Institutions Act, this is a good attempt, I think, by me and my colleagues to ensure that there is some fairness introduced in this act, that if the minister is going to withhold operating money to homes, a notice be given to that home, and that the home have the right of appeal, which I think is fundamental in our democracy. I would hope that the government, since it didn't during the review of the Charitable Institutions Act seek to act on this motion in a significant way, will reconsider its previous position.
Mrs Sullivan: Mr Chairman, we strongly support the motion of the third party in this particular area.
The Chair: I'll put the motion. All those in favour of Mr Wilson's motion? All those opposed? Defeated.
We then move to the Liberal motion, 29.1.
Mrs Sullivan: I will not be putting that forward, Mr Chairman.
The Chair: Thank you. Not moved. We go to your next amendment, Ms Sullivan.
Mrs Sullivan: I move that section 17 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act after section 30:
"Term of service agreement
"30.0.1(1) Each service agreement shall be for a one-year term.
"If no new service agreement
"(2) If a new service agreement is not entered into before the expiry of the current service agreement the following provisions apply:
"1. Despite subsection (1), the current service agreement continues in force until a new service agreement is entered into or until the current service agreement is terminated.
"2. Any new service agreement that is entered into shall be deemed to have been in force since the current service agreement would have, but for paragraph 1, ceased to be in force.
"3. Interest shall be paid on all unpaid amounts that, under the new service agreement, should have been paid during the time the new service agreement is deemed to have been in force."
This motion is to ensure that the municipal homes are paid for the period of time during which a service agreement is being negotiated at the new rate, when the new rate is agreed to, and that interest is paid on moneys which have to be borrowed to ensure the operating costs are met during that period of time.
Mr Jim Wilson: Mr Chairman, before you rule the motion out of order, I just want to express my support for it.
The Chair: And I therefore do rule it out of order. No, I shouldn't say "therefore." The Chair was a little slow, Ms Sullivan. That should have been ruled out of order.
Mr Randy R. Hope (Chatham-Kent): Why are you ruling it out of order?
Mr Wessenger: The payment.
The Chair: The payment at the last part, number 3.
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Mr Hope: Just for consistency for the record, because you've always indicated why you ruled something out of order.
The Chair: It's under section 56 of the standing orders, but specifically the third clause.
Now, Ms Sullivan, let's see what we have in this next one. This is section 30.0.2.
Mrs Sullivan: This one is in order, Mr Chairman, I will assure you before I read it.
The Chair: Just one moment. The next one I have is section 30.0.2. Is that what everyone has?
Mrs Sullivan: That's the one I have.
The Chair: Just one second. Do you have that now? Okay? Fine, go ahead.
Mrs Sullivan: I move that section 17 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act, after section 30.0.1:
"Arbitration where failure to negotiate service agreements
"30.0.2(1) The municipality maintaining and operating a home, the municipalities maintaining and operating a joint home or the board of management of a home may require an arbitration by the appeal board, by giving notice in accordance with subsection (2), if there has been a failure to successfully negotiate,
"(a) an initial service agreement;
"(b) a subsequent service agreement; or
"(c) amendments to a service agreement in response to changing circumstances.
"Notice requiring arbitration
"(2) To require an arbitration, a notice requiring an arbitration must be mailed or delivered to the minister and to the appeal board.
"Arbitration
"(3) If the appeal board receives a notice under subsection (2), the appeal board shall arbitrate the matters in dispute.
"Parties
"(4) The parties to an arbitration are the person requiring the arbitration and the minister.
"Applicable provisions
"(5) Subsections 19.2(3) and (5) apply, with necessary modifications, with respect to an arbitration.
"Powers of appeal board
"(6) In arbitrating the matters in dispute the appeal board may order the minister,
"(a) to sign on behalf of the crown in right of Ontario, a service agreement with such terms as the appeal board specifies; or
"(b) to sign on behalf of the crown in right of Ontario, an agreement that amends an existing service agreement in such manner as the appeal board specifies."
This motion is to require a different action from the appeal board, which is one of dispute resolution and arbitration, when there is difficulty that cannot be solved through direct negotiation between the ministry and the home which is negotiating the service agreement or when the patient classification and case mix index has changed so substantially that negotiations are necessary.
Mr Jim Wilson: I just want to express my support for this amendment. It speaks to a very important element that's currently missing in Bill 101, and that is the right of arbitration. You'll note that the next PC amendment also speaks to that. I would like to say, once again, that the government has really refused opposition attempts to put in a significant appeal mechanism when it comes to negotiating the terms of a service agreement or giving some fairness and some balance and some rights to facilities. I think it's a fairly heavy-handed manner in which the government goes about putting in place service agreements.
The government tells us it wants to be consultative, but, again, operators of facilities and municipalities are asking us, if the government is so sure that there won't be a lot of problems in the future, why it is afraid of allowing significant appeal mechanisms in this part of the bill and allowing arbitration if needed? So I would like the parliamentary assistant to expand on what he means by the appeal mechanisms that the government will seek to bring forward during phase 2.
Mr Wessenger: The details of the type of appeal mechanism have not yet been considered. It will have to be done through consultation with stakeholders. So there are no specific proposals at this stage of how it would be dealt with.
Mr Jim Wilson: Perhaps we could have a further explanation from the parliamentary assistant, if for no other reason than for the record, to try and convince us or tell us once again why the government does not want appeal mechanisms such as we've proposed and arbitrations such as opposition parties have proposed.
Mr Wessenger: I think it's fair to say that the government would not be in favour of an arbitration system with respect to these items. I think the preference for dealing with the matter would be some type of appeal process. As I said, this is without prejudice to the matter being considered, but I am expressing a personal opinion here. I would expect some form of administrative board procedure would be the one that would be most looked at for whatever consideration and would be examined with stakeholders to see what jurisdiction and what items would be subject to appeal, and so forth, of the procedure with respect -- we're only surmising here, because it hasn't really been worked on. No proposal has be worked on. Until the end of the consultation with the groups, you're not going to have something more specific.
Mr Jim Wilson: The important question is, what happens in the interim before you bring forward phase 2 -- it's not clear to me or I think really to anyone else when that's going to happen -- of your long-term care reform legislation? What will happen in the meantime? We were told in the government's selling of this legislation that it was an attempt to bring fairness into the system, and it was certainly along that vein. One would think you would not want nursing homes, municipalities, charitable homes, for example, to have to resort to court action in the interim, given that there are no appeal mechanisms allowed, or arbitration. I'd like the parliamentary assistant's comment on that.
It was brought to my attention many times yesterday by nursing home operators that in the interim all they can see is that if they get into a conflict with the government surrounding service agreements, they'll have to resort to the courts. That's an expensive and I think very onerous position to put operators in.
Mr Wessenger: I'm advised that we've had enhancement contracts with nursing home operators for years. There's never been, I understand, a case of a court matter. The matters have usually been dealt with by negotiation and all matters have been resolved, I understand, without the necessity of going to the court. But the court is the ultimate if the situation does arise. Certainly, from past experience, I am advised there has not been a problem with these contracts.
Mrs Sullivan: I think it's very clear that the past experience will in fact not be a reference point for future experience. The entire funding mechanism is changing. The requirements that are placed on the homes are changing. The contractual relationship is changing.
What we have heard through the hearing process is that homes themselves wanted a less formal, more flexible approach so that disputes with respect to agreements could be placed on the table and that residents also wanted a less formal approach to dealing with disputes. What we see under this act is an inflexible, formal, confrontational, litigious system.
Any changes that the government has made to date to the bill will only add to that. They will increase the time lines, they will increase the cost and they will increase the adversarial nature of any resolution of disputes. We feel that is very inappropriate and we are really concerned when the parliamentary assistant tells us that any changes will have to wait for a later phase, for phase 2, when we don't even know when phase 2 will finally come forward. We haven't really even seen phase 1 at this point.
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Mr Wessenger: The only comment I would make on that is the fact that how matters are administrated is not a matter of how legislation reads, and certainly I would concur with the intention of trying to have dispute resolution informally set up to deal with matters. I'm sure the ministry is of the same view.
The Chair: Thank you. Shall the motion put by Ms Sullivan carry? All in favour? Opposed? The motion is defeated.
We next move to the Conservative motion, 30.0.1.
Mr Jim Wilson: I move that clause 30 -- I'm sorry. Did that get renumbered?
The Chair: No. Your next one should be 30.0.1. You may have to just flip ahead in your package. We've got them a little bit out of order.
Mr Wessenger: Could I just ask for a point of clarification here? I have some motions before me, and I wonder if they've been withdrawn: 30(1)(c) and 30(1)(a). They're PC motions.
The Chair: No. To help members, we're going to deal -- the Chair apologizes. Mr Wilson, we will go to 30(1)(a), then to 30(1)(c) and then to 30.0.1, which I think is the way you have them.
Mr Jim Wilson: Thank you. I move that clause 30(1)(a) of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be struck out and the following substituted:
"(a) shall provide that it continues in full force and effect until replaced or cancelled in accordance with the regulations;
"(a.1) shall contain a dispute resolution mechanism for resolving disputes related to the service agreement;
"(a.2) shall provide for a right to arbitration if the dispute resolution mechanism fails to resolve a dispute;
"(a.3) shall contain the other provisions required by the regulations to be contained in a service agreement."
Just once again, Mr Chairman, I think it's a mistake by this government not to allow more fairness into this section of the act with regard to service agreements. There should be a dispute resolution mechanism so that homes do not have to resort to the courts and there should be a right to arbitration, and there also should be stipulated, even though we've been told it may not be necessary, that any existing service agreement remains in force until it's replaced by a new one.
The Chair: Shall Mr Wilson's motion carry? All in favour? Opposed? Defeated.
We will then move to your next motion, Mr Wilson, 30(1)(c).
Mr Jim Wilson: As it follows from the previous motion, Mr Chairman, I will not introduce it.
The Chair: Okay, that motion is not moved, and then to your next one, 30.0.1.
Mr Jim Wilson: I move that section 17 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act after section 30:
"Arbitration
"30.0.1(1) This section applies with respect to arbitrations under a service agreement.
"Notice
"(2) An arbitration is commenced by a party to a service agreement giving written notice to the other party of its desire to arbitrate a dispute related to the service agreement.
"Appointment of board of arbitration
"(3) Within fourteen days of the written notice having been given, the parties,
"(a) shall jointly appoint a member of the appeal board to sit as a board of arbitration; or
"(b) shall each appoint a person to sit on the board of arbitration.
"Same
"(4) If the parties each appoint a person to sit on the board of arbitration, the two persons so selected shall within ten days after the second of the persons has been appointed, appoint a member of the appeal board.
"Powers of board of arbitration
"(5) The board of arbitration shall hold a hearing to examine and decide the matters that are in dispute between the parties.
"Service agreements
"(6) Any decision of the board of arbitration shall form part of the service agreement.
"Costs
"(7) The board of arbitration may award costs.
"Appeal to Divisional Court
"(8) A party may appeal a decision of the board of arbitration to the Divisional Court on a question of law or fact or both.
"Powers of court on appeal
"(9) On an appeal to the Divisional Court from a decision of the board of arbitration under this section, the Divisional Court may do any one or more of the following:
"1. Affirm or rescind the decision of the board of arbitration.
"2. Substitute its opinion for that of the board of arbitration.
"3. Exercise any power of the board of arbitration."
Mr Chairman, I think my previous comments with respect to this matter stand.
The Chair: Shall Mr Wilson's motion carry? All in favour? Opposed? The motion is defeated.
We then go to government motion 30.1(1)(a).
Mr Wessenger: I move that clause 30.1(1)(a) of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by striking out "for basic accommodation" in the first line and substituting "for a class of basic accommodation."
Again, this is to allow for the different rates to short-term and long-term basic accommodation.
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Government motion 30.1(1)(e).
Mr Wessenger: I move that clause 30.1(1)(e) of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be struck out and the following substituted:
"(e) for care, services, programs or goods that are not mentioned in clause (a), (b), (c), (d) or (2)(a) and in respect of which the resident has entered into a written agreement with the municipality, the municipalities or the board of management, as the case may be, the amount determined in accordance with the written agreement."
This complies with the change in the Charitable Institutions Act.
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Government motion 30.1(2)(b).
Mr Wessenger: I move that clause 30.1(2)(b) of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by striking out "or on behalf of" in the fifth line.
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Government motion 30.1.1.
Mr Wessenger: I move that section 17 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act after section 30.1:
"Debt" --
This will not be moved.
The Chair: Withdrawn, not moved.
Mrs Sullivan: Mr Chairman, could I have some clarification on just where the government intended to go with this motion, even though it's not put, because it seems to me that we've had a number of public statements with respect to resident charges being based on income and not on assets. This motion as it is drafted would lead us to believe that the government in fact is changing its direction in that matter, and it seems to me that should be an issue of public record.
Mr Wessenger: No, this is not what it's about. This is to ensure that there is a legal obligation on the part of the resident to the home for the aged or the rest home, so that they can sue for the moneys owing on the accommodation.
Mrs Sullivan: Presumably the debt would fall to the estate?
Mr Wessenger: Yes, it would.
Mrs Sullivan: Which would move it then to the asset issue, I suggest to you.
Mr Wessenger: If people do not pay their accommodation liability that they're obliged to pay, then that would accrue, obviously, as a debt.
The Chair: Just to make sure we all understand then --
Mr Wessenger: It's covered by your amendment who is responsible for it, so it's similar.
The Chair: The government motion 30.1.1 is not moved. We now move to the proposed Liberal motion 30.1.1.
Mrs Sullivan: I move that section 17 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act:
"Resident responsible for payment for accommodation
"30.1.1(1) A resident is responsible for the payment of those amounts demanded in accordance with 30.1, by a municipality maintaining and operating a home, by municipalities maintaining and operating a joint home or by a board of management of a home, for accommodation.
"Minister to give statements
"(2) The minister shall provide, annually and on the request of a resident, a statement setting out how much the resident may be charged for accommodation under subsection 30.1(1)."
Mr Wessenger: Could we just hold for a minute to see whether legislative counsel is happy with this wording?
The Chair: Shall I put Ms Sullivan's motion? All in favour? Opposed? Carried.
Mrs Sullivan: I'm surprised.
The Chair: Some tentativeness there. We then move to the Conservative motion 30.2.
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Mr Jim Wilson: I move that section 30.2 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill be amended by adding the following subsection after subsection (1):
"No recovery of charge
"(1.1) No deduction shall be made under subsection (1) unless written notice about the fact that the item paid for has not been provided or made available to the resident is given to the minister within ninety days after the date on which the person for whom the payment was accepted discovers the fact."
Again, this is an attempt to ensure that after someone discovers that a service or item -- because the next motion deals with services -- was not properly provided to a resident, within 90 days the matter be dealt with so that it's not left for an indefinite period of time.
The Chair: Shall Mr Wilson's motion carry? Opposed? It is defeated. Mr Wilson, you have a further amendment to 30.2.
Mr Jim Wilson: I move that section 30.2 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by adding the following subsection after subsection (2):
"No recovery of charge
"(2.1) No deduction shall be made under subsection (2) unless written notice about the fact that the payment exceeds the amount permitted to be charged under section 30.1 is given to the minister within ninety days after the date on which the person from whom the payment was accepted payment discovers the fact."
Again, I think it's a reasonable motion given that it's a 90-day time period after the discovery of the fact.
Mrs Yvonne O'Neill (Ottawa-Rideau): It should pass.
The Chair: Shall Mr Wilson's motion carry? All in favour? Opposed? It is defeated.
Mr Wilson, you have a further amendment to 30.2.
Mr Jim Wilson: The word "futility" does cross my mind from time to time.
I move that section 30.2 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by adding the following subsection after subsection (3):
"No recovery of charge
"(3.1) No deduction shall be made under subsection (3) unless written notice about the fact that the item paid for has been inadequately provided is given to the minister within ninety days after the date on which the person from whom the approved corporation accepted payment discovers the fact."
Again, these motions are important because operators do tell us that, for example, when a person is deceased and the operator is dealing with the family or loved ones in trying to clean up some of the bills that may be outstanding, from time to time families refuse to pay operators of homes. They then hide under the act by indicating that perhaps the service wasn't provided properly, it was inadequate or the item was never received. It's a bit unfair.
All this simply does is introduce fairness, saying that after the discovery of the fact something was wrong or something was inadequately provided, in fairness to operators, families and residents, there be given 90 days to bring that forward and to rectify the situation. I don't see anything wrong with these amendments, and I don't know why the government won't support them.
The Chair: Shall Mr Wilson's motion carry? All in favour? Opposed? It is defeated.
We then move to a Liberal amendment 30.2.1
Mrs Sullivan: I move that section 17 of the bill be amended by adding the following section to the Homes for the Aged and Rest Homes Act after section 30.2:
"Restriction on reducing payments, etc
"30.2.1 The minister may not reduce or withhold payments under section 28 or deduct an amount from a payment under section 30.2 if the reduction, withholding or deduction would put a resident's safety, health or security at risk or would cause any of the services or programs in a resident's plan of care to be interrupted."
Mr Jim Wilson: I just want to express my support for this amendment. We've maintained all the way along that the real people who will be hurt -- with respect to the government withholding funding for a breach of a service agreement, a breach of contract with a home -- will be residents, and I think that amendment attempts to bring in some safeguards in that regard.
The Chair: Shall Ms Sullivan's motion carry? All in favour? Opposed? Defeated.
We then move to a Conservative motion, 30.2.1 and 30.2.2, Mr Wilson.
Mr Jim Wilson: I move that section 17 of the bill be amended by adding the following sections to the Homes for the Aged and Rest Homes Act, after section 30.2:
"Notice before deduction
"30.2.1(1) Before making a deduction under section 30.2, the minister shall serve on the municipality, the municipalities or the board of management, as the case may be, a notice setting out,
"(a) the minister's proposal to make a deduction under section 30.2;
"(b) the proposed amount of the deduction;
"(c) detailed reasons for making the deduction;
"(d) the requirements set out in subsection (4) for entitlement to a hearing by the appeal board; and
"(e) the minister's power under subsection (5) to carry out the proposal; and
"(f) the requirements set out in subsection (6) for obtaining an extension of the time for giving a notice requiring a hearing.
"Service of notice
"(2) A notice under subsection (1) may be served personally or by registered mail addressed to the municipality or the board of management, as the case may be, at its most recent address known to the minister.
"Deemed time of service
"(3) If the notice is served by registered mail, the service shall be deemed to have been made on the seventh day after the day of mailing.
"Entitlement to a hearing
"(4) A municipality or a board of management that is served with a notice under subsection (1) is entitled to a hearing by the appeal board if it mails or delivers to the minister and to the appeal board, within thirty days after being served, a notice requiring a hearing by the appeal board.
"Minister may carry out proposal
"(5) If no hearing is required in accordance with subsection (4) by the municipality maintaining and operating the home, by any of the municipalities maintaining and operating the joint home or by the board of management of the home, as the case may be, the minister may carry out the proposal described in the notice served under subsection (1).
"Extension of time
"(6) A municipality or a board of management may apply to the appeal board for an extension of the time for giving a notice requiring a hearing, either before or after the time expires, and the appeal board,
"(a) may extend the time for giving the notice if it is satisfied that there are reasonable grounds for applying for the extension; and
"(b) may give such directions as it considers proper in light of the extension.
"Hearing
"(7) If a municipality or a board of management requires a hearing in accordance with this section, the appeal board shall appoint a time and place for and shall hold a hearing.
"Same
"(8) The time appointed by the appeal board for a hearing must be within ninety days after the day the appeal board received the notice requiring the hearing.
"Parties
"(9) The parties to a proceeding before the appeal board under this section are,
"(a) the municipality, municipalities or board of management requiring the hearing;
"(b) the minister;
"(c) the person from whom the payment was accepted; and
"(d) such other persons as the appeal board specifies.
"Proceedings
"(10) Subsections 19.2(3), (5) and (6) apply to the proceedings and decisions of the appeal board under this section.
"Powers of appeal board
"(11) After a hearing by the appeal board under this section, the appeal board,
"(a) may, if the minister has not yet carried out the proposal described in the notice served under subsection (1),
"(i) allow the minister to carry out the proposal;
"(ii) direct the minister to refrain from carrying out the proposal; or
"(iii) find that an amount lower than that specified in the proposal is reasonable in the circumstances and allow the minister to deduct such lower amount under section 30.2;
"(b) may, if the minister has carried out the proposal under subsection (5),
"(i) find that the proposal was reasonable in the circumstances;
"(ii) direct the minister to pay the amount deducted to the municipality, the municipalities or the board of management, as the case may be; or
"(iii) find that an amount lower than that specified in the proposal was reasonable in the circumstances and direct the minister to pay to the municipality, the municipalities or the board of management, as the case may be, the difference between the amount specified in the proposal and the amount that the appeal board found was reasonable;
"(c) may substitute its opinion for that of the minister; and
"(d) may make such other order as it considers just.
"Powers of court on appeal
"30.2.2 On an appeal to the Divisional Court from a decision of the appeal board under section 30.2.1, the Divisional Court,
"(a) may affirm or rescind the decision of the appeal board;
"(b) may substitute its opinion for that of the minister or the appeal board; and
"(c) may exercise all the powers of the appeal board."
Again, this is an attempt to introduce some fairness into this legislation, and I might as well say it before they do it: I'm extremely disappointed that the government doesn't support at least the thrust of this legislation at this time. I don't think we can wait for phase 2 for all the appeal mechanisms the government says it might bring forward.
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The Chair: Thank you, Mr Wilson. Shall Mr Wilson's motion carry? All in favour? Opposed? Defeated.
Mr Wilson, you have a subsequent amendment to 30.2.
Mr Jim Wilson: I move that section 30.2 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by adding the following subsection after subsection (3):
"No recovery of charge
"(3.1) No deduction shall be made under subsection (3) unless written notice about the fact that the item paid for has been inadequately provided is given to the minister within ninety days after the date on which the person from whom the approved corporation accepted payment discovers the fact."
Mr Chairman, I won't reiterate my comments stated previously with respect to this matter.
The Chair: Thank you. Shall Mr Wilson's motion carry? All in favour? Opposed? Defeated.
Mr Wilson, a further amendment to 30.3(1)(a)?
Mr Jim Wilson: I move that clause 30.3(1)(a) of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be struck out and the following substituted:
"(a) the rights and obligations of the resident and of the municipality, the municipalities or the board of management."
Again, as was the case during our review of the Charitable Institutions Act, this is an attempt to put into this legislation the fact that not only do residents have significant rights, and that is properly so, but management, in this case the municipality or the municipalities or the board of management, also have rights with respect to this legislation.
Mrs Sullivan: Hear, hear.
The Chair: Shall Mr Wilson's motion carry? All in favour? Opposed? Defeated.
Then government motion 30.3, Mr Wessenger.
Mr Wessenger: I move that section 30.3 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be struck out and the following substituted:
"Notice to residents
"30.3(1) A municipality maintaining and operating a home, the municipalities maintaining and operating a joint home and the board of management of a home shall give to each resident of the home or joint home, as the case may be, to the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident's personal care and to such other person as they may direct, a written notice,
"(a) setting out the rights of the resident under subsection 1.1(2) and stating that the municipality, each of the municipalities or the board of management, as the case may be, is obliged to respect and promote those rights;
"(b) describing the accommodation, care, services, programs and goods that the municipality, each of the municipalities or the board of management, as the case may be, is required to provide or offer under this act and under the service agreement relating to the home or joint home;
"(c) stating that the resident, the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident's personal care or such other person as they may direct may request access to and an explanation of the resident's plan of care, and specifying the person to whom such a request must be made;
"(d) setting out the procedures for making complaints about the maintenance or operation of the home or joint home, the conduct of the staff of the home or joint home or the treatment or care received by the resident in the home or joint home; and
"(e) setting out such other matters as are prescribed by the regulations.
"Obligations re plan of care
"(2) If a request is made in accordance with clause (1)(c), the municipality, the municipalities or the board of management shall ensure that access to and an explanation of the plan of care is provided to the person who made the request."
The Chair: Any comments?
Mrs Sullivan: With respect to this amendment and to others which deal with these service agreements which are being negotiated, I just want to place on the table that my colleagues and I have learned that there have been instructions or information to several area offices indicating that those area offices will be closed. We have been told that service agreements will be put into place by area offices for the nursing home sector, along with people who are now employed as program supervisors under Comsoc.
In this motion we have a requirement that the accommodation, care, services etc that are included in the service agreement must be written down and the information about those services must be provided to the resident. In fact, what we may well be looking at is a significant postponement of long-term care, a situation where the contracts cannot indeed be negotiated, where in fact what we are now dealing with is a large case of fluff. We know that the ministry has recently asked for line-by-line accounting of existing expenses, which bears absolutely no relationship to level-of-care funding, nor to the development of a case mix index that's based on the classification of patients.
With this motion and with all of the other motions which have been on the table with respect to the service agreements, which are fundamental to the delivery of long-term care, it seems to me that we're being led up the garden path.
Mr Jim Wilson: Mr Wessenger, would you like to respond to that first? Mine is more pertaining to the motion.
Mr Wessenger: I'm not in a position to respond to all speculative comments. This provision purely relates to giving notice of rights to residents and their substitute decision-makers, and comments are not really relevant to this legislation.
Mr Jim Wilson: I'm sure Mrs Sullivan would like to take another crack at that, but in the meantime, I'd like to ask, just to ensure conformity to this government amendment, is a standard form being drawn up so that homes for the aged, rest homes, nursing homes and charitable institutions will be sure to provide all that's required in this motion in terms of a written notice -- all that's required in the written notice -- to the resident? Does the operating manual speak to that?
Mr Wessenger: Does the service manual speak to the --
Mr Jim Wilson: This requires written notice to the resident.
Mr Wessenger: Yes.
Mr Jim Wilson: I'm just wondering if there's a standard form being drawn up. Some of this is already in practice and some of it isn't. I understand there isn't uniformity; it depends on the home. I've been asked to ask you whether some standardization is going to be brought in, or whether every operator and administrator is going to have to read the act and try to figure out exactly what the heck the government wants.
Mr Wessenger: Okay, I'll ask counsel. She may be able to clarify.
Ms Czukar: Consideration is being given to developing a standard information package relating to the standard information; that is, the matter set out in the act and regulations. Of course, there would be information that's specific to each home regarding the specific services to be offered there and so on, but consideration is being given to assisting homes with being able to give the notice and having standard information being given to people where it's applicable.
Mr Jim Wilson: I appreciate that, because I think a standard form, where homes could simply fill in the blanks, personalizing it to their own home, would be appropriate to ensure that all residents across the province were treated equally.
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Government motion 30.4.
Mr Wessenger: I move that section 30.4 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be amended by:
(i) renumbering clause (a) as clause (a.1) and adding the following clause:
"(a) a copy of section 1.1"; and
(ii) adding the following clause after clause (a.1):
"(a.2) a copy of the most recent inspection report relating to the home or joint home, as the case may be, received by the municipality, the municipalities or the board of management, as the case may be, under subsection 21(15)."
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Conservative motion 30.4.
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Mr Jim Wilson: I move that section 30.4 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be struck out and the following substituted:
"Having documents available
"30.4(1) A municipality maintaining and operating a home, the municipalities maintaining and operating a joint home and the board of management of a home shall ensure that the following documents are available for inspection in the home or joint home, as the case may be:
"1. A copy of the service agreement relating to the home or joint home, as the case may be.
"2. A copy of each of the financial statements, reports and returns filed under this act with the minister by the municipality, the municipalities or the board of management, as the case may be.
"3. All other documents required by the regulations to be available for inspection in the home.
"Notice to residents
"(2) The municipality, the municipalities or the board of management, as the case may be, shall post a notice in the home informing residents how they can inspect the documents referred to in subsection (1)."
Again, to refer to my earlier remarks or my remarks of yesterday when we were dealing with the Charitable Institutions Act and the same section therein, this is an amendment which would ensure that residents and anyone entering a home would have full access to all the documents required by regulation and all the documents spelled out currently in the legislation and have them available for inspection. It is an attempt to perhaps make a neater package and a better presentation to residents, consumers and families, to ensure that the aesthetics of the home are maintained to be exactly that of a home and that a common place be set aside for the inspection of these documents.
Again, I think it's a very reasonable request. It is not trying in any way to limit access to the necessary documents, but I think it's a more commonsense approach to this whole issue of posting documents in a home.
The Chair: Shall Mr Wilson's motion carry? All those in favour? Opposed? The motion is defeated.
Ms Sullivan, the Liberal motion, section 30.4.
Mrs Sullivan: I move that section 30.4 of the Homes for the Aged and Rest Homes Act, as set out in section 17 of the bill, be struck out and the following substituted:
"Availability of information
"30.4 A municipality maintaining and operating a home, the municipalities maintaining and operating a joint home and the board of management of a home shall ensure that the following documents are made available in a prominent place in the home:
"1. A copy of the service agreement relating to the home.
"2. Copies of those financial statements, reports and returns filed with the minister that the regulations require to be made available.
"3. All other documents and information that the regulations require to be made available."
Once again, this amendment is put forward precisely to the issue of posting of information. We believe the requirement that the documentation be posted is one that is frankly silly. Having the required information available in a place where it's usable, perhaps at a desk, accessible without interference by management of the home, is an appropriate way of ensuring that residents and their families or others who are concerned with their care have access to the information but the place isn't a mass of wall clutter.
The Chair: Shall Ms Sullivan's motion carry? All those in favour? Opposed? Defeated.
We then move to the government motion, sections 30.5 to 30.10.
Mr Wessenger: I move that section 17 of the bill be amended by adding the following sections to the Homes for the Aged and Rest Homes Act after section 30.4:
"Residents' council
"30.5(1) If a request for the establishment of a residents' council is made to the administrator of a home or joint home by at least three persons, each of whom is a person mentioned in subsection (2),
"(a) the administrator shall promptly notify the director of the request;
"(b) the administrator shall promptly notify the municipality maintaining and operating the home, the municipalities maintaining and operating the joint home or the board of management of the home, as the case may be, of the request; and
"(c) the municipality, the municipalities or the board of management, as the case may be, shall assist the persons who made the request in establishing a residents' council for the home within sixty days of the request.
"Request for residents' council
"(2) For the purpose of subsection (1), the following persons may request the establishment of a residents' council for a home or joint home:
"1. A resident of the home or joint home, as the case may be.
"2. A person who is lawfully authorized to make a decision on behalf of a resident of the home or joint home, as the case may be, concerning the resident's personal care.
"Right to be a member
"(3) Subject to subsection (4), the following persons are entitled to be members of the residents' council of a home or joint home:
"1. A resident of the home or joint home, as the case may be.
"2. A person who is lawfully authorized to make a decision on behalf of a resident of the home or joint home, as the case may be, concerning the resident's personal care.
"3. A person selected by the resident or by the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident's personal care.
"Who may not be a member
"(4) The following persons may not be members of the residents' council of a home or joint home:
"1. A member of the council of the municipality maintaining and operating the home, a member of a council of any of the municipalities maintaining and operating the joint home or a member of the board of management of the home, as the case may be.
"2. The administrator of the home or joint home, as the case may be.
"3. A member of the staff of the home or joint home, as the case may be.
"4. Any other person who is responsible for the operation of the home and who is employed by the municipality maintaining and operating the home, by any of the municipalities maintaining and operating the joint home or by the board of management of the home, as the case may be.
"Appointment by minister
"(5) At the request of a residents' council, the minister may appoint no more than three persons to be members of the residents' council, and those persons shall serve as members at the pleasure of the residents' council.
"Same
"(6) Only a person who lives in the area in which the home or joint home is located and who is not employed by and does not have a contractual relationship with the ministry of the minister may be appointed under subsection (5).
"Meeting
"30.6(1) Unless a home or joint home has a residents' council, the municipality maintaining and operating the home, the municipalities maintaining and operating the joint home or the board of management of the home, as the case may be, shall, at least once in each year, convene a meeting of the residents and the persons who are lawfully authorized to make a decision on behalf of a resident concerning the resident's personal care, to advise them of their right to establish a residents' council.
"Results of meeting
"(2) Within thirty days after the meeting, the municipality, the municipalities or the board of management, as the case may be, shall notify the director of the results of the meeting.
"Powers of residents' council
"30.7 It is the function of a residents' council of a home or joint home, and the council has the power, to,
"(a) advise residents of the home or joint home, as the case may be, respecting their rights and obligations under this act;
"(b) advise residents of the home or joint home, as the case may be, respecting the rights and obligations of the municipality maintaining and operating the home, the municipalities maintaining and operating the joint home or the board of management of the home, as the case may be, under this act and under the service agreement relating to the home or joint home, as the case may be;
"(c) meet regularly with representatives of the municipality, representatives of the municipalities or representatives of the board of management, as the case may be, to,
"(i) review inspection reports relating to the home or joint home, as the case may be, received by the municipality, the municipalities or the board of management, as the case may be, under subsection 21(15),
"(ii) review the allocation of money for accommodation, care, services, programs and goods provided in the home or joint home, as the case may be;
"(iii) review the financial statements relating to the home or joint home, as the case may be, filed with the minister under the regulations, and
"(iv) review the operation of the home or joint home, as the case may be;
"(d) attempt to mediate and resolve a dispute between a resident of the home or joint home, as the case may be, and the municipality maintaining and operating the home, the municipalities maintaining and operating the joint home or the board of management of the home, as the case may be; and
"(e) report to the minister any concerns and recommendations that in its opinion ought to be brought to the minister's attention.
"Residents' council assistant
"30.8(1) With the consent of a residents' council, the minister may appoint a residents' council assistant to assist the residents' council in carrying out its responsibilities.
"Duties
"(2) In carrying out his or her duties, a residents' council assistant shall take instructions from and report to the residents' council.
"Information and assistance
"30.9(1) A municipality maintaining and operating a home, the municipalities maintaining and operating a joint home and the board of management of a home shall cooperate with the residents' council and the residents' council assistant and shall provide them with such financial and other information and such assistance as is required by the regulations.
"Obstruction
"(2) No person shall refuse entry to a home or joint home to a residents' council assistant or otherwise hinder, obstruct or interfere with a residents' council assistant carrying out his or her duties.
"Offence
"(3) Any person who contravenes subsection (1) or (2) is guilty of an offence and on conviction is liable to a fine of not more than $5,000 for a first offence and not more than $10,000 for each subsequent offence.
"Immunity
"30.10 No proceeding shall be commenced against a member of a residents' council or a residents' council assistant for any act done under section 30.7, unless the act is done maliciously or without reasonable grounds."
The Chair: Thank you. I should say, "Well done; deep breath." Any discussion of this motion? Shall the government motion carry? All in favour? Opposed? Carried.
Ms Sullivan, 30.5 to 30.9.
Mrs Sullivan: Mr Chairman, as my motion is virtually identical to that which the parliamentary assistant has just read and we just passed, I will not be putting mine forward.
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The Chair: So that is not moved. I would then ask, shall section 17 of the bill, as amended, carry? All in favour? Opposed? Carried.
Now we move to section 18. Shall subsection 18(1), as in the bill, carry? Shall subsection 18(2) carry? Carried. Shall subsection 18(3) carry? Carried.
Then we come to subsection 18(4). Mr Wessenger, there is a government amendment.
Mr Wessenger: I move that paragraph 15 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(4) of the bill, be struck out and the following substituted:
"15. requiring that parts of the bed capacity of homes and joint homes be set aside for various classes of accommodation, and regulating the amount of bed capacity that must be set aside for each class;"
This again is with respect to the short-term and long-term bed situation.
The Chair: Shall Mr Wessenger's motion carry? Carried.
Another government motion -- sorry, wait a minute. We did subsection 18(4). Shall subsection 18(4), as amended, carry? Carried. Shall subsection 18(5) carry? Carried.
We come then to subsection 18(6). Mr Wessenger.
Mr Wessenger: I move that paragraph 18 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(6) of the bill, be amended by striking out "short-stay accommodation" in the third and fourth lines and substituting "short-stay program."
The Chair: Shall the government motion carry? Opposed? Carried.
We then have a Conservative amendment, subsection 31(1), Mr Jackson.
Mr Cameron Jackson (Burlington South): Subsection 31(1)? I have a subsection 18(6).
The Chair: Yes, subsection 18(6), but it's --
Mr Jackson: That's fine. I will not be tabling that motion, but the next one I will.
The Chair: Okay, not moved. I have a government motion first. Mr Wessenger.
Mr Wessenger: I move that paragraph 19 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(6) of the bill, be struck out and the following substituted:
"19. prescribing the maximum amounts or governing the manner of determining the maximum amounts that may be demanded or accepted from or on behalf of a resident under clauses 30.1(1)(a) and (b), prescribing the information or proof that is to be provided before a determination is made, requiring that the information provided for the purpose of a determination be provided under oath, and prescribing the persons or other entities who may make the determination;"
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Shall subsection 18(6), as amended, carry? Carried.
We will then move to subsection 18(7). First a government amendment, paragraph 31(1)26.
Mr Wessenger: I move that paragraph 26 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(7) of the bill, be amended by,
(i) adding, after "other" in the last line of subclause (i), "documents and"; and
(ii) striking out "and" at the end of subclause (i) and adding the following subclause after subclause (i):
"(i.1) requiring that the information provided by the municipality, the municipalities or the board of management, as the case may be, for the purpose of the reconciliation, be provided under oath, and"
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Mr Jackson, we then have the Conservative amendment.
Mr Jackson: I move that subparagraph (i) of paragraph 26 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(7) of the bill, be amended by striking out "audited financial statements, proof of maintenance and operating costs, information about the level of occupancy of the home" in the eighth, ninth, tenth and eleventh lines and substituting "proof of maintenance and operating costs, information about the financial affairs and the level of occupancy of the home."
Briefly, the concern here is that the interpretation of "audited financial statements" is a very, very expensive term and, as we have heard, the ministry is currently struggling with the requirement to have fully audited statements. It strikes me that we're subjecting these institutions to the interventions of CAs at great expense, which is an expense which accrues to the resident, ultimately, in the scheme of things, and that audited financial information, we've been led to believe, will satisfy the ministry's requirements. But quite frankly, this becomes a very expensive requirement, and if the government certainly now isn't fully up and equipped to deal with it, as it's indicated, then we think it presents an additional financial burden. We can still have a level of accountability and we can still have the government's ability to control and comprehend the financial status of any given institution at any one time without going this extra step and extra expense, so we're proposing this amendment. If it's not supported by the government, perhaps it could modify at its own initiative the audited financial statements and just make that audited financial information. But the word "statement" means that a CA must intervene, and that becomes extremely expensive.
Mr Wessenger: I'd just indicate that this is permissive, not mandatory, and it's the regulatory power. I think it's very important that we maintain the right to require audited statements, so we will not be supporting it.
The Chair: Shall the Conservative motion carry? All in favour? Opposed? The motion is defeated.
We move on to another Conservative amendment.
Mr Jackson: I move that paragraph 28 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(7) of the bill, be struck out and the following substituted:
"28. governing service agreements, including their replacement and cancellation and including prescribing provisions that must be contained in all service agreements and matters that must be provided for in all service agreements."
As my colleague has indicated, this attempts to put in legislation more clarity than leaving it to regulation, the point of clarification we're raising here.
The Chair: Shall Mr Jackson's motion carry? All in favour? Opposed? It is defeated.
Shall section -- sorry.
Mrs O'Neill: Before we take the vote on this, I'd just like to say about this whole section --
The Chair: I'm sorry, before we take a vote on --
Mrs O'Neill: -- on this section, if I may make an intervention.
The Chair: May I call the section and then I'll recognize you?
Mrs O'Neill: Okay, thanks.
The Chair: We will then call the vote on subsection 18(7), as amended, Ms O'Neill.
Mrs O'Neill: I find the whole attitude of this section is really demeaning to municipalities. Certainly they have business plans, they have councils that they are responsible to and thence ratepayers, on a very regular basis. I would like to ask the parliamentary assistant, if I may, because I do find the part about the oath almost offensive. I can't believe why everyone in a municipality would have to provide things under oath. Who is going to be the witness to those oaths? Are they going to have to go beyond the municipal building to get the oaths, or is one municipal employee going to be witness to another? The whole thing just smacks of overkill.
Mr Wessenger: It's not really related to this motion, but --
Mrs O'Neill: Well, it's related to the section. Have you thought out how it's going to be implemented?
Mr Wessenger: It's a regulation-making power and it's permissive. It says the ministry may require oath; it doesn't say it will. So it will do it where it's appropriate.
Mrs O'Neill: Boy, that leaves the municipalities wondering if they're the appropriate one that's not going to be trusted and has to have an oath on the information they're going to provide to the government. This is something new; it's a big move. It may sound like very little. The municipalities are going to examine this; they're going to get all their legal authorities out and examine how this act is going to apply to them. All I am saying is that there's not much of a partnership being built here, which will then, in my mind, I'm sorry, hurt the individual residents because the service agreements are not going to be built on a good basis.
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The Chair: Shall subsection 18(7), as amended, carry? All in favour? Carried.
We then move to subsection 18(8).
Mr Jackson: I move that paragraph 32 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(8) of the bill, be struck out and the following substituted:
"32. governing applications to placement coordinators for a determination, including prescribing the placement coordinators to whom applications may be made and the frequency with which applications may be made;"
The Chair: Shall Mr Jackson's motion carry? All in favour? Opposed? The motion is defeated.
We have then Mr Wessenger, a government motion to subsection 31(1).
Mr Wessenger: I move that paragraph 34 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(8) of the bill, be struck out.
This deletes the regulation-making power requiring and governing consent to admission and care provided in the home.
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
We then have a Liberal motion, subsection 31(1).
Mrs Sullivan: I move that subsection 18(8) of the bill be amended by adding the following paragraph to subsection 31(1) of the Homes for the Aged and Rest Homes Act:
"34.1 prescribing the qualifications for persons and entities to be designated as placement coordinators;"
This motion is placed to ensure that there is included in the regulation a description of the qualifications needed for either a person, an agency or other body to act as a placement coordinator.
Mr Wessenger: Might I ask if Ms Sullivan would consider withdrawing the motion in view of the fact that there is a government motion with respect to section 35.2 requiring that placement coordinators have certain qualifications and meet certain requirements. I think the language is more appropriate. I wonder if in the circumstance she might consider it.
Mrs Sullivan: I'll stand it down until we get to that one.
The Chair: Okay, this is deferred. We then continue with a Liberal amendment, again to subsection 31(1).
Mrs Sullivan: I think the government one comes first, does it -- or am I wrong?
The Chair: We're just having a discussion on that. The Chair is open to information. We can go ahead with the government motion. That may simplify life.
Mr Wessenger: I move that paragraph 35 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(8) of the bill, be struck out and the following substituted:
"35. prescribing, for the purpose of clause 18(8.5)(c), additional circumstances which are grounds for a committee of management or a board of management to withhold approval for the admission of a person to a home or joint home;
"35.1 prescribing and governing the obligations of a committee of management and a board of management in relation to giving or withholding approval for the admission of a person to a home or joint home, and governing the written notice required to be given under subsection 18(8.6)."
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Mrs Sullivan: Given that the government motion is carried, we don't need my motion.
The Chair: To be clear, your motion being what?
Mrs Sullivan: To strike that section.
The Chair: Yes. Sorry. Not the one you deferred but your amendment --
Mrs Sullivan: No, the next one.
The Chair: Paragraph 35 of section 31 is not moved. Thank you.
Okay, then we go to the next government motion.
Mr Wessenger: I move that subsection 18(8) of the bill be amended by adding the following paragraph to subsection 31(1) of the Homes for the Aged and Rest Homes Act, after paragraph 35.1:
"(35.2) requiring that placement coordinators have certain qualifications or meet certain requirements and prescribing such qualifications or requirements."
The Chair: Shall the government motion carry? Opposed? Carried.
Mrs Sullivan: Now that the government motion has carried, I will withdraw the motion which I stood down respecting the qualifications of placement coordinators.
The Chair: Thank you. It's the motion you had deferred. It has now been withdrawn. We then move next to a Conservative amendment. Mr Jackson.
Mr Jackson: I move that paragraph 36 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(8) of the bill, be struck out and the following substituted:
"36. prescribing, for the purpose of section 30.4, the additional documents that must be available for inspection in the home, and governing the notice required to be posted under that section."
The Chair: Shall Mr Jackson's motion carry?
Interjections: No.
The Chair: Okay, defeated.
Government motion.
Mr Wessenger: I move that paragraph 37 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(8) of the bill, be struck out and the following substituted:
"37. governing short-stay programs in homes and joint homes."
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Again government motion 31(1), Mr Wessenger.
Mr Wessenger: I move that paragraph 39 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(8) of the bill, be struck out and the following substituted:
"39. governing the quality management system to be developed and implemented for monitoring, evaluating and improving the quality of the accommodation, care, services, programs and goods provided to residents of homes and joint homes."
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
A Conservative motion to 31(1).
Mr Jackson: I move that paragraph 39 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(8) of the bill, be struck out and following substituted:
"39. governing quality management programs, including their development, implementation and revision;"
The Chair: Shall Mr Jackson's motion carry? All in favour? Opposed? Defeated.
A government motion to 31(1).
Mr Wessenger: I move that paragraph 40 of subsection 31(1) of the Homes for the Aged and Rest Homes Act, as set out in subsection 18(8) of the bill, be amended by striking out "of which notice must be given" in the third and fourth lines and substituting "which must be set out in the notice."
The Chair: All those in favour of the government motion? Opposed? Carried.
Again, government motion, Mr Wessenger.
Mr Wessenger: I move that subsection 18(8) of the bill be amended by adding the following paragraph to subsection 31(1) of the Homes for the Aged and Rest Homes Act, after paragraph 40:
"40.1 governing inspection reports."
The Chair: Shall the motion carry? All those in favour? Opposed? Carried.
Then, Ms Sullivan, Liberal motion to 40.1 and 40.2 of subsection 31(1).
Mrs Sullivan: I move that subsection 18(8) of the bill be amended by adding the following paragraphs to subsection 31(1) of the Homes for the Aged and Rest Homes Act:
"40.1 respecting the establishment and conduct of residents' councils;
"40.2 respecting the information, financial information and assistance a municipality maintaining and operating a home, the municipalities maintaining and operating a joint home and the board of management of a home shall give to a residents' council and a residents' council assistant;"
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The Chair: Shall Ms Sullivan's motion carry? All in favour? Opposed? Motion is defeated.
Government motion to 31.1.
Mr Wessenger: I move that subsection 18(8) of the bill be amended by adding the following paragraphs to subsection 31(1) of the Homes for the Aged and Rest Homes Act, after paragraph 40.1:
"40.2 respecting the establishment and conduct of residents' councils;
"40.3 respecting the financial and other information and the assistance that a municipality and a board of management must give to a residents' council and a residents' council assistant."
Mrs Sullivan: Just as a point of clarification, how does the government motion differ from the motion I just put and the government voted against?
Mr Wessenger: There's some difference in the language in 40.3. The intent is probably somewhat similar, but we wanted to have consistency in the bill.
Mrs Sullivan: You didn't want to accept an opposition amendment, that's why.
The Chair: What is it they say about consistency?
Shall the government motion carry? All opposed? Carried.
Shall section 18(8) of the bill, as amended, carry? Carried.
Shall section 18, as amended, carry? Carried.
I'm sorry, just step back. I need to ask you if section 18(9) shall carry. Carried.
Now, shall section 18 of the bill, as amended, carry? Carried.
We then move to a new section, 18.1. You'll recall that we dealt with government motion 32 yesterday and it carried.
Now then, shall section 19 of the bill carry as in the bill?
Interjection: No.
The Chair: No, sorry.
Mrs Sullivan: I think there's a government motion before this.
The Chair: Okay, just a minute. Hold it. Sorry, section 19 again: Shall section 19 as in the bill carry? Carried. Thank you.
Now we move to section 20. I have a government --
Mrs Sullivan: Mr Chairman, has the government already put -- yes it has. Never mind.
The Chair: To ask a question is to answer it.
We then go to section 20 and a government motion to 17(b).
Mr Wessenger: I move that clause 17(b) of the Ministry of Community and Social Services Act, as set out in section 20 of the bill, be amended by adding after "grants" in the last line, "and requiring that information provided to the minister in connection with grants be provided under oath."
This again is permissive and allows that information can be required to be sworn if necessary.
The Chair: Shall the government motion carry? All those in favour? Opposed? Carried.
Shall section 20 of the bill, as amended, carry?
Mrs Sullivan: Just a minute, Mr Chairman. You're going a little fast here.
The Chair: All right, sorry. We've just dealt with government motion 17(b) to section 20. We've passed that and I was then going to put the question with respect to section 20. It's the Ministry of Community and Social Services Act.
Mrs Sullivan: Right, and I think one of the things we wanted to put on the table was an objection with respect to the requirement that information be provided to the minister under oath. My colleague, I think, would like to speak to that as well.
The Chair: We have voted on that.
Mrs Sullivan: I understand that. We didn't have a chance to speak to it.
The Chair: We'll allow Ms O'Neill, if you --
Mrs O'Neill: I'm just speaking to the whole section.
The Chair: There's unanimous consent? Thank you.
Mrs O'Neill: I'm speaking to the whole section 19. I think the communities that came before us --
The Chair: I'm sorry, are you speaking to section 20?
Mrs O'Neill: No, 19.
The Chair: But we have dealt with 19.
Mrs O'Neill: Well, 19 and 20 then, the whole thing.
The Chair: All right, with unanimous consent.
Mrs O'Neill: I think the communities that came before us are going to be very sorry that we didn't hear them. This is the only part of the act where we could have intervened and the government could have intervened on the disabled issue. There were suggestions made and there were clarifications requested, whether they were disabled or whether they were the young, the children, where there is absolutely no mention in this act. The seniors are also feeling very fragile here and we have not clarified one thing for them, in my humble opinion.
The Chair: Shall section 20, as amended, carry? Carried.
Pardon me. Just let the Chair get organized here.
Mr Jim Wilson: Mr Chairman?
The Chair: Yes, Mr Wilson, as I try to find myself here.
Mr Jim Wilson: Before posing the question on section 21, I'd just like to make a comment on it.
The Chair: Go ahead.
Mr Jim Wilson: Section 21 of the bill deals with extended care facilities and really the whole issue of extended care services. I think the public should be aware that contrary to the government's stated intentions and contrary to anything it ever said while it was in opposition or on the campaign trail back in 1990, this bill, and it hasn't been dealt with to any great extent, really delists extended care services as an insured service under medicare.
I just want to place on the record in very strong terms that I and my caucus colleagues are not at all pleased to see extended care being delisted without, as Minister Lankin promised me last year during a debate in the estimates committee, a full public debate. I think it's the beginning of the slippery slope.
The Senior Citizens' Consumer Alliance for Long-Term Care Reform is having a press conference right now, next door, at which they talk about the end of medicare. They see it as two to three years away. They are aware that this is a delisting. They are also aware that the government has floated ideas about delisting other services such as reproductive services and in vitro fertilization. When Ms Lankin first became Health minister, we even had some scarier thoughts reported in the media that perhaps elderly seniors would no longer have access to medically necessary operations because the government was going to review the efficacy of such procedures.
I think, to be fair to the government, it's incumbent upon the government not to do this without a full public debate specifically on this. We had public hearings on this bill, but really the only association to comment in any strong terms at all was the Ontario Nursing Home Association itself.
They pointed out to committee members that this was the first major delisting we've seen under medicare, and yet they were not able to pursue that matter in a forthright manner with this committee because of the catch-22 we're all in, which is that the government, along the process of introducing Bill 101, and by the time it got to committee here, tied future funding to the nursing home sector to the passage of this bill. They have a gun to our heads, as it were, as legislators. Given that residents will suffer if the money doesn't flow, it wouldn't be wise to hold up this legislation. On the other hand, I just want to make it clear to all members of the public that this is a significant matter, that extended care no longer exists in this province and that it is the slippery slope for the end of medicare and certainly flies in the face of anything the NDP ever said in the past.
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The Chair: Shall section 21 of the bill carry? Carried.
Shall section 22 of the bill carry? Carried.
We come to section 23 of the bill, which is part VI, the Municipality of Metropolitan Toronto Act, and we have a government amendment.
Mr Wessenger: I move that section 23 of the bill be struck out and the following substituted:
"23. Section 186 of the Municipality of Metropolitan Toronto Act is repealed."
This section of the Municipality of Metropolitan Toronto Act provides that the municipality of Metropolitan Toronto is liable for the cost of maintaining an indigent person in a nursing home, once the board of management accepts the indigent person, if there's no bed available in the home for the aged. In light of the new funding formula, this section is no longer applicable.
Mrs O'Neill: I'd like to know where the representation on this matter came from and who is actually going to foot the bill now for the indigent person. I can't understand why it was presented when the bill was first presented, because I don't remember hearing any witnessing that would ask this to be struck. What is going on here?
Mr Wessenger: I understand the municipality of Metropolitan Toronto asked that it be struck. The fact is, the funding will be provided under the funding formula for all residents. If you want further explanation, I can certainly ask counsel to add anything.
Mrs O'Neill: I think it would be good to get it on the record, please.
Ms Czukar: What section 186 did was, if an indigent person was in a nursing home awaiting accommodation in a home for the aged, if the municipality had accepted the person for admission to the home for the aged but didn't have the bed yet, the municipality at that point acquired the financial responsibility for the person even though he was still in a nursing home. That is all irrelevant given that the province will fund both nursing homes and homes for the aged.
The municipality of Metropolitan Toronto requested that the section be repealed rather than amended to replace wording regarding placement coordinators making decisions, because it was irrelevant. Both the municipality and the Ontario Nursing Home Association have agreed that the section should be repealed.
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Shall section 23 of the bill, as amended, carry? Carried.
We will then move to section 24 of the bill. This is now part VII, the Nursing Homes Act. A Liberal amendment, Ms Sullivan.
Mrs Sullivan: I'm not going to be putting this motion forward because the government has defeated it in the other two bills. I think they're making a mistake, but I shan't be putting it forward anyhow.
The Chair: The Liberal amendment is not moved.
Shall section 24 of the bill, as in the bill, carry? Carried.
We will then move to section 24.1. Mr Wessenger has a government amendment.
Mr Wessenger: I move that the bill be amended by adding the following section after section 24:
"24.1(1) Subsection 2(1) of the act is amended by striking out `this act and the regulations' in the second and third lines and substituting `this act, the regulations and a service agreement between the crown in right of Ontario and a licensee.'
"(2) Subsection 2(3) of the act is amended by striking out `this act and the regulations' in the second line and substituting `this act, the regulations and a service agreement relating to a nursing home.'
"(3) Subsections 2(4), (5), (6) and (7) of the act are repealed and the following substituted:
"Deemed contract
"(4) A licensee of a nursing home shall be deemed to have entered into a contract with each resident of the home, agreeing to respect and promote the rights of the resident as set out in subsection (2)."
The Chair: Comments?
Mrs Sullivan: I'd like some clarification and I think this is the appropriate place to do it because this particular motion, as well as others, of course, speaks about the licensees. Will nursing homes continue to be licensed?
Mr Wessenger: I will ask counsel to respond to that.
Ms Czukar: Yes.
Mrs Sullivan: Why?
Ms Czukar: First of all, this section deals with amendments to the bill of rights section so I'm not certain how this comes up under licensing, but if the question relates to signing a service agreement as a condition of funding and operating -- I'm guessing. Is that the question? I'm not sure how it comes up under the bill of rights section.
Mrs Sullivan: What is occurring here is that you are changing the words "this act and the regulations" to "this act, the regulations and a service agreement between the crown...and a licensee." What I'm asking is why one would still have a licensing process, which seems to me to continue to maintain a bureaucratic treatment when indeed the contractual arrangement is now going to be between a nursing home and the government through a service agreement. What you are saying is that there will still be a licensing process on top of that. It seems bizarre to me. There's no other place I can ask this question because the word "licensee" is used throughout because the change hasn't been made to the Nursing Homes Act to eliminate the licensing process.
Ms Czukar: It's not unlike the Charitable Institutions Act, where the approved corporation must be approved in order to be able to operate a home for the aged, for example, or another kind of service as a charitable institution and still be required to sign an agreement with respect to the funding in particular and not be able to operate unless such an agreement has been signed. The approval or licensing process is an approval process that relates to certain kinds of conditions or requirements before the service agreement is negotiated.
Mrs Sullivan: I would suggest to you, respectfully, that as you're looking at phase 2, that's a question that should be examined. I think it's a process duplication that will add to the cost of administration when in fact the same requirements that are needed for licensing can be included or can be demanded through a service agreement and through the regulations.
Mr Wessenger: Perhaps I should indicate that I'll take the member's comments under consideration.
The Chair: Shall the government motion carry? All those in favour? Opposed? Carried.
We then move to section 25. I have a Liberal amendment to 4(2).
Mr Wessenger: I haven't got this one.
The Chair: One moment, please. There was a motion distributed yesterday, I believe.
Ms Sullivan, if you'd proceed.
Mrs Sullivan: The ministry likes this one, too. I move that subsection 4(2) of the Nursing Homes Act, as set out in section 25 of the bill, be struck out and the following substituted:
"Issuance of licence
"(2) No licensee shall operate a nursing home unless,
"(a) the licensee is a party to a service agreement with the crown in right of Ontario that relates to the home; and
"(b) the service agreement complies with the act and the regulations."
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The Chair: Sorry, "with this act"?
Mrs Sullivan: Counsel, "this"?
Ms Czukar: "The act."
Mrs Sullivan: Legislative counsel had written both words in.
The Chair: This was a test to see if we were really awake. So it's "with the act."
Mrs Sullivan: "With the act," all right.
The Chair: And "the regulations."
There was a suggestion that there was broad concurrence with this. Shall I put the motion? All those in favour? Opposed? Carried.
Shall section 25, as amended, carry? Carried.
Shall section 26, as in the bill, carry? Carried.
Section 27, government amendment to 13(a.1).
Mr Wessenger: I move that clause 13(a.1) of the Nursing Homes Act, as set out in section 27 of the bill, be amended by striking out "is in breach of its" in the first line and substituting "has breached the."
This is similar to the other amendments that have been made in the other act.
The Chair: Shall the government motion carry? All in favour? Opposed? Carried.
Shall section 27, as amended, carry? Carried.
Then new section, 27.1, Liberal amendment, Ms Sullivan.
Mrs Sullivan: Mr Chairman, I won't be putting this motion.
The Chair: This motion is not moved.
We then move to section 28 and again a Liberal motion, to 20.1(2) and (2.1). Ms Sullivan.
Mrs Sullivan: I move that subsection 20.1(2) of the Nursing Homes Act, as set out in section 28 of the bill, be amended by striking out "classes of persons" in the second line.
I further move that section 20.1 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection:
"Contract for payment
"(2.1) No person or entity may be designated by the minister as a placement coordinator unless a contract is being entered into between the person or entity and the minister on behalf of the crown in right of Ontario and the contract provides for the payment of the person or entity for acting as a placement coordinator."
The Chair: Ms Sullivan, that is out of order under section 56 of the standing orders.
Mrs Sullivan: Thank you, Mr Chairman.
Mr Jim Wilson: If I may, Mr Chairman --
The Chair: Mr Wilson, did you wish to make a comment?
Mr Jim Wilson: It may not be in order to comment on a motion that was out of order, but again I think Mrs Sullivan's motion that you've so ruled is extremely important because the whole question of who's paying for placement coordination has been left up in the air, and I have a funny feeling that with the record of this government, they're going to download that cost on to the institutions.
The Chair: I have a Liberal amendment, 20.1(2.2).
Mrs Sullivan: I move that section 20.1 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection:
"Qualifications
"(2.2) No person or entity may be designated by the minister as a placement coordinator unless the person or entity meets the qualifications prescribed by the regulations."
The Chair: Shall Ms Sullivan's motion carry? All in favour? Opposed? Defeated.
Conservative motion, 20.1(5)(a).
Mr Jim Wilson: I move that clause 20.1(5)(a) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"(a) Within the six months preceding admission, a placement coordinator has determined that the person is eligible for admission to a nursing home; and"
Mr Chairman, I'd be prepared to withdraw this motion if I received assurance from the parliamentary assistant that the principle of this motion is being incorporated in the government's own amendments.
Mr Wessenger: This again was the one where the six months was incorporated in with section 8.4, which we haven't yet moved, of course.
Mr Jim Wilson: Thank you. Mr Chairman, I'll withdraw this motion.
The Chair: That motion will then not be moved. We go next to Liberal motion 20.1(5.1).
Mrs Sullivan: I think the government has a motion before that.
Mr Wessenger: I think we have one before that, 20.1(5) to (8.7).
The Chair: I do have that in front of me. I suggest we deal with the government motion because that may then expedite the number of others that are also listed, so we'll go to government motion 20.1(5) to (8.7).
Mr Wessenger: I move that subsections 18(5) to (8) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Admission
"(5) A licensee of a nursing home shall not admit a person unless the person's admission to the nursing home is authorized by the placement coordinator designated for the nursing home under subsection (3), and shall admit a person whose admission to the nursing home is so authorized.
"Applications to placement coordinator
"(6) A person may apply for a determination by a placement coordinator respecting the person's eligibility for admission to a nursing home and for authorization of admission with respect to such nursing home or homes as the person selects.
"Assistance
"(7) A placement coordinator who determines that a person is eligible for admission shall, if the person wishes, assist the person in selecting the nursing home or homes with respect to which the person will apply for authorization of admission.
"Person's preferences
"(8) In assisting a person under subsection (7), the placement coordinator shall consider the person's preferences relating to admission, based on ethnic, spiritual, linguistic, familial and cultural factors.
"Determination respecting eligibility
"(8.1) A placement coordinator shall determine whether a person is eligible for admission to a nursing home only if the person applies for the determination in accordance with the regulations.
"Determination respecting authorization
"(8.2) The placement coordinator designated for a nursing home under subsection (3) shall determine whether to authorize a person's admission to the nursing home only if the person applies for authorization of admission with respect to the nursing home in accordance with the regulations.
"Compliance with act and regulations
"(8.3) A placement coordinator shall make all determinations respecting eligibility for admission and all determinations respecting authorization of admission in accordance with this act and the regulations.
"Assessments etc to be taken into account
"(8.3.1) In making a determination respecting a person's eligibility for admission, a placement coordinator shall take into account any of the following which are provided to the placement coordinator:
"1. An assessment of the person made by a health practitioner relating to the person's impairment or capacity.
"2. An assessment or information relating to the person's requirements for medical treatment, health care or other personal care.
"Conditions of authorization
"(8.4) The placement coordinator designated for a nursing home under subsection (3) may authorize the admission of a person to the nursing home only if
"(a) the placement coordinator or another placement coordinator has determined, within the six months preceding authorization, that the person is eligible for admission to a nursing home;
"(b) the licensee of the nursing home to which the person's admission is to be authorized approves the person's admission to the nursing home; and
"(c)l the person consents to being admitted to the nursing home.
"Approval
"(8.5) A licensee of a nursing home shall approve a person's admission to the nursing home unless
"(a) the nursing home lacks the physical facilities necessary to meet the person's care requirements;
"(b) the staff of the nursing home lack the nursing expertise necessary to meet the person's care requirements; or
"(c) circumstances exist which are prescribed by the regulations as being a ground for withholding approval.
"Written notice
"(8.6) A licensee who withholds approval for the admission of a person to a nursing home shall give to the person, the director and the placement coordinator designated for the nursing home under subsection (3) a written notice setting out the ground or grounds on which the licensee is withholding approval and a detailed explanation of the supporting facts.
"Alternative services
"(8.7) A placement coordinator shall suggest alternative services or make appropriate referrals on behalf of an application if
"(a) the placement coordinator determines that the applicant is not eligible for admission to a nursing home; or
"(b) the placement coordinator determines that the applicant is eligible for admission to a nursing home but does not authorize their immediate admission."
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Mr Jim Wilson: I'd just like to state that we'll be supporting this motion. I think it incorporates a number of the PC amendments that were put forward. It speaks to consumer choice, and in particular it speaks to the person's preferences, which I think are very important. It also incorporates, as was mentioned earlier, the previous PC motion, which was withdrawn because it is incorporated in this amendment, regarding the fact that people must be assessed in a six-month time frame and not left unassessed for longer than that period, if possible, on a waiting list. For those reasons and others, we're supportive of this amendment.
The Chair: Shall the government motion carry? Opposed? Carried.
Just before going back to the Liberal amendment to subsection 20.1(5.1), regarding the ongoing debate around "the" and "this," I am now informed that "the" should have been "this" and that "this" should not have been "the." So I am reopening section 25.
I'll get some guidance from the clerk. Do I need to read the offending paragraph or simply indicate that "the" has now become "this"? Perhaps, Ms O'Neill, seeing as this was a Liberal motion, you would move -- the question is what. Does she need to read that?
Mrs O'Neill: Do you want me to go right through it again?
The Chair: Yes, probably the best thing would be to just read it again.
Mrs O'Neill: I move that subsection 4(2) of the Nursing Homes Act, as set out in section 25 of the bill, be struck out and the following substituted:
"Issuance of licence
"(2) No licensee shall operate a nursing home unless,
"(a) the licensee is a party to a service agreement with the crown in right of Ontario that relates to the home; and
"(b) the service agreement complies with this act and the regulations."
The Chair: Shall this motion carry? All in favour? Opposed? Carried.
Mr Jim Wilson: While we obviously agree with this, do you not need a motion to reopen the section?
The Chair: You're probably right.
Mr Jim Wilson: I think it takes unanimous consent to reopen a section.
The Chair: May I have unanimous consent to reopen that?
Mr Wessenger: Yes, unanimous consent is given.
The Chair: Thank you. There.
Mr Jim Wilson: I would just hate this bill not to pass because somebody was diligently reading his Hansard.
The Chair: It's a good thing you said "this."
Mr Wessenger: Do we have to repass the section then?
The Chair: We did it, so I think we're clear. Now we'll go forward to section 28, a Liberal amendment to subsection 20.1(5.1).
Mrs O'Neill: I think that particular amendment is included in the previous government amendment, so we'll not be placing it.
The Chair: It is not moved. Mr Wilson, subsection 20.1(6).
Mr Jim Wilson: I won't be placing this amendment, given that I've attempted twice before.
The Chair: It is not moved. Ms O'Neill, I believe.
Mrs O'Neill: We're in the same category; it seems the government suggests this is unnecessary.
The Chair: Again, Ms O'Neill with subsection 20.1(7).
Mrs O'Neill: Yes, I will be moving that.
The Chair: That is not moved.
Mrs O'Neill: I think I did want to move that.
The Chair: Oh, I'm sorry. You will move subsection 20.1(7)?
Mrs O'Neill: Yes.
The Chair: Please go ahead.
Mrs O'Neill: I move that subsection 20.1(7) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Determination regarding eligibility
"(7) A placement coordinator to whom application has been made in accordance with the regulations for a determination respecting a person's eligibility for admission to a nursing home shall, in accordance with the regulations, determine whether the person is eligible for admission and, if the placement coordinator determines that the person is eligible, determine a priority level for the person's admission."
As we were saying, as we've presented this previously, there does seem to be confusion around this issue, and this seems to be what the homes would find much more acceptable.
The Chair: Shall Ms O'Neill's motion carry? All those in favour? Opposed? Defeated.
Mr Wilson, 20.1(7.1).
Mr Jim Wilson: This has been incorporated to a large degree in the government's previous amendment and I will not move it.
The Chair: To the same part, Ms O'Neill?
Mrs O'Neill: I think I will read this in as well, 20.1. Is that the one we're at?
The Chair: We're at 20.1(7.1).
Mrs O'Neill: I move that section 20.1 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection:
"Assessments etc to be taken into account
"(7.1) In making a determination respecting a person's eligibility for admission, a placement coordinator shall take into account any assessments made by a physician of the person relating to the person's impairment or capacity and any other assessments or information relating to the person's requirements for medical treatment, health care or personal care."
We've presented our reasons earlier.
The Chair: Shall Ms O'Neill's motion carry? All those in favour? Opposed? Defeated.
Conservative motion, Mr Wilson, 20.1(8).
Mr Jim Wilson: I move that subsection 20.1(8) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Priority and authorization
"(8) Subject to subsection (10), if the placement coordinator designated for a nursing home under subsection (3) receives an application, made in accordance with the regulations, for authorization of a person's admission to the home, the placement coordinator shall assign to the person a priority rating and, taking the priority rating into account, shall determine in accordance with the regulations whether to authorize the person's admission to the home.
"Assigning priority rating
"(8.1) The priority rating assigned to a person under subsection (8) shall be based on the immediacy of the need for admission of the other persons applying for admission.
"Priority rating for spouse
"(8.2) Despite subsection (8.1), a person applying for admission to a nursing home in which his or her spouse is resident shall be assigned, for the purposes of admission to the home, a priority rating that is higher than the priority rating assigned to the applicants for admission to the home who do not have spouses resident in the home.
"Priority rating for veteran
"(8.3) Despite subsections (8.1) and (8.2), a veteran applying for admission to a nursing home that receives or has received financial contributions from the Royal Canadian Legion shall be assigned, for the purposes of admission to such homes, a priority rating that is higher than the priority rating assigned to non-veterans applying for admission to such homes."
The intent of this amendment was to ensure that the government dealt with the issue regarding priority access for Canada's veterans where federal-provincial agreements are now in place. Secondly, it was an attempt to ensure that the government did not simply dismiss the spousal issue.
I would like a vote on it, although I will note in fairness that the government has moved, I think because both opposition parties forced it in this direction in previous amendments and amendments to come, along the line of the principles indicated in this motion.
Mrs O'Neill: If I could clarify, our critic has had to leave, because, as you know, this meeting for today was called at very short notice. I too am going to leave very soon. I understood there had been an agreement that we would stack the votes from 12 to 12:30 until whatever happens at 2. Is that true?
The Chair: We can defer the votes.
Mrs O'Neill: I would like to do that on these issues, if we could.
The Chair: That's fine. We'll present them, discuss them, and we will simply defer the vote.
Mrs O'Neill: So beginning with this one or the next one I think would be more than satisfactory.
The Chair: Shall we vote on this one and then do that consequently?
Mrs O'Neill: That's fine.
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The Chair: With respect then to 20.1(8), shall Mr Wilson's motion carry? Opposed? Defeated.
It's 12 o'clock. We're going to go on until 12:30 and reconvene at 1:30, but from 12 to 12:30, whatever we get through, we'll defer the vote and from 1:30 to 2 we will defer the vote and then deal with those at 2 or shortly thereafter and then carry on.
Mr Wessenger: Unless we're all agreed.
The Chair: Unless we're all together, as they say.
I then have a Liberal amendment 20.1(8.1).
Mrs O'Neill: I move that section 20.1 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection:
"Preferences and requirements of persons
"(8.1) In determining whether to authorize a person's admission to a nursing home, a placement coordinator shall take into account,
"(a) the person's ethnic, cultural, religious, linguistic and geographical preferences; and
"(b) the programs and services available at the nursing home that would help to meet the person's ethnic, cultural, religious, physical, linguistic and geographic requirements."
I've just read that in because we have not been successful in getting geographical preferences, but I'm not going to request a vote on that issue.
The Chair: Just so I'm clear then, the amendment 20.1(8.1) is --
Mrs O'Neill: It's been included in all the others except for geographic and we wanted to emphasize that.
The Chair: So it is removed?
Mrs O'Neill: Yes.
The Chair: Or not moved, I guess. Ms O'Neill, the next one is also yours.
Mrs O'Neill: I move that section 20.1 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection:
"Limitation
"(8.2) A placement coordinator shall not authorize a person's admission to a nursing home unless the placement coordinator has determined that the care and services required for the person can be provided at the nursing home."
The Chair: Any discussion on that? If not, we'll defer the vote. Just for the record, I'll note that the previous Liberal amendment was withdrawn.
Mrs O'Neill: That's correct.
The Chair: Then Conservative amendment 20.1(8.4).
Mr Jim Wilson: I move that section 20.1 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection after subsection (8.3):
"Alternative plan of care
"(8.4) A placement coordinator shall suggest an alternative plan of care to an applicant if,
"(a) the placement coordinator determines that the applicant is not eligible for admission to a nursing home; or
"(b) the placement coordinator determines that the applicant is eligible for admission to a nursing home but does not authorize their immediate admission."
Mr Wessenger: I think this is the one that's included, Mr Wilson, in one we already passed. It's one of the items that was included in (8.7).
Mr Jim Wilson: Which is exactly what I was going to ask you to say. I just want to ensure, Mr Wessenger, that the reason it is included is because there was a PC amendment on the table that the government saw fit to incorporate in its own amendment.
Of course the thrust of this amendment was to ensure that potential residents or applicants are simply not left in limbo and that the placement coordinator has an obligation to provide and to suggest, I think is the language in the amendment, alternative plans of care.
The Chair: So that is withdrawn?
Mr Jim Wilson: Withdrawn.
The Chair: We had dealt with 20.1(5) to (8.7), the government amendment, which was carried. We then have the Liberal amendment 20.1(9.1).
Mrs O'Neill: We feel this was a very important amendment on the veterans and their concerns. It has been included in government amendments now, so we will not be placing it.
The Chair: That is not moved. Now a subsequent Liberal amendment to 20.1(9.2).
Mrs O'Neill: I move that section 28 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.1:
"Information to home
"20.1.1 A placement coordinator who authorizes a person's admission to a nursing home shall, if the person consents, give to the licensee of the nursing home any of the following information that the placement coordinator has:
"1. Information about assessments of the person.
"2. Information about the person's social and personal care needs.
"3. The names and addresses of anyone who is authorized to make decisions for the person.
"4. Information about the person's medical history."
Mr Wessenger: We will be moving a motion that I believe incorporates that as well as other information. So I wonder if Ms O'Neill would either --
Mrs O'Neill: Why don't we stand it down? I had the feeling you were going to do that but I wanted to be sure.
The Chair: Sorry. I think, Ms O'Neill, you just read into the record your 20.1.1, but did you not have an amendment to 20.1(9.2), "Preference for persons discharged from facilities"?
Mrs O'Neill: Yes, I've got it here. Just to clarify, does what Mr Wessenger just said apply to what I read or does it apply to --
Mr Wessenger: It applied to what you read, not the other section.
Mrs O'Neill: Okay, that's fine. What should we do then, just stand down the other thing that I read?
The Chair: In point of fact that would have been coming up next. So we'll defer that, do the government one, and then hopefully that will clarify everything. But let's now deal with this one, "Preference for persons discharged from facilities."
Mrs O'Neill: I'm sorry I am causing more confusion than necessary.
The Chair: No, that's quite all right.
Mrs O'Neill: I move that section 20.1 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection:
"Preference for persons discharged from facilities
"(9.2) In making determinations under this section, placement coordinators shall, subject to subsection (9.1), ensure that preference is given to persons whose discharge as a resident was authorized under section 20.3.2, section 9.7.2 of the Charitable Institutions Act or section 19.1.2 of the Homes for the Aged and Rest Homes Act."
The Chair: Okay, we'll defer the vote on that.
You have read into the record, Ms O'Neill, your motion 20.1.1. We have deferred that and we'll move on to the government amendment to the same section, 20.1.1.
Mr Wessenger: I move that section 28 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.1:
"Information to licensee
"20.1.1(1) A placement coordinator who authorizes a person's admission to a nursing home shall give to the licensee of the nursing home the information mentioned in a paragraph of subsection (2) if,
"(a) the placement coordinator has the information mentioned in the paragraph; and
"(b) consent to the disclosure of the information to the licensee is given by,
"(i) the person whose admission is authorized; or
"(ii) the person, if any, who was lawfully authorized to consent to admission to the nursing home on behalf of the person whose admission is authorized.
"Same
"(2) The information referred to in subsection (1) is the following:
"1. Information about assessments of the person whose admission is authorized.
"2. Information about the person's medical history.
"3. Information about the person's social and other care requirements.
"4. The name and address of the person, if any, who was lawfully authorized to consent to admission to the nursing home on behalf of the person whose admission is authorized."
The Chair: Thank you.
Mrs O'Neill: I presume that's the one he was referring to, correct?
The Chair: Yes.
Mrs O'Neill: So we could withdraw.
The Chair: But we'll need to deal with the government motion first.
Mr Wessenger: I must say that we'll have to stand this one down because I'd like now to move, as we did with the other act, to substitute decisions resolutions.
The Chair: So we are deferring and then going to --
Mr Wessenger: Section 37.1 of the bill, section 39 of the Nursing Homes Act. That's the substitute decisions provision.
The Chair: So you will now deal with the substitute decision-making provision, 37.1, which is a new section.
Mr Wessenger: Yes.
The Chair: All right. Please go ahead.
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Mr Wessenger: I move that the bill be amended by adding the following section after section 37:
"37.1 The act is further amended by adding the following section:
"Transition
"39(1) This section applies until the Substitute Decisions Act, 1992 comes into force, and when the Substitute Decisions Act, 1992 comes into force, this section is repealed.
"Identifying person who is lawfully authorized
"(2) For the purposes of this act and the regulations, a person mentioned in a paragraph of subsection (3) is lawfully authorized to make a decision on behalf of another person concerning that person's personal care if,
"(a) the person on whose behalf the decision is to be made is apparently incapable of making the decision; and
"(b) the person mentioned in the paragraph is,
"(i) at least sixteen years old;
"(ii) available;
"(iii) apparently capable of making the decision; and
"(iv) willing to make the decision.
"Same
"(3) For the purpose of subsection (2), the following persons may be lawfully authorized:
"1. The apparently incapable person's committee of the person committed under the Mental Incompetency Act.
"2. A spouse or partner of the apparently incapable person.
"3. A child of the apparently incapable person.
"4. A parent of the apparently incapable person.
"5. A brother or sister of the apparently incapable person.
"6. Another relative of the apparently incapable person.
"Meaning of `capable' and `incapable'
"For the purpose of this section, a person is capable of making a decision if the person is able to understand the information that is relevant to making the decision and is able to appreciate the reasonably foreseeable consequences of a decision or lack of decision, and a person is incapable of making a decision if the person is not capable of making the decision.
"Meaning of `available'
"(5) For the purpose of this section, a person is available if it is possible, within a time that is reasonable in the circumstances, to communicate with the person and obtain a decision.
"Meaning of `spouse'
"(6) In this section, `spouse' of an apparently incapable person means a person of the opposite sex,
"(a) to whom the apparently incapable person is married; or
"(b) with whom the apparently incapable person is living or was living immediately before being admitted to the nursing home, in a conjugal relationship outside marriage, if the two persons,
"(i) have cohabited for at least one year,
"(ii) are together the parents of a child, or
"`(iii) have together entered into a cohabitation agreement under section 53 of the Family Law Act.
"Meaning of `partner'
"(7) Two persons are partners for the purpose of this section if they have lived together for at least one year and have a close personal relationship that is of primary importance in both persons' lives.
"Ranking
"(8) A person mentioned in a paragraph of subsection (3) is not lawfully authorized to make a decision if a person mentioned in an earlier paragraph of section 3 is lawfully authorized to make it.
"Same
"(9) If two or more persons mentioned in the same paragraph of subsection (3) would be lawfully authorized to make the decision, they shall select one person from among them, and the person selected is the only one of them who is lawfully authorized to make the decision.
"Decisions on person's behalf
"(10) A person who makes a decision on behalf of an apparently incapable person shall do so in accordance with the following principles:
"1. If the person knows of a wish that the apparently incapable person expressed while capable, the person shall make the decision in accordance with the wish.
"2. If the person does not know of a wish that the apparently incapable person expressed while capable, the person shall make the decision in the apparently incapable person's best interests.
"Best interests
"(11) In deciding what an apparently incapable person's best interests are, the person making the decision shall take into consideration,
"(a) the values and beliefs that the person knows the apparently incapable person held when capable and believes the apparently incapable person would still act on if capable; and
"(b) the apparently incapable person's current wishes, if they can be ascertained."
We'll defer the vote.
Mr Jim Wilson: Just in case I don't have the time when we actually vote on this, I want to indicate that we will not be supporting this amendment, as was the case the previous two times that it was presented, because we do not feel that it really lives up fully to the intent of the Substitute Decisions Act and that the interim measures simply aren't well enough thought out.
The Chair: We'll then go back to government motion 20.1.2, because we are deferring the vote on 20.1.1.
Mr Wessenger: We'll have to defer the vote on this too, I think.
The Chair: Yes, but it needs to be presented.
Mr Wessenger: Oh, 20 --
The Chair: Section 20.1.2. I believe I'm right. You have moved 20.1.1.
Mr Wessenger: Yes.
The Chair: We have deferred the vote on that, so we're now going to your motion 20.1.2.
Mr Wessenger: Oh, this one. Okay, thank you. I move that section 28 of the bill be amended by adding the following section to the Nursing Homes Act, after section 20.1.1:
"Preference for veterans
"20.1.2 The minister shall ensure that preference is given to veterans for access to beds that,
"(a) are located in nursing homes for which funding is provided under an agreement between the government of Ontario and the government of Canada relating to veterans; and
"(b) are designated by the minister as veterans' priority access beds."
The Chair: Then we will defer the vote on that.
Mr Wessenger: It may be that this is -- I'm wondering --
The Chair: I think we need to defer the votes because we agreed to do that.
Mr Wessenger: Okay.
The Chair: Then government motion 20.2.
Mr Wessenger: I move that section 20.2 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by:
(i) striking out "a placement coordinator or a member" in the second and third lines and substituting "an"; and
(ii) adding the following subsection:
"Placement coordinator's liability
"(2) Subsection (1) does not relieve a placement coordinator of liability for the acts or omissions of its employees or agents."
Again, vote deferred.
The Chair: Then Mrs Fawcett, Liberal motion 20.1.1. Sorry, 20.2.1.
Mr Wessenger: No, I have 20.1.1. Oh, that was withdrawn.
The Chair: Excuse me. Just on that point, there's some confusion with respect to the Liberal motion 20.1.1 as to whether it was withdrawn or deferred. I thought it had been withdrawn but it's been indicated at the table that it's still --
Mrs Joan M. Fawcett (Northumberland): Ms O'Neill withdrew that.
The Chair: I thought she had as well. I think, then, with your concurrence, Ms Fawcett, we'll just note that the Liberal amendment 20.1.1 has been withdrawn.
Now, Ms Fawcett, Liberal amendment 20.2.1.
Mrs Fawcett: I move that section 28 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.2:
"Notice of determination to licensee
"20.2.1(1) A placement coordinator who determines that a person's admission to a nursing home should be authorized shall serve a notice of the determination on the licensee of the nursing home.
"Application provisions
"(2) Subsections 20.3(2), (3), (4) and (6) apply, with necessary modifications, with respect to a notice of determination under subsection (1).
"Hearing by appeal board
"(3) A licensee that is served with a notice of determination is entitled to a hearing by the appeal board if the licensee mails or delivers to the placement coordinator and to the appeal board, within thirty days after the notice of determination is served, a notice requiring a hearing.
"Applicable provisions
"(4) Subsections 20.4(1), (2) and (5) apply, with necessary modifications, with respect to a hearing required by a licensee under subsection (3).
"Powers of appeal board
"(5) After a hearing by the appeal board, the appeal board may,
"(a) affirm the determination made by the placement coordinator;
"(b) rescind the determination made by the placement coordinator and refer the matter back to the placement coordinator for redetermination in accordance with such directions as the appeal board considers proper; or
"(c) rescind the determination made by the placement coordinator, substitute its opinion for the opinion of the placement coordinator and direct the placement coordinator not to authorize the person's admission to the nursing home."
Vote deferred?
The Chair: That will be deferred.
Government amendment 20.3.
Mr Wessenger: I move that section 20.3 of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Notice of determination
"20.3(1) If a placement coordinator determines that an applicant for a determination respecting eligibility for admission to a nursing home is not eligible, the placement coordinator shall ensure that the applicant and the person, if any, who applied for the determination on behalf of the applicant are notified of,
"(a) the determination of ineligibility;
"(b) the reasons for the determination; and
"(c) the applicant's right to apply to the appeal board for a review of the determination.
"Application to appeal board
"(2) The applicant may apply to the appeal board for a review of the determination of ineligibility made by the placement coordinator."
Vote deferred.
The Chair: Deferred.
Liberal amendment 20.3(1), (2.1), (3), (4), (5), (7), Ms Fawcett?
Mr Wessenger: I have a 20.3.
Interjections.
The Chair: Now wait. I guess this is a new one. The order here is sometimes different. I'm not quite sure -- I think as we're just reading these in at the present time, why don't you go ahead with what I suggested.
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Mr Jim Wilson: There is a section 20.3, Liberal.
The Chair: Okay, do section 20.3.
Mrs Fawcett: I move that section 28 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.3:
"Notice of determination to person seeking admission
"20.3.1(1) A placement coordinator who determines that a person's admission to a nursing home should not be authorized shall serve a notice of the determination on the person.
"Applicable provisions
"(2) Subsections 20.3(2), (3), (4) and (6) apply, with necessary modifications, with respect to a notice of determination under subsection (1).
"Hearing by appeal board
"(3) A person who is served with a notice of determination is entitled to a hearing by the appeal board if the person mails or delivers to the placement coordinator and to the appeal board, within thirty days after the notice of determination is served, a notice requiring a hearing.
"Applicable provisions
"(4) Subsections 20.4(1), (2) and (5) apply, with necessary modifications, with respect to a hearing requested by a person under subsection (3).
"Powers of appeal board
"(5) After a hearing by the appeal board, the appeal board may,
"(a) affirm the determination made by the placement coordinator;
"(b) rescind the determination made by the placement coordinator and refer the matter back to the placement coordinator for redetermination in accordance with such directions as the appeal board considers proper; or
"(c) rescind the determination made by the placement coordinator, substitute its opinion for the opinion of the placement coordinator and direct the placement coordinator to authorize the person's admission to the nursing home."
The Chair: The vote will be deferred. There is also a section 20.3 Conservative motion, so let us put that next on the record and then we'll do this.
Mr Jim Wilson: I won't introduce this amendment. It was an attempt once again to legislate a priority rating system and to change a bit of the language.
The Chair: That was section 20.3 and that is not moved. I'll then go to Mrs Fawcett to do the longer one with all the parts. It's subsections 20.3(1), (2.1), (3), (4), (5) and (7). It's a one-page motion.
Mrs Fawcett: Yes, I have that now. Thank you.
I move that subsection 20.3(1) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Notice of determination
"(1) A placement coordinator who makes a determination whether an applicant is eligible for admission to a nursing home shall serve on the applicant a notice of determination."
I further move that section 20.3 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection:
"Contents of notice
"(2.1) A notice of determination of eligibility under subsection (1) shall inform the applicant of,
"(a) the priority level for the person's admission;
"(b) the requirements set out in subsection (5) for entitlement to a hearing by the appeal board; and
"(c) the requirements set out in subsection (6) for obtaining an extension of the time for giving a notice requiring a hearing."
I further move that subsections 20.3(3), (4), (5) and (7) of the Nursing Homes Act, as set out in section 28 of the bill, be amended by striking out "determination of ineligibility" everywhere it appears and substituting "determination."
The Chair: The vote is deferred. Mr Wilson, section 20.3.1.
Mr Jim Wilson: I move that section 28 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.3:
"Discharge for transfer
"20.3.1(1) The licensee of a nursing home may apply, in accordance with the regulations, to the placement coordinator designated for the nursing home for authorization to discharge a resident for transfer to an appropriate alternative setting if the care requirements of the resident cannot be met in the nursing home.
"Determination
"(2) The placement coordinator to whom an application under subsection (1) is made shall determine whether the resident's care requirements can be met in the nursing home.
"Authorization
"(3) If the placement coordinator determines that the care requirements cannot be met, the placement coordinator shall authorize the applicant to discharge the resident and shall advise the applicant on an appropriate alternative setting for the resident.
"Discharge
"(4) An applicant may discharge a resident of a nursing home when so authorized by a placement coordinator.
"Notice of determination
"(5) The placement coordinator shall serve a notice on the applicant if the placement coordinator determines that the resident's care requirements can be met in the nursing home and determines not to authorize the resident's discharge, and subsections 20.3(2) to (7) apply with necessary modifications."
The Chair: Thank you. We'll defer that.
Ms Fawcett, 20.3.1 and 20.3.3. That is a yellow Liberal motion.
Mrs Fawcett: I don't have that.
The Chair: By colour only: 20.3.2 and 20.3.3.
Mrs Fawcett: Okay.
The Chair: This will be the last one we'll deal with before the break.
Mrs Fawcett: I move that section 28 of the bill be amended by adding the following sections to the Nursing Homes Act, after section 20.3.1:
"Discharge for transfer
"20.3.2(1) A licensee of a nursing home may apply, in accordance with the regulations, to the placement coordinator designated for the home for authorization to discharge a resident for transfer to an appropriate alternative setting if the care requirements of the resident cannot be met in the home.
"Notice to resident
"(2) The applicant shall give notice of the application to the resident.
"Determination
"(3) The placement coordinator to whom an application under subsection (1) is made shall determine whether the resident's care requirements can be met in the home.
"Authorization
"(4) If the placement coordinator determines that the care requirements cannot be met, the placement coordinator shall authorize the applicant to discharge the resident and shall advise the resident on an appropriate alternative setting for the resident.
"Discharge
"(5) An applicant may discharge a resident of a nursing home when so authorized by a placement coordinator if an appropriate alternative setting for the resident is available and transfer to that setting is consented to by the resident or a person authorized to consent on behalf of the resident.
"Notice of determination
"(6) The placement coordinator shall serve a notice on the applicant if the placement coordinator determines that the resident's care requirements can be met in the home and determines not to authorize the resident's discharge.
"Applicable provisions
"(7) Subsections 20.3(2), (3), (4) and (6) apply, with necessary modifications, with respect to a notice of determination under subsection (6).
"Hearing by an appeal board (discharge)
"20.3.3(1) A licensee of a nursing home who is served with a notice of determination under subsection 20.3.2(6) is entitled to a hearing by the appeal board if the licensee mails or delivers to the placement coordinator and to the appeal board, within thirty days after the notice of determination is served, a notice requiring a hearing.
"Applicable provisions
"(2) Subsections 20.4(1) and (2), 14(3) and 20.4(5) apply, with necessary modifications, with respect to a hearing required by a licensee under subsection (1).
"Powers of appeal board
"(3) After a hearing by the appeal board, the appeal board may,
"(a) affirm the determination made by the placement coordinator;
"(b) rescind the determination made by the placement coordinator and refer the matter back to the placement coordinator for redetermination in accordance with such directions as the appeal board considers proper; or
"(c) rescind the determination made by the placement coordinator, substitute its opinion for the opinion of the placement coordinator and direct the placement coordinator to authorize the resident's discharge."
The Chair: Thank you. Just before we break, because I had down two amendments, 20.3.1 and 20.3.3, I just want to note that what you read was 20.3.2 and 20.3.3. Is that correct? That is what is on your sheet?
Mrs Fawcett: Yes.
The Chair: That's right, so if anyone had another one, it doesn't exist --
Mrs Fawcett: Okay. Actually, I had that here but I didn't read the right number.
The Chair: -- except in my head. So that vote will be deferred.
At this point, then, we will recess until 1:30.
The committee recessed at 1229.
AFTERNOON SITTING
The committee resumed at 1331.
The Chair: Good afternoon. We begin the afternoon session. We are at government amendment 20.4(1) and (2).
Mr Wessenger: I move that subsections 20.4(1) and (2) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Hearing
"20.4(1) When the appeal board receives an application for a review of a determination of ineligibility, it shall promptly appoint a time and place for a hearing.
"Same
"(2) The hearing shall begin within twenty-one days after the day the appeal board receives the application for the hearing, unless the parties agree to a postponement.
"Notice to parties
"(2.1) The appeal board shall notify each of the parties of the time and place of the hearing at least seven days before the hearing begins.
"Parties
"(2.2) The parties to the proceeding before the appeal board are the applicant who was determined to be ineligible for admission, the placement coordinator who made the determination and such other parties as the appeal board specifies.
"Notice to minister
"(2.3) When a placement coordinator is notified by the appeal board of a hearing, the placement coordinator shall promptly give the minister written notice of the hearing together with written reasons for the determination of ineligibility made by the placement coordinator.
"Minister entitled to be heard
"(2.4) The minister is entitled to be heard by counsel or otherwise in a proceeding before the appeal board under this section."
The Chair: We'll defer the vote on that motion. Mr Wilson, 20.4(1.1).
Mr Jim Wilson: I will not be introducing this, given that the government's motion that was just read sets the time frame for 21 days versus 90 days.
The Chair: Not moved. We will then move to government motion 20.4(3).
Mr Wessenger: I move that subsection 20.4(3) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Quorum of appeal board
"(3) Three members of the appeal board constitute a quorum and are sufficient for the exercise of the jurisdiction and powers of the appeal board under this act."
The Chair: We'll defer the vote on that and move to 20.4(4).
Mr Wessenger: I move that subsection 20.4(4) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out.
Vote deferred on that, please.
The Chair: Just one second. That was 20.4(4).
Mr Wessenger: I think we can have the PC one withdrawn; it's exactly the same, and the Liberal one is exactly the same.
Mr Jim Wilson: Since the PC motion is exactly the same, we'll withdraw it, or not introduce it.
The Chair: So that is the Conservative motion 20.4(4), and the same for the --
Mrs Fawcett: For the Liberal motion 20.4(4).
The Chair: I also have a Liberal motion 20.4(3) and (6).
Mrs Fawcett: Is that included in what the government read or is that different?
The Chair: Does that relate to the government motion? Perhaps Mr Wessenger and Mr Wilson could --
Mrs Fawcett: I don't have a copy of the government motion, unfortunately.
The Chair: I think perhaps we'd better read it in and then we'll deal with that.
Mrs Fawcett: I move that subsections 20.4(3) and (6) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out. And defer.
The Chair: That would be deferred.
Mr Wessenger: I think it may be covered, but we can deal with that later.
The Chair: Then we are at government motion 20.4(5.1) to (5.4).
Mr Wessenger: I move that section 20.4 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsections after subsection (5):
"Evidence of disabled person
"(5.1) If a party to a proceeding before the appeal board under this act wishes to give evidence in the proceeding or wishes to call another person as a witness to give evidence in the proceeding but the party or other person is unable to attend the hearing by reason of age, infirmity or physical disability, the appeal board members holding the hearing may, at the request of the party, attend upon the party or the other person, as the case may be, and take his or her evidence.
"Medical report proves inability
"(5.2) A medical report signed by a legally qualified medical practitioner stating that the practitioner believes that the person is unable to attend the hearing by reason of age, infirmity or physical disability is proof, in the absence of evidence to the contrary, of the inability of the person to attend the hearing.
"Opportunity for all parties
"(5.3) No appeal board member shall take evidence from a party or other person under subsection (5.1) unless reasonable notice of the time and place for taking the evidence is given to all parties to the proceeding and each party attending is given an opportunity to examine or cross-examine the party or other person, as the case may be.
"Recording of evidence
"(5.4) The oral evidence taken before the appeal board at a hearing and the oral evidence taken from a party or other person under subsection (5.1) shall be recorded and, if required, copies of a transcript of the evidence shall be furnished on the same terms as in the Ontario Court (General Division)."
Vote deferred.
The Chair: Deferred.
Then the government motion 20.4(6).
Mr Wessenger: I move that subsection 20.4(6) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Health Insurance Act
"(6) Subsections 23(1), (2), (4), (5) and (6) of the Health Insurance Act apply to the proceedings and decisions of the appeal board under this act."
The Chair: That will also be deferred. We then have Conservative motions.
Mr Jim Wilson: Both Conservative motions dealing with subsection 20.4(7) will not be introduced. Since the government hasn't agreed to previous amendments, these would no longer make sense.
The Chair: Thank you, Mr Wilson. So those two motions are not moved. Then we go to government motion 20.4(7.1).
Mr Wessenger: I move that section 20.4 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsection after subsection (7):
"Decision and reasons
"(7.1) The appeal board shall render its decision within one day after the end of the hearing and shall provide written reasons to the parties within seven days after rendering the decision."
Vote deferred.
The Chair: Deferred. Mr Wilson, 20.4.1.
Mr Jim Wilson: Again, Mr Chairman, this amendment wouldn't make sense in light of previous amendments having been voted down, so I will not introduce it.
The Chair: This is not being moved. You have a subsequent amendment 20.6(3) to (5).
Mr Jim Wilson: I'm in the process of determining whether that still makes sense, Mr Chairman.
The Chair: We can pause a while.
Mr Jim Wilson: It really doesn't, so it won't be introduced.
The Chair: Not moved. This takes us to government motion 20.8.
Mr Wessenger: I move that section 20.8 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by striking out "and" at the end of clause (c) and by adding the following clause after clause (c):
"(c.1) an opportunity to participate fully in the development and revision of the resident's plan of care is provided to the resident, to the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident's personal care and to such other person as they may direct;"
The Chair: We'll defer that.
Then Liberal amendment 20.8(d).
Mrs Fawcett: I move that clause 20.8(d) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out.
The Chair: There are three amendments, two that follow on the same section, Ms Fawcett.
Mr Wessenger: If I might assist Ms Fawcett --
Mrs Fawcett: All right, would you please.
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Mr Wessenger: The ones previous: One was withdrawn. That was the one relating to the second, which was four lines, and the one moved by Miss Sullivan was the one with five lines, so I suggest you might not move the --
The Chair: So the one that was just moved.
Mr Wessenger: Yes.
The Chair: Okay. The second one was withdrawn --
Mr Wessenger: Yes.
The Chair: -- and the third one was moved, or not moved.
Mr Wessenger: The third one was moved, the second one was not moved.
The Chair: Right.
Mrs Fawcett: The second one was not moved.
The Chair: But the third one, with the five lines -- if you would move that.
Mrs Fawcett: I move that clause 20.8(d) of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"(d) the care outlined in the plan of care, for which the licensee is responsible for providing under the service agreement or a contract between the licensee and the resident, and for which the licensee has been compensated, is provided to the resident."
Mr Jim Wilson: Mr Chairman, the first Liberal clause 20.8(d), was that withdrawn? That's the one to strike out the clause.
The Chair: Yes.
Mr Jim Wilson: Right, it's redundant. It was dropped.
Mrs Fawcett: What would I do, just withdraw it?
The Chair: Yes, if you want to withdraw it.
Mrs Fawcett: I withdraw it now that I see what it's --
The Chair: Okay, so the first one is withdrawn; the second one not moved; the third one has been presented. The Chair appreciates the advice and cooperation of members and please feel free to continue.
Subsections 20.8(2) and (3), that's a Liberal amendment.
Mrs Fawcett: I move that section 20.8 of the Nursing Homes Act, as set out in section 28 of the bill, be amended by adding the following subsections:
"Resident's participation in developing plan
"(2) A plan of care for a resident shall not be developed or revised without the participation of the resident or another person authorized to act on the resident's behalf.
"Resident's consent in implementing plan
"(3) A plan of care for a resident shall not be implemented without the consent of the resident or another person authorized to consent on the resident's behalf."
Mr Wessenger: That is partially covered.
Mrs Fawcett: That is partially covered. As I was reading it, I realized that.
The Chair: We'll defer on that one.
Mr Hope: Just before you move on, there were two 20.8(d)s for the Liberals and was there one that -- both of them got deferred over --
The Chair: There were three of them: the first one withdrawn, the second one not moved and the third one is moved.
Mr Hope: It's deferred, okay.
The Chair: It'll be deferred. Then the one we just did is deferred and then we go to section 20.8.1, which is the one entitled "Immunity for employees." Do you have that, section 20.8.1?
Mrs Fawcett: Section 20.8.1, right.
I move that section 28 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.8:
"Immunity for employees
"20.8.1 No proceeding for damages shall be commenced against an employee of a nursing home for any act done in good faith in the performance or intended performance of the person's duty or for any alleged neglect or default in the performance in good faith of the person's duty."
The Chair: That will be deferred and we then go to section 20.9.
Mr Wessenger: I move that section 20.9 of the Nursing --
The Chair: Sorry, it's a Liberal --
Mr Wessenger: There are two motions.
The Chair: I think yours is -- oh, I'm sorry. I don't show it on my list.
Mrs Fawcett: There is a government 20.9 and then the Liberal 20.9.
The Chair: Okay. Let's do the government one first and then we'll do the Liberal one.
Mr Wessenger: They may wish to withdraw it.
The Chair: It gives Miss Fawcett a break.
Mr Wessenger: I move that section 20.9 of the Nursing Homes Act, as set out in section 28 of the bill, be struck out and the following substituted:
"Quality management
"20.9 A licensee of a nursing home shall ensure that a quality management system is developed and implemented for monitoring, evaluating and improving the quality of the accommodation, care, services, programs and goods provided to the residents of the nursing home."
The Chair: That will be deferred. Now, if we go back to the Liberal motion --
Mrs Fawcett: It appears to be covered in the government motion. I'm glad the government took our advice.
The Chair: So the Liberal 20.9 is not moved and we go to the Conservative amendment.
Mr Jim Wilson: Mr Chairman, given that the government did indeed take the opposition's advice with regard to quality management, it's not necessary to introduce this amendment.
The Chair: Okay, it's not moved.
Mr Wilson, 20.9(2).
Mr Jim Wilson : C'est la même chose, Monsieur.
The Chair: Merci beaucoup. Not moved.
Conservative amendment, 20.10.
Mr Jim Wilson: I won't be moving that amendment, Mr Chairman. I'll be defeated on that one.
The Chair: Not moved.
That completes all of the parts of section 28, so we will come back on the deferred votes as well as having to deal with this section in its entirety.
We'll now go on to section 29, beginning with Mrs Fawcett. Section 29, 20.11(1.1), if that is handy.
Mrs Fawcett: I move that section 20.11 of the Nursing Homes Act, as set out in section 29 of the bill, be amended by adding the following subsection:
"Payments must be sufficient
"(1.1) The payments under subsection (1) must be in such amounts that the payments, together with any amounts for which residents are responsible, are sufficient to defray all the costs described in subsection (1)."
The Chair: Mrs Fawcett, I regret, but that is out of order under section 56 of the standing orders.
Mrs Fawcett: A pity, Mr Chairman.
The Chair: We move to the next Liberal amendment, which is 20.11(2).
Mrs Fawcett: I move that subsection 20.11(2) of the Nursing Homes Act, as set out in section 29 of the bill, be struck out and the following substituted:
"Service agreement
"(2) No payment shall be made under subsection (1) unless,
"(a) the licensee receiving the payment is a party to a service agreement with the crown in right of Ontario that relates to the nursing home; and
"(b) the service agreement complies with this act and the regulations."
The Chair: And that will be deferred.
Government amendment, Mr Wessenger.
Mr Wessenger: I move that subsection 20.11(3) of the Nursing Homes Act, as set out in section 29 of the bill, be amended by striking out "is in breach of his, her or its" in the second and third lines and substituting "has breached the".
Mr Jim Wilson: Mr Chairman, we'll be opposing this amendment when the time comes to vote.
The Chair: You have the next amendment, Mr Wilson, 20.11.1 and 20.11.2.
Mr Jim Wilson: With the committee's indulgence, I'd like to proceed with this amendment.
I move that section 29 of the bill be amended by adding the following sections to the Nursing Homes Act, after section 20.11:
"Notice before reduction or withholding
"20.11.1(1) Before reducing or withholding a payment to a licensee under subsection 20.11(3), the minister shall serve on the licensee a notice setting out
"(a) the minister's proposal to reduce or withhold a payment under subsection 20.11(3);
"(b) the proposed amount of the reduction or the amount proposed to be withheld, as the case may be;
"(c) the breach or breaches of the service agreement on which the minister relies for reducing or withholding payment;
"(d) the requirements set out in subsection (4) for entitlement to a hearing by the appeal board;
"(e) the minister's power under subsection (5) to carry out the proposal; and
"(f) the requirements set out in subsection (6) for obtaining an extension of the time for giving a notice requiring a hearing.
"Service of notice
"(2) A notice under subsection (1) may be served personally or by registered mail addressed to the licensee at the licensee's most recent address known to the minister.
"Deemed time of service
"(3) If the notice is served by registered mail, the service shall be deemed to have been made on the seventh day after the day of mailing.
"Entitlement to a hearing
"(4) A licensee who is served with a notice under subsection (1) is entitled to a hearing by the appeal board if the licensee mails or delivers to the minister and to the appeal board, within 30 days after being served, a notice requiring a hearing by the appeal board.
"Minister may carry out proposal
"(5) If the licensee does not require a hearing in accordance with subsection (4), the minister may carry out the proposal described in the notice served under subsection (1).
"Extension of time
"(6) The licensee may apply to the appeal board for an extension of the time for giving a notice requiring a hearing, either before or after the time expires, and the appeal board
"(a) may extend the time for giving the notice if it is satisfied that there are reasonable grounds for applying for the extension; and
"(b) may give such directions as it considers proper in light of the extension.
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"Hearing
"(7) If the licensee requires a hearing in accordance with this section, the appeal board shall appoint a time and place for and shall hold a hearing.
"Same
"(8) The time appointed by the appeal board for a hearing must be within ninety days after the day the appeal board received the notice requiring the hearing.
"Parties
"(9) The parties to a proceeding before the appeal board under this section are the licensee, the minister and such other persons as the appeal board specifies.
"Proceedings
"(10) Subsections 20.4(3), (5) and (6) apply to the proceedings and decisions of the appeal board under this section.
"Powers of appeal board
"(11) After a hearing by the appeal board under this section, the appeal board,
"(a) may, if the minister has not yet carried out the proposal described in the notice served under subsection (1),
"(i) allow the minister to carry out the proposal;
"(ii) direct the minister to refrain from carrying out the proposal; or
"(iii) find that an amount lower than that specified in the proposal is reasonable in the circumstances and allow the minister to make a reduction or withholding under subsection 20.11(3) in such lower amount;
"(b) may, if the minister has carried out the proposal under subsection (5),
"(i) find that the proposal was reasonable in the circumstances;
"(ii) direct the minister to pay to the licensee the amount of the reduction or the amount withheld, as the case may be; or
"(iii) find that an amount lower than that specified in the proposal was reasonable in the circumstances and direct the minister to pay to the licensee the difference between the amount specified in the proposal and the amount that the appeal board found was reasonable;
"(c) may substitute its opinion for that of the minister; and
"(d) may make such other order as it considers just.
"Powers of court on appeal
"20.11.2 On an appeal to the Divisional Court from a decision of the appeal board under section 20.11.1, the Divisional Court,
"(a) may affirm or rescind the decision of the appeal board;
"(b) may substitute its opinion for that of the minister or the appeal board; and
"(c) may exercise all the powers of the appeal board."
My previous comments stand with respect to this issue.
The Chair: We'll defer that. Ms Fawcett, 20.12.1.
Mrs Fawcett: Federal funding for veterans: I believe that has been covered.
The Chair: This motion in and of itself would be out of order.
Mrs Fawcett: We certainly realize it's a very important part that should be included.
The Chair: And it has been. Then Conservative motion 20.13(1)(a).
Mr Jim Wilson: I move that clause 20.13.(1)(a) of the Nursing Homes Act, as set out in section 29 of the bill, be struck out and the following substituted:
"(a) shall provide that it continues in full force and effect until replaced or cancelled in accordance with the regulations;
"(a.1) shall contain a dispute resolution mechanism for resolving disputes related to the service agreement;
"(a.2) shall provide for a right to arbitration if the dispute resolution mechanism fails to resolve a dispute;
"(a.3) shall contain the other provisions required by the regulations to be contained in a service agreement."
The Chair: That'll be deferred. Next, 20.13(1)(c), which is also yours, Mr Wilson.
Mr Jim Wilson: I move that clause 20.13.(1)(c) of the Nursing Homes Act, as set out in section 29 of the bill, be amended by adding after "(a)" in the last line, "(a.1), (a.2) or (a.3)".
The Chair: Deferred. A Liberal amendment 20.13.1, term of service agreement.
Mrs Fawcett: I move that section 29 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.13:
"Term of service agreement
"20.13.1(1) Each service agreement shall be for a one year term.
"If no new service agreement
"(2) If a new service agreement is not entered into before the expiry of the current service agreement the following provisions apply:
"1. Despite subsection (1), the current service agreement continues in force until a new service agreement is entered into or until the current service agreement is terminated.
"2. Any new service agreement that is entered into shall be deemed to have been in force since the current service agreement would have, but for paragraph 1, ceased to be in force.
"3. Interest shall be paid on all unpaid amounts that, under the new service agreement, should have been paid during the time the new service agreement is deemed to have been in force."
The Chair: Mrs Fawcett, I'll have to rule this motion out of order under section 56, the third clause, dealing with payments.
Mrs Fawcett: Thank you, Mr Chairman. It is a pity.
The Chair: So the Liberal motion, section 20.13.1, is out of order. We then move to the Conservative motion, section 20.13.1.
Mr Jim Wilson: I move that section 29 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.13:
"Arbitration
"20.13.1(1) This section applies with respect to arbitrations under a service agreement.
"Notice
"(2) An arbitration is commenced by a party to a service agreement giving written notice to the other party of its desire to arbitrate a dispute related to the service agreement.
"Appointment of board of arbitration
"(3) Within fourteen days of the written notice having been given, the parties,
"(a) shall jointly appoint a member of the appeal board to sit as a board of arbitration; or
"(b) shall each appoint a person to sit on the board of arbitration.
"Same
"(4) If the parties each appoint a person to sit on the board of arbitration, the two persons so selected shall, within ten days after the second of the persons has been appointed, appoint a member of the appeal board.
"Powers of the board of arbitration
"(5) The board of arbitration shall hold a hearing to examine and decide the matters that are in dispute between the parties.
"Service agreements
"(6) Any decision of the board of arbitration shall form part of the service agreement.
"Costs
"(7) The board of arbitration may award costs.
"Appeal to Divisional Court
"(8) A party may appeal a decision of the board of arbitration to the Divisional Court on a question of law or fact or both.
"Powers of court on appeal
"(9) On an appeal to the Divisional Court from a decision of the board of arbitration under this section, the Divisional Court may do any one or more of the following:
"1. Affirm or rescind the decision of the board of arbitration.
"2. Substitute its opinion for that of the board of arbitration.
"3. Exercise any power of the board of arbitration."
The Chair: We will defer that.
Liberal amendment, section 20.13.2.
Mrs Fawcett: I move that section 29 of the bill be amended by adding the following section to the Nursing Homes Act after section 20.13.1:
"Arbitration where failure to negotiate service agreements
"20.13.2(1) A licensee of a nursing home may require an arbitration by the appeal board by giving notice in accordance with subsection (2) if there has been a failure to successfully negotiate,
"(a) an initial service agreement;
"(b) a subsequent service agreement; or
"(c) amendments to a service agreement in response to changing circumstances.
"Notice requiring arbitration
"(2) To require an arbitration, a notice requiring an arbitration must be mailed or delivered to the minister and to the appeal board.
"Arbitration
"(3) If the appeal board receives a notice under subsection (2), the appeal board shall arbitrate the matter in dispute.
"Parties
"(4) The parties to an arbitration are the person requiring the arbitration and the minister.
"Applicable provisions
"(5) Subsections 14(3) and 20.4(5) apply, with necessary modifications, with respect to an arbitration.
"Powers of appeal board
"(6) In arbitrating the matters in dispute, the appeal board may order the minister,
"(a) to sign on behalf of the crown in right of Ontario a service agreement with such terms as the appeal board specifies; or
"(b) to sign on behalf of the crown in right of Ontario an agreement that amends an existing service agreement in such manner as the appeal board specifies."
The Chair: We'll defer the vote on that and go to the Conservative motion, clause 20.14(1)(a).
Mr Jim Wilson: I move that clause 20.14(1)(a) of the Nursing Homes Act, as set out in section 29 of the bill, be struck out and the following substituted:
"(a) the rights and obligations of the resident and of the licensee."
Again, this is just recognizing that the institutions have rights, as do residents.
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The Chair: Deferred, and then government motion 20.14.
Mr Wessenger: I move that section 20.14 of the Nursing Homes Act, as set out in section 29 of the bill, be struck out and the following substituted:
"Notice to residents
"20.14(1) A licensee of a nursing home shall give to each resident of the nursing home, to the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident's personal care and to such other person as they may direct, a written notice,
"(a) setting out the rights of the resident under subsection 2(2) and stating that the licensee is obliged to respect and promote those rights;
"(b) describing the accommodation, care, services, programs and goods that the licensee is required to provide or offer under this act and under the service agreement relating to the nursing home;
"(c) stating that the resident, the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident's personal care or such other person as they may direct may request access to and an explanation of the resident's plan of care, and specifying the person to whom such a request must be made;
"(d) setting out the procedures for making complaints about the maintenance or operation of the nursing home, the conduct of the staff of the nursing home or the treatment or care received by the resident in the nursing home; and
"(e) setting out such other matters as are prescribed by the regulations.
"Obligations re plan of care
"(2) If a request is made in accordance with clause (1)(c), the licensee shall ensure that access to and an explanation of the plan of care is provided to the person who made the request."
The Chair: That will be deferred. Government motion 20.15.
Mr Wessenger: I move that section 20.15 of the Nursing Homes Act, as set out in section 29 of the bill, be amended by:
(i) renumbering clause (a) as clause (a.1) and adding the following clause:
"(a) a copy of section 2;" and
(ii) adding the following clause after clause (a.1):
"(a.2) a copy of the most recent inspection report relating to the home received by the licensee under subsection 24(13)."
The Chair: That will be deferred. We have another government motion, 20.15(2).
Mr Wessenger: I move that subsection 20.15 of the Nursing Homes Act, as set out in section 29 of the bill, be amended by adding the following subsection:
"Exception
"(2) In posting anything under subsection (1), the licensee shall not disclose the salary of an individual."
The Chair: That will be deferred. Then a Liberal motion 20.15.
Mrs Fawcett: I move that section 20.15 of the Nursing Homes Act, as set out in section 29 of the bill, be struck out and the following substituted:
"Availability of information
"20.15 A licensee of a nursing home shall ensure that the following documents are made available in a prominent place in the home:
"1. A copy of the service agreement relating to the home.
"2. Copies of those financial statements, reports and returns filed with the minister that the regulations require to be made available.
"3. All other documents and information that the regulations require to be made available."
The Chair: That will be deferred. We then have a Conservative motion 20.15.
Mr Jim Wilson: I move that section 20.15 of the Nursing Homes Act, as set out in section 29 of the bill, be struck out and the following substituted:
"Having documents available
"20.15(1) A licensee of a nursing home shall ensure that the following documents are available for inspection in the home:
"1. A copy of the service agreement relating to the home.
"2. A copy of each of the financial statements, reports and returns that the licensee has filed with the minister under this act.
"3. All other documents that the regulations require the licensee to have available for inspection in the home.
"Notice to residents
"(2) The licensee shall post a notice in the home informing residents how they can inspect the documents referred to in subsection (1)."
The Chair: That will be deferred.
That completes the amendments in section 29. We will then, however, go on with section 30, because there are a couple under section 29 where there may be a recorded vote, so we'll continue with section 30. We have a series of government amendments we will deal with first. Mr Wessenger, I think there are four there, beginning with 21(1)(a).
Mr Wessenger: I move that clause 21(1)(a) of the Nursing Homes Act, as set out in section 30 of the bill, be amended by striking out "for basic accommodation" in the first line and substituting "for a class of basic accommodation."
The Chair: And 21(1)(e)?
Mr Wessenger: I move that clause 21(1)(e) of the Nursing Homes Act, as set out in section 30 of the bill, be struck out and the following substituted:
"(e) for care, services, programs or goods that are not mentioned in clause (a), (b), (c), (d) or (2)(a) and in respect of which the resident has entered into a written agreement with the licensee, the amount determined in accordance with the written agreement."
The Chair: Thank you. Deferred. Clause 21(2)(b).
Mr Wessenger: I move that clause 21(2)(b) of the Nursing Homes Act, as set out in section 30 of the bill, be amended by striking out "or on behalf of" in the fifth line.
The Chair: Thank you. Deferred. Government amendment 21.1.
Mr Wessenger: This will not be moved.
The Chair: Okay, not moved. Then we go to Liberal amendment under 30.1, 21.1. That's a new one.
Mrs Fawcett: I don't have any of those.
The Chair: Okay, that's 30.1.
Mrs Fawcett: I move that the bill be amended by adding the following section:
"30.1 The act is amended by adding the following section:
"Resident responsible for payments for accommodation
"21.1(1) A resident is responsible for the payment of those amounts demanded by a licensee for accommodation in accordance with section 21.
"Minister to give statements
"(2) The minister shall provide, annually and on the request of a resident, a statement setting out how much the resident may be charged for accommodation under subsection 21(1)."
The Chair: Thank you. I then have a Conservative motion to section 31 of the bill on section 22.
Mr Jim Wilson: I move that section 22 of the Nursing Homes Act, as set out in section 31 of the bill, be amended by adding the following subsection after subsection (1):
"No recovery of charge
"(1.1) No deduction shall be made under subsection (1) unless written notice about the fact that the item paid for has not been provided or made available to the resident is given to the minister within 90 days after the date on which the person from whom the licensee accepted payment discovers the fact."
The Chair: Thank you. That will be deferred. You have a further amendment to this section?
Mr Jim Wilson: I move that section 22 of the Nursing Homes Act, as set out in section 31 of the bill, be amended by adding the following subsection after subsection (2):
"No recovery of charge
"(2.1) No deduction shall be made under subsection (2) unless written notice about the fact that the payment exceeds the amount permitted to be charged under section 21 is given to the minister within ninety days after the date on which the person from whom the licensee accepted payment discovers the fact."
The Chair: Thank you. Vote deferred. A final amendment to 22.
Mr Jim Wilson: I move that section 22 of the Nursing Homes Act, as set out in section 31 of the bill, be amended by adding the following subsection after subsection (3):
"No recovery of charge
"(3.1) No deduction shall be made under subsection (3) unless written notice about the fact that the item paid for has been inadequately provided is given to the minister within ninety days after the date on which the person from whom the approved corporation accepted payment discovers the fact."
I wonder if the wording in the last -- not that it's going to matter. It says "approved corporation" where the prior ones talked about "licensee." I think it's a slip of drafting there. Perhaps with the committee's indulgence, we could just say --
Mr Wessenger: Yes, we could change that to "licensee."
The Chair: Sorry, could you just show again where that is?
Mr Jim Wilson: It's the last two lines, where it says, "approved corporation." It should say "the licensee." So strike "approved corporation."
The Chair: Okay, if that's clear. Thank you. We'll just do the final two amendments of this section, then we'll have a short pause so that we can all understand clearly what it is we're going to be voting on and then we will go forth. We have a Liberal amendment, 22.1.
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Mrs Fawcett: I move that section 31 of the bill be amended by adding the following section to the Nursing Homes Act after section 22:
"Restriction on reducing payments etc
"22.1 The minister may not reduce or withhold payments under section 20.11 or deduct an amount from a payment under section 22 if the reduction, withholding or deduction would put a resident's safety, health or security at risk or would cause any of the services or programs in a resident's plan of care to be interrupted."
The Chair: Thank you. Deferred. The final amendment under this section, Mr Wilson, is your amendment to sections 22.1 and 22.2.
Mr Jim Wilson: I move that section 31 of the bill be amended by adding the following sections to the Nursing Homes Act after section 22:
"Notice before deduction
"22.1(1) Before making a deduction under section 22, the minister shall serve on the licensee a notice setting out,
"(a) the minister's proposal to make a deduction under section 22;
"(b) the proposed amount of the deduction;
"(c) detailed reasons for making the deduction;
"(d) the requirements set out in subsection (4) for entitlement to a hearing by the appeal board;
"(e) the minister's power under subsection (5) to carry out the proposal; and
"(f) the requirements set out in subsection (6) for obtaining an extension of the time for giving a notice requiring a hearing.
"Service of notice
"(2) A notice under subsection (1) may be served personally or by registered mail addressed to the licensee at the licensee's most recent address known to the minister.
"Deemed time of service
"(3) If the notice is served by registered mail, the service shall be deemed to have been made on the seventh day after the day of mailing.
"Entitlement to a hearing
"(4) A licensee who is served with a notice under subsection (1) is entitled to a hearing by the appeal board if the licensee mails or delivers to the minister and to the appeal board, within thirty days after being served, a notice requiring a hearing by the appeal board.
"Minister may carry out proposal
"(5) If the licensee does not require a hearing in accordance with subsection (4), the minister may carry out the proposal described in the notice served under subsection (1).
"Extension of time
"(6) The licensee may apply to the appeal board for an extension of the time for giving a notice requiring a hearing, either before or after the time expires, and the appeal board,
"(a) may extend the time for giving the notice if it is satisfied that there are reasonable grounds for applying for the extension; and
"(b) may give such directions as it considers proper in light of the extension.
"Hearing
"(7) If the licensee requires a hearing in accordance with this section, the appeal board shall appoint a time and place for and shall hold a hearing.
"Same
"(8) The time appointed by the appeal board for a hearing must be within ninety days after the day the appeal board received the notice requiring the hearing.
"Parties
"(9) The parties to a proceeding before the appeal board under this section are,
"(a) the licensee;
"(b) the minister;
"(c) the person from whom the licensee accepted the payment; and
"(d) such other persons as the appeal board specifies.
"Proceedings
"(10) Subsections 20.4(3), (5) and (6) apply to the proceedings and decisions of the appeal board under this section.
"Powers of appeal board
"(11) After a hearing by the appeal board under this section, the appeal board,
"(a) may, if the minister has not yet carried out the proposal described in the notice served under subsection (1),
"(i) allow the minister to carry out the proposal;
"(ii) direct the minister to refrain from carrying out the proposal; or
"(iii) find that an amount lower than that specified in the proposal is reasonable in the circumstances and allow the minister to deduct such lower amount under section 22;
"(b) may, if the minister has carried out the proposal under subsection (5),
"(i) find that the proposal was reasonable in the circumstances;
"(ii) direct the minister to pay the amount deducted to the licensee; or
"(iii) find that an amount lower than that specified in the proposal was reasonable in the circumstances and direct the minister to pay to the licensee the difference between the amount specified in the proposal and the amount that the appeal board found was reasonable;
"(c) may substitute its opinion for that of the minister; and
"(d) may make such other order as it considers just.
"Powers of court on appeal
"22.2 On an appeal to the Divisional Court from a decision of the appeal board under section 22.1, the Divisional Court,
"(a) may affirm or rescind the decision of the appeal board;
"(b) may substitute its opinion for that of the minister or the appeal board; and
"(c) may exercise all the powers of the appeal board."
Just to add comment to that, it's again a very important amendment that I've put forward primarily on behalf of the Ontario Nursing Home Association. They believe deeply that notices should be served before deductions and that it should be required on behalf of the minister to do that, and secondly, that there should be proper appeal mechanisms in this legislation. So far, in our clause-by-clause deliberations, the government has refused to accept these suggestions.
The Chair: We will take a short recess of up to five minutes, just to order the votes on the deferred items.
The committee recessed at 1416 and resumed at 1426.
The Chair: We are now ready to deal with the deferred votes. Just to assist everyone, because there is a considerable number, I will read the section and note the party that moved the motion, and also the number.
The first one, then, section 28, a Liberal amendment, 20.1(8.2): Shall the motion carry? Defeated.
Section 28, Liberal motion 20.1(9.2): Shall the motion carry? Defeated.
Section 28, government motion 20.1.1. All in favour? Opposed? Passed.
Government motion, again, section 28, 20.1.2: Shall the motion carry? Agreed.
Government motion 20.2: Shall it carry? Carried.
Section 28, Liberal motion 20.2.1: Shall the motion carry? Defeated.
Shall government motion 20.3 carry? Carried.
Liberal motion 20.3(1), (2.1), (3), (4), (5), (7): Shall the motion carry? Defeated.
Conservative motion, section 28, 20.3.1: Shall the motion carry? Defeated.
Section 28, Liberal motion 20.3: Shall the motion carry? Defeated.
Section 28, Liberal motion 20.3.2 and 20.3.3: Shall the motion carry? Defeated.
Government motion 20.4(1) and (2): Shall the motion carry? Carried.
Government motion, again, section 28, 20.4(3): Shall the motion carry? Carried.
Government motion --
Mrs Sullivan: Recorded vote, please, on 20.4(3).
The Chair: Government motion 20.4(3) or -- sorry, it's just that there are two -- 20.4(4)?
Mrs Sullivan: No, 20.4(3).
The Chair: A recorded vote.
Mr Jim Wilson: We just did (3).
Mrs Sullivan: Yes, a government motion.
Ayes
Cooper, Hope, Jamison, O'Connor, Wessenger, Wilson (Simcoe West), Wiseman.
The Chair: The motion is carried.
Mr Jim Wilson: You'd better ask who doesn't like it.
The Chair: Oh, sorry. I'm getting ahead of myself. Those opposed?
Nays
Fawcett, O'Neill (Ottawa-Rideau), Sullivan.
The Chair: The motion is carried.
Government motion 20.4(4): Shall the motion carry? Carried.
Liberal motion 20.4(3) and (6): Shall the motion carry? Defeated.
Section 28, government motion 20.4(5.1) to (5.4): Shall the motion carry? Carried.
Government motion 20.4(6): Shall the motion carry? Carried.
Government motion 20.4(7.1): Shall the motion carry? Carried.
Government motion 20.8: Shall the motion carry? Carried.
Liberal motion 20.8(d): Shall the motion carry? Defeated.
Liberal motion 20.8(2) and (3): Shall the motion carry? Defeated.
Liberal motion 20.8.1 --
Mr Jim Wilson: A recorded vote.
The Chair: A recorded vote on the Liberal motion, 20.8.1.
All those in favour of the motion?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: All those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: The motion is defeated.
Section 28, government motion 20.9: Shall the motion carry? Carried.
Shall section 28, as amended, carry? Carried.
We then move on to section 29, Liberal motion 20.11(2): Shall the motion carry? Carried.
Government motion 20.11(3): Shall the motion carry? Carried.
Conservative motion 20.11.1 and 20.11.2 --
Interjection: A recorded vote.
The Chair: A request for a recorded vote. Shall the motion carry?
All those in favour?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: All those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: The motion is defeated.
Conservative amendment 20.13(1)(a): Shall the motion --
Mr Jim Wilson: A recorded vote.
The Chair: All those in favour?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: All those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: The motion is defeated.
20.13(1)(c): Shall the motion carry?
Mrs Sullivan: A recorded vote.
Mr Wessenger: No.
The Chair: Same vote?
Mr Wessenger: Same vote.
The Chair: Same vote. The motion is defeated -- and recorded.
The next is Conservative motion 20.13.1.
Mr Jim Wilson: A recorded vote.
The Chair: A recorded vote. Same vote?
Mr Wessenger: Same vote.
The Chair: Same vote. The motion is defeated.
The next is a Liberal amendment 20.13.2.
Mrs Sullivan: A recorded vote.
The Chair: A recorded vote is requested. Same vote?
Mr Wessenger: Yes.
Mrs Sullivan: Reversed.
The Chair: Same vote. The motion is defeated. Mrs Sullivan had a good lunch.
Conservative motion 20.14(1)(a): Shall the motion carry?
Mr Jim Wilson: I would like a recorded vote.
The Chair: Same vote? Okay, the motion is defeated.
Government motion 20.14: Shall the motion carry? Carried.
Government motion 20.15: Shall the motion carry? Carried.
Government motion 20.15(2): Shall the motion carry? Carried.
Liberal motion 20.15: Shall the motion carry? Defeated.
Sorry, I'm going a little quickly there.
Conservative motion 20.15 --
Mr Jim Wilson: A recorded vote.
The Chair: A recorded vote. Shall the motion carry?
All those in favour?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: All those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: The motion is defeated.
Shall section 29, as amended, carry? Carried.
Government motion 21(1)(e), shall the motion carry? Carried.
Government motion 21(2)(b), shall the motion carry? Carried.
Shall section 30, as amended, carry? Carried.
Section 30.1, Liberal amendment 21.1, shall the motion carry? Carried.
Mrs Sullivan: Mr Chairman, did we leave out one motion from section 30, a government motion to section 21.1?
The Chair: Not moved.
Mrs Sullivan: All right. Thanks.
The Chair: We have passed 21.1, so I would now ask, shall section 30.1 carry? Carried.
Section 31, Conservative amendment 22, shall the motion --
Mr Jim Wilson: Could I have a recorded vote on this and the following three, Mr Chairman?
The Chair: Okay. A recorded vote is requested. The amendment, section 22, Mr Wilson, all those in favour?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: Those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: The motion is defeated.
Another Conservative amendment 22, same vote?
Interjections: Same vote.
The Chair: The third Conservative amendment to section 22, same vote?
Interjections: Same vote.
The Chair: Liberal amendment 22.1, shall the motion carry?
Interjections: No.
The Chair: Okay, defeated.
Conservative motion 22.1 and 22.2, recorded vote. All those in favour?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: Those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: The motion is defeated.
Mr Jim Wilson: We also stood down the substitute decisions stuff.
The Chair: Yes, correct. I'll just find that. That is section 37.1 of the bill, and it was a government amendment to section 39.
Mrs Sullivan: Recorded vote.
The Chair: Shall the motion carry? Those in favour?
Ayes
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: Those opposed?
Nays
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: The motion is carried.
Shall section 37.1 carry? Carried.
I didn't put the vote on section 31. Shall section 31 carry? Carried.
We'll then move on to section 32, and I have a government motion 24(1). Mr Wessenger.
Mr Wessenger: I move that the definition of "record" in subsection 24(1) of the Nursing Homes Act, as set out in section 32 of the bill, be amended by adding, after "form" in the last line, "but does not include that part of a record that deals with quality management activities or quality improvement activities."
The Chair: Shall the motion carry? Carried.
Government motion 24(2)(b), Mr Wessenger.
Mr Wessenger: I move that clause 24(2)(b) of the Nursing Homes Act, as set out in section 32 of the bill, be struck out and the following substituted:
"(b) may, if he or she has reasonable grounds to believe that records or other things pertaining to a nursing home are kept in a place that is not in the home, enter the place at all reasonable times in order to inspect such records and other things."
The Chair: Shall the motion carry? Carried.
Liberal amendment 24(2)(b), Ms Sullivan.
Mrs Sullivan: I won't be putting that amendment, Mr Chairman.
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The Chair: A second Liberal motion to the same --
Mrs Sullivan: I won't be moving that amendment.
The Chair: Not moved, and a further Liberal motion to 24(2.1).
Mrs Sullivan: I am not moving that amendment.
The Chair: That is not moved. A Conservative motion to 24(2) and (3).
Mr Jim Wilson: I move that subsections 24(2) and (3) of the Nursing Homes Act, as set out in section 32 of the bill, be struck out and the following substituted:
"Inspection
"(2) An inspector may at all reasonable times enter and inspect a nursing home, for the purpose of determining whether there is compliance with this act, the regulations, a licence or a service agreement."
The Chair: Shall the motion carry? All those in favour? Opposed? Defeated.
We then go to another Conservative motion, 24(4.1).
Mr Jim Wilson: I move that section 24 of the Nursing Homes Act, as set out in section 32 of the bill, be amended by adding the following subsection:
"Limitation on inspectors' powers
"(4.1) Subsection (4) does not give an inspector the authority to conduct an examination or test on an individual."
This is simply an attempt to clear up the terminology, particularly "examination," to ensure that inspectors are not in any way conducting medical examinations or tests.
Mrs Sullivan: Recorded vote, please.
The Chair: A recorded vote is requested. Shall the motion carry? All those in favour?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: Those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: It is defeated.
Liberal amendment 24(4.1), (4.2) and (4.3).
Mrs Sullivan: I move that section 24 of the Nursing Homes Act, as set out in section 32 of the bill, be amended by adding the following subsections:
"Exception, solicitor-client privilege
"(4.1) Subsection (4) does not override any solicitor-client privilege to which a record is subject.
"Exception, law enforcement
"(4.2) An inspector is not entitled to have access to a record or part of a record whose disclosure could reasonably be expected to produce one of the results described in subsection 14(1) of the Freedom of Information and Protection of Privacy Act (law enforcement).
"Exception, personnel records, quality review, etc.
"(4.3) An inspector is not entitled to have access to a personnel record or to a record or part of a record dealing with,
"(a) quality review activities;
"(b) peer review or performance review activities; or
"(c) quality improvement activities."
The Chair: Shall the motion carry? Defeated.
Conservative amendment 24(11).
Mr Jim Wilson: I move that subsection 24(11) of the Nursing Homes Act, as set out in section 32 of the bill, be amended by inserting after "at the inspector's request" in the fourth and fifth lines, "and at a time that is mutually agreed upon".
The Chair: Shall the Conservative motion carry? All those in favour? Opposed? Defeated.
Another Conservative amendment, 24(11.1).
Mr Jim Wilson: I move that section 24 of the Nursing Homes Act, as set out in section 32 of the bill, be amended by adding the following subsection after subsection (11):
"Reimbursement of expenses
"(11.1) The minister shall reimburse the licensee of a nursing home for all extraordinary expenses incurred in the preparation, production and interpretation of records of the home for an inspector."
The Chair: That is out of order under section 56 of the standing orders.
Government amendment 24(13).
Mr Wessenger: I move that section 24 of the Nursing Homes Act, as set out in section 32 of the bill, be amended by adding the following subsection:
"Inspection report
"(13) Upon completing an inspection under this section, an inspector shall prepare an inspection report and shall give a copy of the report to the licensee of the nursing home."
The Chair: Shall the government motion carry? Carried.
Conservative motion 24(13).
Mr Jim Wilson: This is a much better motion, dealing with the same subject.
I move that section 24 of the Nursing Homes Act, as set out in section 32 of the bill, be amended by adding the following subsection:
"Inspection report
"(13) Within thirty days of completing an inspection under this section, an inspector shall submit a full report of all findings, conclusions and recommendations to the administrator of the nursing home."
The Chair: Shall Mr Wilson's motion carry? All in favour? Opposed? Defeated.
Government motion 24.0.1, Mr Wessenger.
Mr Wessenger: I move that section 32 of the bill be amended by adding the following section to the Nursing Homes Act after section 24:
"Warrant
"24.0.1(1) A justice of the peace may issue a warrant authorizing an inspector named in the warrant to enter premises specified in the warrant and to exercise any of the powers mentioned in subsection 24(4), if the justice of the peace is satisfied on information under oath that,
"(a) the inspector has been prevented from exercising a right of entry to the premises under subsection 24(2) or has been prevented from exercising a power under subsection 24(4); or
"(b) there are reasonable grounds to believe that the inspector will be prevented from exercising a right of entry to the premises under subsection 24(2) or will be prevented from exercising a power under subsection 24(4).
"Expiry of warrant
"(2) A warrant issued under this section shall name a date on which it expires, which date shall not be later than thirty days after the warrant is issued.
"Extension of time
"(3) A justice of the peace may extend the date on which a warrant issued under this section expires for an additional period of no more than thirty days, upon application without notice by the inspector named in the warrant.
"Use of force
"(4) An inspector named in a warrant issued under this section may use whatever force is necessary to execute the warrant and may call upon a police officer for assistance in executing the warrant.
"Time of execution
"(5) A warrant issued under this section may be executed only between 8 am and 8 pm, unless the warrant specifies otherwise.
"Other matters
"(6) Subsections 23(2) and 24(5) to (13) apply with necessary modifications to an inspector executing a warrant issued under this section."
Mrs O'Neill: Is there enough detail in this particular amendment or does the government foresee detailed regulations going together with this?
Mr Wessenger: We don't make regulations about warrants.
Mrs O'Neill: Why I'm asking that question is -- you may not make regulations about warrants, and I understand that, but how the warrant, when, all of these things are part of this. I am still very concerned that a good precedent be established and that there be good reasons for this very, very threatening, jackboot kind of operation.
I'm still having difficulty with it and I think the nursing homes are going to have difficulty with it as are the other two kinds of facilities we've dealt with.
Mr Wessenger: I might just indicate that this was prepared at the request of the Ontario Medical Association. They wanted to have a warrant as evidence if someone comes into their office, so this was done.
Mrs O'Neill: This is much broader than doctors' offices, folks. I'm sorry.
Mrs Sullivan: That's right. It's quite different from what the Ontario Medical Association requested. The OMA certainly did not request the inclusion of the use of "whatever force is necessary" powers given to the inspector. The OMA has been quite satisfied with what's included in our amendment, which says that the inspector may call on a police officer for assistance in execution.
The Chair: Shall the government motion carry?
Mrs O'Neill: Recorded vote, please.
The Chair: Recorded vote?
Mrs O'Neill: Yes.
The Chair: All those in favour?
Ayes
Cooper, Hope, Jamison, O'Connor, Wessenger, Wilson (Simcoe West), Wiseman.
The Chair: Those opposed?
Nays
Fawcett, O'Neill (Ottawa-Rideau), Sullivan.
The Chair: Liberal amendment 24.1.
Mrs Sullivan: As a result of the passage of the last motion, I will not place this motion but I do want --
The Chair: It's 24.1.
Mrs Sullivan: It would be 24.0.1 renumbered. I do want to underline how strongly we object to the government's wording in its motion and how strongly we feel that appropriate wording is that of our motion, which says that the inspector may call on a police officer for assistance and doesn't provide the inspector with additional powers to pull a gun or whatever else is seen to be additional use of force.
The Chair: So that motion is not moved.
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Mr Jim Wilson: May I express my disappointment that Mrs Sullivan didn't put forward the Liberal motion she feels so strongly about. I was looking forward to a recorded vote in which I could vote against it.
Also, being as polite as possible, I don't think the public should be scared by the wording of the government's motion. It's quite a normal wording. It only makes sense that if inspectors are to carry out the object of the warrant, they need to use force. Perhaps it is the wording, when it says "use of force" and "may use whatever force is necessary," that scares people. Let's just reassure the public that there's nothing terribly unusual about this provision.
The Chair: I think the points have been made.
Mrs O'Neill: I doubt somehow that it will be implemented.
Mr Jim Wilson: Inspectors don't have guns, Mr Chairman.
Mrs Sullivan: I just wanted to point out one more thing and then I will not refer to this again.
The Chair: One last comment.
Mrs Sullivan: The very last bill that used a warrant as part of the drafting of the legislation included the wording of my amendment and not that of the government amendment. In fact the government amendment wording is the unusual wording. That's the last word on the issue.
Mr Jim Wilson: How is that bill now?
The Chair: We now move to a government amendment, section 24.2.
Mr Wessenger: I move that section 32 of the bill be amended by adding the following section to the Nursing Homes Act after section 24.1:
"Protection from reprisals
"24.2(1) No person shall do anything or refrain from doing anything in retaliation for another person making a disclosure to an inspector so long as the disclosure was made in good faith.
"No interference
"(2) No person shall seek by any means to compel another person to refrain from making a disclosure to an inspector."
The Chair: Shall the government motion carry? Carried.
Shall section 32, as amended, carry? Carried.
Shall section 33, as in the bill, carry? Carried.
We now move to section 34, a government amendment, sections 29 to 33.
Mr Wessenger: I move that section 34 of the bill be struck out and the following substituted:
"34. Sections 29 to 33 of the act are repealed and the following substituted:
"Residents' council
"29(1) If a request for the establishment of a residents' council is made to the administrator of a nursing home by at least three persons, each of whom is a person mentioned in subsection (2),
"(a) the administrator shall promptly notify the director and the licensee of the nursing home of the request; and
"(b) the licensee shall assist the persons who made the request in establishing a residents' council for the nursing home within sixty days of the request.
"Request for residents' council
"(2) For the purpose of subsection (1), the following persons may request the establishment of a residents' council for a nursing home:
"1. A resident of the nursing home.
"2. A person who is lawfully authorized to make a decision on behalf of a resident of the nursing home concerning the resident's personal care.
"Right to be a member
"(3) Subject to subsection (4), the following persons are entitled to be members of the residents' council of a nursing home:
"1. A resident of the nursing home.
"2. A person who is lawfully authorized to make a decision on behalf of a resident of the nursing home concerning the resident's personal care.
"3. A person selected by the resident or by the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident's personal care.
"Who may not be a member
"(4) The following persons may not be members of the residents' council of a nursing home:
"1. The licensee of the nursing home.
"2. An officer or director of the licensee.
"3. A person with a controlling interest in the licensee.
"4. The administrator of the nursing home.
"5. Any other member of the staff of the nursing home.
"Appointment by minister
"(5) At the request of a residents' council, the minister may appoint no more than three persons to be members of the residents' council, and those persons shall serve as members at the pleasure of the residents' council.
"Same
"(6) Only a person who lives in the area in which the nursing home is located and who is not employed by and does not have a contractual relationship with the ministry may be appointed under subsection (5).
"Meeting
"29.1(1) Unless a nursing home has a residents' council, the licensee of the nursing home shall, at least once in each year, convene a meeting of the residents of the nursing home and the persons who are lawfully authorized to make a decision on behalf of a resident concerning the resident's personal care, to advise them of their right to establish a residents' council.
"Results of meeting
"(2) Within thirty days after the meeting, the licensee shall notify the director of the results of the meeting.
"Powers of residents' council
"30. It is the function of a residents' council of a nursing home, and the council has the power, to,
"(a) advise residents of the nursing home respecting their rights and obligations under the act;
"(b) advise residents of the nursing home respecting the rights and obligations of the licensee of the nursing home under this act and under the service agreement relating to the nursing home;
"(c) meet regularly with the licensee or, if the licensee is a corporation, with representatives of the licensee, to,
"(i) review inspection reports relating to the nursing home received by the licensee under subsection 24(13),
"(ii) review the allocation of money for accommodation, care, services, programs and goods provided in the nursing home,
"(iii) review the financial statements relating to the nursing home filed with the minister under the regulations, and
"(iv) review the operation of the nursing home;
"(d) attempt to mediate and resolve a dispute between the licensee and a resident of the nursing home; and
"(e) report to the minister any concerns and recommendations that in its opinion ought to be brought to the minister's attention.
"Residents' council assistant
"31(1) With the consent of a residents' council, the minister may appoint a residents' council assistant to assist the residents' council in carrying out its responsibilities.
"Duties
"(2) In carrying out his or her duties, a residents' council assistant shall take instructions from and report to the residents' council.
"Information and assistance
"32(1) A licensee of a nursing home shall cooperate with the residents' council and the residents' council assistant and shall provide them with such financial and other information and such assistance as is required by the regulations.
"Obstruction
"(2) No person shall refuse entry to a nursing home to a residents' council assistant or otherwise hinder, obstruct or interfere with a residents' council assistant carrying out his or her duties.
"Immunity
"33. No proceeding shall be commenced against a member of a residents' council or a residents' council assistant for any act done under section 30, unless the act is done maliciously or without reasonable grounds."
The Chair: Thank you.
Mr Jim Wilson: I would like to comment on this because I know much of this is currently in the act when it comes to residents' councils, and I am supportive of residents' councils. But I just wonder -- and I appreciate the parliamentary assistant's comments -- with respect to the fact that now that the Advocacy Act is in, and advocates will be in these nursing homes whenever the act comes into effect and is up and running, I'm worried that the voices of residents themselves will be drowned out by advocates, the power of the minister to appoint people to these residents' councils.
It seems there will be a lot more professionals around giving their advice on what's good for the residents than the residents themselves. I'm just wondering, since much of it is supposed to be in practice now, but we've not had the experience of advocates in the homes, as under the Advocacy Act, has the government really thought this through?
Secondly, I want to raise the question of costs. As I understand it, the onus is placed on the home for the cost of these councils. Now councils in and of themselves don't cost that much, but I suppose you now have a residents' council assistant. Was there discussion with homes in this respect in terms of what costs might be incurred?
I think there's a lot of worry out there that services are being cut, and we don't want to download any more costs on to the backs of nursing homes or homes for the aged or charitable homes if we can avoid it. Basically I appreciate his comments because I know the amendment will go forward, but I just wonder if the government has thought it through in light of the new experience out there.
Mr Wessenger: First of all, with respect to the appointment of a residents' council assistant, it is with the residents' council; it's not something that's done unilaterally. With respect to the additional persons being appointed, again it's at the request of the residents' council. So these are only done at the residents' council's request.
Mr Jim Wilson: It also says in that section that they serve "at the pleasure." That means that at any time the residents' council could vote to dismiss them?
Mr Wessenger: Yes.
Mr Jim Wilson: Okay, I just wanted to be clear on that.
The Chair: Thank you. Shall the motion carry? Carried. Shall section 34, as amended, carry? Carried.
Shall section 35, as in the bill, carry? Carried.
Then we move to section 36 and two government amendments.
Mr Wessenger: I move that section 36 of the Nursing Homes Act, as set out in section 36 of the bill, be amended by striking out "20.1(7), (8) and (10), section 20.3 and subsections 20.4(8) and 20.6(5)" in the fourth and fifth lines and substituting "20.1(7), (8), (8.1), (8.2), (8.3), (8.3.1), (8.4), (8.7) and (10), section 20.1.1 and subsections 20.3(1), 20.4(2.3) and (8) and 20.6(5)."
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The Chair: Shall the government motion carry? Carried.
There is just the one amendment to 36, am I right?
Mr Wessenger: Yes.
The Chair: Shall section 36 then, as amended, carry? Carried.
Shall section 37, as in the --
Mr Wessenger: No, we have amendments to 37.
The Chair: We move then to subsection 37(1), a government amendment.
Mr Wessenger: I move that paragraph 1 of section 38 of the Nursing Homes Act, as set out in subsection 37(1) of the bill, be amended by striking out "and `short-stay accommodation"' in the third and fourth lines and substituting ", `short-stay program' and `veteran."'
It's a definition section.
The Chair: Shall the government motion carry? Carried.
Mr Jim Wilson: I will not be moving PC motion 37(1).
The Chair: Yes, 37(1). You're not --
Mr Jim Wilson: We're not moving it; it's not necessary.
The Chair: Not moved. Shall subsection 37(1), as amended, carry?
Mr Wessenger: The counsel seems to think there is another.
The Chair: There was another 36.
Mr Wessenger: That was the one we replaced. It's all right.
The Chair: We'll get our cylinders going again here. Did we just pass 37(1), as amended?
Mr Wessenger: Yes, as amended.
The Chair: Okay. Shall subsections 37(2) and (3), as in the bill, carry? Carried.
Then section 37(4), government amendment.
Mr Wessenger: I move that paragraph 5 of section 38 of the Nursing Homes Act, as set out in subsection 37(4) of the bill, be struck out and the following substituted:
"5. requiring that parts of the licensed bed capacity of nursing homes be set aside for various classes of accommodation, and regulating the amount of bed capacity that must be set aside for each class;"
Mr Jim Wilson: Mr Chairman, could I make a point on that since I think it's the last opportunity to do so? I just want assurance from the parliamentary assistant that staff will provide us with the comprehensive briefing I requested the other day concerning the different rates, types of accommodation etc.
Mr Wessenger: I'm sure that your request has been noted.
The Chair: Thank you. Shall the government motion carry? Carried.
Shall subsection 37(4), as amended, carry? Carried.
Shall subsection 37(5), as in the bill, carry? Carried.
We move then to 37(6) and a Conservative amendment.
Mr Jim Wilson: It's really no longer relevant since the previous amendment didn't pass.
The Chair: Not moved. Shall subsection 37(6), as in the bill, carry? Carried.
Shall subsection 37(7), as in the bill, carry? Carried.
Subsection 37(8): I have a government amendment.
Mr Wessenger: I move that paragraph 19 of section 38 of the Nursing Homes Act, as set out in subsection 37(8) of the bill, be struck out and the following substituted:
"19. prescribing the maximum amounts or governing the manner of determining the maximum amounts that may be demanded or accepted from or on behalf of a resident under clauses 21(1)(a) and (b), prescribing the information or proof that is to be provided before a determination is made, requiring that the information provided for the purpose of a determination be provided under oath, and prescribing the persons or other entities who may make the determination;"
The Chair: Shall the government motion carry? Carried.
Shall subsection 37(8), as amended, carry? Carried.
Shall subsection 37(9), as in the bill, carry? Carried.
Shall subsection 37(10), as in the bill, carry? Carried.
We then come to subsection 37(11), and the first amendment is a Conservative amendment. Mr Wilson.
Mr Jim Wilson: Just one moment, Mr Chairman. There is a government motion --
The Chair: There is a government motion --
Mr Jim Wilson: -- for a later paragraph.
The Chair: -- for a later paragraph.
Mr Jim Wilson: I move that paragraph 29 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out and the following substituted:
"29. governing applications to placement coordinators for a determination, including prescribing the placement coordinators to whom applications may be made and the frequency with which applications may be made;"
The Chair: Shall Mr Wilson's motion carry? All those in favour? Defeated.
I then have a government motion. Mr Wessenger.
Mr Wessenger: I move that paragraph 31 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out.
This deletes the regulation-making power requiring and governing consent to admission and care provided in a home, because consent to admission is now required under subsection 20.1(8.4).
The Chair: Shall the motion carry? Carried. What was the number on that again, please?
Mr Wessenger: Subsection 37(11), paragraph 31 of section 38.
The Chair: Fine. Thank you. That carries.
I then have a Liberal amendment, 31.1. Ms Sullivan. Mr Wessenger believes he has one which covers yours, Ms Sullivan.
Mrs Sullivan: But his doesn't come till later. I just want to be certain that he puts it on the table, so I'll read mine in.
I move that subsection 37(11) of the bill be amended by adding the following paragraph to section 38 of the Nursing Homes Act:
"31.1. prescribing the qualifications for persons and entities to be designated as placement coordinators;"
I'll stand that down until the government reads in its motion.
The Chair: Deferred. I then have a second Liberal amendment. Ms Sullivan.
Mrs Sullivan: I will read it in and then stand it down.
I move that paragraph 32 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out.
I will stand that down.
The Chair: We'll stand that down. We then come to the government amendment. Mr Wessenger.
Mr Wessenger: I move that paragraph 32 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out and the following substituted:
"32. prescribing, for the purpose of clause 20.1(8.5)(c), additional circumstances which are grounds for a licensee to withhold approval for the admission of a person to a nursing home;
"32.1. prescribing and governing the obligations of a licensee in relation to giving or withholding approval for the admission of a person to a nursing home, and governing the written notice required to be given under subsection 20.1(8.6)."
The Chair: Shall the government motion carry? Carried.
Mrs Sullivan: Mr Chairman, I will therefore withdraw the amendment proposed to paragraph 32 of section 38.
The Chair: Yes. So 32 is withdrawn. Your other one remains until we get to it, right?
Mrs Sullivan: Yes.
The Chair: The next amendment is also a government amendment. Mr Wessenger.
Mr Wessenger: I move that subsection 37(11) of the bill be amended by adding the following paragraph to section 38 of the Nursing Homes Act, after paragraph 32.1:
"32.2. requiring that placement coordinators have certain qualifications or meet certain requirements and prescribing such qualifications or requirements."
The Chair: Shall the government motion carry? Carried.
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Mrs Sullivan: Mr Chairman, as a result of that motion, I will withdraw my motion to section 38 of 37(11).
The Chair: That was 31.1?
Mrs Sullivan: Yes.
The Chair: Okay, that is withdrawn.
We then have a government motion.
Mr Wessenger: I move that paragraph 34 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be amended by:
(i) adding, after "other" in the last line of subclause (i), "documents and"; and
(ii) striking out "and" at the end of subclause (i) and adding the following subclause after subclause (i):
"(i.1) requiring that the information provided by the licensee for the purpose of the reconciliation be provided under oath, and"
Mrs Sullivan: Recorded vote.
The Chair: A recorded vote is requested. Shall the government motion carry? All those in favour?
Ayes
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: All those opposed?
Nays
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: The motion is carried.
I then have a Conservative amendment.
Mr Jim Wilson: I move that subparagraph (i) of paragraph 34 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out and the following substituted:
"(i) requiring the licensee to provide, at specified intervals, proof of maintenance and operating costs, information about the financial affairs and the level of occupancy of the nursing home and other information, and"
This is the last opportunity for the government to get it right, as the previous minister was fond of saying, and to delete the reference to audited financial statements, which I am told you don't need. What you need is audited financial information, and if you're a chartered accountant and you see the word "statement," you start racking up the bill. A little common sense would be appreciated in this area, and I would like a recorded vote on the amendment.
The Chair: A call for a recorded vote. Shall Mr Wilson's motion carry? All those in favour?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: All those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: The motion is defeated.
We have a second amendment. Mr Wilson.
Mr Jim Wilson: I move that paragraph 36 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out and the following substituted:
"36. governing service agreements, including their replacement and cancellation and including prescribing provisions that must be contained in all service agreements and matters that must be provided for in all service agreements."
Mr Chairman, I would like a recorded vote.
The Chair: Shall Mr Wilson's motion carry? All those in favour?
Ayes
Fawcett, O'Neill (Ottawa-Rideau), Sullivan, Wilson (Simcoe West).
The Chair: All those opposed?
Nays
Cooper, Hope, Jamison, O'Connor, Wessenger, Wiseman.
The Chair: The motion is defeated.
Next is a government motion.
Mr Wessenger: I move that paragraph 39 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out and the following substituted:
"39. governing short-stay programs in nursing homes."
The Chair: Shall the government motion carry? Carried.
A government motion again. Mr Wessenger.
Mr Wessenger: I move that paragraph 42 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out and the following substituted:
"42. governing the quality management system to be developed and implemented by licensees for monitoring, evaluating and improving the quality of the accommodation, care, services, programs and goods provided to residents of nursing homes."
The Chair: Shall the government motion carry? Carried.
A Conservative motion.
Mr Jim Wilson: I move that paragraph 42 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be struck out and the following substituted:
"42. governing quality management programs, including their development, implementation and revision;"
I think this is better than what the government just passed, Mr Chairman, and I'd ask for a recorded vote.
The Chair: A call for a recorded vote.
Shall Mr Wilson's motion carry? All those in favour?
Ayes
Wilson (Simcoe West).
The Chair: All those opposed?
Nays
Cooper, Fawcett, Hope, Jamison, O'Connor, O'Neill (Ottawa-Rideau), Sullivan, Wessenger, Wiseman.
The Chair: The motion is defeated. Same old gang.
The government motion, Mr Wessenger.
Mr Wessenger: I move that paragraph 43 of section 38 of the Nursing Homes Act, as set out in subsection 37(11) of the bill, be amended by striking out "of which notice must be given" in the third and fourth lines and substituting "which must be set out in the notice."
The Chair: Shall the government motion carry? Carried.
Mr Wessenger: I move that subsection 37(11) of the bill be amended by adding the following paragraph to section 38 of the Nursing Homes Act, after paragraph 43:
"44. governing inspection reports."
The Chair: Shall the government motion carry? Carried.
Now, shall subsection 37(11), as amended, carry? Carried.
Mr Jim Wilson: I was just going to indicate that there is one more PC motion, perhaps. I won't be introducing it.
The Chair: Okay. thank you.
Interjections.
Mr Jim Wilson: No, it's dealt with; it's veterans.
The Chair: Shall subsection 37(12) carry as in the bill? Carried.
Shall section 37, as amended, carry? Carried.
We then move to part VIII, "Commencement and Short Title." Shall section 38 carry? Carried.
Shall section 39 carry? Carried.
Shall the title of the bill carry? Carried.
Shall I report the bill, as amended, to the House? Agreed.
We have removed that amendment. Mr Hope.
Mr Hope: Mr Chair, as we wind down the amendments to this, I just want to make a few comments. In the four weeks that we've heard public hearings and the three days of clause-by-clause, I've seen a lot of cooperation from all parties, and that's even including our House leader's office, which granted an extension. I am hoping that the cooperation we've seen in the four weeks and three days continue on into third reading of this piece of legislation so that those who are waiting, recipients of this, can be expedited this year, within a very short time.
I just want to say thanks to you, as the Chair of the committee, and also to the two opposition parties for the cooperation that has been given on this bill.
The Chair: Thank you. I would like, if I might, as Chair, just to thank a number of -- Mr O'Connor.
Mr Larry O'Connor (Durham-York): I just feel compelled, at this time, to acknowledge a few folks from the ministry. Within the bureaucracy, there has been an awful lot of work going into this. There has been the consultation that has taken place over a lot of years, and right from first reading in the House and through the committee process, we've had a lot of hard work taking place. Some of the people have been with us in the committee hearings, some of them haven't, and I want to acknowledge the hard work they've done. As you can tell by the number of amendments, the committee hearing process certainly did point to some need for changes and we've been able to accomplish that. I want to thank the opposition members for working with us through this process. I just wanted to point that out.
Mr Jim Wilson: I don't want to rain on anyone's parade. I want you to know that the cooperation came because we had a gun to our heads and that it wasn't the most free-will cooperation I've ever extended in my life. But I do want to say to you, Mr Chairman, that I think you did an excellent job and I appreciate your tolerance and patience. You guided us through this with extreme skill, and for that I'm grateful.
The Chair: Thank you. Ms Sullivan.
Mrs Sullivan: Mr Chairman, I too want to commend you. As usual, your work has been superlative. I'd also like to express the thanks of all members of the committee to Hansard, to legislative research, to legislative counsel and to the clerk for assisting us as we have gone through this process.
Additionally, I would like to indicate, on behalf of our party, that we hope this legislation will be scheduled very early in the session, because the passage and proclamation of this bill will affect the funding received in the long-term care sector and will have a significant and profound effect on the kinds of services and care that people receive in the community.
Mr Wessenger: I'd like to also add my thanks to members of the committee for the cooperative approach that has been taken with respect to this bill and how it's proceeded. I too look forward to having it proceed very quickly. I also appreciate very much the guidance the Chairman has given with respect to expediting the process of this bill and keeping us on track and not dealing with extraneous items.
I'd like, though, to particularly thank two members of ministry staff who've been invaluable and dedicated many hours to this legislation: Gail Czukar, our legislative -- not our counsel here; for the ministry -- who has been invaluable, and also Geoff Quirt, who has added a great deal of enlightenment to members with respect not only to this legislation, but to the whole question of long-term care policy. I very much appreciate the efforts of those two ministry staff and, of course, all ministry staff. There are the ministry staff sitting back there, Louise Hurst, who's here today, and also political staff who've been very involved.
I think it's been a very worthwhile and thorough process. We can all be proud that we've got a good piece of legislation to go to the House.
The Chair: Just before breaking, perhaps I might express my appreciation, on behalf of all members of the committee in particular, to all of the groups and individuals who, over the course of our hearings, came before the committee, both those who presented in person and the many individuals and groups who wrote to the committee. I think we want to be sure to say thank you for so many people who participated in that way.
I want, as Chair, to also thank the parliamentary assistant for his cooperation, the two critics, all of the members. We've thanked a number of people who have helped us through these proceedings and I'd like to add the interpreters -- merci beaucoup -- and the broadcasting and recording service. I think whenever we are on the road, we owe a particular debt of gratitude to what they go through. I know it's been noted, but I'll note it as well: as usual, the excellent service from Hansard, from legislative research, the legislative counsel's office; again, ministry staff who have been very helpful. Last, but certainly not least, the ever-pleasant clerk, who has been able to get us through all kinds of problems. We really appreciate all of your efforts.
With that, we will draw these hearings to a close and we will reconvene at the call of the Chair.
The committee adjourned at 1523.