SINGLE-SITE STRATEGY TAKING LONG TO EXECUTE
Order for health-care workers costs no jobs, means a pay increase for some
B.C. moved this week to prevent health-care workers from staffing more than one long-term care facility, a month after Dr. Bonnie Henry first flagged the practice as a factor in the spread of COVID-19.
“As of today it is official,” the provincial health officer announced Thursday. “We have been using orders to implement a process to make it possible for care workers — health-care workers of all kinds — to work at a single site only.”
But the process is not yet completed, according to Health Minister Adrian Dix.
The “single-site transition framework” will be implemented “in the coming days” by the Health Ministry in consultation with the affected regions, unions and public and private employers.
The process is complicated and it will also be expensive. Dix estimated the tab for implementation at $10 million a month so long as the new regime is in place. Most of the money will go to ensuring that health workers won’t have to take a cut in pay or hours as they are confined to staffing a single facility.
The rationale for the move was evident with Thursday’s figures on the outbreak, released at the same time as the announcement from Dr. Henry and Dix.
B.C. has some 235 cases of COVID-19 associated with long-term care and assisted living facilities. The tally includes 143 residents and 92 staff.
Moreover, 60 per cent of the deaths in B.C. have been of residents in long-term care.
“Residents of long-term care and assisted living are very vulnerable to COVID-19,” Dr. Henry explained.
“What we are trying to do is make sure that the workers who provide the service to people in long-term care are able to work at a single facility.”
Staff working in multiple facilities is a problem the New Democrats inherited from the previous B.C. Liberal government.
But as Dr. Henry also acknowledged Thursday, “this is something we have recognized from the very beginning of this outbreak.
“The challenges that we have with health-care workers of all kinds needing to work at multiple different facilities makes it such a challenge to try to control outbreaks. That has been brought to the forefront during this pandemic in many ways. And it is a part of the tragedy with the multiple long-term care facility outbreaks.”
She recognized the problem in her daily media briefings as far back as March 9. “We are very aware of that and it is a challenge with our system — health care workers work in many different facilities sometimes.” It was the day she announced the first COVID-19 death in B.C., that of a man in his 80s who had been a resident at the ill-fated Lynn Valley Care centre.
She also disclosed that one health-care worker, who had worked in at least two facilities, had become infected.
The ministry would be following up with contact tracing of the infected worker and look deeper into the problem of workers staffing more than one facility, she pledged.
By March 20, Dr. Henry was reporting that 18 health-care workers had become infected and there were now nine deaths, eight of them associated with the outbreak in the Lynn Valley centre.
She was asked whether prohibitions were now in place to prevent staff from moving between facilities.
Or were they still able to do that?
“Very good questions,” replied Dr. Henry.
Appropriate steps had been taken in the facilities directly impacted by the outbreak. But not across the board.
“We have been working on that for the last week. We are in the process of ordering and I have had staff from the Ministry of Health look at how we can manage so that for all long-term care homes — particularly in the Lower
Mainland, given the risk that we are seeing — the staff are assigned to a single facility.” That was three weeks ago. In the interim, she has issued orders that have shut hundreds of businesses and cost thousands of workers their jobs.
Why is this order — which costs no jobs and actually means a pay increase for some health-care workers — taking so long to implement?
“It’s complicated,” said Dr. Henry.
“It was really a matter of understanding the problem where people were; how many were working at different areas. Being able to pull all that data together was one of the first steps that we did. That happened over the last couple of weeks. And to understand people’s preferences was another part of it, so there’s a lot of negotiation.”
Most of those negotiations were with unions in the health-care sector, I presume. Dix said the framework impacts provisions in 50 to 60 collective agreements and some 4,200 workers will “have where they are working change.”
“In some health authorities, this has happened more quickly than others,” said the minister. “But it is an exceptional change.”
Both he and Dr. Henry said one goal was to ensure that workers could exercise their preference for a place to work, without having to worry about a loss of income.
The work-in-one-place order is effective only for the duration of the pandemic.
But Dr. Henry says that every year the flu was being spread by staff moving between care facilities. So it is hard to imagine the system will go back to the way things were before the current outbreak.
Most of the money will go to ensuring that health workers won’t have to take a cut in pay or hours as they are confined to staffing a single facility.