While the Cassellholme Home for the Aged awaits a third-party review in efforts to transition from a district home to an independent non-profit organization, others are trying to have their voice heard in the process.
See original story: Cassellholme looks at new model for long term care
The Canadian Union of Public Employees (CUPE) and the president of its Ontario division Fred Hahn are lobbying for community members and front line staff to have a say.
The Cassellholme board paid KPMG Advisory Services $30,000 to carry out a financial and governance analysis report last summer, which indicated that moving the home to a non-profit model would result in substantial savings for the partnering municipalities amidst its $60 million renovation.
But last week, a CUPE release accused the member municipalities of “secret dealings with consultants and closed door votes,” and claimed their requests for information were met with “radio silence.”
See the release: Cassellholme's future hinges on open talk
Hahn, who was elected as president of the province’s largest union in 2010, stepped up to the podium in Council Chambers on Monday night to ask the politicians in-person to consider disagreeing with the KPMG recommendations and open up the community’s involvement and access to information.
“CUPE is filing formal freedom of information (FOI) requests with all the contributing municipalities,” reads the CUPE release. “That process began recently with the filing of an FOI with the North Bay clerk’s office. The request covers all correspondence, reports, motions and votes.”
But Coun. Chris Mayne, chairman of the Cassellholme board, angrily responded to those statements on Monday.
“As board chair, I don’t recall any contact at all,” Mayne said to Hahn. “To be quoted in the media as portraying a great deal of silence, I take offence to that to be honest. I’m very much in favour of constructive, positive discussion, but I don’t like to see it framed as a combative atmosphere.”
Last December, the majority of the council voted in favour of signing a non-binding letter of intent that allowed the city to take a confidential look at the municipal long-term care facility’s finances and governance.
Cassellholme then provided a copy of the financial analysis regarding the possible transition to the member municipalities, all of whom will be asked to individually vote for or against the proposal in the next six-to-eight weeks.
Mayne also reassured Hahn that there will be opportunities for public input and community discussion once that happens.
But Hahn also took issue with the KPMG recommendation too. After reviewing many academic studies, he said the suggestions are cookie-cutter recommendations and the report would be detrimental to North Bay’s home.
“Municipal long-term care homes have higher standards of care for residents in those homes,” said Hahn. “They provide a level of accountability and transparency because of the connection that city councillors have on those boards.
“The reason why municipal long-term care facilities are able to maintain a level of care that's higher than others is that there’s additional supports that come from the municipal level of government,” he added. “People in communities want to continue to invest from their collective resources - their parents and grandparents built the communities that they live in.”
He said switching to a non-profit model would put the home at the whims of provincial government funding, presenting unique financial challenges that he argued usually result in reducing the number of direct hands-on hours, staffing cuts and contracting food supply, for example.
But some, like Coun. Tanya Vrebosch, who sits on the Cassellholme board, questioned how exactly those changes would transpire.
“I don’t see how the level of care would change by changing the funding model - the same workers are there, the same people that care about the patients are there, all of that same stuff will still be there; it would just be a different funding model,” she said.
Mayne also said there isn't necessarily a linear connection between funding and quality of care. He used Timmins' municipally-run home as an example, which has had double the compliance calls compared to Cassellholme and the cost per household in the city is more than $180, compared to $108 in North Bay.
“They did point out how some homes operate less efficiently if they’re a municipal home or for-profit home,” Mayne explained, “but I haven’t seen the direct correlation between money spent and the quality of service received.
“The governance itself doesn’t determine the level of care - to me, that’s very much a product of the attitude and enthusiasm of staff," he added. "The board is very conscientious of levels of care and there are provincial standards we have to meet. In most cases, Cassellholme exceeds those standards and that’s what we’re looking to continue.”
He and the other councillors that sit on the Cassellholme board, all of whom have a personal connection to the facility, said there has never been any consideration to compromise the level of care.
“Right now, I’m very comfortable that the level of care will be as it is right now,” said Mayne. “The union contracts that are in place today are exactly the same the morning after it would turn to non-profit, nothing changes: we don’t drop the unions, we don’t cut staffing numbers.”
The Local Health Integration Network (LHIN) and Ministry of Health and Long Term Care have expressed their support for the project, but their financial contribution is conditional on the board solving the governance problem.
Four of the minicipal funding partners have asked to leave Cassellholme and put their funding towards a separate redevelopment proposal in Mattawa. But unanimous approval is required by all of the funding partners, as well as provincial approval, before any changes can be made to the Cassellholme governance.
If the not-for-profit model is not unanimously accepted by all of the funding partners, the existing district long-term care model would continue.
The board unanimously agreed to stick with the current site on Olive Street for their proposed redevelopment, keeping the renovation price tag to an estimated $60 million, all of which has to be financed.
The home is designed for up to 240 residents and the demand of their services continues to increase. Part of the forthcoming renovation could see the number of beds increase to closer to 300.
Council originally supported the redevelopment project back in 2012 on the condition that the home would borrow the required funding themselves, not the city.