Liberal Leader Steven Del Duca has said he's not a fan of profit in long-term care. On Tuesday, he made it platform-official, releasing a plan to transition Ontario entirely to not-for-profit and municipally-run LTC (costing to come).

The COVID-19 pandemic laid bare the decades-long issues with long-term care, killing 4,329 residents in the process. For-profit homes have had worse health outcomes throughout the pandemic, while executives have raked in massive profits and bonuses.

Del Duca joins the NDP, which released a plan to end for-profit care in October 2020.

Both parties diverge hard from the Ford government, which sees for-profit care as crucial to creating enough beds to house Ontario's aging population. It's been speeding up construction of these homes in an attempt to meet the demand.

The NDP plan includes cost estimates, unlike the Liberals'. But Del Duca said those are coming in the next few days, with the rest of the costed Liberal platform.

Each plan will cost billions. Ontario's LTC system is a web of for-profit and not-for-profit homes, all of which are funded by the government. To end for-profit care, a provincial government will have to not only ramp up the number of beds it builds and spend more on home care to divert people from the system, but buy existing for-profit LTC facilities — which make up more than half of all homes — and transition them to a not-for-profit model.

Speaking alongside a couple of seniors Tuesday morning, Del Duca said it's worth it.

"There will be a cost. There will be an investment for sure. But what's the alternative? Is the alternative to stand here and tell Judy and Cliff and my parents that we just don't give a damn?"

The Liberal plan

Del Duca said he'll aim to end for-profit LTC homes by 2028. He said there are "multiple paths" to get there, including an "accelerator fund" for non-profit care, purchasing for-profit homes, and expanding home care.

Buying the for-profit homes will cost $2 billion each year until 2028, according to party estimates shared with the Toronto Star.

The party will also build and redevelop 58,000 beds "in hundreds of smaller, non-profit care homes that look and feel like actual homes."

And Del Duca promised more comprehensive inspections, with harsher fines for rule-breaking homes. The PCs did away with comprehensive LTC inspections before the pandemic.

Del Duca also promised to repeal Bill 218, which protects LTC homes from lawsuits over the transmission of COVID-19.

A key part of the plan will be increasing home care, so seniors can avoid long-term care altogether. Del Duca promised $2 billion more for home care by hiking the budget by 10 per cent per year. He said this will result in 400,000 more seniors having access to home care by 2026.

For-profit home care will still exist, but non-profits will be prioritized, the party said.

The Liberals would also:

Build 15,000 more assisted living homes
Expand and make permanent the PC-introduced Seniors’ Home Safety Tax Credit, which gives seniors cash to renovate their homes to make them safer
Make the Ontario Caregiver Tax Credit refundable, tax-free and paid out throughout the year
Give family caregivers access to more unspecified support programs and tools

The NDP plan

The Official Opposition plans to end all private LTC by 2030, through many of the same avenues.

The NDP says it will phase out funding for-profit homes and transition that money to not-for-profits and municipalities to help them take over for-profit homes and build new ones. Like the Liberal plan, new homes will be smaller and will aim to feel like home — not a warehouse.

The New Democrats promise 50,000 new beds by 2030, which it says will obliterate the wait list.

Homes will also once again be subject to comprehensive, surprise inspections under the NDP plan, with harsher penalties.

And an NDP government would collect race-based and socioeconomic data, as well as data on how many employees are part-time vs. full-time.

The party says it would spend $1 billion on home care over four years, and match federal spending. That would increase service volumes by 5 per cent per year, it says.

The NDP says the total cost of its plan would be $750 million more per year for eight years ($6 billion), plus an extra $3 billion in annual operations costs. Ontario currently spends $4.6 billion on long-term care and $3.2 billion on home care annually.

For-profit homes are not pleased

In his announcement, Del Duca compared the current LTC system to other historic "mistakes," like burning coal or Canada's mistreatment of Indigenous people.

The Ontario Long-Term Care Association, which represents for-profit and not-for-profit homes, called his comments "unacceptable." It said Del Duca hurt workforce morale and shamed families for putting loved ones into long-term care.

"Elections are about debating issues. This unfortunately crosses a line," CEO Donna Duncan and board chair Brent Gingerich said in a statement to members obtained by QP Briefing.

"Comments like the ones made today perpetuate the stigma and guilt we have been trying to overcome," they said.

The OLTCA released its own suggested blueprint for the sector on Friday. It focuses largely on a softer inspection process, calling for legislation that allows homes more freedom to "innovate" instead of relying on "cookie-cutter" approaches.

"This work starts with empathy and compassion, which were missing today," the memo reads.

The NDP and Liberal plans go further than the not-for-profit LTC lobby has called for. The CEO of AdvantAge Ontario, which represents the province's non-profit homes, has said all new beds should be non-profit — but that she's not calling for the for-profit sector to be dismantled.

Why it could happen

Ontarians could see a blend of plans if the Progressive Conservatives are reduced to a minority and the Liberals and NDP form a coalition. Neither side has ruled it out. And they've been playing nice of late.

Not always, though.

The NDP quickly noted in a press release just before the announcement that the Liberals didn't seem to mind for-profit LTC during their 15 years in power. It noted the party has accepted over $125,000 in political contributions from for-profit care companies since 2014, and only built 611 new beds while in government.

"Andrea Horwath’s NDP is the only party ready to fix the broken seniors care system and put residents first, starting by fixing home care and removing the profits from long-term care," the release reads.

Del Duca admitted his government's record wasn't perfect, and sought to distance himself from it.

"The way that we have been comfortable — and I mean this collectively, as Ontarians — we have been comfortable with the warehousing and the institutionalizing of our seniors. I think it's really important for me to also say, our party, right now, has new leadership and a new Ontario Liberal team," he said, adding that "progress doesn't end."

Liberals officially join NDP in seeking to end for-profit long-term care

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