Bill C-295

An Act to amend the Criminal Code (neglect of vulnerable adults)

This enactment amends the Criminal Code to create an offence for long-term care facilities, their owners and their officers to fail to ensure necessaries of life are provided to residents of the facilities.
The enactment also allows the court to make an order prohibiting the owners and the officers of such facilities from being, through employment or volunteering, in charge of or in a position of trust or authority towards vulnerable adults and to consider as an aggravating factor for the purpose of sentencing the fact that an organization failed to perform the legal duty that it owed to a vulnerable adult.

Criminal Code

[Larry Maguire, Conservative, Brandon—Souris, MB]

Madam Speaker, first and foremost, I want to thank my colleague from Vancouver Centre for introducing this private member’s bill to strengthen the Criminal Code provisions to protect our loved ones who reside in long-term care facilities.

Almost every Canadian knows someone who has been a resident of a long-term care facility. It goes without saying that when a family member or friend gets to that point in their life when they need extra care, we want to know that they are safe and being taken care of.

I also want to take a moment to thank the health care aides, nurses and the kitchen, laundry, housekeeping and recreation staff who work in our long-term care facilities across Canada. They should know how appreciative we all are of everything each and every one of them do.

Whenever we talk about frontline health care workers, I always feel that there is not enough attention given to those who work in our long-term care facilities. They provide care 24 hours a day, seven days a week. It does not matter if there is a blizzard or horrendous weather, they answer the call and go to work. From working holidays to working night shifts, I know that it is not always easy on their families. I also know that the job is not easy on their bodies. They do it because they truly care for the residents that they serve.

In many cases, the residents they care for start to feel like a member of the family. Long-term care facilities are not hospitals. They are people’s homes. The people who live there are not patients. They are residents. While this distinction may seem trivial, I can assure members it is not. In most cases, this will be people’s last home. It behooves us all to ensure that we do everything we can to protect those who are most vulnerable and in need of care.

The pandemic showed how fragile our long-term care facilities are in this country, as my colleague just outlined in the presentation of her bill. There is a litany of reasons for that, but I want to start by talking about the challenges that both health care workers and the residents of those facilities face.

A significant number of the workers in our long-term care facilities are shift workers, who must either pick up extra days or work double shifts to try to get 40 hours a week. There are very few full-time health care aide or nursing positions that guarantee 40 hours a week. Many health care workers have a job at another long-term care facility to earn enough money to provide for their families.

We quickly saw the consequences of how long-term care facilities are staffed as soon as the pandemic started. Immediately, staff could no longer work in more than one facility to contain the spread of COVID. The result was that facilities were then short-staffed. It only got worse as people either had to quarantine or could no longer work as many hours as their child care options became severely impacted.

Sadly, we watched in horror as the news stories started to emerge about how short-staffed certain long-term care facilities were. Some families had the ability to take their loved ones into their homes as soon as the pandemic started. However, it was only a small number as the level of care was too much. As family members were prohibited from entering care homes due to the pandemic, all they could do was hope and pray that their loved ones were taken care of.

In many cases, when a parent, sibling or close friend becomes a resident of a long-term care facility, it is not unusual to visit them multiple times a week. Children come into the facility to help their parents eat, wash and clean up their rooms. Anyone who has ever worked in a long-term care facility knows how integral family members are to the well-being of the residents. A lot of family members also become volunteers at the long-term care facility, to help where they can, to ease the workload and to make the residents as comfortable as they can.

All that support was gone as soon as the pandemic started, and with the staffing challenges that were already present going into the crisis, unfortunately, we quickly learned of the dire consequences for many residents.

We must never forget the Canadian Armed Forces medical and support personnel who were temporarily deployed to support our long-term care facilities. It was their report they tabled in May 2020 that brought considerable attention to the conditions they encountered in our long-term care facilities.

They discovered systemic deficiencies in the establishment and management of infection control areas within long-term care facilities. There was a lack of care and distribution of personal protective equipment and enforcement of personal health measures. As well, as previously stated, there were severe staff shortages that compounded problems in long-term care facilities.

It is with that in mind we can turn our attention to the provisions contained in Bill C-295. I welcome the debate and attention on amending the Criminal Code to protect those who live in long-term care facilities.

Currently, the Criminal Code states under “Duties Tending to Preservation of Life” that a parent, guardian or spouse is under a legal duty to provide necessaries of life to those under their care when they are unable to do so themselves due to age, illness, mental disorder or cannot otherwise provide for themselves. That is the most important area.

There have been numerous court cases over the years where people have been charged and convicted of such crimes, but to the best of my knowledge, never has the owner or manager of a long-term care facility been charged and convicted under this section of the Criminal Code.

Bill C-295 would amend the Criminal Code to clearly stipulate that owners and managers of long-term care facilities would be added to that list of being legally responsible to provide necessaries of life to residents of their facilities. This level of legal protection for those who live in long-term care facilities, as stated in Bill C-295, must be studied. I would urge my colleagues to vote in favour of this bill.

It is imperative we refer this legislation and have the much-needed debate about how the federal government can better legally protect those who live in long-term care facilities. As the onus would be on the Crown to lay the charges, we must carefully craft the legislation to ensure there are no loopholes.

I would recommend to my colleagues on the Standing Committee on Justice and Human Rights to invite legal and health care experts to ensure the definition of “necessaries of life” is adequate to ensure there are legal penalties for those who fail in their duties. This will start a much larger debate about whether provincial regulations, which dictate the operations and level of care, including accountability provisions, are stringent enough.

As we debate this legislation tonight, I can assure members there are currently long-term care facilities that are running short-staffed. We know there are staff having to work double shifts so residents can get the care they need. As well, there are still far too many rooms in long-term care facilities with four beds, which is a challenge at the best of times let alone during a pandemic or flu season.

We can all agree that all levels of government, including the non-profits and companies that provide long-term care, must dramatically improve the conditions of long-term care facilities.

In closing, I was proud to run under our Conservative platform in the last election which would have directly provided federal funding that would have boosted the number of health care aides and other critical staff working in our long-term care facilities. I welcomed our commitment to prioritize and streamline immigration to include new measures to attract health care workers, especially in priority areas and regions. Our pledge to devote specific federal infrastructure funding to renovate and improve long-term care facilities was well received by many who work in the health care field.

Let us ensure this is just the start of a much larger conversation about how we can improve the living conditions, including the level of care, our loved ones receive. This legislation should pass second reading and be sent to the justice committee as quickly as possible.

[Hedy Fry, Liberal, Vancouver Centre, BC]

moved that Bill C-295, An Act to amend the Criminal Code (neglect of vulnerable adults), be read the second time and referred to a committee.

Madam Speaker, it is my pleasure to stand for the second reading of my private member's bill, Bill C-295, which would amend sections 214 and 215 of the Criminal Code to include penalties for the neglect of vulnerable adults.

What this amendment would do is add some definitions. One is “long-term care facility”, which means somewhere with three or more adults unrelated to the owner or manager by blood or marriage. We are also defining what a manager is. A manager is somebody who administers, hires staff, purchases supplies like medical supplies, directs the daily performance of facility staff, coordinates and plans care for the residents and how the staff provides that care, applies protocols and procedures to give good care, and controls and evaluates those procedures and the quality of care in order to do something very important, which is to provide the necessities of life to residents.

Section 215 of the act defines the duty to provide necessities of life and the bill defines the failure to perform this as meaning to endanger life or to cause health to be injured permanently. Those are the two things we mean by the words “failure to perform”.

This bill would also prohibit an offender who has been found culpable from seeking or obtaining work in any facility that takes care of vulnerable adults, or even volunteering in a facility that takes care of vulnerable adults. By “vulnerable adults” we mean anyone who is vulnerable as a result of age, mental disorder, illness or disability or who is frail. The penalty for failure to do this means a person would be liable to imprisonment for a term not exceeding two years or would be punished on summary conviction.

Why are we bringing this up right now? It is because COVID-19 showed us that vulnerable adults are very much at risk. Let us look at the deaths in Canada as a result of COVID-19. Sixty-nine per cent were vulnerable adults, compared with the international average of 41% anywhere else in the world. We know that long-term care facilities are under provincial jurisdiction, so what we saw across this country during COVID-19 was a large variability in the results and deaths by province, depending on what province they were living in.

It is interesting to note that in long-term care facilities, residents got 3% of the total COVID cases, yet that resulted in 43% of deaths from COVID. For instance, in Ontario, the incidence of death in long-term care facilities was 13 times higher than for the average 69-year-olds living in the community. What does that tell us? It tells us that there is a definite association between long-term care facilities and deaths and outbreaks due to COVID.

We know that 54% of long-term care facilities in Canada are private, and what we have seen is that many of them are not only private but for-profit. Following the first year of COVID, we got a report from the 4th Canadian Division's joint task force. If members will recall, we sent in the armed forces to help in some of these long-term care facilities. We also had a report from the Canadian Institute for Health Information, or CIHI, as it is called. Both of these were scathing reports. They sounded like something out of a horror movie.

We heard that many of the aides who worked in these areas did not have any real training. They did not have any ongoing medical education or health education training. Many of them did not follow protocols and many were not registered. Many of them were also not able to provide the care they were supposed to be providing.

We found that cleanliness was a huge issue, according to those two reports. There were cockroaches in these areas and people did not take care of residents who soiled themselves. They laid in their soil, sometimes for a whole day.

We found that the ability to give medication was compromised. Medication was often outdated in the facilities, and for the people who were getting medication, it was not even working for them. We also found out that cross-contamination was huge. Many persons who were working in these areas would go from one patient to another without changing their personal protective equipment and without washing their hands, causing cross-contamination.

We heard some horror stories. We heard about the abuse of these patients, where if they complained of pain or decided that they needed help, quite often they would get pushed roughly and handled badly. However, it was the lack of any protocol to deal with the pandemic and an epidemic that was very frightening in some of these facilities.

These facilities are run by the provinces. Long-term care facilities are a provincial jurisdiction. What can the federal government do? What we can do is make those people who own or manage these facilities liable with a penalty under the Criminal Code for the failure to provide the appropriate care by any medical standard whatsoever.

Let us remember that there was burnout at these long-term care facilities. There was also the fact that many of the people who worked in these facilities were being paid less than equivalent medical personnel in other facilities of any kind.

We have just thrown seniors under the bus in many of these long-term care facilities, and we saw that with the deaths from COVID. I think we should be ashamed that, in Canada, we have a 69% COVID death rate in vulnerable adults versus 41% in any other country in the world. We need to do something about it. We are saying that we should make accountable anyone who manages such a facility, or owns such a facility, who did not have any of the protocols and did not do anything about cross-contamination.

We found out that the reason a lot of the aides were not doing the kinds of things they needed to do with personal protective equipment was that they were told that they should not spend money and that they should use it once, twice or three times. We know that is not how to deal with contamination.

Some of this was all about saving money. Some of it was about being scared. Some of it was about not knowing what to do and not having sufficient protocols and procedures. I really believe that we need to work with the provinces to create new sets of protocols and a real set of standardization of care for persons in long-term care facilities.

We need to make those who run or own those facilities very accountable under the Criminal Code. We could have the same penalties as under the section of the Criminal Code for the abuse of children or for failure to provide care for children who are vulnerable. We need to do this now for seniors.

I think that most of us know that COVID-19 is not our last pandemic. We know that with globalization, with people travelling everywhere, anyhow at any time, the cross-contamination of disease from one jurisdiction or one country to another can create what we now call pandemics. Pandemics are happenings, and pandemics are here to stay.

We need to be very clear about setting clear accountability and clear penalties for those who fail to provide care for vulnerable adults, which is the first thing. Then, as most of you will know, we need to also look at how we work with provinces to provide a pan-Canadian standard of care and a clear standard of care for many of these facilities. We know that 54% of them are for-profit organizations and are private sector organizations, and they do not have the appropriate ability to take care of adults.

Members who know a senior person or a vulnerable adult, whether they be disabled or senior, who actually perished or was harmed irrevocably under COVID-19 in one of these facilities would support this bill, because they know that it is important. If we do not care for the vulnerable among us, if we allow people to make money off people's vulnerability, if we allow people not to take due care and not to have compassion and the best quality of care for those who live in their long-term care facilities as adults, then we are failing, and we are failing badly.

I hope members will support this bill, because I think it is absolutely necessary. It is currently the only way the federal government can take care of this problem. It will take a while to negotiate with provinces. It will take a while to look at standards of care. It will take a while to do that, but in the interim, those who fail to provide appropriate care for vulnerable adults living in long-term care facilities will be penalized under the law, under sections 214 and 215 of the Criminal Code.

[Hedy Fry, Liberal, Vancouver Centre, BC]

moved for leave to introduce Bill C-295, An Act to amend the Criminal Code (neglect of vulnerable adults).

Mr. Speaker, I rise to introduce my private member's bill, an act to amend the Criminal Code regarding neglect of vulnerable adults, and I want to thank the member for Alfred-Pellan for seconding the bill.

The COVID-19 pandemic exposed clear evidence of abuse of seniors in care facilities across the country. With the lack of appropriate care and protection, as well as negligence and failure to follow accepted protocols, this situation resulted in appallingly high rates of COVID transmission in many long-term care facilities and led to increased mortality rates.

This bill aims to prevent a recurrence of those tragic outcomes by creating an offence for owners and managers of adult care facilities who fail to provide due care in accordance with accepted protocols and who are negligent in their duty to provide the necessities for a good quality of life. It would also allow courts to make an order prohibiting the owners and managers of such facilities from being in charge of or in a position of trust or authority toward vulnerable adults and to consider, as an aggravating factor for the purpose of sentencing, the fact that an organization failed to perform the legal duty that it owed to a vulnerable adult.

As Mahatma Gandhi said, “The true measure of any society can be found in how it treats its most vulnerable members.”

(Motions deemed adopted, bill read the first time and printed)