One year before the deadline, 24 of the 37 private long-term care and residential centres (CHSLDs) are still not contracted, according to data obtained by The duty.
Since the start of the process announced in June 2022, the government has contracted a third of the private CHSLDs that were not yet contracted. This process was intended as a response to the numerous scandals of mistreatment and unsanitary conditions that broke out in private seniors’ facilities during the COVID-19 pandemic. Former Minister of Seniors Marguerite Blais had committed to contracting half of the private CHSLDs by 2023. Her successor, Sonia Bélanger, must close this file by June 2025. While a third of the facilities have been contracted since her commitment, Quebec says the target will be reached.
Signing a contract with a private CHSLD links it to the public health network. Employees become employees of the public network, which means that salary conditions, benefits and everything related to collective agreements are standardized for all centres, explains Paul Arbec, president of the Association des établissements de longue durée privées du Québec (AELDPQ). Equitable funding, “to give all establishments the same means so that they can meet their mission,” is the primary goal of the contract. In the 2022-2023 budget plan, the government provided $19.3 million to “harmonize public and private CHSLDs.”
We found that it is more difficult for smaller institutions because they do not have the economies of scale of a large institution with 200 or 150 beds.
Paul Arbec says he is “satisfied” with the 13 private CHSLDs that have signed agreements to date. The agreement process is “well received by members”, even if “not all members are completely satisfied”, he believes.
More complicated for small CHSLDs
Among these less satisfied members are mostly smaller CHSLDs, which are facing difficulties and have not yet made the transition to the agreement. “We have noticed that it is more difficult for the smallest establishments because they do not have the economies of scale of a large establishment with 200 or 150 beds. There is a challenge there,” says the president of the AELDPQ. The ministry is however “aware and has agreed to concessions to improve this situation,” adds Mr. Arbec. The exact terms and status of the negotiations are confidential.
Among its members, the AELDPQ included 23 non-contracted private CHSLDs. Of these, 10 have been contracted and 13 are still under discussion. Not all private CHSLDs are members of the AELDPQ. Its president specifies that some AELDPQ member centres — a number that can be “counted on the fingers of one hand” — are “at a very preliminary stage of conversations.”
“We definitely feel more and more pressure [de la part du ministère] to complete the exercise,” however, Paul Arbec points out. A process that turns out to be more complex than expected. “There is no one who cannot be contracted from one month to the next. Whereas here, that is what we expected,” states the president of the AELDPQ.
Even if it is theoretically possible according to him to sign an agreement with the 24 private CHSLDs that are not already signed by June 2025, with negotiations well underway for most of them, “we are certainly not convinced that all the promoters will want to [le conventionnement] ” says Mr. Arbec. He also believes that some private CHSLDs will change their vocation in order to avoid becoming contracted. The Ministry of Health and Social Services, for its part, says it is maintaining its June 2025 objective, emphasizing that contracting is a “priority” for it.
Provisional administration
Earlier this week, Quebec announced that it was taking over management, for at least 180 days, of three Argyle CHSLDs, owned by Excelsoins, in Longueuil, Saint-Lambert and Pointe-Claire. According to reports consulted by The dutyproblems of neglect persist in these establishments. They are not yet approved.
In July 2021, The duty had revealed recurring problems of negligence on the part of the administration during an investigation into the CHSLD Argyle in Saint-Lambert. Eighteen residents, caregivers and employees of the private residence testified to problems related to the care and hygiene of users as well as the cleanliness of the establishment.
Following the investigation of the Dutyan independent investigator was mandated by the ministry to assess the situation at the CHSLD in Saint-Lambert and deemed that it was “imperative that the CISSS de la Montérégie-Centre maintain the monitoring and close support that it has put in place in recent months” in order to bring the centre up to standard.