Province to provide update on long-term care projects in 'coming weeks'

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The Department of Social Development will be giving an update “in the coming weeks” on details of a bilateral agreement with the federal government to improve long-term care.

Last week, New Brunswick signed two bilateral agreements totaling $430 million to improve health care services and access, and to help seniors stay at home longer.

The Working Together agreement will provide more than $313 million to support New Brunswick’s three-year action plan, including more availability of primary care, recruitment initiatives and expanded mental-health services.

The Aging with Dignity agreement will allot roughly $117 million to the province’s five-year plan for long-term care, including improvements to palliative care, strengthening the workforce, and increasing safety measures.

Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents’ Rights, said in a previous interview she was happy to see the signing of the agreement, but would like to see a timeline on when the initiatives will be rolled out.

“I’d like to see some action,” she said last week.

Kate Wright, spokesperson for Social Development, said in an email several initiatives in the recently announced agreement are underway, including nursing home facility assessments and upgrades to nursing home ventilation and special care home equipment.

“The Department of Social Development believes all of the targets and timeframes identified in the agreement’s action plan are attainable,” she said. “Further details pertaining to the agreement will be shared in the coming weeks.”

The agreement states the province must provide data to the Canadian Institute for Health Information by no later than Oct. 1. It must also update residents in an “integrated manner” the progress of initiatives outlined in the agreement beginning in the 2024-25 fiscal year.

Anne Grenier, spokesperson for Health Canada, said in an email that targets and indicators are “essential parts” of the agreement.

“In order to receive its full funding allocation and payments, New Brunswick is required to publicly report annually to its residents on progress related to the targets outlined in its agreement, and share data and information with CIHI related to common indicators,” she said.

Funding for the agreements will be paid in semi-annual installments. The first installment is expected to be paid within 30 days of executing the agreement.

According to the 2021 census, out of the total population of 775,610 New Brunswick citizens, 177,160 are adults aged 65 years and over, contributing to a 22.8 per cent of the total population.

The province is also witnessing an “explosive growth” in the population of baby boomers born between 1946 and 1965, and are now starting to turn 75 years and over. Over the next 20 years, this cohort of older seniors is projected to increase from 75,900 to 145,700, representing 92 per cent growth.

“The rapid growth in seniors’ population is putting pressure on the province’s long-term care system,” the federal government said in the agreement document.

Community care/palliative care improvements

Part of the agreement is to improve home care services in the province. According to CIHI, 14 per cent of new long-term care residents could have been cared for at home.

The median target for new referral to receiving care through Extra Mural services is one day with 90 per cent of the referrals being processed within 10 days. The target date is March 31, 2025.

An electronic medical records system for Extra Mural patients is to be fully implemented by March 31, 2025.

One of the additions is a new role called a community coordinator which will serve to enable clients to have more timely access to services and better navigation.

The cost estimates are based on an initial pilot, then a phased scale up across the province to a resulting 16 front line coordinators in the service deliver zones and 1 employee for central coordination.

The target is for 3,500 clients to receive care coordination by March 31, 2028.

The agreement calls for the development and maintenance of a “partner portal” for all partners that provide services to clients of Social Development, such as home support agencies, special care home operators, nursing home administrators, and Extra Mural Program health professionals.

The purpose of the portal is to improve communication, and for requesting and paying for services.

The agreement states the initiative will initially support 47 home support agencies delivering services to 5,500 clients in the first year. Expansion to other partners in remaining out years will include approximately 508 long term care facilities serving approximately 11,600 clients.

The target for the portal is for all of the agencies to have the system implemented by March 31, 2028.

A new community care bed model will be piloted at two special care home test sites by March 31, 2025. The aim is to replace the current special care home models to meet the increasing care needs while the resident remains in one location, in order to relieve pressures on the nursing home system.

“The funding model would aim to cover care and operational costs to provide basic services to residents and not to increase profit margins,” the agreement states. “No federal funding will be disbursed directly to private, for-profit facilities, for the other listed initiatives.”

Another goal is for more than 55 per cent of palliative care deaths to happen at home rather than the hospital, and the target is March 31, 2026. The development of a provincial palliative care monitoring and reporting framework is underway.

Recruitment and retention goals

Recruitment and retention of staff for long-term care is another priority in the agreement, which includes funding to support personal support workers or licensed practical nurses who are getting training under the Step Up to Nursing program.

“While recruitment remains a top pressure, retention must also be addressed,” the agreement states, adding that support is being given to nursing home boards to improve management and workplace culture, resulting in greater retention of workforce and in turn a reduction of vacant beds across the sector.

“As work continues, new initiatives can be implemented with this funding to support the end goal of sustaining full utilization of available long term care beds in the system,” the agreement states.

The target is to bring down the number of nursing homes with chronic vacancies (more than five vacant beds) to 5 per cent of facilities in the province by March 31, 2028.

A training plan for long-term care staff based on a needs assessment is to be developed and fully implemented by March 31, 2028. The training will include dementia care, workplace safety, care and clinical services, adult protection and infection prevention and control.

Nursing home upgrades

Upgrades to nursing home infrastructure is part of the agreement, including 21 ventilation projects completed by March 31, 2027, 13 call bells replaced by March 31, 2028, 750 beds and 840 mattresses replaced by March 31, 2026, four call bell systems, five generators, and 40 lifts installed in special care homes by March 31, 2028.

Assessments will also be carried out for 62 non-profit nursing homes to plan capital projects, and the target date to complete them is March 31, 2026.