Working conditions for personal support workers in Ontario

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Miranda Ferrier is the president and founder of the Ontario Personal Support Workers Association (OPSWA), which has been lobbying the Ontario government to regulate the profession. rabble spoke to Ferrier about OPSWA's goals and aspirations, the challenges of the job, and the organization's affiliation with CarePartners and the for-profit home care lobby. 

The following are excerpts from the conversation, edited for length and clarity. The interview was conducted in November 2019.

rabble: How does OPSWA function? Is it a union?

Ferrier: We're a professional association, like the Registered Nurses Association of Ontario. The majority of our members have unions.

What are your goals as an organization?

Self-regulation of personal support workers (PSWs). We truly believe that PSWs are at the bottom of the hierarchy. They are unregulated, and don't get any respect or recognition for their work. We hear it daily from our members, that they just feel downtrodden and burnt out. They feel like they're being taken advantage of in a lot of cases.

We believe with self-regulation we have a base to grow the profession. A lot of PSWs that left the field have said that if self-regulation happens they'll come back.

Right now schools are closing a lot of their PSW programs across Ontario because they can't fill the classroom. It's a really sad state of affairs for the PSW profession currently. So my job is trying to get self-regulation, promote the PSW because right now it's not a job that we can promote. What are you going to say, "Come work in home care for $16.50 an hour"?

You're going to work 70 hours a week. You don't get any travel time [compensation]. So we're on the same page with a lot of the unions and our goal is to work with them. 

So how is self-regulation helpful? If I'm a PSW and earning $16.50, for example, how would the association help me?

So in order to keep PSWs in the field, one of the brilliant ideas my education department came up with is, "Let's specialize the PSWs." The PSW training is between six to eight months at either a career college or community college. So when they come out into the field, they don't have all the training that they need.

We have a lot of trainings with the association that will help the PSWs, give them specialized training in the areas that they want to go into, and therefore actually increase the wages for them.

The biggest issue in our sector is there is no accountability. So if a PSW [neglects a patient] -- she should be under investigation and have her PSW certificate taken away from her. But unfortunately, because we're unregulated, that PSW can be written up by [the employer], fired, sign an agreement and get rehired [somewhere else]. Or go down down the street and work in a long-term care home. 

So the cycle of abuse in the PSW world is rampant because we don't have a way to hold these individuals accountable. Let's say a nurse messes up, they're in deep [trouble]. But if a PSW messes up, and they can easily go, "ehh."

So that's where a regulatory body would be helpful.

Exactly. We have a third party that audits my membership and holds my members accountable. And it's called the Personal Support Worker Institute of Canada.

And it just [formed over] over the summer. [At OPSWA] we can't advocate for PSWs and [also] discipline them -- it's a huge conflict of interest. So we have a separate body now that does all of that.

But if a PSW who's a member of our association [is neglectful], and we get a complaint, that complaint's then filed through the Personal Support Worker Institute of Canada and they launch an investigation. 

If the investigation deems that that PSW did something wrong, then it goes to the board, which consists of six personal support members and six members of the public. The board then makes a decision as to whether or not that PSW could still keep their association membership.

I understand that many home care providers cap wages at around $19. Is it common for PSWs to get higher wages with better training?

It's becoming more common. As far as wages are concerned, that really is more of a union issue than an association issue. Regulation would automatically raise the wages for PSWs because you can't pay regulated professions $16.50 an hour; it just doesn't work. 

From a professional association standpoint, do we believe that PSWs deserve to be paid more money? Absolutely. I think that they should at least be starting out at $18.25. That would be a good starting point in home care. 

Home care is like Pandora's box, because once you open it, you're going to have so many stories. There are so many different components. If you look at the public sector, the big [providers] that receive funding from the government have the money to pay them the $19.75 an hour, $20 an hour. Like, I know [a big for-profit firm] was offering full-time positions with salaries. 

They've really changed their tune. It's taken this massive crisis to make that happen, which is unfortunate.

The big companies have the money. But the private companies [not government-funded] can't afford to pay their PSWs even $19 or $20 an hour. 

I notice that CarePartners is one of your sponsors, one of the for-profit companies that has poor working conditions.

The sponsors of OPSWA are not partners, they are sponsors. That means they put up job ads with us, they come out to our conferences to try to hire PSWs, they send their PSWs for training, stuff like that.

I don't have a say in their day-to-day operations at CarePartners. But we do work with them for the betterment of PSWs. I mean truthfully, there's going to be employers out there that join the association to try to quote unquote, make it look good.

From my experience of dealing with higher-ups at CarePartners, I have no issues with them. They seem to be on the same page as everyone else in relation to this crisis. But that's just what I see, right? I'm not in the day-to-day with CarePartners.

Now I have PSWs who are members of my association that love working for CarePartners. But I can say that for every single home care company in the province, it doesn't really matter which one it is. And I think it really depends on where you work as well -- which branch, which region, who's your supervisor. We find one of the biggest issues in home care is not so much the CEOs at the top, it's the supervisors. 

But it's also a structural thing, right? Because the CEO of CarePartners, Linda Knight, is also the chair of Home Care Ontario [which predominantly represents for-profit home care companies].  And Home Care Ontario is also one of your sponsors. And I'm just wondering what this affiliation means because Home Care Ontario welcomed Doug Ford's Bill 47, which is widely condemned as an anti-worker's-rights legislation. There seems to be a bit of tension over here, because [companies like] CarePartners profit from the exploitation of their workers.

It's hard for me to answer that because I'm not involved in that. What we're involved in is with the betterment and advancement of the personal support worker.

Do I agree with everything that all of my sponsors do? No. But if I truly believe that CarePartners was in essence, trying to [hurt] the personal support workers, I would not be friendly with them.

I don't know if you did any research on me, but I'm quite known for speaking my mind. I say it like it is. And if I don't like someone, I will cut them off at the knees.

Because at the end of the day, I'm about the personal support worker. I'm not about whether or not you're unionized or not, whether they work in home care, long-term care, hospital, etc. 

We're about the entire being of the personal support worker. Being a PSW myself, I worked for home care companies. I worked for Bayshore -- that was no fun. I've been there. I've been in the trenches with these people -- when you're going out for a half-an-hour call when you live in Cambridge, and you're going out to Guelph. 

What solutions do you advocate to improve conditions for workers?

Full-time positions,* set hours, maybe salaries, guaranteed benefits. 

I was a care coordinator and a PSW. I've seen it from both sides. Both sides are not easy. There is no easy solution to this. To throw more money to the PSWs -- it's great for the short term.

*Note: About 38 per cent of jobs in the home and community care sector are full time.

What do you mean?

Let's say the Ontario government in a perfect world throws more money at these home care companies and all PSWs in home care are making $23 an hour. That's going to fix the system for a short term [only].

Because the real issue boils down to the fact that the PSW is the lowest of the low on the hierarchy of health care. A PSW once said this to me [when] she called me crying [and said], "Miranda, I got told today by my supervisor that PSWs are at the bottom of the totem pole and that we're worthless." 

And I turned around and said to her, "Think about it. If we're at the bottom of the totem pole, what happens to the totem pole if we're gone? It falls, if there's no support."

So at the end of the day, it's always about money, right? [But if] we look at the whole being of the PSW and all of the issues [such as] lack of recognition and lack of proper training -- that's where the problems truly lie.

And if we can fix that, then we can fix the rest. That's what we believe. And that's not [something] we came up with during a board meeting one day. That's from years and years of working for the PSWs [and doing the research].

What is your take on the Ford government's reforms and how they will impact home care?

I think it's always positive when you are getting rid of a massive amount of bureaucracy. I was astounded at the number that came out yesterday in the news and how much money they're going to be saving a year by firing these nine LHIN CEOs. Our hope is that the money will trickle down to the frontline.

I can't speak to [the benefits of] the Super Agency or the Ontario Health Teams -- no one knows anything. People are asking me and I'm asking them. There are all these associations and we should know what's going on but we don't. It's to be seen whether it works or not. 

So that does that also speak to the Ford government's lack of transparency because I've spoken with other people as well and they also seem to be in the dark about what exactly is going to happen.

So we're in the same boat. Their lack of transparency is slightly concerning. However, we see movement on the ground in relation to change. It's very, very slow. And again, let's go back to the fact that it is government and government's slow at everything. 

We've had our proposal in front of the Ontario government for over a year for self-regulation of personal support workers and they haven't even looked at the PSW file. And we're in a mass staffing crisis. Funny, I know. We really just don't know what's going on.

I noticed that there are Progressive Conservative MPPs who have endorsed your organization [on your website]. Are you affiliated with the party? 

No. We don't favour any one party. People say, "Oh, you guys are PC-friendly." Well, of course, I am right now because they're the ones in power. When the Liberals were in power, we fought really hard to work with the Liberal government [as well].

They didn't want any part of a professional association for PSWs, unfortunately. So we went to the opposition, which at that time were the Conservatives. And so we worked very closely with the PCs when Patrick Brown was the leader. And we wound up on their election platform to self-regulate PSWs.

Then Doug Ford came into power and now it's to be seen whether that happens. They seem to be the only ones who seem to be open to working with us. 

But we work with everybody. I keep in touch with the NDP, mainly France Gelinas' office as she's the health-care critic. 

Zaid Noorsumar is a journalist who has written for the CBC, VICE, The Canadian Press, the Toronto Star and Rankandfile.ca. He was rabble's labour beat reporter for 2019.

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