Page - 343 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

343Fault Lines: COVID-19, the Charter, and Long-term Care are regulated at the provincial/territorial level. But although govern- ments provide over 70% of funding, long-term care falls outside the framework of the Canada Health Act and the single-payer system.18 As a result, levels of public investment and ownership vary greatly across the country, and no national standards or uniform conditions exist.19 There is wide agreement that “funding and services have not kept pace with increasing needs of residents.”20 Over the past 20 years, health care and seniors’ advocacy groups, labour unions, public inter- est and human rights organizations, researchers, ombudspersons, and governments themselves, have criticized the substandard condition of many facilities, the insufficient level of public funding, the undue financial burden placed on low-income seniors, wait times, and the lack of oversight and failure to enforce existing health, safety and other regulations.21 Poor wages and working conditions, as Pat Armstrong, <www.seniorsadvocatebc.ca/app/uploads/sites/4/2018/01/QuickFacts2018- Summary.pdf>; “This is Long-Term Care 2019” (2019) at 3, online (pdf): Ontario Long-term  Care  Association <www.oltca.com/OLTCA/Documents/Reports/ TILTC2019web.pdf>. 18. “Health Spending—Nursing Homes” (last visited 29 May 2020) online (pdf): Canadian Institute for Health Information <secure.cihi.ca/free_products/infos- heet_Residential_LTC_Financial_EN.pdf>; Steven Lewis, “The Pandemic and the Politics of Long-term Care in Canada”, Policy  Options (11 May 2020), online: <policyoptions.irpp.org/magazines/may-2020/the-pandemic-and-the-politics- of-long-term-care-in-canada/>. In Ontario, for example, provincial funding in 2018 was $4.28 billion or 7% of the overall provincial health budget; “About Long-term Care in Ontario: Facts and Figures” (last visited 29 May 2020), online: Ontario  Long  Term  Care  Association <www.oltca.com/oltca/OLTCA/Public/ LongTermCare/FactsFigures.aspx>. 19. “Ensuring Quality Care for All Seniors” (November 2018) 5-11, online (pdf): Canadian Health Coalition <www.healthcoalition.ca/wp-content/uploads/2019/12/ Seniors-care-policy-paper-FINAL-Version-Dec-2019.pdf>; “Seniors in Transition: Exploring Pathways Across the Care Continuum” (2017), online (pdf): Canadian Institute for Health Information <www.cihi.ca/sites/default/files/document/seniors- transition-methodology-notes-2017-en-web.pdf>; “Dignity Denied: Long-term Care and Canada’s Elderly” (February 2007) at 7, online (pdf): National Union of Public  and  General  Employees <nupge.ca/sites/default/files/publications/Medicare/ Dignity_Denied.pdf>. 20. “This is Long-Term Care 2016” (2016) at 8, online (pdf): Ontario  Long-term  Care  Association <www.oltca.com/OLTCA/Documents/Reports/TILTC2016.pdf>. 21. See e.g. National Union of Public and General Employees, supra note 19; Canadian Health Coalition, supra note 19; Andrew Longhurst, “Privatization  and  Declining  Access  to  Seniors’  Care:  An  Urgent  Call  for  Policy  Change” (March 2017), online (pdf): BC  Office  of  the  Canadian  Centre  for  Policy  Alternatives <www.policyalternatives.ca/ sites/default/files/uploads/publications/BC%20Office/2017/03/access_to_seniors_ care_report_170327%20FINAL.pdf>; “Situation Critical: Planning, Access, Levels of Care and Violence in Ontario’s Long-Term Care” (21 January 2019), online (pdf):