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Staff members wave to family and friends who came out to show support of residents and staff in the McKenzie Towne Long Term Care centre, in Calgary, Alta., Thursday, April 2, 2020.Jeff McIntosh/The Canadian Press

Alberta needs to hire thousands of health care workers for its continuing care facilities within the decade, even as it shifts its focus to helping more seniors age at home, to improve the quality of life for elderly citizens, according to a third-party review commissioned by the government.

The province on Monday released a 207-page report from MNP LLP, an auditing firm, examining the future of Alberta’s long-term care facilities, designated supportive living operations, and home care services. The report, as a whole, recommends shrinking the portion of the population who receive care in facilities to 30 per cent from 39 per cent by 2030. Conversely, care at home would climb to 70 per cent from 61 per cent.

The province, however, is not obliged to adopt the recommendations, which MNP produced after a year-long review. The United Conservative Party favours giving elderly residents increased opportunity to age at home, and MNP believes its proposal would reduce capital costs by $1.7-billion. But the report also calls for more hours of direct care each day for residents in facilities, requiring the equivalent of 6,776 additional full-time jobs. It also recommended increasing the number of full-time positions available, rather than relying on part-time and casual labour.

The government had a contentious relationship with health care workers before the coronavirus arrived and the pandemic exacerbated those tensions. The union that represents registered nurses in the province, for example, is advising would-be RNs to find work outside Alberta because it does not trust government to support positions here.

Health Minister Tyler Shandro brushed off questions about Alberta’s ability or desire to hire thousands of new health care aides and nurses in continuing care operations. The recommended hiring spree would cost $498-million annually, MNP said, which would be offset by $452-million in savings should the shift to more home-based care succeed.

“We know that we need to start the planning now, in 2021, for the beds and the staffing,” Mr. Shandro told reporters.

Demand for continuing care services in Alberta will rise by 62 per cent by 2030, MNP said. To meet demand, while ensuring affordability, the province must deliver more care at home rather than in facilities, MNP said.

“This shift is also consistent with recommended improvements related to quality of life, client choices and the ability to live at home/community longer and increasing the use of self-directed care,” MNP said.

The review, which recommends Alberta maintain a mix of public, not-for-profit and private continuing care facilities, took about a year and cost just shy of $500,000, the government said.

The proposed new health care positions stem from the report’s suggestion that Alberta increase the direct hours of care each resident in its facilities receives each day. Long-term care residents, for example, would receive 4.5 hours of direct care each day, up from an average of 3.4 now. MNP noted Alberta’s funding model for direct care, which covers nursing, personal care, professional and non-professional therapies, was implemented in 2014-15 and has not changed in six years despite evidence indicating residents are more frail when they enter long-term care than in the past.

Heather Smith, the president of the United Nurses of Alberta, said the province is already struggling to meet staffing demands. She does not think the government could meet MNP’s hiring recommendations.

“Not with the signals they are giving to nurses in this province right now,” she said, noting the union expects Alberta to lay off nurses after the COVID-19 pandemic settles. UNA is concerned the government wants to diminish the role of registered nurses in continuing care, Ms. Smith said. This makes the possibility of mass hiring unlikely, she said.

“I don’t believe we will have those resources.”

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