OPINION:

Senior Care at a Crossroads in King Township

May 26, 2021

By Tom Butt

King Township is at a crossroads for planning how it will provide future Senior health care and wellness services. COVID-19 has made it worse as many seniors are reluctant to follow the traditional path of giving up the family home. Even before the pandemic, neglect in long term care was prevalent across the province and residents experienced terrible feelings of isolation when separated from family and confined to their care facility. Were we listening when a large majority of seniors spoke out that they did not want to go into long term care? Do we have a deficit in LTC beds or a demand for alternative services that focus on the consumer/family. Can we shift the paradigm away from a corporate model that maximizes efficiencies to one that focuses on providing a continuum of quality care?

At recent Council meetings, Township planning staff have outlined a process to permit a large LTC facility to replace the monastery at Marylake. Because this solution is based on a for-profit model prevalent across York Region, and one we are most familiar with, it is assumed by many to be the appropriate model for our local community. Township staff accepted this submission to confirm zoning, but have not provided Council or citizens the historical utilization data they developed to support this conclusion. Why did staff accept a request to define zoning for LTC at Marylake knowing that the very data supporting that request were not used by AFOI to apply for LTC beds from the Ministry of LTC last September? The excellent history of Mariann House and its operational record were used to convince the Ministry of LTC to allocate new beds to the Marylake site. As the independent LTC Commission in Ontario recently stated ”the skills at raising capital for construction projects might not be the best ones to operate a LTC home”. Citizens are becoming more attuned to the delivery of care to seniors and the new environments within which this care is provided.

What we really need are changes in operational and care delivery policies and facility design solutions that can set new targets for quality care which can be delivered in a more economical way. King Township should not be looking for a single corporation to harvest LTC bed licenses from smaller providers facing economic challenges and rush to build a free-standing, single level of care, separated from many of the traditional support services—such as transportation, community home care, supportive housing, life lease, etc.—necessary for any institution to flourish in a supportive continuum of care. Many long-term care facilities, including the proposed model at Marylake, are institutional in their design and in the way care is provided. The owners’ historical focus on adding an infirmary, and its related clinical items, to a 1950s designed hostel should not be seen as a foundation for changing the zoning of the property to accommodate a licensed LTC facility. Unfortunately, Township planning staff supported this myopic approach to designing a contemporary LTC facility. There are better models out there, but their uptake has been very slow, thus staff are seen as perpetuating a broken system.

Unique to the Marylake project is the reality that the subject property is located outside of King City’s urban boundary in the Greenbelt and Oak Ridges Moraine and thus development of this site is controlled by the Conservation Plans associated with these two provincial protection acts. In addition, the footprint of the monastery is less than 165 feet from a kettle lake -Mary Lake- and thus well within the 120 metre buffer zone of a featured presentation which has its own planning standards. Legal advice is adamant that during the zoning change process, guidelines and standards of the ORMCP must be applied. As section 6(4) states:

Nothing in this Plan applies to prevent the expansion of an ‘existing*’institutional use, if the applicant demonstrates that,

  1. there will be no change in use; and
  2. the expansion will not adversely affect the ecological integrity of the Moraine area

(*where ‘existing’ is defined by ORMCP as being lawfully in existence on November 15, 2001).

We should be reviewing these issues now and not waiting for the site plan approval Application. Waiting until the application for site plan approval to adjudicate section 6(4) compromises all parties involved that believe Marylake is a shovel ready project. Both government agencies and interested community groups were affected. These include; the local LHIN that had to approve the integration of this project within the York Region LTC system; the Ministry of LTC that allocated new beds to this site; Mariann House that needs to relocate it LTC operations; and the community of King Township and its MPP which want a new seniors complex to be developed locally.

Many experts are asking why the industry would use community funding raising as well as new community tax resources on constructing new facilities that have not been revised to incorporate what we are now learning from COVID-19? The recently concluded Long Term Care COVID-19 Commission identified many exciting and different options demonstrating successful LTC operations. It is absolutely crucial that we fix the many challenges in caring for our seniors that were identified even before the pandemic, and that have since become headline horror stories. These facilities need to move away from the cookie-cutter approach and look to offer complex care to specialized populations requiring a high level of nursing, restorative or clinical care. The primary objective for planning the Marylake property can not be fitting the new design on the historical footprint of the 1950s monastery.

In recent years, various models have been explored for providing services to Ontario’s seniors so that they can enjoy the equivalent of aging-in-place. Perhaps all parties involved in King, including community and family representation, could gather to focus on alternatives to large institutional models as being proposed for Marylake. Yes, we have demands to replace outdated facilities housing ward accommodation. Yes, we are facing a baby-boom spike in the number of seniors in the next few years. Yes, King is underserved in seniors’ programming and related facilities. But is the proposed 188 bed LTC facility for the Marylake campus the right choice at this time? It may be meeting the needs of AFOI, but is it a plan for the future of King Township?

When will it be time for King Township to explore the continuum of seniors programming successfully introduced in many similar communities across Ontario or even on an international level for those countries also facing a growing elderly population. Can a home based/family caregiver model work in King Township? What integration of community programming or inter-generational activities could be offered to assist seniors to remain in our community? Should retirement homes or life lease facilities (including partial or full meal services) be included in the mix? On this campus? As part of a village of care? When do we call on acute care services of the local hospitals—or when do they call on our activities? What facilities are needed, and when are they needed, as the care requirements of the individual senior evolve? The options are many and need to be acknowledged before each level of care is defined.

When these and many other questions facing LTC development in King are answered, we can then address the pressing issues of size, location, corporate ownership, capital budget, operational models, fundraising and integration with comparable programs located across York Region and offered in our provincial teaching/research centres. The planning guidelines of the Oak Ridges Moraine and the Greenbelt Conservation Plans and the regulations of the TRCA present major hurdles for the development of services for seniors. King Township Council will need input from all parties involved to ensure a successful “Village of Care” to meet the future needs of our senior residents. We look forward to monitoring Township staff as they grapple with how to fit a seniors health and wellness centre, requiring substantial acreage, onto the Marylake property and still conform to the standards and guidelines of the ORMCP.