'It is truly the wild west': Ontario non-profit LTC homes demand caps on temp agency fees

Not-for-profit long-term care homes in Ontario are spending millions of dollars on temporary health-care staff because the agencies they work for are "exploiting the health human resource crisis," a provincial association says.

In a voluntary survey conducted among members of AdvantAge — the association representing the majority of the province's not-for-profit and municipal long-term care homes — one agency was found to be charging homes as much as $150 per hour for a registered nurse, 249 per cent more than the typical rate.

"We have agencies who wait in our parking lot and talk to our staff on their departure from their day of work," said Steven Harrison, the CEO of Tri-County Mennonite Homes, which runs homes in Stratford and the Kitchener-Waterloo area. 

Harrison's group is among the 100 facilities that took part in the survey — roughly half of AdvantAge's membership. The results come as many Ontario health-care staffers, including nurses, personal support workers and others, have been leaving permanent public-sector positions. Some have turned to agencies that often promise more flexibility and higher wages amid chronic understaffing, overwork and burnout due to the pandemic.

Agencies then tell staff, "you don't need to work as long or as hard with as much commitment and we can get you more money to do basically the same work," Harrison said.

"People are tired; there is no reprieve right now for anyone on the front-line and resiliency is starting to wane," he added.

"What [the agencies] are doing is taking advantage of a very desperate situation in the health-care sphere."

Harrison says non-profit homes like his continue to lose staff to agencies but have  been unable to raise salaries significantly due to Bill 124 — legislation passed by the Ford government to limit wage increases for public sector workers. He says they are at the mercy of whatever agencies want to charge to meet their staffing shortfalls.

"For the agencies, it is truly the wild west," said Harrison.

He says his homes are projected to spend more than $3 million on agency workers in the fiscal year ending March 31, compared to close to $150,000 the year before the pandemic. They had originally budgeted to spend just under $300,000 this fiscal year.

"These are taxpayers' dollars that we are funded with and they are being … squandered in a manner that was never anticipated when the dollars were being allocated to us to deliver this care," he said.

Harrison, AdvantAge and others are calling on the provincial government to implement a framework limiting what agencies can charge and what extra charges are reasonable. They say such a move would bring accountability to a situation where homes might no longer be able to provide adequate care because they can't afford to pay wages at these rates.

"It's a really serious situation," said Lisa Levin, CEO of AdvantAge. With agencies charging more than double the typical wage for a registered nurse, the government "needs to restrict these hourly agency rates and they need to do this urgently," she said.

AdvantAge's survey found that agency health care workers were performing about seven per cent of the work in the last six months of 2022, but receiving more than 16 per cent of the wages in long-term care homes.