Based on the latest modelling data for the province of Ontario, the number of active COVID-19 cases including those requiring hospitalization, continues to climb, having recently reached its highest levels since the beginning of the pandemic. That said, as of April 19th, there were almost 2,000 patients in hospitals simply waiting to be transferred to a long-term care home. In light of this, as well as the fact that there are sufficient long-term care home spaces to which these patients could be moved, the provincial government is taking steps to create more critical care capacity in hospitals. Specifically, it has announced its plans to support the safe placement of these patients out of hospital, including through changes to rules on staffing in long-term care and retirement homes.
Ensuring Appropriate Levels of Care in Long-Term Care and Retirement Homes
On April 23, 2021, O. Reg. 158/20 (Limiting Work to a Single Retirement Home) and O. Reg. 146/20 (Limiting Work to a Single Long-Term Care Home) under the Reopening Ontario (A Flexible Response to COVID-19) Act, 2020 were amended in order to ensure appropriate levels of care in long-term care and retirement homes. More specifically, the recent amendments exempt fully immunized employees – meaning those that have received the total required number of doses of a COVID-19 vaccine approved by Health Canada, with the final dose having been received at least 14 days ago – of such institutions from the temporary restrictions prohibiting them from working in more than one home, or in another health care setting. The exemption applies province-wide unless employees are otherwise directed by a local medical officer of health.
As it currently stands, fully immunized employees in Ottawa who work in long-term care homes or retirement homes are exempt from the regulations limiting work to a single long-term care home or retirement home, as Dr. Vera Etches, the region’s Medical Officer of Health, has not directed otherwise.
Employers are required to post a copy of the order in a conspicuous and easily accessible location in each of the homes that they operate.
Allowing Flexibility in Staffing and Related Matters in Long-Term Care and Retirement Homes
In a further effort to ensure appropriate levels of care in long-term care and retirement homes, the provincial government has provided Ontario Health and Home and Community Support Services (HCCSS) with the authority to redeploy staff – including both regulated and unregulated health professionals, as well as unregulated staff – to long-term care homes and retirement homes as needed.
Additionally, the provincial government has introduced a new emergency order under the Emergency Management and Civil Protection Act. O. Reg. 317/21 (Agreements Between Health Service Providers and Retirement Homes) applies where, in response to the COVID-19 pandemic, a health service provider as defined in the Connecting Care Act, 2019 and a licensee of a retirement home have entered into an agreement or arrangement to have the retirement home provide alternative space, accommodation or care services for the health service providers patients, or for its former patients discharged during the emergency, on a temporary, short-term basis. Pursuant to this new regulation, such an agreement or arrangement:
- Will not impact whether the health service provider or the retirement home are considered to be a hospital for the purposes of the Hospital Labour Disputes Arbitration Act,
- Will not impact whether the health service provider or licensee are treated as constituting one employer for the purposes of the Labour Relations Act, 1995, and
- Will not cause the health service provider to be considered to have sold a part of its business to the licensee for the purposes of the Labour Relations Act, 1995.
Implementing Other Measures Unrelated to Staffing Rules
In conjunction with the above changes to staffing rules, the provincial government will be taking a number of additional steps to support the safe placement of patients in long-term care and retirement homes. These include:
- Encouraging patients in hospitals to accept long-term care home placements in a home that might not be their preferred choice by temporarily waiting co-payments for these patients and maintaining their priority status on the waitlist for their preferred home,
- Authorizing the transfer of hospital patients to long-term care or retirement homes (with or without their consent) in order to respond to major surge events, and
- Changing the rules regarding admissions and transfers to long-term care homes as detailed in Directive 3, including as it relates to fully immunized, partially immunized/unimmunized, and recently recovered residents.
In Our View
Employers in the hospital and long-term care sectors will be pleased to see that the provincial government is taking proactive steps to implement and adapt temporary measures that will allow them to more effectively address the current reality of the pandemic in Ontario, all while protecting patient and resident safety. Emond Harnden will continue to monitor and to report on any further developments in this regard.
For more information on your rights and obligations as an employer dealing with COVID-19 or related issues, please contact Vicky Satta at 613-940-2753, Porter Heffernan at 613-940-2764, or Mélissa Lacroix at 613-940-2741.