The Ontario government has adopted an emergency order allowing the province to issue a mandatory management order for a long-term care home struggling to deal with a COVID-19 outbreak. This order would support the use of rapid, immediate and effective management alternatives to protect residents and staff within a home. The manager could be any person, including a corporation or a hospital.
"We are doing everything we can to fortify the iron ring of protection around our long-term care residents and the heroic frontline staff who care for them," said Premier Doug Ford. "By taking this step, we will be better prepared to immediately swing into action if a home is struggling to contain this deadly virus."
A long-term care home may require management assistance if they face challenges like a high number of cases among residents or staff, a high number of deaths, an outbreak that has not yet been resolved, significant staffing issues or outstanding requirements from infection prevention and control assessments. Decisions regarding when and where to assign additional management support will be made on a case-by-case basis.


"We are incredibly grateful to long-term care operators across the province who are working tirelessly each day to contain COVID-19 outbreaks," said Dr. Merrilee Fullerton, Minister of Long-Term Care. "This is another step we are taking to ensure homes are provided with the support they need at this challenging time to maintain the quality of care our residents deserve."


On April 15, 2020, the government announced a COVID-19 Action Plan for Long-Term Care Homes to help prevent the spread of the virus by focusing on additional testing, containment, addressing staffing challenges and securing personal protective equipment.
The province also adopted several emergency orders restricting the movement of staff between multiple homes; enabling the implementation of pandemic premium pay for LTC staff; and enabling the deployment of hospital staff to address staffing shortages and the use of Infection Prevention and Control teams.
In addition, Canadian Armed Forces personnel have been deployed into five long-term care homes to provide support where significant staffing shortages are occurring.

Official Opposition Leader Andrea Horwath said the government’s move to take over the management of long-term care homes in Ontario is welcome, but should have come much sooner, and the government needs to take action on it quickly. The NDP has been calling on the government to do this for weeks, as Ontarians watched in horror as COVID-19 swept through long-term care facilities, infecting vulnerable seniors and staff.
Ontario’s first COVID-19 death in long-term care dates back to March 24. By March 31, British Columbia’s chief medical officer of health had assumed responsibility for nursing care staff in the Vancouver region, and by April 5, this authority was in effect province wide. Quebec was taking similar steps by mid-April. In mid-April, in response to calls from the NDP, health unions and health care staff to take over homes, Ontario’s Long Term Care Minister Merillee Fullerton refused, saying: “Other provinces do things differently than Ontario.”
“Families who have a parent or grandparent in long-term care in Ontario will no doubt be relieved to learn the government is finally using its power to take over management in these facilities, but many will wonder why their loved ones were left so vulnerable for so long,” said Horwath. “We can’t afford to lose any more days or weeks in the middle of a pandemic when seniors’ and workers’ lives are on the line. Now that we’re moving in the right direction, we need to see swift action to get new leadership into those nursing homes in crisis.”
Horwath added that it’s troubling to see language suggesting that ‘corporations’ could be put in charge of these facilities, despite higher death rates in privately run long-term care homes. According to a Toronto Star report, the risk of contracting and dying from COVID-19 in a long-term care outbreak is four times higher in for-profit homes compared to municipally run public homes and double compared to non-profit homes.
“Seniors in Ontario and their loved ones deserve to know that when the government says it’s stepping in to take over the management of long-term care homes, it’s not just handing the reins from one private operator to another,” said Horwath. “We owe it families across the province to get this right.”

The federal government is giving seniors a one-time, tax-free top-up payment to help manage extra costs associated with the coronavirus.
Seniors Minister Deb Schulte says seniors who receive old age security will get $300, and those who receive the guaranteed income supplement will receive $200.
In all, the $2.5-billion measure will provide payments to 6.7 million seniors, Schulte says.
She says many have faced an increase in the cost of living as a result of the COVID-19 pandemic, from more for dispensing fees for medications or delivery fees for food and services.


She also says their savings have taken a beating as stock markets have tumbled.
The government is also announcing that it won’t suspend OAS and GIS payments to seniors who forget to file their taxes on time.
The most recent federal figures show there were 6.5 million seniors receiving old age security payments in March.
There were 2.1 million receiving GIS payments, which are meant to put a financial floor under seniors.

Sources: toronto.citynews.ca/2020/05/12/seniors-financial-aid-coronavirus/
Sources: www.canada.ca/en/department-finance/economic-response-plan.html#individuals

NDP Leader Andrea Horwath says that Ontario deserves a broad and thorough public inquiry into long-term care, including why the system was in crisis before the pandemic hit; how the pandemic response left seniors homes so vulnerable; and an examination of the future of for-profit homes in Ontario.
“It’s heartbreaking to think of seniors left in understaffed, under-resourced nursing homes, with virtually no regulations in place to protect them, while COVID-19 swept through home after home. The staff who care for our most vulnerable have been run off their feet, and have been putting their lives at risk in facilities that don’t have enough personal protective equipment, and that may not have had proper isolation or infection control procedures in place.” Horwath said. “Tragically, residents and staff have lost their lives. We owe it to them, to their families and loved ones, to make major changes to this system, to protect every life from here on.”
Horwath said slow-to-arrive half-measures, loopholes and mixed messaging from the Ford government need to be examined by an independent public inquiry, as does the state of the system before the pandemic hit. She also wants different types of ownership in long-term care scrutinized, comparing outcomes for non-profit homes versus for-profit homes versus public, municipally-owned homes.
“I oppose profits being made by corporations in long-term care. Let’s lay all the facts on the table in a thorough and independent public inquiry,” said Horwath.
Data released Tuesday by the Ontario Health Coalition shows a significantly higher death rate due to COVID-19 in long-term care homes that are owned by for-profit corporations, compared to non-profit homes and public, municipal homes. The analysis showed that the rate of death was 9 per cent in for-profit homes, 5.25 per cent in non-profit homes and 3.62 per cent in publicly-owned, municipal homes.
“I envision a community-based non-profit and public seniors care system – one that doesn’t siphon away frontline funding to pad the pockets of multi-national corporations, but instead uses every penny to deliver the best care,” said Horwath. “This inquiry could be the start of putting Ontario on a new, better, safer and more dignified path.”
Privatization of long-term care increased dramatically in the 1990s under Premier Mike Harris. Harris is now the chair of the board for a massive long-term care for-profit corporation.

The Ontario government is extending emergency electricity rate relief to families, farms and small businesses until May 31, 2020 during the COVID-19 outbreak. Customers who pay time-of-use electricity rates will continue to be billed at the lowest price, known as the off-peak price, 24 hours a day, seven days a week. This electricity rate relief, initially provided for a 45-day period starting on March 24, 2020, has been extended by an emergency order under the Emergency Management and Civil Protection Act. The rate relief is intended to be in place for an additional 24 days.  ​

Starting May 5th, the Ontario government is expanding virtual mental health services to help thousands of Ontarians experiencing anxiety and depression, including frontline health care workers, during the COVID-19 outbreak. These Internet-based Cognitive Behavioural Therapy (iCBT) programs were developed in partnership with MindBeacon and Morneau Shepell and will be provided at no out-of-pocket costs to Ontarians across the province.
The details were provided today by Premier Doug Ford, Christine Elliott, Deputy Premier and Minister of Health, and Michael Tibollo, Associate Minister of Mental Health and Addictions, during National Mental Health Week.
"Even though this virus has taken a heavy toll on our everyday lives, we are doing everything we can to keep people healthy, physically and mentally," said Premier Ford. "By expanding access to free virtual and online mental health supports, I want those who are struggling to know that we are here to support and help you cope with the stress, isolation and anxiety during these extraordinary times."
As part of the government's $12 million commitment to mental health during COVID-19, the emergency funding is helping mental health agencies hire and train more staff, purchase the necessary equipment and technology they need to help patients, and support the creation and enhancement of virtual and online supports for mental health services including:

• Internet-based Cognitive Behavioural Therapy (iCBT): Clients can self-refer to programs through the various service providers listed and be guided through their client journey to find the appropriate supports they need. Online iCBT is supported by therapists and available in English and French.
• Supports for frontline health care workers: Online iCBT is available to frontline health care workers experiencing anxiety, burnout or post-traumatic stress disorder. Those requiring intensive levels of care could be referred to virtual face-to-face care, as well as weekly online peer discussion groups and access to confidential support from a clinician.
• Virtual mental health support services: These include BounceBack telephone coaching and workbooks, and Kids Help Phone for children and youth.

"In order to help stop the spread of this deadly virus our frontline workers are working long hours in stressful situations and people across the province are doing their part by staying home, in many cases alone," said Minister Elliott. "We know these actions are not easy and can cause stress, anxiety and other mental health issues. That's why we are providing virtual mental health supports, allowing people to get the help they need while still physically distancing."
The province has also established a Mental Health and Addictions COVID-19 Response Table, led by the Mental Health and Addictions Centre of Excellence at Ontario Health, to mitigate the impact of COVID-19 on access to public mental health and addictions services. Its members include representatives from across Ontario's mental health and addictions sector, who are working collaboratively to focus on maintaining services during the outbreak. The Response Table is identifying concerns and implementing quick solutions, supporting virtual care strategies, sharing best practices, and connecting with other COVID-19 regional and provincial tables to ensure any issues impacting the province's mental health and addictions system are quickly resolved. 
"Ontario's mental health and addictions organizations are working around-the-clock to ensure individuals and families have access to the critical mental health and addictions supports they need," said Minister Tibollo. "I applaud these mental health professionals for their commitment, dedication and compassion during these unprecedented times."
At Ontario.ca/coronavirus, people can find information about the different virtual mental health and wellness options that meet their unique needs, including online therapy.
Quick Facts

• This week is National Mental Health Week, Maternal Mental Health Week and Children's Mental Health Week, which coincides with National Child and Youth Mental Health Day on May 7.
• Five hospitals have partnered with the Ministry of Health and the Mental Health and Addictions Centre of Excellence at Ontario Health to provide specific services for frontline health workers: Centre for Addiction and Mental Health, Ontario Shores Centre for Mental Health Sciences, St. Joseph’s Healthcare Hamilton, The Royal Mental Health Centre, and Waypoint Centre for Mental Health Care.
• Mental health and addictions challenges affect over one million Ontarians each year.

Christine Elliott, Deputy Premier and Minister of Health, Todd Smith, Minister of Children, Community and Social Services, Michael Tibollo, Associate Minister of Mental Health and Addictions, and Jill Dunlop, Associate Minister of Children and Women's Issues, released the following statement to acknowledge Mental Health Week:
"During this unprecedented time in Ontario, many people are facing great challenges as a result of the COVID-19 outbreak. During Mental Health Week this year, we are dedicated to raising awareness around an issue that affects over one million Ontarians each year.
Our government recognizes many Ontarians are experiencing increased anxiety because of COVID-19 and are worried about their health, the health of their family and friends, and the future of their livelihoods and are feeling anxious in physical isolation. We want to help those who need support and have taken immediate action to ensure everyone can access the high-quality care they expect and deserve.
Recently, our government announced up to $12 million in emergency funding to immediately expand online and virtual mental health supports. This brings additional access to care for people across the province and specific services to our frontline heroes.
We know maintaining physical distancing can be stressful for many people across the province. Just as it is critical that Ontarians heed the advice of our public health experts to stay at home and maintain safe physical distancing, it is critical that we continue providing everyone with the supports they need to stay both physically and mentally healthy. Ontario's community mental health and addictions sector is working hard every single day to continue delivering services to people in need. We thank them all for their efforts and we will continue working collaboratively with them to identify further opportunities for investments to ensure all Ontarians have access to supports.
This week also marks Maternal Mental Health Week and Children's Mental Health Week, which coincides with National Child and Youth Mental Health Day on May 7. The mental health of all children and youth in Ontario is of great importance. That is why we have recently expanded programs, such as BounceBack, and have provided emergency funding to Kids Help Phone, to further support children and youth who are struggling with their mental health.
Ontario also launched a Roadmap to Wellness: A Plan to Build Ontario's Mental Health and Addictions System, which provides a clear path forward toward offering Ontarians easier access to standardized, high-quality care and supports in communities across the province. As we implement this plan, we will continue listening and collaborating with our partners to ensure it works for all Ontarians.
We are committed to creating an Ontario where everyone is fully supported in their journey toward mental wellness. While you are staying home, we urge you to stay in touch with each other, and to reach out for help when you need it and to those who may be struggling. Even if we cannot be close physically, we are all in this together."

Ontario has significantly increased testing and contact tracing capacity, allowing health experts to identify cases of COVID-19 and support efforts to stop the spread of the virus in the community, long-term care homes, and other congregate settings. In partnership with Ontario Health, Public Health Ontario, local public health units, and hospital and community laboratories, the Ontario government has developed an integrated laboratory system which has established the province as a national leader in daily testing volumes per capita.
"We've been working around the clock to establish a vast and robust testing regime, which is critical in our fight against this deadly virus," said Premier Ford. "We're now exceeding our target of 16,000 tests a day, with many of those tests aimed at protecting our long-term care residents and staff. This important milestone provides a strong foundation for gradually reopening our economy and getting people back to work, while protecting the health and safety of all Ontarians."
Testing is being carried out in hospitals, long-term care homes, group homes, shelters, emergency child care centres, and other congregate settings. Once test samples are collected and received from frontline staff, patients, residents and children, labs are providing test results generally within 24 to 48 hours. On May 2, 2020, the province released updated guidance to the health sector to ensure consistency across the province, and to help guide decision-making on the testing of priority population groups.
To date, Ontario has conducted over 342,000 tests, with testing results being made available to patients through the user-friendly online portal. The portal was developed to help ease pressure on frontline workers, allowing them to focus their efforts on combating COVID-19.
"Thanks to the joint efforts of this diverse group of health experts we have dramatically expanded the scale and scope of COVID-19 testing provincewide and have emerged as a national leader," said Christine Elliott, Deputy Premier and Minister of Health. "We have met and exceeded our testing goals, which is critical to containing and limiting the spread of this new virus, both in our communities and in long-term care homes and other shared living spaces."
The new integrated laboratory system will support the province's health care system and laboratory network far beyond the COVID-19 pandemic. The provincewide testing network consists of more than 20 organizations and is coordinating and leveraging the diverse expertise located throughout the province. This is being achieved through daily check-ins and processes that address operational needs, such as:

• Levels of supplies, expected supply consumption per day, inventory replenishment and other supply chain issues
• Equipment information
• Technical capacity and advances
• Test turn-around times and the shifting of test samples to laboratories that have spare processing capacity
• Ongoing scientific and technical review of test performance
• Alternative approaches to processing
• Emerging technology

Ontario has also helped expand the capacity of public health units to conduct contact tracing and case management. Ontario's Action Plan: Responding to COVID-19 provided $100 million in additional investments for public health units to support COVID-19 monitoring and testing, including funding to support enhanced contact tracing. This funding enables public health units to hire more personnel.
In addition, Ontario previously issued an emergency order to provide public health units the authority and flexibility they need to make staffing decisions that support their ongoing efforts to contain the virus. With the help of volunteers, public health units have been able to expand their capacity to conduct case and contact management ― both of which are critical to stopping the spread of the virus. These include the thousands of retired nurses and medical students who have signed up through the province's website.
Quick Facts

• On April 10, 2020, the province committed to expanding its testing capacity by doubling the number of tests processed each day to 8,000 by April 15, 2020 and 14,000 by April 29, 2020.
• Within 48 hours of implementation, the province’s COVID-19 Action Plan for Protecting Long-Term Care Homes significantly increased testing of long-term care staff and residents.
• The province’s COVID-19 Action Plan for Vulnerable People further expanded testing of staff and clients at group homes, homeless shelters, and other congregate settings.
• Ontario has a provincewide network of 23 laboratory sites working in coordination to further increase capacity and test turn-around times for COVID-19 testing.
• Ontario is now a leader in Canada in daily testing volumes per capita. Recent expansion of testing has the province’s per capita testing ahead of Alberta, British Columbia and Quebec.

Additional Resources

• Ontario’s Action Plan: Responding to COVID-19
• Visit Ontario's website to learn more about how the province continues to protect Ontarians from COVID-19.

Today, the Ontario government issued new temporary emergency orders under the Emergency Management and Civil Protection Act to support the immediate needs of the province's hospitals and health care workers so they can better manage critical health care human resources during COVID-19.
"By taking these steps today, we are improving flexibility for our hospitals and health care workers so they can focus more of their time and resources on providing patient care and stopping the spread," said Premier Ford. "We will do whatever it takes to ensure our frontline health care heroes are safe and have everything they need to do their jobs more efficiently."  
The new temporary emergency orders issued today will:

• Give hospitals the authority and flexibility to more quickly appoint, re-appoint and grant privileges to medical and other professional staff, in order to address potential surge volumes due to COVID-19. This emergency order will allow for the reduction of administrative processes and better enable hospitals to focus operational resources on providing frontline services.

• Authorize coroners, registered nurses appointed as coroner investigators, and public health units to access the provincial electronic health record to help reduce demands on clinicians' time related to death investigations, reduce exposure to COVID-19 related death investigations, and improve the ability to monitor the spread of the virus.

• Allow registered nurses appointed as coroner investigators to complete medical certificates of death instead of a physician or nurse practitioner, giving these medical professionals more time to focus on patient care.

"Extending the authority to a limited number of registered nurses, who are trained and authorized to investigate deaths, is imperative as we work to stop the spread of COVID-19," noted Solicitor General Sylvia Jones. "This temporary order will help ensure clinicians remain available for patient care as well as provide respectful care of the deceased and the timely completion of medical certificates of death."
Quick Facts

• Registered nurses, currently appointed under s. 16.1 of the Coroners Act, are trained in all aspects of death investigation, including determination of cause and manner of death. Training specific to completion of the medical certificate of death will be provided with ongoing review and mentoring.
• The completion of a medical certificate of death is necessary to understand the extent of infection and illness in the community.

Additional Resources

• Learn more about Ontario’s Action Plan: Responding to COVID-19.
• Visit Ontario's website to learn more about how the province continues to protect Ontarians from COVID-19​