I am proud to be part of a COVID-19 Working Group established by the Ontario Bar Association’s (OBA) Elder Law Section. We are urging the Ontario government to act now to increase the safety of older adults living in long-term care homes. The OBA letter to Ministers Fullerton and Cho found here makes specific recommendations for the implementation of immediate measures, some of which are:

Resume unannounced annual Resident Quality Inspectors

The Long-Term Care Homes Act requires inspections at least annually, without advance notice, to ensure compliance.  However, in the fall of 2018, the Ministry of Long-Term Care scaled back comprehensive Resident Quality Inspections to focus on ‘risk-based’ complaints-triggered inspections. The government is being asked to resume unannounced annual on-site and in-person inspections, as they are an essential compliance measure to protect the vulnerable population of residents in long-term care homes.

Safeguard residents’ right to give informed consent or refusal to treatment and the delivery of personal assistance services

In the long-term care setting, Ontario law requires informed consent of a person or their legally authorized substitute decision-maker both in respect of treatment and personal assistance services. This necessitates health care providers and personal support workers having the ability to engage with residents, to explain risks and options, and to address questions. Their ability to do so is hampered by staff shortages, insufficient personal protective equipment and a lack of resources and training. The Ministry of Long-Term Care is being asked to ensure that health care providers and personal support workers have the knowledge, resources and time to properly engage with residents and ensure their consent or refusal to treatment is fully informed.

Ensure sufficient life safety measures are installed in long-term care homes.

Long-term care homes are exempt until January 1, 2025 for installation of automatic fire sprinklers under the Ontario Fire Code, on the basis that under a long-term care home rebuild program, all Ontario long-term care homes would be brought up to current standards by January 1, 2025. Given the delay in the rebuild program, many older long-term care homes still do not have automatic fire sprinklers, and are unlikely to be brought up to current standards by January 2025. The government is being called upon to implement sufficient life safety measures, including installing automatic fire sprinklers in all Ontario long-term care homes as soon as possible.

Accelerate the completion of a long-term care home rebuild program**

Currently, approximately one-third of all long-term care beds in Ontario remain at the 1972 standard. These beds accounted for 57% of the province’s 1,691 reported COVID-19 deaths in long-term care homes (as of early June). The Ministry of Long-Term Care is being asked to take immediate control of the rebuild program to ensure that new homes are built or rebuilt promptly, in locations that meet the demand for long-term care home services.

I am appreciative of everyone who supported this initiative, and to the Working Group in particular: Lawrence Swartz (Chair), Graham Webb, Raymond Leclair, Kim Gale and Amy MacAlpine.

Have a great day,

Natalia Angelini

** Here you can find the announcement that was just made regarding the acceleration of the rebuild program.