Throughout the summer, as part of the Province’s reopening strategy, the Ministry of Children, Community and Social Services (the “Ministry”) has released guidelines on resuming in-person visits in congregate care living settings. See our previous articles on these visitation guidelines in our COVID-19 Resource Centre here. These guidelines have been updated and revised over time to reflect the risk of COVID-19 in the wider community. While no doubt introduced with good intentions, the guidelines have at times been less than clear and, in some cases, been overly restrictive, applying a one-size-fits-all approach that failed to recognize the diverse needs, abilities and vulnerabilities of the very people the guidelines were designed to protect.
These issues have had negative repercussions for people, families and support agencies alike. People living in congregate care have reported suffering social and familial isolation and decline in overall health and wellbeing; families have reported extreme anxiety about their loved ones and the pain of separation; and agencies have found themselves between a rock and a hard place – on the one hand bound to follow the government’s guidelines, directed to observe the recommendations of public health, required by law to ensure the safety of people supported and staff, and on the other hand genuinely concerned with and invested in the human rights and psychosocial well-being of the people they support.
Fortunately, with the move to Stage 3 of Ontario’s re-opening plan, the government has introduced modifications to the Ministry’s guidance (sent to agencies after business hours on Friday, August 28, 2020). These modifications have provided some clarity and flexibility, and opened the door to greater opportunities for visitation in the community.
Current Expanded Guidelines
The new, expanded guidelines on “Short-Stay Absences and Outings and Essential Overnight Absences” for individuals living in congregate care settings build upon existing rules for in-residence visits for family and friends discussed here. These most recent rules provide direction as to the procedures that must be followed for people who reside in congregate care settings and wish to go out into the community. These guidelines are summarized below:
Short-Stay Absences and Outings:
Short-Stay Absences and Outings are community outings during the day (and not overnight) including friend and family outings, shopping, errands, walks, appointments, and for children and youth, going to school.
“Short-Stay Absences and Outings are subject to the following requirements :
- People supported engaging in these visits must pass an active screening questionnaire for signs, symptoms of and potential exposure to COVID-19 (Note: that if a person supported does not pass the screening, agencies are instructed to follow its isolation policies);
- People supported must perform proper hand hygiene upon entry and exit of a congregate care setting, and while out in the community (use of hand sanitizer regularly);
- People supported must wear a face covering/mask (cloth mask is acceptable) when entering indoor spaces, or when they are within 6 feet/2 meters of others in outdoor spaces. People supported are encouraged to practice physical distancing practices as much as possible and adhere to local public health unit advice; and
- As much as possible, people supported must avoid crowded indoor spaces and interactions with multiple people during outings and masks should only be removed indoors for eating and drinking and then immediately put back on afterwards.
Essential Overnight Absences
Essential Overnight absences, such as to a family home, are defined as being “necessary to maintain the health, wellness and safety or any applicable legal rights of a resident.” These absences are approved at the discretion of the agency and will be assessed through the lens of whether the absence is “truly vital.”
The latest Ministry guidance also provides further details on essential overnight visits, which include the following requirements for people supported taking part in an essential overnight absence:
- Upon return, pass an active screening questionnaire that screens for signs
- and symptoms of and potential exposures to COVID-19;
- Only receive outdoor visitors during the 14 days;
- Monitor for symptoms;
- Avoid using common areas; however, if a common area cannot be avoided, the resident must use a face covering/mask;
- Limit contact with other residents;
- Only participate in group activities if physical distancing is maintained (i.e., a
- distance of 6 feet or 2 metres) and the use of a face covering/mask;
- Practice proper hand hygiene by washing their hands often
- Adhere to respiratory etiquette; and
- Continue to follow appropriate physical distancing guidelines (i.e., maintaining a distance of 6 feet or 2 metres).
The guidelines provide that during the 14-day post-absence period, people supported can still go on community outings and this will not reset the 14 days. Only a subsequent overnight absence will reset the 14 days. Testing and isolation of people supported returning from overnight absences should be conducted in consultation with local public health units, based on individual circumstances. The 14-day precaution period does not apply to people supported who have previously tested positive for COVID-19 and have recovered.
Throughout the COVID-19 Pandemic Period, PooranLaw has advocated for the government to provide greater clarity and flexibility for people, families and agencies alike, and to ensure that their directions appropriately balance the sometimes conflicting interests of health and safety and human rights. We are pleased to see that, despite ongoing restrictions and room for improvement, people supported in congregate care settings now have greater opportunities to reunite with their loved ones.
PooranLaw continues to monitor Ministry guidance and will post updates on our “insights” page online, as they become available.
Note: This article provides general information only and does not constitute, and should not be relied upon as, legal advice or opinion. PooranLaw Professional Corporation holds the copyright to this article and the article and its contents may not be copied or reproduced in any form, in whole or in part, without the express permission of PooranLaw Professional Corporation.