O. Reg. 271/21 – Work Redeployment for Local Health Integration Networks and Ontario Health

Description:

  • The emergency order provided the authority and flexibility to Home and Community Care Support Services (HCCSS) organizations (formerly Local Health Integration Networks) and Ontario Health to voluntarily deploy staff, such as care coordinators, nurses and others, to work in hospitals that were experiencing significant capacity pressures due to COVID-19covid 19.
  • In addition, the emergency order authorized HCCSS organizations to deploy staff to backfill redeployed staff within and to another HCCSS organization.
  • The emergency order came into effect on April 9, 2021.
  • The emergency order was amended to authorize HCCSS organizations and Ontario Health to take any reasonably necessary measure to assist long-term care homes and retirement homes, in addition to hospitals, with respect to work deployment and staffing.
  • The emergency order was amended on June 2, 2021 to continue redeployments to hospitals only and to continue to provide HCCSS organizations with the authority to redeploy staff to other HCCSS organizations in order to backfill those redeployed to hospitals. Redeployment to long-term care homes and retirement homes was no longer required with decreasing case counts and lessened pressures on hospitals and their ICUs.

Why the emergency order was needed:

  • Amid rising case rates, hospitalizations and ICU occupancy, it was necessary to utilize all highly trained and skilled employees to support the health care system to the best extent possible. Trained staff were urgently required at Ontario’s hospitals to ensure the ongoing provision of clinical care to patients (those with and without COVID-19covid 19.)
  • The pandemic strained the capacity of hospitals to treat patients with acute care needs. The volume of work, extended pressure on hospital staff and the need to enhance hospital capacity as infection and hospitalization rates rose resulted in a large number of vacancies in clinical and other positions across hospitals. This was compounded by high levels of staff absenteeism caused by illness and mental distress.
  • The order was a reasonable measure because it provided the system with options to address health human resources demand across the continuum of care. Hiring new staff or entering into new contracts with service provider organizations would have been a time-consuming process that would not support urgent same-day or same-week demands for services.

Extension and revocation:

  • The emergency order was extended following the termination of the third declared emergency. This emergency order expired on June 30, 2021 because it was no longer needed following general improvements in public health and health care trends.

O. Reg. 272/21 – Transfer of Hospital Patients

Description:

  • This emergency order authorized hospitals to transfer patients to alternate hospital sites without obtaining the consent of the patient or, where the patient was incapable, their substitute decision maker in situations where a hospital’s resources were at significant and immediate risk of becoming overwhelmed.
  • The emergency order permitted hospitals to only transfer patients to alternate hospital sites when doing so was necessary to respond to a major surge in cases. When the attending physician was satisfied that the patient would receive the care they required at the other site, then the transfer could be made without compromising the patient's medical condition and where all other conditions specified within the order were met.
  • The emergency order came into effect on April 9, 2021.
  • The emergency order was amended on April 28, 2021 to permit hospitals to also transfer patients designated as alternate level of care (“ALC patients”) to either a long-term care home or a retirement home without obtaining the consent of the patient, or where the patient was incapable, their substitute decision maker. This was revoked on June 2, 2021.

Why the emergency order was needed:

  • The emergency order was necessary to assist hospitals to transfer patients to alternate hospital sites on an urgent basis to respond to rapidly rising hospitalization rates. This emergency order supported enhanced patient flow and maximized capacity across the hospital system.
  • The order was a reasonable measure relative to others because it helped support an appropriate level of health system capacity during the third wave of the COVID-19covid 19 pandemic in Ontario. Inter-hospital transfers were necessary to enable effective load-balancing across the health system and voluntary patient transfers would not have been adequate.

Extension and revocation:

  • The emergency order was extended following the expiration of the third declared emergency. This order expired on June 30, 2021 because it was no longer needed following general improvements in public health and health care trends.

O. Reg. 304/21 – Work Redeployment for Independent Health Facilities

Description:

  • The emergency order provided independent health facilities with the authority to redeploy staff to hospitals while remaining under the employment of the independent health facility.
  • The emergency order came into effect on April 21, 2021.

Why the emergency order was needed:

  • Amid rising case rates, hospitalizations, and ICU occupancy, it was necessary to utilize all highly trained and skilled employees to support the health care system to the best extent possible.
  • The COVID-19covid 19 pandemic strained the capacity of hospitals to treat patients with acute care needs. The volume of work, extended pressure on hospital staff and the need to enhance hospital capacity as infection and hospitalization rates rose resulted in a large number of vacancies in clinical and other positions across hospitals, compounding high levels of staff absenteeism caused by illness and mental distress.
  • Trained staff were urgently required at Ontario’s hospitals to ensure the ongoing provision of clinical care to patients with and without COVID-19covid 19.
    • Independent health facilities employ staff that have a range of clinical expertise that assisted hospitals to respond to, prevent and alleviate the effects of COVID-19covid 19.
  • The order was a reasonable measure relative to others because it provided the timeliest response and most consistent approach. The existing governing frameworks did not enable the movement of staff. It would not have been timely or feasible to amend or address each individual collective agreement in the broader health care sector to reflect the temporary measures needed to respond to the pandemic. Hiring new staff or entering into new contracts with independent health facilities would have been a time-consuming process that would not support urgent same-day or same-week demands for services.

Extension and revocation:

  • The emergency order was continued following the termination of the third declared emergency. It expired on June 16, 2021 as it was deemed no longer necessary following general improvements in public health and health care trends.

O. Reg. 305/21 – Regulated Health Professionals

Description:

  • The emergency order authorized regulated health professionals from other Canadian provinces and territories to work in any Ontario hospital.
  • The emergency order also authorized regulated health professionals to operate outside of their regular scope of practice if the services are consistent with the duties/privileges assigned by the hospital or part of an alternative care or staffing plan that the hospital has implemented.
  • This order also allowed hospitals to redeploy other staff to key areas that were needed to facilitate the province’s response to the COVID-19covid 19 pandemic.
  • The emergency order came into effect on April 21, 2021.

Why the emergency order was needed:

  • Amid rising case rates, hospitalizations and ICU occupancy, it was necessary to utilize all highly trained and skilled employees to support the health care system to the best extent possible.
  • The pandemic strained the capacity of hospitals to treat patients with acute care needs. The volume of work, the extended pressure on hospital staff and the need to enhance hospital capacity as infection and hospitalization rates rose resulted in a large number of vacancies in clinical and other positions across hospitals, compounding high levels of staff absenteeism caused by illness and mental distress.
  • The order was a reasonable measure relative to others because it provided the timeliest response, as the existing governing frameworks did not enable the movement of staff.

Extension and revocation:

  • The emergency order was extended following the termination of the third declared emergency. It is still in effect as of October 7, 2021.

O. Reg. 317/21 – Agreements Between Health Service Providers and Retirement Homes

Description:

  • This emergency order supported the transfer of patients discharged from health service providers to retirement homes on a temporary or short-term basis by addressing potential labour implications where the health service provider and retirement home have entered into an agreement or other arrangement for the transfer.
  • The emergency order came into effect on April 23, 2021.

Why the emergency order was needed:

  • In anticipation of unsustainable capacity strains due to the alarming trends in COVID-19covid 19 cases and intensive care unit occupancy in Ontario hospitals, this emergency order was made to create more flexibility to transfer alternative level of care patients out of hospitals to retirement homes.
  • Without the order, retirement homes entering into these arrangements and offering additional beds and services may have been considered hospitals under the Hospital Labour Disputes Arbitration Act or as one employer under subsection 1(4) the Labour Relations Act, 1995, making them subject to hospitals’ collective agreements. The order further expressed that the health service provider is not considered to have sold a part of its business to the retirement home for the purposes of section 69 of the Labour Relations Act, 1995. This provision was to prevent the application of successor rights. Without the order, the transfer of patients into retirement homes would have increased their labour costs and decreased affordability for residents.
  • The order was a reasonable alternative to other measures as it would not have been feasible to make multiple legislative or regulatory amendments to address these labour relations implications. The emergency order ensured rapid, provincewide changes that could facilitate the participation of retirement homes in this voluntary program.

Extension and revocation:

  • The emergency order was extended following the termination of the third declared emergency.
  • The order expired on June 16, 2021 as it was deemed no longer necessary due to the success of provincial measures and widespread vaccination efforts that significantly reduced COVID-19covid 19 cases and eased pressures on hospitals.