By Jack Hauen and Sneh Duggal
Province taking over more long-term care homes
Premier Doug Ford announced the province will take over five more long-term care homes, effective immediately: Eatonville in Etobicoke, Hawthorne Place in North York, Altamont in Scarborough, Orchard Villa in Pickering, and Camilla Care Community in Mississauga. The province had already installed new management at two other homes: Downsview in North York, and River Glen Haven in Sutton.
The five new homes include all four for-profit homes that were the subject of the <a href="https://www.qpbriefing.com/2020/05/26/ford-vows-justice-after-army-report-exposes-brutal-long-term-care-conditions/" target="_blank" rel="noopener noreferrer">Canadian Armed Forces report exposing horrific conditions</a>, as well as Camilla, a private 236-bed facility that has seen 61 resident deaths. The other home in the report, Grace Manor, will retain its non-profit management.
The army has accepted Ford's request to stay on for awhile longer, he announced. He had asked for 30 days on Tuesday, but the army agreed to at least 16, Ford said.
“In the face of these problems, we’ll use every tool at our disposal,” he said at his Wednesday press conference. “I want eyes and ears in the homes we’re most worried about, keeping a close watch.”
Six teams of two inspectors will be sent to each home to all five from the report, plus Camilla, for two weeks, to interview staff and residents and review charts and records. At least one inspector will stay at their assigned home over the entire period, Ford said.
Over the next three weeks, the province will conduct "extremely rigorous inspections" of 19 other hard-hit homes, Ford said, adding that eight of those inspections have already been completed. Random spot checks will be conducted at other homes over the next 30 days, he said.
“My message to all long-term care homes: get your act together,” he said, though he added that he doesn’t want to paint all facilities with a broad brush. The inspections will determine who are "good operators" and who are "bad actors," he said.
“Be a good operator. I don’t think it’s too hard,” he said, adding that most homes are doing well. “It’s poor management in my opinion — it starts at the top.”
The government is "fully prepared" to take over or shut down more homes, or pull licenses from operators, Ford said.
Government inspections before the CAF report have been called into question — critics wonder how the province could not have known about the conditions if regular, in-depth inspections were taking place. Provincial statistics show that all of the facilities' last resident quality inspections (RQIs) — unannounced, comprehensive inspections which were supposed to be yearly until the current government changed that policy— were conducted in 2017 or 2018. The Ford government completed only nine of these inspections last year, <a href="https://www.cbc.ca/news/canada/seniors-homes-inspections-1.5532585" target="_blank" rel="noopener noreferrer">CBC reported in April</a>.
Long-Term Care Minister Merrilee Fullerton contended that there were "dozens of inspections done in these homes over the course of since June of 2018," and almost 3,000 inspections across all long-term care homes.
"I know early on the media really went on the number nine for the RQIs. That is a red herring. The inspections have been done," she said, referring to incident- and complaint-based inspections — not random, in-depth examinations.
Homes with COVID-19 outbreaks "can spiral out of control very quickly," partly due to staffing shortages that existed before the pandemic, Fullerton said. "The inspections, even if you did them every five minutes, it wouldn't have changed the crises in staffing in our long-term care homes."
NDP Leader Andrea Horwath said there is "no doubt" the government did not complete the inspections they should have been doing. If there really were thousands of smaller, complaint-based inspections, that means there were thousands of cries for help from residents, she said.
“This government is months late and still not doing everything in their power to help seniors,” she said, adding that the Ford government “refuses to take responsibility” for its role in the crisis.
Liberal health critic John Fraser said the government's response to the crisis is "best described as flat-footed." He repeated his call for a public inquiry into long-term care.
Before Ford's announcement, Green Leader Mike Schreiner said the province doesn't have enough inspectors, and that the current inspection regime "doesn't work."
“We need to prioritizing care over profits," he added.
Clearing the way for elective surgeries
The government has amended a provincial directive that was first issued in March and ordered hospitals to significantly ramp down elective surgeries and procedures — paving the way for this work to begin provided that hospitals can meet certain criteria.
The resumption of scheduled surgeries and procedures was included in Ontario's Stage 1 reopening plan, which kicked in on May 19, but this hasn't exactly happened yet <a href="https://www.qpbriefing.com/2020/05/25/provincial-directive-asking-hospitals-to-ramp-down-scheduled-surgeries-and-procedures-still-in-place/" target="_blank" rel="noopener noreferrer">because Directive #2 was still in place</a> and hospitals are currently creating plans to resume these surgeries. While hospitals have been performing urgent surgeries, <a href="https://www.qpbriefing.com/2020/05/11/72000-fewer-surgeries-performed-in-ontario-over-six-weeks-of-the-covid-19-pandemic/" target="_blank" rel="noopener noreferrer">thousands of scheduled surgeries</a> have been deferred since mid-March, including more than <a href="https://www.qpbriefing.com/2020/05/15/cancer-and-covid-19-surgeons-speak-of-surgery-reductions-patient-fears-and-triaging/" target="_blank" rel="noopener noreferrer">2,000 fewer cancer surgeries</a>.
The directive, issued by Chief Medical Officer of Health Dr. David Williams on March 19, said "all non-essential and elective services should be ceased or reduced to minimal levels, subject to allowable exceptions, until further notice."
Health Minister Christine Elliott's spokesperson, Hayley Chazan, confirmed on Wednesday that the directive had been updated.
"Ontario has now amended Directive #2 to support the gradual restart of all deferred and non-essential and elective services, including in hospitals and for all regulated health professionals," Hazan wrote in an email. Some of the regulated health professionals include dentists, massage therapists, chiropractors, psychologists, dietitians, occupational therapists and naturopaths. "It's important to note that this does not mean that all health services will be available on May 27."
She said regulatory bodies are "developing guidance to ensure high-quality and safe clinical care that must be met before services can resume. Colleges will also provide advice on which services can and should be, or continue to be, provided virtually."
As for hospitals looking to resume scheduled surgeries, Chazan said they should continue to develop and finalize plans that ensure they meet specific criteria, which were outlined in Ontario Health's May 7 <a href="https://www.ontariohealth.ca/sites/ontariohealth/files/2020-05/A%20Measured%20Approach%20to%20Planning%20for%20Surgeries%20and%20Procedures%20During%20the%20COVID-19%20Pandemic.pdf" target="_blank" rel="noopener noreferrer">framework document </a>titled "A Measured Approach to Planning for Surgeries and Procedures During the COVID-19 Pandemic." The criteria include having a rolling 30-day supply of personal protective equipment and reserving 15 per cent capacity within hospitals for any potential spike in COVID-19 patients.
The Ministry of Health has also developed a guidance document for the health sector that focuses on staffing, supplies and equipment, risk assessments and preconditions that should be met before services are resumed.
The guidance document refers to the amended directive and states that health care providers "are encouraged to limit the number of in-person visits for the safety of health care providers and their patients."
The guidelines encourage health care providers to do a risk assessment before they meet a patient to determine the potential for exposure to an infection like the novel coronavirus. They also outline active screening measures like over the phone and on site along with passive screening such as signs asking patients to wear face coverings if possible and carry out proper hand hygiene.
Commission starting in July
The independent commission the government had scheduled for September will be moved up to July, Ford added, though he again declined to turn it into a full public inquiry, as opposition parties and advocates have demanded.
“We will get to the bottom of this as quickly as possible," he said.
Ford said the commission will have the power to fully investigate his government's response to the crisis, and that he would appear as a witness if called.
“We want this to happen," he said.
Fullerton staying on
Though Horwath has called for Fullerton's resignation, Ford said her job is safe.
“Absolutely not. I stand behind my minister 100 per cent,” he said, calling her the “most knowledgeable person down here at Queen’s Park” on long-term care issues.
Schreiner refused to back Horwath's call for Fullerton to resign, saying earlier in his press conference that parties need to "tone down the partisanship” and collaborate during the pandemic.
No quarantine for asymptomatic people
If you're a healthy person with no COVID-19 symptoms who's followed the premier's advice and gotten tested anyway, you don't need to self-isolate until you get your results back, Ford said.
"If you aren't showing symptoms, you're asymptomatic, you can go right back to work. You can continue on with your life," he said.
Ford thanked Ontarians for going out to get tested. "The lineups were great right across this province," he said.
Landlord and tenant bill moves forward
Bill 184 passed second reading on Wednesday, prompting outcry from tenant advocates and opposition parties.
The bill would force tenants to give written notice to the Landlord and Tenant Board (LTB) if they wish to discuss issues like chronic disrepair, which the board could use to deny evictions if the landlord is found not to have met their obligations. Currently, tenants can discuss those issues freely in eviction hearings.
It also skips from repayment agreements agreed upon by the LTB, straight to an eviction order, without a hearing for the tenant if they miss a payment.
And it allows landlords to increase rent without giving the tenant the required 90 days' notice, if the tenant pays the raised amount for 12 months.
<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
In less than 3 hours, <a href="https://twitter.com/fordnation?ref_src=twsrc%5Etfw">@fordnation</a> Is going to try and push through legislation that will make it easier to evict for nonpayment of rent. Putting up a folksy facade, telling tenants not to worry and then going behind their backs to do this. <a href="https://t.co/jsktIVsOK6">https://t.co/jsktIVsOK6</a>
&mdash; Randy M. (@randymclin1) <a href="https://twitter.com/randymclin1/status/1265631509773529090?ref_src=twsrc%5Etfw">May 27, 2020</a></blockquote>
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But the bill also adds compensation for tenants in buildings with less than five residential units, if the landlord ends the lease due to demolition or renovations. The LTB would also have the power to require landlords to pay tenants up to 12 months' rent if they try to evict a tenant in bad faith. The bill also aims to make it easier to spot that bad faith, making landlords who want to evict a tenant to use the unit themselves disclose to the LTB if they have done it before.
The Tories should not be speeding up evictions at all, much less during a pandemic, NDP and Green MPPs said (though the provincial moratorium on rental evictions remains in place).
“It was always wrong for the Ford government to attempt to make evictions easier, and it’s even worse to use the pandemic as a cover to sneak through changes that will hurt tenants,” said NDP tenant rights critic Suze Morrison. “Tenants are frantically treading water to stay afloat during the pandemic, because the Ford government has refused to provide rent relief."
Schreiner said the bill is "inappropriate," especially right now, when the government should be focusing solely on COVID-related matters — but that he hopes the bill can be fixed at committee.
Fraser said he voted against the bill, saying more social housing needs to be built. He also called for a "retool" of the bill in committee.
"We're in a state of emergency. What's the hurry?" he said.
A spokesperson for Housing Minister Steve Clark described the changes as "less red tape" for tenants and landlords.
"Ontario’s rental housing rules are complex and it takes too long for tenants and landlords to resolve disputes. Our government wants to make sure that tenants and landlords have easy access to a quick and fair way to resolve disputes," Julie O'Driscoll said.
What a card
Seniors and Accessibility Minister Raymond Cho looked a bit stiff at a photo op on Wednesday.
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Thank you to the Korean community for their generous donation of PPEs. Incredibly grateful to <a href="https://twitter.com/MofaToronto?ref_src=twsrc%5Etfw">@MofaToronto</a> , members of KOTRA and The Korean Chamber of Commerce! <a href="https://twitter.com/StanChoMPP?ref_src=twsrc%5Etfw">@StanChoMPP</a> <a href="https://twitter.com/C_Mulroney?ref_src=twsrc%5Etfw">@C_Mulroney</a> <a href="https://t.co/pl8g8WuwVZ">pic.twitter.com/pl8g8WuwVZ</a>
&mdash; Raymond Cho (@RaymondChoPC) <a href="https://twitter.com/RaymondChoPC/status/1265708870682509312?ref_src=twsrc%5Etfw">May 27, 2020</a></blockquote>
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The politician "attended" a donation of personal protective equipment from Korean organizations as a cardboard cutout, along with the real versions of MPPs Stan Cho and Caroline Mulroney.
After some tweets from confused reporters, premier's office spokesperson Ivana Yelich said the 83-year-old Cho is following the advice of Ontario's Chief Medical Officer of Health, Dr. David Williams, who urged those over 70 to stay home.
"Minister Cho is doing just that," she said in a tweet.
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Yes, because Ontario&#39;s Chief Medical Officer of Health has strongly urged those over the age of 70 to stay at home. Minister Cho is doing just that. <a href="https://t.co/TDit8jkjZP">https://t.co/TDit8jkjZP</a>
&mdash; Ivana Yelich (@yelich_ivana) <a href="https://twitter.com/yelich_ivana/status/1265734316123881474?ref_src=twsrc%5Etfw">May 27, 2020</a></blockquote>
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