Effective September, 2021

The ministry is providing guidance to congregate care settings to protect the health and safety of residents, staff and visitors across the province. Specific direction for youth justice open and secure facilities has also been provided to prevent the spread of COVID-19.

This guidance outlines ministry-specific direction for MCCSS-funded and licensed congregate care settings within the context of Ontario’s Roadmap to Reopen. It is intended to be followed with other applicable legislation and health guidance including local public health direction in response to local community spread.

See COVID-19 Guidance for MCCSS-funded and Licensed Congregate Living Settings for additional detail.

Visits

People planning a visit to a congregate care setting are advised to contact the residence in advance to:

• make sure the home is free of outbreaks
• get information on the home's visitor policy and any other restrictions
• schedule a visit where required

Visitor type	Indoor	Outdoor
Essential An essential visitor is generally a person who: Performs essential services to support the ongoing operation of a service agency (including a contractor); and/or Considered necessary to maintain the health, wellness and safety, or any applicable legal rights, of a congregate living resident. An essential visitor includes the following: A parent/guardian, other family member, or other person recognized as meeting the criteria above. An essential visitor may also include: Social service workers (e.g. child welfare workers, day program operators etc.) Health care providers (e.g. doctor, nurse, personal support worker)	Permitted Unscheduled Unsupervised Active screening Surgical/procedure mask required Brief physical contact permitted (e.g. a hug)	Permitted Unscheduled Unsupervised Active screening Brief physical contact permitted (e.g. a hug) Choice not to mask + physical distance outdoors if all parties are fully immunized
Non-essential A non- essential visitor is generally a person who: Provides non-essential services, who may or may not be hired by the site or the resident and/or their substitute decision maker; and/or For social reasons (e.g. family members or friends). Note: there are no longer separate parameters for a ‘designated’ visitor type.	Permitted Scheduled Supervised Active screening Surgical/procedure mask Physical distancing required Brief physical contact permitted (e.g. a hug) Maximum number of visitors in line with social gathering limits in Roadmap to Reopen (dependent on the Step)	Permitted Scheduled Supervised Active screening Brief physical contact permitted (e.g. a hug) Choice not to mask + physical distance outdoors if all parties are fully immunized Maximum number of visitors in line with social gathering limits in Roadmap to Reopen (dependent on the Step)

Absences for residents

Absence Type
Short stay (same day) This includes essential absences (e.g., work, school, medical appointment, physical exercise) and recreational outings (activities for pleasure, visits to a friend’s home).	Permitted in line with activities and social gathering parameters in Roadmap to Reopen
Overnight (essential) Considered necessary to maintain the health, wellness and safety, or any applicable legal rights, of a resident. Includes short-term and extended absences.	Permitted If partially or non-immunized: 14-day precautions or until negative PCR test is received. PCR test is optional and should take place no earlier than 5-7 days following return of the resident to the setting to account for potential incubation period. If fully immunized: active screening only upon return.
Overnight (general) Any non-essential overnight absence. Includes short-term and extended absences.	Permitted in line with social gathering parameters in Roadmap to Reopen. If partially or non-immunized: 14-day precautions or until negative PCR test is received. PCR test is optional and should take place no earlier than 5-7 days following return of the resident to the setting to account for potential incubation period. If fully immunized: active screening only upon return.

New admissions/transfers

• A new admission/transfer must undergo active screening for COVID-19 signs and symptoms.
• If they do not pass screening, the site will follow section 5 below.
  • This is the ONLY requirement for a fully immunized person.
• A new admission who is not fully immunized must follow additional precautions until they receive a negative result on a COVID-19 PCR test ¹ OR 14 days has passed:
  • Monitor for symptoms.
  • Avoid using common areas; however, if a common area cannot be avoided, the person must use a medical (surgical/procedure) mask if tolerated.
  • Limit contact with other residents.
  • Only participate in group activities if physical distancing is maintained (i.e., 2 metres) and a medical (surgical/procedure) mask is used for the duration of the activity.
  • Practice proper hand hygiene by washing their hands often (using soap and water or using an alcohol-based hand sanitizer).
  • Adhere to respiratory etiquette.

Leaving the setting for a short stay absence/outing will NOT reset the 14-day time period. However, an overnight stay during the same 14-day period will reset the 14- day period.

Managing a COVID-19 positive case (staff or resident)

• Where a congregate care setting has identified a suspected, presumed or confirmed case of COVID-19 of a staff or resident, the following precautions are to be put in place within 24 hours:
• Essential visits are permitted with full PPE for visitor.
• All indoor and outdoor non-essential visits are suspended.
• Residents should avoid leaving the residence as much as possible and respect specific guidance from specific settings and local public health (i.e., residents may be directed through the local PHU or through active screening to not attend work or school).
• Residents must not attend any in-person congregate day programming (virtual attendance only).
• The above precautions are to remain in place until the service provider is notified by the local PHU that the infected person(s) has recovered and/or outbreak protocols are not needed.

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Direction for non-residential services in congregate settings

Service providers providing MCCSS-funded non-residential services in a congregate (shared) setting are to adhere to provincial requirements under applicable legislation and health guidance related to group sizes, IPAC measures etc. including, but not limited to:

• The Reopening Ontario (A Flexible Response to COVID-19) Act and relevant regulations and orders

Local Public Health Unit direction to address local circumstances (e.g. community spread).

• Resources to prevent COVID-19 in the Workplace

Service providers, as employers, are obligated to adhere to applicable legislative or regulatory requirements related to health and safety such as those in the Occupational Health and Safety Act (OHSA) and its regulations.

Also see: MCCSS COVID-19 Operational Guidelines: Re-Opening Day Supports for Adults with Developmental Disabilities 2.0

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[1] A PCR test for a new admission/transfer is optional for the resident and should take place 5-7 days following return to account for potential incubation period.