Updated direction for congregate care settings |

The ministry is providing guidance to congregate care settings in light of high COVID-19 case numbers in communities across the province. Specific direction for youth justice open and secure facilities has also been provided to prevent the spread of COVID-19.

When a congregate care setting is in a community that is beginning to see increased community spread, the ministry will contact them to apply further precautions. These could include:

Enhanced implementation of infection prevention and control protocols
Enhanced visitor and home visit restrictions, where applicable
Increased restrictions for client participation in community/day programs, where applicable

Wherever possible, essential visits such as those necessary to maintain the health, wellness and safety of a resident will be permitted to continue unless the local public health unit directs otherwise as part of outbreak management. An essential visitor may include, but is not limited to a parent or guardian, a social service worker or a health care provider.

Provincial emergency and Stay-At-Home Order

On April 7, 2021, the Ontario government, in consultation with the Chief Medical Officer of Health and other health experts, has declared a third provincial emergency under s 7.0.1 (1) of the Emergency Management and Civil Protection Act (EMPCA). A provincewide Stay-At-Home Order was also issued, effective April 8, 2021 at 12:01 am.

At this time, all congregate care settings in all public health unit regions across the province are to follow enhanced precautions.

Enhanced precautions will remain in place until the setting has been notified by the ministry that the community’s level of COVID-related risk has changed.

Non-essential visits and reintegration leaves continue to be restricted in youth justice facilities until further notice.

The ministry’s number one priority is to protect the health and safety of those in our congregate care settings, as well as those who care for them. Specific measures will be implemented on a location-by-location basis, following public health guidance.

Table: Summary of visitor and recreational activities by precaution level

Visits

Note: In addition to the guidelines below, all indoor and outdoor visitors must always wear a minimum of a surgical/procedure mask and eye protection (e.g. face shield, goggles, safety glasses with side shields) when entering a congregate living setting.

	Normal Precautions	Additional Precautions	Enhanced Precautions	Outbreak/ Comprehensive Precautions
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 may include but is not limited to the following: A parent/guardian Social service workers (e.g. child welfare workers, day program operators etc.) Health care providers (e.g. doctor, nurse, personal)	Permitted	Permitted	Permitted	Permitted Essential visitors who meet the requirements for visitation in outbreak/ comprehensive conditions must wear full PPE required for outbreak conditions.
Designated A resident and/or substitute decision maker may designate up to 2 people at a time as “designated visitors”. Designated Visitors: Are not required to schedule an appointment to visit a congregate living setting within provided that their visit is within the site’s permitted visitation hours. May be required to wait outside of the congregate living setting if the site is at its maximum visitor capacity. While appointments are not required it is advised that to schedule an appointment to avoid wait times.	Permitted	Designated visitor privileges suspended. See Essential or non-essential visitor privileges as appropriate for alternate options.	Designated visitor privileges suspended. See Essential or non-essential visitor privileges as appropriate for alternate options.	Designated visitor privileges suspended. See Essential or non-essential visitor privileges as appropriate for alternate options.
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). Non-essential visits must be scheduled in advance.	Permitted, including: Unsupervised Indoor Outdoor	Permitted with limitations: Supervised only Physically distanced only Indoor Outdoor	Permitted, with limitations: Supervised only Physically distanced only Outdoor visits only Indoor visits suspended	Non-essential visitor privileges suspended.

Normal Precautions

Additional Precautions

Enhanced Precautions

Outbreak/ Comprehensive Precautions

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 may include but is not limited to the following:

A parent/guardian
Social service workers (e.g. child welfare workers, day program operators etc.)
Health care providers (e.g. doctor, nurse, personal)

Permitted

Essential visitors who meet the requirements for visitation in outbreak/ comprehensive conditions must wear full PPE required for outbreak conditions.

Designated

A resident and/or substitute decision maker may designate up to 2 people at a time as “designated visitors”.

Designated Visitors:

Are not required to schedule an appointment to visit a congregate living setting within provided that their visit is within the site’s permitted visitation hours.
May be required to wait outside of the congregate living setting if the site is at its maximum visitor capacity.
While appointments are not required it is advised that to schedule an appointment to avoid wait times.

Permitted

Designated visitor privileges suspended.

See Essential or non-essential visitor privileges as appropriate for alternate options.

Designated visitor privileges suspended.

See Essential or non-essential visitor privileges as appropriate for alternate options.

Designated visitor privileges suspended.

See Essential or non-essential visitor privileges as appropriate for alternate options.

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).

Non-essential visits must be scheduled in advance.

Permitted, including:

Unsupervised
Indoor
Outdoor

Permitted with limitations:

Supervised only
Physically distanced only
Indoor
Outdoor

Permitted, with limitations:

Supervised only
Physically distanced only
Outdoor visits only
Indoor visits suspended

Non-essential visitor privileges suspended.

Short-term outings or absences

	Normal Precautions	Additional Precautions	Enhanced Precautions	Outbreak/ Comprehensive Precautions
Health and well-being activities outside of residence (e.g. doctor’s appointments, work, school etc.).	Permitted	Permitted	Permitted	Permitted, when: authorized by screening for activity and/or public health advice; or essential for medical purposes only and virtual care is not possible.
Recreational activities outside of residence	Permitted	Permitted	Suspended	Suspended
Day supports	Permitted. Max group size (including staff) is 10 people.	Permitted. Max group size (including staff) is 10 people.	Permitted, when: Max group size (including staff) is 5 people.	Suspended

Normal Precautions

Additional Precautions

Enhanced Precautions

Outbreak/ Comprehensive Precautions

Health and well-being activities outside of residence (e.g. doctor’s appointments, work, school etc.).

Permitted

Permitted, when:

authorized by screening for activity and/or public health advice; or
essential for medical purposes only and virtual care is not possible.

Recreational activities outside of residence

Permitted

Suspended

Day supports

Permitted.
Max group size (including staff) is 10 people.

Permitted, when:
Max group size (including staff) is 5 people.

Suspended

Essential overnight absences

	Normal Precautions	Additional Precautions	Enhanced Precautions	Outbreak/ Comprehensive Precautions
Essential overnight absences An essential overnight absence (e.g. to a family home) considered necessary to maintain the health, wellness and safety, or any applicable legal rights, of a resident.	Permitted	Permitted	Permitted	Suspended

Normal Precautions

Additional Precautions

Enhanced Precautions

Outbreak/ Comprehensive Precautions

Essential overnight absences

An essential overnight absence (e.g. to a family home) considered necessary to maintain the health, wellness and safety, or any applicable legal rights, of a resident.

Permitted

Suspended