Regulation - LGIC
Fixing Long-Term Care Act, 2021; Phase 1 Regulations
Regulation Number(s):
246/22
Instrument Type:
Regulation - LGIC
Bill or Act:
Providing More Care, Protecting Seniors, and Building More Beds Act, 2021 - Schedule 1: Fixing Long-Term Care Act, 2021
Summary of Decision:
On April 11, 2022, The Fixing Long-Term Care Act, 2021 (FLTCA) was proclaimed into force to regulate Ontario's long-term care home sector.
On the same day, the Long-Term Care Homes Act, 2007 (LTCHA) was revoked, which means it is no longer in force.
The new Act also includes a new regulation.
Key changes being introduced through the regulation include:
- Enhancing emergency planning requirements to support greater sector preparedness in the event of an emergency, including outbreaks, epidemics and pandemics.
- Defining "caregiver" and requiring all long-term care homes to have a visitor policy that respects the Residents' Bill of Rights and ensures that caregivers continue to have access to long-term care homes during an outbreak.
- Updating palliative care requirements to align with a shift in practice towards an approach that is not solely focused on end-of-life care.
- Expanding and clarifying infection prevention and control (IPAC) roles and requirements to improve resident safety and quality of life.
- Defining the calculation method for direct care targets as part of the commitment to increase the system average of direct care provided by nurses and personal support workers to four hours per resident, per day in four years, and to increase the system average of allied health care to 36 minutes per resident, per day.
- Clarifying the roles/responsibilities of medical directors to improve oversight.
- Additional protections for whistleblowers.
- Addressing the amounts and criteria for issuing administrative monetary penalties as deterrents for non-compliance with the Act.
- Updating and adding definitions to increase transparency and accountability within the licensing process.
The next phase of regulation development, anticipated later in 2022, would focus on elements that require more consultation with residents, families, home operators, and other experts and/or more time to build operational capacity to support successful implementation.
On the same day, the Long-Term Care Homes Act, 2007 (LTCHA) was revoked, which means it is no longer in force.
The new Act also includes a new regulation.
Key changes being introduced through the regulation include:
- Enhancing emergency planning requirements to support greater sector preparedness in the event of an emergency, including outbreaks, epidemics and pandemics.
- Defining "caregiver" and requiring all long-term care homes to have a visitor policy that respects the Residents' Bill of Rights and ensures that caregivers continue to have access to long-term care homes during an outbreak.
- Updating palliative care requirements to align with a shift in practice towards an approach that is not solely focused on end-of-life care.
- Expanding and clarifying infection prevention and control (IPAC) roles and requirements to improve resident safety and quality of life.
- Defining the calculation method for direct care targets as part of the commitment to increase the system average of direct care provided by nurses and personal support workers to four hours per resident, per day in four years, and to increase the system average of allied health care to 36 minutes per resident, per day.
- Clarifying the roles/responsibilities of medical directors to improve oversight.
- Additional protections for whistleblowers.
- Addressing the amounts and criteria for issuing administrative monetary penalties as deterrents for non-compliance with the Act.
- Updating and adding definitions to increase transparency and accountability within the licensing process.
The next phase of regulation development, anticipated later in 2022, would focus on elements that require more consultation with residents, families, home operators, and other experts and/or more time to build operational capacity to support successful implementation.
Analysis of Regulatory Impact:
The ministry has completed an analysis of the estimated regulatory impact of the regulation and identified benefits including:
-Improved quality of life and care for residents of long-term care homes.
-Greater protections for long-term care homes to optimize resident safety and enhanced sector preparedness in the event of an emergency, including outbreaks, epidemics and pandemics.
-Improved sector oversight and accountability measures to enhance compliance.
Estimated average annual direct compliance costs for all long-term care homes in Ontario are between $20M to $23.8M, or approximately $38K on average for each long-term care home per annum.
Estimated costs associated with Ontario Regulation 246/22 are primarily operational and administrative in nature and associated with the implementation of requirements necessary to operationalize legislative changes proposed under the Fixing Long-Term Care Act, 2021 in the areas of:
1. Emergency planning
2. Quality of care
3. Resident safety
4. Staffing
5. Accountability, enforcement, transparency and quality improvement
A note on methodology:
The primary objective of the Regulatory Impact Assessment is to estimate the direct compliance costs that would be exclusively absorbed by regulated entities, in this case long-term care licensees.
Given the ministry's historic and ongoing role co-funding long-term care licensees, costs associated with new staffing-specifically Full-Time Equivalents-have been excluded from the analysis.
This approach considers the unique profile of long-term care homes as Broader Public Sector entities and their funding relationship with the government.
As the ministry undertakes a phased approach to regulation development, it will continue to monitor the implementation of the Fixing Long-Term Care Act, 2021 and Ontario Regulation 246/22 to identify priority areas for investment and burden reduction and consult with stakeholders and inter-ministerial partners to develop modern, evidence-based regulatory approaches to regulate the long-term care sector.
-Improved quality of life and care for residents of long-term care homes.
-Greater protections for long-term care homes to optimize resident safety and enhanced sector preparedness in the event of an emergency, including outbreaks, epidemics and pandemics.
-Improved sector oversight and accountability measures to enhance compliance.
Estimated average annual direct compliance costs for all long-term care homes in Ontario are between $20M to $23.8M, or approximately $38K on average for each long-term care home per annum.
Estimated costs associated with Ontario Regulation 246/22 are primarily operational and administrative in nature and associated with the implementation of requirements necessary to operationalize legislative changes proposed under the Fixing Long-Term Care Act, 2021 in the areas of:
1. Emergency planning
2. Quality of care
3. Resident safety
4. Staffing
5. Accountability, enforcement, transparency and quality improvement
A note on methodology:
The primary objective of the Regulatory Impact Assessment is to estimate the direct compliance costs that would be exclusively absorbed by regulated entities, in this case long-term care licensees.
Given the ministry's historic and ongoing role co-funding long-term care licensees, costs associated with new staffing-specifically Full-Time Equivalents-have been excluded from the analysis.
This approach considers the unique profile of long-term care homes as Broader Public Sector entities and their funding relationship with the government.
As the ministry undertakes a phased approach to regulation development, it will continue to monitor the implementation of the Fixing Long-Term Care Act, 2021 and Ontario Regulation 246/22 to identify priority areas for investment and burden reduction and consult with stakeholders and inter-ministerial partners to develop modern, evidence-based regulatory approaches to regulate the long-term care sector.
Further Information:
Proposed Phase 1 Regulation
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Providing More Care, Protecting Seniors, and Building More Beds Act, 2021
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ONTARIO REGULATION 246/22
ONTARIO REGULATION 246/22
Proposal Number:
22-HLTC002
Posting Date:
January 18, 2022
Summary of Proposal:
The Providing More Care, Protecting Seniors, and Building More Beds Act, 2021, received Royal Assent on December 9, 2021. Upon proclamation, the Fixing Long-Term Care Act, 2021 (Act) will come into effect to govern the long-term care sector. At the same time, the Long-Term Care Homes Act, 2007 will be repealed.
Given the transformative nature of the new legislative framework for the long-term care home sector and the ongoing impact of the pandemic, a phased approach to regulation development is being undertaken.
The first phase of regulation development focuses on regulations needed to support the Act coming into force. As part of this phase, many provisions from Ontario Regulation 79 10 will necessarily be carried forward to form part of the proposed regulation to support the Act.
Phase 1 key changes in the proposed regulation include:
- Enhancing emergency planning requirements to support greater sector preparedness in the event of an emergency, including outbreaks, epidemics and pandemics.
- Defining caregiver and requiring all long-term care homes to have a visitor policy that respects the Resident Bill of Rights and ensures that caregivers continue to have access to long-term care homes during an outbreak.
- Requiring that integration of a palliative care philosophy include a holistic and comprehensive assessment of a resident's needs and when needed, improvements to a resident's quality of life, symptom management, psychosocial supports and end-of-life care, always subject to a resident's consent.
- Expanding and clarifying infection prevention and control (IPAC) roles and requirements to improve resident safety and quality of life.
- Defining the calculation method for direct care targets as part of the commitment of an average of four hours of care per resident per day.
- Clarifying the roles and responsibilities of medical directors to improve oversight.
- Adding additional protections for whistleblowers.
- Addressing the amounts and criteria for issuing administrative monetary penalties as deterrents for non-compliance with the Act.
Given the transformative nature of the new legislative framework for the long-term care home sector and the ongoing impact of the pandemic, a phased approach to regulation development is being undertaken.
The first phase of regulation development focuses on regulations needed to support the Act coming into force. As part of this phase, many provisions from Ontario Regulation 79 10 will necessarily be carried forward to form part of the proposed regulation to support the Act.
Phase 1 key changes in the proposed regulation include:
- Enhancing emergency planning requirements to support greater sector preparedness in the event of an emergency, including outbreaks, epidemics and pandemics.
- Defining caregiver and requiring all long-term care homes to have a visitor policy that respects the Resident Bill of Rights and ensures that caregivers continue to have access to long-term care homes during an outbreak.
- Requiring that integration of a palliative care philosophy include a holistic and comprehensive assessment of a resident's needs and when needed, improvements to a resident's quality of life, symptom management, psychosocial supports and end-of-life care, always subject to a resident's consent.
- Expanding and clarifying infection prevention and control (IPAC) roles and requirements to improve resident safety and quality of life.
- Defining the calculation method for direct care targets as part of the commitment of an average of four hours of care per resident per day.
- Clarifying the roles and responsibilities of medical directors to improve oversight.
- Adding additional protections for whistleblowers.
- Addressing the amounts and criteria for issuing administrative monetary penalties as deterrents for non-compliance with the Act.
Contact Address:
400 University Avenue, 6th Floor, Toronto, ON M5G 1S5
Effective Date:
April 11, 2022
Decision:
Approved