Regulation - LGIC
Amendments to Ontario Regulation 246/22
Regulation Number(s):
Ontario Regulation 246/22
Instrument Type:
Regulation - LGIC
Bill or Act:
Fixing Long-Term Care Act, 2021
Summary of Decision:
Amendments to Ontario Regulation 246/22 came into effect on September 21, 2022. These changes operationalize the statutory amendments to the Fixing Long-Term Care Act, 2021 (FLTCA), that also came into force on September 21, 2022, by way of Bill 7: More Beds, Better Care Act, 2022, which received Royal Assent on August 31, 2022.
Analysis of Regulatory Impact:
Amendments to Ontario Regulation 246/22 are operationalizing statutory changes to FLTCA to ensure that eligible patients, clinically determined to need an alternate level of care, receive the right care in the right place. More specifically, these amendments facilitate the admission of eligible alternate level of care (ALC) patients from public hospitals to long-term care homes, where they can receive care to better meets their needs.
These regulatory amendments include new provisions that apply to long-stay beds except High Priority Access Beds, Direct Access Beds, and beds in the four Indigenous long-term care homes
The estimated compliance costs to long-term care licensees are expected to be minor and administrative in nature and are associated with additional staff time to learn about the new requirements. This is anticipated to be a one-time cost concentrated in the first year of implementation.
The regulatory changes may result in broader implications for the volume of information to be reviewed, resident admissions, discharges and turnover in long-term care homes. This is not, however, included in the estimated compliance costs as the impact is anticipated to vary by home based on several factors, including the number of eligible ALC patients, demand by home, geographic location, bed vacancy rates, etc.
These regulatory amendments include new provisions that apply to long-stay beds except High Priority Access Beds, Direct Access Beds, and beds in the four Indigenous long-term care homes
The estimated compliance costs to long-term care licensees are expected to be minor and administrative in nature and are associated with additional staff time to learn about the new requirements. This is anticipated to be a one-time cost concentrated in the first year of implementation.
The regulatory changes may result in broader implications for the volume of information to be reviewed, resident admissions, discharges and turnover in long-term care homes. This is not, however, included in the estimated compliance costs as the impact is anticipated to vary by home based on several factors, including the number of eligible ALC patients, demand by home, geographic location, bed vacancy rates, etc.
Further Information:
Notice Under Section 194 of the Fixing Long-Term Care Act, 2021
Proposal Number:
22-HLTC029
Posting Date:
Summary of Proposal:
•The regulation establishes a revised LTC home admissions process when consent is not obtained and is aligned as much as possible with the current admission process.
•The revised process applies to long-stay beds except High Priority Access Beds, Direct Access Beds, and beds in the four Indigenous LTC homes.
•Eligibility criteria for admission to LTC has not changed.
•Similar information will be provided to patients to help ensure they are aware of the regular and revised admissions processes and their options.
•The assessments to determine eligibility will evaluate similar areas of care needs using the "most information available". Information will be collected using existing records or in consultation with the patient's health care providers (e.g., hospital staff, primary care provider, and home and community care services provider) as well as Developmental Services Ontario and some organizations that support people with a developmental disability.
•Selection of LTC homes by a placement coordinator will be unlimited in number and will consider the patient's conditions and circumstances; their preferred class of accommodation, if any; and proximity of the home to their preferred location(s), within set geographic parameters.
•A patient's preferred location is defined in regulation as:
o the address of a location or locations specified by the patient, or
o where a location is not specified by the patient, their primary residence or the hospital where they are located when the homes are selected.
o A geographic parameter of a 70 km radius (from the preferred location) will be used across Ontario except in the areas within the boundaries of the North East and North West Home and Community Care Support Services (HCCSS) regions where the radius will be 150 km.
o A placement coordinator will be able to select an LTC home outside the geographic parameter in the North East and North West HCCSS regions, when there is no LTCH within the geographic parameter or limited vacancy within the geographic parameter (i.e., may then select the next closest LTC home(s) to preferred location that can meet patient's needs).
•Patients will be put on the existing long-stay waitlist in the crisis category for the homes selected by the placement coordinator and their preferred homes. They will remain in the crisis category of the waitlist until they are placed in a preferred home.
•A licensee will be required to review the patient's information provided by the placement coordinator promptly and approve or withhold approval of the patient onto the LTC home waitlist in writing.
•Placement coordinators will be able to authorize admission to preferred accommodation even if basic accommodation has been requested and require it to be made available as basic accommodation.
•Similar to the current process, the patient must move into the LTC home in five days otherwise the bed may be offered to the next person on the waiting list.
•Once admitted, if the resident declines admission to any of their preferred homes they will be removed from the waitlist; it will be assumed they have accepted their current home.
Other Changes
•The current pandemic provision is repealed since it is no longer needed. Transitional provisions are added.
•A technical amendment related to reunification priority access bed (RPAB) provision is made to allow for a vacant RPAB bed to be utilized when either spouse is discharged.
•The revised process applies to long-stay beds except High Priority Access Beds, Direct Access Beds, and beds in the four Indigenous LTC homes.
•Eligibility criteria for admission to LTC has not changed.
•Similar information will be provided to patients to help ensure they are aware of the regular and revised admissions processes and their options.
•The assessments to determine eligibility will evaluate similar areas of care needs using the "most information available". Information will be collected using existing records or in consultation with the patient's health care providers (e.g., hospital staff, primary care provider, and home and community care services provider) as well as Developmental Services Ontario and some organizations that support people with a developmental disability.
•Selection of LTC homes by a placement coordinator will be unlimited in number and will consider the patient's conditions and circumstances; their preferred class of accommodation, if any; and proximity of the home to their preferred location(s), within set geographic parameters.
•A patient's preferred location is defined in regulation as:
o the address of a location or locations specified by the patient, or
o where a location is not specified by the patient, their primary residence or the hospital where they are located when the homes are selected.
o A geographic parameter of a 70 km radius (from the preferred location) will be used across Ontario except in the areas within the boundaries of the North East and North West Home and Community Care Support Services (HCCSS) regions where the radius will be 150 km.
o A placement coordinator will be able to select an LTC home outside the geographic parameter in the North East and North West HCCSS regions, when there is no LTCH within the geographic parameter or limited vacancy within the geographic parameter (i.e., may then select the next closest LTC home(s) to preferred location that can meet patient's needs).
•Patients will be put on the existing long-stay waitlist in the crisis category for the homes selected by the placement coordinator and their preferred homes. They will remain in the crisis category of the waitlist until they are placed in a preferred home.
•A licensee will be required to review the patient's information provided by the placement coordinator promptly and approve or withhold approval of the patient onto the LTC home waitlist in writing.
•Placement coordinators will be able to authorize admission to preferred accommodation even if basic accommodation has been requested and require it to be made available as basic accommodation.
•Similar to the current process, the patient must move into the LTC home in five days otherwise the bed may be offered to the next person on the waiting list.
•Once admitted, if the resident declines admission to any of their preferred homes they will be removed from the waitlist; it will be assumed they have accepted their current home.
Other Changes
•The current pandemic provision is repealed since it is no longer needed. Transitional provisions are added.
•A technical amendment related to reunification priority access bed (RPAB) provision is made to allow for a vacant RPAB bed to be utilized when either spouse is discharged.
Contact Address:
400 University Avenue, 6th Floor, Toronto, ON M5G 1S5
Effective Date:
September 21, 2022
Decision:
Approved