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Article | Covid-19

Canadian Health Sector: COVID-19 Update

Fasken
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Health Law Bulletin

Measures implemented in July by governments across Canada to respond to the COVID-19 pandemic continue to be focused on re-opening businesses and services, including in the health care sector, while also aiming to reduce and prevent the spread of COVID-19.  This bulletin summarizes key recent legislative changes, government orders and other significant developments affecting health care providers and organizations across Canada.[1]

For additional information and insights visit the Fasken Coronavirus (COVID-19) Knowledge Centre. In addition, see our previous bulletins summarizing key health sector updates across Canada in March 2020, up to April 5, 2020, up to April 12, 2020, up to April 19, 2020, up to April 26, 2020, up to May 3, 2020, up to May 17, 2020, up to May 31, 2020, up to June 14, 2020 and up to June 28, 2020.

Alberta

On July 3, 2020, the Chief Medical Officer of Health issued an order outlining updated operational and outbreak standards for residential addiction treatment service providers. The order replaces a previous order, described in our earlier bulletin.

On July 6, 2020, the Alberta government introduced Bill 30, the Health Statutes Amendment Act. According to the Government of Alberta announcement, the proposed amendments are intended to improve governance and accountability, improve access to medically necessary surgeries, and engage Albertans in the health care system.  Although Bill 30 is not specifically to address COVID-19, among the changes is clarification regarding COVID-19 quarantine requirements under the Public Health Act.

On July 12, 2020, the Alberta government announced a request for proposals to review the province's response to the COVID-19 pandemic in order to enhance the province's capacity to respond to a potential second wave of COVID-19 and any future pandemics.  Areas to be reviewed include the health system response.

On July 13, 2020, the Alberta government announced that 20 million free masks are available province-wide, including for pickup at the counter or drive-thru of more than 700 partner restaurant locations. 900,000 of the masks are going to long-term care and seniors facilities.

On July 14, 2020, the Chief Medical Officer of Health issued an order restricting the movement of staff members and contracted providers at a hospital in Edmonton experiencing a COVID-19 outbreak.  Staff members and contracted providers (including medical staff and midwifery staff) are restricted from providing in-person services at any other facility for 14 days after providing services at the hospital.

On July 15, 2020, the Alberta government announced updated ambulance regulations to help improve efficiencies and enable more timely and appropriate access to emergency medical services.  It is expected that the new regulations will provide greater flexibility to respond to Albertans during the pandemic. 

On July 16, 2020, the Chief Medical Officer of Health issued an order outlining conditions for permitting visitors to a long-term care home, licensed supportive living facility or any residential facility offering hospice services.[2]  The order came into effect on July 23, 2020, and replaces the previous order on visitors, described in our earlier bulletin. On the same date, the Chief Medical Officer of Health explained that this change is a shift from a 'restricted access' to a 'safe access' approach to continuing care facilities. Each facility is expected to develop a local visitor policy based on consultation with residents, families, and staff.

British Columbia

On July 8, 2020, the COVID-19 Related Measures Act (described in our previous bulletin) received Royal Assent. The Act codifies many of the province's ministerial orders related to COVID-19 and limits civil liability related to COVID-19. The Act came into force on July 10, 2020.

On July 9, 2020, the Minister of Health issued an order amending the Laboratory Services Regulation. This is further to an order issued on June 22, 2020, pursuant to which registered nurses and registered psychiatric nurses can prescribe tests for patients suspected to have COVID-19.

Also on July 9, 2020, the Minister of Health issued an order waiving the requirement within the Provider Regulation under the Pharmaceutical Services Act that records kept by a pharmacy provider enrolled in the opioid agonist treatment provider sub-class in respect of each prescription received by the provider for opioid agonist treatment services include the signature of a beneficiary (person who is enrolled in a drug plan). The Minister of Health also issued two orders (Order 211/2020 and Order 213/2020) that make it easier for pharmacy providers to offer medications that help treat opiate addictions. These orders are intended to address the strains on the health care system as a result of COVID-19 and make it easier for pharmacists to offer medications that help treat opiate addictions during the pandemic.

On July 15, 2020, the Minister of Public Safety and Solicitor General made an order bringing into effect the Health Care Labour Adjustment (COVID-19) Order No. 2, replacing the first Health Care Labour Adjustment (COVID-19) Order described in our earlier bulletin. The orders address the implementation of single site orders, requiring that health care employers restrict the movement of staff between facilities.

On July 21, 2020, the British Columbia government extended the province's state of emergency to August 4, 2020

Also on July 21, 2020, the government announced that it has released the first progress report on the B.C. Surgical Renewal Commitment.

On July 23, 2020, the British Columbia government announced investments in health profession-related education and training at post-secondary institutions.

Manitoba

On June 29, 2020, the Manitoba government announced that they are investing more than $358 million in capital projects throughout the province, including: $280 million to safety upgrades to personal care homes, $46 million to digital health initiatives, and $32 million to equipment and infrastructure upgrades at health care facilities.

On July 2, 2020, the Manitoba government announced a request for proposals and innovative solutions to address the backlog of elective surgeries created by the COVID-19 pandemic.  Proposals can be submitted by both public and private facilities.

In our earlier bulletin, we reported that the Manitoba government announced that the province will develop outdoor, all-season visitation shelters near personal care homes to allow residents to safely have visits.  On July 7, 2020, the Manitoba government announced that it was inviting public feedback[3] on the proposal, including with respect to design requirements related to physical distancing protocols, personal protective equipment, frequency of use and ways to support quality visits.  The province is aiming to have the sites in place by the fall to allow safe visits throughout the year.

On July 14, 2020, the Manitoba government announced that they have extended the province-wide state of emergency for a period of 30 days.

On July 20, 2020, new public health orders were introduced in Manitoba, coming into effect on July 21, 2020 and replacing public health orders introduced on June 25, 2020. Further updated orders were issued on July 24, 2020, and replace the July 20, 2020 orders effective July 25, 2020.

As of July 25, 2020, a number of changes were made to the fourth phase of the Restoring Safe Services roadmap as part of the #RestartMB program, based on public feedbackPhase Four includes increasing visitation at personal care and long-term care homes.  Each site will need to develop specific plans for enabling outdoor/indoor visitation by visitors to ensure the safety of residents within the facilities.

In July, Shared Health Manitoba updated a number of its resources for health care providers and staff.

New Brunswick

On July 9, 2020, New Brunswick's State of Emergency mandatory order was renewed and revised pursuant to New Brunswick's Emergency Measures Act.

On July 14, 2020, the New Brunswick government announced that it has made amendments to the federally funded essential worker wage top-up program.  The program now includes private sector home care support workers.  Pursuant to the amendments, private sector home care support workers who provided direct, in-home personal care to clients of the Department of Social Development between March 19, 2020 and July 9, 2020 will be eligible to receive the benefit.  The amount of the benefit depends on the hours worked.

On July 17, 2020, New Brunswick's Office of the Chief Medical Officer of Health (Public Health) posted a guidance document entitled "Visitation Recovery Guidance Document for Long-Term Care Facilities (LTCF) for use in facilities currently in the Yellow Phase of Provincial Recovery".

Newfoundland and Labrador

The Government of Newfoundland and Labrador issued an order, effective July 16, 2020, extending the province's public health emergency for a further period of 14 days.

On July 17, 2020, Newfoundland and Labrador announced that it has extended the deadline for employers to submit their applications under the Newfoundland and Labrador COVID-19 Essential Worker Support Program from July 30, 2020 to August 20, 2020. The program, offered in association with the federal government, will provide a one-time payment to individuals who meet the eligibility criteria and work in professions included in the Government of Canada's "Guidance on Essential Services and Functions in Canada During the COVID-19 Pandemic" document, including health sector workers.

Northwest Territories

On July 23, 2020, the Government of the Northwest Territories announced that it has extended the territory-wide Public Health Emergency under the Northwest Territories' Public Health Act.

Nova Scotia

On June 30, 2020, the Government of Nova Scotia announced that a review of the COVID-19 outbreak at certain continuing care organizations is being conducted. The government also stated that it will conduct a separate, internal review of broader infection prevention and control within the province's long term care sector.  Both reviews will make recommendations to help avoid or contain future outbreaks.  The recommendations will be delivered to the Health and Wellness Minister by September 15, 2020 and will be made public after the review period.

On July 17, 2020, a restated order of the Chief Medical Officer of Health was issued under the province's Health Protection Act.

On July 26, 2020, the government renewed the provincial state of emergency pursuant to Nova Scotia's Emergency Management Act until August 9, 2020.

Nunavut

On July 23, 2020, the Government of Nunavut announced the extension of the territory's public health emergency until August 6, 2020. All existing measures under the public health emergency order remain in effect.

Ontario

On July 7, 2020, the Government of Ontario introduced Bill 195, Reopening Ontario (A Flexible Response to COVID-19) Act, 2020, to give the province flexibility to address the ongoing risks and effects of the COVID-19 outbreak as part of the government's plan for its continued safe and gradual reopening once the declaration of emergency ends.  The government stated that ongoing updates will be provided and that a report will be tabled within four months of the proposed legislation coming into force.  Bill 195 received Royal Assent on July 21, 2020, and comes into force on a day to be named by proclamation.  Specifically, the legislation will:

continue emergency orders in effect under the Emergency Management and Civil Protection Act ("EMCPA") for an initial 30 days;
allow the legislature to further extend these orders for up to 30 days at a time, as required;
allow the legislature to amend certain emergency orders continued under the EMCPA if the amendment relates to:
labour redeployment or workplace and management rules;
closure of places and spaces or regulation of how businesses and establishments can be open to provide goods or services in a safe manner;
compliance with public health advice; or
rules related to gatherings and organized public events;
not allow new emergency orders to be created; and
allow emergency orders to be rescinded when it is safe to do so.

The ability to extend and amend orders under the new legislation is limited to one year, unless extended by the Ontario legislature.

On July 14, 2020, the government announced that it will be providing $1,408,475 in funding through the Ontario Together Fund to scale up the manufacturing of made-in-Ontario N95 masks.

On July 16, 2020, the government extended the majority of Ontario's emergency orders currently in force under the EMCPA until July 29, 2020.  On July 17, 2020, a series of orders were issued to extend or amend the existing emergency orders.  The following health care orders were extended: work redeployment for certain health service providers; work deployment measures in long-term care homes; streamlining requirements for long-term care homes; work deployment measures for boards of health; work deployment measures in retirement homes; agreements between health service providers and retirement homes; temporary health or residential facilities; limiting work to a single long-term care home; hospital credentialing processes; management of long-term care homes in the outbreak; and management of retirement homes during the outbreak.

Also on July 17, 2020, the government announced a second round of research projects to prevent, detect and treat COVID-19 through the $20 million Ontario COVID-19 Rapid Research Fund.

Prince Edward Island

On June 29, 2020, the Government of Prince Edward Island updated its Long-Term Care Facilities and Nursing Homes Staff Movement Order.

On July 6, 2020, the province published an update to their Directive on Visitation to Long-Term Care Facilities and Nursing Homes.

Quebec

The Government of Quebec renewed the province's public health emergency on June 30, 2020 until July 8, 2020; on July 8, 2020 until July 15, 2020; on July 15, 2020 until July 22, 2020; and on July 22, 2020 until July 29, 2020.

On July 4, 2020, the Minister of Health and Social Services issued an order that, among other things, amended the collective agreements in force in the health and social services network and the employment conditions that apply to non-unionized salaried personnel to provide an inconvenience bonus to employees who work shifts accompanied by candidates enrolled in training for positions in health care facility patient service support, including nurses.

In an earlier bulletin, we reported that on April 29, 2020, the Government of Quebec issued an order suspending the coming into force of provisions that provide for a reorganization of the chain of procurement of goods and services as it currently exists and the dissolution of the health and social services network joint procurement groups. On July 8, 2020, the Government of Quebec issued an order providing for the coming into force of the suspended provisions on September 1, 2020. The order states that, in view of the current situation of the COVID-19 pandemic, a September 1 coming into force ensures the continuity of health and social services network procurement and prevents the risks of disruption of health and social services.

Saskatchewan

On July 7, 2020, the Chief Medical Health Officer issued the most recent public health order as part of the staged lifting of restrictions under the phased approach of the Re-Open Saskatchewan Plan. Effective July 7, 2020, Saskatchewan expanded visitation guidelines to facilities including acute and long-term care, personal care and group home settings. Updated information about family and support people presence and visitor restrictions is also available.

Beginning July 13, 2020, additional health services resumed in Saskatchewan, including mental health and addictions support, such as social detox and addictions inpatient treatment; additional chronic diseases management/wellness programs/stroke prevention; and specialized services for clients with developmental disabilities, autism and brain injuries.  This next phase of service resumption will also include increased surgical volumes. Virtual care continues to be offered, and the government reports that since initiating expanded virtual care options as a result of the pandemic in March, more than 175,000 appointments have been delivered through this option. All service resumptions are available on the Saskatchewan Health Authority Service Alerts webpage. In the July 13 announcement, the Government of Saskatchewan also announced that, effective July 14, 2020, COVID-19 testing is available to anyone, regardless of whether they have symptoms.

On July 16, 2020, the Saskatchewan government announced that due to an increased risk for COVID-19 in the southwest and west-central areas of Saskatchewan, visitation at the hospital, long-term care homes and personal care homes in the area will be temporarily restricted.

On July 24, 2020, the Saskatchewan government announced that northwest Saskatchewan businesses, services and events can proceed as permitted under the current Phase 4 of the Re-Open Saskatchewan plan. The current list of critical and allowable businesses include a number of health services.

Yukon

On June 30, 2020, the Government of Yukon released more details regarding Phase 2 of Yukon's plan for safely lifting COVID-19 public health measures, which began on July 1, 2020.

Also on June 30, 2020, the Civil Emergency Measures Health Protection (COVID-19) Order, M.O. 2020/35, was repealed and replaced by the Civil Emergency Measures Health Protection (COVID-19) Order, M.O. 2020/46.

On July 2, 2020, the government released visitation guidelines for long-term care homes.

On July 14, 2020, Yukon's Chief Medical Officer of Health & Yukon Communicable Disease Control provided an update on COVID-19 to all health care providers. The update included an announcement regarding the release of new testing guidance for health care providers, which broadens the list of symptoms and uses a universal symptom list for all patients.

Federal

Effective June 29, 2020, the Government of Canada issued an order bringing into effect the Minimizing the Risk of Exposure to COVID-19 in Canada Order (Mandatory Isolation), No. 3 under the Quarantine Act.

Also effective June 29, 2020, the Government of Canada issued an order extending the effective date of a previous order restricting entry into Canada by foreign nationals arriving from the United States.

On July 16, 2020, the federal government announced a federal investment of more than $19 billion, through the Safe Restart Agreement, to help provinces and territories restart their economies and improve resilience to possible future waves of the virus.  Priority areas include investments in health care; funding to secure a reliable source of personal protective equipment; support for vulnerable Canadians – including those in long-term care, home care, and palliative care; and enhanced capacity for testing, contact tracing, and data management and information sharing to mitigate future outbreaks.[4]


 


 

[1]  This bulletin addresses updates published up to 12:00 pm (EST) on July 26, 2020.

[2] A summary of the guidelines is also available at https://www.alberta.ca/protecting-residents-at-congregate-care-facilities.aspx.

[3] The survey closed on July 15, 2020.

[4] Thank you to summer law students Rachel Hung, Gordon Lee, Montana Licari, Jasmeen Kabuli, Katerina Ignatova, Sabrina Chang and Nicolas Kasting for their research assistance.

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