O. Reg. 484/22: GENERAL

filed September 14, 2022 under Fixing Long-Term Care Act, 2021, S.O. 2021, c. 39, Sched. 1

ontario regulation 484/22

made under the

Fixing Long-Term Care Act, 2021

Made: September 14, 2022
Filed: September 14, 2022
Published on e-Laws: September 14, 2022
Printed in The Ontario Gazette: October 1, 2022

Amending O. Reg. 246/22

(GENERAL)

1. (1) Subsection 228 (7) of Ontario Regulation 246/22 is amended by adding “or is no longer deemed to occupy a reunification priority access bed in accordance with subsection (8)” at the end.

(2) Subsection 228 (8) of the Regulation is revoked and the following substituted:

(8) A person who is admitted to a reunification priority access bed from the waiting list that is required to be kept under subsection 227 (2) is deemed to occupy a reunification priority access bed despite a transfer that is described in section 239, until the person or their spouse or partner is discharged from the long-term care home.

2. The Regulation is amended by adding the following sections:

ALC patients being considered for long-term care home admission

240.1 (1) This section and sections 240.2 and 240.3 apply in the special circumstances of processing the admission of an ALC patient to a long-term care home for a long-stay bed, in accordance with section 60.1 of the Act.

(2) Where a person described in subsection (1) is being considered for admission to a long-term care home, placement co-ordinators and licensees are exempt from complying with the requirements under Part IV of the Act to the extent necessary to effect the admission, and the modifications provided for in this section and sections 240.2 and 240.3 are made respecting the application of Part IV of the Act.

(3) If, at any time during the admission process, the ALC patient or their substitute decision-maker, if any, submits an application for determination of eligibility for admission to a long-term care home or an application for authorization of admission or consents to the admission, the applicable provisions of Part IV of the Act apply to the application and the admission, subject to subsection (4) of this section and subsections 240.2 (1), (3), (10) and (11) and 240.3 (2), (4), (6) to (8) and (10) to (12) of this Regulation.

(4) If a determination of eligibility has started under this section without the consent of the ALC patient or their substitute decision-maker, as the case may be, and the ALC patient or substitute decision-maker subsequently agrees to the application, the ALC patient is not required to submit an application if the assessments are already underway.

(5) Where a placement co-ordinator receives a request from an attending clinician to determine an ALC patient’s eligibility for admission to a long-term care home or the ALC patient has already been determined eligible for long-term care home admission and the ALC patient’s applying to additional homes is being considered, the placement co-ordinator shall,

(a) meet with the patient or the patient’s substitute decision-maker, if any;

(b) provide information to the patient or their substitute decision-maker, if any, about the long-term care home placement process under section 60.1 of the Act and related regulations, and the admission process under sections 49 to 54 of the Act and related regulations;

(c) where applicable, ask the patient or their substitute decision-maker, if any, whether they will submit an application for determination of eligibility for admission to a long-term care home in accordance with subsection 50 (1) of the Act;

(d) where applicable, inform the patient or their substitute decision-maker, if any, that if they do not consent to submit an application for a determination of eligibility that,

(i) the placement co-ordinator shall proceed to determine eligibility, and if eligible, identify a home or homes for the patient, and

(ii) the patient or the substitute decision-maker may choose to participate in the admissions process at any stage;

(e) where applicable, inform the patient or their substitute decision-maker, if any, of the implications of a choice described in subparagraph (d) (ii);

(f) provide the patient or their substitute decision-maker, if any, with information about a resident’s responsibility for payment for charges for accommodation and the maximum amounts that may be charged by a licensee for accommodation; and

(g) advise the patient or their substitute decision-maker, if any, that a resident may apply to the Director for a reduction in the charge for basic accommodation and that a resident who makes such an application may be required to provide supporting documentation including,

(i) the resident’s Notice of Assessment issued under the Income Tax Act (Canada) for the resident’s most recent taxation year,

(ii) the resident’s proof of income statement (option “C” print) from the Canada Revenue Agency for the resident’s most recent taxation year, or

(iii) the resident’s written authorization to electronically obtain income information for the resident’s most recent taxation year from the Canada Revenue Agency.

(6) Where the ALC patient or their substitute decision-maker, if any, refuses to apply for a determination of eligibility, the placement co-ordinator shall make a determination of eligibility for admission to a long-term care home based on as much information as is available in the circumstances about the patient’s,

(a) physical and mental health;

(b) requirements for medical treatment and health care;

(d) requirements for personal care; and

(e) behaviour.

(7) The placement co-ordinator may request that an assessment of the matters described in clauses (6) (a) to (e) be conducted by a physician, a registered nurse in the extended class or a registered nurse on the staff of the hospital for the purpose of determining the ALC patient’s eligibility for admission to a long-term care home.

(8) Where a placement co-ordinator requests an assessment of an ALC patient under subsection (7) in a situation where the patient or their substitute decision-maker, if any, does not consent to the patient being assessed for the purpose of determining their eligibility for admission to a long-term care home, the person conducting the assessment shall base their assessment solely on a review of existing hospital records relating to that patient.

(9) In addition to an assessment conducted under subsection (7), the placement co-ordinator may collect the information referred to in subsection (6) about an ALC patient through any or all of the following:

1. Consultation with,

i. the attending clinician and any other member of the hospital staff who has directly been involved in providing care to the patient while in hospital,

ii. a primary health care provider of the patient,

iii. a home and community care services provider who provided home and community care services to the patient immediately before the patient was admitted to hospital, or

iv. an application entity or service agency as defined in the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008.

2. Review of records of personal health information relating to the patient that are held by the hospital or by a primary health care provider, a home and community care services provider or an application entity or service agency referred to in subparagraph 1 ii, iii or iv.

(10) The following persons are prescribed for the purposes of paragraph 5 of subsection 60.1 (3) of the Act as persons who are authorized to collect, use and disclose personal health information about an individual, where the collection, use or disclosure, as the case may be, is necessary to determine an ALC patient’s eligibility for admission to a long-term care home or to effect the admission of a patient to a home in accordance with section 60.1 of the Act and the regulations:

1. A home and community care services provider.

2. A primary health care provider.

3. An entity that provides community mental health and addiction services.

4. An application entity or service agency as defined in the Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008.

(11) In this section,

“home and community care services provider” means,

(a) a health service provider or Ontario Health Team that provides home and community care services under the Connecting Care Act, 2019, or

(b) a local health integration network as defined in section 2 of the Local Health System Integration Act, 2006; (“fournisseur de services de soins à domicile et en milieu communautaire”)

“primary health care provider” means any person or entity that provides primary health care services, including,

(a) a person who is a member within the meaning of the Regulated Health Professions Act, 1991,

(b) an entity that operates a group practice of persons referred to in clause (a),

(d) an entity that operates a family health team, or

(e) an entity that operates an Aboriginal health access centre. (“fournisseur de soins de santé primaires”)

Application for authorization of admission, ALC patients

240.2 (1) After an ALC patient has been determined to be eligible for long-term care home admission either under Part IV of the Act or section 240.1 of this Regulation, the placement co-ordinator shall provide the patient or substitute decision-maker, if any, with information about,

(a) the length of waiting lists and approximate times to admission for relevant long-term care homes;

(b) vacancies in relevant long-term care homes; and

(2) If, after being provided with the information described in subsection (1), the ALC patient or their substitute decision-maker, if any, refuses to submit an application for authorization of admission, the placement co-ordinator shall select one or more homes for the ALC patient even if the ALC patient is already on a waiting list for one or more homes, and no application is required to authorize admission under section 60.1 of the Act.

(3) If an application for authorization of admission has commenced under this section without the consent of the ALC patient or their substitute decision-maker, as the case may be, and the patient or substitute decision-maker subsequently agrees to the application for authorization of admission, the ALC patient is not required to submit an application for authorization of admission.

(4) If the ALC patient is already on the waiting list for homes that they have selected, any additional homes selected by the placement co-ordinator under subsection (2) do not count toward the limit set out in section 181 of this Regulation.

(5) In selecting a long-term care home for the ALC patient, the placement co-ordinator shall consider,

(a) the patient’s condition and circumstances;

(b) the class of accommodation requested by the patient, if any; and

(6) If no class of accommodation is requested by the ALC patient, the placement co-ordinator shall select basic accommodation.

(7) The placement co-ordinator shall only select a long-term care home for the ALC patient,

(a) that is within a 70 kilometre radius from the patient’s preferred location; or

(b) that is within a 150 kilometre radius from the patient’s preferred location, if the patient’s preferred location is in the geographic area of the North East Local Health Integration Network or the North West Local Health Integration Network.

(8) The restrictions set out in clause (7) (b) do not apply where there is not a long-term care home within the radius that would otherwise apply, or there are limited vacancies in the available homes, in which case the placement co-ordinator shall select the home or homes that are next closest to the patient’s preferred location.

(9) If the home selected by the placement co-ordinator is not in the geographic area of the placement co-ordinator making the offer, that placement co-ordinator shall co-ordinate with the appropriate placement co-ordinator for that home.

(10) The appropriate placement co-ordinator shall provide the licensee of each selected home with copies of the assessments and other relevant information gathered under section 240.1.

(11) The licensee shall, in writing, approve or withhold approval of the admission in accordance with subsections 51 (7) to (9) of the Act promptly after receiving the information under subsection (10) of this section, and if the licensee withholds approval of the ALC patient’s admission, the licensee shall, at the time of withholding, inform the appropriate placement co-ordinator in writing of the ground or grounds on which the licensee is withholding approval and a brief explanation of why, but is not required to notify the patient.

(12) In this section,

“patient’s preferred location” means,

(a) the address or addresses identified by the ALC patient or the substitute decision-maker, if any, or

(b) if an address is not identified by the patient or the substitute decision-maker, the address of the patient’s primary residence, or, where a primary residence of the patient cannot be identified, the address of the hospital where the patient is located.

Waiting lists and admission, ALC patients

240.3 (1) If the ALC patient or their substitute decision-maker, if any, refuses to make an application for authorization of admission to the long-term care home selected by the placement co-ordinator, no application is required to authorize admission under section 60.1 of the Act.

(2) If the ALC patient or their substitute decision-maker, if any, has made an application for authorization of admission under section 51 of the Act to a home or homes or agrees to the application for authorization of admission to a home or homes selected by the placement co-ordinator under section 60.1 of the Act, the placement co-ordinator shall place the patient in category 1 of the waiting list referred to in section 188 of this Regulation in respect of every waiting list on which they are placed unless the patient would otherwise be placed in a higher ranking category.

(3) If the ALC patient or their substitute decision-maker, if any, refuses to make an application for authorization of admission to the long-term care home selected by the placement co-ordinator under section 60.1 of the Act, the placement co-ordinator shall place the patient in category 1 of the waiting list referred to in section 188 of this Regulation in respect of every waiting list on which they are placed, unless the patient would otherwise be placed in a higher ranking category.

(4) If the ALC patient was admitted to a home chosen by the placement co-ordinator under section 60.1 of the Act or consents to admission to a home chosen by the placement co-ordinator and, immediately prior to the admission to the home, they met the criteria set out in subsection 227 (2) of this Regulation, the placement co-ordinator shall maintain their place on the applicable waiting list for a reunification priority access bed.

(5) The placement co-ordinator shall authorize the admission of an ALC patient to a long-term care home selected by the placement co-ordinator only if,

(a) the licensee of the home has not withdrawn the approval of the applicant’s admission under section 202;

(b) the information provided to the licensee under subsection 240.2 (10) was obtained by the placement co-ordinator within three months preceding the authorization or if, within the preceding three months, there was a significant change in the ALC patient’s condition or circumstances and a reassessment was made at that time; and

(6) The appropriate placement co-ordinator may authorize the ALC patient’s admission to preferred accommodation in the home even if basic accommodation has been requested, and, in such a case, the licensee shall make the accommodation available as basic accommodation.

(7) If the placement co-ordinator authorizes placement in preferred accommodation under subsection (6) and the ALC patient moves into the home, the licensee shall place them on the internal transfer list in accordance with clause 239 (1) (a) on the date of the patient’s admission even if the patient has not explicitly requested the transfer.

(8) If the ALC patient is admitted as a resident to preferred accommodation under subsection (6) and the resident or the substitute decision-maker, if any, removes the resident from any other long-term care home waitlists and would rather the resident remain in preferred accommodation, the licensee may then charge the resident for preferred accommodation in accordance with the Act and this Regulation.

(9) If the ALC patient does not move into the home before noon of the fifth day following the day on which they are informed of the availability of accommodation in the home, the placement co-ordinator may offer the bed to the next applicant on the waiting list, unless the licensee agrees to the patient moving in at a later time on the fifth day.

(10) If the ALC patient is admitted as a resident to a long-term care home that is not one of their preferred homes, and the resident or their substitute decision-maker, if any, later refuses an offer of admission to one of those homes, the placement co-ordinator shall remove the resident from all waiting lists.

(11) If the ALC patient is admitted as a resident to a long-term care home that is not one of their preferred homes, the placement co-ordinator shall limit the number of waiting lists the resident is on to five.

(12) If the ALC patient is admitted as a resident to a long-term care home that is not their preferred home and the patient or their substitute decision-maker, if any, does not apply within six months to a preferred home or homes, the placement co-ordinator shall follow the applicable requirements related to waiting list categories and ranking within categories in sections 187 to 201 for admission to any new long-stay bed.

Residents previously admitted to preferred accommodation under pandemic, hospital admissions

240.4 (1) This section applies in the following circumstances:

1 Where a resident was admitted to a long-term care home under section 208.2 of Ontario Regulation 79/10 (General) made under the former Act.

2. Where a resident was admitted to a long-term care home under section 242 of this Regulation prior to the coming into force of this section.

3. Where a person consented to the admission under section 242 of this Regulation but did not move into the home before the coming into force of this section.

(2) If the placement co-ordinator authorized the admission of a resident or person described in subsection (1) to preferred accommodation when basic accommodation had been requested, the licensee shall place the resident on the internal transfer list in accordance with clause 239 (1) (a) as of the date of their admission even if they have not explicitly requested the transfer.

3. Section 242 of the Regulation is revoked.

4. The English version of subsection 243 (1) of the Regulation is amended by adding “home” after “long-term care”.

5. The definition of “personal health information” in subsection 351 (4) of the Regulation is revoked.

6. Subsection 390 (5) of the Regulation is revoked.

7. Subsection 391 (6) of the Regulation is revoked.

Commencement

8. This Regulation comes into force on the later of the day section 2 of the More Beds, Better Care Act, 2022 comes into force and the day this Regulation is filed.

Français

O. Reg. 484/22: GENERAL

Tags

Share