Overview

Effective immediately, all open and secure custody/detention youth justice facilities must follow this guidance and the Interim Direction (February 2022) to prevent the spread of COVID-19.

Find out about the latest public health measures and provincial guidelines.

As the COVID-19 outbreak situation changes, we may provide further direction.

February 2022 interim direction

In response to the continued increase in spread of COVID-19 variants, the Ministry of Children, Community and Social Services (MCCSS) is taking additional precautions to help protect youth and staff in MCCSS-funded and licensed youth justice custody and detention facilities.

This addendum replaces the January 2022 (V2) interim direction addendum.

Beginning February 21, 2022 and until further notice all MCCSS-funded and licensed youth justice custody and detention facilities are required to implement additional precautions outlined in the following extended measures.

Use of rapid antigen testing

Dependent on test kit availability, and until further notice, all youth justice facilities are to use rapid antigen tests to:

  • Support test-to-work strategies to support early return to work when required for critical staffing. Learn more about the Ministry of Health’s (MOH) COVID-19 Interim Guidance: Omicron Surge Management of Critical Staffing Shortages in Highest Risk Settings.
  • Screen all staff who enter a youth justice facility regardless of vaccination status, at a frequency of 2 times per week (7-day period).
    • This may include the minimum once-per-week rapid antigen screening requirement for unvaccinated staff under the service provider’s vaccination policy. Vaccination policy requirements under CMOH Letters of Instruction and existing agency business processes are expected to continue.
  • Directly operated youth justice facilities should continue to follow direction for OPS staff with respect to antigen testing requirements, in accordance with the OPS COVID-19 Safe Workplace Directive.
    • Facilities that are currently using at-home antigen screening for staff may continue to do so.
  • Screen all visitors entering a facility (regardless of the visitor’s vaccination status). Exception only if the visitor presented a negative rapid antigen test result at the same facility the day before.
  • For youth justice directly operated custody and detention facilities, all non-OPS employees or representatives acting on their behalf (for example, vendors/their employees) are required to follow the OPS COVID-19 Safe Workplace Directive-Supplementary Directive:
    • Non-OPS employees include those who have regular and sustained in-person interaction with employees in an OPS workplace during the performance of their work. This includes contractors/sub-contractors (for example, I&IT and management fee-for service consultants, custodial and cleaning workers, security guards), adjudicators and broader public sector (BPS) secondees.
  • Testing youth who are symptomatic where PCR testing is not available in a timely manner.  Learn more about COVID-19 Integrated Testing & Case, Contact and Outbreak Management Interim Guidance: Omicron Surge.
  • While MCCSS facilities have been identified by the MOH as a priority for PCR testing, where such testing is not available, any positive results from a rapid antigen test will no longer require a confirmed laboratory-based PCR or molecular point of care test (for example, ID NOW).
    • Staff, youth and visitors receiving a positive rapid antigen test result will be presumed to have COVID-19.
    • Where a confirming PCR test is not available, service providers will follow existing guidance for positive case management for staff and youth including MOH isolation requirements.

Use of N95 respirators

Based on the Public Health Ontario (PHO) interim technical brief (December 15, 2021), fit-tested N95 respirators are being recommended for use in facilities when providing direct care to someone who is suspected or confirmed positive with COVID-19. Service providers should be reviewing the PHO technical brief to determine if they fall within the scope of the interim recommendations on the usage of N95 respirators.

A fit-tested N95 respirator continues to be required when performing (or supporting a person during) an aerosol generating medical procedure and the person is suspected or confirmed COVID-19 positive.

Service providers should be determining the appropriate PPE for staff based on the organization’s risk assessment and factors specific to the staff role/function including risk of infection.

In cases of providing direct care to someone who is suspected or confirmed positive with COVID-19 a fit-tested N95 respirator is recommended. If a fit tested respirator is not available when it is required, other appropriate PPE in the interim would include the use of a respirator that is not fit tested, until fit testing is undertaken for applicable staff.

As service providers consider the need for fit testing to support effective use of N95s, consideration should also be given to establishing internal fit testing capacity to support sustainable access to fit testing within the organization. As a reminder, service providers can also engage their local MCCSS IPAC Champion if support is needed for fit testing. If an organization is accessing private/third party fit testing through available services, this would be considered an eligible expense through CRRF.

As previously communicated, based on the organization's PCRA MCCSS-funded or licensed service providers may identify situations not described in the guidance linked above where PPE including N95 respirators may be used as part of an individual's care plan.  Service providers should ensure documentation of any such requirements within the individual's care plan.

  • N95 respirators will be available to staff in facilities based on an organization's risk assessment of the needs of individuals receiving service and the nature of the supports being provided by staff and documented in an individual's care plan.
  • Service providers should ensure the appropriate and necessary policies and procedures are in place to support the access to and usage of N95 respirators as part of a respiratory protection program. For example, the process for staff to access to respirators outside of regular business hours. This may require engagement of an organization's Joint Health and Safety Committee (JHSC) in the development and review of measures and procedures.
  • A service provider's respiratory protection program should incorporate the necessary training for staff to ensure that the PPE will be used safely and appropriately by staff and in accordance with any industry-based standards that may exist.

Please note: PHUs may continue to provide direction that may be different and/or in addition to those set out in this Interim Direction to prevent and mitigate the spread of COVID-19 and/or other infectious diseases to ensure a tailored response to each local outbreak scenario.

Mandatory positive case reporting

Service providers must continue to report COVID-19 cases through the ministry's Serious Occurrence Reporting system. A positive case can now be based on a positive result on any PCR, molecular point of care, or rapid antigen test. Regardless of the test(s) conducted, each positive case should only be reported once (that is, where a positive rapid antigen test is reported, there is no need to report again if a subsequent positive PCR test is received).

Read the Ministry of Health’s COVID-19 Interim Guidance: Omicron Surge Management of Critical Staffing Shortages in Highest Risk Settings. This is applicable to open/secure youth justice facilities operated by transfer payment recipients only. Directly operated sites continue to follow their updated isolation requirements.

On January 12, 2022, the MOH issued COVID-19 Interim Guidance: Omicron Surge Management of Critical Staffing Shortages in Highest Risk Settings, which provides a framework for service providers of certain highest risk settings (including MCCSS funded and licensed congregate living settings) to use when considering early return to work of staff who are otherwise not eligible for early return to work as a mitigation to critical staffing shortages. This framework may be used and implemented by service providers without approval or review by the local PHU. Service providers also do not require the approval of the ministry.

All settings should fully utilize staffing strategies in their continuity of operations plan to avoid and mitigate situations of staffing shortages impacting care before utilizing early return to work for staff in isolation. Options with lower risk should be exhausted prior to progressing to options with more risk. The use of options with more risk should be commensurate to the risk of insufficient staffing to youth. As service providers are informing their program supervisor about critical staffing issues, they should also advise them that “high risk staffing options” are being implemented. This is for awareness (not approval) and to help your program supervisor identify additional supports that could be provided.

Rapid antigen tests have been prioritized to highest risk settings for use for test-to-work strategies to support early return to work when required for critical staffing.

Visits to youth justice facilities

Face-to-face, in person interactions between visitors and the people supported in our congregate settings play a key role in providing physical, emotional and cognitive support to residents and in maintaining their health and well-being.

Visits may take place indoors or outdoors on the facility property, depending on the ability of the facility to support either outdoor or indoor visitation.

All in-person visits should adhere to the Youth Justice Services Manual Custody/Detention Standard - 5.11 Visits, site specific policies and procedures and associated manual standards at all times.

No in-person visits are permitted if the facility is experiencing an outbreak. An outbreak is declared by the Local Public Health Unit (LPHU) and/or one laboratory confirmed case of a resident or staff.

We strongly encourage virtual visits wherever possible.

Agencies should consider resident and staff health and virus susceptibility as well as the overall well-being of all facility residents when determining whether in-person visits are appropriate.

Visitors are to be actively screened, including rapid antigen testing before being allowed entry into the setting, and must wear appropriate personal protective equipment (PPE) for the duration of their visit.

Personal protective equipment (PPE) during visits

Visitors must follow PPE requirements.

Indoor visits — You must wear a surgical/procedure mask and eye protection (for example, face shield) at all times while inside the congregate living setting while the visit is taking place.

All visitors must wear eye protection (that is, face shield, goggles, safety glasses) at all times during indoor visits unless they are able to always safely maintain 2 metres distance or there is a solid barrier between them and facility staff, youth or each other. Outdoor visits – You must wear a surgical/procedure mask at all times while the outdoor visit is taking place.

The facility or service provider will:

  • tell you during screening at the door that you must strictly adherence to the masking/eye protection requirements as a condition of entry when the visit is indoor
  • tell you that failing to adhere to the conditions may mean you will be asked to leave
  • provide you a surgical/procedure mask and eye protection as needed

Facility operators can order PPE through the Critical Supplies and Equipment survey portal. (Learn more about PPE).

In the event practices and approaches are unclear, transfer payment recipient facilities may wish to contact a ministry representative and/or your respective legal counsel. For directly operated sites, consultation can occur with senior leadership within the Service Delivery Branch, as appropriate. In the event of any conflict between the direction in this protocol and any legislation or emergency orders that apply to youth justice custody and detention settings, the applicable legislation and applicable orders prevail.

Reintegration Leaves

Non-essential reintegration leaves are restricted until further notice.

School attendance

Service providers are to follow local school board direction regarding school attendance.

Enhanced PPE for staff

All staff must wear a surgical/procedure mask at all times except when:

  • eating and drinking (as long as a full 2 metre or 6 foot physical distance from others can be maintained)
  • outside and physical distance can be maintained
  • alone in an office

Isolation gowns

Staff must also wear an isolation gown when providing direct care to youth with respiratory symptoms and/or are under droplet/contact precautions.

Eye protection

Eye protection (face shield, goggles, safety glasses) is mandatory for all staff as follows:

  • when working or entering the following areas:
    • intake and admission areas
    • intake Units (if applicable)
    • close observation/secure de-escalation areas (if applicable)
    • all staff and visitor screening areas
    • any area designated to be in outbreak status based on a risk assessment conducted by corporate health care in collaboration with public health
    • kitchen, laundry area or any area where unable to always maintain 2 metres distance unless there is a solid barrier between workstations
    • any area where video or audio court and video visits take place where a distance of 2 meters is not feasible
  • in the following circumstances:
    • always when providing direct care or escorting youth with suspected or confirmed COVID-19
      • at all times during medication administration, including health care staff administering, and escorting staff, and staff delivering medications (face shield recommended)
      • when performing a COVID test, if within 6 feet without a solid barrier (face shield recommended)
      • when within 6 feet with no solid barrier during any aerosol generating medical procedure (AGMP), including CPR
      • always when directed by local public health units or health care staff following a risk assessment

Requirements for eye protection and other PPE may change based on a risk assessment (for example, during outbreaks, high community prevalence) or public health recommendations.

While not mandatory, staff may continue to wear eye protection at any time in a facility. This would be most appropriate in areas where physical distancing of a minimum of 2 metres from others without a solid barrier cannot be maintained. Examples include shared offices and training rooms.

All visitors must wear eye protection (that is, face shield, goggles, safety glasses) at all times during indoor visits unless they are able to always safely maintain 2 metres or 6 foot distance or there is a solid barrier between them and facility staff, youth or each other.

In the event practices and approaches are unclear, transfer payment recipient facilities may wish to contact a ministry representative and/or your respective legal counsel. For ministry operated sites, consultation can occur with senior leadership within the Service Delivery Branch, as appropriate.

Eye protection needs to:

  • be intended for protecting the eyes from mucous membranes
  • protect the eyes

Prescription glasses and sunglasses alone are not considered adequate protection.

The eye protection should shield the sides of the eyes/face so that droplets are less likely to land on the eyes.

Staff areas

For staff areas, Public Health Ontario advises:

  • discontinue all activities that require close contact, including in-person group meetings
  • stagger use of common areas
  • move furniture to support keeping people 2-metres apart and use tape on the floor to indicate where furniture should stay
  • clean and disinfect common areas at least twice a day

Important: Failure to carefully use and manage PPE supplies is known to contribute to the spread of COVID-19 in congregate care settings, including among staff.

Personal protective equipment (PPE) supply

Surgical/procedure masks, hand sanitizer, gloves, disinfectant wipes, face shields and isolation gowns are considered “core” PPE types. They can be obtained via the Critical Supplies and Equipment (CSE) survey portal by reporting your current inventory and your forecasted usage.

Eye goggles and safety glasses are considered a "niche" PPE type and can be obtained through the Ontario Association of Children’s Aid Societies (OACAS) Shared Services PPE Order Page.

Service providers are asked to use discretion when ordering niche PPE (eye goggles or safety glasses for example) and should default to using core PPE (face shields) when operationally feasible.

Agencies should forecast their requirements based on this new standard in the CSE survey portal. In case of an emergency (for example, a COVID-19 outbreak, having less than a 5 day supply of PPE) organizations requiring additional surgical masks, eye protection and isolation gowns can request additional supply from the OACAS Shared Services PPE Order Page.

Screening questions

Screening in youth justice open and secure facilities must include the following question to all individuals seeking to enter the setting:

  1. Are you aware of the recommendations and restrictions in this community regarding gathering size, hand and respiratory hygiene, and the use of face coverings and masks?
  2. Are you following these recommendations and restrictions regularly outside this setting you are seeking to enter?

Facility screening must also continue to be enhanced for staff with the following questions:

  1. Do you understand that you are expected to properly don your personal protective equipment and wear it at all times in this setting with the exception of when you are eating?
  2. Do you acknowledge that at any time your PPE is removed you must maintain a distance of 2 metres or 6 feet from others?

Please remember that interacting with colleagues outside of work without face coverings and social distancing raises the risks of COVID-19 transmission.

Read a list of all COVID-19 symptoms and use additional Government of Ontario screening tools.

Precautions for settings in an active outbreak

If a youth justice facility is in an active COVID-19 outbreak (one or more positive COVID-19 cases), the following additional measures must be followed:

  • Seek outbreak-specific training resources available via Public Health Ontario, including the appropriate use of PPE and infection prevention and control practices.
  • Implement enhanced cleaning practices.
  • Restrict new admissions (where possible) in settings experiencing an outbreak.
  • Seek support from your local public health unit to assess the need for testing of all residents and staff who may have been exposed.
  • Limit staff mobility to working in one site only.
  • Staff who are asymptomatic but test positive for COVID-19 must follow outbreak precautions and isolate for the number of days as recommended by the local public health unit. These individuals must not return to work until the time recommended by the local public health unit.

Other measures

The measures above are essential to addressing the risks of COVID-19 transmission in youth justice open and secure facilities.

As has become well known during the pandemic, what we do in our personal lives contributes directly to infection risks in workplaces. All Ontarians, including staff at youth justice facilities, must adhere strictly to public health practices in their personal life that help stop the spread of COVID-19.

Find out about the latest public health measures, advice and restrictions.

To support the provincial efforts, facilities should supplement the practices discussed here. Facilities should set measures to maintain and enhance work from home arrangements where it is not essential for employees to attend the workplace.

Non-essential reintegration leaves continue to be restricted in youth justice facilities until further notice however, they will be considered on a case by case basis.

Our number one priority is protecting the health and safety of those in youth justice settings, as well as the people who care for them.

Specific measures will be implemented on a location-by-location basis, following public health guidance.