January 2022 (v2) INTERIM DIRECTION - Extended Measures

Youth Justice Services Custody and Detention Facilities

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 INTERIM DIRECTION Addendum.

Beginning January 13, 2022 and until at least January 31, 2022 all MCCSS-funded and licensed youth justice custody and detention facilities are required to implement additional precautions outlined in the following Extended Measures:

Visits to Youth Justice Facilities:

Face-to-face, in person interactions between essential 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.

The Ministry also recognizes, consistent with the announcements of January 3 moving the province into a modified Step 2 with time-limited measures to help blunt transmission, suspension of non-essential visits are appropriate measures at this time.

Use of Rapid Antigen Testing

Effective immediately and until further notice, facilities are to use rapid antigen tests to:

**Non-employees entering OPS workplaces will be required to complete the Non-Employee COVID-19 Screening Form prior to entering an OPS workplace.

**Non-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 (e.g. I&IT and Management Fee-For Service consultants, custodial and cleaning workers, security guards), Adjudicators, and Broader Public Sector (BPS) secondees.

While MCCSS funded and licensed facilities have been identified by the MOH as a priority for PCR testing, in the event that 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 (e.g., ID NOW).

Use of N95 Respirators

In facilities the need for the use of N95 respirators will most often be indicated based on an individual’s medical status, specifically individuals who are known or suspected to have COVID-19 and/or as recommended by a public health unit (PHU).

PHO’s interim recommended PPE when providing direct care for individuals with suspected or confirmed COVID-19 includes a fit-tested, seal-checked N95 respirator (or equivalent or greater protection), eye protection, gown, and gloves.

A fit tested N95 respirator (or equivalent or greater protection) should be used when an individual’s medical needs require an aerosol-generating medical procedure and they are known or suspected to have COVID-19.

* A non-fit tested N95 (or equivalent) respirator is considered an alternative to a medical mask.

Please review PHO’s Technical Brief ‘Interim IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19’ (December 15, 2021) for more information.

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.

Fit Testing for N95 Respirators

Before N95s can be accessed and used, service providers must have identified staff fit tested to ensure a proper seal and trained on appropriate usage of the respirator.

If there is a positive case within a setting, N95s can be accessed through the OACAS web portal https://request.cwconnects.org/tpr/ and flagged as an emergency order for shipments within 24-48 hours. NOTE: while fit testing is recommended, it is not required in order to place an emergency order.

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. 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 (i.e., where a positive rapid antigen test is reported, there is no need to report again if a subsequent positive PCR test is received).

MOH COVID-19 Interim Guidance: Omicron Surge Management of Critical Staffing Shortages in Highest Risk Settings (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 Ministry of Health (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 Public Health Unit (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 residents. 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.