How do Canada’s provinces compare on restricting movement of care workers during COVID-19?

Along with restricting non-essential visits, another important measure to mitigate the introduction and transmission of COVID-19 in long-term care, assisted living and independent living residences, is preventing employees from working at more than one site. Some Canadian provinces took this approach early on, limiting workers to one site to help prevent the spread of COVID-19 among vulnerable populations.

Implementing this measure, however, has been challenging. With many employees working at multiple care sites, provincial governments have had to level wages and provide some type of top-up emergency pay.

While some provinces issued orders restricting staff from working at multiple sites, other jurisdictions only put forward recommended guidelines. Here’s how provinces in Canada compare on restricting the movement of care workers during the COVID-19 pandemic.

British Columbia

On March 23rd, 2020, Vancouver Coastal Health’s Medical Health Officer Dr. Althea Hayde temporarily ordered all care workers to stop working at multiple care homes. Exceptions were made for physicians, paramedics and laboratory technicians. The same order also required all sites to deny access to all visitors to the facility, with the limited exception of immediate family members and the spiritual adviser of residents who are clinically assessed to be at the end of their lives.
On March 26th, 2020, following an order by Provincial Health Officer Dr. Bonnie Henry, workers in British Columbia’s long-term care, acute care and assisted-living facilities were limited to working at a single site.
In early April, Health Minister Adrian Dix said the “single-site transition framework” will be implemented “in the coming days” by B.C.’s Ministry of Health in consultation with the affected regions, unions, and public and private employers. The process is complicated and it will also be expensive. Dix estimated the tab for implementation at $10 million a month so long as the new regime is in place.
In mid-April, BCCPA said it is concerned by delays in restricting workers to a single site during the COVID-19 pandemic, after learning 4,200 staff were still working at more than one site.
In an April 24, 2020 interview, BCCPA’s CEO said the practice of care home workers needing to work at multiple sites will be looked at once the COVID-19 pandemic subsides. In particular, it was noted that at the beginning of the pandemic, BCCPA advocated immediately to make sure that workers did not go from site to site as it identified early on as being something that could spread the virus.
In early May, BCCPA stated publicly that the delay in restricting workers to a single site during the COVID-19 pandemic is partly the result of confusion around wage structure. At that time 276 of the 545 facilities in B.C. with multiple-facility employees had completed a single-site plan.
On May 7th, 2020, Fraser Health Authority Chief Medical Officer Dr. Martin Lavoie noted that they expect by May 8th all 141 seniors’ care homes in their region will have staffing plans that limit care aides to a single site.
By mid-May, nearly all B.C. care facilities that had employees working at multiple locations came up with plans to limit those workers to one site.
On May 26th, Minister Adrian Dix announced that 497 out of 545 sites are now fully complying with the single site order. Progress is underway at the remaining 46 sites.

Alberta

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In early April, a Calgary operator that operates five seniors’ care homes said it is restricting its staff from working at more than one location to prevent further COVID-19 spread in continuing-care centres. The Brenda Strafford Foundation implemented the policy internally on March 25th and urged the province to impose multiple-workplace restrictions across Alberta.
Alberta Chief Medical Officer of Health Dr. Deena Hinshaw announced new rules for long term care including limiting staff to working at only one continuing-care site. The order applies to all workers employed in continuing care and to all continuing care facilities, including for-profit, not-for-profit and public facilities. As outlined in the order from April 10th, this was to be effective April 23rd.
Shortly after the announcement, United Nurses of Alberta filed a province-wide grievance seeking immediate clarity from Alberta Health Services on how it will apply Chief Medical Officer of Health Dr. Deena Hinshaw’s order restricting workers to one site only.

Ontario

On March 22nd, Ontario recommended limiting wherever possible those working at multiple locations but did not issue medical order.
On April 14th, 2020, Ontario Premier Doug Ford announced the province will issue an emergency order prohibiting employees from working at multiple long-term care facilities in an effort to slow the spread of COVID-19.
On April 15th, 2020, Ontario issued a new emergency order restricting long-term care staff from working in more than one long-term care home, retirement home or health care setting. These measures are being taken on the advice of Ontario’s Chief Medical Officer of Health. The order came into effect April 23rd, however, it does not limit multiple home care providers from entering licensed retirement homes.

Saskatchewan

In mid-April, Saskatchewan Health Authority CEO Scott Livingstone said new rules were coming to reduce the movement of healthcare staff between long-term care homes, which have been the source of deadly COVID-19 outbreaks across Canada. At the time, the SHA was being pressured to limit the movement of staff between facilities to reduce the risk of the virus spreading amongst seniors, who are most vulnerable to COVID-19.
On April 17th, 2020, Saskatchewan’s chief medical health officer’s public health order was updated to include the following: As of April 28th, 2020, long-term care and personal care homes must ensure that each staff member works in only one facility. A care home may seek approval from a medical health officer to permit a staff member to work in more than one facility if they are unable to ensure adequate staffing levels as a result of complying with this order. This public health order now also includes personal care homes and formalizes existing requirements for long-term care and affiliate care homes, including health screening and masking while on shift.

Manitoba

On April 27th, 2020, Manitoba announced it would become the latest province to ban health-care workers from working at more than one facility.

Atlantic Canada

On April 14th, New Brunswick put forward a recommendation (not a medical order) that staff should avoid working in different facilities if possible. On April 17th, Nova Scotia outlined that Public Health should determine whether staff from a facility in outbreak can work in non-outbreak facilities.
In mid-April, P.E.I. recommended that staff from a facility in outbreak should not work in non-outbreak facilities. In mid-April, Newfoundland went further by issuing an order to prevent staff from working at multiple sites.

Quebec