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Lailamie Viloria, 48, a personal support worker at Fudger House Long Term Care home in Toronto receives a COVID-19 vaccine at St. Michael's Hospital in Toronto.Melissa Tait/The Globe and Mail

Ontario will make COVID-19 vaccinations mandatory by Nov. 15 for all staff working directly in long-term care homes, and will not make exceptions for workers who prefer to be regularly tested for infection instead, Premier Doug Ford’s government announced on Friday.

The new policy means long-term care staff, support workers, students and volunteers who fail to show proof of double vaccination and do not provide valid medical exemptions will not be able to enter long-term care homes to work. But the policy does not apply to visitors or essential caregivers entering homes, who will still be able to sidestep the vaccination requirement by submitting to COVID-19 testing.

The province is leaving it up to individual homes and companies to decide the consequences for employees who are barred from their workplaces because they fail to meet the new conditions.

Long-Term Care Minister Rod Phillips said Friday that while staff vaccination rates in homes have improved, the increase is not enough to protect residents, and there are wide variations in vaccination rates between homes. He also said the province has seen an increase in outbreaks linked to unvaccinated workers in long-term care facilities.

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Almost 60 per cent of the province’s 626 long-term care homes have staff vaccination rates below 90 per cent, Mr. Phillips said, and 99 homes are below 80 per cent. At Labdara Lithuanian Nursing Home in Toronto, for example, only 51 per cent of staff are fully vaccinated.

“We want to protect all long-term care residents and all staff regardless of which home they live or work in. And the evidence shows in long-term care settings these rates are not acceptable, especially in the context of the Delta variant which is more transmissible,” Mr. Phillips said.

“Given the reality of the Delta variant across Canada and around the world, we need to do more.”

Long-Term Care Minister Rod Phillips said Friday that while staff vaccination rates in homes have improved, the increase is not enough to protect residents, and there are wide variations in vaccination rates between homes.Melissa Tait/The Globe and Mail

The new measures announced Friday also include random testing of fully vaccinated staff and residents, to help detect possible breakthrough infections of COVID-19, as well as “rigorous inspections” of homes’ methods of preventing and controlling infections. The government is also now publicly posting staff vaccination rates for each home online.

Mr. Phillips said the new rules may affect staffing at some homes, but the government has offered funding and support teams to work with facilities facing shortages of workers. He also said he expects an additional 11,000 new personal support workers to graduate from training programs in coming months.

Healthcare groups and opposition parties supported the move, but said the government needs to go even further, by applying the mandatory policy to hospital employees and other types of health care workers, as well as education workers. Currently, those groups are offered regular COVID-19 testing as an alternative to vaccination.

Anthony Dale, president and CEO of the Ontario Hospital Association, called for a “consistent provincial approach” across all health care sectors, which he said are “highly interconnected.”

“With COVID-19 vaccination becoming mandatory in long-term care, we feel the time has come to adopt a mandatory approach for all health care workers, including those in hospitals, too,” he said.

Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, said nurses and many home care groups already agree with mandatory vaccinations. “Everybody is on board. Move with a uniform approach by November 15: every single health care worker and every education worker,” she said.

Ontario’s NDP and Liberal opposition parties agreed. “These mandates should be immediately extended to all types of elderly and home care as well as hospitals and schools,” Ontario Liberal Leader Steven Del Duca said.

British Columbia, Alberta, Quebec and Nova Scotia have all made vaccination a condition of employment for health care workers. Some Ontario hospitals have introduced their own vaccine mandates, rather than waiting for the provincial government to act. The University Health Network in Toronto has said that it will fire employees who aren’t vaccinated by Oct. 22.

In August, the country’s five largest for-profit long-term care home chains – Chartwell, Extendicare, Responsive Group, Revera and Sienna – announced that COVID-19 vaccinations would be mandatory for long-term care and retirement home staff in their facilities across Canada. As of Oct. 12, staff who are not fully vaccinated will be placed on unpaid leaves of absence.

Lisa Levin, CEO of AdvantAge Ontario, a group that represents municipal and not-for-profit long-term care homes, said the group is “extremely relieved” by the new vaccination requirement, which means homes no longer have to assume the legal risk of introducing their own vaccine mandates for staff.

But she urged the government to expand its mandates to all health workers.

“All Ontarians deserve to be protected. And our long-term care sector, which has been struggling to retain staff all throughout the pandemic, cannot risk losing much-needed staff to other health care settings where vaccinations are not required,” she said in a statement.

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