On October 5 2021, VHA Home HealthCare (VHA) leaders held a virtual event for the public to share updates about VHA’s move to mandatory vaccination and other initiatives to keep its community as safe as possible throughout the pandemic. You can view a full transcript and recording of the event below.

[Tracey Turriff:] Good morning everyone and thank you for joining VHAHome HealthCare’s Client and Family Town Hall. My name is Tracey Turriff and I am VHA’s Senior Communications and PR Manager. This morning we will be answering pre-submitted questions and providing updates on our COVID response and on vaccination at VHA. if you have any technical difficulties during the call please email communications@vha.ca or you can call 416-280-8426 and we will get right back to you to help you out. We’re recording this town hall and we’ll make the recording available afterwards. To begin, VHA Home HealthCare would like to acknowledge that we are living and working on Indigenous land. Toronto is the traditional territory of many nations including the Mississaugas of the Credit, the Anishinaabeg, the Chippewa the Haudenosaunee and the Wendat Peoples. I will now turn it over to Kathryn Nichol to get us started.

[Kathryn Nichol]: Thank you Tracey and good morning everyone. Thank you so much for joining us today. We certainly appreciate this opportunity to connect with you and share all that we are doing to provide safe care for clients and families and safe work for our staff and our service providers.

So during the last 18 months I’ve heard from many clients and their families, many wanting to express their thanks for the dedicated and compassionate care that they’ve received during the pandemic and of course some expressing valid concerns and I just wanted to say that I appreciate your support and I welcome these calls and these emails. I know how important our care is to you and your families and it’s a responsibility that we take very seriously. Your calls help me and all of us, especially those of us that are here this morning, to understand and stay focused on what matters most to you. There’s certainly a few key areas of concern going on right now in the in the health system but a key area of concern for the home care sector has really been a lack of health human resources and while capacity in personal support services has been the long-standing concern for all home care providers in Ontario, the pandemic has really intensified the situation and now unfortunately we’re experiencing a shortage of nurses as well and you would have heard and read about this in the media. We aren’t alone in this as every corner of the health system is hiring nurses and I wanted to reassure you that we are focusing intently on recruitment and retention and working closely with health system partners to align our efforts. One of the key learnings over the last year and a half has been that home care is a very safe way to receive care during a pandemic, possibly the safest way. VHA was able to provide training and personal protective equipment to our teams and as an essential health care service we were able to provide continuous care from March 2020 right at the beginning of the pandemic through to today and thankfully there were very few cases of transmission of infection between workers and clients across the whole home care sector in Ontario. In recent months we’ve been extensively involved in vaccination efforts both supporting our team members to get vaccinated but also helping with vaccination clinics and outreach across our communities and in early September you’ll likely be aware that Ontario’s Ministry of Health issued a directive they call it Directive #6 and it was a directive to home care organizations including VHA that requires mandatory reporting of vaccination status. So I’m pleased to share that in addition to complying with directive number six VHA is taking the further step of making vaccination mandatory for all of our staff, service providers, students and volunteers. And to hear more about this and other updates I’m pleased to pass things over to members of my team, so Kathy Sidhu VHA’s Interim Vice President of Quality, Best Practice and Education and Kathy’s also the lead of our Pandemic Response Team, David Fry, VHA’s Vice President of Client Services who just joined our organization this summer, and Kelley Myers, our Vice President of Han Resources and Organizational Development. So we’ll have brief updates and then we’ll answer a number of questions that were submitted ahead of the call. We hope that you find this information helpful. Thank you again for joining us this morning and Kathy without further adieu I’ll pass it over to you.

[Kathy Sidhu]: Great thank you Kathryn and good morning to everyone who was able to join the call today. I’m really happy to be here like Kathryn said to be able to share some more details about VHA’s ongoing response efforts to COVID-19 on behalf of our pandemic response team. So this Pandemic Response Team is really like a task force and as Kathryn mentioned I’ve had the pleasure of leading that over the last short while. The real focus of this task force is to monitor and respond to all the twists and turns that we’ve seen since wave one and this group still remains very active  20 months later as we’re in the thick of wave four. The primary goal of this team or this task force that we have is to ensure that we’re always staying ahead of and on top of Ministry of Health guidance and directives, public health orders and requirements with the ultimate goal of making sure that we’re keeping all of our team members and all of our clients and families as safe as possible. You’re going to see that I’m just going to provide an update today on two critical areas where our team has been spending the majority of its time over the last short while so we’re going to give some information related to infection prevention and control or you’re going to hear me refer to that as IPAC so that’s sort of our infection prevention and control area and the other big hot topic around vaccination and talk to you a little bit more about our vaccination plan. To start with infection prevention and control, so as expected you know in the face of an infectious disease related health crisis IPAC practices have been front and centre throughout the pandemic and they have been absolutely paramount. Now what some of you may have seen in the news over this time with the pandemic is really infection prevention and control information specific to hospitals and long-term care. But we obviously as a home healthcare organization have really been focused on guidance specific to our home care setting in our home care environment and we have a specific guidance docents that we follow and it’s noted there on the bottom of the slide. It’s the COVID-19 guidance for home and community care providers that comes out from the Ministry of Health. There have been six iterations of this and revisions over the course of the pandemic so that’s where we’ve been focused and making sure that we’re up to date and responding to some of the changes within that docent. Most of what I’m going to share right now on the screen I think happened, alluded to, that we implemented these right away and we’ve just sort of been refining them or updating them over time when and where we need to based on the updates on the key docents. But in all instances we’ve either met or surpassed IPAC requirements and all of our practices and processes are hardwired. They’re part of our day-to-day regular routine so as you can see on the slide there are quite a number of IPAC measures that we have in place and when layered all together these have made our VHA home care services and as Kathryn mentioned, the home care setting actually one of the safest sectors to receive health services. To start one of the IPAC measures we have in place, a very important one, is daily screening assessments for COVID-19. Many of you will be familiar with this and many of us are now all very familiar with the screening questions that come in almost every place that we go just checking for signs and symptoms in certain situations that would predispose someone to COVID-19 so not only are our staff and service providers screening our clients and families they’re doing that screening prior to doing visits. Our staff and our service providers are screening themselves each and every day before they go to work and then we have strong protocols that  if there are concerns or if they’re flagged they are not going to work that day so that’s the very first important layer. Then the next very important layer in IPAC is personal protective equipment and we have really put a lot of time and energy to establishing ways of getting PPE out to our staff and service providers so that they have a constant supply of this very important personal protective equipment with them. It includes things like their masks, their eye protection, gowns and gloves and everybody is very well stocked so that they’re able to deliver care safely with all of the equipment that they need.  Another big bucket that we had that Kathryn mentioned is  we have done a lot of knowledge based education and training with our teams specific to COVID- 19. We have a specific learning module that people must complete that tells them all about the infection prevention and control information about COVID-19 and then we have a lot of additional supplemental information. We have great video clips on specific infection topics. We have posted open  question and answer for around infection prevention and control. We have a really great dedicated inbox where people can ask questions that they have about infection prevention and control and they get answers in real time and then we have all of our resources posted on our intranet and they’re available to our staff and service providers 24 7. Additionally at VHA we’re extremely fortunate to have a dedicated infection prevention and control leader. This individual is truly an IPAC expert and is dedicated to monitoring all of the IPAC requirements and identifying how we’re going to implement them as an organization and embed them into our practices. He does a lot of that translation and helps the organization put all of this into the front line and into our operations and processes. This individual’s also connected with many IPAC leaders not only within the home care sector but other sectors so always staying on top of an abreast of all of the IPAC activities and this individual is also extremely busy and has a lot of time focused at the ground level supporting our teams and our supervisors with IPAC questions that come in. We really have a strong framework of support and resources to our staff around IPAC. The last layer here is a big one as well and it’s vaccination. We have spent a serious amount of time in this area as you can imagine. Right when vaccinations were rolling out as we recall at the end of 2020 VHA was quick to develop a position statement that really proclaimed our organizational stance right away that we were an organization that strongly encouraged vaccination and that was a message that we circulated loud and clear both internally in our organization as well as externally  with vaccination really being an additional measure to help reduce the spread of COVID to reduce the risk of serious illness and hospitalizations and really being an extra safety measure to help us move through the pandemic. Internally around vaccination we’ve had focused efforts I’d say in three main areas. One is around promoting vaccinations, so telling people where and how and when they can get vaccinated. We found that we’re constantly posting and circulating all of these opportunities and helping people navigate their being able to get out for first and second doses. The next bucket was really trying to help people understand any hesitancies that they had related to vaccination and  having strategies where we could do things to help increase their confidence to go and get vaccinated. We did a survey to try to understand what was holding individuals back and then we tried to address some of those hesitancies or those concerns again providing more information and hosting webinars and question and answer sessions. Lastly we did everything we could to remove barriers for people to get out to get vaccinations so we supported individuals with time off work so that they could go out and get those important doses that they needed to try to strengthen our workforce in increasing our vaccination rates. I do want to let you know as well externally we were involved quite a bit with this vaccination as well. We did release our position statement early on externally where we also encouraged our clients and families to get vaccinated for the same reasons. We were also fortunate to be able to partner with many other healthcare organizations to actually drive and administer vaccinations so being on the end of actually supporting administration of vaccinations in Ontario particularly in the GTA by supporting either on-site clinics or supporting mobile vaccination clinics. So as you can see on this slide here and what it contains has really been keeping our task force busy. This is a very important area and we continue to work in this realm. So that’s a little overview there and now I’m actually going to move on to vaccination itself in terms of our vaccination plan that Kathryn alluded to. All of the pre-vaccination work that we did really positioned us well to launch what we call  a two-phased vaccination plan as Kathryn mentioned. I’m going to provide an overview to tell you what that’s about so that you can understand it a little bit and you can understand where we’re at in our vaccination progress. I’m going to start first with phase one and phase one was triggered by that directive number six that Kathryn mentioned. This was a mandatory directive that was announced on August 17th by Ontario’s Chief Medical Officer of Health and in that announcement it was mandated that all home and community care organizations including VHA. The requirement was to report and we had to report on one of the three options. Every staff, service provider, student and volunteer had to report at VHA if they were either fully vaccinated, if they had a medical exemption for not being vaccinated or they had to provide proof that they completed an education learning module about vaccination. In addition in directive six there’s also a requirement that for anyone who is not fully vaccinated with two doses of vaccination they need to participate in a rapid antigen testing program and they’re required to do that so in this first phase and the directive six  they actually gave us a specific date to implement and that was September 7th so that really shaped the timing of phase one. So we had to have this in place by phase one and we did that and met that requirement. Now moving on to phase two this actually happened on September 3rd so just after the announcement of directive number six VHA along with 22 other home and community care service provider organizations, we announced our voluntary decision to move to mandatory vaccination. Phase one was all about reporting information and phase two is truly about being vaccinated. You’ll see in this phase that all team members are required to have two full doses of vaccine or have a medical or human rights exemption so it’s not about reporting and this removes the option for individuals who have done the e-learning. Those individuals would not meet the criteria. In mandatory they would have to be vaccinated in this actual phase. I’m pleased to be able to share some of the results with you about our vaccination rates. If we move on to the next slide you’ll see here that we have had a 94  percent response rate or reporting rate.  94 percent of our workforce has reported their vaccination results and of that 94, 92 currently have two full doses of vaccination so they’re fully vaccinated but that number actually goes up to 97 when we include individuals who have just had their first dose or are planning on getting vaccinated.  I do want to pause here and just say how impactful this is and how powerful this is to see that VHA as an organization will essentially have a 97 percent vaccination rate and the impact that this has on safety for all. And on to the last slide and just briefly to wrap up here we do have some work to do for the people who have not yet reported and for the people who have completed that education module we are connecting and working with those individuals to help move them towards mandatory vaccination to make sure that we retain everybody as much as possible as we move through these phases again with the ultimate goal of having a fully vaccinated workforce in phase two later this year.

[Tracey]: Thank you very much Kathy for that very helpful update and now we are going to move into the questions that were pre-submitted before the call and Kathryn I’m going to direct the first question to you. The question is ‘Why do you believe it is a good idea to make COVID vaccination mandatory for your staff?’

[Kathryn:] Yes well certainly there are a number of reasons why this is a good move. First and foremost and of relevance obviously to this group is for our clients and families. As we know it will further reduce the chance of transmission of infection particularly for those who are most vulnerable for our staff, service providers, students and volunteers. There’s strong research that shows that vaccines are a very important strategy as they’re effective in preventing serious illness and hospitalization and we certainly want that for our team. Also VHA moved to a mandatory vaccination position as part of a collective move on behalf of 23 home care organizations in the province so really for the health sector this is a very powerful message that we’re united in the desire to provide high quality and safe care and due to the fragile state of our depleted healthcare workforce  really the only way to do this and ensure we can continue to provide safe and reliable home care is to do it together as a sector. Working together as a collective minimizes our risk of losing people between organizations and hopefully minimizes the risk of losing people from the health sector completely and you know as I mentioned we really can’t afford to lose a single health worker from our team. And finally, for health concerns in the public  taking a consistent approach not just across the home care sector but aligned with other  health organizations builds public confidence in our system and emphasizes more than ever  that home really is the safest place to receive care right now. So there’s a lot of reasons for why it is the right thing right now and I’m very proud to say that our organization is taking that move along with so many of our partner health organizations.

[Tracey:] Thank you Kathryn and David I’m going to direct the next question to you. ‘We have heard there is a shortage of home care workers as Kathryn has been just speaking about. Can you speak to what we are doing to make sure clients receive the care they need?’

[David Fry:] Sure thanks very much Tracey and thank you for the question and as Kathryn mentioned, certainly like no other time in the home and community care sector we’re experiencing a shortage of home care workers whether it’s personal support workers, nurses who deliver shift care and even most recently in the last six months or so we’re experiencing pressures around our therapy services so it really is unprecedented times in terms of the shortage of home care workers. I think first and foremost what are we doing  in terms of making sure that our clients receive the care that they need, we’re prioritizing every effort to minimize any disruptions in existing relationships with clients and families with a focus on what is the priority or essential care and so daily our teams, whether it’s the front line teams who are out in the field supporting our teams work to prioritize where we may be experiencing some unexpected gaps or pressures and they’re triaging and making some changes in schedules based upon clients and caregiver needs so we certainly take the relationship and the needs of our clients very seriously and we make those changes in a thoughtful way with lots of communication and preparation to clients and families ultimately to try to be making sure that for the finite resources we do have that we’re meeting those essential care needs over the last year. VHA has been trialing a variety of improvement ideas so for example on weekends we’ve been focusing in the Toronto area on trying to tighten our geography area for our  personal support workers so they don’t have to travel as much so we’re able to maximize their time as much as possible and look to our clients and families to help us in defining what is it that’s essential so what’s the support that we can be providing on the weekend and overall that’s helping us to minimize last minute changes. It’s helping to minimize cancellations so it’s things like that that we’re exploring as an organization to help address the truly provincial crisis in terms of health care in home and community care shortages.

[Tracey:] Thank you very much David and Kathy I’m going to direct this next question your way. ‘I understand the directive from the ministry requires that any staff who are not fully vaccinated undergo testing every week and you were speaking to this earlier. Can you speak to what’s happening around this at VHA?’

[Kathy:] Yes great thanks Tracey, so yes as mentioned earlier directive six does mandate that any VHA worker or staff or service provider, student or volunteer, someone who’s not fully vaccinated meaning that they’ve had full two doses of vaccine, need to complete rapid antigen testing. This is happening at VHA and we’ve developed a rapid antigen testing program at VHA with an at-home testing approach so people are going to be doing this testing at their home and it does involve three main components so there’s a training component so that all of the people involved in rapid antigen testing know how to do the test they know how to do the swabbing and how to get the test result and then they know how to report their test results into our system so that we can monitor test results and see how that’s going.  Another component is that we have made sure that we have secured rapid antigen test kits to get out to those individuals and we’ll be able to mail those out for the at-home testing on a regular basis and then last we’ve developed a reporting application so sort of a reporting system where our team members will be putting their test results into that system and they’ll be doing that two times per week. They also will have some reminders that will help them make sure that they do their testing and we have kind of fail-safe alerts and notifications that if someone fails to do a test or that they have a failed test result  that the organization is alerted, the supervisors are alerted and there are instructions about not proceeding to work at that time so we have all of these safeguards that are built in around our rapid antigen testing program. We’re able to monitor those results and we’re also doing quality checks on the test results themselves to see what’s coming in making sure that they match up and that they’re completed as they’re supposed to so we have that whole program packaged as per the requirement in directive six and we’re actively launching that this week.

[Tracey:] Thank you Kathy and Kelley I’m going to ask if you could answer this next question. There’s been a lot of coverage in the media about the challenges for nurses and other health care workers. How is VHA supporting our team members?

[Kelley Myers:] As we’re in the fourth wave of the pandemic it is very true that many healthcare workers are exhausted. At VHA throughout the pandemic we’ve tried to balance the need for time off for our workforce while still meeting the needs of our clients. We’ve encouraged staff to take time as needed whether that’s in the form of vacation time, personal days or sick leave. When that’s appropriate our supervisors have worked with our teams to provide time off where possible so that staff can rest and recharge and our teams have really pulled together to provide coverage for one another. Throughout the pandemic we’ve also offered a range of supports to encourage all aspects of well-being with a focus on mental health, physical health, sleep, nutrition, exercise, financial well-being and social connection and of course as Kathy has really talked about workplace health and safety. We’ve built an extensive library of resources for our teams and they can access these any time of the day or night in addition to our employee assistance services which are available 24 hours a day seven days a week and lastly we’ve also surveyed our teams to gain insight on the issues that matter most to them and our leaders are focused on bringing about improvements based on this feedback. Thanks Tracey.

[Tracey:] Thank you very much Kelley. Kathryn I’m going to ask if you can speak to this next question. Why are you requiring staff to get vaccinated if they are already wearing full PPE?

[Kathryn:] Yeah thanks Tracey that’s a great question because certainly PPE when it’s used  properly is very effective it’s in a very effective strategy but the answer to this question is I’m going to steal from some of my infection prevention and control colleagues they call it the swiss cheese model so if i might just explain where they’re coming from so vaccination is  yet another layer of defense for us and for the clients and families that we serve and the swiss cheese strategy is a strategy that’s  talked about  regarding protection from an infectious respiratory disease like COVID so if you picture a block of swiss cheese sliced up the holes in the slices don’t line up if you think about each slice as a defense strategy so one could be screening one could be hand hygiene one could be distancing one is masking or PPE and one is vaccination each strategy or slice has holes that the virus can get through but when you put them all together the block is solid and it blocks transmission of the virus and transmission of the infection so the swiss cheese model is a good model i think to describe why just one strategy is never enough against  an infectious respiratory illness  and also it’s really important to say that vaccination is one of those strategies that’s particularly effective  it’s got great evidence to show that it prevents serious illness and hospitalization and in particular  right now as we’re in a bit of a critical state with the pandemic it is an even more important  defense strategy to make sure that we use because it’s really important that we do everything we can to keep our schools our businesses and our communities open and keep our health system functioning properly so hopefully that answers your question i always find the swiss cheese model a great way to describe how this  makes it a great strategy of defense.

[Tracey]: Thank you very much Kathryn absolutely I can picture the swiss cheese that’s really helpful thank you.  David I’m going to ask if you can speak to this next question. I am a new client to VHA who needs PSW assistance there have already been instances when VHA wasn’t able to send a worker or when we were told someone was coming and then they didn’t show up. What are we supposed to do when this happens and how are you working to fix these issues?

[David:] Thanks Tracey for the question and the swiss cheese is making me hungry as we approach the lunch hour.  I just would comment I’m going to start with the end what are we doing to work on fixing these issues so we’ve set off an important initiative internally that’s working with clients families our team members to look at how do we improve our functions how do we support our coordination teams in the important conversations that they have with clients and families in terms of their schedule how do we make that work better how can we deliver upon commitments of service when it comes to if we have to make changes in your care plan which inevitably will have to happen because of how  you know we’re dealing with human beings and people have unexpected changes in their day so I just would say first and foremost we are doing some important work internally this work is  refreshed in the last fall or this fall rather and it’s really anchored in trying to make things more client-centered focused around living into the commitments that we want to make around improving communication if unfortunately though just backing up in terms of a PSW not arriving today so if you did have an instance today where a worker doesn’t show up  of course first off our apologies for that inconvenience because we can appreciate that our PSW’s in particular are often a lifeline to our clients and families and that inconvenience can really be very disruptive so apologies for that experience the main suggestion would be for a client and family member to call our office at our main number to  let our team members know  what’s taken place that someone hasn’t arrived and internally what we will do is follow up with our psw to make sure they’re safe check in on their whereabouts and then connect back with our client and family member around how could we look to reschedule their care but as i said looking at ways that we can make these make our communication make our connection with clients and families around important schedules that that is an area that we appreciate there’s lots of improvement work for us to be making.

[Tracey:] Thanks very much David.  Kathy I’m going to ask if you could speak to this next question. What protective equipment are staff expected to wear when they are in my home?

[Kathy:] Great thanks Tracey. So home care workers can be expected to be wearing their universal surgical mask and universal eye protection so whether that’s a face shield or goggles for all visits so you’ll expect to see all your home care workers having those two things for all visits. Now if the client passes that the COVID19 respiratory screener that I mentioned a bit earlier staff will continue to follow routine IPAC practices and they would have the option of wearing a glove and gown just as they would in a normal circumstances where if they feel they’re going to be exposed to bodily fluids or fluids of some sort they would put on their gloves and their gown. If they’re not going to be exposed to that you may not see your worker wearing gloves but do know that those individuals are performing rigorous hand hygiene. You’ll see them using their alcohol-based hand soap or hand rub for hand hygiene or they’ll be washing their hands in soapy water at the sink. So now in situations- I’m going to get into a little bit more nitty-gritty detail here- but if in a situation a client or if you’re an individual that doesn’t pass the COVID-19 respiratory screener that I mentioned or if you are symptomatic or if there’s an infectious disease that’s indicated for the individual our home care workers will be then in that instance wearing you’ll see them with gloves in gowns in addition to the mask and the face shield at that point.  o Those are situations where you would see them with all four of those items on. I’m going to speak a little bit more detail to one other situation that if it is that a client has or an airborne disease to where there’s aerosolized particles or an airborne based condition or if our worker is performing what is called an aerosol generating medical procedure so we call them agmps, where there’s a risk of aerosolized particles to be in the environment, at that point actually the evidence suggests that our worker be wearing an n95 mask so that’s the only indication for when you’ll see a worker wearing that n95 or n95 mask  and that is actually to help keep the home care worker safe from the particles that are in  aerosolized in the air. That is a situation where you’ll see that mask specifically being worn. I will speak just briefly about booties as well because sometimes people ask about the footwear.  Booties themselves, those things that cover people’s feet, are not a part of formal PPE. Staff are not to wear their outdoor shoes in into clients’ homes. It’s VHA policy that individuals have a dedicated indoor shoe or a shoe cover of some sort but just booties themselves are not part of a personal protective equipment or part of that package so hope that helps. Thank you Tracey.

[Tracey:] Thank you Kathy. Kelley I’m hoping you could speak to this next question. ‘My psw left the workforce earlier in the pandemic because she had to stay home with her children when they were doing school online from home. Have most workers in this situation come back and how are you managing this?’

[Kelley:] Thanks Tracey so at VHA we have had over 1,000 unique  leaves of absence throughout the pandemic as staff have needed time off for personal reasons or to support their families. Despite this we’ve continued  to manage to provide services that are needed to clients and their families the shift to virtual care in both our rehab and nursing services has helped to increase our capacity to deliver care and we’ve also worked hard to continue to recruit workers and as Kathryn mentioned retain the talent that we have. While most of our workers have returned we still have numerous staff who are out on leave. Our supervisors are in regular contact with them and have created return to work plans on a case-by-case basis to meet the unique needs of each staff member. We’ve seen an encouraging positive trend over the past few weeks as the COVID numbers have leveled off and children have returned to school.

[Tracey:] Thanks very much Kelley.  David I’m hoping you can speak to this next question. ‘I am a mother of a child with complex medical needs who can’t go to school without a nurse. What are you doing to support our family?’

[David:] Thank you Tracey for the question and unfortunately  similar to many of the other services and disciplines that that I spoke about earlier, child and family nursing service this September has been  significantly impacted by  challenges with either nurses leaving our sector or changes in terms of their availability and for each child especially medically complex children and families. We work very hard to prioritize their needs and ensure as much as possible, we’re meeting their needs. That has not been the case this September in all cases so we actively are continuing as Kelley mentioned to improve our recruitment efforts work with other service provider partners and other agencies to identify some sustainable solutions. So for example this Fall we’ve entered into a partnership with an organization that will help us in being able to deliver nursing care for child and families in particular children who need shift type of support, so more continuous care while they’re at school and so we think that partnership will help us in alleviating some of the pressures and the difficulties that families are experiencing and we look for other solutions with our other partners.

[Tracey:] Thank you David. Kelley I’m going to direct this question your way. ‘Can I request only fully vaccinated staff? If not can you explain why not and why can’t I ask my worker if they’re vaccinated?’

[Kelley:] Okay so as Kathy described VHA is moving toward a fully vaccinated workforce and we’re really pleased to report  that our reporting rates  are currently very high again as Kathy mentioned with 92 percent  with two doses, another five percent with a second dose pending bringing us up to 97 percent.  With respect to requesting fully vaccinated staff, we are obligated to follow the guidelines provided by Home and Community Care Support Services and they have mandated that visits are not to be scheduled on the basis of vaccination status. You can ask your health care workers if they are vaccinated however it is up to each individual staff member to determine whether they’re comfortable disclosing their personal health information which is protected by law.

[Tracey:] Thank you Kelley. Kathy I’m hoping you could speak to this next question. ‘Are you keeping track of which clients are vaccinated and are you expecting clients to get vaccinated?’

[Kathy:] Great thank you Tracey. So to answer the first question, no we are not keeping track of which clients are vaccinated. We’re not tracking that or recording that in any way and the reason is knowing someone’s vaccination status does not  factor in or impact the care that we provide. It’s not a piece of information that would impact any of our practices or the way that we would deliver care so we are not tracking that. To answer the second question ‘are we expecting clients to get vaccinated?,’ I would say that we are certainly expecting or suspecting that our client and family vaccination rates mirror that of Ontario’s provincial vaccination rate so I believe we’re at about 72 percent now of fully two dose vaccinated Ontarians in the province so I would suspect that our clients and family would mirror that percentage although we do suspect that probably even a larger number of our clients and families are fully vaccinated since the introduction of vaccinations last year. With our position statement we certainly have taken the stance of also encouraging and strongly encouraging not only our home care workers but also our clients and families to get vaccinated as that additional safety measure that as Kathryn so nicely described in terms of it being an extra layer of protection  to reduce the spread of COVID19 to reduce serious illness and hospitalization for our clients and families as well. Thank you Tracey.

[Tracey:] Thank you very much Kathy.  David I’m going to pose this next question to you. ‘How are you making sure your staff are following all the necessary protocols to keep everyone safe?’

[David:] Thanks Tracey. I think what  would just comment on what Kathy talked about earlier about a number of different ways that our infection control team work closely  with our client services supervisors or frontline team members. In the fields we have a number of different ways whether it’s training specific, self-assessment protocols that our team work very closely with our infection control colleagues to help make sure that we are following all the necessary protocols.

[Tracey:] Thanks very much David  and Kathy I’m going to come back to you for this one. ‘I am homebound and haven’t received a COVID vaccination yet. Could you help me get vaccinated?’

[Kathy:] Great thank you Tracey and thank you for this question, I’m so glad it’s here  because it’s so important to remember that there are still so many individuals that are looking to be vaccinated and we need to ensure that everyone has access to vaccines. In general just to start, to help we have posted information for clients and families on our website www.vha.ca and you’ll see on the website we have a tile that’s called COVID19 information for clients and families and when you click on that and scroll down we have a whole section about where to go for vaccination information and in there are at least six or seven tips and options about places you could go, individuals that you can contact to help book vaccination appointments, so it includes things like the link to the provincial booking system, the online link and the phone number. There’s actually information for those in the city of Toronto around a transportation plan from the city that will help vulnerable residents actually get transportation to a clinic. We also have information now about third dose vaccinations that are now available to eligible special populations and specifically for homebound clients. The option here would always be to contact your Home and Community Care Support Services regional contact so whether you have a coordinator, to be able to contact your HCCSS coordinator and ask them to help you navigate getting a vaccination appointment. That individual will help you navigate that and coordinate that and get that booked. As well there’s always additional options to contact your local pharmacy or your family physician to help with further options to get vaccinated. Thank you Tracey.

[Tracey:] Thank you very much Kathy and this is going to be our last question for the town hall and I’m going to direct this to you Kathryn. ‘I feel like I’m worrying all the time. I worry about the wonderful PSWs who come to my home and I hope they’ll be okay and I also worry that my husband and I won’t get the care we need if our PSWs don’t show up because there aren’t enough workers with the fourth wave continuing and such an extreme shortage of staff. Is there anything you can tell me to reassure me?’

[Kathryn:] Thanks Tracey and  I understand the worry. I worry too for different reasons  but it is distressing to hear that there’s so much anxiety with clients and families worrying about PSWs and whether they’re going to receive the home support they need. So we’ve talked a lot this morning about the health human resources crisis that we’re in as a health sector and obviously relevant to us is the home sector home health care sector and we’ve certainly struggled with a lack of PSWs or not enough PSWs for about four years and as we’ve spoken about how this has spread now during the pandemic to nursing and to therapy as well. We know it’s across many sectors. Sadly it’s across the whole health sector and we’re seeing it as well in food, retail, tourism and others and so while it is certainly concerning, if we are to think about what is reassuring, what I think is reassuring is that it came out very clear  that  the safest way to receive care is in the home during a pandemic and that has not ever been as widely recognized as it as it is now and there is a real increased awareness among health leaders of that fact and also that a healthy home care sector is critical to ensuring hospitals are able to discharge patients, avoid hallway medicine and avoid crowding up their emergency departments. They cannot do this alone and I think that there has been widespread new levels of understanding in this regard and we actually have many health sector leaders even beyond home care advocating loudly for investments in home care. So that is reassuring to me as a home care leader and certainly while this team here, the team at VHA and certainly myself, we’re very committed to ongoing positive collective advocacy for a healthy and stable home care system for Ontarians, it will we will only be successful if we have the whole sector behind us and so I believe we’re certainly going in that direction. So I personally find that reassuring and I hope that you find that reassuring too. I think the other hope is that as we move from a pandemic state to a state where we’re more in recovery  that our HHR situation will improve  and I know I have colleagues who certainly feel that we’re in a very acute stage at the moment but that there is hope at the end of the tunnel so I’m  holding that as also being  reassuring and again I hope that helps with the worry and the distress that many of our clients and families have.

[Tracey:] Thank you very much Kathryn  and on that hopeful note  we will conclude our town hall there. Thank you all for joining us today and thanks very much to Kathryn and Kathy and Kelley and David  for sharing all of that information. We hope everyone found it helpful. We will be posting a recording of this town hall on our website  that will be up later this week and we will be including it in the next issue of our Voice newsletter for clients and families so if by chance you are not already receiving our voice newsletter and would like to do so or if you have any additional questions that we weren’t able to answer today during the call please send an email to communications@vha.ca ca or you can call 416-280-8426 and we’ll do our best to answer your questions and get you that Voice newsletter if you’d like to receive it regularly. Thanks again everyone for joining us  and  we hope you will all take good care  and have a good day.