05 - March 26, 2013 County Council Agenda
ORDERS OF THE DAY
FOR TUESDAY, MARCH 26, 2013 – 10:30 A.M.
ORDER
1st Meeting Called to Order
2nd Adoption of Minutes – March 12, 2013
3rd Disclosure of Pecuniary Interest and the General Nature Thereof
4th Presenting Petitions, Presentations and Delegations
DELEGATION:
10:30 a.m.
William Funston, Advisor,Port Bruce Ratepayers Association
re: Concerns about Dexter Line (ATTACHED)
11:30 a.m.
Randy Denning, President, Elgin St. Thomas EMS 2012 Annual
Report ( PowerPoint) (ATTACHED)
5th Motion to Move Into “Committee Of The Whole Council”
6th Reports of Council, Outside Boards and Staff
7th Council Correspondence
1) Items for Consideration
2) Items for Information (Consent Agenda)
OTHER BUSINESS
8th
1) Statements/Inquiries by Members
2) Notice of Motion
3) Matters of Urgency
9th Closed Meeting Items - None
10th Recess
11th Motion to Rise and Report
12th Motion to Adopt Recommendations from the Committee Of The Whole
13th Consideration of By-Laws
14th ADJOURNMENT
LUNCH WILL BE PROVIDED
NOTICE:
Deputy Warden for March - Councillor Jenkins
Deputy Warden for April - Councillor Walters
April 14, 2013 4:00 p.m. - 2013 Mayor’s Charity Hockey Challenge
Timken Centre
April 23, 2013 9:00 a.m. - County Council Meeting (Meeting not
th
required on April 9)
th
June 27, 2013 5 Annual Warden’s Charity Golf Tournament -
St. Thomas Golf & Country Club
November 15, 2013 2013 Warden’s Banquet - Dutton-Dunwich Community
Centre
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COUNTY COUNCIL MINUTES
Tuesday, March 12, 2013
The Elgin County Council met this day at the Administration Building at 10:00 a.m. with all
members present.
Warden McWilliam in the Chair.
A moment of silence was observed on behalf of the late Marian Millman, Past Warden of Elgin
County.
Councillor Wiehle introduced Colby, a working guide dog he is currently taking care of on behalf
of a family with an autistic child. Colby sat quietly and observed the proceedings.
ADOPTION OF MINUTES
Moved by Councillor Mennill
Seconded by Councillor Marr
THAT the minutes of the meeting held February 12, 2013 be adopted.
- Carried.
DISCLOSURE OF PECUNIARY INTEREST AND THE GENERAL NATURE THEREOF
–
None.
DELEGATION
Liz Brown, Executive Director and Diane Storey, Treasurer of the Board of Directors,
Violence Against Women Services Elgin County, requested that council send a letter of
support to the Ontario government for their new capital building project of a women’s shelter.
Moved by Councillor Walters
Seconded by Councillor Mennill
THAT Elgin County Council support the Violence Against Women’s capital building project
and strongly encourage the Province of Ontario to provide the much-needed funding
assistance for the building campaign.
- Carried Unanimously.
Moved by Councillor Jenkins
Seconded by Councillor Wiehle
THAT we do now move into Committee Of The Whole Council.
- Carried.
REPORTS
Elgin County Museum 2012 Annual Report – Councillor Jenkins and Museum Curator
Councillor Jenkins provided background to the report followed by the curator who outlined
the highlights of the 2012 year of exhibits and projects. Councillor Jenkins thanked the
county staff for their work.
Moved by Councillor Jenkins
Seconded by Councillor McIntyre
THAT the report titled “Elgin County Museum 2012 Annual Report” dated February 19, 2013
be received and filed.
- Carried.
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County Council 2 March 12, 2013
Intellectual Freedom and the Public Library - Library Coordinator
The coordinator presented the PowerPoint report on Intellectual Freedom and its impact on
the library policies and collections.
Moved by Councillor Ens
Seconded by Councillor Couckuyt
THAT the PowerPoint presentation titled “Intellectual Freedom and the Public Library 2012”
dated March 12, 2013 be received and filed.
- Carried.
Business Retention and Expansion: Agri-food Sector – General Manager of Economic
Development
The general manager presented the report regarding the undertaking by staff to review the
agri-food sector, as well as the survey findings of stakeholders. The Chief Administrative
Officer drew attention to the next steps for staff, included in the report.
Moved by Councillor McIntyre
Seconded by Councillor Wiehle
THAT the report titled “Business Retention and Expansion: Agri-food Sector” dated February
13, 2013 be received and filed; and,
THAT the report titled “Elgin County Agri-food Business Expansion and Retention Study”
dated November 2012 be received and filed.
- Carried.
Funding Agreement: Elgin Business Resource Centre Satellite Offices – General
Manager of Economic Development
The general manager presented the report and the agreement between the county and the
Elgin Business Resource Centre regarding the satellite business office in Aylmer and the
soon-to-open satellite office in Dutton/Dunwich.
Moved by Councillor Walters
Seconded by Councillor Wiehle
THAT County Council directs the Chief Administrative Officer to sign the funding agreement
with the Elgin Business Resource Centre (EBRC) pertaining to an EBRC satellite office in
Aylmer and a satellite office in Dutton/Dunwich.
- Carried.
Quarterly Information Report: Contract Awards (October 1, 2012 to December 31,
2012) and Direct Negotiation and Expenditures (January 1, 2012 to December 31, 2012)
– Purchasing Coordinator
The coordinator presented the report regarding the awarding of various contracts.
Moved by Councillor Marr
Seconded by Councillor Mennill
THAT the report titled “Quarterly Information Report - Contract Awards (October 1, 2012 to
December 31, 2012) and Direct Negotiation and Expenditures (January 1, 2012 to December
31, 2012)” be received and filed.
- Carried.
Behavioural Supports Ontario (BSO) Long-Term Care Home Staffing Resources:
Additional Funding Announcement for Personal Support Worker - Director of Homes
and Seniors Services
The director presented the report outlining additional funding from the Province of Ontario for
the Behavioural Supports Ontario program staffing in the county’s three homes for seniors.
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County Council 3 March 12, 2013
Moved by Councillor Mennill
Seconded by Councillor Ens
THAT the Chief Administrative Officer be directed to sign the Behavioural Supports Ontario
(BSO) additional funding agreement for 2013 - 2014; and,
THAT the report titled “Behavioural Supports Ontario (BSO) Long-Term Care Home Staffing
Resources: Additional Funding Announcement for Personal Support Worker” dated March 4,
2013 be received and filed.
- Carried.
Housekeeping/Laundry Policy – Director of Homes and Seniors Services
The director presented the report regarding changes in policy 2.23.1 and 2.23.2 for
housekeeping and laundry services in the county’s three homes for seniors.
Moved by Councillor Jenkins
Seconded by Councillor Couckuyt
THAT County Council approve the revisions to the Housekeeping/Laundry Policy 2.23.1;
and,
THAT County Council approve the new policy Housekeeping/Laundry 2.23.2 - Personal
Clothing Item: Missing; and,
THAT the report titled “Housekeeping/Laundry Policy” dated February 19, 2013 be received
and filed.
- Carried.
Employee Benefits Renewal 2013 – Director of Human Resources
The director presented the report showing the analysis of group benefits under consideration
for renewal.
Moved by Councillor Marr
Seconded by Councillor Jenkins
THAT County Council approve the negotiated renewal rate adjustments with Manulife
Financial for the County of Elgin, effective March 1, 2013.
- Carried.
Silvercreek Solar Farm Agreement – Deputy Director of Engineering Services
The deputy director presented the report and the agreement between the county and
Silvercreek Solar Farm for the use of county roads to install a buried hydro transmission line.
Moved by Councillor Mennill
Seconded by Councillor Ens
THAT the Warden and Chief Administrative Officer be authorized and directed to enter into an
agreement with Silvercreek Nominee Inc., to install transmission infrastructure on portions of
Imperial Road and Glencolin Line.
- Carried.
Asset Management Funding Agreement – Deputy Director of Engineering Services
The deputy director presented the report regarding the county’s successful application
through the Municipal Infrastructure Investment Initiative (MII) Asset Management Program
and the next steps in the process.
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County Council 4 March 12, 2013
Moved by Councillor Jenkins
Seconded by Councillor McIntyre
THAT the Chief Administrative Officer be authorized and directed to enter into an agreement
with the Province of Ontario to receive funding under the Municipal Infrastructure Investment
Initiative (MII) Asset Management Program.
- Carried.
Award of Largie Bridge Replacement, Dutton/Dunwich and Fire Sprinkler: Terrace
Lodge – Director of Engineering Services
The director presented the results of tender bids under consideration for the two projects.
Moved by Councillor Walters
Seconded by Councillor Couckuyt
THAT Western Fire Protection Inc., be selected for the supply and installation of the fire
sprinkler system at Terrace Lodge, Contract No. 4502-12-03 at a total price of $124,950
plus applicable taxes; and,
THAT Spriet Associates be selected for the engineering services for Largie Bridge
Replacement, Proposal No. 6290-13-04 at the proposed fee of $44,800 plus applicable
taxes.
- Carried.
Thames Valley District School Board: Connection to Elgin Manor Waste Water
Treatment Plant – Director of Engineering Services
The director presented the report outlining the hook-up of Southwold Public School to the
Elgin Manor Waste Water Treatment Plant (WWTP), to accommodate an increase in student
enrolment.
Moved by Councillor McIntyre
Seconded by Councillor Mennill
THAT the report titled “Thames Valley District School Board: Connection to Elgin Manor
Waste Water Treatment Plant” dated February 13, 2013 be received and filed; and,
THAT staff be directed to give notice to Elgin Limited Partnership 1 indicating that the waste
water treatment agreement will be revised; and,
THAT staff be directed to forward correspondence to the Thames Valley District School
Board to confirm they are permitted to connect to the county’s WWTP, subject to the
acceptance of the terms and conditions as approved by the County Solicitor; and,
THAT a one-time connection fee of $10,000 and consumption charge of $11/meter to treat
the sewage, and the consumption charge be reviewed periodically and adjusted if required.
- Carried.
Dexter Line – Environmental Study Report and Municipal Class Environmental
Assessment Notice of Completion – Director of Engineering Services
The director presented the report noting the county is ready to finalize the Municipal Class
Environmental Assessment (EA) planning process for the Dexter Line relocation project
located west of Port Bruce. He introduced Dave Malik, Project Planner, Dexter EA, who was
in attendance to respond to any inquiries.
Moved by Councillor Mennill
Seconded by Councillor Couckuyt
THAT the report titled “Dexter Line: Environmental Study Report and Municipal Class
Environment Assessment Notice of Completion” dated February 18, 2013 be received and
authorized for circulation as part of the EA for the project; and,
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County Council 5 March 12, 2013
THAT the Municipal Class EA Notice of Completion for the Elgin County Road 24 project
(Dexter Line) dated March 12, 2012 is authorized to be issued and circulated.
- Carried.
Energy Management Tool Services Agreement: Local Authority Services – Director of
Engineering Services
The director presented the report and the agreement regarding an Ontario regulation that
requires public agencies to annually report on energy use and greenhouse gas emissions.
Moved by Councillor Jenkins
Seconded by Councillor Ens
THAT the report titled “Energy Management Tool Services Agreement Local Authority
Services” dated February 13, 2013 be received and filed; and,
THAT the Director of Engineering Services be authorized and directed to sign the service
agreement with the Local Authority Services.
- Carried.
CORRESPONDENCE
Items for Consideration
1. David Warden, Chair, Elgin St. Thomas Board of Health requesting County Council’s
support of the Elgin St. Thomas Public Health Unit’s new headquarters on Talbot Street,
St. Thomas.
2. Mary Brennan, Director of Council Services/Clerk, County of Essex with a resolution
petitioning the Government of Canada to reconsider the closure of the Visa and
Immigration sections at the Canadian Consulates General in Detroit.
3. Russ Powers, AMO President, updating Council on Interest Arbitration and the need to
press our local MPPs for stronger amendments to current legislation.
4. Clinton Shane Ekdahl, Founder of “Day of the Honey Bee” seeking Council’s
endorsement of the establishment of a “National Day of the Honey Bee” by the Federal
and Provincial Government.
The following recommendation was adopted in regard to Correspondence Item #1:
Moved by Councillor Walters
Seconded by Councillor Couckuyt
THAT Elgin County Council write a letter of support regarding the construction of a new
Board of Health headquarters in St. Thomas.
- Carried.
The following recommendation was adopted in regard to Correspondence Item #2:
Moved by Councillor Marr
Seconded by Councillor Wiehle
THAT Elgin County Council support the resolution from the County of Essex petitioning the
government to reconsider the closure of the Visa and Immigration Sections at the Consulates
General in Detroit.
- Carried.
The following recommendation was adopted in regard to Correspondence Item #3:
Moved by Councillor Mennill
Seconded by Councillor Marr
THAT Correspondence Item #3 be received and filed.
- Carried.
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County Council 6 March 12, 2013
The following recommendation was adopted in regard to Correspondence Item #4:
Moved by Councillor Wiehle
Seconded by Councillor Mennill
THAT Elgin County Council supports the “National Day of the Honey Bee” and expresses its
support in a letter to the Federal and Provincial Government.
- Carried.
Items for Information (Consent Agenda)
1. City/Council Liaison Meeting Minutes from January 31, 2013 meeting.
2. Linda Li-Chee-Ming, Awards and Recognition Programs Lead, requesting nominations
for Earth Day Canada’s 2013 Hometown Heroes Award Program.
3. Judy Berkin, Business Services Officer, Thames Valley District School Board, informing
Council of Board’s adoption of “Encouraging Facility Partnerships Policy” and related
procedure; and, surplus space available for Cooperative Undertaking at Arthur Voaden
Secondary School, St. Thomas.
4 Margaret Neufeld, Administrative Assistant, Intech Clean Energy Inc., informing Council
of the Ministry of Environment’s renewable energy approval for a 500kW ground-
mounted solar facility planned for Rodney.
5. Municipality of Central Elgin informing Council of Notice of Completion of Municipal Class
Environmental Assessment to develop a strategy to implement stormwater conveyance
and stormwater management measures for a portion of the East Side Development Area.
Moved by Councillor McIntyre
Seconded by Councillor Ens
THAT Correspondence Items #1 – 5 be received and filed.
- Carried.
OTHER BUSINESS
Statements/Inquiries by Members
Councillor McIntyre expressed his appreciation for the 2012 Year in Review Report.
Notice of Motion
Councillor Wiehle noted that the Ontario Bee Keepers’ Association may seek support of Elgin
County Council in the future regarding the Provincial Government’s plan to repeal the Ontario
Bees Act.
Matters of Urgency
- None
Motion to Adopt Recommendations of the Committee of the Whole
Moved by Councillor Jenkins
Seconded by Councillor Ens
THAT we do now adopt recommendations of the Committee Of The Whole.
- Carried.
BY-LAWS
Moved by Councillor Walters
Seconded by Councillor Couckuyt
THAT By-Law No. 13-06 “Being a By-Law to Establish a Pay Schedule for Employees
Covered by the Job Evaluation Scale” be read a first, second and third time and finally
passed.
- Carried.
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County Council 7 March 12, 2013
Moved by Councillor McIntyre
Seconded by Councillor Jenkins
THAT By-Law No. 13-07 “Being a By-Law to Authorize the Execution of a Collective
Agreement Between the Corporation of the County of Elgin and Service Employees
International Union Local 1 Canada with Respect to the Corporation’s Full and Part-Time
Employees at the Elgin Manor, Terrace Lodge and Bobier Villa” be read a first, second and
third time and finally passed.
- Carried.
Moved by Councillor Mennill
Seconded by Councillor Wiehle
THAT By-Law No. 13-08 “Being a By-Law to Confirm Proceedings of the Municipal Council of
the Corporation of the County of Elgin at the March 12, 2013 Meeting” be read a first, second
and third time and finally passed.
- Carried.
ADJOURNMENT
Moved by Councillor Walters
Seconded by Councillor McIntyre
THAT we do now adjourn at 11:30 a.m. and meet again on March 26, 2013 at the County
Administration Building Council Chambers at 9:00 a.m.
- Carried.
Mark McDonald, Cameron McWilliam,
Chief Administrative Officer. Warden.
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ELGIN ST.THOMAS
Emergency Medical Services
2012 Annual Report
EMS -County of Elgin
1
2012
EXECUTIVE SUMMARY
This report is to update
County Council on EMS
operations in 2012.
In this report we believe that
the Ministry of Health data
has improved over previous
years.
EMS -County of Elgin 2012
2
CHUTE / REACTION
TIME
Chute time compliance for
Code 4 (Urgent) calls over all
Stations in Elgin County was
61.5% under 1 Minute and
36.9% under 2 Minutes. In
addition the Chute time 90
th
percentile for 2012 overall in
the County of Elgin was 1
minute 21 seconds. An
improvement of 3 seconds.
EMS -County of Elgin 2012
3
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NEW RESPONSE TIME
STANDARD 2012
The data below is based on 80% of actual numbers. Data
presently still being manually entered .
CTAS LevelElginCounty Elgin County
StandardAchieved
Sudden Cardiac 6 Minutes 6 Minutes
Arrest (SCA)45% of the time62% of the time
CTAS 18 Minutes8 Minutes
60% of the time72% of the time
CTAS 210 Minutes10 Minutes
75% of the time79% of the time
CTAS 310 Minutes10 Minutes
91.5% of the time80% of the time
CTAS4 & 520 Minutes20 Minutes
95% of the time94% of the time
EMS -County of Elgin 2012
4
90Percentile Response Time
th
Elgin County Standard
14 Minutes 15 Seconds
Municipality / 201020112012
LTM
Aylmer 6.586.876.53
Bayham23.5524.4222.22
Central Elgin 14.1213.5213.11
Dutton Dunwich14.1014.2714.39
Malahide14.9015.1514.59
Southwold15.6815.0213.54
West Elgin13.2212.8012.20
St. Thomas 7.767.537.22
Overall for DDA12.5312.5512.22
Mandated14.25 14.25 14.25
EMS -County of Elgin 2012
5
T2-T7 Time from Notification
to Clear & Available
This is the time taken on average
for all calls to complete. Time 2 is
the time the Paramedics are
notified until Time 7 which
indicates they are now clear for
assignments. Average for 2012
was 67.2 minutes.
EMS -County of Elgin 2012
6
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Elgin St.ThomasEMS
2012 Call Volume
Priority1Priority2 Priority 3Priority 4 Prioriy8 Total
Station
St.Thomas54399983197517125312
Edward
Street
St.Thomas2883559311827492847
Shaw
Dutton39519843031833855
Rodney5112734010941567
Aylmer60103047651251264
TOTAL93515022054692686313845
EMS -County of Elgin 2012
7
Calls by External Upper
Tier EMS in Elgin County
Low Priority Calls 17
High Priority Calls 249
Code 8 Emergency Coverage 137
TOTAL calls by other EMS in
Elgin–403
EMS -County of Elgin 2012
8
Calls by Elgin EMS in other
External Upper Tier
Municipalities.
Low Priority Calls –9
High Priority Calls –188
Code 8–Emergency Coverage –91
TOTAL Calls by Elgin EMS in
other Municipalities -288
EMS -County of Elgin 2012
9
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OFFLOADING DELAYS
This is the amount of time it
takes to handover care to the
Hospital.
Of the 1471 calls meeting the
definition of OFFLOAD Delay the
average delay was 7.36 Min.
The Maximum delay being 108
Min. 90% of the Delays in
Offloading were less than 13
Min. This is a non-issue at
present in Elgin County.
EMS -County of Elgin 2012
10
Elgin Ambulance Fleet 2012
KMs. Travelled 504972
10 Ambulances 2006 to2013
1Supervisory 2010
1 Administrative 2004
EMS -County of Elgin 2012
11
Collision Summary
2012
Total of 6 Collisions consisting
of deer hit, tree branches and 3
backing up incidents.
From no cost to a high of
$1,000.00.
EMS -County of Elgin 2012
12
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CARDS, LETTERS of
APPRECIATION COMPLAINTS
During 2012 Elgin St. Thomas
EMS received 10 complimentary
letters of appreciation. Also
during this timeframe there were
2 complaints received. Both
complaints were fully investigated
and 1 closed with remediation to
staff were warranted and the
other is ongoing with MoH
involvement on the Services
request. The result of the MoH
investigation was received
recently and the remediation
required has taken place.
EMS -County of Elgin 2012
13
INITIATIVES TAKEN
Intravenous Therapy (IV’s)
PCI StemiBypass Protocol
Paperless reporting –ePCR
(Electronic Patient Call Reporting)
EMS -County of Elgin 2012
14
QUESTIONNAIRES
During the year 2012, 175
Quality Assurance mailings went
out to the public. Of these 140
were returned. Of those returned
135 were Excellent, 4 were Very
Good and only one could be
considered negative.
EMS -County of Elgin 2012
15
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QUESTIONS ?
EMS -County of Elgin 2012
16
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REPORTS OF COUNCIL AND STAFF
March 26th, 2013
Staff Reports – (ATTACHED)
General Manager of Economic Development – Community Improvement Planning in Elgin
County
Accessibility Coordinator – Elgin County Multi-Year Accessibility Plan
Land Division Secretary-Treasurer – Tariff of Fees for Land Division Consent Applications
Purchasing Coordinator – Provision of Land Ambulance Services, Proposal No. 02-02-2013
Director of Financial Services – Budget Comparison – February 2013 YTD
Director of Homes & Seniors Services – YWCA Agreement
Director of Homes & Seniors Services – Policy Revision – Minimizing Restraining of Residents:
Use of Restraints and Use of Personal Assistance
Devices
Director of Homes & Seniors Services – Medication Administration Policy - New and Medication
- Self Administration by a Resident - Revised
Director of Engineering Services – Centennial Avenue, Central Elgin, East Side
Development Area
Deputy Director of Engineering Services – Award of Tenders – Engineering Capital
Projects
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REPORT TO COUNTY COUNCIL
FROM: Alan Smith, General Manager of Economic Development and Tourism
SteveManager of Planning
Evans,
DATE: March 14, 2013
SUBJECT: Community Improvement Planning in Elgin County
INTRODUCTION:
A number of Elgin Countys local municipalities have Community Improvement Plans
(CIPs) which provide incentives by way of grants or loans for improvements to buildings
and structures in areas where deterioration is occurring. Downtown façade
improvements are a common community improvement initiative; however municipalities
are now using CIPs in more innovative ways.
The new Elgin County Official Plan includes policies which allow the County to make
grants or loans to the Council of a local municipality for the purposes of carrying out a
CIP. This opportunity for a funding partnership between partner municipalities is now
permitted under Section 28 of the Planning Act.
The partnership opportunity that is now available to the County could help in directing
improvements in targeted areas that are of County-wide importance from an economic
development perspective including tourism and industrial development.
DISCUSSION:
Section 28 (7.2) of the Planning Act states:
The Council of an upper-tier municipality may make grants or loans to the
council of a lower-tier municipality & for the purpose of carrying out a community
improvement plan that has come into effect, on such terms as to security and
otherwise as the council considers appropriate, but only if the official plan of the
municipality making the grant or loan contains provisions relating to the making
of such grants or loans .
Municipalities are now using CIPs in more innovative ways which can address growth
management, intensification, energy efficiency and employment attraction. Community
improvement planning has become a more flexible and powerful tool for significant
rehabilitation and development and the ability of upper and lower tiers to partner in
financing improvements only adds to this flexibility.
Economic Development and Tourism believes CIPs provide an opportunity to promote
tourism and industrial development on a more regional basis. The County of Elgin could
coordinate the preparation of a Master CIP with local municipalities and have the Plan
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adopted by each of the seven local municipalities. Ontario Ministry of Municipal Affairs
and Housing, supports municipalities working together to achieve common community
improvement planning objectives.
Elgins Economic Development Strategy supports the creative economy and tourism
while the more recent Employment Land Strategy clearly shows that the County must
not turn its back on attracting industry to its employment lands strategically located
along the 401. With this in mind the County could develop a Master CIP dealing
specifically with its economic development objectives which will provide guidance to its
local municipalities and a regional perspective to outside investment opportunities.
Elgin County could explore a number of other incentive programs such as Tax
Increment Financing Zone, Tax Incentive Zone and Export Distribution Zone as part of
this initiative.
CONCLUSIONS:
The Department of Economic Development and Tourism has budgeted $10,000 to help
fund CIP initiatives. These funds would provide an opportunity to determine the
feasibility of a County CIP in consultation with our local municipal partners and the
Province.
It is the opinion of the General Manager of Economic Development and the Manager of
Planning that a County of Elgin CIP is one of the key tools that the County and local
Municipalities can use to help achieve the goals of their respective Official Plans and
Economic Development Strategies. This approach ensures consistency in the incentive
programs offered across the County and allows for the partners to pool resources.
RECOMMENDATION:
THAT County Council endorse this report in principle and direct the General Manager of
Economic Development to consult with local municipalities and the Province and report
back with his findings including the estimated costs of developing a Master CIP for Elgin
County.
All of which is Respectfully Submitted Approved for Submission
______________________ _____________________
Steve Evans Mark G. McDonald
Manager of Planning Chief Administrative Officer
______________________
Alan Smith
General Manager, Economic Development
and Tourism
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REPORT TO COUNTY COUNCIL
FROM: Jennifer Cowan, Accessibility Coordinator
Rob Bryce, Director of Human Resources
DATE: March 1, 2013
SUBJECT: Elgin County Multi-Year Accessibility Plan
INTRODUCTION:
The Integrated Accessibility Regulation (IAR) requires that municipalities develop and
maintain a multi-year accessibility plan. The purpose of the plan is to meet the
obligations of the Regulation and ensure that barriers are removed or prevented.
This report highlights the progress made to date by the County and outlines next steps
for the multi-year accessibility plan.
DISCUSSION:
The multi-year plan outlines Elgin County’s commitment to provide accessible services
to the public and how this will be achieved.
The multi-year plan will be reviewed and updated in 2015. The Joint Accessibility
Advisory Committee (JAAC) has been consulted on the development of this plan.
The Design of Public Spaces regulation came into effect on January 1, 2013. The
Accessibility Coordinator will work with staff to determine the best way to implement the
requirements which will be included in the updated plan in 2015.
For the remainder of 2013, the focus will be on training staff, continuing to develop
policies and developing procedures related to the Design of Public Spaces regulation.
Each year a report will be developed outlining progress made in meeting the goals of
this plan. Both the progress report and the multi-year accessibility plan will be posted
on the County’s website.
CONCLUSION:
The attached multi-year accessibility plan outlines the County’s commitment to
accessible services, and demonstrates the next steps taken in meeting the obligations
under the Integrated Accessibility Regulation.
In 2013 the Accessibility Coordinator will continue work with staff and the Joint
Accessibility Advisory Committee to ensure compliance with the Integrated Accessibility
Regulation.
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RECOMMENDATION:
THAT the County of Elgin Multi-Year Accessibility Plan be adopted and posted on the
County’s website.
All of which is Respectfully Submitted Approved for Submission
Jennifer Cowan Mark G. McDonald
Accessibility Coordinator Chief Administrative Officer
Rob Bryce
Director of Human Resources
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ELGIN COUNTY
MULTI-YEAR ACCESSIBILITY PLAN
2013-2015
24 24
TABLE OF CONTENTS
Introduction.....................................................................................................................3
Commitment................................................................................................................3
Background.................................................................................................................3
Accessibility Advisory Committee................................................................................3
Obligations...................................................................................................................3
Monitor and Review.....................................................................................................4
Plan coordination.........................................................................................................4
Timeline and Deliverables...............................................................................................5
Outcomes....................................................................................................................5
Approach.....................................................................................................................5
Timelines.....................................................................................................................5
Accessible Customer Service..........................................................................................6
Integrated Accessibility Regulation.................................................................................7
General........................................................................................................................7
Information and Communications................................................................................8
Employment...............................................................................................................10
Accessible Built Environment....................................................................................11
Communication..........................................................................................................12
Feedback...................................................................................................................12
2
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INTRODUCTION
COMMITMENT
The County of Elgin is committed to removing barriers that prevent people with
disabilities from accessing our facilities and services.
This Multi-Year Accessibility Plan outlines the County’s approach to ensuring that
services provided will be done so in an accessible manner. The County will continue to
develop inclusive workplace policies and procedures.
The County endeavours to demonstrate leadership for the local municipalities. Our goal
is to ensure accessibility for our employees and the public we serve in our services and
facilities.
BACKGROUND
For several years, the Joint Accessibility Advisory Committee has been removing
barriers through processes outlined in the Ontarians with Disabilities Act (ODA), 2001.
This process will continue, however, it will become integrated into the multi-year
planning cycles. This process will combine the planning requirements of the Ontarians
with Disabilities Act, 2001 and the Accessibility for Ontarians with Disabilities Act, 2005.
This combined planning process will be reviewed once every five years or until the
ODA, 2001 is repealed.
ACCESSIBILITY ADVISORY COMMITTEE
The Joint Accessibility Advisory Committee is a public committee that is comprised of
people with disabilities and staff members from the County and Municipality of Central
Elgin. The purpose of the committee is to provide advice to Councils on the removal
and prevention of barriers.
OBLIGATIONS
This Multi-Year Plan is based upon requirements under the Accessibility for Ontarians
with Disabilities Act (AODA).The AODA sets out the roadmap for an accessible Ontario
by 2025. It contains standards in the following five areas:
Customer Service
Information and Communications
Employment
Transportation and;
Built Environment
3
26 26
The Accessible Customer Service Standard came into effect in 2008. In 2011, under
the Integrated Accessibility Regulation, the Province combined Information and
Communications, Employment and Transportation.
This plan outlines the requirements of the AODA along with projected timelines. An
annual status report will be developed that will report on the previous years
accomplishments.
Annually this plan will be updated to include a review of current barriers. At that time a
status report will developed and made available to the public. Once every five years the
entire plan will be updated along with a public consultation.
MONITOR AND REVIEW
This Multi-Year Accessibility Plan will be reviewed and updated at least once every five
years. An annual status report will be completed to document the progress and
measures taken to implement Elgin County’s strategy and meet the requirements under
the Integrated Accessibility Regulation.
PLAN COORDINATION
The County’s Accessibility Coordinator is responsible for the development of this plan,
in consultation with the Joint Accessibility Advisory Committee.
All staff have a role to play in identifying, removing and preventing barriers.
Employees who are engaged and knowledgeable are able to incorporate accessibility
considerations into their daily business practices.
4
27 27
TIMELINE AND DELIVERABLES
OUTCOMES
People with disabilities will receive quality goods and services in a timely
manner.
People with disabilities will have access to County-produced information
and communications. Alternate formats and communication supports will
be made available if original format is not accessible.
A barrier-free recruitment process.
Greater accessibility in County-owned facilities.
Staff will be able to identify barriers to accessibility and actively seek
solutions to prevent or remove them.
APPROACH
Develop policies and procedures.
Incorporate accessibility into planning processes.
Train staff
Engage the public in feedback.
Work to remove barriers to employment.
Continue to make facilities accessible and;
Ensure there is access to information and communications.
TIMELINES
The development of policies
Developing a multi-year accessibility plan
2012-2013
Purchasing requirements
Emergency and public safety information
Public Libraries
Employment
Training
2014-2016
Feedback process
Accessible formats and communication supports
Accessible Websites and web content
5
28 28
ACCESSIBLE CUSTOMER SERVICE
The County of Elgin is committed to ensuring that all customers receive accessible
services in a timely manner. Members of the public will receive an equitable customer
service experience that meets their needs. The County will achieve this by:
Reviewing and updating policies to ensure high quality, accessible
service.
Embedding accessibility requirements into staff training and orientation
materials.
Reviewing customer feedback and taking appropriate action.
Progress
Developed Accessible Customer Service Policy (2009)
Alternate formats are available through the Accessibility Coordinator
Customer Service Training to all staff.(2009)
Customer Service Training to volunteers.
Continuing to review and updating policies to ensure consideration of
people with disabilities.
Accessible Customer Service Training to new employees – offered
monthly. (ongoing)
Updated purchasing policy to ensure that third party contractors are
familiar with the AODA and the County’s Accessibility Policy.
Reviewed Accessible Customer Service Policy and incorporated
requirements under the Integrated Accessibility Regulation. (County
Accessibility Policy 2.130
Updated Accessible Customer Service Training for new staff
Goals
Review current processes to receive feedback from the public.
Review current processes on how public can request an alternate format.
Continue to fulfill the needs of residents and customers under the
Accessible Customer Service Standard.
File ongoing reports with the Ministry of Community and Social Services
6
29 29
INTEGRATED ACCESSIBILITY REGULATION
GENERAL
The Integrated Accessibility Regulation requires the County to:
Develop policies on how the County will achieve accessibility and meet the
requirements of the regulation
Develop a statement of organizational commitment
Develop a multi-year accessibility plan and post an annual status report on the
County’s website outlining the progress that has been made.
Train staff on the requirements of the regulation and the Ontario Human Rights
Code as it pertains to people with disabilities.
Progress
Developed County Accessibility policy which describes how Elgin County will
achieve accessibility through meeting the requirements under the Integrated
Accessibility Regulation.
County Accessibility Policy – HR 2.130
o
Included in the County Accessibility Policy is a statement of organizational
commitment.
Goals
Review corporate HR policies to ensure they reflect the requirements of the
AODA.
The County of Elgin will prepare an annual status report identifying the progress
made in implementing this multi-year accessibility plan. The plan, and annual
status report will be posted on the County’s website and be available in an
accessible format upon request.
Training will be provided to staff on the Integrated Accessibility Regulation and
the Ontario Human Rights Code. This training will be provided to staff on an
ongoing basis.
Consult with Accessibility Advisory Committee and the public on the Multi-Year
Accessibility Plan
7
30 30
INFORMATION AND COMMUNICATIONS
Information and communications are a large part of County of Elgin daily business. It is
because of this that it so important to ensure that information and communications are
created in a way that considers accessibility.
The County will follow universal design principles and best practices when developing,
implementing and maintaining information and communications strategies. This includes
websites, print communications materials as well as face-to-face interactions.
The County is committed to ensuring that information and communications are available
and accessible to people with disabilities. We will do this by:
Achieving compliance with the Web Content Accessibility Guidelines (WCAG 2.0)
to ensure external websites are accessible to people with disabilities.
Developing resource materials for creating accessible documents for common
software programs such as MS Word, Excel and PowerPoint.
Ensuring that emergency information, procedures, plans and public safety
information is available in alternate formats, when requested.
Developing a training strategy to ensure that staff have the knowledge, tools and
technical advice to create accessible materials.
Progress
Website Redesign in accordance with WCAG 2.0 (February 2013)
Training for staff on how to make documents accessible, in accordance with
(April 2013 and ongoing)
WCAG 2.0 requirements.
Emergency Plan and related procedures are available in an alternate format,
upon request
Developed resources for staff on making documents accessible
Creating Accessible Documents Training (Word and PDF)
o
Goals
Documents are available in an alternate format, upon request. Staff should
ensure that “alternate formats available upon request” is on all print documents.
Educate staff on the need for accessible documents
Review Communications Policy
Develop a strategy of how to ensure existing (pre 2012) documents are
accessible or available upon request.
Develop corporate templates
Audit Elgin County libraries to determine what accessibility features and
materials are available.
8
31 31
Accessibility Coordinator to review Laserfiche program to determine the
accessibility of documents.
Research accessible communications and determine if a guideline is needed for
staff.
9
32 32
EMPLOYMENT
The County of Elgin is committed to providing ensuring that the process of finding,
getting and keeping a job is as inclusive as possible in order to build an effective
workforce. Human Resources staff will be provided resources in order to meet
compliance under the Integrated Accessibility Regulation. It is expected that training
will cover a variety of topics, including:
Understanding employer obligations to provide employment accommodations.
How to identify and remove barriers in the workplace.
Enhancing workplace emergency responses through individualized
emergency response information and assistance as required.
Revising individual work plans and developing a manager’s guide, tools and
templates to remove barriers from the recruitment process.
Progress
Job advertisements let the public know that accommodations will be provided,
upon request. Applicants need to make their accommodation needs known in
advance.
Developed workplace emergency response information policy and notified
staff.
Emergency Workplace Response for Employees with Disabilities – HR
o
2.130.1
Goals
Amend Accommodations Policy and notify staff
Develop a barrier-free recruitment process to remove barriers from the hiring
process.
Reviewing job advertisements and descriptions on a go-forward basis.
o
Removing barriers from the selection process. All applicants invited to
o
interviews will be asked if they require accommodations in order to
participate.
Job advertisements are currently posted in a variety of newspapers and
websites. Job advertisements and descriptions will be provided in an
alternate format upon request.
10
33 33
ACCESSIBLE BUILT ENVIRONMENT
The County of Elgin will strive to ensure that new facilities are designed and built with
Universal Design Principles in mind. All building plans are currently reviewed by the
Joint Accessibility Advisory Committee.
As part of the procurement process staff are required to consult with a variety of
standards and guidelines to determine the most accessible and feasible design choice.
On January 1, 2013 the Province of Ontario amended the Integrated Accessibility
Regulation (O.Reg 191//11) to include the Design of Public Spaces. This section was
previously known as the Accessible Built Environment as it relates to exterior spaces.
During the development of this plan, the Province released the proposed accessibility
requirements for the Ontario Building Code. The Ministry of Municipal Affairs and
Housing accepted public feedback on these proposed amendments until March 1, 2013.
It is anticipated that these amendments will be included in the Ontario Building Code in
2014.
This plan will be updated in 2014 to include provisions as outlined in the Design of
Public Spaces and the Ontario Building Code.
11
34 34
COMMUNICATION
This plan will be available on Elgin County’s website, located at www.elgincounty.ca.
A copy of this plan is available by contacting the Accessibility Coordinator.
FEEDBACK
The County of Elgin is committed to ensuring accessibility is a reality throughout all
facilities and business operations. There is still so much to accomplish, and as we
progress, we would like to hear from you.
Do you have any thoughts or feedback on what has been accomplished so far? Or
ideas on how to plan or how projects could be improved?
Please contact us with your questions and ideas.
CONTACT
Phone
519-631-1460 x 167
Fax519-633-7785
MailJennifer Cowan, Accessibility Coordinator
Elgin County, Administration Building
450 Sunset Drive, St. Thomas ON N5R 5V1
Emailjcowan@elgin-county.on.ca
This document is available in alternate formats.
12
35 35
REPORT TO COUNTY COUNCIL
FROM: Susan Galloway, Secretary-Treasurer, Land Division Committee
DATE: March 14, 2013
SUBJECT: Tariff of Fees for Land Division Consent Applications
INTRODUCTION:
Inflationary increases in administration costs to provide services incurred by the processing of
Land Division Consent Applications have prompted staff to conduct a survey with consent-
granting authorities to determine if the fees charged by the County are comparable to what
other municipalities are charging.
DISCUSSION:
The County’s current fees are $1,000.00 ($750.00 for the application and $250.00 for deed
stamping) and have been in place since September 2007. As the attached Appendix “A”
indicates, these fees are much lower than the overall fees charged by other municipalities with
the exception of the City of St. Thomas. Due to inflationary pressures since 2007 and in
keeping with the requirement to be revenue neutral, staff recommends that the fees be
increased in accordance with attached Appendix “B”.
CONCLUSION:
Fees have not increased since September 2007. To keep pace with inflation and to ensure
cost recovery, staff is recommending that: the Application Fee be increased from $750.00 to
$1,000.00; the Validation of Title fee be increased from $750.00 to $1,000.00; the Application
Deferral be increased from $100.00 to $300.00; and the Changes to Conditions be increased
from $50.00 to $100.00 to help offset expenditures, and other fees to remain the same as
those contained in the present fee structure.
RECOMMENDATION:
THAT the report titled “Tariff of Fees for Land Division Consent Applications” dated March 14,
2013, be received and filed; and,
THAT the Tariff of Fees for processing Land Severance Applications be amended as follows:
a) Increase fees for Application for Consent and Validation of Title from $750.00 to
$1,000.00; Increase fees for Application Deferrals from $100.00 to $300.00; and
Increase fees for Changes to Conditions from $50.00 to $100.00 to reflect increased
administrative costs associated with the processing of the application;
b) All other associated fees shall remain the same as those contained in the present fee
structure; and,
36 36
THAT the necessary by-law be prepared.
Respectfully Submitted Approved for Submission
Susan Galloway,
Secretary-Treasurer
Clayton Watters, Mark G. McDonald
Director, Engineering Services Chief Administrative Officer
37 37
APPENDIX “A”
COMMITTEE OF ADJUSTMENT/LAND DIVISION COMMITTEE SURVEY – 2013 FEES
Municipality of Chatham Kent
COA Consent Fees $2105.00
Validation of Title $1390.00
Consent Change of Condition $ 520.00
Haldimand County
COA Consent Fees Minor $1066.00
Major $1598.00
Deed Stamping $ 240.00
Consent Change of Condition – no recirculation required $353.00
Consent Change of Condition – recirculation required $373.00
City of London
Consent Fees $1100.00 for first lot created
$ 100.00 each additional lot
Other Consents $ 900.00
Certification $ 100.00 for first certification
$ 200.00 for each additional certification
County of Oxford
LDC Consent Fees $1845.00
$ 915.00 each additional lot
Clearance of Conditions $ 100.00 per lot
Changes to Approved Conditions $ 115.00
Revised Application (Major) $ 335.00
Revised Application (Minor) $ 165.00
Validation Order $ 595.00
County of Perth
LDC Consent Fees $1200.00
Validation of Title $1200.00
Application Amendment $ 250.00
Changes to Conditions $ 250.00
Municipality of Strathroy-Caradoc
COA Consent Fees $1750.00 for first consent
$ 300.00 for each additional lot
City of St Thomas
COA Consent Fees $ 450.00
Deed Stamping $ 200.00
Municipality of Thames Centre
COA Consent Fees $1500.00 for first consent
$ 200.00 for each additional lot
38 38
APPENDIX “B”
CURRENT FEES
Consent Fees $ 750.00
Deed Stamping Fee $ 250.00
Validation of Title $ 750.00
Validation Certification $ 250.00
Application Deferral $ 100.00
Application Amendment $ 100.00
Changes to Conditions $ 50.00
PROPOSED FEES
Consent Fees $1000.00
Validation of Title $1000.00
Application Deferral $ 300.00
Changes to Conditions $ 100.00
39 39
REPORT TO COUNTY COUNCIL
FROM: Sonia Beavers, Purchasing Coordinator
DATE: March 19, 2013
SUBJECT: Provision of Land Ambulance Services, Proposal No. 02-01-2013
INTRODUCTION:
The contract for the Provision of Land Ambulance Services expires December 31, 2013.
A Request for Proposal was issued on February 1, 2013 and submissions were
received until March 14, 2013.
DISCUSSION:
Seven companies were registered on the plan takers list; however, only one submission
was received on March 14, 2013 from Medavie EMS Ontario Limited.
Medavie EMS Ontario Limited is a corporation incorporated under the Canada Business
Corporations Act. It is registered as an extra-provincial domestic corporation with the
Ministry of Government Services in Ontario. Medavie EMS Ontario Limited is a wholly
owned subsidiary of Medavie EMS Inc.
If Medavie EMS Ontario Limited is the successful proponent, with the County of Elgin’s
approval, it is Medavie’s intention to incorporate a new company registered to carry on
business in Ontario to negotiate a contract for the services with the County of Elgin.
This company will be 100% owned by Medavie EMS Inc. and it will operate under the
same governance structure as Medavie EMS Ontario Limited.
The Proposal is currently being evaluated and a further report to Council will be
forthcoming.
RECOMMENDATION:
THAT the “Provision of Land Ambulance Services, Proposal No. 02-01-2013” dated
March 19, 2013 be received and filed.
All of which is Respectfully Submitted Approved for Submission
Sonia Beavers Mark G. McDonald
Purchasing Coordinator Chief Administrative Officer
Jim Bundschuh
Director of Financial Services
40 40
REPORT TO COUNTY COUNCIL
FROM: Jim Bundschuh Director of Financial Services
DATE: March 18, 2013
SUBJECT: Budget Comparison February 2013 YTD
INTRODUCTION:
Attached is the budget comparison through February 2013 for the County showing total
performance to budget of $170 thousand
.
DISCUSSION:
Highlights of the budget performance as shown on Attachment I is as follows:
Line 18 Homes for Senior Services: $99 thousand favourable performance resulting
from favourable performance in wages.
RECOMMENDATION:
THAT the report titled Budget Comparison February 2013 YTD dated March 18,
2013 be received and filed.
All of which is Respectfully Submitted Approved for Submission
Jim Bundschuh Mark G. McDonald
Director of Financial Services Chief Administrative Officer
41 41
YTD
County of Elgin
FULL YEAR
Budget ComparisonBudgetBudgetActual
Perform.
As of February 28, 2013
NetNetNetNet
1 (27,244,614) - 20 (20)
TAXES
2INTEREST CHARGES & INCOME(81,080) (6,757) (10,740)
3,983
3SOCIAL SERVICES - ST. THOMAS 3,051,000--
-
4
HEALTH UNIT938,360--
-
5
GRANTS811,865795,915795,915
-
6
RENTAL INCOME (78,341)(31,377)(31,377)
( 0)
7
PROPERTY ASSESSMENT719,640179,910179,910
-
8
ONTARIO MUNICIPAL PARTNERSHIP FUN (442,725)(1,770,900) (442,725)
-
9
PROJECTS(69,930)21,50721,505
2
- - - 0
10
Total Corporate(23,724,001)516,473512,507
3,966
11
WARDEN AND COUNCIL357,19957,22853,979
3,249
12
ADMINISTRATIVE SERVICES472,17471,06468,498
2,566
13
FINANCIAL SERVICES577,46183,41477,779
5,636
14
HUMAN RESOURCES487,18275,67971,518
4,161
15
ADMINISTRATION BUILDING484,09344,35639,407
4,949
16
CORPORATE SERVICES574,784286,164282,891
3,273
17
ENGINEERING SERVICES10,206,441371,999366,703
5,296
18
HOMES FOR SENIORS SERVICES4,616,438(164,996)(264,370)
99,373
19
MUSEUM/ARCHIVES389,66482,68980,574
2,115
20
LIBRARY SERVICES2,457,831303,350300,895
2,456
21
INFORMATION TECHNOLOGIES833,127114,449103,146
11,303
22
PROVINCIAL OFFENSES(76,343)(330,874)(331,380)
506
23
COLLECTIONS - POA(21,263)(300)(300)
-
24
AMBULANCE & EMERGENCY SERVICES2,748,618423,844408,710
15,134
25
ECONOMIC DEVELOPMENT & TOURISM1,170,98275,30169,315
5,986
---
-
26
Total Departmental25,278,3861,493,3681,327,365166,003
27
Total1,554,3852,009,8421,839,872169,969
42 42
J:\Common\Finance\Monthly Performance\Financial Services\Summary Report18/03/2013 2:44 PM
REPORT TO COUNTY COUNCIL
FROM: Rhonda L. Duffy
Director Homes and Seniors Services
DATE: March 18, 2013
SUBJECT: YWCA Agreement Renewal
INTRODUCTION:
In a previous report to council the following recommendation wasTHAT Council direct
ends March 31, 2013 and is due for renewal.
DISCUSSION:
In order to ensure at a approved
an annual fee of $2,000.00 to be charged to the YWCA. This amount is based upon cost recovery
only and does not generate additional revenues for the County.
recommending a minimum of a 3% increase to the 2013/2014 contract.
CONCLUSION:
The YWCA continues to utilise the Terrace Lodge Pool as a commun
therapeutic programs. These programs are of great benefit to th
communities and are accessed by individuals of all ages and with
RECOMMENDATION:
THAT Council direct staff to negotiate at minimum a 3% inflation
agreement with the YWCA; and,
THAT Council direct staff to sign the 2013/2014 agreement with t; and,
THAT the report WCA Agreement and Pool Usage Fees Review" dated March 18, 2013 be
received and filed.
Respectfully Submitted Approved for Submission
Rhonda L. Duffy Mark McDonald
Director Homes & Seniors Services Chief Administrative Officer
43 43
REPORT TO COUNTY COUNCIL
FROM: Rhonda L. Duffy
Director of Homes and Seniors Services
DATE: March 18, 2013
SUBJECT: Policy Revision - Minimizing Restraining of Residents:
and Use of Personal Assistance Devices
INTRODUCTION:
The
(PASDs) has required review and revisions in keeping with the Lo
(LTCHA) 2007 and Regulations.
DISCUSSION:
regarding the use of restraints
(physical, chemical, environmental) and PASDs within the homes h
and combined to ensure alignment with the requirements of the LT
Regulations. The staff of the home shall ensure that the least
physical restraint is used as an intervention after all alternat
been considered or tried and found to be ineffective. This poli
requirements of assessment, consent, ongoing monitoring, care pl
evaluation for the use of restraints and PASDs.
The policy is anchored in the provisions of the LTCH Act and uph
Every resident has the right to live in a safe and clean enviro
Every resident has the right not to be restrained, except in th
circumstances provided for under this Act and subject to the req
provided for under the Act
CONCLUSION:
This policy meets the requirements of the LTCH Act and Regulatio
receive training prior to assuming job responsibilities and annu
policy.
RECOMMENDATION:
THAT Council approve the policy Restraints: Minimizing Restraining of Residents:
Use of Restraints and Use of Personal Assistance Devices; and,
44 44
THAT Policy Revision Restraints: Minimizing Restraining of
Residents: Use of Restraints and Use of Personal Assistance Dev dated March
18, 2013 be received and filed.
All of which is Respectfully Submitted Approved for Submission
Rhonda L. Duffy Mark G. McDonald
Director of Homes and Seniors Services Chief Administrative Off
45 45
DRAFT
HOMES AND SENIOR SERVICES
`
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 1of 12
The staff of the home shall ensure that the least restrictive type of physical restraint is used as an
intervention after all alternatives to restraining have been considered or tried and found to be
ineffective.
No resident shall be restrained for the convenience of staff or as a disciplinary measure. Only
legally approved, commercially made physical restraints may be used in accordance with
Only chemical restraints, as prescribed by the physician, are to be used. Environmental barriers
or locks can only be us
Exception to this policy: Common law duty (LTCHA s. 36; Reg 79/10 s. 110 (1, 3-5, 8).
Duty of a caregiver to restrain or confine a person when immediate action is necessary to
prevent serious bodily harm to the person or to others (see Procedure in Emergency
Situations below).
PURPOSE:
This policy is anchored in the provisions of the Long-Term Care Homes Act, 2007 and upholds
the following asp
Every resident has the right to live in a safe and clean environment
Every resident has the right not to be restrained, except in the limited circumstances
provided for under this Act and subject to the requirements provided for under this Act.
Definitions:
Physical Restraints
In RAI-MDS 2.0 a physical restraint is defined as any manual method, or any physical or
the person cannot remove easily, and that does, or has the potential
freedom of movement or normal access to his or her body.
46 46
DRAFT
HOMES AND SENIOR SERVICES
`
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 2of 12
A resident may be restrained by a physical device if the restraining of the resident is included in
a resident is both physically
and cognitively able to release themselves is not a restraining of the resident (LTCHA).
Prohibited Devices
Under the LTCHA and Regulation 79, there are several (LTCHA s. 35; Reg
79/10 s. 112) that limit movement and are not to be used in the home as follows:
Roller bars on wheelchairs, commodes or toilets
Vest or jacket restraints
Device with locks that can only be released by a separate device
Four point extremity restraints
Device used to restrain to a commode or toilet
Device that cannot be immediately released by staff
Sheets, wraps, tensors or other types of strips or bandages used other than for therapeutic
purpose
Also under section 31 of the LTCHA, no physical device can be applied to restrain a resident
who is in bed, except to allow for a clinical intervention that part
The use of a physical device, from which a resident is able to both physically and cognitively
release themselves, is not a restraining device (LTCHA s. 30 (2)).
A method that imposed less control on the resident than restraining or confining the resident e.g.
using a monitoring device on a resident to deal with incidents such as falls, wandering, and
aggressiveness is an alternate treatment intervention.
Any use of a prohibited physical restraint, restraining for staff convenience or as a method of
a form of resident
abuse.
Environmental Restraints (LTCHA s. 32)
Any device or barrier that limits the movement of an individual, and thereby confines an
individual to a specific geographic area or location (e. g. secured units, wander-guard systems).
The use of barriers, locks and other devices or controls at stairways as a safety measure is not a
restraining of a resident.
Chemical Restraints (LTCHA s. 36 (3-4))
Pharmaceuticals given with the specific and sole purpose of inhibiting specific behaviour or
movement. Differentiating between the use of a drug as a therapeutic agent or a restraint is
47 47
DRAFT
HOMES AND SENIOR SERVICES
`
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 3of 12
difficult. However, when a drug is used to treat clear-cut, psychiatric or medical symptoms, it is
not usually considered a restraint.
Administration of drugs as a treatment
re is not a restraint
of the resident (LTCHA).
Common law duty (LTCHA s. 36 (1))
Duty of a caregiver to restrain or confine a person when immediate action is necessary to prevent
serious bodily harm to the person or to others.
Emergency Situation (LTCHA s. 36 (1))
An instance where a resident is apparently experiencing severe suffering or is at risk of
sustaining serious bodily harm if the treatment is not administered promptly (Health Care
Consent Act, 1996). Emergency use of physical restraints are permitted only if their use is
immediately necessary to prevent the resident from injuring him/herself or others or to prevent
the resident from interfering with life sustaining treatment and no other less restrictive
interventions are feasible.
PROCEDURE:
Assessment and Evaluation
(See Appendix A: Decision Tree For Minimizing Restraining;
Appendix B: Quarterly Alternatives to Physical Restraint Assessment Form; Appendix C: Initial
Assessment for Use of Physical Restraint; and Appendix D: Quarterly Review for Use of
Physical Restraint).
A physician or Registered Nurse Extended Class (RNEC) in collaboration with the
interdisciplinary team may prescribe a physical restraint. The prescribing clinician should ensure
that alternatives have been considered, and informed consent is obtained for the treatment from
the resident and/or the substitute decision-maker.
1. Assess resident for condition, circumstances or clinical indicators that potentially require
treatment interventions in collaboration with the team.
2. Include precipitating factors for considering a restraint including the clinical indicator(s) that
necessitates the physical restraint.
3. Include any/all alternatives that were tried or considered and why they were not suitable.
48 48
DRAFT
HOMES AND SENIOR SERVICES
`
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 4of 12
4. Obtain input from interdisciplinary team members (e.g. registered nurse, physiotherapist,
occupational therapist) to identify alternative treatment options to be tried prior to the use of
restraints.
5. Include in the written order what device is being ordered and instructions relating to the order.
6. Discuss with the resident/SDM:
Goals such as elimination of the restraint, reduction of the severity, duration and/or
frequency of use
Measurable objectives
Period of day when the restraint is required
Frequency that resident will be checked
Frequency of position change
Frequency of skin care
Frequency of range of motion exercises and ambulation
Frequency of evaluation of the side effects of restraints on resident behaviour
Deadline date for re-evaluation of the need for restraint
7.Obtain and record informed consent (see Appendix G: Consent and Information form for
including that the risks and benefits of alternative treatment
options and risks and benefits related to use of the restraint have been outlined to the
resident/SDM (Health Care Consent Act, 1996).
Care Plan
.
1Establish resident focused goals including reduction of severity, frequency, duration or
elimination of the restraint.
2. Integrate alternative strategies wherever possible.
3. Ensure the care plan strategies have adopted the least restrictive restraint for the shortest
amount of time necessary.
5. Outline specific steps for monitoring the resident at a minimum of hourly (registered nursing
staff or a person who is authorized by registered nursing staff). Specify who, when, and what to
observe in the care plan (Reg 79/10 s. 110).
6. Outline steps for releasing and repositioning the resident at least every 2 hours (exception for
bed rail use when the resident is able to reposition him/herself) (Reg 79/10 s. 110 (4)). Specify
49 49
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`
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 5of 12
how this will be done (e.g. involvement of physiotherapist, recreation, transferring from chair to
bed to toilet).
7. Outline steps for releasing and repositioning more frequently as required by the individual
8.Ensure the plan includes an interdisciplinary team approach and develop a comprehensive,
integrated restorative focused plan.
effectiveness of the restraint, need for ongoing restraint, potential of employ a less restrictive
restraint at a minimum of every 8 hours and more frequently as determined by the circumstances
Implement
Interdisciplinary Team
1. Implement the care plan strategies
2. Document every hour on restraint monitoring record and every 2 hours when the restraint is
released and the resident is repositioned and care plan interventions have been followed (see
Appendix E: Physical Restraint Monitoring Record).
Monitor and Evaluate
Monitor and evaluate according to the individualized care plan.
Restraint Policy Utilization Review
Administrator, Manager of Resident Care, Registered Nursing Staff, Continuous Quality
Improvement Team
1. Perform an analysis of the available data related to the use of physical devices and also
pursuant to the common law duty (LTCHA s. 36). The type of information to be used in the
analysis of the policy on restraint utilization may include:
Care plan reviews and the clinical indicators or circumstances causing the need for
restraint, analyzing the potential to reduce severity or eliminate use of restraint.
The documented reasons for restraints based on resident population and their physical
and cognitive health (see RAI-MDS 2.0 section G and B) and personal histories.
The types of alternatives tried and unsuccessful.
50 50
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HOMES AND SENIOR SERVICES
`
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 6of 12
The least restrictive methods of restraint have been used in light of resident population
and conditions.
The trends in alterations in skin integrity.
Number and severity of falls comparing quarter to quarter through RAI-MDS 2.0 section
J and QI reports to see if restraint use has had an impact.
Number of reactive behaviours comparing quarter to quarter to see if restraint has had an
impact through RAI-MDS 2.0 section E, ABS score and quality improvement reports.
Trends in data recorded on internal tools such as Appendix C: Physical Restraint
Monitoring Record and Appendix F: Restraint Audit Tool.
2. Evaluate the policy effectiveness annually or more frequently.
Annually evaluate the utilization and effectiveness of the policy for minimizing
restraining of residents and what changes and improvements are required in order to
ensure that the use of restraints is in compliance with the LTCHA and Reg 79/10s. 113.
Documentation and Parties Responsible
The following table describes the various forms of documentation required when minimizing
restraining of residents and the parties responsible (Reg 79/10 s. 110(7)).
DocumentationParties Responsible
Informed ConsentPhysician,RNEC or RN, RPN
Written orderPhysician, RNEC
RAI-MDS 2.0 Registered Nursing Staff (for measurable
objectives and outcomes)
Alternative treatment sheetTeam
Care planRegistered Nursing Staff, OT, PT
Restraint Flow Sheet: frequency hourlyRN, RPN, Personal Support Worker
Monthly analysis of restraining of residents Registered Nursing Staff
by use of a physical device (LTCHA s. 31)
Review and Revise the care plan every 3 RN, RPN
months
Annual evaluation of the effectiveness of the Administrator, Manager of Resident Care,
policy and improvement introduced resulting Registered Nursing Staff, CQI team
from the evaluation (LTCHA s. 29)
51 51
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`
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 7of 12
Procedure in Emergency Situations
In emergency situations (see definition of emergency situation above), the RN may decide on the
use and type of restraint that is required provided that:
1. Available alternative methods have been tried and failed.
2. The interventions and reactions of the resident are documented as are the justification for
restraint use including the precipitating circumstances, who made the order, what device was
ordered and any instructions related to the order, the person who applied the restraint and the
time of application.
release and repositioning, time of removal or discontinuance and follow-up care must be
documented. Document is completed according to the plan of care.
4.
5. The resident must be assessed every 15 minutes by physician, RNEC or registered staff and at
e order is obtained
from an on--end), the
regular attending physician must be made aware of and re-evaluate the order at the earliest
reasonable opportunity.
6. If the restraint is to be continued, the attending physician is responsible for reordering the
restraint including the type of restraint and the application details.
7. Proceed as per policy for use of restraints.
Staff Orientation and Training
Staff Orientation
Prior to assuming their job responsibilities, direct care staff must receive training on restraints
policies and procedures and the correct use of equipment as it relates to their jobs (LTCHA s. 76
(1)).
Training
Direct care staff must receive annual retraining on restraints policies and procedures and the
correct use of equipment as it relates to their jobs.
Orientation and training includes the following:
52 52
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`
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 8of 12
Staff and contractors who provide direct care to residents must receive orientation and annual
retraining on minimizing restraining of residents.
1. Registered staff oriented and trained using Least Restraint- Last Resort Presentation
homes orientation presentation.
2. Hands on instruction and practice on correct use of physical restraints.
3. Other as deemed necessary by the home.
Summary
The following table summarizes the LTCHA restraints requirements at a glance as originally
published within the following source document: The Fundamentals of the Long-Term Care
-
Long-Term Care Homes Act Regulation Project, Ministry of Health and Long-Term Care and
Jane E. Meadus, Barrister & Solicitor, Institutional Advocate Advocacy Centre for the Elderly,
Tuesday, August 31, 2010.
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POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 9of 12
USE OF PERSONAL ASSISTANCE SERVICE DEVICES (PASDs)
PURPOSE:
daily living. The care plan must also outline how the specific personal assistance service device
is to be used and the timeframe for its use. The care plan must be communicated to all staff and
followed consistently.
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POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 10 of 12
Personal Assistance Service Device (PASD)
A personal assistance service device (PASD) is a device used to assist a person with a routine
activity of living. A PASD may limit or inhibit movement and may restrain a resident but is not
considered a restraint if the intent is to provide assistance with activities of daily living (LTCHA
s. 33(1-5); Reg 79/10 s. 111(1-2)).
to promote independence and quality of life. The care plan must indicate the removal of the
device as soon as no longer needed to promote independence. When a PASD (i.e. a device) is
being used to restrain a resident rather than to assist the resident with a routine activity of living,
it is considered a restraining device (LTCHA s. 36 (6) & s. 31).
PROCEDURE:
Assessment
The use of the PASD must be approved by one of the following:
A physician
A registered nurse
A registered practical nurse
A member of the College of Occupational Therapists of Ontario
A member of the College of Physiotherapists of Ontario
Note: if the PASD is being used to restrain a resident, then the policy for Minimizing
Restraining of Residents: Use of Restraints must be followed.
The assessment will:
1. Identify precipitating factors for considering a PASD including the clinical indicator(s) or
functional deficits.
2. Obtain input from team members (e.g. registered nurse (RN), physiotherapist (PT),
occupational therapist (OT)) to identify alternative treatment options tobe tried prior to the use
of a PASD.
3. Consider and try alternatives to the use of a PASD.
4. Include any/all alternatives that are tried/considered and why they were not suitable.
5. Discuss with the resident/SDM:
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POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 11 of 12
Goals for use of the PASD
Measurable objectives related to support for daily living activity
Period of day when the PASD is required
Frequency that resident will use it
Deadline date for re-evaluation of the need for the PASD
used to restrain a resident rather than to assist the resident with a routine activity of
living, it is considered as a restraining device (LTCHA s. 36 (6) & s. 31)
Alternatives to the PASD
6. Obtain and record informed consent (including that the risks and benefits of alternative
treatment options and risks and benefits related to use of the PASD have been outlined to the
resident/SDM (Health Care Consent Act, 1996).
7. Develop goals and strategies on the care plan in collaboration with the team.
8. Provide the PASD when alternatives have been deemed ineffective to assist the resident with
the routine activity of living.
personal history, and is the least restrictive of such reasonable PASDs that would be effective to
assist the resident with the routine activity of living.
Care Plan
1. The plan of care must reflect the goals for use of the PASD and how, when and why the
device is to be used.
2. Establish resident focused goal related to support for specific activity of living for which the
device is required.
3. Intervention descriptions will include how the PASD will be used, when, how long, who will
apply and remove, frequency of monitoring, and the specific risks associated (e.g. skin
breakdown).
4.
and instructions t
5. The PASD must be removed as soon as it is no longer required to provide the resident with
the specific routine of daily living for which it is intended.
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POLICY & PROCEDURE NUMBER:
DEPARTMENTNursing SUBJECT: Restraints: Minimizing
:
Restraining of Residents: Use of Restraints
and Use of Personal Assistance Devices (PASDs)
APPROVAL DATE: ___________ REVISION DATE:___________
Page 12 of 12
Implementation
1. Implement strategies according to the care plan.
Monitoring and Evaluation
1.Monitor according to the care plan.
2. Ensure the care plan is being followed.
3. Is resident functional ability improved or maintained by using the PASD?
4.Is the resident satisfied with use of PASD?
5. Continually monitor emotional, cognitive, physical responses to use of PASD.
6. Evaluate to determine if goals are achieved.
Documentation
Documentation of PASD must include the following:
Authorization of the use of the device.
Care plan to indicate intent as a PASD otherwise follow restraint documentation
procedures.
Progress toward stated goal.
Monitoring and evaluation of PASD.
Consent and Information Form for Use Of
Appendix G
Adapted from: OANHSS LTCHA Implementation Member Support Project: Minimizing
Restraining of Residents and the Use of Personal Assistance Service Devices (PASDs)
57 57
APPENDIX A:
DECISION TREE FOR MINIMIZING RESTRAINING
Assess and describe precipitating
factors, condition or
circumstances including:
-Risk to resident
-Risk to others
Is there
potential
No
Modify care plan
for harm
toself or
Yes
Is
serious
Yes
No
risk to
self or
others
Follow emergency restraint policy.
Follow policy on use of restraints:
Registered Nurse:
-Interdisciplinary team assess
-Check for comfort, hunger, need for toilet.
and recommend
-Consider potential interventions.
approaches/alternatives
-If deemed to be ineffective, investigate and determine least
-Test alternatives
restrictive alternative type of restraint.
-Applyrestraint.
-Obtain verbal order within 12 hours.
-Check resident every 15 minutesor more frequently as
required by the situation
-If restraint is to be continuedafter12 hours, obtain written
order and informed consent.
Are
alternati
No restraint:
Yes
ves
modify care plan
No
Doctor/RN/RPN/RNEC
Consent
No
Do not restrain
obtain informed consent obtained
from resident/SDM.
Yes
Follow policy on use of restraints:
-Order LEAST RESTRICTIVE type of restraint: include, how, when, why to be used
and plan to discontinue restraint.
-Apply restraint for the shortest period of time.
-Monitor resident for comfort, changes in behaviour at least hourly or as frequently
as required. Every 2 hours release the restraint and reposition the resident.
-Continually monitor for potential to reduce the severity of or eliminateuse of the
restraint.
-Withdraw restraint when risk to self or to others no longer exists.
58 58
HOMES AND SENIOR SERVICES Appendix B
Quarterly Alternatives toPhysical Restraint Assessment Form
Resident Name: Resident Number: Effective Date:
Location: Admission Date: Date of Birth:
Category: Physician: Title: QUARTERLY:
Alternative to / physical
Restraints assessment
Form.
AENVIRONMENTAL1.Bed in lowest position and brakes on.
2.Call light functional and accessible.
3.Adequate lighting.
4.Assess furniture arrangement.
5.Side rail(s).
6.Commode at bedside for toileting at night.
7.Other
BPHYSICAL AND 1.Assess all physical needs / issues ie: infection, delirium, hunger, thirst, rest, etc
PSYCHOSOCIAL CARE
2.Check footwear and avoid shoe laces.
3.Review medications for adverse effects.
4.Ensure pain management.
5.Check all sensory aids, ie: glasses, hearing aids
6.Try different positioning aids, ie: wedges,cushions, air mattress
7.Scheduled toileting routine developed.
8.Other.
CRECREATION / 1.Recreation referral completed.
PHYSIOTHERAPY
2.Physiotherapist / Occupational Therapist referral completed.
3.Assess need for assistive devices.
4.Other.
DREASON FOR RESTRAINTDescribe imminent danger to the resident or others.
1.Unsafe mobility / postural
2.Agitated behaviour
3.Aggressive behaviour
4.Interference with specific medial treatment.
5.Other.
EEFFECTIVENESS OF
1.Type of Restraint. Is it effective?
RESTRAINT
FCOMMENTS FROM How does restraint use effect the Resident?
MULTIDISCIPLINARY TEAM
1.
59 59
HOMES AND SENIOR SERVICES Appendix B
Quarterly Alternatives toPhysical Restraint Assessment Form
GRECOMMENDATIONS1.Continue use of Restraint?
2.Consent re-obtained from Resident / SDM.
3.Comments:
HMD TEAM MEMBERSList all team members included in this review.
1.Registered Staff:
2.Doctor (Quarterly Review)
3.Resident / SDM
4.Other:
60 60
HOMES AND SENIOR SERVICES Appendix C
Initial Assessment for Use of Physical Restraint
Resident Name: Resident Number: Effective Date:
Location: Admission Date: Physician:
Title: Initial Assessment Facility Name:
for use of Physical
Restraint
Facility Address:
AREASON FOR USE Restraint use is only mandated if the resident is in imminent danger of injuring him/herself or others.
OF PHYSICAL Describe resident behaviour prompting restraint use:
RESTRAINT
1.unsteady gait.
2.climbs out of bed
3.forgets ambulation device (i.e. walker, cane)
4.frequent falls
5.sliding out of chair/wheelchair
6.unbuckles seatbelt
7.attempts self-transfer
8.Other:
BALTERNATIVES 1.Side Rail
ATTEMPTED
2.recliner
3.family companion
4.high-low bed
5.1:1 activities
6.directed / supervised ambulation
7.call light functional and accessible
8.Adequate lighting
9.Assess furniture arrangement
10.Commode by bedside for toileting at night
11.Assess all physical needs /issues-infection, Delirium, Hunger, Thirst, Rest.
12.Check footwear and avoid shoelaces
13.Review medications for adverse effects
14.Ensure pain management
15.Check all sensory aids-glasses, hearing aids
16.Try different positioning aids-wedge, pommel, cushions, air mattress
17.Scheduled toileting routine developed
18.Other:
Describe the reasons for the ineffectiveness of the alternatives:
61 61
HOMES AND SENIOR SERVICES Appendix C
Initial Assessment for Use of Physical Restraint
CDECISION TO 1.State who decided to apply the restraint and the reason for it:
RESTRAIN
2.Family Notified:
1. Yes 2. No
Date and Time of notification:
3.Name and status of person providing explanation to family:
4.Consent obtained and signed by resident / SDM.
DREASON FOR Physician order is required
RESTRAINT
1.Physician order received must specify type of restraint, duration of application, reason for
restraint and specify when it is to be used (i.e. seatbelt, while up in chair, for repeated attempts to
rise unattended.
Prescribing physician:
2.
must be obtained within 12 hours of application of the restraint:
62 62
HOMES AND SENIOR SERVICES Appendix D
Quarterly Review for Use of Physical Restraint
Resident Name: Resident Number: Effective Date:
Location: Admission Date: Physician:
Title: Quarterly Review for Facility Name:
Use of Physical
Restraints
Facility Address:
AREASONFOR Describe imminent danger to the resident or others:
RESTRAINT
1.unsafe mobility / postural instability
2.agitated behaviour
3.aggressive behaviour
4.interference with specific medical treatments
5.Other:
BEFFECTIVENESS OF 1.
RETRAINT
1. Yes 2. No
Comments:
CCOMMENTS FROM How does restraint use affect the resident?
MULTIDISCIPLINARY
TEAM
DRECCOMENDATIONS1.Continue use of restraint:
1. Yes 2. No
2.Reconsent obtained and signed by resident / SDM
Comments / Reason for decision:
EMD TEAM MEMBERSList all members of the team included in this review:
1.Registered Staff:
2.Doctor i.e. ¼ med review:
3.Resident:
4.Other(s):
63 63
HOMES AND SENIOR SERVICES Appendix E
Physical Restraint Monitoring Record
The physical restraint monitoring record is found within Point of Care which is an
application of the Point Click Care documentation system.
For every resident utilizing a physical restraint, Point of Care will prompt the personal
support worker on each of the following questions to ensure a minimum of hourly checks
and every 2 hour repositioning:
1.Uses chair that prevents rising?
Yes
No
Resident not available
Resident refused
Not applicable
2.Uses trunk restraint?
Yes
No
Resident not available
Resident refused
Not applicable
3.Restraint use
Applied
Released, repositioned, reapplied
Removed
Resident not available
Resident refused
Not applicable
4.What was the response to the restraint?
Calm
Agitated
Sleeping
Tearful
Resident not available
Resident refused
Not applicable
64 64
Appendix F: Restraint Audit Tool
Restraints in Effect
Month:
Physical
Restraint
Care plan Monitoring Restraint
Treatmentsto strategies (type, Record(type,severity,
Alternative Date of reason, Quarterly reason, frequency
assessment strategies tried order (type, informed Quarterly response, q1h summaryresponse, q1h reduced,
completedand found to reason, when consentMed check & q2h Admission/annual /RAPS check & q2h increased, Other
RM #Residents Name(MM/DD/YY)be ineffectivetoapply)(MM/DD/YY)Reviewintervention)care/other conferencesidentifiedintervention)discontinuedinformation
65 65
Appendix G
HOMES FOR SENIORS
Consent and Information Form for use of Restraints / PASD
(Family and Resident)
1.Has an explanation of the type of restraint/PASD that is being proposed Yes No
been explained to you?
Physical Restraint:
i.e.is defined as any manual method, or any physical or mechanical device,
f movement or normal access
to his or her body. A resident may be restrained by a physical device if the restraining of the resident is
physically and cognitively able to release themselves is not a restraining of the resident (LTCHA).
Environmental Restraint
i.e.Any device or barrier that limits the movement of an individual, and
thereby confines an individual to a specific geographic area or location (e.g. secured units, wander-
guard systems). The use of barriers, locks and other devices or controls at stairways as a safety measure
is not a restraining of a resident.
Chemical Restraint:
i.e.Pharmaceuticals given with the specific and sole purpose of inhibiting specific
behaviour or movement. Differentiating between the use of a drug as a therapeutic agent or a restraint is
difficult. However, when a drug is used to treat.
Personal Assistance Service Device (PASD):
i.e.personal assistance service device (PASD) is a device
used to assist a person with a routine activity of living. A PASD may limit or inhibit movement and may
restrain a resident but is not considered a restraint if the intent is to provide assistance with activities of
daily living (LTCHA s. 33(1-5); Reg 79/10 s. 111(1-2)).
2. Have the alternatives to the use of a PASD and / or restraint Yes No
been explained to you?
3.Has an explanation of the risks and benefits of the restraint / PASD been Yes No
explained to you?
4. Type of restraint / PASD to be used are: Physical
Environmental
Chemical
PASD
Describe exact type of restraint / PASD:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
66 66
Appendix G
HOMES FOR SENIORS
Consent and Information Form for use of Restraints / PASD
OR
I give my consent to the restraint /PASD method outlined above
I refuse to give consent to the type of restraint / PASD being proposed
Signature of Resident or Substitute Decision Maker: ___________________________________
Relationship to Resident: _________________________________________________________
RN/RPN Signature:_____________________________ Date: ___________________________
DateReason for RN/RPN Resident/SDM CommentsNCP Updated
ReviewSignatureSignature
Comments: ____________________________________________________________________
67 67
REPORT TO COUNTY COUNCIL
FROM: Rhonda L. Duffy
Director of Homes and Seniors Services
DATE: March 18, 2013
SUBJECT: Medication Administration Policy New and Medication Self
Administration by a Resident - Revised
INTRODUCTION:
Past practice re: medication administration has been that the ho
contracted pharmacy policy and procedures related to medication
Long Term Care Homes Act (LTCHA), 2007 requires that the facilit
medication administration policies.
DISCUSSION:
The Medication Administration and the Medication Self Administration by a Resident
policy have been developed utilizing the LTCHA, 2007, the College of Nurses of Ontario
(CNO) medication standard and has been reviewed by the Homes Medical Directors.
With the revision of the policy Medication Self Administration by a Resident, the policy
titled Self Administration & Medication Left at Bedside will be deleted.
CONCLUSION:
The policies meet the requirements of the LTCH Act and Regulatio
standard of practice.
RECOMMENDATION:
; and,
- ; and,
Policy New and Medication Self
Administration by a Resident-Revised be received and filed.
All of which is Respectfully Submitted Approved for Submission
Rhonda L. Duffy Mark G. McDonald
Director of Homes and Seniors Services Chief Administrative Off
68 68
HOMES AND SENIOR SERVICES DRAFT
Evaluation for Self-administration of Medications Appendix 1
Purpose:
cognitive and physical ability to administer his/her own medications.
To be completed by:
RN/RPN in an interview with the resident
Re: Medication(s) to be self administered:___________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Resident: __________________________________ has demonstrated:
Name of Resident
Comments
The ability to recognize each of the
medication(s).
A knowledge of what the medication(s)
are for.
A knowledge of the correct times to take
each medication.
The ability to read the labels on the
medication.
The manual dexterity required to take
the correct dose.
A sufficient knowledge of any
precautions or adverse effects explained
to him/her by the nurse or physician.
An ability to anticipate when the
medication needs reordering
Resident understands that these
medications must be protected from
access by other persons.
Signed: ___________________________________ __________________________
Nurse Assessor Date
Reviewed by: ______________________________ __________________________
Attending Physician Date
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HOMES AND SENIOR SERVICES
POLICY & PROCEDURE NUMBER:
DEPARTMENTNursingSUBJECT: Medication Self Administration by a Resident
:
APPROVAL DATE: _April 2004 REVISION DATE:__March 2013
Page 1of 2
PURPOSE:
1. To ensure the safe and accurate administration of medications is achieved through careful and
structured ordering, documentation and checking procedures.
2. To support self-administration of medications by residents to assist in the building of the
residents independence, self-esteem and functional abilities.
PROCEDURE:
1. A resident will not be permitted to have or keep medications on his/her person or in his/her
room unless authorized by the residents attending physician under such conditions as the
physician may impose. E.g. Nitroglycerin spray kept at the bedside for
administration/application to resident by the RN/RPN.
2. At the request of a resident to self-administer medications, the RN/RPN will assess the
--
3.A written order must be present in th
conditions or circumstances for self-administration.
capability of self-administering medication/treatments including a description of any required
assistance.
5. The RN/RPN will direct the supervision and implementation of self-administration, ensuring
the resident receives information on:
a) Storage of the medication
b) Accountability for amount taken
c) Replacement of medication
d) Possible adverse reactions
The RN/RPN may access the pharmacist of physician for assistance in providing this
information.
6. Any medications for self-by noting the
appropriate code for self-administration in the box.
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DRAFT
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POLICY & PROCEDURE NUMBER:
DEPARTMENTNursingSUBJECT: Medication Self Administration by a Resident
:
APPROVAL DATE: _April 2004 REVISION DATE:__March 2013
Page 2of 2
7. The RN/RPN must ensure that medications/treatments left for self-administration are:
a) Kept in a secure, preferably locked, place to prevent misuse by other residents
b) Taken/used by the resident as intended and not discarded or accidentally taken by another
resident
8. This process shall be monitored daily. If at any time, the registered staff have any cause for
concern they will document this in the resident chart, discuss concerns with resident or power of
attorney for personal care (if consent from POA) and communicate with physician to determine
if the system shall continue or not. If the registered staff is concerned for resident safety, they
may remove the medication until the review with resident, POA and physician is complete.
9. The RN/RPN will do on-going -administer
his/her medications/treatments and will periodically document this in the progress notes.
10. The residents competency to self medicate must be regularly reassessed (every 3 months)
utilising the -administration of Medi
resident deemed competent for self-administration, the physician will re-order the direction for
medication self-administration as part of the quarterly medication review.
71 71
DRAFT
Decision Tree: Deciding About Medication Administration Appendix A
Use this tool to help you determine whether or not to administer a medication. Be sure to consider all of the
components of medication administration in this document.
Proper authorizing mechanism in place?
For example, order or medical directive
NO
YES
Assessed client factors?
For example, identify client, verify consent
Do not administer
NO
medication
Take appropriate action
to safeguard client
interest and ensure
YES
continued care; for
example, follow up with
Assessed your abilities?
prescriber
For example, your knowledge of medication, skills to
reconstitute and administer, judgment to identify and respond to
outcomes
NO
YES
Assessed environmental supports?
For example, human and technological resources to monitor
and intervene if needed, systems in place to support safe
medication administration
NO
YES
Administer medication
YES
Evaluate outcomes
If an adverse reaction occurs, take appropriate action
Note:
Document during and/or after administering medication, according to documentation standards.
72 72
73 73
74 74
75 75
76 76
77 77
ELGIN COUNTY HOMES AND SENIORS SERVICES
POLICY AND PROCEDURE REFERENCE NUMBER:
DEPARTMENT: Nursing SUBJECT:
Self-Administration & Medications Left at Bedside
APPROVAL DATE: CURRENT REVISION DATE: April 2004
REVISION DATE:___________ REVISION DATE:___________ REVISION DATE:___________
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PURPOSE:
1.To ensure the safe and accurate administration of medications is achieved through careful
and structured ordering, documentation and checking procedures.
2.To support self-administration of medications by residents to assist in the building of the
residents independence, self-esteem and functional abilities.
PROCEDURE:
1.A resident will not be permitted to have or keep medications on his/her person or in his/her
room unless authorized by the residents attending physician under such conditions as the
physician may impose. E.g. kept at the bedside for administration/application to resident by
the RN/RPN (e.g. Nitroglycerin spray, tablets)
2.-administer his/her
medications/treatments (Appendix I).
3.
conditions or circumstances for self-administration.
4.The RN/RPN will document on the residents care plan and the Multidisciplinary Notes their
capability I self-administering medications/treatments including a description of any required
assistance (i.e. reminders to take medications).
5.The RN/RPN will direct the supervision and implementation of self-administration, ensuring
the resident receives information on:
a)Storage of the medication
b)Accountability for amount taken
c)Replacement of medication
d)Possible adverse reactions
The RN may access the pharmacist or physician for assistance in providing this information.
6.Recording on the MAR- any medications for self-administration must be noted on the
7.The RN/RPN must ensure that medications/treatments left for self-administration are:
a)Kept in a secure, preferably locked place to prevent misuse by other residents.
b)Taken/used by the resident as intended and not discarded or accidentally taken by another
resident.
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ELGIN COUNTY HOMES AND SENIORS SERVICES
POLICY AND PROCEDURE REFERENCE NUMBER:
SUBJECT:
Self-Administration & Medications Left at Bedside
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8.-administer
his/her medications/treatments, and will periodically document this in the Progress Notes.
9.-medicate must be regularly reassessed (every 3 months) by
on the
medication records MAR. on multidisciplinary notes, care plan.
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REPORT TO COUNTY COUNCIL
FROM: Peter Dutchak, Deputy Director of Engineering Services
Sonia Beavers, Purchasing Coordinator
DATE: March 20, 2013
SUBJECT: Award of Tenders – Engineering Capital Projects
INTRODUCTION:
As part of the approved 2013 Capital Budget, tenders were advertised and issued as
per the County's Procurement Policy. Submissions were received until Thursday, March
14, 2013 for;
a) Asphalt Crack Sealing, Contract No. 6090-13-01
b) Cold In-Place Recycling with Expanded Asphalt Material (CIREAM),
Contract No. 6200-13
c) Culvert Sliplining, Contract No. 6290-13-01
d) Fibreglass Reinforced Chip Seal, Contract No. 6250-13A
e) Granular A Shouldering, Contract No. 6250-13B
f) Hot Mix Asphalt, Contract No. 6220-13
g) Microsurfacing (Type 3), Contract No. 6250-13
h) St. George Street Reconstruction, Contract No. 6200-13-01
Submissions for the Glencolin Line Bridge Rehabilitation, Contract No. 6290-12-01 were
received until March 19, 2013.
DISCUSSION:
Asphalt Crack Sealing, Contract No. 6090-13-01
Six companies submitted a bid for the Asphalt Crack Sealing Tender. Bids were
received as follows:
Company Bid (exclusive of HST)
MSO Construction Limited $52,800.00
The Crack Master $55,960.00
Niagara Crack Sealing $56,200.00
A-1 Asphalt Maintenance Limited $67,600.00
J. Di Iorio Construction Limited $84,000.00
Road Master Road Construction and Sealing Limited $85,400.00
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MSO Construction Limited submitted the lowest bid for the Asphalt Crack Sealing
Tender at a total price of $52,800.00, exclusive of contingency allowance and exclusive
of H.S.T., for the supply of labour, equipment and materials to crack seal various county
roads. This bid is within budget estimates.
Cold In-Place Recycling with Expanded Asphalt Material (CIREAM)
Contract No. 6200-13
Two companies submitted a bid for the Cold In-Place Recycling with Expanded Asphalt
Material (CIREAM) Tender. Bids were received as follows:
Company Bid (exclusive of HST)
Roto-Mill Incorporated $1,269,177.00
Lavis Contracting Company Limited $1,302,735.00
Roto-Mill Incorporated submitted the lowest bid for the Cold In-Place Recycling with
Expanded Asphalt Material (CIREAM) Tender at a total price of $1,269,177.00, inclusive
of a $40,000 contingency allowance and exclusive of H.S.T., for the supply of labour,
equipment and materials to rehabilitate three sections of County Roads. This bid is
within budget estimates.
Culvert Sliplining, Contract No. 6290-13-01
Four companies submitted a bid for the Culvert Sliplining Tender. One bid was declared
non-compliant. The compliant bids were received as follows:
Company Bid (exclusive of HST)
Birnam Excavating Limited $139,975.64
Gary D. Robinson Contracting Limited $187,700.00
Elgin Construction $225,036.86
Birnam Excavating Limited submitted the lowest bid for the Culvert Sliplining Tender at
a total price of $139,975.64 inclusive of a $10,000 contingency allowance and exclusive
of H.S.T., for the supply of labour, equipment and materials to install a pipe liner inside
two existing culverts. This bid is within budget.
Fibreglass Reinforced Chip Seal, Contract No. 6250-13A
One company submitted a bid for the Fibreglass Reinforced Chip Seal Tender. The bid
was received as follows:
Company Bid (exclusive of HST)
Norjohn Contracting and Paving Limited $101,850.00
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Norjohn Contracting and Paving Limited submitted the lowest bid for the Fibreglass
Reinforced Chip Seal Tender at a total price of $101,850.00, exclusive of contingency
allowance and exclusive of H.S.T., for the supply of labour, equipment and materials to
place fibreglass reinforced chip seal in two locations within the County of Elgin. This bid
is within budget.
Granular A Shouldering, Contract No. 6250-13B
Four companies submitted a bid for the Granular A Shouldering Tender. The bids were
received as follows:
Company Bid (exclusive of HST)
D&D Trucking and Construction Services $ 98,279.50
Walmsley Bros. Limited $105,310.00
Coco Paving Incorporated $124,155.00
McCann Paving Incorporated $136,459.50
D&D Trucking and Construction Services Limited submitted the lowest bid for the
Granular A Shouldering Tender at a total price of $98,279.50, exclusive of contingency
allowance and exclusive of H.S.T., for the supply of labour, equipment and materials to
place Granular A Shouldering on various roads throughout Elgin County. This bid is
within budget.
Hot Mix Asphalt, Contract No. 6220-13
Three companies submitted a bid for the Hot Mix Asphalt Tender. The bids were
received as follows:
Company Bid (exclusive of HST)
Walmsley Bros. Limited $1,531,182.00
Coco Paving Incorporated $1,667,000.00
Dufferin Construction Company $1,762,508.00
Walmsley Bros. Limited submitted the lowest bid for the Hot Mix Asphalt Tender at a
total price of $1,531,182.00, inclusive of a $50,000 contingency allowance and
exclusive of H.S.T., for the supply of labour, equipment and materials to place hot mix
asphalt on various roads throughout Elgin County. This bid is within budget.
Microsurfacing (Type 3), Contract No. 6250-13
Two companies submitted a bid for the Microsurfacing (Type 3) Tender. The bids were
received as follows:
Company Bid (exclusive of HST)
Duncor Enterprises Incorporated $598,830.08
MSO Construction Limited $603,268.00
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Duncor Enterprises Incorporated submitted the lowest bid for the Microsurfacing Tender
at a total price of $598,830.08, inclusive of a $25,000 contingency allowance and
exclusive of H.S.T., for the supply of labour, equipment and materials to place
microsurfacing type 3 on various roads throughout Elgin County. This bid is within
budget.
St. George Street Reconstruction, Contract No. 6200-13-01
Nine companies submitted a bid for the St. George Street Reconstruction Tender. The
bids were received as follows:
Company Bid (exclusive of HST)
Elgin Construction $342,744.19
Birnam Excavating Limited $351,135.05
Aar-Con Excavating $356,470.00
Tri-Con Excavating Incorporated $378,000.00
All Season Excavating $388,240.00
J-AAR Excavating Limited $398,735.25
Greenfield Contracting $427,493.40
Dufferin Construction Company $481,154.50
Premier North Limited $481,246.50
Elgin Construction submitted the lowest bid for the St. George Street Reconstruction
Tender at a total price of $342,744.19, inclusive of a $25,000 contingency allowance
and exclusive of H.S.T., for the supply of labour, equipment and materials required for
the reconstruction of St. George Street. This bid is within budget.
Glencolin Line Bridge Rehabilitation, Contract No. 6290-12-01
Six companies submitted a bid for the Glencolin Line Bridge Rehabilitation Tender. The
bids were received as follows:
Company Bid (exclusive of HST)
Gary D. Robinson Contracting Limited $264,620.00
Jarlian Construction $281,556.00
Weathertech Restoration Incorporated $295,059.00
Spectre Construction and Management $296,709.50
Theo Vandenberk Construction $305,107.00
Facca Incorporated $420,000.00
Gary D. Robinson Contracting Limited submitted the lowest bid for the Glencolin Line
Bridge Rehabilitation Tender at a total price of $264,620.00, inclusive of a $20,000
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contingency allowance and exclusive of H.S.T., for the supply of labour, equipment and
materials required for the rehabilitation of Glencolin Line Bridge. This bid is within
budget.
As per the County of Elgin’s Purchasing Policy, if change orders are required for any of
the above listed projects and the cost increases above the tender amount approved by
Council by less than 10%, and the amount is within the overall budgeted project
amount, work will proceed upon authorization by the Director. However, if the cost
increases above the tender amount approved by Council by more than 10%, the
Director will prepare a further report to Council outlining the expenditures.
RECOMMENDATION:
THAT MSO Construction Limited be selected for the Asphalt Crack Sealing Tender,
Contract No. 6090-13-01 at a total price of $52,800.00, exclusive of contingency
allowance and exclusive of H.S.T.; and,
THAT Roto-Mill Incorporated be selected for the Cold In-Place Recycling with Expanded
Asphalt Material (CIREAM) Tender, Contract No. 6200-13 at a total price of
$1,269,177.00, inclusive of a $40,000 contingency allowance and exclusive of H.S.T.;
and,
THAT Birnam Excavating Limited be selected for the Culvert Sliplining Tender, Contract
No. 6290-13-01 at a total price of $139,975.64, inclusive of a $10,000 contingency
allowance and exclusive of H.S.T.; and,
THAT Norjohn Contracting and Paving Limited be selected for the Fibreglass
Reinforced Chip Seal Tender, Contract No. 6250-13A at a total price of $101,850.00,
exclusive of contingency allowance and exclusive of H.S.T.; and,
THAT D&D Trucking and Construction Services be selected for the Granular A
Shouldering Tender, Contract No. 6250-13B at a total price of $98,279.50, exclusive of
contingency allowance and exclusive of H.S.T.; and,
THAT Walmsley Bros. Limited be selected for the Hot Mix Asphalt Tender, Contract No.
6220-13 at a total price of $1,531,182.00, inclusive of a $50,000 contingency allowance
and exclusive of H.S.T.; and,
THAT Duncor Enterprises Incorporated be selected for the Microsurfacing (Type 3)
Tender, Contract No. 6250-13 at a total price of $598,830.08, inclusive of a $25,000
contingency allowance and exclusive of H.S.T.; and,
THAT Elgin Construction be selected for the St. George Street Reconstruction Tender,
Contract No. 6200-13-01 at a total price of $342,744.19, inclusive of a $25,000
contingency allowance and exclusive of H.S.T.; and,
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THAT Gary D. Robinson Contracting Limited be selected for the Glencolin Line Bridge
Rehabilitation Tender, Contract No. 6290-12-01 at a total price of $264,620.00, inclusive
of a $20,000 contingency allowance and exclusive of H.S.T.; and,
THAT if the cost increases above the tender amount approved by Council by more than
10%, the Director will prepare a further report to Council outlining the expenditures; and,
THAT the Warden and Chief Administrative Officer be authorized to sign the contracts.
All of which is Respectfully Submitted; Approved for Submission;
Peter Dutchak Mark G. McDonald
Deputy Director of Engineering Services Chief Administrative Officer
Sonia Beavers
Purchasing Coordinator
Clayton Watters
Director of Engineering Services
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CLOSED MEETING AGENDA
March 26th, 2013
Staff Report:
1)Tree Commissioner Municipal Act, Section 240.2 (e) litigation or potential
litigation, including matters before administrative tribunals, affecting the
municipality or local board – Tree Violation.
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