One nurse, 39 patients overnight shift, let that sink in. Here we are yet again talking about another case involving a nursing error resulting in a patient death. Welcome back to the channel everybody. For those of you who are new around here, my name is Michael A.K.A. Dr. Chalini, nine on my board certified diagnostic and interventional radiologist in New Jersey. Now I just made a video last week talking about the Radonda Vaught case, which linked up here if you haven't seen it. And afterwards I was flooded with comments and DMs asking me to talk about another case that not many people know about involving a nurse by the name of Christian Ganey. At first I didn't really look into it because I don't have too much extra time on my hands. However, I'm on vacation this week and I have a little extra time to do some research. So now you have left me no choice but to do a deep dive on this particular case, go over the details, discuss what happened, and of course give my thoughts on the case. Let's go. Okay, so let's go ahead and jump right in with the details of this case and figure out exactly what happened. And just for anybody watching, I'm getting all of this information from the CMS report on this case, which was written up around 2018, I believe. And as always, I will leave a link to this 141 page document so you can peruse it at your leisure. So Christian Ganey is a 30 year old travel nurse working for the Cathedral Village Long Term Care Facility in Pennsylvania. And just so we're all clear going forward, this case took place in 2018. During the particular night shift she was working when this event took place, she was taken care of 39 patients by herself. Just let that sink in for a minute. That's right, one nurse, 39 patients, overnight shift, let that sink in. But more on that later. Of those 39 patients was an 84 year old male that was admitted on April 9th of 2018. The patient's diagnosis included hypertension, CVA or cerebral vascular accident, also known as a stroke, which we will presume to be ischemic in nature given like 85% plus of strokes are ischemic in origin. The patient also had expressive aphasia, which may have been a result of that stroke or even a previous stroke. And by the way, expressive aphasia is basically when patients have trouble speaking or they may have difficult producing coherent spoken language. However, their comprehension is relatively maintained. So what we were always taught in school and this doesn't always follow the textbook but they can understand it but what comes out is broken and jumbled. Of note, this patient also had no code status documented which is kind of weird all together because almost everybody who walks in the door for any hospital or long-term care facility has their code status documented immediately. It is in every single patient's chart I've ever worked with at every hospital I've ever been in. It's like in big letters, code status, DNR, full code, DNI, et cetera, et cetera. And one of the first questions asked to a patient when they come into any hospital or long-term care facility is what do you want us to do when your heart stops? And that is their code status. And for those patients who are demented or delirious or can't speak or can't provide their own answers there's usually a document that accompanies them or they have a family member document the code status. The patient also had a feeding tube which I will presume again to be a gastric feeding tube which the patient was supposed to be fed 16 hours per day. During the patient's short stay he experienced four separate falls ranging from 9.45 p.m. on April 9th through 1.55 a.m. on April 12th which is a period of three days, yay math. On April 12th, 2018 at approximately 11.30 p.m. the patient was found lying on the floor next to his bed. Facility documentation related to this fall showed that the patient had an unwitness fall and had a laceration to the right temple of about one by one centimeters and the same laceration on the right shoulder as well and an abrasion on the knee. After this unwitness fall, the nurse, Miss Ganey and a nursing aide transfer the patient to a wheelchair and brought him to the lobby or near the nurse's station so they could monitor him. I guess since maybe this patient had so many falls and they were covering so many other patients they wanted to keep a close eye on him so that this didn't happen again. That's just me reading between the lines not true documentation. At this time they did notify the overnight physician and started the neuro checks based on the facilities protocol. So this particular facilities policy on neurological evaluation dated last approved on February 18th of 2015 revealed that any resident with the potential for head trauma injury or having an acute change in level of consciousness will receive 72 hours of neurological evaluation following notification of the physician. So, so far, so good. In addition, the policy indicated that the neurological assessments were to be completed as follows. Every 15 minutes for the first hour followed by every hour for the next three hours and then every two hours for the next four hours. Every four hours for the next 16 hours. Every eight hours for the next 48 hours. You see now why I popped it up on a box and didn't try to memorize that. Further documentation from the report I mentioned prior that will be linked in my description box. The fall happened on April 12th at 1130 p.m. and a neuro flow sheet was performed following the fall and continued until April 13th at 720 a.m. However, the patient was found to be unresponsive and have no observable signs of life somewhere between 7 a.m. and 715 a.m. at which time Nurse Ganey and the nursing aides and staff gathered the patient up, transferred the patient back to the room and put the patient in his bed. The patient was pronounced deceased approximately two minutes later at 717 a.m. However, according to the documentation done by Nurse Ganey, she had completed the patient's vitals and done a neuro evaluation at 720 a.m., which is three minutes after the patient was pronounced deceased. Nurse Ganey later admitted to phosphine documentation at 720 a.m. on that day. Review of the facility's camera footage showed that following the patient's transfer to the lobby at 1144 p.m. until 7 a.m., a period of over seven hours Miss Ganey did not complete any of the scheduled neurological checks. Furthermore, when the staff noticed that the patient was unresponsive, no attempt was made to call 911 and no resuscitative efforts were performed according to documentation and camera footage, which goes back to my previous point on knowing the patient's DNR status. However, per review of this facility's policies, review of the facility policy do not resuscitate in the event that the heart stops beating or breathing stops and there is no medical intervention started. Last approved, February 21st, 2018 revealed that all residents will be resuscitated, a.k.a. the use of CPR when there is no observable sign of life unless they have a do not resuscitate order. So like it says at the very bottom there, in a not so confusing way, CPR will be initiated on all residents without observable signs of life unless a DNR order is obtained. So let's get back to the case. While the patient was also in the lobby for those seven hours, the patient was not hooked up to a feeding tube, which caused the patient to miss approximately six hours of nutritional support. It was also found out that the patient was not assisted to the toilet during this time of being on night watch and was found to be heavily saturated in urine and feces. Following the patient's death, he was transferred to a medical examiner, which noted that blunt force trauma and subdural hematoma resulted in the patient's death. So now that we know about the case and what exactly happened, let's talk about some of the questions I have about the case. One, why was the patient allowed to fall five times or four times before the final incident? Thanks to some internet folks, apparently there was some legislation passed to residents in long-term care facilities giving them the right to fall, which means basically that healthcare facilities and their workers have duty to educate patients on preventing falls, but we cannot ethically restrain patients to prevent them from falling. So basically we can't morally put them in restraints or even have bedrails on the sides of the beds to prevent falling because it limits the patient's autonomy or their right to fall. And I'm hoping someone in the comments below that works in a long-term care facility can kind of help me out with this one because this was the first time I've ever heard of this piece of legislation. It kind of goes against what you think because if you had someone fall multiple times, you think you would at least put up bedrails or something to prevent them from falling again, but I don't know, I don't work in a long-term care facility, so this is definitely news to me. The other particular thing about this case is that you may say, well, if the patient fell four times already, why weren't they transferred out to the hospital or somewhere to monitor them closely? Well, it may come down to payment. So anytime a patient goes to one of these facilities, they're usually paid for by the Centers for Medicare or Medicaid Services. If for some reason, during the first 30 days of that admission at the long-term care facility, the patient has to go back to the hospital, the CMS does not reimburse the long-term care facility appropriately. And they may not even pay them at all because they may see that this facility is unfit to care for sick patients, they don't deserve their money. So what happens in this scenario is that long-term care facilities may actually hold onto these patients longer and longer, even though they may require a hospitalization because they don't wanna lose out on funding. And this doesn't just happen in long-term care facilities. It's also true with like dialysis work, which is in my wheelhouse. Sometimes a patient will come in with a fistula and we may need to do some work on it. And if that patient comes back within 30 days after having the initial treatment, we don't get paid for it because it was deemed that the procedure we did prior was unsuccessful for whatever reason. And that's just completely up to the CMS. The next question I have about this case is why was Nurse Ganey in charge of 39 patients by herself? Now that is a very good question that I unfortunately don't hold the answer to. Maybe the long-term care facility didn't wanna pay for three to four nurses because that's expensive. Or maybe they had a nursing shortage and couldn't get coverage for the night. And they just had to take whatever they could get. I don't think we'll ever know the reason for it because I doubt the administration will ever tell us and nobody's gonna go after them apparently so we'll never know. The next question I have is why did Nurse Ganey falsely document that she did neurological evaluation after the patient had already passed? Falsely documenting stuff in medicine is one of those huge no-nos that we are taught from day one not to do. Never document something that didn't happen for this reason and many other reasons. But with that being said, false documentation happens every single day in every single hospital. You think every healthcare worker that's taking vitals is counting respirations every single time they go and do vitals? No, I don't even know who does that. But it's always documented. As the nurses who are watching this know there are tons of things that they're supposed to document on a daily basis that it may not add any value to anything or anyone in respect to patient care. But they don't have time to document everything because they're already stretched too thin as it is. I'm not saying you should falsely document stuff or that all documentation is dumb. I just think that excess documentation is a systemic issue. And yes, you should never falsely document. The next question I have about this case is why did they bring the patient to the lobby or near the nurse's station after he had his final fall? Was it to keep an eye on the patient because they knew they had such a high patient census of 39 patients and they didn't think that they would be able to get to all the neurological checks over the next couple of hours? And maybe they thought that they could keep a close eye on him or were able to see them with their own eyes that would make up for not being able to do neurological checks. I don't know. The next question I have about this case is why were no resuscitative efforts performed? I think we know the first answer is the patient had no code status which is an issue from the very get-go. The goal of acquiring a code status is that the entire healthcare team is on the same page in the event of the patient's heart stops. It helps to alleviate questions and running around looking for patient information when a patient's heart stops because time is of the essence, obviously. So why didn't they get the code status? Who knows? However, given the fact that Ms. Ganey was a travel nurse that was just covering a night shift at this facility that she may or may not have ever worked in before, I doubt she was familiar with this particular facility's CPR guidelines on patients who do not have a code status. However, this facility's guidelines for that particular scenario are pretty common amongst every hospital I've ever worked at. So what about Cathedral Village? What did they do after this incident? Well, this particular long-term care facility posed immediate jeopardy to patient health and safety. And on April 19th, 2018, or six days after the event, an immediate action plan was developed, including the following. One, all staff will be reeducated immediately regarding the abuse, neglect, and exploitation with emphasis on definition, examples, and reporting requirements. Alternate staff on site will be educated immediately. Fall management program policies will be revised immediately. All residents will be reassessed for fall risk. Alternate facility staff will be reeducated regarding the policy modifications immediately. All new admissions will be assessed for fall risk within four hours of admission. So what was the result of this case? Well, Nurse Ganey was originally charged with felony neglect and involuntary manslaughter, which are quite the charges. However, she pleaded down and got sentenced to six months of house arrest with another four years of probation. She'll also be barred from seeking reinstatement of her license or working in a care facility during those four years. So the question we've all been waiting for, what do I think about this case? Well, for one, I think the fact that this happened is absolutely terrible. Nobody wants this to happen to their loved ones and nobody expects anything like this could happen to their loved ones when they go to a long-term care facility. My 94-year-old, Randad, is currently in a long-term care facility and I visit there frequently. So this definitely hits a little close to home. And now that I think about it, I only remember seeing like one to two nurses while I was there and they have a pretty sizable community, which now makes me question what the actual nurse-to-patient ratio is and I'm going to try to find that out. I don't think it's the nurses fault that they are putting these situations with high patient-to-nurse ratios. This is just another example of systemic issues within healthcare. Nursing shortages and hospitals and healthcare facilities not wanting to spend the extra money to pay nurses to ensure the safety of their patients. This is all too common. She was basically a substitute nurse who was left on her own to care for dozens and dozens of patients overnight and that pretty much hit the nail in the head. Like seriously though, how are you supposed to be doing multiple neuro checks an hour when you have a census of 39 patients? It's just not feasible. And speaking of this being a systemic issue, again, I asked, why are the administrators not held accountable or held to the same standard as the nurse? Is it because it's easier to blame one single person rather than an entire system that sets their employees up for failure? And like I spoke about in the Redonda Vaught video linked up here, this is just another hit to nurses and all healthcare workers. Our goal in healthcare is to promote a just culture which establishes unity and positively impacts work environments. A culture in which mistakes that happened are discussed and the causes of these errors are figured out together so that they don't happen again rather than just automatically punishing one person. If you only punish one person for their mistakes when more than one person was involved, the one punished is ultimately failed by the very system they work for. And it definitely doesn't help with bringing those mistakes forward. I do want to make it clear though that the mistakes misgain me made are unacceptable. However, there's always a however, the system needs to be changed as a whole and the system needs to be held accountable, not just one person. Otherwise we will continue to see healthcare shortages and decreased reporting of incidents which is ultimately worse for healthcare workers and ultimately their patients. Thank you all for watching everybody. If you enjoyed this, please leave a comment below. Let me know what you think on the case and as always, please subscribe to my channel. Follow me on Instagram and Tech Talk if you don't already and as always, I'll see you all on the next video. Bye.


Hi everyone, Joe for Jaspy's casebreaks.com coming at you with the random number block randomizer for limited pick your team It's actually pick your team six not pick your team five. That's Mistake There you go. So it's actually for pick your team six where I need to pick your team five And it's a random number block randomizer for that big chunk of teams, right? They're almost the entire break There's also two extra spots were given away So let's gather all the names here If you bought a spot straight up you got a chance at an extra spot Let's roll it randomize it four to one five times top two after five Get extra spots one two three four and five there you go Chris and Hans congrats to you Extra spots go in your way. All right now Let's copy those names now. We'll randomize you a number Let's roll it and randomize it six and a one seven times for names and numbers one two three four five six and a one seventh and final time I got Chris down to David six and a one seven times for the numbers one two three four five six and once more seventh and final time I've got five down to seven All right Chris with five Hans with three David with two Adam with zero you'll get any and all redemptions for that big group of teams They're haunt with eight Chris with the one and nine Alan with six Jeff with four and David with seven All right, so let's put seven right and let's let's get that whole list of teams right there, too All right, so there you go. We'll see in the next video for the break itself. Just piece case breaks calm


questions. I recognize the leader of Her Majesty's Loyal Opposition. Thank you very much, Speaker. My first question this morning is to the Premier. Speaker, as families anxiously watch the news of the spread of COVID-19, they're asking some serious questions about the government's contingency plans and about their own ability to take time away from work if sickness requires them to. The government has made it clear that they will not take the advice of doctors, nurses, and health professionals who have implored them to reinstate paid sick days. What measures is the government ready to put in place to help people and their employers if they're unable to work due to illness or quarantine? Thank you, Mr. Speaker. I can tell you that health and the well-being of Ontarians is our government's number one priority. Our government has taken a transparent approach, regular updating to the media and the people of Ontario, Mr. Speaker, via the media and online. Our government is acting to ensure readiness and to respond to a range of outbreak scenarios. We're expanding our testing capacity and establishing dedicated assessment centres to ease pressures on hospitals. We've also enhanced screening at long-term care homes. Ontario has stood ready and assisted by the federal government, which I want to thank the federal government for their announcement today, and we look forward to going up the Ottawa starting tonight to sit down with the rest of the premiers and the federal government to discuss a further plan. Thank you. Supplementary question. Well, Speaker, indeed the federal government did announce this morning measures to make it easier to access employment insurance, but thousands of working women and men in Ontario, nearly one in 10, don't qualify for employment insurance coverage. Does the Ford government have a plan to protect these workers when they need to take time away from work? Mr. Speaker, Ontario has stood ready and assisted again by the federal government in caring and repatriating the Canadians that are overseas at CFB Trenton and also the NAV Canada Centre. Our government will work with the federal government to ensure that our public health care system will respond appropriately. We look forward to engaging with our provincial and federal partners at the First Ministers meeting. We are implementing an enhanced paramedic response team that brings all the partners together, Mr. Speaker, and I look forward to meeting the leader of the opposition after this session and the other leaders of the other parties to further discuss this. Thank you. Final supplementary. Well, Speaker, I'm still not getting a response to the question outside of the great work that's been done by our health professionals and public health in the province. No one should ever have to be in a situation where they're having to choose between their ability to earn a living and being able to stay healthy or keeping other people healthy. But many working people feel that this is a choice that they may be facing. Now more than ever, they need a government that's ready to act to ensure that they don't have to make that choice. Instead, that they have a government that defends stripping...  So what contingency plans does a government have in place, Speaker, to ensure that people will be able to take time off work, from work, when they need it? Deputy Premier and Minister of Health. Speaker, we are encouraging people who feel ill to stay at home and we are encouraging employers to support that advice and they are. We have a situation right now where notes are not mandatory. They can be asked for in some circumstances by employers. But employers in Ontario right now understand that we are dealing with a very unusual set of circumstances and they're responding accordingly. Employers now have the option to require reasonable proof of the circumstances that entitle that employee to leave. That is what is happening right now. People are being responsible, both employees and employers. We feel that no other steps are required at this point because people are acting in the way that they should under these circumstances where everyone is required to play their part and to serve their role in making sure that they protect themselves and they protect their co-workers and the people around them. Thank you, Speaker. My next question is to the Premier, but we feel that the government should be taking the advice of health professionals who say get rid of this requirement for sick notes completely. Don't make it optional. And make sure that people have paid sick days to rely on. That's what the professionals are suggesting that this government do and we would agree with that advice, Speaker. I wish the government agreed with that advice. But this week the court government has repeatedly stated that they have contingency plans in place to deal with everything from increased demands on our health system to disruptions to business, the ability to deliver public services. Will the government start laying out the details of their contingency plan, Speaker? Yes, of course, there is a meeting that has been established following question period with the leader of the official opposition and the leaders of the other parties to provide in greater detail the enhanced measures that are being taken under the plan. We can't sit back and just assume that things will continue to be the way they are right now. We know that what's happening in other countries, it's the COVID-19 is escalating. We are preparing for that. We don't assume that what we're dealing with now will stay the same. So we are looking at assessment centers. For example, having people to be able to, in a very short order, to be able to be diagnosed at home with having the public health worker come to their home to be able to diagnose them. We are putting all of these measures in place. We're looking at large gatherings. What we should do about large gatherings? Should we put protective measures in place and prevent them from happening? We are looking at the entire possibility of events. We plan for the worst-case scenario. Of course, we hope it doesn't happen, but if it does, we will be ready for it. The supplementary question. Well, Speaker, I'm certainly looking forward to this afternoon's meeting, but I do believe that it's really important that the public is provided with information. I think the public having information is paramount to reducing their fears and worries about what's happening here in our province. You know, one of the specific areas where people have concerns is in our hospital sector. As a Premier knows, hospitals across Ontario are routinely operating over 100% capacity. People were being treated in hallways and conference rooms before COVID-19 was even a factor here in Ontario. Ontario hospitals say they will need an investment of over $900 million just to stay where they are, which is with the broken system that the Liberals left us with. What is the government's contingency plan? Should a hospital go into a lockdown or quarantine? I think there are several issues that were mentioned in the question from the Leader of the Opposition. First, with respect to making sure that the public is aware of what is happening, we are doing that. We are being open and transparent with the people of Ontario. Dr. Williams, our Chief Medical Officer of Health in the province of Ontario, holds conferences twice a week on Mondays and Thursdays with information that is immediately available to the public. We are also updating our website ontario.ca slash coronavirus twice a day at 10.30 in the morning at 5.30 in the afternoon to give people the information they need on where we stand in Ontario with the number of coronavirus cases of COVID-19, and also the personal precautions that people can take. That is very important that people are aware of what they need to do. Secondly, the Leader of the Official Opposition asked about the preparedness of our hospitals. We have a plan in place that is being discussed on a daily basis at the command table and at the regional tables to make sure that if one hospital has to be shut down because of too many cases of coronavirus or if it's spreading within that hospital, that there are plans for other hospitals to take over the work that's being done at that hospital. That is happening across the province of Ontario. We want to make sure that if we have a situation where one is in lockdown, others are there to take the place in reasonable proximity to that hospital. So the people of Ontario need not fear about whether the hospitals will be able to handle this situation. They will be, and the plan is set and ready to go. Thank you. The final supplementary. Well, Speaker, when the vast majority of hospitals in Ontario are operating at over 100% capacity, that doesn't leave us with much comfort, unfortunately. Ontario's homeless shelters are another situation that we're concerned about. The shelters and emergency services for people who are without a home are asking similar questions, Speaker. People who are homeless are already at increased health risk, as we all know. And that's doubly true during communicable disease outbreaks. Nurses and health professionals want to know what the government contingency plans are for this particularly vulnerable population. When can they expect to see some answers, Speaker? Well, thank you. First of all, with respect to our hospitals and the fact that many of them are over 100% capacity, that is true. Again, as I indicated the other day, this is not a situation that we created. That was created in the 15 years before our party took government. But we have a plan in place that is going to reduce that capacity. With all of that said, we know that there is a plan that will work in all of our hospitals, that we are very fortunate in that the cases that have presented thus far, the vast majority of people are able to be self isolated at home, those who've been confirmed with COVID-19. And that should we require more spaces in the future, those spaces can be created. It is important to note that not every patient needs to be treated in a negative pressure room. That is where people are commonly diagnosed. If they have been diagnosed with COVID-19 and need to be in hospital, they can remain in isolation and isolation spots have been created in our existing hospitals to make sure that we can safely treat those patients that have been confirmed with COVID-19 and the rest of the patients who are there for other reasons. In terms of people who are in homeless shelters and people who are living on the streets of Toronto, our public health units are working very carefully throughout our entire population to make sure that if people need to be diagnosed, there are places where they can be diagnosed as well as treated. We want to make sure that no person, no person in Ontario that needs care will go without it. We have a situation set up where every person can receive care. We are working very carefully with our public health units who are doing a tremendous job in all of our communities. Thank you, Mr. Speaker. For the Minister of Health. Ontarians count on healthcare workers to care for them, to help them heal, and to keep them safe. And healthcare workers count on things like infection control and protective equipment to keep them safe and their patients. In the absence of clear, unequivocal scientific data, they are saying that the province should continue with the precautionary principle, which dictates higher standards of protection. Will the Minister listens to healthcare workers and provide them with the equipment they are asking to protect themselves from possible airborne threats? Minister of Health. Well, first I want to thank all of the frontline personal healthcare workers that are dealing with COVID-19. They are doing, and they do need to be supported by the appropriate personal protective equipment. We have been following the advice that has been given to us by the medical and scientific community, and presently Ontario has been an outlier vis-a-vis other provinces and other countries in the sense that we have been assuming that there is airborne as well as droplet transmission of COVID-19. The medical evidence is telling us that it is not airborne, but it is droplet-borne protection, and therefore the personal protective equipment that is being recommended is what we are switching to now, and that is what we are going to be providing. We did hear from a group of public health community and chief nurses, executive colleagues, and we also heard from a number of leading experts in infectious diseases, and Speaker, I would like to read what they have sent to us. We commend and support efforts to expand Ontario's stockpile of N95 respirators, but we also strongly believe that it is essential to change current recommendations to manage patients with suspected or confirmed COVID-19 in droplet or contact precautions, and to recommend airborne precautions only for aerosol generating medical procedures, such as bronchoscopies. Making this change immediately is the best approach for pandemic planning. This is the evidence and the advice that we have received from the experts, the medical experts, and the scientific experts, and this is the advice that we are following. One of the important lessons Ontario Public Health learned from SARS was to ensure that health care workers have the protection that they and their patient needs to stay safe, to be safe. As long as experts are sorting out the science and the sciences start to get disseminated, we all know that we should continue to use the precautionary principle, which means ensuring that there are more rather than fewer precautions for the people who keep our health care system functioning. Until we get clear science, until we get clear data that shows that COVID-19 is not airborne, will the Minister commit to the protection of Ontario patients and the protection of Ontario health care workers and the way front-line health care workers are calling her to do? The precautionary principle is very important when there is medical and scientific evidence to back it up. In this case, the World Health Organization, the Registered Nurses Association of Ontario, and others have recommended to us that it is droplet transmission that we need to be concerned about, not airborne transmission. That is what we are following. We want to make sure that the people of Ontario are safe, that our health workers are kept safe, but the World Health Organization's guidance for the rational, appropriate use of personal protective equipment in addressing COVID-19 says that PPE should be used based on the risk of exposure, the type of activity, and the transmission dynamics of the pathogen, whether contact, droplet, or aerosol. The overuse of PPE will have a further impact on supply shortages. Health care workers involved in the direct care of patients should use the following PPE, gowns, gloves, medical masks, and eye protections, goggles or face shields if needed, for bronchoscopies. Specifically for aerosol-generating procedures such as intubation or ventilation, health care workers should use respirators, eye protection, gowns, and gloves. We are following the medical advice that we have received from the World Health Organization, from the Registered Nurses Association of Ontario, and from numerous experts on the COVID-19. We are following the medical and scientific advice that they are recommending for us, and that is what is going to continue to guide our decisions with respect to coverage and dealing with COVID-19. Thank you very much, Speaker. My question is to the Premier. Premier, many individuals in my riding and throughout this province have seen continued coverage regarding the coronavirus. I want to take this opportunity to thank Dr. David Williams, Ontario's Chief Medical Officer of Health for his leadership in providing a strong, reassuring presence during these times. I know our government is actively engaging on this file, and the Minister of Health and all her officials continue to provide strong leadership with twice-weekly media briefings, frequent news releases, and daily website updates. Premier, would you please provide the legislature with an update on Ontario's efforts to address the coronavirus in this province? Questions to the Premier. Well, thank you. And I want to thank our member from Aurora, Bridges Richmond Hill, for the question. Mr. Speaker, I first want to acknowledge, as we all have, our dedicated healthcare professionals. We'll leave no stone unturned to make sure our frontline healthcare workers are protected. They're paramedics, nurses, doctors, long-term care workers. It's our top priority to make sure they're taken care of until they're able to take care of the other folks there. Our government takes this issue very seriously, Mr. Speaker. And that is why we've created a central command table headed up by our great Minister of Health. And I have to tell you, Mr. Speaker, our Minister of Health is working around the clock, seven days a week, 24 hours a day, making sure the ship is guided in the proper direction. A supplementary question. We go back to the Premier. Premier, I'd also like to take the opportunity to thank all the frontline medical workers in my riding as well. We realize this virus has caused concerns throughout the world's financial markets. And I know that my constituents are deeply concerned about the global economic uncertainty. The people of Ontario elected a government committed to fiscal prosperity and sound economic planning. With the Premier, outline to the House the state of Ontario's economy during this ongoing global uncertainty. I want to thank the member, Mr. Speaker, but I can tell you, we are committed to supporting and protecting the interests of all Ontarians full stop. We will do whatever it takes to make sure we continue on with the economy moving forward as we've seen. You know, the economic impacts of COVID-19 are concerning to our government. I'm sure governments around the world. But Mr. Speaker, you've seen us for the last 18 months in here, making sure that we are prudent with taxpayers' money. We're fiscally responsible, Mr. Speaker. This is the reason you have to be fiscally responsible for situations that you face. As we say, you need the rainy day fund. And that's exactly what our government is doing. Mr. Speaker, economically, our government is so much further ahead than any everyone else. But again, every decision we make, we have to make sure we're being fiscal prudent managers of the taxpayers' money to make sure our economy continues to boom as you've seen. Thank you very much. The next question is from the member for Kiwetnaw. Good morning, Mr. Speaker. My question is to the Premier. Tomorrow, the Premier will be joining First Ministers and the Prime Minister for the First Ministers meeting. On Monday, the Premier spoke about the issues he plans to raise. But I didn't hear the Premier mention any of the challenges facing First Nations, especially in light of COVID-19. Well, the Premier uses his opportunity in Ottawa to address these issues with the Prime Minister. The Minister of Indigenous Affairs. Thank you, Mr. Speaker. We, of course, look forward to this opportunity. The federal government has submitted a couple of items that they want to discuss, and we have a couple that we'd like to discuss. And frankly, in view of these ongoing circumstances with respect to COVID-19, it compels us, Mr. Speaker, to talk and ensure that there is a strategy in place for Indigenous communities, particularly and notably for isolated and remote Indigenous communities, Mr. Speaker, in the wake of conferences that members have traveled back and forth through. We want to ensure that we take, just as we have and will continue to do, in any other community in Ontario, appropriate responses for those communities. Thank you, Mr. Speaker. A supplementary question. Back to the Premier. Infectious diseases can be especially devastating for First Nations communities. The government tells people to wash their hands, but it's hard to do, and there's no clean running water. The government tells people to self-isolate, but how do you do that when you live in a house of 10 to 12 people in each home? These are the issues that can be ignored. Our issues, our communities deserve answers. Will the Premier commit to raising them at this meeting? Mr. Health to apply? Well, I thank the member very much for your question. They are serious, significant issues that you are raising, and I can tell you that with the new response structure that we've set up with the command table and the regional tables, I can tell you we also have sector or specific issue tables where we can bring up issues such as repatriation issues, local case issues, but certainly dealing with First Nations partners to make sure that we can understand the specific issues that are being faced and work through solutions. That's something that we are working through provincially, but it's certainly something that I as health minister will be raising with the federal health minister, a part of my discussions with her, because as I said previously, we want to make sure that everyone in Ontario, should they need assistance with COVID-19, will receive that assistance. Recognizing the unique circumstances that many of First Nations partners are experiencing, we want to make sure that we deal with them appropriately and provide the necessary services and supplies that are needed. Thank you very much. The next question is for Ottawa South. Thank you very much, Mr. Speaker. My question is for the Premier. Good morning, Premier. So it's hard to believe we're still talking about a license plate some three weeks later, and I do have to say that hearing the Premier say that he was heartbroken was hard to understand. Speaker, here's what I know. Almost every day in this legislature, right over here in the gallery, there are heartbroken families sitting here, and we all know why they're here. We know they're here because their children aren't getting the supports that they need. Up until now, the government has only spent about half the 600 million they say they've allocated to the OAP, and families with children with autism in the North are not only heartbroken, they're devastated because the government has destroyed capacity in the North. So, Speaker, through you, what does the Premier have to say to these families? The Minister of Children, Community and Social Services. Well, thanks very much, Mr. Speaker, for the opportunity to respond to this question under the direction of this Premier. We have actually doubled the amount of funding in the Ontario Autism Program from $300 million to $600 million, Mr. Speaker, with the advice of families and experts from the autism sector, we are developing a needs-based program that is going to meet the needs of far more children in the province than ever received support from that government, Mr. Speaker. Under the direction of Stephen Del Duca and the previous Liberal government, Mr. Speaker, there were 8,000 children in the province that were receiving service from the provincial government while thousands and thousands more waited. And I can tell you that in the last several months, we have seen thousands more children than ever before receiving funding from the Ontario Autism Program, and we will continue to see that funding roll out over the coming months, Mr. Speaker. Speaker, I thank the Minister for his answer, and I'm sure the families would have appreciated response from the Premier. And I don't think that's what families are experiencing. So, it's clear that the Premier and his ministers have made a mess of the OAP, which is something this government has a habit of doing. The problem is here, it's not us. It's children and their families that are paying the price for this. Now, we understand the government's offering interim services in four regions of this province. What about all the rest? What about all the rest? So, Speaker, to you, I'll ask the Premier again, what do you have to say as leader of this province to those families who are falling between the cracks because of your mismanagement? Thank you, Speaker. Order. Premier to reply. Mr. Speaker, it's pretty rich of this member to come out when the first crisis that I faced as Premier was you banked up the system. You banked up the system. We're $100 million short. We had to put emergency funds to help families with autism. I met a lady the other day, came up to me out of the blue and said, thank you for helping us. This is the first time we've seen funding. We've doubled. We have actually doubled the funding to $600 million as they sat back and ignored these families for years, for 15 years they were ignored. Thousands and thousands of families were struggling as they sat back and did absolutely nothing for these families, Mr. Speaker. We're taking care of these families. We're putting $600 million in. People are getting their checks down, Mr. Speaker, and they're 10 times better off than they were under the Liberal government. The House will come to order. Let's start the clock. Next question, the member for Markham Union. Thank you, Mr. Speaker. My question is for myself. We have heard from many of our constituents about the risk of COVID-19. It's apparent that every member of this House is interested in making sure the people of Ontario are safe from this virus. That is why an open, transparent approach has been so important. I have directed my constituents to Ontario.ca slash coronavirus so that they can get the most up-to-date accurate information and the fact sheet in a variety of languages. Ontario is continuing to monitor this situation closely as we prepare and enhance response. Speaker, I think it is important that we continue to make clear the actions that are being taken in response to COVID-19. Can a minister tell this House about the readiness of our province? Thank you, Mr. Speaker. Questions to the Minister of Health? Thank you to the member from Markham Unionville for his question. I know this is very important to you and to your constituents. Since we first heard of this virus, Speaker, our government has been open and transparent with the actions that we've taken. We've offered media briefings twice a week, frequent news releases, twice daily website updates, daily stakeholder briefings, and a number of briefings offered to all parties in this House. Speaker, we are now implementing an enhanced response. This includes a new command table, five regional planning tables, implementation tables, and a personal protective equipment table. We are ensuring Ontarians readiness should this situation escalate. For example, we are establishing dedicated assessment centres to ease pressures on hospitals and are also increasing our lab capacity. Speaker, let me be clear, this is our top priority and we have a plan that is going to work. A supplementary question. Thank you, Speaker, and thank you to the Minister of Health for your response. The Minister of Finance is reserving to hear that our government continues to follow this situation closely. Our government is aware of their uncertainty and their currency exists but understands the importance of managing these risks. Could the Minister of Finance please explain what our government is doing to ensure we are prepared to respond to their economic impacts as this situation continues to unfold? Questions to the Minister of Finance. Thank you to the member from Markham Unionville for that question. And as always, as with all my colleagues, I appreciate his counsel and advice as we look at the economic impacts. First and foremost, of course, are making sure that the health resources are in place and we've made it clear to our frontline workers as well as to Ontarians that the resources required to address this issue will be in place to support the health of Ontarians. But we are also in the midst of a difficult economic situation internationally and we continue to monitor that situation. I can say that it is to the best instance of Ontarians that this government has been focused on a prudent, responsible approach to finances. As I mentioned in this legislature last week, the Parliamentary Budget's office, an independent office of the federal government, has indicated for the first time, Mr. Speaker, since they have been monitoring the fiscal stability of this province, Ontario is on a stable financial footing. This will serve us well as we deal with the uncertainties ahead and your constituents and the rest of the Ontarians can rely on us to manage the books financially. Thank you very much. The next question, the leader of the official office. Thank you, Speaker. My question is for the Premier. This morning I announced that I'll be introducing a private members bill that if passed would protect the independence of the Ontario Human Rights Commission. There's a need, Mr. Speaker, because as we've seen with the Premier's attempt to appoint his buddy Ron Tavener to the top job in the OPP, this government cannot stop meddling in the independent appointment process. Despite over 300 applications to the commission made through the proper process and agreed upon channels, this Premier went ahead and appointed his own picks for commissioners, including one who the integrity commissioner found would often be in a conflict of interest and therefore unable to do the job much of the time. Does the Premier believe he should be meddling in the Ontario Human Rights Commission? Attorney General, to reply. Thank you, Mr. Speaker. I look forward to seeing the bill that she announced at 9.45 this morning on the off chance. There's something constructive in it. I'm looking forward to it, Mr. Speaker. I am confident with the independence of the OHRC, Mr. Speaker, and the important work that they do. But here's the irony. Here's the irony, Mr. Speaker. The leader of the opposition would say we want to take the politics out of it, so we're going to politicize it. It makes no sense, Mr. Speaker. Now, Mr. Arsenal's credentials are unparalleled. They are unparalleled. He is exactly the kind of person that you would want on the commission. He has 20 years of frontline experience. He was an Aboriginal liaison officer, Mr. Speaker. He is so qualified. He was the first-ever holder of the community engagement officer, Mr. Speaker. And he is so unbelievable. But we know that the opposition have no use for our frontline police officers. They don't respect them. They don't want their input, and they discount everything you have to say, Mr. Speaker. The House will come to order. Start the clock. Supplementary question. Well, Speaker, I've never seen such a shameful response from an attorney general. He's by the United Nations, Speaker, when it comes to the independence of these very kinds of bodies. So shame on the attorney general. Shame on a member of this cabinet to behave in such an undignified way when this is an extremely, extremely important principle that we're trying to ensure is upheld in the province of Ontario. What my bill does is take the memorandum of understanding, which provides a clear understanding of how the appointment process for the Ontario Human Rights Commission should work, the very MOU that this attorney general refuses to sign, and actually enshrines it into law. I'd say that's a huge improvement. The Premier must stop trying to put his thumb on the scale to influence the appointment process, Speaker. It has to stop. So will the Premier do the right thing, the thing that is as a standard around the world, enshrined in the UN principles that were undertaken in Paris? Will he do the right thing, recognize the need for the Human Rights Commission to actually operate without government interference and support this extremely important bill? Mr. Speaker, it will come as no surprise to this House that the leader of the opposition is ill-informed again. I signed that MOU in February, Mr. Speaker, so we can put that to bed. Now, Mr. Speaker, the second part to this, order. Order. Order. I'm listening to the Attorney General's answer. So far he's said nothing that's unparliamentary. Order. The Attorney General. Thank you, Mr. Speaker. And the other irony here with the opposition is that they think by excluding perspectives and experience that they're being inclusive. That's how they think, Mr. Speaker. Only in the NDP world do they think that we should shun the advice of front-line officers who have something to contribute to the welfare of this province, Mr. Speaker. The Human Rights Commission is independent. They operate independently. They will continue to operate independently, and they're doing a fantastic job. Thank you, Mr. Speaker. Start the clock. The next question. Again, the member for Scarborough, Gilbert. Thank you, Speaker. My question is to the Minister of Health and the Deputy Premier. Minister, grocery shelves are losing stock of hand sanitizers, and I believe that people are following yours and others' advice to wash their hands with soap and water. But as concerns over COVID-19 grows, I believe that they need clarity from officials in terms of how to behave and how to act. And so far, I don't believe that your government is being clear, and I've listened to you this morning and the Premier as you've answered questions around, for instance, employers and giving paid time off to employees who need to self-quarantine or who have contacted this virus. The federal government has acted. Will the provincial government take clear and decisive action? We need to learn the lessons of 2003 from the SARS outbreak. That started in Scarborough. I paid close attention at that time. Will you ensure that the government restricts access to long-term care facilities in the event of a community acquired? Thank you very much. Minister of Health to reply. Thank you. Well, I would certainly agree with the member that we did learn lessons from SARS. We carefully learned those lessons and we put into place processes and protocols, including the Public Health Agency of Ontario, to deal with situations such as the one that we're facing now. So we do have a plan in place. We do have people at all levels who are prepared to take action as they need to. We are following this situation very, very closely. We are letting the public know about every step that we are taking. We are being open and transparent about it. Dr. Williams, our Chief Medical Officer of Health, is the one that is doing the daily briefings. I believe that is very important, so the people of Ontario hear directly from him, not through me, not through what some might perceive to be a political lens. They are hearing directly from him about the steps that they need to take. I will expand further my supplemental. Thank you, Speaker. I want to thank the Minister for her answer. Minister, I believe that at times like this, we need to take courageous action. And the Public Health units, as you know, they are the heroes. They are the ones that protect our societies, our communities from communicable diseases. Sudbury just received its first case of confirmed COVID-19, so it is now spreading to the north. Right now, under your ministry's expectations, there is a modernization effort. There are cuts that have been made to public health boards and public health units, and there's downloading to municipalities. It's not the time for that. So will you suspend that action so that 100% of the resources available to our public health teams across this province can be put toward defending the public against this unknown virus and making sure that Ontarians are protected? Minister of Health. Thank you. I will agree with the member that our Public Health units and people in public health, as well as front-line protective personal health workers, are the ones that we should be applauding and celebrating and giving them all of the resources that they need in order to do their jobs. I actually spoke with Ms. Blair, who's working with Mr. Pine this morning with respect to the consultation efforts that are being done by Mr. Pine and his group with respect to municipalities and the work that the public health units are doing. They have put their consultations in abeyance because they know that the public health units have to put all of their resources right now into dealing with COVID-19. That is the appropriate use. We need to make sure that we respond to the absolute priorities in public health. That is what they are now doing, and that's what we would expect them to do. I thank them for their continued efforts. Thank you very much, Mr. Speaker. My question is for the Minister of Children and Women's Issues. Speaker, the members involved in developing the anti-human trafficking strategy have spoken of consultations, roundtables and insights they have received from those on the front lines who have devoted their time to support the survivors of trafficking. We know that there is no better measure of success than of feedback from those who work directly on such challenging issues, and as such we understand how impactful their opinions are. Speaker, can the Minister please tell the House what kind of response they have received from these frontline care providers following the launch of the anti-human trafficking strategy? Thank you. The Associate Minister of Children and Women's Issues. Thank you, Mr. Speaker, and thank you to the members from Mississauga and Mr. Tuxwell for that question. Our government worked to ensure that our new anti-human trafficking strategy was designed with the input of those who spend every day on the front lines who help us create a strategy that would truly serve the survivors of this heinous crime. Speaker, following our announcement, we were encouraged by the tremendously positive responses from these community leaders across Ontario. These are people like Karen Kennedy, President and CEO of Boost Child and Youth Advocacy Centre, who said, and I quote, I commend the provincial government for recognizing the serious issue of trafficking of girls and women in Ontario. They are taking bold steps to implement a comprehensive strategy that supports and enhances the work of community stakeholders, law enforcement and criminal justice across sectors to prevent and hopefully bring an end to this terrible crime. We have listened to stakeholders and brought in a real plan that will make a difference. The supplementary question. Thank you, Speaker, and thank you to the Minister for that response. Speaker, human trafficking is a completely unacceptable and disgusting crime and the victims deserve the appropriate support to heal. Speaker, a large part of the new anti-human trafficking strategy is focused on First Nations, Métis and Inuit communities. We all know too well that Indigenous women and girls are at a higher risk of being assaulted and trafficked. We also know that they need Indigenous-led and Indigenous-specific supports to help them heal from the trauma of being sex trafficked. This requires working with Indigenous partners and organisations to provide the most appropriate supports. Can the Minister explain how this strategy addresses the specific needs of Indigenous communities across Ontario? Minister? Thank you for your question. It has been an honour to have been able to speak with experts from across Ontario who work firsthand with survivors of trafficking. This includes Indigenous partners such as Chiefs of Ontario and Native Friendship Centres and more. They have worked tirelessly to support victims across Ontario and we are determined to ensure that the strategies we implement not only support their work but are well aligned with the principles of trauma-informed culturally appropriate care. We made a focus to have not just Indigenous-informed but Indigenous-led supports that met the needs of the organisations providing service but, more importantly, to the survivors who are healing from their trauma. I want to personally thank the Ontario Native Women's Association for their advocacy and work on this with our government and to thank you to Coraline McGuire-Syrett for her passion on this issue. I am truly honoured to have your support as we work to fight against the exploitation of Ontario's women and girls and we intend to work with you every step of the way to ensure that those who are victimised in trafficking have the care. The next question, the member for Brampton Centre. Thank you. Good morning, Speaker. My question is for the Premier. Today we are joined by Rakesh Tawari who has been waiting nearly a decade for justice. His son Prashant passed away at Brampton Civic Hospital in 2014 while he was on a 24-hour suicide watch. He was left unsupervised for nearly three hours, a clear break from protocol. Speaker, I knew Prashant personally. He was my brother's closest friend, a vibrant young man who reached out to the system for help. And the mental health system failed him as it continues to fail so many young people across this province. The Tawari family has been seeking justice and hoping for answers to prevent future tragedies here in our hospitals, but have been unable to get a court date due to a backlog of cases in our courthouse in Brampton and across the GTA. Does the Premier understand what it means to families like Prashant to wait for years and years to access justice? The Attorney General will apply. Thank you Mr. Speaker and thank you to the member from Brampton Centre for highlighting this challenge and the member from Miss Saga Centre had previously brought it to my attention as well. It is a troubling situation Mr. Speaker and obviously I can't comment on individual situations but I can comment on the state of the courts as we inherited them from the previous government. It is a terrible situation and we are working hard every day to fix it and the Brampton Courthouse is a good example where we're close to finishing the construction to open up more courtrooms to create more capacity. I talk every day with justice stakeholders and I'm meeting with the Chief Justice again tomorrow to talk about a variety of issues just like this because victims need to and families and those who are impacted by our system need to get the service that they deserve Mr. Speaker and I look forward to speaking more with you in the supplementary. Thank you. The supplementary, the member for Brampton East. Back to the Premier. Nearly seven years ago Prashant Tabari was taken from us. He was under suicide watch at Brampton Civic when he took his life. He was only 20 years old. For nearly seven years his family has been asking how could this happen? How could he take his life when he's at a hospital when he was supposed to be safe and protected? To get the answers and justice they deserve the Prashant family has taken their matter to court. Prashant was my friend. He was a special young man. He was an amazing athlete, a passionate artist. He was wise beyond his years. All the family wants is to have their day in court but because of the backlog in our justice system there are literally no days available. They're waiting and waiting to no end. Prashant's family is here today in the Assembly. They deserve to have their case heard. Premier, justice delayed is justice denied. Will you act now to address the backlog in our justice system so that their family and the many other families that are waiting don't have to wait any longer? Mr. Speaker I'd like to thank the member for the question and the comment and the background. It is true that justice delayed is justice denied. It is something that troubles me. It's something that we've been working on from the moment we got elected Mr. Speaker and it's something we know impacts every member of society especially a situation like this a very very tragic situation and we know that we can do better. We know that the system needs to be modernized needs to be updated. We need more capacity. We need to use the resources we have properly. I'm open to any ideas that members may have, the public may have. We're working every day to make the system work better and fix what was left behind to just decay quite frankly and it's shameful that the previous government let that happen. Thank you Mr. Speaker. Thank you very much. Next question member for Flamboy. Good morning Mr. Speaker. My question is for the Minister of Energy, Northern Development and Mines and Indigenous Affairs. Mr. Speaker the film and television industry knows the North is a prime destination for productions making significant contributions to Ontario's economy. We are increasingly recognized as a destination of choice because we have the infrastructure needed for high quality film and television productions. Can the Minister tell us about the significant investment he made in the Sudbury film industry just last week? Thank you Mr. Speaker. I was so excited to be back in Sudbury last week and especially at Science North. I want to shout out for D. Labine and the extraordinary work he does at Science North. It's no longer Sudbury North as we had made a pact a number of years ago to ensure that the amazing things that go on there tweak the curiosity of kids all across Northern Ontario and they've done that. But we were there on that day Mr. Speaker to announce more than 8.5 million dollars in 12 local productions. Season 5 of Letter Kenny. The children's very popular French television series Emily et Campagnier. Science North production of Jane Goodall's response for Hope. IMAX film Mr. Speaker. Ontario is home to Hollywood blockbusters and Oscar and Emmy award-winning films. We especially appreciate the great work that's being done in Sudbury in North Bay and Canador College producing an amazing platform Mr. Speaker to celebrate Northern Ontario's heritage response television production. Way to go Sudbury North Bay and Canador College. Supplementary question. Thank you Minister for the answer and included in the eight and a half million dollar investment was 1.6 million dollars for TFO and carte blanche films to produce seasons three and four of the French language children's television series Emily et Campagnier. It also included an investment in Cinefest the Sudbury Film Festival for the 32nd Cinefest Sudbury International Film Festival in September of this year. Can the minister tell us the importance of these French language investments? Minister to reply. Thank you Mr. Speaker. I appreciate the question. We want to support the film industry in the north of Ontario because we want to build Ontario together. This plan allows us to create more jobs that are well paid and ends with production and post production in the movies and TV shows. We have new investments so that northern communities can grow and prosper especially in Sudbury and North Bay where this sector is growing. The next question the members of Parkdale High Park. Thank you Speaker. My questions to the Premier. This government wants to pretend that their cuts to education this year had no impact on the classroom. Well try to tell that to Lauren a student in my riding who thanks to conservative cuts had her great 12 biology class a class that she needs to graduate and get into university become unavailable this year when she asked her school what she should do the options were night school or drop out. Mr. Speaker it is absolutely appalling that students have had courses that they need to graduate cancelled and this is the state of affairs that the government wants to continue going forward. When will this government apologize for using students like Lauren as pawns in their war against our public school system. Thank you very much Speaker. The aim of the government continues to be to get a deal. It is why today we're before three of our labour partners to drive finality to over 300 days of negotiating that students could stay in class. That's our obligation to every student this province and our hope in this negotiations to advance a good deal for students. One that ensures that classroom sizes remain effectively frozen in both elementary and in high school. A plan that will see more money's flowing for special education to 100% to support those with the greatest needs in our schools. It is a plan Speaker that ensures that merit guides hiring. Overall we believe this is a plan that will ensure students succeed get ahead and get access to good jobs in the future Speaker. Supplementary question. Speaker. The Conservatives think that their plan to kick kids out of the classroom and onto the Internet will replace the teachers that have been fired so far. But again students like Lauren have found exactly the opposite has happened. She tried to sign up for an online course to replace her biology class despite biology labs being almost impossible to complete online. But it turns out that even those online classes were unavailable thanks to course cancellations and class size changes. Again to the Premier when gifted students like Lauren are struggling with online learning why did this government ever think that forcing these programs on to every student was a good idea. Good question. Minister of Education reply. Well thank you member thank you to the member opposite for the question just if I may provide an update on the Toronto District School Board they provide their staffing information just two days ago based on the new provincialized average of 23. What Toronto District School Board said is that staffing decisions will have no fiscal impact to the board at 23. There will be a projected increase of 21 secondary teaching positions as a consequence and there is not expected to be losses of secondary school programs and course offerings for student speaker. So I just want to make sure that that remains a debate. What I would also assert to the member opposite that's for 2021 and the bottom line is speaker our aim remains today with three of our Federation partners to get a deal to keep kids in class and advance a program that works well for parents that freezes classroom sizes that gives an opt-out for online learning that ensures special ed funding continues to flow for those with the greatest needs. It is a good response and the time is now to get it done speaker. The next question the member for Perry Salmos. Thank you Mr. Speaker my question is for the Minister of Finance. Many families are worried about the high cost of child care especially through the summer. My writing of Perry Salmos spoke as home to many great summer camps where kids have the chance to explore and enjoy the outdoors. For example for 90 years now the YWCA camp Tapa Wingo near Perry Sound has been growing has been providing enriching and rewarding camping experiences for young girls. For many parents camps are more than just learning learning experiences for their kids. There are also necessary forms of child care which allow parents to continue to work while school is out. Mr. Speaker can the Minister inform the House how our plan to build Ontario together is working to make child care including summer camps in Ontario more affordable. Mr. Finance. Mr. Speaker through to the member thank you the member from Perry Sound, Muskoka for that question. Mr. Speaker our plan to build Ontario together is making life more affordable to the tune of three billion dollars of relief Mr. Speaker this year. Mr. Speaker we're providing relief to those who need it most including 300,000 low and middle income families who Mr. Speaker will be eligible for up to $1,250 per child on average in terms of relief for child care expenses and by doing so we're letting those parents make the choice about the best child care option for their family and it and and that does include as the member pointed out summer camps another very very effective means for parents to seek child care. In addition we're also investing a billion dollars over the next five years to create 30,000 new child care spaces. Mr. Speaker Mr. Speaker that's all part of our government's pragmatic plan to make Ontario families have a more affordable life and to build Ontario together. Supplementary. Well thank you the minister for that answer I'm happy to hear that our government is providing a relief in the form of the child care tax credit for parents across the province and proud our government is focused on putting more money back into the pockets of Ontario's hardworking families. I'm also pleased to hear that summer camp costs are eligible for the care tax credit. Summer camps provide not only great experience for campers but good summer jobs for young people. Can the minister please elaborate on how our government is making it easier for parents to afford child care. Well Mr. Speaker the member is absolutely right we are leaving more money in the pockets of Ontarians every day because it's the right thing to do as a result of our balanced and prudent approach to managing the public's finances we're able to do that while we still invest in vital services like health care education transit and roads. We're also keeping more money in the pockets of low income Ontarians Mr. Speaker saving them up to $850 for 1.1 million Ontarians starting this year. We're helping entrepreneurs grow the economy Mr. Speaker with 5.4 billion dollars for those job creators so that they can grow this economy and keep it going. Our plan is already making a difference Mr. Speaker as I mentioned already the parliamentary budget officer said that Ontario is now on a fiscally sustainable course. This is what our plan to build Ontario together is all about. The next question the member for University of Rosedale. Thank you Speaker my question is to the Premier. Yesterday the city of Ottawa said the P3 private consortium operating its failing LRT system deserves a quote kick in the pants. That's because after opening only six months ago Ottawa's new LRT has been saddled with problem after problem after problem. Ottawa City Council is sending a notice of default to the P3 group because unlike what Ottawa was promised the LRT wasn't built on time and certainly hasn't been built on budget. The city has spent countless dollars to bring in relief buses while transit users struggle to get where they're going on time. Why given all the evidence of the P3 is a substantial failure would this government continue to ignore our call for a moratorium on P3s until the Auditor General has done a review. Great question. To respond on behalf of the government the Minister of Infrastructure. Well thank you Mr. Speaker and I thank the member officer for the question. You know as I've said in the legislature many times Ontario is making the largest investment in infrastructure that has ever occurred before $144 billion over 10 years Mr. Speaker. You know using P3s enable us to build the critical infrastructure that our municipalities and everyone in our province wants Mr. Speaker. I've said before since 2005 infrastructure Ontario has built 125 projects worth over $100 billion Mr. Speaker. So I say to the member opposite does she not want roads does she not want transit does she not want schools does she not want correction facilities does she not want That concludes question period this morning. I understand them. I understand the member for Timmons has a point of order. I'd ask the House to come to order so I can hear it. Mr. Speaker I have a rise on a point of order understanding order section 25 in response to the leader of the opposition Attorney General Rose today and claimed that a moratorium under understanding with Human Rights Commission was signed in February. We have checked with Human Rights Commission that is not the case there has been no signed document and the member should withdraw his car and apologize. Could I please have an opportunity to respond. It's not a valid point of order in this case. Do you have another point of order. Second point of order but I know I can't challenge you but we'll leave it at that at this point. I will I I stand Mr. Speaker in regards to standing order 22 standing order 22 says the use of laptops tablets and smartphones is permitted in the chamber and committee rooms provided they are operated suddenly do not impair impaired decorum. It goes on to say and are not used as telephone recording devices cameras or props earlier today during question period the member from Branford brand was recording members of my caucus or filming with his camera with his camera or recording with his telephone. What was going on on this side of the house. I ask you to bring this member under control and then he delete whatever he's done over here. Order member for Tim is absolutely correct in his contention that standing order 22 and I'll repeat it for all members the use of laptops tablets and smartphones is permitted in the chamber and committee rooms provided they are operated silently do not impair decorum and are not used as a telephone recording device camera or prop that's a new standing order that the house has adopted. There's been a suggestion made that the member for brand brand for brand has used his phone inappropriately I'm going to ask him if he wishes to comment on the point of order. Mr. Speaker I am aware of the standing orders I would not do that with my mobile device and if I left anyone with that impression I apologize profusely thank you. The member for order order the member for Hamilton Mountain must withdraw for unparliamentary come on comment. I'll withdraw. And the chair has to assume that all members are honourable but I hope I've made myself abundantly clear reading the standing order and all members understand it for future reference. We have a deferred vote on government notice of motion number 75 relating to the allocation of time on bill 156 enact to protect Ontario's farms and farm animals from trespassers and other forms of interference and to prevent contamination of Ontario's food supply call in the members this will be a five minute bill. I'm going to ask the members to please take their seats. I'm going to ask the members again to take their seats. On March 10th 2020 Mr. Calandra moved government notice of motion number 75 relating to allocation of time on bill 156 enact to protect Ontario's farms and farm animals from trespassers and other forms of interference and to prevent contamination of Ontario's food supply. All those in favour of the motion will please rise one at a time and be recognised by the clerk. Mr. Calandra, Mr. Lecce, Mr. Fidelli, Mr. Fidelli, Ms. Elliott, Mr. Phillips, Mr. Bethan Fawley, Mr. Clark, Mr. Smith-Babe Quinty, Mr. Hardiman, Mr. Yacobesque, Ms. McLeod, Mr. Tobolo, Mr. Dunlop, Mr. Romano, Mr. Walker, Ms. Thompson, Mr. Downey, Ms. Fullerton, Ms. Jones, Mr. Sikaria, Mr. Scott, Mr. Rickford, Mr. Sirma, Mr. Coe, Mr. Bailey, Mr. Pettipese, Mr. McDowell, Mr. Joe Willedale, Mr. Gill, Ms. McKenna, Mrs. Martin, Mr. Parsons, Ms. Skelly, Mr. Nichols, Mr. Puccini, Mr. Miller-Perry Sound Muskoka, Mr. Barrett, Mr. Osterhoff, Mr. Tanagasa, Ms. Fee, Ms. Dababba, Ms. Hogarth, Ms. Cousindoga, Ms. Tanger, Ms. Wy, Ms. Carr-Hulley, Ms. Park, Mr. Kuzeta, Mr. Pan, Ms. Triantafilopoulos, Mr. Crawford, Mr. Cran, Mr. Rashid, Mr. Bowler, Mr. Smith-Petiber-Porta, Mr. Roberts, Mr. Cuck, Mr. Sandu, Ms. Gamari, Mr. Canapathy, Mr. Radbicki, Mr. Savalli, Mr. Savalli, Sorry. All those opposed to the motion will please rise one at a time and be recognized by the clerk. Mr. Bissau, Mr. Bissau, Madam Jeller, Ms. Fite, Ms. Singh-Brandtons-Sentz, Mr. Vantoff, Mr. Tabbes, Ms. Sattler, Ms. Shaw, Ms. Begum, Mr. Yarra, Ms. Taylor, Ms. Shamantha, Ms. Armstrong, Mr. Kernahan, Mr. West, Mr. Steven, Mr. Gates, Mr. Gretzky, Ms. French, Mr. Miller-Hamilton-Estony Creek, Mr. Miller-Hamilton-Estony Creek, Mr. Singh-Brandtons-East, Ms. Andrews, Ms. Andrews, Mr. Hatfield, Ms. Carpoching, Ms. Bert, Mr. Birch, Ms. Burns-Bagall, Mr. Arthur, Ms. Bell, Ms. Glover, Ms. Morrison, Mr. Rikosevich, Mr. Harden, Ms. Montieth-Farrell, Mr. Hassan, Mr. Fraser, Ms. Wynne, Ms. Hunter, Mr. Shreiner, Mr. Shreiner. The ayes are 62. The nays are 38. I declare the motion carried. There being no further business, this House stands in recess until 3 p.m.