DDO Legislative Update

A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.


Bill 160 – Strengthening Quality and Accountability for Patients Act, 2017


Introduced by Hon. Eric Hoskins, Minister of Health and Long-Term Care, the Bill was carried on First Reading on September 27, 2017.


This Bill amends, repeals and enacts various health-care related bills to strengthen quality and accountability for patients:


  1. Ambulance Act
    • Amendments are made in respect of directives by the Minister, appointment of Directors, powers of inspectors and investigator, disclosures, paramedics, fee rules, definitions and regulation making authority.
    • If passed, paramedics are given increased flexibility to deliver alternative care options on-scene to patients, avoiding unnecessary visits to the emergency department.


  1. Excellent Care for All Act, 2010
    • Ontario Health Quality Council (the “Council”) can lease office space without obtaining Lieutenant Governor in Council’s approval
    • Permit the Council to collect, use, and disclose PHI for purposes to be prescribed by regulations
    • Create exemption from application of the Freedom of Information and Protection of Privacy Act for records in custody/control of the Council that were prepared or obtained by the patient ombudsman in the course of conducting an investigation within meaning of section 13.3 of the Excellent Care for All Act, 2010.
    • Allow the government to make regulations specifying purposes for which Health Quality Ontario may collect, use and disclose PHI in its yearly reports


  1. Health Protection and Promotion Act
    • Replacing terms, adding Ontario Agency for Health Protection and Promotion as a recipient of reports regarding diseases and events, extending dismissal notice and attendant rights of medical officers of health to associate medical officers of health, remove approval requirements for an acting medical officer of health appointed by a board of health,  Minister may issues orders relating to new or emerging diseases and provisions related to such orders, amend matters subject to Lieutenant Governor in Council and Minister regulations, and remove transition provisions.
    • If passed, HPPA, would permit regulation of recreational water facilities like splash pads and pools to protect infants and children. It would also regulate personal service settings like barber shops, nails salons, and tattoo parlours to better prevent infection.


  1. Health Sector Payment Transparency Act, 2017
    • This is a new Act and has been getting a lot of coverage in the media. The purpose of this Act is to require the reporting of information about the financial relationships that exist in Ontario’s health care system, including health care research and education , and to enable the collection, analysis and publication of that information in order to strengthen transparency.
    • The Act requires certain transactions to be reported to the Minister who will analyze and publish the information and it also establishes a framework for inspections and other compliance mechanisms.
    • The Act provides for periodic review by the Minister.
    • The medical industry would have to report all information about transfer of value, which include meals, hospitality, travel associated expenses and financial grants. This information would be available online, and can be accessed by the public.


  1. Long-Term Care Homes Act, 2007
    • “Secure units” provisions are repealed and a new system is enacted to deal with the restraining and confining of residents.
    • System of administrative penalties are provided for, Director and Minister is given power to suspend a license. The Minister may also make operational and policy directives in respect of long-term care homes.


  1. Health Care-Consent Act, 1996
    • Act is amended to provide rules with respect to confining in a care facility, and respecting reviews by the Consent and Capacity Board.


  1. Personal Health Information Protection Act, 2004
    • Related amendments are made to PHIPA


  1. Substitute Decisions Act, 1992
    • Related amendments are made to SDA


  1. Medical Radiation and Imaging Technology Act, 2017
    • This Act repeals and replaces the Medical Radiation Technology Act, 1991. This Act governs the practice of medical radiation and imaging technology.


  1. Ontario Drug Benefit Act
    • This Act is amended to specify that regulations are not required in order for the Minister and the executive officer to disclose personal information.
    • 23(3)(b) is repealed and replaced to make a change relating to establishing reimbursements criteria for certain drug benefits listed on the ODB Formulary. Currently, section 23 of the ODBA indicates the reimbursement criteria for these benefits could include a requirement that the use of a drug be prescribed by a physician or member of a class of physicians specified by the executive officer. The amendment provides the executive officer to establish the reimbursement criteria relating to any prescriber or class of prescribers and not only physicians.


  1. Ontario Mental Health Foundation Act
    • This Act is repealed, and consequential amendments are made to other Acts.


  1. Oversight of Health Facilities and Devices Act, 2017
    • Regulatory system is established for community health facilities and energy applying and detecting medical devices such as X-ray machines, CT scanners, ultrasounds and MRIs.
    • The position of executive officer for the regulatory system is created.
    • Inspecting bodies are made to carry out functions with respect to community health facilities.
    • Wide range of enforcement tools are provided for.


  1. Independent Health Facilities Act, Healing Arts Radiation Protection Act and the Private Hospitals Act are repealed.


  1. Retirement Homes Act, 2010
    • The Act is amended to allow the Minister, if it believes it is within public interest to do so, to unilaterally amend the MOU between the Minister and the Retirement Homes Regulatory Authority (“Authority”) after giving the Authority the notice that the Minister considers reasonable in the circumstances.
    • The Minister may require the Authority to:
      1. Establish advisory committees and policy, legislative or regulatory reviews related to the Authority be carried out.
      2. Make available to the public certain information relating to the compensation for members of its boards of directors or officers or employees of the Authority.
    • Auditor General may audit the Authority
    • 70 of the Act is made more specific regarding the permitted confinement of residents of a retirement home.
    • Power of an investigator under s. 80 of the Act to conduct investigations under a warrant are expanded
    • Registrar may apply to the Superior Court of Justice for an order directing a person to comply with a provision of the Act or the regulations made under it or with an order made under the Act. Upon application, the court may make any order that the court thinks fit.


For more information about the Bill: http://www.ontla.on.ca/web/bills/bills_detail.do?locale=en&Intranet=&BillID=5096

News Release by MOHLTC: https://news.ontario.ca/mohltc/en/2017/09/ontario-improving-transparency-in-health-care.html

Backgrounder by MOHLTC: https://news.ontario.ca/mohltc/en/2017/09/strengthening-quality-and-accountability-for-patients-act-2017.html



Ontario Regulation 358/17

O.REG 358/17 is an amending regulation of RRO 1990, REG 460 under the Freedom of Information and Protection of Privacy Act.

The Schedule designates agencies, boards, commissions, corporations and other bodies as institutions and persons as head of that institution is updated to include:

  • Health Shared Services Ontario, and the CEO

The following institutions have been removed from the Schedule:

  • Ontario Seniors’ Secretariat
  • Ontario Women’s Directorate
  • Pan/Parapan American Games Secretariat
  • Provincial Advisory Committees

This regulation came into force on September 5, 2017.

For more information about the regulation:  https://www.ontario.ca/laws/regulation/r17358


Articles of Interest

TGLN & Constitutional Challenge

Liver Transplant rules violate my rights, dying man says

Recovering alcoholic’s unique court battle for liver transplant shelved after his health improves


Ontario bill will reveal drug company payments to doctors

Canada’s access to information system faring worse under Trudeau government-audit

Opioid Crisis

Public Health Board Members call on Ontario to declare opioid crisis state of emergency

Statement on Ontario’s Opioid Strategy

Pharmacies lobby for mandatory $75 prescription consult to help curb opioid crisis

Health Care

Ontario poised to reopen shuttered hospital to cope with bed crunch

‘Working with one arm tied behind our back’: Hospitals are ill-equipped to treat obese patients, experts say

Grey Matters: Medical mistakes made on patients must be red-flagged

Mental Health

Human rights commission accuses Ontario of mistreating prisoners with mental health issues

Ontario teen who lost parents urges feds to create national mental health plan

Health Litigation

Brampton family goes to court to keep daughter on life support

Ottawa spent $110K in legal fees fighting First Nations girl over $6K dental procedure


Ottawa woman named chair of Ontario’s first Patient and Family advisory council after daughter’s death

Ontario appoints supervisor for Brant Community Healthcare System

Interesting Reads

Untold story of the Canadian Kardashians

What’s happening in our city this weekend:

Chef Gordon Ramsey just helped launch Cobalt Social pop-up restaurant in Toronto

AGO: Guillermo del Toro: At Home with Monsters

Interesting Podcast to make your commute better:

My Favorite Murder: https://itunes.apple.com/us/podcast/my-favorite-murder-karen-kilgariff-georgia-hardstark/id1074507850?mt=2

DDO Legislative Update

A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.


Bill 126: Illegal Pill Press Act, 2017

Introduced by

Michael Harris, MPP (Kitchener—Conestoga)

  • Critic, Research, Innovation & Science
  • Member, Standing Committee on Estimates
  • Critic, Transportation
  • Progressive Conservative Party of Ontario

Current Status

  • April 27, 2017: First Reading – Carried
  • September 21, 2017: Second Reading – Debate
    • Second Reading – Carried
    • Ordered referred to Standing Committee – Standing Committee on General Government


This Bill makes changes to the Drug and Pharmacies Regulation Act. It proposes to prohibit a person from possessing or using designated pharmaceutical equipment, unless that person is either a pharmacist or a person acting under the supervision of a pharmacist. Also, if the person uses the equipment, he or she must use the equipment in a pharmacy that has received a certificate of accreditation.

A designated pharmaceutical equipment is considered any of the following: a pill or tablet press, a tablet machine, a capsule filling machine, a pharmaceutical mixer or a tablet punch or die, subject to the qualifications, if any, that are specified by the regulations made under the Act, and any other equipment that is specified by the regulations.

Full Text of the Bill




Homes for Special Care Funding Rate Increase

The Ministry of Health and Long-Term Care wants to modernize the Homes for Special Care program. The proposed regulations include the following changes, with effective date of January 1, 2018 or the date the regulation is filed, whichever is later:

  • 43 of Regulation 636 under the Homes for Special Care Act be amended, authorizing the Ministry of Health and Long-Term Care to provide a 3% increase in the funding rate provided to licensees.
  • Funding rate per person will increase from $1,556.12 to $1,602.80 for each full month the tenant receives care in the home.
    • The daily funding rate per person (for periods less than a month) is proposed to increase from $51.16 to $52.69.

Comments due: October 19, 2017

For more information about the regulation: http://www.ontariocanada.com/registry/view.do?postingId=24905&language=en


Homes for Special Care Modernization (OPDP)

As above, this proposed change also relates to the modernization of the Homes for Special Care program, to take effect on January 1, 2018, if approved. The Ministry of Health and Long-Term Care is proposing an amendment to Ontario Regulation 201/96, under the Ontario Drug Benefit Act, to support the Community Homes for Opportunity program, an initiative related to the Homes for Special Care program. The Ministry of Health and Long-Term Care is proposing to prescribe persons who reside in homes that are part of the Community Homes for Opportunity program who are insured persons under the Health Insurance Act as a class of eligible persons for the purposes of the Ontario Drug Benefit Act.

Comments due: October 19, 2017

For more information about the regulation: http://www.ontariocanada.com/registry/view.do?postingId=24906&language=en




DDO Legislative Update

A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.



Bill 154: Cutting Unnecessary Red Tape Act, 2017

Introduced By:

Brad Duguid, MPP

  • Minister of Economic Development and Growth
  • Ontario Liberal Party

 Current Status

  • September 14, 2017: First Reading – Carried


The Bill is part of a government initiative to “cut unnecessary red tape” – red tape is an idiom that refers to excessive regulation or formal rules. The Bill enacts, amends, and/or repeals many Acts. The Schedules set out the amendments/repeals of the Acts separately. Some Schedules bare the name of a Ministry, which indicates that the Schedule relates to Acts that are administered by that Ministry or affect that Ministry.

These are the Schedules in this Bill (bold indicates likely relevance):

  • Schedule 1: Ministry of Agriculture, Food and Rural Affairs
  • Schedule 2: Ministry of the Attorney General
    • This Schedule includes changes to the Charities Accounting Act                               
  • Schedule 3: Repeal of the Employers and Employees Act
  • Schedule 4: Reducing Regulatory Costs for Business Act, 2017
  • Schedule 5: Ministry of the Environment and Climate Change
  • Schedule 6: Ministry of Government and Consumer Services — Corporate Amendments
  • Schedule 7: Ministry of Government and Consumer Services — Corporations Act and Related Amendments
    • This Schedule includes changes to the Business Corporations Act and other corporate acts
  • Schedule 8: Ministry of Government and Consumer Services — Not-for-Profit Corporations Act, 2010 and Consequential Amendments
  • Schedule 9: Ministry of Government and Consumer Services — Registration and Other Statutes
  • Schedule 10: Ministry of Municipal Affairs
  • Schedule 11: Accessibility Amendments

Full Text of the Bill



Bill 151: Workplace Safety and Insurance Amendment Act (PTSD Benefits), 2017

Introduced By:

Taras Natyshak, MPP

  • Critic, Digital Government
  • Critic, Community Safety and Correctional Services
  • Critic, International Trade
  • New Democratic Party of Ontario

Current Status

  • September 12, 2017: First Reading – Carried
  • September 14, 2017: Second Reading – Debate
    • September 14, 2017: Second Reading – Carried on division
    • September 14, 2017: Ordered referred to the Standing Committee on Regulations and Private Bills


The Bill amends the Workplace Safety and Insurance Act, 1997. Section 14’s application is expanded to include entitlement to benefits under the insurance plan for posttraumatic stress disorder to

  • nurses,
  • health care workers that provide assistance to first responders, and
  • workers, with the exception of police officers, who provide police services or support the work of people who provide such services.

Full Text of the Bill



Bill 149: Ministry of Mental Health and Addictions Act, 2017

Introduced By

France Gélinas, MPP

  • Critic, Health
  • Critic, Pharmacare
  • Deputy Third Party House Leader
  • Critic, Francophone Affairs
  • New Democratic Party of Ontario

Current Status

  • September 11, 2017: First Reading – Carried
  • September 14, 2017: Second Reading – Debate
    • Second Reading – Carried on division
    • Ordered referred to the Standing Committee on Finance and Economic Affairs


The Bill establishes the Ministry of Mental Health and Addictions. Section 4 highlights the functions and duties of the Minister.

Full Text of the Bill




Proposed Regulatory Amendment to O. Reg. 386/99 under the Home Care and Community Services Act, 1994 (HCCSA) Relating to Direct Funding Agreements for the Purpose of Self-Directed Care (SDC)

In May 2015, the Ministry announced the “Patients First: A Roadmap to Strengthen Home and Community Care”, which was a three-year plan to improve and expand home and community care. This included the Self-Directed Care initiative – clients are able to hire their own provider, or purchase services from a provider of their choice, using funding provided directly to them.

The proposed regulatory amendment would:

  • Specify the community services that LHINs may fund when providing direct funding to, or on behalf of, a person to purchase a community service;
  • Identify who the eligible client cohorts are; and
  • Exempt LHINs from the current service maximums that are in place for personal support services regarding direct funding agreements for the purpose of self-directed care entered into with, or on behalf of, adults with an acquired brain injury.

This would apply where the Minister has approved a LHIN to provide funding to, or on behalf of, a person to purchase a community service.

Comments due: October 9, 2017

For more information about the regulation: http://www.ontariocanada.com/registry/view.do?postingId=24865&language=en

Proposed regulatory amendments for the regulation of diagnostic medical sonographers under the College of Medical Radiation Technologists of Ontario

The proposed regulation would regulate the technologists that perform diagnostic medical sonography under the College of Medical Radiation Technologists of Ontario (CMRTO). The proposal includes:

  • Establishing a minimum entry to practice, along with quality assurance requirements
  • Providing a province-wide complaints and discipline mechanism administered by the CMRTO
  • Providing employers, practitioners, and the public with relevant information about the practitioners’ qualifications and their past conduct on the CMRTO’s public register

Comments due: October 16, 2017

For more information about the regulation: http://www.ontariocanada.com/registry/view.do?postingId=24694&language=en

Proposed amendments to Ontario Regulation 79/10 under the Long-Term Care Homes Act, 2007.

Many amendments are being proposed, and if approved, it is proposed that they would come into effect on January 1, 2018. Amendments include:

  • Allowing the Director under the Act to designate reunification priority access beds for persons in crisis seeking to be reunified in a long-term care home with their spouses/partners.
    • There would be separate waiting lists for these beds, with requirements to be on the wait list and priority for admission to these beds to be set out in the regulation.
  • Requiring the Minister or Director under the Act to disclose personal information about an individual to a health regulatory college and the Ontario College of Social Workers and Social Services Workers, if the Minister or Director is of the opinion that it is advisable to do so.
  • Enabling the Director under the Act to designate specialized units on his/her own initiative.
  • Permitting the Ministry to serve a document by using a commercial courier.

Comments due: October 26, 2017

For more information about the regulation: http://www.ontariocanada.com/registry/view.do?postingId=24855&language=en


PHIPA: Mandatory Breach Notification

The Information and Privacy Commissioner of Ontario (“IPC”) recently released a guidance document explaining when privacy breaches must be reported to the Commissioner. The Guidelines are entitled “Reporting a Privacy Breach to the Commissioner: Guidelines for the Health Sector” (September 2017).  The Guidelines also require custodians to begin tracking statistics on privacy breaches as of January 1, 2018 and to begin filing an annual report with these statistics on March 1, 2019.

When does the requirement to report certain breaches to the IPC take effect?
These reporting requirements come into effect October 1, 2017, via amendments to the PHIPA Regulation.

Who reports?
Health information custodians with custody and control of personal health information.

What is to be reported?
Any of the categories of breaches described in the PHIPA regulation.

In the Guidelines, the IPC breaks down the categories of mandatory privacy breach reports and gives some examples of circumstances that must be reported. There are 7 categories of breaches – but only one category is necessary to trigger the requirement to report. The categories are:

  • use or disclosure without authority
  • stolen information
  • further use or disclosure without authority after a breach
  • pattern of similar breaches
  • disciplinary action against regulated health professionals
  • disciplinary action against non-College members
  • significant breach.

These Guidelines apply to reports that must be made to the Commissioner and they are not applicable to notification of individuals whose privacy has been breached.

When should notice be given?
The Guidelines do not specify when notice is to be given; however, it is wise to make such reports as soon as reasonably possible after the breach occurs. The IPC may be able to offer guidance toward mitigating the effects of the breach.

The Guidelines are available here:


Contact us for guidance on when to report privacy breaches or to participate in our Privacy Officer training.

For more information contact mjdykeman@ddohealthlaw.com or spalter@ddohealthlaw.com.

DDO Legislative Update

A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.


The Ontario Legislature has adjourned until September 11, 2017.



No new regulations of interest.

Articles of Interest


Opioid Crisis

A public health crisis: health-care workers call on Ontario to declare opioid emergency

My son’s death offers lessons for ending the overdose epidemic


Personal Support Workers

Why doesn’t Ontario want health-care workers to be accountable?



Docs in northeast first to get provincially funded training in medically assisted dying



Health Canada reviewing fix to protect pacemakers from hackers


First Nations

Jane Philpott looks to bring Indigenous health delivery to new department



Save your health, boost your career

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