DDO Health Law Update

April 26, 2019: A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.

Bills

 

Bill 100, Protecting What Matters Most Act (Budget Measures), 2019

 

This Bill is still in second reading.

More Information: Bill 100

Proposed Regulations

 

REG 201/96 – Implementing a Health Network System Processing Fee, Ontario Drug Benefit Act (“ODBA”)

MOHLTC is proposing amendments to the regulation under the ODBA that would change pharmacy reimbursement policies to introduce an administration fee for the processing and payment of drug claims, and establish a smarter, more efficient and fiscally responsible system to delivery publicly funded health benefits. This amendment is conditional on the introduction and passage of legislative amendments related to the ODBA. The amendments would introduce an administration fee of $0.10 for the processing and payment of drug claims, and would be deducted from each claim for payment submitted by a pharmacy for a drug funded under the Ontario Drug Benefit Program.

More Information: https://www.ontariocanada.com/registry/view.do?postingId=29431&language=en

Comment Due Date: May 24, 2019

 

Reg 201/96 – Establishing Efficient Pharmacy Reimbursement Policies, ODBA

MOHLTC is proposing the following amendments:

  • Prescribing a tiered mark-up payable to pharmacies and dispensing physicians for supplying listed drug products under the ODBA that is based on the cost of the drug dispensed; and
  • Removing the payment of a dispensing fee for drug products supplied for a long term care (“LTC”) home resident by a pharmacy service provider retained by the LTC home. Instead of dispensing fee, these pharmacy service providers would receive a professional fee for all pharmacy services provided to the LTC home that is based on the number of beds in the home.

More Information: https://www.ontariocanada.com/registry/view.do?postingId=29454&language=en

Comment Due Date: May 24, 2019

 

Reg 79/10, Long-Term Care Homes Act, 2007

Proposed amendments allow the designation of High Acuity Priority Access Beds in LTC homes. Applicants meeting eligibility criteria would be placed on a separate waiting list. To be eligible, applicant would need to require and likely benefit from the following:

  • Ongoing nursing and other personal care given by or under the supervision of a registered nurse who has relevant expertise whether as the result of training or experience; or
  • Ongoing technology-based care that requires the support of a member of a college as defined under the Regulated Health Professions Act, 1991.

More Information: https://www.ontariocanada.com/registry/view.do?postingId=29389&language=en

Comment Due Date: May 22, 2019

 

Regulation 552, Health Insurance Act

MOHLTC is proposing to amend regulation 552 under the Health Insurance Act to end the Ontario Health Insurance Program (OHIP) coverage for emergency services (arising while outside of the country) for Ontarians travelling outside of Canada. If approved, this change would take effect October 1, 2019.

More information: https://www.ontariocanada.com/registry/view.do?postingId=29390&language=en

Comment Due Date: April 30, 2019

 

DDO Training, Blogs and Articles

Sign up for Privacy Officer Training!

 

Articles of Interest

 

Cannabis

11 Ontario cannabis stores have been fined $12,500 for not being open yet

Ontario pharmacist now required to complete a cannabis course

 

Health Care System

Nova Scotia: This is the face of the health-care crisis: Woman issues plea to N.S premier

Ontario looks to cut OHIP program covering emergency medical costs abroad

London-area hospital trio eye Ontario health team application

Ottawa’s chief medical officer talks priorities as public health agency braces for change

Ontario’s proposed cuts welcomed by critics of ’boutique psychiatrists’ who over-treat wealthy patients

Ambulance dispatchers in ‘hectic and unhealthy’ office, MPP Fife says

Randall Denley: Ontario’s health system needs change. But has Ford got it right?

Provincial cuts will cost Hamilton millions and threaten public health services

 

Long Term Care Homes

Advocates cry foul after Ontario officials alter nursing home inspection report without explanation

 

Privacy

Privacy watchdog taking Facebook to court, says company breached privacy laws

 

Professionalism and Misconduct

Edmonton gynecologist cleared of misconduct charge

Vaughn doctor arrested for allegedly sexually assaulting female patient during physical exam

 

Things to do this Weekend

Things to do this weekend in Toronto

Everything to do, see, eat and drink at Stackt, Toronto’s new outdoor market made of shipping containers

Toronto’s 25 best sandwiches

 

DDO Health Law Update

April 18, 2019: A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.

Bills

 

Bill 74

 

The Bill received royal assent on Friday, April 18.

 

More Information: Bill 74

 

Bill 100, Protecting What Matters Most Act (Budget Measures), 2019

 

This Bill was introduced by Hon. Victor Fedeli, Minister of Finance and is currently in second reading.

 

The Bill includes 61 schedules, each relating to amendments to a different existing statute. The following schedules might be of interest to the health care community:

Schedule 31 Freedom of Information and Protection of Privacy Act Amendments include data integration, provision for the designation of units within ministries that may collect personal information in order to compile information for among other things the planning for the delivery of programs and services provided, provides for rules governing the collection, use and disclosure of this personal information and the Information and Privacy Commissioner is given the authority to conduct reviews of the units’ practices and procedures.

The grounds on which personal information can be disclosed under Part III of the Act are also amended.
Schedule 53 Public Sector Labour Relations Transition Act, 1997 Section 8 of the Public Sector Labour Relations Transition Act, 1997 is repealed and replaced. The new section 8 provides that the Act applies when two or more health service providers are amalgamated or when all, or substantially all, of the assets of one health service provider are transferred to another health service provider. Rules respecting the application of the Act in those circumstances are also set out. The Lieutenant Governor in Council is given the power to make regulations that provide for transitional matters in connection with the implementation of these amendments, and complementary and consequential amendments are also made.
Schedule 61 Vital Statistics Act The Schedule amends the Vital Statistics Act. Instead of tabling in the Assembly the annual report of registrations under the Act that subsection 3 (5) requires the Registrar General to prepare, the Registrar General is required to publish it in a manner that the Registrar General considers appropriate.
In deciding under subsection 34 (1) to correct an error made in a registration, the Registrar General no longer requires a statutory declaration to supplement evidence of the error. The Schedule adds powers for the Registrar General to make regulations governing the correction of errors in a registration. It also transfers some of the present regulation-making powers of the Lieutenant Governor in Council to the Registrar General.

 

More Information: Bill 100 

 

Regulations

 

No new and approved regulations of interest.

 

DDO Training, Blogs and Articles

 

Sign up for Privacy Officer Training!

Cyber Breach Planning: Lessons from the Equifax Breach

 

Government Newsroom

 

Ontario Health Team Webinar on Patient Partnership (April 25, 2019 @ 12 pm). Registration: vvcnetwork.ca/OHTwebcastApril25

Become an Ontario Health Team

Government investing $27 Billion to help end hallway health care

 

Articles of Interest

 

Cannabis

City pushing for closure of 21 illegal cannabis shops but still faces uphill battle

 

Health Care System

SCC says it will not hear appeal from doctors who want to keep names of top OHIP billers secret

Ontario government may let pharmacists prescribe treatments for minor issues like sore throat

Opinion: Published doctor billings must be put in context

Doctors sound alarm after SickKids shuts down Motherrisk program

 

Things to do this Weekend

Things to do this weekend in Toronto

What’s open, what’s closed in Toronto: Easter long weekend

DDO Health Law Update

April 12, 2019: A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.

Bills

Bill 74 is currently in Third Reading.

 

Regulations

 

No new and approved regulations of interest.

 

DDO Training, Blogs and Articles

Sign up for Privacy Officer Training!

Bill 74 is out of committee

Ontario Health Teams – Collaborative Models

How Privacy Laws are Changing to Protect Personal Information

The Broader Public Sector Interim Measures – Mandatory or Voluntary Compliance?

 

Government Newsroom

 

2019 Ontario Budget: Ontario’s Plan to Protect What Matters Most

Register for the next Ontario Health Teams webinar: April 16, 2019 at 12:00 pm

 

Articles of Interest

 

Cannabis

Toronto’s second legal pot store opens in ritzy Yorkville neighbourhood

A dozen of Ontario’s cannabis stores penalized for not opening on time

Ford government committed to lifting cap on pot shops in Ontario

 

Health Care System

Doctors and residents leave St. Joseph’s healthcare psych ER over safety concerns

Ontario budget proposes consolidating 35 public health units into 10 regional entities

Health-care superagency will save $350 million a year, Fedeli says in Ontario budget

Ontario budget 2019: A child-care credit, dental care for seniors, and drinking in parks on the way

Striking public health nurse rallying for new employer mandate

What Ontario’s plan to reduce public health units could mean

Supreme court decision could lift lid on physician billing figures in Ontario

 

Professionalism

Doctor charged in death of physician wife pleads guilty to second-degree murder

Doctor disciplined for sexual relationship with Pembroke patient

‘He stole money’: Hamilton lawyer loses license after misappropriating $2 million from Caledonia class action settlement fund

Lawsuit alleges Manitoba physicians college broke agreement to refrain from criticisms of chiropractors

 

AI

Ai pioneer urges Toronto to back ethical use of artificial intelligence

Artificial Intelligence: The good and the bad

The rise of the robot: Why Ottawa is poised to be the next artificial intelligence hub

The limits of artificial intelligence in insurance

From bionic arms to predicting patient surges in ER, AI is reshaping patient care

 

Things to do this Weekend

Who will win the Game of Thrones? Who will die? Our TV writers on how it’s all going to end.

Things to do this weekend in Toronto

Ontario Health Teams – Collaborative Models

The Ontario Ministry of Health and Long-Term Care is seeking applications from health care organizations to form Ontario Health Teams (OHTs). Successful applicants that meet the readiness requirements will be designated by the Minister as “integrated care delivery systems” under Section 29 of the Connecting Care Act (Bill 74). Designated OHTs will be prioritized for future investments and be eligible for performance-based financial incentives.

The vision is for every patient in Ontario to be served by an OHT that provides a continuum of coordinated care.

Every OHT needs to establish its own leadership, accountability and governance model. There is no prescribed right or wrong way to set up an OHT. The model you choose needs to work for your organizations. It needs to ensure that there is a mechanism to make collaborative decisions that will support the continuum of care envisioned by the MOHLTC. The model will likely evolve over time – in initial stages the participating organizations will likely want to maintain their autonomy while coordinating service delivery and decision-making. This model may evolve, as the organizations work together and better understand each other’s operations and services, to more integrated management and/or governance models.

We can help.

We have worked for years with health care organizations on many different types of collaborative models that span the spectrum from complete integration to complete autonomy with coordinated decision-making. These models include variations on the following:

  • collaborative governance models that facilitate shared boards or shared committees that implement joint decision-making and allow for coordinated financial and clinical oversight
  • alliance arrangements that allow separate boards or separate committees to work together to make joint decisions
  • arrangements that facilitate efficiency through sharing of scarce resources – those resources may include management resources, back-office services or IT services (including sharing of an electronic medical record)
  • complete integrations through merger or amalgamation.

We would be happy to work with you to review the options that are available, how they may evolve, and what solution would best suit your potential OHT. We can also help to ensure that whatever model you establish reflects best governance and oversight practices to manage the financial and quality risks (and opportunities) associated with collaborative service delivery.

We can also document your model in a formal legal agreement that will demonstrate your readiness to move forward as a designed OHT.

Please contact either Kathy O’Brien (kobrien@ddohealthlaw.com) or Michael Gleeson (mgleeson@ddohealthlaw.com) for a discussion about next steps.

Bill 74 is Out of Committee

Bill 74 – The People’s Health Care Act, 2019 – has been reported out of Committee and was ordered for third reading yesterday.

There are very few changes – the handful of significant changes are summarized below:

  • Big changes for LTC homes. Sections 33(2)(d) and (e) are changed to remove a prohibition on the Minister issuing a specific type of integration order to municipalities and boards of management that are LTC licensees and to stand-alone LTCs that are not part of another type of health service provider. The Minister may now issue an integration order to these LTC homes to “co-ordinate services with or partner with” another person/entity funded by Ontario Health. In the first draft these types of LTC homes were protected from the issuance of this type of integration order.
  • Facilitated integration decisions. The Minister can issue a “facilitated decision” order only after the parties reach an agreement with respect to the integration – this is an improvement.
  • Appointment of supervisor. The Bill clarifies that the Minister may only appoint a supervisor over a health service provider that is funded by Ontario Health.
  • Indigenous health. In a couple places there’s a positive obligation on the Minister to engage with Indigenous communities before specifying the planning entities for Indigenous health that it will formally engage with.
  • Equity. Generally, in the background, there is a new commitment to equity and equitable health outcomes.

 

If you have any questions, please contact Kathy O’Brien @ kobrien@ddohealthlaw.com.

The Broader Public Sector Interim Measures – Mandatory or Voluntary Compliance?

The Interim Measures, effective March 18, 2019, were released by the Ontario Government to centralize the Ontario Public Service and broader public sector (“BPS”) purchasing and supply chains. It is part of the government’s plan to transition to a centralized procurement model and is applicable to hospitals, school boards, universities, colleges and post-secondary institutions, children’s aid societies and shared services organization/group purchasing organizations.

This blog focuses on the impact of the Interim Measures on BPS organizations, based on information available to us.

What are the Interim Measures?  

New procurements of goods and services valued at $25,000 or higher are subject to the Interim Measures, which request BPS organizations to use an existing Vendor of Record (“VOR”) arrangement where possible and appropriate; and ensure all new contracts have a term not exceeding two years, including any extensions. “New procurement” is broadly defined and includes any new RF[X], new limited tendering, new piggyback or extension of any existing contract beyond the current term.

Does your organization have to comply with the Interim Measures?

Funding ministries will inform BPS organizations on whether compliance with the Interim Measures is mandatory or voluntary. In order for it to be mandatory, there must be a legislative authority for the funding ministry to provide direction to the BPS organization – and the funding ministry must clearly exercise that legislation authority. For voluntary compliance, there is either no legislative authority available or legislative authority has not been exercised.

So, how will your organization know if compliance with the Interim Measures is mandatory or not? You will have to ask yourself the following questions:

  • What does your cover letter from the funding ministry say?
    • Check the cover letter and materials provided by your funding ministry to see if it explicitly states whether the requirements are mandatory or voluntary. The covering letter may state that compliance is expected as opposed to required.
    • Does the cover letter refer to any legislative authority to issue a directive to your organization?
  • Does your Ministry have legislative authority to provide directive to your organization to comply with the Interim Measures?
    • For example, for hospitals, the Interim Measures are not mandatory as the Ministry of Health and Long-Term Care does not have the legislative authority to issue procurement directives to the hospitals. Only the Management Board of Cabinet has the authority under the Broader Public Sector Accountability Act.

So, if compliance is voluntary, what does that mean for your organization? Even if the Interim Measures are voluntary, we recommend that BPS organizations should try to comply with the Interim Measures where they can in order to demonstrate that they are good “BPS citizens”.  Remember that BPS organizations still have to comply with the BPS Procurement Directive.

If you are unsure about whether your organization has to comply with the Interim Measures, feel free to reach out to DDO’s procurement team:

Kathy O’Brien – kobrien@ddohealthlaw.com

Michael Gleeson – mgleeson@ddohealthlaw.com

Pamela Seto – pseto@ddohealthlaw.com