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O. Reg. 107/96: CONTROLLED ACTS

under Regulated Health Professions Act, 1991, S.O. 1991, c. 18

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Versions

Regulated Health Professions Act, 1991

ONTARIO REGULATION 107/96

CONTROLLED ACTs

Historical version for the period August 31, 2023 to September 24, 2023.

Note: On September 25, 2023, the day subsection 66 (1) of Schedule 1 (Integrated Community Health Services Centres Act, 2023) to the Your Health Act, 2023 comes into force, the Regulation is amended by striking out “independent health facility” wherever it appears and substituting in each case “integrated community health services centre”. (See: O. Reg. 216/23, s. 1)

Note: On September 25, 2023, the day subsection 66 (1) of Schedule 1 (Integrated Community Health Services Centres Act, 2023) to the Your Health Act, 2023 comes into force, the Regulation is amended by striking out “Independent Health Facilities Act” wherever it appears and substituting in each case “Integrated Community Health Services Centres Act, 2023”. (See: O. Reg. 216/23, s. 2)

Last amendment: 301/23.

Legislative History: 306/02, 228/03, 296/04, S.O. 2006, c. 27, s. 19, 97/10, 87/14, 167/15, 566/17, 570/17, 103/18, 183/18, 360/19, 64/20, 9/21, 900/21 (amended by 356/22 and 178/23), 120/22, 310/22, 356/22, 560/22, 97/23, 200/23, 216/23, 301/23.

This is the English version of a bilingual regulation.

Interpretation

0.1 In this Regulation,

“diagnostic ultrasound” means ultrasound that produces an image or other data; (“ultrasonoscopie”)

“out of province medical laboratory technologist” means a person who is exempted from subsections 9 (1) and (2) of the Medical Laboratory Technology Act, 1991 by a regulation made under that Act; (“technologiste de laboratoire médical hors province”)

“out of province physician” means a person who is exempted from subsections 9 (1) and (3) of the Medicine Act, 1991 by a regulation made under that Act; (“médecin hors province”)

“out of province registered nurse in the extended class” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds, in another Canadian jurisdiction, the equivalent of a certificate of registration in the extended class for registered nurses in Ontario; (“infirmière autorisée ou infirmier autorisé de la catégorie supérieure hors province”)

“out of province registered nurse in the general class” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds, in another Canadian jurisdiction, the equivalent of a certificate of registration in the general class for registered nurses in Ontario; (“infirmière autorisée ou infirmier autorisé de la catégorie générale hors province”)

“out of province registered practical nurse” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds, in another Canadian jurisdiction, the equivalent of a certificate of registration in the general class for registered practical nurses in Ontario; (“infirmière auxiliaire autorisée ou infirmier auxiliaire autorisé hors province”)

“out of province respiratory therapist” means a person who is exempted from subsections 9 (1) and (2) of the Respiratory Therapy Act, 1991 by a regulation made under that Act. (“thérapeute respiratoire hors province”) O. Reg. 296/04, s. 1; O. Reg. 200/23, s. 1.

Forms of Energy

1. The following forms of energy are prescribed for the purpose of paragraph 7 of subsection 27 (2) of the Act:

1.  Electricity for,

i.  aversive conditioning,

ii.  cardiac pacemaker therapy,

iii.  cardioversion,

iv.  defibrillation,

v.  electrocoagulation,

vi.  electroconvulsive shock therapy,

vii.  electromyography,

viii.  fulguration,

ix.  nerve conduction studies, or

x.  transcutaneous cardiac pacing.

2.  Electromagnetism for magnetic resonance imaging.

3.  Soundwaves for,

i.  diagnostic ultrasound, or

ii.  lithotripsy.  O. Reg. 107/96, s. 1.

Exemptions

1.1 (1) In the course of engaging in the practice of medical laboratory technology, an out of province medical laboratory technologist is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under section 4 of the Medical Laboratory Technology Act, 1991 that a member of the College of Medical Laboratory Technologists of Ontario would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members. O. Reg. 200/23, s. 2 (1).

(2) A member of the College of Medical Laboratory Technologists of Ontario or an out of province medical laboratory technologist is exempt from subsection 27 (1) of the Act with respect to taking blood samples from veins or by skin pricking if,

(a)  the procedure is ordered by an out of province physician or an out of province registered nurse in the extended class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Medical Laboratory Technology Act, 1991 and in any regulation made under that Act that apply to members of the College of Medical Laboratory Technologists of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario or by a member of the College of Nurses of Ontario who is a registered nurse in the extended class, as applicable. O. Reg. 200/23, s. 2 (1).

1.2 A member of the College of Medical Radiation and Imaging Technologists of Ontario is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under paragraphs 1 to 4 of section 4 of the Medical Radiation and Imaging Technology Act, 2017 if,

(a)  the procedure is ordered by an out of province physician; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Medical Radiation and Imaging Technology Act, 2017 and in any regulation made under that Act that apply to members of the College of Medical Radiation and Imaging Technologists of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario. O. Reg. 200/23, s. 2 (1).

1.3. In the course of engaging in the practice of medicine, an out of province physician is exempt from subsection 27 (1) of the Act with respect to performing any acts under section 4 of the Medicine Act, 1991 that a member of the College of Physicians and Surgeons of Ontario would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members. O. Reg. 200/23, s. 2 (1).

1.4 (1) In the course of engaging in the practice of nursing, an out of province registered nurse in the general class is exempt from subsection 27 (1) of the Act with respect to performing any acts under section 4 of the Nursing Act, 1991 that a member of the College of Nurses of Ontario who is a registered nurse in the general class would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members. O. Reg. 200/23, s. 2 (1).

Note: On the day subsection 2 (1) of Schedule 22 to the Stronger, Healthier Ontario Act (Budget Measures), 2017 comes into force, subsection 1.4 (1) of the Regulation is amended by striking out “section 4” and substituting “section 4.1”. (See: O. Reg. 200/23, s. 2 (2))

(2) Subject to subsection (3), in the course of engaging in the practice of nursing, an out of province registered nurse in the extended class is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under section 5.1 of the Nursing Act, 1991 that a members of the College of Nurses of Ontario who is a registered nurse in the extended class would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members. O. Reg. 200/23, s. 2 (1).

(3) The requirement in subsection (2) for an out of province registered nurse in the extended class to comply with the regulations made under the Nursing Act, 1991 applies subject to the following modification:

1.  The requirement in subparagraph 3 iv of subsection 17 (1) of Ontario Regulation 275/94 (General), made under the Nursing Act, 1991, to record a registration number issued by the College on a prescription does not apply to the out of province registered nurse in the extended class. O. Reg. 200/23, s. 2 (1).

(4) In the course of engaging in the practice of nursing, an out of province registered practical nurse is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under section 4 of the Nursing Act, 1991 that a member of the College of Nurses of Ontario who is a registered practical nurse in the general class would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members. O. Reg. 200/23, s. 2 (1).

(5) A member of the College of Nurses of Ontario who is a registered nurse in the general class or an out of province registered nurse in the general class is exempt from subsection 27 (1) of the Act with respect to a procedure listed in section 4 of the Nursing Act, 1991 if,

Note: On the day subsection 2 (1) of Schedule 22 to the Stronger, Healthier Ontario Act (Budget Measures), 2017 comes into force, subsection 1.4 (5) of the Regulation is amended by striking out “section 4” in the portion before clause (a) and substituting “section 4.1”. (See: O. Reg. 200/23, s. 2 (3))

(a)  the procedure is ordered by an out of province physician or an out of province registered nurse in the extended class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Nursing Act, 1991 and in any regulation made under that Act that apply to members of the College of Nurses of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario or by a member of the College of Nurses of Ontario who is a registered nurse in the extended class, as applicable. O. Reg. 200/23, s. 2 (1).

(6) A member of the College of Nurses of Ontario who is a registered practical nurse in the general class or an out of province registered practical nurse is exempt from subsection 27 (1) of the Act with respect to a procedure listed in section 4 of the Nursing Act, 1991 if,

(a)  the procedure is ordered by an out of province physician, an out of province registered nurse in the extended class or an out of province registered nurse in the general class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Nursing Act, 1991 and in any regulation made under that Act that apply to members of the College of Nurses of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario or by a member of the College of Nurses of Ontario who is a registered nurse in the general or extended class, as applicable. O. Reg. 200/23, s. 2 (1).

(7) A member of the College of Nurses of Ontario or an out of province registered practical nurse is exempt from subsection 27 (1) of the Act with respect to a procedure listed in subsection 15 (4) of Ontario Regulation 275/ 94 (General) made under the Nursing Act, 1991 if,

(a)  the procedure is ordered by an out of province registered nurse in the general class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Nursing Act, 1991 and in any regulation made under that Act that apply to members of the College of Nurses of Ontario, other than the requirement that the procedure be ordered by a member of the College of Nurses of Ontario who is a registered nurse in the general class. O. Reg. 200/23, s. 2 (1).

(8) A member of the College of Nurses of Ontario who is a registered nurse in the extended class or an out of province registered nurse in the extended class is exempt from subsection 27 (1) of the Act with respect to administering a substance by injection or inhalation if,

(a)  the procedure is ordered by an out of province physician; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Nursing Act, 1991 and in any regulation made under that Act that apply to equivalent members of the College of Nurses of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario. O. Reg. 200/23, s. 2 (1).

1.5 (1) In the course of engaging in the practice of respiratory therapy, an out of province respiratory therapist is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under section 4 of the Respiratory Therapy Act, 1991 that a member of the College of Respiratory Therapists of Ontario would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members. O. Reg. 200/23, s. 2 (1).

(2) A member of the College of Respiratory Therapists of Ontario or an out of province respiratory therapist is exempt from subsection 27 (1) of the Act with respect to a procedure listed in paragraph 1, 2 or 4 of section 4 of the Respiratory Therapy Act, 1991 if,

(a)  the procedure is ordered by an out of province physician or by an out of province registered nurse in the extended class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Respiratory Therapy Act, 1991 and in any regulation made under that Act that apply to members of the College of Respiratory Therapists of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario or by a member of the College of Nurses of Ontario who is a registered nurse in the extended class, as applicable. O. Reg. 200/23, s. 2 (1).

2. A member of the College of Chiropodists of Ontario is exempt from subsection 27 (1) of the Act for the purpose of applying electricity for electrocoagulation or fulguration.  O. Reg. 107/96, s. 2.

3. (1) A member of the Royal College of Dental Surgeons of Ontario is exempt from subsection 27 (1) of the Act for the purpose of applying electricity for defibrillation or electrocoagulation.  O. Reg. 107/96, s. 3 (1).

(2) A member of the Royal College of Dental Surgeons of Ontario is exempt from subsection 27 (1) of the Act for the purpose of applying electricity for electromyography or nerve conduction studies, in the course of conducting research.  O. Reg. 107/96, s. 3 (2).

3.1 A member of the College of Medical Radiation and Imaging Technologists of Ontario is exempt from subsection 27 (1) of the Act for the purpose of applying electromagnetism if the application is ordered by a member of the College of Physicians and Surgeons of Ontario, an out of province physician, a member of the Royal College of Dental Surgeons of Ontario who holds a specialty certificate of registration authorizing the practice of the specialty of Oral and Maxillofacial Surgery, a member of the College of Nurses of Ontario who is a registered nurse in the extended class or an out of province registered nurse in the extended class and,

(a)  the electromagnetism is applied for magnetic resonance imaging using equipment that is,

(i)  installed in a site of a public hospital where the public hospital is approved as a public hospital under the Public Hospitals Act and the site of the public hospital is graded under that Act as a Group N site of a hospital, and

(ii)  operated by the public hospital mentioned in subclause (i);

(a.1)  the electromagnetism is applied for magnetic resonance imaging using equipment that is installed in, and operated by, the University of Ottawa Heart Institute;

(b)  the electromagnetism is applied for magnetic resonance imaging and all of the following conditions are met:

(i)  the electromagnetism is used to support, assist and be a necessary adjunct, or any of them, to an insured service within the meaning of the Health Insurance Act,

(ii)  the magnetic resonance imaging is provided to persons who are insured persons within the meaning of the Health Insurance Act,

(iii)  the electromagnetism is applied in an independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging; or

(c)  the electromagnetism is applied for magnetic resonance imaging and all of the following conditions are met:

(i)  the electromagnetism is not used to support, assist and be a necessary adjunct, or any of them, to an insured service within the meaning of the Health Insurance Act, or the magnetic resonance imaging is not provided to persons who are insured persons within the meaning of that Act, or both,

(ii)  the electromagnetism is applied in a facility that is operated by an operator that holds a licence under the Independent Health Facilities Act in respect of magnetic resonance imaging,

(iii)  the electromagnetism is applied in a facility that is operated on the same premises as the independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging that is operated by the operator mentioned in subclause (ii),

(iv)  the electromagnetism is applied using the same equipment that is used to provide magnetic resonance imaging in the independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging that is operated by the operator mentioned in subclause (ii),

(v)  the operator of the facility in which the electromagnetism is applied is a party to a valid and subsisting agreement with the Minister concerning the provision of magnetic resonance imaging. O. Reg. 228/03, s. 1; O. Reg. 566/17, s. 1; O. Reg. 360/19, s. 1; O. Reg. 120/22, s. 1; O. Reg. 200/23, s. 3.

4. A member of the College of Midwives of Ontario is exempt from subsection 27 (1) of the Act for the purpose of applying, or ordering the application of, soundwaves for pregnancy diagnostic ultrasound or pelvic diagnostic ultrasound. O. Reg. 566/17, s. 2.

4.1 (1) A member of the College of Nurses of Ontario, other than a registered nurse in the extended class, an out of province registered nurse in the general class or an out of province registered practical nurse is exempt from subsection 27 (1) of the Act for the purpose of applying soundwaves for diagnostic ultrasound, as long as the member, out of province registered nurse in the general class or out of province registered practical nurse has a therapeutic nurse-patient relationship with the person to whom the soundwaves are being applied and the soundwaves are being applied for the purpose of conducting one or more routine nursing assessments of a patient to assist in the development or implementation of the patient’s plan of care. O. Reg. 200/23, s. 4.

(2) A member of the College of Nurses of Ontario who is a registered nurse in the extended class, or a person who is an out of province registered nurse in the extended class, is exempt from subsection 27 (1) of the Act for the purpose of applying, or ordering the application of, soundwaves for diagnostic ultrasound. O. Reg. 200/23, s. 4.

5. (1) A member of the College of Physicians and Surgeons of Ontario or an out of province physician is exempt from subsection 27 (1) of the Act for the purpose of applying, or ordering the application of, electricity for a procedure listed in paragraph 1 of section 1 or soundwaves for a procedure listed in paragraph 3 of section 1. O. Reg. 200/23, s. 5 (1).

(2) A member of the College of Physicians and Surgeons of Ontario or an out of province physician is exempt from subsection 27 (1) of the Act for the purpose of applying or ordering the application of electromagnetism if,

(a)  the electromagnetism is applied for magnetic resonance imaging using equipment that is,

(i)  installed in a site of a public hospital where the public hospital is approved as a public hospital under the Public Hospitals Act and the site of the public hospital is graded under that Act as a Group N site of a hospital, and

(ii)  operated by the public hospital mentioned in subclause (i);

(a.1)  the electromagnetism is applied for magnetic resonance imaging using equipment that is installed in, and operated by, the University of Ottawa Heart Institute;

(b)  the electromagnetism is applied for magnetic resonance imaging and all of the following conditions are met:

(i)  the electromagnetism is used to support, assist and be a necessary adjunct, or any of them, to an insured service within the meaning of the Health Insurance Act;

(ii)  the magnetic resonance imaging is provided to persons who are insured persons within the meaning of the Health Insurance Act,

(iii)  the electromagnetism is applied in an independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging; or

(c)  the electromagnetism is applied for magnetic resonance imaging and all of the following conditions are met:

(i)  the electromagnetism is not used to support, assist and be a necessary adjunct, or any of them, to an insured service within the meaning of the Health Insurance Act, or the magnetic resonance imaging is not provided to persons who are insured persons within the meaning of that Act, or both,

(ii)  the electromagnetism is applied in a facility that is operated by an operator that holds a licence under the Independent Health Facilities Act in respect of magnetic resonance imaging,

(iii)  the electromagnetism is applied in a facility that is operated on the same premises as the independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging that is operated by the operator mentioned in subclause (ii),

(iv)  the electromagnetism is applied using the same equipment that is used to provide magnetic resonance imaging in the independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging that is operated by the operator mentioned in subclause (ii),

(v)  the operator of the facility in which the electromagnetism is applied is a party to a valid and subsisting agreement with the Minister concerning the provision of magnetic resonance imaging. O. Reg. 228/03, s. 2; O. Reg. 566/17, s. 3; O. Reg. 200/23, s. 5 (2).

6. A member of the College of Psychologists of Ontario is exempt from subsection 27 (1) of the Act for the purpose of applying, or ordering the application of, electricity for aversive conditioning.  O. Reg. 107/96, s. 6.

7. A person is exempt from subsection 27 (1) of the Act for the purpose of applying electricity for aversive conditioning if the application is ordered and directed by a member of the College of Physicians and Surgeons of Ontario, by an out of province physician or by a member of the College of Psychologists of Ontario. O. Reg. 200/23, s. 6.

7.1 (1) A member of the College of Medical Radiation and Imaging Technologists of Ontario, a member of the College of Respiratory Therapists of Ontario, an out of province respiratory therapist, an out of province registered nurse in the general class, an out of province registered practical nurse or a member of the College of Nurses of Ontario, other than a member who is a registered nurse in the extended class, is exempt from subsection 27 (1) of the Act for the purpose of applying soundwaves for diagnostic ultrasound if the application is ordered by a member with ordering authority, and the soundwaves for diagnostic ultrasound are applied,

(a)  in a site of a public hospital where the public hospital is approved as a public hospital under the Public Hospitals Act, and the equipment is operated by the public hospital;

(b)  in a private hospital operated under the authority of a licence issued under the Private Hospitals Act and the equipment is operated by the private hospital;

(b.1)  in the University of Ottawa Heart Institute, and the equipment is operated by the University of Ottawa Heart Institute;

(c)  in an independent health facility licensed under the Independent Health Facilities Act in respect of diagnostic ultrasound on a site for which that independent health facility is licensed in respect of diagnostic ultrasound; or

(d)  in a fixed site where health services are customarily performed, and the application is ordered by a member with ordering authority who treats his or her own patients in the course of his or her health care practice, but only if,

(i)  there exists an ongoing professional health care relationship between the patient and the member with ordering authority, or between the patient and a regulated health professional who ordinarily practises with that member at one or more sites in Ontario,

(ii)  there exists an ongoing professional health care relationship between the patient and a regulated health professional who has given an opinion on the health of the patient, or between the patient and a regulated health professional who ordinarily practises at one or more sites in Ontario with the regulated health professional who has given the opinion, and the patient has requested that the member with ordering authority confirm, refute or vary that opinion and,

(A)  the member orders the application of soundwaves for diagnostic ultrasound in the course of an assessment of the patient resulting from that request, and

(B)  the diagnostic ultrasound is directly related to that assessment, or

(iii)  there exists an ongoing professional health care relationship between the patient and a regulated health professional who has referred the patient to the member with ordering authority for the purpose of a consultation, or between the patient and a regulated health professional who ordinarily practises at one or more sites in Ontario with the regulated health professional who has made the referral and,

(A)  the member conducts an assessment of the patient, and

(B)  the diagnostic ultrasound is directly related to that assessment or services arising out of that assessment.  O. Reg. 296/04, s. 2; O. Reg. 566/17, s. 4 (1, 2); O. Reg. 360/19, s. 2; O. Reg. 97/23, s. 1; O. Reg. 200/23, s. 7 (1).

(2) In this section,

“member with ordering authority” means,

(a)  a member of the College of Midwives of Ontario, with respect to ordering the application of soundwaves for pregnancy diagnostic ultrasound or pelvic diagnostic ultrasound,

(b)  a member of the College of Nurses of Ontario who is a registered nurse in the extended class or an out of province registered nurse in the extended class, with respect to ordering the application of soundwaves for diagnostic ultrasound, or

(c)  a member of the College of Physicians and Surgeons of Ontario or an out of province physician, with respect to ordering the application of soundwaves for diagnostic ultrasound. O. Reg. 296/04, s. 2; O. Reg. 566/17, s. 4 (3); O. Reg. 200/23, s. 7 (2).

7.2 During the period that begins on December 30, 2017 and ends on December 31, 2019, a person is exempt from subsection 27 (1) of the Act for the purpose of treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behaviour, communication or social functioning. O. Reg. 570/17, s. 1.

7.3 A person is exempt from subsections 27 (1) and 30 (1) of the Act for the purpose of treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgement, insight, behaviour, communication or social functioning where such act is done as part of the requirements to become a member of the Ontario College of Social Workers and Social Service Workers and the act is done under the supervision or direction of a member of the Ontario College of Social Workers and Social Service Workers. O. Reg. 570/17, s. 1.

7.4 A member of the Royal College of Dental Surgeons of Ontario who holds a specialty certificate of registration authorizing the practice of the specialty of Oral and Maxillofacial Surgery, a member of the College of Nurses of Ontario who is a registered nurse in the extended class or an out of province registered nurse in the extended class is exempt from subsection 27 (1) of the Act for the purpose of ordering the application of electromagnetism if,

(a)  the electromagnetism is applied for magnetic resonance imaging using equipment that is,

(i)  installed in a site of a public hospital where the public hospital is approved as a public hospital under the Public Hospitals Act and the site of the public hospital is graded under that Act as a Group N site of a hospital, and

(ii)  operated by the public hospital mentioned in subclause (i);

(b)  the electromagnetism is applied for magnetic resonance imaging using equipment that is installed in, and operated by, the University of Ottawa Heart Institute;

(c)  the electromagnetism is applied for magnetic resonance imaging and all of the following conditions are met:

(i)  the electromagnetism is used to support, assist and be a necessary adjunct, or any of them, to an insured service within the meaning of the Health Insurance Act,

(ii)  the magnetic resonance imaging is provided to persons who are insured persons within the meaning of the Health Insurance Act,

(iii)  the electromagnetism is applied in an independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging; or

(d)  the electromagnetism is applied for magnetic resonance imaging and all of the following conditions are met:

(i)  the electromagnetism is not used to support, assist and be a necessary adjunct, or any of them, to an insured service within the meaning of the Health Insurance Act, or the magnetic resonance imaging is not provided to persons who are insured persons within the meaning of that Act, or both,

(ii)  the electromagnetism is applied in a facility that is operated by an operator that holds a licence under the Independent Health Facilities Act in respect of magnetic resonance imaging,

(iii)  the electromagnetism is applied in a facility that is operated on the same premises as the independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging that is operated by the operator mentioned in subclause (ii),

(iv)  the electromagnetism is applied using the same equipment that is used to provide magnetic resonance imaging in the independent health facility licensed under the Independent Health Facilities Act in respect of magnetic resonance imaging that is operated by the operator mentioned in subclause (ii),

(v)  the operator of the facility in which the electromagnetism is applied is a party to a valid and subsisting agreement with the Minister concerning the provision of magnetic resonance imaging. O. Reg. 120/22, s. 2; O. Reg. 200/23, s. 8.

8. (1) The following activities are exempt from subsection 27 (1) of the Act:

1.  Revoked: S.O. 2006, c. 27, s. 19 (1).

2.  Ear or body piercing for the purpose of accommodating a piece of jewellery.

3.  Electrolysis.

4.  Tattooing for cosmetic purposes.  O. Reg. 107/96, s. 8; S.O. 2006, c. 27, s. 19 (1).

(2) A person who is a member of a College listed in Column 1 of the Table is exempt from subsection 27 (1) of the Act for the purpose of performing acupuncture, a procedure performed on tissue below the dermis, in accordance with the standard of practice and within the scope of practice of the health profession listed in Column 2.

TABLE

Item

Column 1

Column 2

1.

College of Chiropodists of Ontario

Chiropody

2.

College of Chiropractors of Ontario

Chiropractic

3.

College of Massage Therapists of Ontario

Massage Therapy

3.1

College of Naturopaths of Ontario

Naturopathy

4.

College of Nurses of Ontario

Nursing

5.

College of Occupational Therapists of Ontario

Occupational Therapy

6.

College of Physiotherapists of Ontario

Physiotherapy

7.

Royal College of Dental Surgeons of Ontario

Dentistry

S.O. 2006, c. 27, s. 19 (2); O. Reg. 167/15, s. 1 (1, 2).

(3) A person mentioned in subsection (2) is exempt from subsection 27 (1) of the Act for the purpose of performing acupuncture only if he or she has met the standards and qualifications set by the College. O. Reg. 167/15, s. 1 (3).

(4) Revoked: O. Reg. 167/15, s. 1 (3).

(5) A person is exempt from subsection 27 (1) of the Act for the purpose of performing acupuncture, a procedure performed on tissue below the dermis, if the acupuncture is performed as part of an addiction treatment program and the person performs the acupuncture within a health facility.  S.O. 2006, c. 27, s. 19 (2).

(6) In subsection (5),

“health facility” means a facility governed by or funded under an Act set out in the Schedule.  S.O. 2006, c. 27, s. 19 (2).

9. Male circumcision is an activity that is exempt from subsection 27 (1) of the Act if the circumcision is performed as part of a religious tradition or ceremony.  O. Reg. 107/96, s. 9.

10. Revoked: O. Reg. 167/15, s. 2.

11. The taking of a blood sample from a vein or by skin pricking is an activity that is exempt from subsection 27 (1) of the Act if the person taking the blood sample is employed by a laboratory or specimen collection centre licensed under the Laboratory and Specimen Collection Centre Licensing Act.  O. Reg. 107/96, s. 11.

12. (1) A medical geneticist who holds a doctorate is exempt from subsection 27 (1) of the Act for the purpose of communicating to an individual or his or her personal representative a diagnosis identifying a genetic disease or genetic disorder as the cause of the symptoms of the individual in circumstances in which it is reasonably foreseeable that the individual or his or her personal representative will rely on the diagnosis, if,

(a)  the disease or disorder identified is within the geneticist’s area of expertise; and

(b)  the geneticist is employed by a university or a health care facility and the communication of the diagnosis is performed in accordance with the university’s or facility’s guidelines or protocols.  O. Reg. 107/96, s. 12 (1).

(2) In this section,

“health care facility” means a facility governed by or funded under an Act set out in the Schedule.  O. Reg. 107/96, s. 12 (2).

13. A member of the College of Nurses of Ontario who holds a general certificate of registration as a registered nurse or an out of province registered nurse in the general class is exempt from subsection 27 (1) of the Act for the purpose of prescribing a solution of normal saline (0.9 per cent) for venipuncture performed to establish peripheral intravenous access and maintain patency. O. Reg. 200/23, s. 9.

14. (1) Subject to subsection (4), a member of the College of Respiratory Therapists of Ontario or an out of province respiratory therapist is exempt from subsection 27 (1) of the Act for the purpose of performing a tracheostomy tube change subject to the terms, conditions and limitations imposed on their certificate of registration. O. Reg. 301/23, s. 1 (1).

(2), (3) Revoked: O. Reg. 301/23, s. 1 (1).

(4) A member of the College of Respiratory Therapists of Ontario or an out of province respiratory therapist shall not perform a procedure described in subsection (1) unless the procedure is ordered by,

(a)  a member of the College of Physicians and Surgeons of Ontario or an out of province physician, the College of Midwives of Ontario or the Royal College of Dental Surgeons of Ontario; or

(b)  a member of the College of Nurses of Ontario who holds an extended certificate of registration under the Nursing Act, 1991 or an out of province registered nurse in the extended class. O. Reg. 200/23, s. 9; O. Reg. 301/23, s. 1 (2).

15. (1) For the purpose of administering a coronavirus (COVID-19) vaccine by injection, the following persons are exempt from subsection 27 (1) of the Act:

1.  A member of the Ontario College of Pharmacists who is a Part A pharmacist, intern, registered pharmacy student or pharmacy technician.

2.  A member of the College of Nurses of Ontario who is a registered nurse in the general or extended class or who is a registered practical nurse in the general class.

2.1  An out of province registered nurse in the general class, an out of province registered nurse in the extended class or an out of province registered practical nurse.

3.  Any person, if a health professional described in subsection (1.1),

i.  is present at the premises where the vaccine is administered, and

ii.  is accessible to the person administering the vaccine to discuss questions relating to, or give directions with respect to, the administration of the vaccine. O. Reg. 9/21, s. 1 (1); O. Reg. 900/21, s. 1 (1); O. Reg. 200/23, s. 10 (1).

(1.1) The health professionals referred to in paragraph 3 of subsection (1) are the following:

1.  A member of the College of Physicians and Surgeons of Ontario or an out of province physician.

2.  A member of the College of Nurses of Ontario who is a registered nurse in the general or extended class.

2.1  An out of province registered nurse in the general class or an out of province registered nurse in the extended class.

3.  A member of the Ontario College of Pharmacists who is a Part A pharmacist. O. Reg. 900/21, s. 1 (2); O. Reg. 200/23, s. 10 (2).

(2) The exemption under subsection (1) is subject to the condition that the person administering the vaccine is engaged to do so by an organization or other entity that has certified to the person that the organization or other entity is a party to an agreement with the Minister governing the administration of the vaccine. O. Reg. 9/21, s. 1 (1).

(3) In this section,

“Part A pharmacist” means a member of the Ontario College of Pharmacists who holds a certificate of registration as a pharmacist and who is listed in Part A of the College’s register. O. Reg. 9/21, s. 1 (1).

Note: On March 31, 2024, section 15 of the Regulation is revoked. (See: O. Reg. 900/21, s. 1 (3); O. Reg. 356/22, s. 1; O. Reg. 178/23, s. 1)

16. (1) Subject to subsections (2) and (3), a Part A pharmacist is exempt from section 27 (1) of the Act for the purpose of prescribing Nirmatrelvir/ritonavir if,

(a)  the patient to whom the drug is being prescribed presents the pharmacist with the results of a positive COVID-19 test;

(b)  the prescribing occurs within five days of onset of symptoms of COVID 19; and

(c)  the patient is not on supplemental oxygen and is,

(i)  60 years of age or older,

(ii)  18 years of age or older but less than 60 years of age, and is,

(A)  immunocompromised,

(B)  at high risk of severe COVID-19 because the individual has one or more comorbidities, or

(C)  at high risk of severe COVID-19 because the individual has inadequate immunity due to being unvaccinated, having an incomplete series of primary COVID-19 vaccination or not having had a COVID-19 vaccine dose or SARS-CoV-2 infection within the past six months. O. Reg. 560/22, s. 1.

(2) The Part A pharmacist shall make a determination as to the patient’s risk for any drug interactions that cannot be properly managed or that prevent Nirmatrelvir/ritonavir from being prescribed and shall not prescribe the drug if such an interaction exists. O. Reg. 560/22, s. 1.

(3) The Part A pharmacist shall notify the patient’s primary care provider, if any, within a reasonable time that the pharmacist prescribed Nirmatrelvir/ritonavir to the patient and provide details respecting the prescription. O. Reg. 560/22, s. 1.

(4) The following are examples of persons who are immunocompromised for the purposes of this section:

1.  Individuals receiving dialysis, such as hemodialysis or peritoneal dialysis.

2.  Recipients of solid-organ transplant who are taking immunosuppressive therapy.

3.  Individuals receiving active treatment 3, such as chemotherapy, targeted therapies or immunotherapy, for solid tumour or hematologic malignancies.

4.  Recipients of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant, who received transplantation within the past two years or who are taking immunosuppression therapy.

5.  Individuals with moderate to severe primary immunodeficiency, such as DiGeorge syndrome or Wiskott-Aldrich syndrome.

6.  Individuals who have experienced HIV with AIDS-defining illness in the last 12 months before starting their vaccine series or severe immune compromise with CD4 count <200 cells/uL or CD4 percentage <15%, or without HIV viral suppression.

7.  Individuals receiving active treatment with the following categories of immunosuppressive therapies:

i.  Anti-B cell therapies such as monoclonal antibodies targeting CD19, CD20 and CD22.

ii.  High-dose systemic corticosteroids.

iii.  Alkylating agents.

iv.  Antimetabolites.

v.  Tumour-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive. O. Reg. 560/22, s. 1.

(5) In this section,

“comorbidities” include, without being limited to,

(a)  cancer,

(b)  cerebrovascular disease,

(c)  chronic kidney disease,

(d)  chronic liver diseases, where the disease is cirrhosis, non-alcoholic fatty liver disease, alcoholic liver disease or autoimmune hepatitis,

(e)  chronic lung diseases, where the disease is bronchiectasis, chronic obstructive pulmonary disease, interstitial lung disease, pulmonary hypertension or pulmonary embolism,

(f)  cystic fibrosis,

(g)  diabetes mellitus, type 1 or type 2,

(h)  disabilities such as Down syndrome, learning, intellectual or developmental disabilities, ADHD, cerebral palsy, congenital disabilities or spinal cord injuries,

(i)  heart conditions such as cardiomyopathies, coronary artery disease, heart failure and similar conditions,

(j)  HIV infection,

(k)  mental health disorders, where the disorder is a mood disorder, including depression, or a schizophrenia spectrum disorder,

(l)  obesity,

  (m)  pregnancy or recent pregnancy,

(n)  primary immunodeficiency diseases,

(o)  smoking, current or former,

(p)  solid organ or blood stem cell transplant,

(q)  tuberculosis, and

(r)  use of corticosteroids or other immunosuppressive medication; (“comorbodités”)

“Part A pharmacist” means a member of the Ontario College of Pharmacists who holds a certificate of registration as a pharmacist and who is listed in Part A of the College’s register. (“pharmacien inscrit à la partie A”) O. Reg. 560/22, s. 1.

SCHEDULE

1.  Alcoholism and Drug Addiction Research Foundation Act.

2.  Revoked: O. Reg. 64/20, s. 1.

3.  Child, Youth and Family Services Act, 2017.

4.  Homes for Special Care Act.

5.  Independent Health Facilities Act.

6.  Fixing Long-Term Care Act, 2021.

7.  Mental Health Act.

8.  Ministry of Community and Social Services Act.

9.  Ministry of Correctional Services Act.

10.  Ministry of Health and Long-Term Care Act.

11.  Revoked: O. Reg. 103/18, s. 1.

12.  Private Hospitals Act.

13.  Public Hospitals Act.

14.  University of Ottawa Heart Institute Act, 1999.

O. Reg. 87/14, s. 2; O. Reg. 566/17, s. 5; O. Reg. 103/18, s. 1; O. Reg. 183/18, s. 1; O. Reg. 64/20, s. 1; O. Reg. 310/22, s. 1.