Health System Improvements Act, 2007, S.O. 2007, c. 10 - Bill 171

EXPLANATORY NOTE

This Explanatory Note was written as a reader’s aid to Bill 171 and does not form part of the law. Bill 171 has been enacted as Chapter 10 of the Statutes of Ontario, 2007

SCHEDULE A
AMBULANCE ACT

Schedule A amends the Ambulance Act. The amendments to subsection 4 (3) of the Act broaden the Minister’s grant-making powers.

The amendments to create Part IV.1 of the Act empower the Minister to designate by regulation,

(a) one or more persons who meet the certification requirements under the Act to provide land ambulance services; or

(b) one or more persons to ensure the provision of land ambulance services.

Any such regulation would set out the duties and powers of a designated person and the conditions to which that person is subject.

Part IV.1 would also make it clear that the creation by regulation of a new or expanded class of persons who have land ambulance responsibilities would not detract from or otherwise affect the duties or powers of an upper-tier municipality or designated delivery agent under Part III or Part IV of the Act, except where the regulation provides otherwise.

Subsection 19 (2) of the Act sets out the persons who are entitled to share personal health information with each other without the consent of the individual to whom the information relates for the purposes described in subsection 19 (3). The amendments to subsection 19 (3) of the Act clarify that the sharing of personal health information permitted under subsection 19 (2) may occur for purposes related to the provision of communication services and base hospital programs.

schedule b
amendments concerning health professions

Schedule B amends various Acts respecting health professions. Clause 23 (2) (d.2) of the Health Professions Procedural Code, Schedule 2 to the Regulated Health Professions Act, 1991, is amended to clarify that the register shall only contain the names of shareholders who are members of the College and not the names of shareholders who are family members. Fines are increased under a number of Acts, obsolete provisions are repealed, and the councils of some health colleges are given the power to designate categories of drugs that may be used or prescribed by members. Changes are made in the powers of dental hygienists to initiate certain procedures. The Pharmacy Act, 1991 is also amended to protect the title “pharmacy technician” and change the composition of the Council of the Ontario College of Pharmacists to include pharmacy technicians, which will be a new class of certificate of registration.

Other miscellaneous amendments are also made.

schedule C
health insurance act

Schedule C amends the Health Insurance Act. The Minister is given the power to classify physiotherapy clinics as health facilities, instead of this being done through regulation. This Schedule also provides for notification of changes to OHIP registration information and clarifies the authority to make regulations requiring provision of this information to OHIP as well as permitting regulations for the security of health cards.

Schedule D
Health Protection and Promotion Act, Ontario Water Resources Act and Safe Drinking Water Act, 2002

Schedule D makes amendments to the Health Protection and Promotion Act, the Ontario Water Resources Act and the Safe Drinking Water Act, 2002.

The amendments to the Health Protection and Promotion Act facilitate the transfer of the regulation of specified small drinking-water systems from the Safe Drinking Water Act, 2002 to the Health Protection and Promotion Act. These amendments include the following:

1. Section 5 of the Act is amended by adding the provision of safe drinking water by small drinking-water systems to the list of mandatory health programs and services superintended, provided or ensured by boards of health.

2. Section 7 of the Act is amended to permit guidelines to adopt by reference codes, formulas, protocols or procedures. Such adoptions may include adopting amendments to the code, formula, protocol or procedure made after the guideline is issued, but such amendments do not come into effect until the Ministry gives notice of them.

3. The Act is amended by adding section 12.1 which, with respect to small drinking-water systems, authorizes a medical officer of health to vary specific provisions in regulations on a temporary basis and allows a medical officer of health to establish interim requirements in respect of a small drinking-water system, provided that the risk to the users of the small drinking-water system is not increased.

4. Section 41 of the Act is amended to include small drinking-water systems in the enforcement provisions.

5. The Act is amended to include broad regulation-making powers in respect of small drinking-water systems to facilitate their regulation. There is also the power to make regulations in respect of transitional matters.

6. Section 102 of the Act is amended by adding the restraint of a contravention of a directive relating to small drinking-water systems by an order of the Superior Court of Justice. Section 102 already authorizes the restraint of an order under the Act.

Several provisions of the Ontario Water Resources Act that refer to other environmental statutes are amended to include a reference to the Safe Drinking Water Act, 2002.

Several references to “water works” are deleted from the Ontario Water Resources Act. The Safe Drinking Water Act, 2002 and the proposed amendments to the Health Protection and Promotion Act govern drinking-water systems to which these references applied.

Section 52 of the Ontario Water Resources Act, which provides for approval of water works, is repealed. The Safe Drinking Water Act, 2002 and the proposed amendments to the Health Protection and Promotion Act govern these facilities.

Clause 106.1 (3) (b) of the Ontario Water Resources Act is amended to bring its language into conformity with subsection 30 (1) of the Act.

The reference to standards for potable water in clause 75 (1) (i) of the Ontario Water Resources Act is deleted. Drinking water standards may be prescribed by regulations made under the Safe Drinking Water Act, 2002 and the proposed amendments to the Health Protection and Promotion Act.

Laboratories licensed under the Safe Drinking Water Act, 2002 may conduct tests relating to small drinking-water systems regulated under the proposed amendments to the Health Protection and Promotion Act. The Safe Drinking Water Act, 2002 is amended to ensure that it applies to these tests and to the laboratories that conduct them.

Other provisions of the Safe Drinking Water Act, 2002 are amended to ensure that they continue to apply with respect to small drinking-water systems regulated under the proposed amendments to the Health Protection and Promotion Act.

References to accredited operating authorities in several provisions of the Safe Drinking Water Act, 2002 are amended to remove the word “accredited”. The amendments will permit these provisions to apply to operating authorities that have not yet been accredited.

Section 54 of the Safe Drinking Water Act, 2002 is amended to clarify its relationship to subsection 52 (1). The amendments that replace subsection 54 (2) (alterations to regulated non-municipal drinking-water systems) also clarify that an application for an approval is required in two circumstances. First, an application is required if an approval under subsection 52 (1) is required and the alteration was authorized by a previously granted approval. Second, an application is required if the alteration relates to a condition that was imposed under subsection 60 (2) of the Act.

Section 127 of the Safe Drinking Water Act, 2002 is amended to refer to certificates. The amendments permit operators of drinking-water systems to appeal decisions made by the Director relating to the operator certification program.

Schedule E
Immunization of School Pupils Act

Schedule E amends the Immunization of School Pupils Act to permit registered nurses who hold an extended certificate of registration to sign a statement of medical exemption under the Act and to undertake other activities under the Act. The amendments also permit other nurses to undertake certain activities under the Act.

schedule F
health protection and promotion act

Schedule F makes numerous amendments to the Health Protection and Promotion Act. Among them:

1. Certain provisions of the Act are amended to add references to “registered nurse in the extended class” and by adding a definition for that term.

2. The definition of “institution” in subsection 21 (1) and of “practitioner” in subsection 25 (2) of the Act are amended to allow the Lieutenant Governor in Council to add to the list of practitioners and institutions by way of regulation.

3. Subsection 29 (1) of the Act is amended to change the location of where the laboratories send reports of positive findings in respect of reportable diseases.

4. The Act is amended to allow reporting by medical officers of health to health facilities in regard of communicable diseases acquired at facilities and to allow for the issuance of orders against institutions or public hospitals for the purpose of dealing with communicable disease outbreaks.

5. Subsection 38 (1) of the Act is amended by adding three additional diseases to the definition of “immunizing agent”.

6. Subsection 39 (2) of the Act is amended to provide an exemption from the confidentiality requirement in subsection 39 (1) where disclosure is authorized under the Act or the Personal Health Information Act, 2004.

7. The Act is amended by adding a new Part, Part VI.I, entitled “Provincial Public Health Powers”. Sections 86, 86.1, 86.2 and 87 of the Act are moved from Part VII “Administration” and placed under Part VI.I. Sections 86, 86.1, 86.2 and 87 will now become sections 77.1, 77.2, 77.3 and 77.4. In addition section 86 (which will become section 77.1) is amended to clarify that the powers of the board of health that the Chief Medical Officer of Health (“CMOH”) may exercise under this section include the power to appoint a medical officer of health or an associate medical officer of health. The Act is amended by adding section 77.5 to allow the Minister of Health and Long-Term Care (“Minister”) to issue orders in regard to the emergency procurement of medications and supplies. The Act is amended by adding section 77.6 to allow the CMOH to issue orders to health information custodians for the purpose of requiring such custodians to provide the CMOH with information, including personal health information. The Act is amended by adding section 77.7 to allow the CMOH to issue directives to health care providers and health care entities respecting precautions and procedures that must be followed to protect the health of persons anywhere in Ontario. The Act is also amended to add section 77.8 to allow the CMOH to collect, retain and use previously collected specimens.

8. The Act is amended by adding section 81.1 to provide for the position of Associate Chief Medical Officer of Health (ACMOH) and to provide for the functions, powers and duties of that office holder.

9. The Act is amended to allow the Minister to enter into accountability agreements with any board of health.

10. Section 95 of the Act is amended by adding the CMOH, ACMOH and employees of boards of health working under the direction of a medical officer of health to the list of persons that are protected from personal liability. Section 95 is also amended to offer protection from personal liability to persons acting pursuant to orders under 77.5, 77.6 or 77.8 or directions under 77.7 of the Act. In addition, section 95 is amended to specify that the Crown is not relieved of liability for the acts or omissions of the CMOH or ACMOH.

11. Section 97 of the Act is amended to provide the Minister with the power to specify diseases for the purpose of the definition of “immunizing agent” in subsection 38 (1).

12. Subsection 100 (3) of the Act is amended to update the list of offences under the Act.

13. Section 102 of the Act is amended to provide the Superior Court of Justice with broader order making powers.

14. Section 106 of the Act is amended to update the service provisions to account for the issuance of class orders under subsection 22 (5.0.1).

SCHEDULE G
amendments to the health insurance act (revisions to Medical Audit Process)

Numerous amendments are made to the Health Insurance Act to revise the physician payment process.

Provisions are made for the creation of the Physician Payment Review Board, the Joint Committee on the Schedule of Benefits, and the Physician Services Payment Committee. Their membership and functions are provided for.

New rules are established providing for the General Manager of OHIP’s possible actions when an incorrect or inappropriate claim is made to OHIP for a physician’s services. In cases of disputes, a panel of the Physician Payment Review Board may hold a hearing and make an appropriate order. Rules for hearing and possible orders are provided for.

Certain provisions that were never proclaimed in force are repealed, as are provisions relating to the Medical Review Committee.

New provisions regarding service of notices are added.

A complementary amendment to the Medicine Act, 1991 is made.

schedule H
Personal Health Information Protection Act, 2004

Schedule H amends the Personal Health Information Protection Act, 2004 to clarify the intent of several provisions and to ensure consistency within the Act and with the Freedom of Information and Protection of Privacy Act and the Municipal Freedom of Information and Protection of Privacy Act. Many of these amendments simplify and move into the Act matters that are now addressed in the regulations under the Act.

schedule I
Public Hospitals Act

Schedule I amends the Public Hospitals Act. The Act is amended to extend protection from liability for the Crown and the Minister to include directions issued by the Minister to hospital supervisors. The Act is also amended to extend the immunity from personal liability for actions taken in good faith to the staff of the persons who were previously protected. Where the Crown would otherwise be liable in respect of a tort committed by the staff of persons who were previously protected, the Crown’s vicarious liability is preserved.

SCHEDULE J
MAKING MISCELLANEOUS CORRECTIONS AND AMENDMENTS

Schedule J makes various amendments of a technical nature.

schedule K
Ontario Agency for Health Protection and Promotion Act, 2007

Schedule K enacts the Ontario Agency for Health Protection and Promotion Act, 2007. The Ontario Agency for Health Protection and Promotion is established. Its objects, powers and governance are provided for. Power is given to transfer Crown property to the Agency, and assorted matters respecting liability are dealt with.

schedule l
Drug and Pharmacies Regulation Act

A number of amendments are made to the Drug and Pharmacies Regulation Act (“DPRA”).

Section 117 of the DPRA is merged into section 1 and a number of terms are either defined or updated, including the definition of “drug” which is updated to, for example, provide that natural health products as defined under the Natural Health Products Regulations of the federal Food and Drugs Act are not drugs for the purposes of the DPRA.

The powers of the Accreditation Committee of the College in subsection 140 (1) are amended to enable the Committee to refer to the Discipline Committee of the College a person who has been issued a certificate of accreditation, a designated manager of the person who has been issued a certificate of accreditation, or the board of directors of a corporation that has been issued a certificate of accreditation, where the Accreditation Committee has reason to believe that a breach of the DPRA or an act of proprietary misconduct has been committed. A new subsection 140 (2.1) makes clear that the interim suspension provisions of the Health Professions Procedural Code under the Regulated Health Professions Act, 1991 (“Code”) apply to persons mentioned in subsection 140 (1). In addition to the existing powers that the Discipline Committee has under the DPRA, the Discipline Committee can direct the Registrar to impose specified terms, conditions and limitations on the certificate. The Discipline Committee may also make an order against a designated manager of a pharmacy in respect of that member’s certificate of registration as set out in subsection 51 (2) of the Code. Under section 140.1, the College shall publish decisions of a panel of the Discipline Committee in respect of a person who has been issued a certificate of accreditation, designated manager, or director who was the subject of the proceeding, including names, in certain instances.

A new subsection 146 (1.1) requires every owner of a pharmacy to designate a designated manager and to inform the College of the designation. Subsection 146 (3) is amended to require that the designated manager display his or her name, certificate of registration, or both clearly and publicly in the pharmacy.

The inspection provisions in section 148 are updated to replace the term “record” with the term “document”, which is defined as a record of information in any form and includes any part of it. New sections 148.1 to 148.4 are modelled on the investigation provisions set out in the Code. An inspector is authorized to obtain a search warrant to enter a premise. An inspector under the authority of a warrant may obtain the assistance of other persons and may enter a place by force. An inspector may also make a copy of the document or object and may remove such document or object if it is not practicable to copy it in the place where it is examined. No person shall obstruct an inspector acting in the course of his or her duties.

Section 149 is revised to provide that only an intern, a registered pharmacy student or a pharmacy technician, all acting under the supervision of a pharmacist who must be present on the premises, and a pharmacist are entitled to compound, dispense, or sell any drug in a pharmacy. The requirement does not apply to the sale of drugs listed in Schedule III in a pharmacy where a pharmacist or an intern is present and available to provide consultation to the purchaser.

Section 150 is revised to prohibit any person from selling any drug where the person knows or should have known that it is not that drug or does not contain any substance that the drug is meant to contain.

Section 152 is revised to require that any prescription that has been mailed or couriered must be traceable.

Section 153 is revised to require that the designated manager must keep a record of every purchase and sale of a drug referred to in the Schedules to the Controlled Drugs and Substances Act (Canada) or the Schedule to the Narcotic Control Regulations (Canada) in a form or manner as the regulations specify.

Section 158 is revised to permit a pharmacist to dispense a drug pursuant to a prescription authorized by a prescriber licensed to practise in a province or territory of Canada other than Ontario if in the professional judgment of the pharmacist the patient requires the drug.

Under new subsection 160 (4), no member and no pharmacy may receive any drug from a wholesaler other than at the location of a pharmacy which ordered the drugs unless it is in the best interests of the patient to have the product delivered to another source.

Some regulation-making authorities and the incorporation by reference provisions are updated. A new regulation-making authority is added to define proprietary misconduct and govern what constitutes an act of proprietary misconduct.

A new section 162.1 would allow the College to apply to court to revoke or suspend a certificate of accreditation if there are concerns about a pharmacy’s operations and where public safety may be at issue. A person may make an appeal of the order to the Ontario Divisional Court.

The penalty provisions in section 165 are updated to increase the penalty in the case of an individual to $50,000 for a second or subsequent offence, and in the case of a corporation to $200,000 for a second or subsequent offence.

Additionally, a number of technical changes are proposed to the DPRA, such as updating certain references to the Code, and replacing the term “Part” with “Act”, “licence” with “certificate of registration”, and “manager” with “designated manager” wherever those terms appear. References to various drug schedules throughout the DPRA are updated and provisions referring to obsolete schedules are repealed.

Most of the provisions of the Schedule come into force on Royal Assent, but some, including the new definition of “drug”, and the amendments that accompany that new definition, come into force on the earlier of the first anniversary of Royal Assent or a date set by proclamation.

Consequential amendments are made to other Acts to correct cross-references.

schedule M
REGULATED HEALTH PROFESSIONS ACT, 1991

Numerous amendments are made to the Regulated Health Professions Act, 1991 (“RHPA”) and the Health Professions Procedural Code (“the Code”) which is a schedule to that Act.

Among the amendments:

1. A definition of “personal information” is added to the RHPA.

2. The Minister is given the power to specify the form and content of the annual reports submitted by the health profession Colleges and the Health Professions Regulatory Advisory Council.

3. Subsection 30 (1) of the RHPA is amended so that no person, other than a member treating or advising within the scope of practice of his or her profession, is able to treat or advise a person with respect to that person’s health in circumstances where it is reasonably foreseeable that “serious bodily harm”, as opposed to the current standard of “serious physical harm”, may result from the treatment or advice or from the omission of treatment or advice.

4. The RHPA is amended by creating and updating exemptions to the requirement that all information gathered by persons in the course of administration of the RHPA, the Code, a health profession act, or the Drug and Pharmacies Regulation Act (”DPRA”) be kept confidential.

5. Section 36.1 is added to the RHPA to allow for the collection of information from the members of the College as is reasonably necessary for the purpose of Ministry health human resources planning.

6. Both the RHPA and the Code are amended to update and consolidate offences and fine levels. The provisions are also updated to provide for different liability levels for first offences and second or subsequent offences, as well as different liability levels for individuals and corporations.

7. Various amendments are made to the Code to clarify language and update cross-references. Various amendments are also made to change references to committees or procedures, to reflect that the new Inquiries, Complaints and Reports Committee (“ICR Committee”) has replaced the former Complaints Committee, and also takes over some functions which formerly belonged to the Executive Committee.

8. The Code is amended to update an existing object of the College and add three new objects.

9. The Code is amended to require every College to have a website, and to include on that website information which may be prescribed by the Minister. The information on the website must be available to the public upon request, and upon payment of a reasonable fee if required by the College, in paper or electronic form.

10. The Code is amended to provide that once a member applies to the Registration Committee to remove or modify any term, condition or limitation on the member’s certificate of registration, and that application has been disposed of, the member may not make a new application for variation within six months of the date of disposition without leave of the Registrar. The Registrar may only give leave for such an application if the Registrar is satisfied that there has been a material change in circumstances that justifies the giving of the leave.

11. The Code is amended to reflect changes to the contents of the public portion of the College register. Public information shall be made available to any person during normal business hours and shall be posted on the College’s website in a manner that is accessible to the public, or any other manner and form specified by the Minister. Rules are established regarding when information may be withheld.

12. The Code is significantly modified to reflect a new streamlined process for dealing with complaints and reports made against members. The Code is amended to permit the use of alternative dispute resolution with respect to a complaint.

13. The Code is amended to permit the Inquiries, Complaints and Reports Committee to make an interim order directing the Registrar to suspend or impose terms, conditions or limitations on a member’s certificate of registration without notice to the member, subject to the right of the member to make submissions while the suspension or the terms, conditions or limitations are in place if the Committee is of the opinion, on reasonable and probable grounds, that the conduct of the member exposes or is likely to expose his or her patients to harm or injury and urgent intervention is needed.

14. The Code is amended so that when a panel of the Discipline Committee makes an order to close a hearing to the public wholly or partly in relation to a person the panel may allow the person and his or her personal representative to attend the hearing, and may also allow another person to attend if to do so does not undermine the reasons for the making of the order and does not cause undue prejudice to a party.

15. The Code is amended to permit a College to apply to a judge of the Superior Court of Justice to have an order made by a panel of the Discipline Committee on the grounds of professional misconduct directing the Registrar to revoke, suspend or impose terms, conditions or limitations on a member’s certificate to take effect immediately despite any appeal if the conduct of the member exposes or is likely to expose his or her patients to harm or injury and urgent intervention is needed.

16. The Code is amended to create mandatory minimum requirements for quality assurance programs and to create an exhaustive list of powers of the Quality Assurance Committee.

17. The Code is amended to require mandatory reporting by a person who operates a facility where one or more members practise if the person has reasonable grounds to believe that a member who practises at the facility is incompetent or incapacitated, in addition to the current requirement that a mandatory report be made for suspected sexual abuse of a patient.

18. The Code is amended to provide for mandatory reports by a member who has been convicted of an offence, or had a finding of negligence or malpractice made against him or her.

schedule N
Chase McEachern Act (Heart Defibrillator Civil Liability), 2007

The Schedule sets out a new Act, the Chase McEachern Act (Heart Defibrillator Civil Liability), 2007. The Act aims to promote the use of automated external heart defibrillators by ensuring that users of defibrillators and the owners and occupiers of premises on which they are installed are protected from civil liability.

schedule o
kinesiology act, 2007

Schedule O enacts a new health profession Act with respect to the regulation of kinesiology and makes complementary amendments to the Regulated Health Professions Act, 1991.

The name of the new College is the College of Kinesiology of Ontario and the new profession is the profession of kinesiology. The Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, is deemed to be part of the new Act.

The scope of practice of kinesiology is the assessment of human movement and performance and its rehabilitation and management to maintain, rehabilitate, or enhance movement and performance.

The College Council will be composed of at least seven and no more than nine persons who are members of the College, and at least six and no more than eight persons appointed by the Lieutenant Governor in Council. In addition, the Council shall have one person selected, in accordance with College by-laws, from among the kinesiology faculty members of an Ontario University. The Council shall have a President and Vice-President elected annually by Council.

The Schedule restricts the use of the title “kinesiologist” to members of the College. No person other than a member may hold themselves out as qualified to practise as a kinesiologist. Anyone who contravenes these restrictions is guilty of an offence and on conviction is liable to a maximum fine of $25,000 for a first offence and a maximum of $50,000 for a subsequent offence.

The Registrar must notify each member of the College if the Minister refers a suggested statutory or regulatory amendment under the new Act to the Health Professions Regulatory Advisory Council.

Transitional provisions in the Schedule provide for the appointment of a transitional Council by the Lieutenant Governor in Council. The transitional Council may do anything that is necessary or advisable for the implementation of the Schedule and anything that it could do once the Act is in force, including accepting and processing applications for registration.

During the transition period, the Minister may review the transitional Council’s activities, require it to make, amend or revoke a regulation and do anything that is necessary or advisable to carry out the intent of the Schedule and the Regulated Health Professions Act, 1991.

After the transition period, the transitional Council shall be the College Council, if it is constituted in accordance with the Act or, if it is not, it shall be deemed to be the Council until a new Council is constituted under the Act. The short title of the new health profession Act is the Kinesiology Act, 2007.

The Schedule amends the Regulated Health Professions Act, 1991 (RHPA) to add the new health profession Act and the profession of kinesiology to Schedule 1 under the RHPA. It also amends the Health Care Consent Act, 1996 to provide that a member of the College is a health care practitioner.

Schedule P
Naturopathy Act, 2007

The Schedule enacts a new health profession Act with respect to the regulation of naturopathy and makes complementary amendments to the Regulated Health Professions Act, 1991 and a number of other Acts.

The College is established as the College of Naturopaths of Ontario and the new profession the College will govern is naturopathy. The Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, is deemed to be part of the new Act.

The practice of naturopathy is the assessment of diseases, disorders and dysfunctions and the naturopathic diagnosis and treatment of diseases, disorders and dysfunctions using naturopathic techniques to promote, maintain or restore health.

In the course of engaging in the practice of naturopathy, a member is authorized to perform certain controlled acts, subject to any terms, limitations or conditions on the member’s certificate of registration.

A member may perform the authorized acts only in accordance with the regulations; any member who does not comply with this requirement shall be found to have committed an act of professional misconduct.

The College Council will be composed of at least six and no more than nine persons who are members of the College and elected in accordance with the by-laws, and at least five and no more than eight persons appointed by the Lieutenant Governor in Council. The Council shall have a President and a Vice-Presidents, elected annually by Council from among Council members.

The Schedule restricts the use of the titles “naturopath” to members of the College. No person other than a member may hold themselves out as qualified to practise as a naturopath or in a specialty of that profession. Anyone who contravenes these restrictions is guilty of an offence and on conviction is liable to a maximum fine of $25,000 for a first offence and a maximum fine of $50,000 for a second or subsequent offence.

The Registrar must notify each member of the College if the Minister refers a suggested statutory or regulatory amendment under the new Act to the Health Professions Regulatory Advisory Council. The College Council, with Ministerial review and approval of the Lieutenant Governor in Council, may make regulations:

(a) prescribing standards of practice involving the circumstances in which naturopaths must make referrals to members of other regulated health professions;

(b) prescribing and governing the therapies involving the practice of naturopathy and prohibiting other therapies;

(c) governing the performance of certain procedures, the purposes or the circumstances under which they may be performed, and prohibiting the performance of certain procedures;

(d) prescribing the substances that may be administered and setting out the purposes or the circumstances under which they may be administered;

(e) prescribing naturopathic examinations and setting out the purposes or the circumstances under which they may be performed and prohibiting the performance of other examinations.

Transitional provisions in the Schedule provide for the appointment of a transitional Registrar and a transitional Council by the Lieutenant Governor in Council. The transitional Council and Registrar may do anything that is necessary or advisable for the implementation of the Schedule and anything that it could do once the Act is in force, including accepting and processing applications for registration.

The short title of the new health profession Act is the Naturopathy Act, 2007.

The Schedule contains a number of complementary amendments, including the following. It amends the Regulated Health Professions Act, 1991 (RHPA) to add the new health profession Act and the professions of naturopathy to Schedule 1 under the RHPA. The Table to the RHPA is amended such that a reference in an Act or regulation that describes a “person registered under the Drugless Practitioners Act” shall be deemed to be a reference to a “member of the College of Naturopaths”. The Schedule also amends the “doctor” title provisions of the RHPA in section 33, providing that a member of the new College is allowed to use the title “doctor”, but only where the phrase “naturopathic doctor” follows immediately after his or her name. The Laboratory and Specimen Collection Centre Licensing Act is amended to clarify that “diagnosis, prophylaxis and treatment” refers only to medical diagnosis, prophylaxis and treatment.

The Schedule repeals the Drugless Practitioners Act and revokes the regulations under that Act. It also amends the Health Care Consent Act, 1996 to provide that a member of the College is a health care practitioner.

schedule q
Homeopathy Act, 2007

The Schedule enacts a new health profession Act with respect to the regulation of homeopathy and makes complementary amendments to the Regulated Health Professions Act, 1991.

The College is established as the College of Homeopaths of Ontario and the new profession the College will govern is homeopathy. The Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, is deemed to be part of the new Act.

The scope of practice of homeopathy is the assessment of body system disorders and treatment using homeopathic techniques to promote, maintain or restore health.

The College Council will be composed of at least six and no more than nine persons who are members of the College and elected in accordance with the by-laws, and at least five and no more than eight persons appointed by the Lieutenant Governor in Council. The Council shall have a President and a Vice-President, elected annually by Council from among Council members.

The Schedule restricts the use of the title “homeopath” to members of the College. No person other than a member may hold themselves out as qualified to practise as a homeopath or in a specialty of the profession. Anyone who contravenes these restrictions is guilty of an offence and on conviction is liable to a maximum fine of $25,000 for a first offence and a maximum fine of $50,000 for a second or subsequent offence.

(a) prescribing standards of practice respecting the circumstances in which homeopaths shall make referrals to members of other regulated health professions;

(b) prescribing therapies involving the practice of homeopathy, governing the use of the prescribed therapies and prohibiting the use of therapies other than the prescribed therapies in the course of the practice of homeopathy.

The short title of the new health profession Act is the Homeopathy Act, 2007.

The Schedule contains complementary amendments. It amends the Regulated Health Professions Act, 1991 (RHPA) to add the new health profession Act and the profession of homeopathy to Schedule 1 under the RHPA. It also amends the Health Care Consent Act, 1996 to provide that a member of the College is a health care practitioner.

schedule r
Psychotherapy act, 2007

The Schedule enacts a new health profession Act with respect to the regulation of psychotherapy and makes complementary amendments to the Regulated Health Professions Act, 1991 (RHPA) and a number of other Acts.

The College is established as the College of Psychotherapists and Registered Mental Health Therapists of Ontario and the new profession the College will govern is psychotherapy. The Health Professions Procedural Code, which is Schedule 2 to the RHPA, is deemed to be part of the new Act.

The scope of practice of psychotherapy is the assessment and treatment of cognitive, emotional or behavioural disturbances by psychotherapeutic means, delivered through a therapeutic relationship based on verbal or non-verbal communication.

In the course of engaging in the practice of psychotherapy, a member is authorized, subject to any terms, limitations or conditions on the member’s certificate of registration, to treat, 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.

The College Council will be composed of at least six and no more than nine persons who are members who are elected in accordance with the by-laws, and at least five and no more than eight persons appointed by the Lieutenant Governor in Council. The Council shall have a President and a Vice-President who must be elected annually by Council from among Council members.

The Schedule restricts the use of the titles “psychotherapist” and “registered mental health therapist” to members of the College. No person other than a member may hold themselves out as qualified to practise as a psychotherapist or registered mental health therapist in Ontario. Anyone who contravenes these restrictions is guilty of an offence and on conviction is liable to a maximum fine of $25,000 for a first offence and a maximum of $50,000 for a second or subsequent offence.

Transitional provisions in the Schedule provide for the appointment of a transitional Registrar and a transitional Council by the Lieutenant Governor in Council. The transitional Council and Registrar may do anything that is necessary or advisable for the implementation of the Schedule and anything that could be done once the Act is in force, including accepting and processing applications for registration.

The short title of the new health profession Act is the Psychotherapy Act, 2007.

The Schedule contains a number of complementary amendments, including the following. It amends the RHPA to add the new health profession Act and the profession of psychotherapy to Schedule 1 under the RHPA. The Schedule also adds the new controlled act of psychotherapy to the existing list of 13 controlled acts within subsection 27 (2) of the RHPA, defining the new controlled act as, “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”. It is clarified that a member of the Ontario College of Social Workers and Social Service Workers is authorized to perform the controlled acts.

The Medicine Act, 1991, Psychology Act, 1991, Nursing Act, 1991 and Occupational Therapy Act, 1991 are amended to include the new authorized act. The Occupational Therapy Act, 1991 is further amended to require members to perform the new authorized act in accordance with the regulations. Complementary regulation-making powers are also provided for under that Act.

Français

chapter 10

An Act to improve health systems by amending or repealing various enactments and enacting certain Acts

Assented to June 4, 2007

CONTENTS

1.	Contents of this Act
2.	Commencement
3.	Short title
Schedule A	Ambulance Act
Schedule B	Amendments Concerning Health Professions
Schedule C	Health Insurance Act
Schedule D	Health Protection and Promotion Act, Ontario Water Resources Act and Safe Drinking Water Act, 2002
Schedule E	Immunization of School Pupils Act
Schedule F	Health Protection and Promotion Act
Schedule G	Amendments to the Health Insurance Act (Revisions to Medical Audit Process)
Schedule H	Personal Health Information Protection Act, 2004
Schedule I	Public Hospitals Act
Schedule J	Making Miscellaneous Corrections and Amendments
Schedule K	Ontario Agency for Health Protection and Promotion Act, 2007
Schedule L	Drug and Pharmacies Regulation Act
Schedule M	Regulated Health Professions Act, 1991
Schedule N	Chase McEachern Act (Heart Defibrillator Civil Liability), 2007
Schedule O	Kinesiology Act, 2007
Schedule P	Naturopathy Act, 2007
Schedule Q	Homeopathy Act, 2007
Schedule R	Psychotherapy Act, 2007
___________

Her Majesty, by and with the advice and consent of the Legislative Assembly of the Province of Ontario, enacts as follows:

Contents of this Act

1. This Act consists of this section, sections 2 and 3, and the Schedules to this Act.

Commencement

2. (1) Subject to subsection (2), this Act comes into force on the day it receives Royal Assent.

Same, Schedules

(2) The Schedules to this Act come into force as provided in each Schedule.

Different dates for same Schedule

(3) If a Schedule to this Act or any portion of a Schedule to this Act provides that it is to come into force on a day to be named by proclamation of the Lieutenant Governor, the proclamation may apply to the whole or any portion of the Schedule, and proclamations may be issued at different times as to any portion of the Schedule.

Short title

3. The short title of this Act is the Health System Improvements Act, 2007.

schedule A
ambulance act

1. Subsection 4 (3) of the Ambulance Act is repealed and the following substituted:

Grants

(3) The Minister may make grants for the purpose of providing or ensuring the provision of services under this Act.

2. The Act is amended by adding the following Part:

part iv.1
land ambulance services — designated persons

Designation

7. (1) The Minister may make regulations,

(a) designating one or more persons who have met the certification requirements under this Act for the purpose of providing land ambulance services;

(b) designating one or more persons for the purpose of ensuring the provision of land ambulance services.

Duties, obligations, etc.

(2) A regulation made under subsection (1) may provide for,

(a) the duties, obligations, powers and responsibilities of a designated person in providing or ensuring the provision of land ambulance services;

(b) the terms and conditions to which a designated person is subject.

Power and authority

(3) Despite anything in Part III or IV or anything in clause 8 (1) (b), a designated person has the power and authority to do anything provided for in a regulation made under subsection (1).

Other duties, etc., not affected

(4) A regulation made under subsection (1) does not affect the duties, obligations, powers or responsibilities of an upper-tier municipality or a delivery agent to ensure the provision of land ambulance services under Part III or IV, except to the extent that the regulation explicitly or by necessary implication provides otherwise.

3. Subsection 19 (3) of the Act is repealed and the following substituted:

Purposes

(3) The purposes mentioned in subsection (2) are purposes relating to the provision, administration, management, operation, use, inspection, investigation or regulation of ambulance services, communication services or base hospital programs or to the enforcement of this Act or the regulations.

Commencement

4. This Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

schedule B
amendments concerning health professions

Audiology and Speech-Language Pathology Act, 1991

1. (1) Section 10 of the Audiology and Speech-Language Pathology Act, 1991 is repealed and the following substituted:

Offence

10. Every person who contravenes subsection 8 (1) or (2) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(2) Sections 12 and 13 of the Act are repealed.

Chiropody Act, 1991

2. (1) Section 12 of the Chiropody Act, 1991 is repealed and the following substituted:

Offence

12. Every person who contravenes subsection 10 (1) or (2) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(2) Section 13 of the Act is amended by adding the following subsection:

Individual drugs or categories

(2) A regulation made under subsection (1) may designate individual drugs or categories of drugs.

(3) Sections 15 and 16 of the Act are repealed.

Chiropractic Act, 1991

3. (1) Section 11 of the Chiropractic Act, 1991 is repealed and the following substituted:

Offence

11. Every person who contravenes subsection 9 (1) or (2) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(2) Sections 13 and 14 of the Act are repealed.

Dental Hygiene Act, 1991

4. (1) Section 5 of the Dental Hygiene Act, 1991 is repealed and the following substituted:

Additional requirements for authorized acts

5. (1) A member shall perform a procedure under the authority of paragraph 1 of section 4 in accordance with any requirements prescribed in the regulations, and may perform such a procedure,

(a) on the member’s own initiative, if none of the contraindications prescribed in the regulations to performing the procedure are present, and if the member ceases the procedure if any of the prescribed contraindications to continuing the procedure are present; or

(b) if the procedure is ordered by a member of the Royal College of Dental Surgeons of Ontario.

Same

(2) A member shall not perform a procedure under the authority of paragraph 2 of section 4 unless the procedure is ordered by a member of the Royal College of Dental Surgeons of Ontario.

Grounds for misconduct

(3) In addition to the grounds set out in subsection 51 (1) of the Health Professions Procedural Code, a panel of the Discipline Committee shall find that a member has committed an act of professional misconduct if the member contravenes subsection (1) or (2).

(2) Section 11 of the Act is repealed and the following substituted:

Offence

(3) Section 12 of the Act is repealed and the following substituted:

Regulations

12. (1) Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations specifying drugs that a member may use in the course of engaging in the practice of dental hygiene.

Individual drugs or categories

(2) A regulation made under subsection (1) may specify individual drugs or categories of drugs.

(4) Section 12 of the Act, as re-enacted by subsection (3), is repealed and the following substituted:

Regulations

12. (1) Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations,

(a) specifying drugs that a member may use in the course of engaging in the practice of dental hygiene;

(b) prescribing requirements for performing scaling teeth and root planing, including curetting surrounding tissue, which requirements may include the educational and experiential qualifications that must be obtained in order for a member to undertake those procedures on the member’s own initiative;

(c) prescribing contraindications to a member performing or continuing to perform on the member’s own initiative the procedures of scaling teeth and root planing, including curetting surrounding tissue.

Individual drugs or categories

(2) A regulation made under clause (1) (a) may specify individual drugs or categories of drugs.

(5) Sections 14 and 15 of the Act are repealed.

Dental Technology Act, 1991

5. (1) Section 9 of the Dental Technology Act, 1991 is repealed and the following substituted:

Offence

9. Every person who contravenes subsection 7 (1), (2) or (3) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(2) Sections 11 and 12 of the Act are repealed.

Dentistry Act, 1991

6. (1) Section 11 of the Dentistry Act, 1991 is repealed and the following substituted:

Offence

(2) Sections 14 and 15 of the Act are repealed.

Denturism Act, 1991

7. (1) Section 10 of the Denturism Act, 1991 is repealed and the following substituted:

Offence

10. Every person who contravenes subsection 8 (1), (2) or (3) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(2) Sections 12 and 13 of the Act are repealed.

Dietetics Act, 1991

8. (1) Section 9 of the Dietetics Act, 1991 is repealed and the following substituted:

Offence

9. Every person who contravenes subsection 7 (1) or (2) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(2) Sections 10 and 11 of the Act are repealed.

Massage Therapy Act, 1991

9. (1) Section 9 of the Massage Therapy Act, 1991 is repealed and the following substituted:

Offence

(2) Sections 11 and 12 of the Act are repealed.

Medical Laboratory Technology Act, 1991

10. (1) Section 11 of the Medical Laboratory Technology Act, 1991 is repealed and the following substituted:

Offence

(2) Sections 13 and 14 of the Act are repealed.

Medical Radiation Technology Act, 1991

11. (1) Section 11 of the Medical Radiation Technology Act, 1991 is repealed and the following substituted:

Offence

11. Every person who contravenes subsection 9 (1), (2) or (3) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(2) Sections 14 and 15 of the Act are repealed.

Medicine Act, 1991

12. (1) Section 11 of the Medicine Act, 1991 is repealed and the following substituted:

Offence

11. Every person who contravenes subsection 9 (1) or (3) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(2) Sections 14 and 15 of the Act are repealed.

Midwifery Act, 1991

13. (1) Section 10 of the Midwifery Act, 1991 is repealed and the following substituted:

Offence

(2) Section 11 of the Act is repealed and the following substituted:

Regulations

11. (1) Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations,

(a) designating the substances that may be administered by injection or inhalation by members in the course of engaging in the practice of midwifery;

(b) designating the drugs that may be prescribed by members in the course of engaging in the practice of midwifery;

Individual drugs or categories

(2) A regulation made under clause (1) (b) or (c) may designate or specify individual drugs or categories of drugs.

(3) Sections 12 and 13 of the Act are repealed.

Nursing Act, 1991

14. (1) Subsection 11 (1) of the Nursing Act, 1991 is repealed and the following substituted:

Restricted titles

(1) No person other than a member shall use the title “nurse”, “nurse practitioner”, “registered nurse” or “registered practical nurse”, a variation or abbreviation or an equivalent in another language.

(2) Subsection 11 (4) of the Act is repealed and the following substituted:

Same

(4) No person shall use the title “nurse anaesthetist”, a variation or abbreviation or an equivalent in another language.

Exception

(4.1) Nothing in subsection (4) prevents a member from using a term, title or designation indicating a specialization of nursing associated with anaesthesia where the member does so in accordance with regulations made by the Council of the College under the Health Professions Procedural Code.

(3) Section 13 of the Act is repealed and the following substituted:

Offence

13. Every person who contravenes subsection 11 (1), (3) or (5) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

(4) Section 14 of the Act is amended by adding the following subsection:

Individual drugs or categories

(1.1) A regulation made under clause (1) (d) may designate individual drugs or categories of drugs.

(5) Sections 16 and 17 of the Act are repealed.

Occupational Therapy Act, 1991

15. (1) Section 9 of the Occupational Therapy Act, 1991 is repealed and the following substituted:

Offence

(2) Sections 11 and 12 of the Act are repealed.

Opticianry Act, 1991

16. (1) Section 11 of the Opticianry Act, 1991 is repealed and the following substituted:

Offence

(2) Sections 13 and 14 of the Act are repealed.

Optometry Act, 1991

17. (1) Section 4 of the Optometry Act, 1991 is amended by adding the following paragraph:

2.1 Prescribing drugs designated in the regulations.

(2) Section 11 of the Act is repealed and the following substituted:

Offence

(3) Section 12 of the Act is repealed and the following substituted:

Regulations

12. (1) Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations,

(a) specifying the drugs that a member may use in the course of engaging in the practice of optometry;

(b) designating drugs for the purposes of paragraph 2.1 of section 4.

Individual drugs or categories

(2) A regulation made under subsection (1) may specify or designate individual drugs or categories of drugs.

(4) Sections 14 and 15 of the Act are repealed.

Pharmacy Act, 1991

18. (1) Clause 7 (1) (a) of the Pharmacy Act, 1991 is amended by adding “at least two and no more than four of whom must hold a certificate of registration as a pharmacy technician” at the end.

(2) Subsection 10 (1) of the Act is amended by striking out ““pharmacist” or “pharmaceutical chemist”” and substituting ““pharmacist,” “pharmacy technician” or “pharmaceutical chemist””.

(3) Subsection 10 (2) of the Act is amended by adding “or a pharmacy technician” after “as a pharmacist.”

(4) Section 12 of the Act is repealed and the following substituted:

Offence

(5) Sections 15 and 16 of the Act are repealed.

Physiotherapy Act, 1991

19. (1) Section 10 of the Physiotherapy Act, 1991 is repealed and the following substituted:

Offence

(2) Sections 13 and 14 of the Act are repealed.

Psychology Act, 1991

20. (1) Section 10 of the Psychology Act, 1991 is repealed and the following substituted:

Offence

(2) Sections 13 and 14 of the Act are repealed.

Regulated Health Professions Act, 1991

21. Clause 23 (2) (d.2) of Schedule 2 to the Regulated Health Professions Act, 1991 is amended by adding “who are members of the College” at the end.

Respiratory Therapy Act, 1991

22. (1) Section 11 of the Respiratory Therapy Act, 1991 is repealed and the following substituted:

Offence

(2) Sections 12 and 13 of the Act are repealed.

Traditional Chinese Medicine Act, 2006

23. (1) This section only applies if Bill 50 (Traditional Chinese Medicine Act, 2006), introduced on December 7, 2005, receives Royal Assent.

(2) References in this section to provisions of Bill 50 are references to those provisions as they were numbered in the first reading version of the Bill.

(3) On the later of the day this section comes into force and the day section 9 of Bill 50 comes into force, section 9 of Bill 50 is repealed and the following substituted:

Offence

Commencement

24. (1) Subject to subsection (2), this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Subsections 4 (1) and (4) and 18 (1), (2) and (3) and section 23 come into force on a day to be named by proclamation of the Lieutenant Governor.

schedule C
health insurance act

1. Section 2 of the Health Insurance Act is amended by adding the following subsections:

Physiotherapy clinics

(7) In the case of physiotherapy clinics that have been prescribed as health facilities for the purposes of the definition of “health facility” in section 1, the Minister may,

(a) approve a change to the name, ownership or location of the clinic; or

(b) approve another clinic to be the replacement for that clinic,

and such a clinic shall be deemed to be prescribed as a health facility, but, for greater certainty, the Minister may not approve a change that increases the number of clinics that are prescribed.

List

(8) The Minister shall keep and maintain a list of clinics approved under subsection (7) and ensure that the list is available to the public.

2. Section 11 of the Act is amended by adding the following subsection:

Change in information

(3) It is the responsibility of every person who has been registered as an insured person to report to the General Manager, within 30 days of its occurrence, every change in the information that was reported to the General Manager for the purposes of establishing his or her entitlement to be or continue to be an insured person.

3. (1) Clause 45 (1) (a) of the Act is repealed and the following substituted:

(a) respecting the form of the health card, and governing the issuance, possession, submission, surrender and destruction of the health card, including measures to protect its security;

(2) Clause 45 (1) (c.2) of the Act is repealed and the following substituted:

(c.2) enabling the General Manager to set requirements, including requirements to provide documentation, relating to registration or renewal of registration as an insured person, or to verify a person’s continuing eligibility to remain registered as an insured person, and making the meeting of any such requirements a condition of being or continuing to be an insured person;

Commencement

4. This Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Schedule D
Health Protection and Promotion Act, Ontario Water Resources Act and Safe Drinking Water Act, 2002

Health Protection and Promotion Act

1. (1) The definition of “operator” in subsection 1 (1) of the Health Protection and Promotion Act is repealed and the following substituted:

“operator”, in relation to a food premise and small drinking-water system, means a person who has responsibility for and control over an activity carried on at the food premise or the small drinking-water system, although there is more than one operator of the same food premise or small drinking-water system; (“exploitant”)

(2) Subsection 1 (1) of the Act is amended by adding the following definition:

“small drinking-water system” means a small drinking-water system as specified by regulation; (“petit réseau d’eau potable”)

(3) Section 5 of the Act is amended by adding the following paragraph:

1.1 The provision of safe drinking water by small drinking-water systems.

(4) Section 7 of the Act is amended by adding the following subsections:

Adoption of codes

(5) A guideline may adopt by reference, in whole or in part, with such changes as are specified in the guideline, any code, formula, protocol or procedure and may require compliance with the code, formula, protocol or procedure so adopted.

Rolling incorporation

(6) If a guideline under subsection (5) so provides, a code, formula, protocol or procedure adopted by reference shall be a reference to it as amended from time to time and whether the amendment was made before or after the guideline was made.

When effective

(7) The adoption of an amendment to a code, formula, protocol or procedure that has been adopted by reference comes into effect upon the Ministry publishing notice of the amendment and transmitting the notice to each board of health.

(5) The Act is amended by adding the following section:

Authority of M.O.H. re small drinking-water systems

12.1 (1) A medical officer of health may, in respect of small drinking-water systems, vary requirements in prescribed provisions of the regulations on a temporary basis and may establish interim requirements with which an owner or operator of the small drinking-water system must comply.

Limitation on power of M.O.H.

(2) In exercising his or her authority under subsection (1), a medical officer of health shall ensure that the risk to the users of the small drinking-water system is not increased by the variance in the requirements or by the establishment of interim requirements.

(6) Subsections 41 (7), (8) and (9) of the Act are repealed and the following substituted:

Private residence

(7) Subsection (3) is not authority to enter a room actually used as a dwelling without the consent of the occupier.

Operator to cease operation

(8) A person mentioned in subsection (1) may require an operator of a food premise or a small drinking-water system to cease the operation of, to dismantle or to excavate, or to do any combination of them on, any equipment on, in or forming part of the food premise or small drinking-water system for the purpose of an examination, investigation, test or inquiry.

Compliance with requirement

(9) An operator of a food premise or small drinking-water system shall comply promptly with a requirement under subsection (8).

(7) Subsection 42 (2) of the Act is amended by striking out “private residence” and substituting “room actually used as a dwelling”.

(8) Subsection 96 (3) of the Act is amended by adding the following clauses:

(m) governing small drinking-water systems;

(n) prescribing provisions in regulations dealing with small drinking-water systems which may be varied by a medical officer of health for the purposes of section 12.1;

(o) prescribing chemical, biological and radiological standards for water from small drinking-water systems and requiring compliance with them;

(p) in respect of any matter related to the health or safety of persons who receive or who may receive water from small drinking-water systems;

(q) requiring owners and operators of small drinking-water systems to comply with prescribed requirements, including, but not limited to, requirements,

(i) governing the construction, alteration, repair, location, operation, maintenance and use, or prohibiting any of them, of small drinking-water systems and related buildings, appurtenances and equipment,

(ii) in respect of the presence of staff, other than the operator, and

(iii) prescribing standards and requirements in respect of owners and operators of small drinking-water systems and in respect of persons who are employed in connection with the systems;

(r) respecting records that must be kept in respect of small drinking-water systems;

(s) specifying powers and duties of medical officers of health and public health inspectors in respect of small drinking-water systems, including authorizing medical officers of health and public health inspectors to issue mandatory directions in respect of individual small drinking-water systems subject to such conditions as may be set out in the regulation;

(t) prescribing reporting requirements by owners and operators of small-drinking water systems, including requirements for reporting to the public and the matters on which owners and operators are to report.

(9) Section 96 of the Act is amended by adding the following subsection:

Transition, small drinking-water systems

(3.1) The Lieutenant Governor in Council may make regulations providing for transitional matters which, in the opinion of the Lieutenant Governor in Council, are necessary or desirable in connection with the regulation of small drinking-water systems and requiring compliance with the provisions of the regulations.

(10) Subsection 102 (1) of the Act is repealed and the following substituted:

Proceedings to restrain contravention of order or directive

(1) Despite any other remedy or any penalty, the contravention by any person of an order made under this Act or of a directive relating to a small drinking-water system may be restrained by order of a judge of the Superior Court of Justice upon application without notice by the person who made the order or issued the directive or by the Chief Medical Officer of Health or the Minister.

Ontario Water Resources Act

2. (1) Section 15.2 of the Ontario Water Resources Act is amended by striking out “the Nutrient Management Act, 2002 or the Pesticides Act” in the portion before clause (a) and substituting “the Nutrient Management Act, 2002, the Pesticides Act or the Safe Drinking Water Act, 2002”.

(2) Section 15.2 of the Act is amended by striking out “or” at the end of clause (b), by adding “or” at the end of clause (c) and by adding the following clause:

(d) section 81, 82, 91, 92 or 93 of the Safe Drinking Water Act, 2002.

(3) Subsection 16.2 (1) of the Act is amended by striking out “or water works” at the end.

(4) Paragraph 2 of subsection 16.2 (4) of the Act is amended by striking out “or water works”.

(5) Section 24 of the Act is repealed and the following substituted:

Licence, etc., condition, permission to inspect

24. It is a condition of every licence, permit or approval under this Act that the holder must forthwith on request permit provincial officers to carry out inspections of any place to which the licence, permit or approval relates, other than a room actually used as a dwelling, if the inspection is authorized by,

(a) section 15, 15.1 or 17 of this Act;

(b) section 156, 156.1 or 158 of the Environmental Protection Act;

(d) section 19, 19.1 or 20 of the Pesticides Act; or

(e) section 81, 82 or 89 of the Safe Drinking Water Act, 2002.

(6) Section 52 of the Act is repealed.

(7) Clause 75 (1) (h) of the Act is amended by striking out “water works and”.

(8) Clause 75 (1) (i) of the Act is amended by striking out “potable and other”.

(9) Clause 75 (1) (t) of the Act is amended by striking out “any water works or sewage works to which subsection 52 (1) or 53 (1) would apply” and substituting “any sewage works to which subsection 53 (1) would apply”.

(10) Clause 89.6 (1) (b) of the Act is amended by striking out “or water works”.

(11) Clause 89.6 (1) (d) of the Act is amended by striking out “subsection 52 (6) or”.

(12) Clause 89.9 (1) (b) of the Act is amended by striking out “or water works”.

(13) Clause 89.9 (1) (d) of the Act is amended by striking out “subsection 52 (6) or”.

(14) Clause 89.14 (b) of the Act is amended by striking out “or water works”.

(15) Clause 89.14 (d) of the Act is amended by striking out “subsection 52 (6) or”.

(16) Clause 106.1 (3) (b) of the Act, as enacted by the Statutes of Ontario, 2005, chapter 12, section 2, is repealed and the following substituted:

(b) in the case of a contravention of subsection 30 (1), contain a description of how the contravention may impair the quality of the water of any waters;

(17) Section 110 of the Act is amended by striking out “or” at the end of clause (b.1), by adding “or” at the end of clause (c) and by adding the following clause:

(d) the Safe Drinking Water Act, 2002.

(18) Subsection 113 (1) of the Act is amended by striking out “the Pesticides Act or” and substituting “the Pesticides Act, the Safe Drinking Water Act, 2002 or” in portion before clause (a).

Safe Drinking Water Act, 2002

3. (1) The definition of “drinking-water test” in subsection 2 (1) of the Safe Drinking Water Act, 2002 is repealed and the following substituted:

“drinking-water test” means,

(a) a test for the purposes of this Act to assist in the determination of the quality of any waters in respect of a drinking-water system,

(b) a test for the purposes of the Health Protection and Promotion Act to assist in the determination of the quality of any waters in respect of a small drinking-water system within the meaning of that Act, and

(2) Subsection 3 (3) of the Act is repealed and the following substituted:

Agreements

(3) The Minister may enter into agreements with such persons, entities or governments as the Minister considers appropriate for the purposes of overseeing the regulation of safe drinking water in Ontario.

(3) Clause 3 (4) (c) of the Act is amended by striking out “under this Act”.

(4) Clause 3 (4) (d) of the Act is amended by striking out “under this Act”.

(5) Subsection 7 (2) of the Act is repealed and the following substituted:

Annual report

(2) The Chief Inspector shall provide an annual written report to the Minister respecting the overall performance of drinking-water systems in Ontario and the inspection of drinking-water systems and containing such other information as the Minister may require.

(6) Paragraph 1 of subsection 18 (1) of the Act is repealed and the following substituted:

1. The operating authority responsible for the system or, if there is no operating authority responsible for the system, the owner of the system.

(7) Subsections 18 (3) and (4) of the Act are repealed and the following substituted:

Duty to report to the owner

(3) If an operating authority is required to report an adverse test result under subsection (1), the operating authority shall also immediately report the adverse test result to the owner of the system for which the operating authority is responsible.

Duty of laboratory to report

(4) Every person operating a laboratory who is required to report an adverse test result under subsection (1) shall also notify the operating authority responsible for the system or, if there is no operating authority responsible for the system, the owner of the system, of every adverse test result relating to the system, immediately after the adverse result is obtained.

(8) The Act is amended by adding the following section:

Duty to report adverse test result

18.1 (1) The person operating the laboratory at which an adverse result was obtained shall report every prescribed adverse result of a drinking-water test conducted on any waters from a small drinking-water system within the meaning of the Health Protection and Promotion Act to the Ministry of Health and Long-Term Care and the medical officer of health immediately after the adverse result is obtained.

Same

(2) A report under subsection (1) shall be made in accordance with the regulations.

Duty of laboratory to report

(3) Every person operating a laboratory who is required to report an adverse test result under subsection (1) shall also notify the operator responsible for the system or, if there is no operator responsible for the system, the owner of the system, of every adverse test result relating to the system, immediately after the adverse result is obtained.

(9) Subsection 54 (1) of the Act is repealed and the following substituted:

Applications

Establishment or replacement of system

(1) If a person proposes to establish or replace a regulated non-municipal drinking-water system and an approval granted by the Director is required under subsection 52 (1), the person shall apply to the Director for the approval.

(10) Subsection 54 (2) of the Act is repealed and the following substituted:

Alteration to system

(2) If a person proposes to carry out an alteration to a regulated non-municipal drinking-water system, an approval granted by the Director is required under subsection 52 (1) and the person has not obtained the required approval, the person shall apply to the Director for the approval.

Same

(2.1) If a person proposes to carry out an alteration to a regulated non-municipal drinking-water system and the alteration relates to a condition of an approval that was imposed under subsection 60 (2), the person shall apply to the Director for an amendment to the approval.

(11) Subsection 54 (4) of the Act is repealed and the following substituted:

Voluntary application for approval

(4) An owner of a regulated non-municipal drinking-water system may apply to the Director for an approval for the purpose of obtaining relief under section 60 from the duty of strict compliance with a regulatory requirement, even if no approval granted by the Director is required under subsection 52 (1).

(12) Clause 69 (a) of the Act is amended by striking out “accredited operating authorities” and substituting “operating authorities”.

(13) Clause 69 (b) of the Act is amended by striking out “accredited operating authority” and substituting “operating authority”.

(14) Clause 74 (2) (a) of the Act is repealed and the following substituted:

(a) it is desirable that the test be available in the area in which the laboratory is situated, or is to be situated;

(15) Subsection 76 (1) of the Act is repealed and the following substituted:

Director’s direction

(1) If the Director considers it necessary, the Director may, by written notice, issue a direction to one or more holders of drinking-water testing licences that a drinking-water test or class of tests is to be conducted under the licence in accordance with a method specified in the direction.

(16) Subsection 76 (2) of the Act is repealed and the following substituted:

May authorize test at non-accredited laboratory

(2) A direction under subsection (1) may authorize the conduct of a drinking-water test at a laboratory that is not accredited for the purpose if the Director considers it necessary.

(17) Paragraph 1 of subsection 127 (1) of the Act is amended by striking out “licence or approval” at the end and substituting “licence, certificate or approval”.

(18) Paragraph 3 of subsection 127 (1) of the Act is amended by striking out “licence or approval” at the end and substituting “licence, certificate or approval”.

(19) Paragraph 4 of subsection 127 (1) of the Act is amended by striking out “licence or approval” at the end and substituting “licence, certificate or approval”.

(20) Paragraph 5 of subsection 127 (1) of the Act is amended by striking out “licence or approval” and substituting “licence, certificate or approval”.

(21) Paragraph 6 of subsection 127 (1) of the Act is amended by striking out “licence or approval” at the end and substituting “licence, certificate or approval”.

(22) Paragraph 8 of subsection 127 (1) of the Act is amended by striking out “licence or approval” at the end and substituting “licence, certificate or approval”.

(23) Subsection 140 (2) of the Act is amended by adding the following paragraph:

7.1 Section 18.1.

(24) Section 143 (3) of the Act is amended by adding the following paragraph:

1.1 A contravention of subsection 18.1 (1), (2) or (3).

Commencement

4. (1) Subject to subsections (2), (3), (4) and (5), this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Section 1 and subsections 3 (1), (2), (5), (6), (7), (8), (14), (15), (16), (23) and (24) come into force on a day to be named by proclamation of the Lieutenant Governor.

Same

(3) Subsection 2 (16) comes into force on the later of the following days:

1. The day the Health System Improvements Act, 2007 receives Royal Assent.

2. The day subsection 2 (28) of the Environmental Enforcement Statute Law Amendment Act, 2005 comes into force.

Same

(4) Subsections 3 (3) and (4) come into force on a day to be named by proclamation of the Lieutenant Governor that is not earlier than the day subsection 3 (4) of the Safe Drinking Water Act, 2002 comes into force.

Same

(5) Subsection 3 (10) comes into force on the later of the following days:

1. The day the Health System Improvements Act, 2007 receives Royal Assent.

2. The day subsection 54 (2) of the Safe Drinking Water Act, 2002 comes into force.

Schedule E
Immunization of School Pupils Act

1. (1) Section 1 of the Immunization of School Pupils Act is amended by adding the following definition:

“registered nurse in the extended class” means a member of the College of Nurses of Ontario who is a registered nurse who holds an extended certificate of registration; (“infirmière autorisée ou infirmier autorisé de la catégorie supérieure”)

(2) The definition of “statement of medical exemption” in section 1 of the Act is repealed and the following substituted:

“statement of medical exemption” means a statement in the prescribed form signed by a physician or registered nurse in the extended class stating that the prescribed program of immunization in relation to a designated disease or designated diseases,

(a) may be detrimental to the health of the person named in the statement, or

(b) is unnecessary in respect of the person named in the statement by reason of past infection or laboratory evidence of immunity. (“déclaration d’exemption médicale”)

2. Subsection 3 (2) of the Act is repealed and the following substituted:

Exception

(2) Subsection (1) does not apply to the parent of a pupil in respect of the prescribed program of immunization in relation to a designated disease specified by a physician or a registered nurse in the extended class in a statement of medical exemption filed with the proper medical officer of health and, where the physician or registered nurse in the extended class has specified an effective time period, only during the effective time period.

3. Subclause 6 (2) (a) (i) of the Act is repealed and the following substituted:

(i) a statement signed by a physician or a member of the College of Nurses of Ontario showing that the pupil has completed the prescribed program of immunization in relation to the designated diseases,

4. Section 10 of the Act is repealed and the following substituted:

Statement by physician or nurse

10. Every physician or member of the College of Nurses of Ontario who administers an immunizing agent to a child in relation to a designated disease shall furnish to a parent of the child a statement signed by the physician or member of the College of Nurses of Ontario showing that the physician or member of the College of Nurses of Ontario has administered the immunizing agent to the child.

5. Clause 12 (2) (b) of the Act is repealed and the following substituted:

(b) that the medical officer of health has not received,

(i) a statement of immunization signed by a physician or a member of the College of Nurses of Ontario showing, or is not otherwise satisfied, that the pupil has completed the prescribed program of immunization in relation to the designated disease, or

(ii) a statement of medical exemption in the prescribed form signed by a physician or a registered nurse in the extended class stating that the prescribed program of immunization in relation to the designated disease is unnecessary in respect of the pupil by reason of past infection or laboratory evidence of immunity.

Commencement

6. (1) This section comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Sections 1 to 5 come into force on a day to be named by proclamation of the Lieutenant Governor.

schedule F
health protection and promotion act

1. Subsection 1 (1) of the Health Protection and Promotion Act is amended by adding the following definition:

“registered nurse in the extended class” means a member of the College of Nurses of Ontario who is a registered nurse holding an extended certificate of registration under the Nursing Act, 1991; (“infirmière autorisée ou infirmier autorisé de la catégorie supérieure”)

2. The definition of “institution” in subsection 21 (1) of the Act is amended by adding the following clause:

(p) a prescribed place,

3. The definition of “practitioner” in subsection 25 (2) of the Act is amended by striking out “or” at the end of clause (e), by adding “or” at the end of clause (f) and by adding the following clause:

(g) a prescribed person.

4. Section 26 of the Act is amended by adding “or registered nurse in the extended class” after “physician”.

5. Subsection 29 (1) of the Act is amended by striking out “in which the laboratory is located” and substituting “in which the person who gives rise to the case resides”.

6. The Act is amended by adding the following sections:

Communicable disease acquired at facility

29.1 (1) Where a medical officer of health is of the opinion, based on information he or she has received, that a communicable disease may have been acquired through exposure at a health facility, and the communicable disease has not been reported to the medical officer of health by that facility, the medical officer of health may report to the administrator of the health facility both the opinion and the basis on which the medical officer of health has come to the opinion.

Definition

(2) In this section,

“health facility” means a hospital to which the Public Hospitals Act applies, a long-term care facility regulated under a statute of Ontario, a psychiatric facility within the meaning of the Mental Health Act, or a person or entity prescribed as a health facility.

Orders to deal with communicable disease outbreaks

29.2 (1) Subject to subsection (2), a medical officer of health may make an order requiring a public hospital or an institution to take any actions specified in the order for the purposes of monitoring, investigating and responding to an outbreak of communicable disease at the hospital or institution.

When order may be made

(2) A medical officer of health may make an order under subsection (1) if he or she is of the opinion, upon reasonable and probable grounds, that an outbreak of a communicable disease exists or may exist at the public hospital or institution, and that the communicable disease presents a risk to the health of persons in the public hospital or institution, and that the measures specified in the order are necessary in order to decrease or eliminate the risks to health associated with the outbreak.

Time

(3) In an order under this section, a medical officer of health may specify the time or times when or the period or periods of time within which the order must be complied with.

Person directed

(4) An order under this section may be directed to the administrator of the public hospital or the superintendent of the institution, and the administrator or superintendent shall ensure that the actions provided for in the order are taken.

Reasons for order

(5) An order under this section is not effective unless the reasons for the order are set out in the order.

Definitions

(6) In this section,

“institution” means an institution as defined in subsection 21 (1); (“établissement”)

“public hospital” means a hospital to which the Public Hospitals Act applies. (“hôpital public”)

7. Section 30 of the Act is amended by adding “or registered nurse in the extended class” after “physician”.

8. (1) Subsection 34 (1) of the Act is repealed and the following substituted:

Physician or extended class nurse to report refusal or neglect of treatment

(1) Every physician and every registered nurse in the extended class shall report to the medical officer of health the name and residence address of any person who is under the care and treatment of the physician or the nurse in respect of a communicable disease and who refuses or neglects to continue the treatment in a manner and to a degree satisfactory to the physician or the nurse.

(2) Subsection 34 (2) of the Act is amended by adding “or registered nurse in the extended class” after “physician”.

(3) Subsection 34 (4) of the Act is amended by adding “or registered nurse in the extended class” after “physician”.

9. (1) Subsection 35 (5) of the Act is amended by striking out “and” at the end of clause (a) and by adding the following clause:

(a.1) to enter any place provided for in the order, including a private residence, for the purposes of locating or apprehending the person who is the subject of the order, where the judge is satisfied based on information provided under oath, that there are reasonable and probable grounds to believe that the person will be found in the place; and

(2) Subsection 35 (6) of the Act is repealed and the following substituted:

Police assistance

(6) An order under this section may be directed to any police force in Ontario, and the police force shall do all things reasonably able to be done to locate, apprehend and deliver the person in accordance with the order.

(3) Subsection 35 (7) of the Act is amended by striking out “four months” and substituting “six months”.

(4) Subsection 35 (11) of the Act is amended by striking out “four months” wherever it appears in the portion after clause (b) and substituting in each case “six months”.

10. Subsection 37 (1) of the Act is amended by adding “or registered nurse in the extended class” after “physician”.

11. (1) The definition of “immunizing agent” in subsection 38 (1) of the Act is amended by striking out “influenza or a prescribed disease” at the end and substituting “influenza, meningococcal-C, pneumococcal, and varicella diseases or a disease specified in regulations made by the Minister”.

(2) Subsection 38 (2) of the Act is repealed and the following substituted:

Duty to inform

(2) If consent to the administration of an immunizing agent has been given in accordance with the Health Care Consent Act, 1996, the physician or other person authorized to administer the immunizing agent shall cause the consenting person to be informed of the importance of immediately reporting to a physician or a registered nurse in the extended class any reaction that might be a reportable event.

12. Subsection 39 (2) of the Act is amended by adding the following clause:

(0.a) where the disclosure is authorized under this Act or the Personal Health Information Protection Act, 2004;

13. Subsection 40 (1) of the Act is amended by adding “or a registered nurse in the extended class” after “physician”.

14. Section 62 of the Act is amended by adding the following subsection:

Report, CMOH

(3) The annual report of the Chief Medical Officer of Health under section 81 shall include a summary of the medical officer of health and associate medical officer of health vacancies in Ontario.

15. The Act is amended by adding the following Part:

Part VI.1
Provincial Public Health Powers

Chief Medical Officer of Health may act where risk to health

77.1 (1) If the Chief Medical Officer of Health is of the opinion that a situation exists anywhere in Ontario that constitutes or may constitute a risk to the health of any persons, he or she may investigate the situation and take such action as he or she considers appropriate to prevent, eliminate or decrease the risk.

Same

(2) For the purpose of subsection (1), the Chief Medical Officer of Health,

(a) may exercise anywhere in Ontario,

(i) any of the powers of a board of health, including the power to appoint a medical officer of health or an associate medical officer of health, and

(ii) any of the powers of a medical officer of health; and

(b) may direct a person whose services are engaged by a board of health to do, anywhere in Ontario, whether within or outside the health unit served by the board of health, any act,

(i) that the person has power to do under this Act, or

(ii) that the medical officer of health for the health unit served by the board of health has authority to direct the person to do within the health unit.

Authority and duty of person directed to act

(3) If the Chief Medical Officer of Health gives a direction under clause (2) (b) to a person whose services are engaged by a board of health,

(a) the person has authority to act, anywhere in Ontario, whether within or outside the health unit served by the board of health, to the same extent as if the direction had been given by the medical officer of health of the board of health and the act had been done in the health unit; and

(b) the person shall carry out the direction as soon as practicable.

Section 22 powers

(4) For the purpose of the exercise by the Chief Medical Officer of Health under subsection (2) of the powers of a medical officer of health, a reference in section 22 to a communicable disease shall be deemed to be a reference to an infectious disease.

Application to judge where risk to health

77.2 (1) If the Chief Medical Officer of Health is of the opinion that a situation exists anywhere in Ontario that constitutes or may constitute a risk to the health of any persons, he or she may apply to a judge of the Superior Court of Justice for an order under subsection (2).

Order of judge of Superior Court of Justice

(2) If an application is made under subsection (1), the judge,

(a) may order the board of health of a health unit in which the situation causing the risk exists to take such action as the judge considers appropriate to prevent, eliminate or decrease the risk caused by the situation; and

(b) may order the board of health of a health unit in which the health of any persons is at risk as a result of a situation existing outside the health unit to take such action as the judge considers appropriate to prevent, eliminate or decrease the risk to the health of the persons in the health unit.

Request to board of health for information

77.3 (1) The Chief Medical Officer of Health may request a board of health to provide such information in respect of the board of health and the health unit served by the board of health as the Chief Medical Officer of Health specifies.

Same

(2) The Chief Medical Officer of Health may specify the time at which, and the form in which, the information must be provided.

Duty to comply

(3) A board of health that receives a request for information under this section shall provide the information in accordance with the request.

Possession of premises for temporary isolation facility

77.4 (1) The Minister, in the circumstances mentioned in subsection (3), by order may require the occupier of any premises to deliver possession of all or any specified part of the premises to the Minister to be used as a temporary isolation facility or as part of a temporary isolation facility.

Extension

(2) An order under subsection (1) shall set out an expiry date for the order that is not more than 12 months after the day of its making and the Minister may extend the order for a further period of not more than 12 months.

Grounds for order

(3) The Minister may make an order under subsection (1) where the Chief Medical Officer of Health certifies in writing to the Minister that,

(a) there exists or there is an immediate risk of an outbreak of a communicable disease anywhere in Ontario; and

(b) the premises are needed for use as a temporary isolation facility or as part of a temporary isolation facility in respect of the communicable disease.

Delivery of possession

(4) An order under subsection (1) may require delivery of possession on the date specified in the order.

Hearing and submissions

(5) The Minister need not hold or afford to any person an opportunity for a hearing or afford to any person an opportunity to make submissions before making an order under subsection (1).

Order for possession

(6) Where a judge of the Superior Court of Justice is satisfied on evidence upon oath,

(a) that there has been or is an immediate risk of an outbreak of a communicable disease anywhere in Ontario;

(b) that the premises are needed for use as a temporary isolation facility or as part of a temporary isolation facility in respect of the communicable disease; and

(i) has refused to deliver possession of the premises to the Minister in accordance with the Minister’s order under subsection (1),

(ii) is not likely to comply with the Minister’s order under subsection (1), or

(iii) cannot be readily identified or located and as a result the Minister’s order under subsection (1) cannot be carried out promptly,

the judge may issue an order directing the sheriff for the area in which the premises are located, or any other person whom the judge considers suitable, to put and maintain the Minister and any persons designated by the Minister in possession of the premises, by force if necessary.

Execution of order

(7) An order made under this section shall be executed at reasonable times as specified in the order.

Application without notice

(8) A judge may receive and consider an application for an order under this section without notice to and in the absence of the owner or the occupier of the premises.

Compensation

(9) The occupier of the premises is entitled to compensation from the Crown in right of Ontario for the use and occupation of the premises and in the absence of agreement as to the compensation the Ontario Municipal Board, upon application in accordance with the rules governing the practice and procedure of that board, shall determine the compensation in accordance with the Expropriations Act.

Procedure

(10) Except in respect of proceedings before the Ontario Municipal Board in accordance with subsection (9), the Expropriations Act does not apply to proceedings under this section.

Emergency procurement, etc., of medications and supplies

77.5 (1) Subject to subsections (3) and (4), the Minister may make an order,

(a) authorizing the procurement, acquisition and seizure of any medications and supplies provided for in the order; and

(b) requiring any person provided for in the order to provide the medications and supplies to any person provided for in the order, on the date or within the dates provided for in the order.

Other provinces and territories

(2) Nothing in this section shall require a person subject to an order to provide to the Minister or to another person specified in the order a quantity of medications and supplies if there exists or may exist an immediate risk that the health of patients in another province or territory of Canada would be jeopardized.

When order may be made

(3) The Minister may make an order under subsection (1) where the Chief Medical Officer of Health has certified in writing that,

(a) there exists or there may exist an immediate risk to the health of persons anywhere in Ontario;

(b) the medications and supplies are necessary to address the risk; and

(c) the Chief Medical Officer of Health is of the opinion that regular procurement processes for medication and supplies are unable to meet the needs of persons in Ontario.

Restriction, private residence

(4) An order under subsection (1) may not authorize entry into a private residence without the consent of the occupier.

No hearing required

(5) The Minister is not required to hold a hearing or give any person an opportunity to be heard or to make submissions before making an order under subsection (1).

Provision of information

(6) For the purposes of this section, the Minister may issue a direction requiring any person to provide such information as the Minister considers necessary in order to identify persons who may have medications and supplies, and any person to whom such a direction is made shall comply with it.

Order of Superior Court judge

(7) Where a judge of the Superior Court of Justice is satisfied, on information provided under oath on an application without notice, that a person provided for in an order under subsection (1) or a direction under subsection (6) has failed to comply with the order or direction, the judge may,

(a) in the case of a failure to comply with an order under subsection (1), make an order directing a sheriff, police force, or any person or persons provided for in the judge’s order, to seize the medications and supplies provided for in the Minister’s order; or

(b) in the case of a failure to comply with a direction under subsection (6), make an order requiring that the direction be complied with.

Reasonable times

(8) An order under subsection (1) or (7) or a direction under subsection (6) may be exercised at any reasonable time provided for in the order or direction.

Compensation for loss of property

(9) If, as the result of the making an order under this section, a person suffers a loss, including a taking, of any personal property, the Lieutenant Governor in Council may by order authorize the reasonable compensation of the person for the loss in accordance with such guidelines as may be approved by the Lieutenant Governor in Council.

Not expropriation

(10) Nothing done under an order made under subsection (1) constitutes an expropriation or injurious affection for the purposes of the Expropriations Act or otherwise at law and there is no compensation for the loss, including a taking, of any real or personal property except in accordance with subsection (9).

Definition

(11) In this section,

“medications and supplies” include antitoxins, antivirals, serums, vaccines, immunizing agents, antibiotics and other pharmaceutical agents, medical supplies and medical equipment.

Order to provide information

77.6 (1) Subject to subsections (2) and (3), where the Chief Medical Officer of Health is of the opinion, based on reasonable and probable grounds, that there exists an immediate and serious risk to the health of persons anywhere in Ontario, he or she may issue an order directing any health information custodian indicated in the order to supply the Chief Medical Officer of Health or his or her delegate with any information provided for in the order, including personal health information.

Restriction

(2) The Chief Medical Officer of Health may only make an order under subsection (1) if he or she is of the opinion, based on reasonable and probable grounds, that the information is necessary to investigate, eliminate or reduce the immediate and serious risk to the health of persons, and the information supplied must be no more than is reasonably necessary to prevent, eliminate or reduce the risk.

Further restriction

(3) Despite anything in the Personal Health Information Protection Act, 2004 or the Freedom of Information and Protection of Privacy Act, the information provided to the Chief Medical Officer of Health must only be used or disclosed to investigate, eliminate or reduce the risk and for no other purpose.

Must comply

(4) A health information custodian that is served with an order under subsection (1) shall comply with the order within the time and in the manner provided for in the order.

Definitions

(5) In this section,

“health information custodian” means a health information custodian within the meaning of the Personal Health Information Protection Act, 2004; (“dépositaire de renseignements sur la santé”)

“personal health information” means personal health information within the meaning of the Personal Health Information Protection Act, 2004. (“renseignements personnels sur la santé”)

Directives to health care providers

77.7 (1) Where the Chief Medical Officer of Health is of the opinion that there exists or there may exist an immediate risk to the health of persons anywhere in Ontario, he or she may issue a directive to any health care provider or health care entity respecting precautions and procedures to be followed to protect the health of persons anywhere in Ontario.

Precautionary principle

(2) In issuing a directive under subsection (1), the Chief Medical Officer of Health shall consider the precautionary principle where,

(a) in the opinion of the Chief Medical Officer of Health there exists or may exist an outbreak of an infectious or communicable disease; and

(b) the proposed directive relates to worker health and safety in the use of any protective clothing, equipment or device.

Must comply

(3) A health care provider or health care entity that is served with a directive under subsection (1) shall comply with it.

No coercion of professionals

(4) For greater certainty, a directive under subsection (1) may not be used to compel regulated health professionals to provide services without their consent.

No conflict with OHSA

(5) Despite subsection (1), in the event of a conflict between this section and the Occupational Health and Safety Act or a regulation made under it, the Occupational Health and Safety Act or the regulation made under it prevails.

Definitions

(6) In this section,

“health care provider or health care entity” means:

1. A regulated health professional or a person who operates a group practice of regulated health professionals.

2. A service provider within the meaning of the Long-Term Care Act, 1994 who provides a community service to which that Act applies.

3. A community care access corporation within the meaning of the Community Care Access Corporations Act, 2001.

4. A hospital within the meaning of the Public Hospitals Act, a private hospital within the meaning of the Private Hospitals Act, a psychiatric facility within the meaning of the Mental Health Act, an institution within the meaning of the Mental Hospitals Act or an independent health facility within the meaning of the Independent Health Facilities Act.

5. A pharmacy within the meaning of Part VI of the Drug and Pharmacies Regulation Act.

6. A laboratory or a specimen collection centre as defined in section 5 of the Laboratory and Specimen Collection Centre Licensing Act.

7. An ambulance service within the meaning of the Ambulance Act.

8. A paramedic under the Ambulance Act.

9. A home for special care within the meaning of the Homes for Special Care Act.

10. A nursing home under the Nursing Homes Act, a home under the Homes for the Aged and Rest Homes Act, or a charitable institution under the Charitable Institutions Act.

11. A centre, program or service for community health or mental health whose primary purpose is the provision of health care.

12. A prescribed person or entity; (“fournisseur de soins de santé ou entité chargée de la fourniture de soins de santé”)

“precautionary principle” has the meaning prescribed in regulations made by the Lieutenant Governor in Council; (“principe de précaution”)

“regulated health professional” means a health practitioner whose profession is regulated under the Regulated Health Professions Act, 1991 or the Drugless Practitioners Act. (“membre d’une profession de la santé réglementée”)

May collect specimens, etc.

77.8 (1) Subject to subsection (2), where the Chief Medical Officer of Health is of the opinion, based on reasonable and probable grounds, that there exists an immediate and serious risk to the health of persons anywhere in Ontario, he or she may,

(a) collect, retain and use previously collected specimens and collect, retain and use information respecting the analysis of previously collected specimens, perform tests on any previously collected specimen of or from any person, animal or plant, living or deceased or any other thing, and acquire any previously collected specimens or test results as he or she considers reasonably necessary to investigate, eliminate or reduce the risk to health;

(b) order any person or entity to provide previously collected specimens or previously gathered information or permit the performance of tests on previously collected specimens for the purposes of clause (a); and

(c) disclose the results of specimen or test analyses to a medical officer of health or similar public health authority in any jurisdiction in or outside of Ontario, as he or she considers reasonably necessary to investigate, eliminate or reduce the risk to the health of persons anywhere in Ontario.

Restriction

(2) Nothing in subsection (1) permits the Chief Medical Officer of Health to compel an individual to provide a bodily sample or submit to tests without the individual’s consent.

Same

(3) Despite the Personal Health Information Protection Act, 2004 and the Freedom of Information and Protection of Privacy Act, the specimens and information collected by the Chief Medical Officer of Health under this section must only be used or disclosed to investigate, eliminate or reduce the risk to health and for no other purpose.

Comply with order

(4) A person or entity that is served with an order under clause (1) (b) shall comply with the order within the time and in the manner provided for in the order.

Personal information

(5) For the purposes of this section, the Chief Medical Officer of Health has the power to collect, use, retain and disclose personal information, including personal health information.

Definitions

(6) In this section,

“personal health information” means personal health information within the meaning of the Personal Health Information Protection Act, 2004; (“renseignements personnels sur la santé”)

“personal information” means personal information within the meaning of the Freedom of Information and Protection of Privacy Act. (“renseignements personnels”)

16. The Act is amended by adding the following sections:

Associate Chief Medical Officer of Health

81.1 (1) The position of Associate Chief Medical Officer of Health is established.

Person who shall hold position

(2) Subject to subsection (3), the position of Associate Chief Medical Officer of Health shall be held by the person or persons who, by virtue of their position, hold the title of “Associate Chief Medical Officer of Health” in the Ministry.

Qualifications

(3) No person is qualified to be or to act as an Associate Chief Medical Officer of Health unless he or she is a physician of at least five years standing and possesses the qualifications prescribed by the regulations for the position of medical officer of health.

Functions, duties, etc.

(4) An Associate Chief Medical Officer of Health,

(a) shall perform such functions and duties as the Chief Medical Officer of Health may specify in writing; and

(b) shall act in the place of the Chief Medical Officer of Health when the Chief Medical Officer of Health is absent or is unable to perform the functions of his or her office or when the office of Chief Medical Officer of Health is vacant.

Regulations

(5) The Minister may make regulations clarifying, modifying or restricting the functions, powers and duties of Associate Chief Medical Officers of Health.

Agreements

81.2 (1) The Minister may enter into an agreement with the board of health of any health unit for the purpose of setting out requirements for the accountability of the board of health and the management of the health unit.

May include services

(2) An agreement under subsection (1) may also provide for services which are to be provided by boards of health in addition to any services set out in this Act or the regulations.

17. Sections 86, 86.1, 86.2 and 87 of the Act are repealed.

18. Subsection 95 (1) of the Act is repealed and the following substituted:

Protection from personal liability

(1) No action or other proceeding for damages or otherwise shall be instituted against the Chief Medical Officer of Health or the Associate Chief Medical Officer of Health, a member of a board of health, a medical officer of health, an associate medical officer of health of a board of health, an acting medical officer of health of a board of health or a public health inspector or an employee of a board of health who is working under the direction of a medical officer of health for any act done in good faith in the execution or the intended execution of any duty or power under this Act or for any alleged neglect or default in the execution in good faith of any such duty or power.

Crown liability

(1.1) Despite subsections 5 (2) and (4) of the Proceedings Against the Crown Act, subsection (1) does not relieve the Crown of liability for the acts or omissions of a minister of the Crown or a Crown employee referred to in subsection (1) and the Crown is liable under that Act as if subsection (1) had not been enacted.

Persons acting under order

(1.2) No action or other proceeding lies or shall be instituted against any person acting pursuant to an order, direction or directive made under section 77.5, 77.6, 77.7 or 77.8 for any act done in good faith in the exercise or performance, or the intended exercise or performance of any duty under an order, direction or directive or for neglect or default in the good faith exercise or performance of such a duty.

19. Section 97 of the Act is amended by adding the following clause:

(g) specifying diseases for the purposes of the definition of “immunizing agent” in subsection 38 (1).

20. Subsection 100 (3) of the Act is repealed and the following substituted:

Offence, specified provisions

(3) Any person who contravenes section 16, 17, 18, 20, 39 or 40, subsection 41 (9), 42 (1), 72 (5), (7) or (8), clause 77.1 (3) (b), subsection 77.3 (3) or 77.5 (6), section 77.7, subsection 82 (13), (14), (15), (16) or (17), 83 (3) or 84 (2) or section 105 is guilty of an offence.

21. Subsection 102 (2) of the Act is repealed and the following substituted:

Proceedings to prohibit continuation or repetition of contravention

(2) Where any provision of this Act or the regulations is contravened, despite any other remedy or any penalty imposed, the Minister or the Chief Medical Officer of Health may apply to a judge of the Superior Court of Justice for an order,

(a) prohibiting the continuation or repetition of the contravention or the carrying on of any activity specified in the order that, in the opinion of the judge, will or will likely result in the continuation or repetition of the contravention by the person committing the contravention; and

(b) requiring the person committing the contravention to take any action that is, in the opinion of the judge, necessary or advisable for the purpose of reducing the likelihood of a continuation or repetition of the contravention.

Enforcement

(2.1) Where a judge has made an order based on an application under subsection (2), the order may be enforced in the same manner as any other order or judgment of the Superior Court of Justice.

22. Subsection 106 (1) of the Act is amended by adding “or in the case of an order to which subsection 22 (5.0.1) applies, as provided in subsections 22 (5.0.2) and (5.0.3)” at the end.

Commencement

23. (1) Subject to subsection (2), this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Sections 1 to 22 come into force on a day to be named by proclamation of the Lieutenant Governor.

SCHEDULE G
amendments to the health insurance act (Revisions to Medical audit process)

1. (1) Section 1 of the Health Insurance Act is amended by adding the following definitions:

“business day” means a day on which Canada Post ordinarily delivers lettermail; (“jour ouvrable”)

“joint committee” means the Joint Committee on the Schedule of Benefits established under subsection 5 (1); (“comité mixte”)

“Ministry” means the Ministry of Health and Long-Term Care; (“ministère”)

“payment correction list” means the list of circumstances for which payments are subject to correction referred to in subsection 5 (7), as amended from time to time; (“liste de rectification au titre des paiements”)

“Review Board” means the Physician Payment Review Board established under subsection 5.1 (1); (“Commission de révision”)

“schedule of benefits” means the schedule of benefits as defined by the regulations. (“liste des prestations”)

(2) The definition of “eligible physician” in section 1 of the Act is repealed.

(3) Section 1 of the Act is amended by adding the following definition:

“payment committee” means the Physician Services Payment Committee established under subsection 5.4 (1); (“comité de paiement”)

2. (1) Section 5 of the Act is repealed and the following substituted:

Joint Committee on the Schedule of Benefits

5. (1) The Minister shall establish a joint committee to perform the functions set out in subsection (3) and the committee shall be known in English as the Joint Committee on the Schedule of Benefits and in French as the Comité mixte de la liste des prestations.

Members

(2) The joint committee shall consist of the prescribed number of members appointed by the Minister,

(a) one-half of whom shall be appointed from among physicians nominated for the purpose by the Ontario Medical Association; and

(b) one-half of whom shall be other physicians.

Functions

(3) The joint committee will,

(a) provide an opinion on its interpretation of any of the provisions of the schedule of benefits,

(i) upon the written request of the General Manager, or

(ii) upon the written request of a physician if clause 18 (14) (c) applies, but shall provide such an opinion without considering any matters specific to the physician’s claim;

(b) where in the opinion of the joint committee it is appropriate to do so, make recommendations to the General Manager and the Ontario Medical Association on amendments to the schedule of benefits based on its opinions under clause (a);

(d) perform such other duties as may be prescribed.

Limitation

(4) The joint committee has the power to act only in an advisory capacity under clause (3) (a) and shall not hold hearings.

Response

(5) The joint committee shall respond to a request under clause (3) (a) within 30 business days of receiving the request, or within any other time that may be prescribed.

If can’t reach opinion

(6) If the joint committee is unable to come to an opinion in response to a request under clause (3) (a), it shall issue a report to that effect.

List

(7) Immediately upon the coming into force of this subsection, there shall be published on the Internet at a website that is accessible to physicians a list of circumstances described in subsection 18 (2) for which payments are subject to correction. The list will initially be established by the Medical Services Payment Committee established by agreement between the Ontario Medical Association and the Crown in right of Ontario.

Payment correction list

(8) For greater clarity, a circumstance described in subsection 18 (2) may be listed or described on the payment correction list without specific reference to subsection 18 (2).

Same

(9) The joint committee shall publish, maintain and amend the payment correction list and cause its amended versions to be published as provided in subsection (7) or in such other manner as may be prescribed.

Remuneration and expenses

(10) Members of the joint committee may be paid such remuneration and receive such reimbursement for expenses as the Lieutenant Governor in Council may determine.

Review Board established

5.1 (1) There is established a board to be known in English as the Physician Payment Review Board and in French as Commission de révision des paiements effectués aux médecins.

Duties

(2) The Review Board shall perform such duties as are set out in this Act and Schedule 1.

May only order authorized payments

(3) For greater certainty, the Review Board may only order payments that are authorized under this Act.

Application of SPPA

(4) Subject to subsection 12 (5) of Schedule 1, the Statutory Powers Procedure Act applies to all proceedings of the Review Board.

Composition

(5) The Review Board shall be composed of no fewer than 26 and no more than 40 members who shall be appointed by the Lieutenant Governor in Council on the recommendation of the Minister, as follows:

1. No fewer than 20 and no more than 30 members who are physicians, one-half of whom are to be selected by the Minister for the Minister’s recommendation, and one-half of whom are to be selected by the Ontario Medical Association for the Minister’s recommendation. If there are not sufficient nominees put forward by that Association to permit the minimum number of 20 physicians to be appointed, the Minister may recommend sufficient physicians to meet or exceed the minimum requirement.

2. No fewer than six and not more than 10 members who are not physicians and who are selected from the public.

Same

(6) A physician shall not be appointed or reappointed as a member of the Review Board unless,

(a) he or she is actively engaged in rendering insured services to insured persons and submitting accounts for insured services to the Plan at the time of first appointment; and

(b) he or she has not been retired from rendering insured services to insured persons and submitting accounts for insured services to the Plan for more than three years in the case of a reappointment.

Same

(7) Both the Ontario Medical Association and the Minister shall make best efforts to ensure that physicians recommended for appointment to the Review Board represent a broad range of physician practices.

Same

(8) A person may not be appointed as a member of the Review Board if he or she is employed in the public service of Ontario or in a Crown agency as defined in the Crown Agency Act.

Chair and vice chairs

(9) The Review Board shall elect one of its members as its chair and at least one but not more than three of its members as a vice chair.

Remuneration and expenses

(10) The members of the Review Board and persons appointed under subsection (11) shall be paid the remuneration and expenses the Lieutenant Governor in Council determines except that the remuneration for physician members shall not be less than $500 a day.

Appointment of persons to assist

(11) The Review Board may appoint from time to time one or more persons having technical or special knowledge of any matter before it to inquire into and report to the Review Board and to assist the Review Board in any capacity in respect of any matter before it.

Not to sit on Review Board or review panel

(12) A person appointed pursuant to subsection (11) shall not sit as a member of the Review Board or of any review panel appointed to conduct a hearing.

Employees

(13) Such employees as the Review Board considers necessary to carry out its duties may be appointed under the Public Service Act.

Annual meeting

(14) The Review Board shall meet annually to review its policies and procedures.

Annual report

(15) The Review Board shall report annually to the Minister.

Tabling of report

(16) The Minister shall submit the report to the Lieutenant Governor in Council and shall cause the report to be laid before the Assembly if it is in session or, if not, at the next session.

Disclosure

5.2 (1) A nominee or other potential appointee to the joint committee or the Review Board shall notify the Minister if he or she has been found guilty of fraud under the Criminal Code (Canada) or if he or she has been found guilty of an offence under the laws of Canada or a province or territory that is relevant to his or her suitability to sit as a member, unless the finding of guilt is for an offence for which he or she has received a pardon.

Same

(2) The requirement to disclose as set out in subsection (1) continues during the term of the person’s appointment or any subsequent reappointment.

Disqualification

5.3 (1) A person who has been found guilty of fraud under the Criminal Code (Canada) or has been found guilty of an offence under the laws of Canada or a province or territory that in the Minister’s opinion is relevant to the person’s suitability to sit as a member of the joint committee or the Review Board may not be appointed or reappointed as a member of the joint committee or the Review Board, unless the finding of guilt is for an offence for which the person has received a pardon.

Same

(2) A physician who has been the subject of a finding of professional misconduct, incompetence or incapacity whether in Ontario or in another jurisdiction may not be appointed or reappointed as a member of the joint committee or the Review Board.

Time-limited disqualification

(3) A physician who has been required to reimburse the Plan as a result of a decision of the Medical Review Committee, the Review Board or the Appeal Board may not be appointed or re-appointed as a member of the joint committee or the Review Board until 10 years have passed since he or she was last required to reimburse the Plan.

Continuing qualifications

(4) A person’s membership in the joint committee or the Review Board is automatically terminated,

(a) in the case of a physician, if he or she ceases to be a member of the College of Physicians and Surgeons of Ontario;

(b) in the case of any member, if he or she ceases to be qualified under subsection (1), (2) or (3); and

(c) in the case of any member, if he or she fails to provide information required under subsection (6) within the time specified by the Minister.

Waiver

(5) If the Minister believes that the circumstances justify it, the Minister may appoint a person who is otherwise disqualified under subsection (1), (2) or (3), or reappoint a person whose membership has been automatically terminated under subsection (4), unless the disqualification or termination is the result of a conviction for fraud under the Criminal Code (Canada) for which the person has not received a pardon.

Information

(6) Any person being considered for appointment or reappointment to the joint committee or the Review Board and any member of the joint committee or the Review Board shall, if requested to do so by the Minister, provide the Minister within the time specified in the request with any information relevant to determining the person’s eligibility to be appointed or reappointed or to remain a member, as a condition of being appointed or reappointed or continuing to be a member, as the case may be.

(2) Subsection (4) only applies if Bill 158 (Public Service of Ontario Statute Law Amendment Act, 2006), introduced on November 2, 2006, receives Royal Assent.

(3) References in this section to provisions of Bill 158 are references to those provisions as they were numbered in the first reading version of the Bill.

(4) On the later of the day this subsection comes into force and the day that section 1 of Schedule A to Bill 158 comes into force, subsections 5.1 (8) and (13) of the Act, as enacted by subsection (1), are repealed and the following substituted:

Same

(8) A person may not be appointed as a member of the Review Board if he or she is employed,

(a) under Part III of the Public Service of Ontario Act, 2006; or

(b) by any agency of the Crown.

. . . . .

Employees

(13) Such employees as the Review Board considers necessary to carry out its duties may be appointed under the Part III of the Public Service of Ontario Act, 2006.

3. The Act is amended by adding the following section:

Physician Services Payment Committee

5.4 (1) The Minister shall establish a committee to perform the functions set out in subsection (5) and the committee shall be known in English as the Physician Services Payment Committee and in French as the Comité de paiement des services de médecin.

Members

(2) The payment committee shall consist of the prescribed number of physicians, appointed by the Minister,

(a) one-half of whom shall be appointed from among physicians nominated for the purpose by the Ontario Medical Association; and

(b) one-half of whom shall be other physicians.

Qualifications, disclosure, etc.

(3) Sections 5.2 and 5.3 apply with necessary modifications to the payment committee.

Chair

(4) The Minister shall appoint a chair for the payment committee, who shall not be a member of the committee, and shall not have a vote in any proceedings of the payment committee.

Functions

(5) The payment committee will have the responsibility for making recommendations to the Minister with respect to amendments to the schedule of benefits and other physician payment programs, and in particular shall,

(a) make timely and appropriate recommendations to amend the schedule of fees and other payment programs to reflect current medical practice and meet the needs of the health care system;

(b) conduct specialty specific or service specific reviews;

(c) on the request of the General Manager, provide its opinion on any proposed amendments to the schedule of benefits; and

(d) perform such other duties as may be prescribed.

Performing role of joint committee

(6) The Lieutenant Governor in Council may make regulations assigning to the payment committee any or all of the role and functions of the joint committee, and where such a regulation has been made, every reference in this Act to anything that may be done by the joint committee with respect to its role or function shall be deemed to be a reference to the payment committee.

Remuneration and expenses

(7) Members of the payment committee may be paid such remuneration and receive such reimbursement for expenses as the Lieutenant Governor in Council may determine.

4. Subsections 12 (2) and (3) of the Act are repealed.

5. (1) Subsection 15.2 (2) of the Act is amended by striking out “physician or”.

(2) Section 15.2 of the Act is amended by adding the following subsection:

Same

(2.1) Despite paragraph 2 of subsection (1), subsections 25 (3), (4), (5), (6) and (8), as they existed immediately before their repeal by the Commitment to the Future of Medicare Act, 2004 cease to apply to physicians on the day that this subsection comes into force.

6. Subsection 16.1 (6) of the Act is repealed and the following substituted:

Keeping and inspection of records

(6) Section 37.1 applies with necessary modifications to a person or entity to whom payment is made pursuant to a direction by a physician or practitioner and,

(a) in the case of a direction by a practitioner, subsections 40 (3) and (4) and sections 40.1 and 40.2 apply with necessary modifications to an inspection of the records required to be kept; and

(b) in the case of a direction by a physician, subsections 37 (5) to (7) apply with necessary modifications in respect of the records required to be kept.

7. Subsections 17.1 (1), (2) and (8) of the Act are repealed and the following substituted:

Fees payable for insured services

(1) A physician or practitioner who submits an account to the General Manager in accordance with this Act for insured services provided by the physician or practitioner is entitled to be paid the fee determined under this section.

Same

(2) An insured person who submits an account to the General Manager in accordance with this Act for insured services provided by a physician or practitioner to the insured person is entitled to be paid the fee determined under this section.

8. (1) Subsection 18 (1) of the Act is repealed and the following substituted:

Payment of accounts

(1) The General Manager shall determine all issues relating to accounts for insured services in accordance with this Act and shall make the payments from the Plan that are authorized under this Act.

(2) Subsections 18 (3) to (9) of the Act are repealed and the following substituted:

Refusal to pay

(3) The General Manager shall refuse to pay for an insured service if the account for the service is not prepared in the required form, does not meet the prescribed requirements or is not submitted to him or her within the prescribed time. However, the General Manager may pay for the service if there are extenuating circumstances.

Refusal to pay

(4) Despite subsection (2), the General Manager may refuse to pay a physician for a service or pay a reduced amount for the service only if a circumstance described in subsection (2) that is also set out or described in the payment correction list exists in respect of the claim or claims, or if permitted to do so by an order of the Review Board.

Referral to Review Board for expedited hearing

(5) Where the General Manager is of the opinion that for a claim or claims submitted for insured services rendered by a physician, a circumstance described in subsection (2) that is not also set out or described in the payment correction list exists in respect of the claim or claims, and is of the opinion that the physician knew or ought to have known that the claim or claims were false, the General Manager may give a notice to the Review Board requesting it to hold an expedited hearing.

Expedited hearing, notice

(6) The General Manager may request an expedited hearing without notice to the physician, but shall promptly afterwards give notice to the physician.

Reimbursement, practitioner or health facility

(7) The General Manager may require a practitioner or health facility to reimburse the Plan for an amount paid for a service if, after the payment is made, the General Manager is of the opinion that a circumstance described in subsection (2) exists.

Exception, practitioner

(8) Despite subsection (7), the General Manager shall not require a practitioner to reimburse the Plan if the sole reason for requiring the reimbursement is that a circumstance described in paragraph 4 or 6 of subsection (2) exists.

Notice, practitioner and health facilities

(9) The General Manager shall give notice to a practitioner or health facility of a decision to refuse to pay for a service, to pay a reduced amount or to require that the Plan be reimbursed.

Notice, physician, refusal to pay or reduced payment

(10) The General Manager shall give notice to a physician of a decision to refuse to pay for a service or to pay a reduced amount because a circumstance described in subsection (2) that is set out or described in the payment correction list exists in respect of the claim or claims.

Notice, physician, re payment correction list after payment

(11) Despite subsections (14) to (18), if the General Manager is of the opinion that an amount paid to a physician for a service should not have been paid or should have been paid at a reduced amount because a circumstance described in subsection (2) that is set out or described in the payment correction list exists in respect of the claim or claims, the General Manager may give notice to the physician of the circumstance and of the amount the General Manager believes is owing.

Limitation on when notice may be given

(12) No notice may be given under subsection (11) more than 19 months after the service to which the claim or claims relates was rendered.

Request for hearing by physician

(13) If the physician disagrees with the decision or opinion of the General Manager as set out in a notice given under subsection (10) or (11), the physician may, within 20 business days of receiving the notice, give a notice to the Review Board requesting it to hold a hearing and at the same time give notice of the request to the General Manager and, in the case of a matter to which subsection (11) applies,

(a) if the physician gives the notice within the 20 business days, the General Manager shall not take any steps to recover any amount alleged to be owed by the physician to the Plan pending the Review Board’s order; or

(b) if there is no notice given within the 20 business days, the General Manager may direct the physician to reimburse the Plan.

Notice of initial opinion

(14) Where the General Manager is of the initial opinion that a circumstance described in subsection (2) exists in respect of one or more claims paid for services provided by a physician, the General Manager may give the physician a notice that,

(a) sets out a brief statement of the facts giving rise to the General Manager’s initial opinion as well as the General Manager’s interpretation of any of the provisions of the schedule of benefits relevant to the matter;

(b) advises that the General Manager is reviewing the physician’s claims and that the physician may, not later than 20 business days after receiving the notice, provide the General Manager in writing with any information that he or she believes is relevant to determining whether a circumstance described in subsection (2) exists in respect of the claim or claims paid as submitted by the physician or an insured person for services provided by the physician; and

(c) advises that the physician may seek an opinion of the joint committee in accordance with clause 5 (3) (a) unless the joint committee has already provided an opinion on the interpretation of those provisions.

Notice

(15) If, after reviewing records and other information in his or her possession and any opinions received from the joint committee, the General Manager is of the opinion that a circumstance described in subsection (2) exists in respect of one or more claims paid for services provided by the physician, the General Manager may give a notice to the physician that,

(a) provides the physician with the General Manager’s reasons for his or her opinion; and

(b) notifies the physician that, unless the physician submits future claims for those services in accordance with the General Manager’s opinion, future claims may be referred to the Review Board and payments for those services may be subject to reimbursement in whole or in part after the date notice is given.

Disagreement with notice

(16) The physician may, within 20 business days of receiving the notice under subsection (15), give a notice to the Review Board requesting it to hold a hearing with respect to the interpretation of any of the provisions of the schedule of benefits relevant to the matter.

Where continuing inappropriate claims

(17) If the General Manager has given a notice under subsection (15) and the physician has not requested a hearing by the Review Board within the time provided in subsection (16) and if, upon reviewing the claims for services rendered by the physician and any other information in the General Manager’s possession, the General Manager is of the opinion that a circumstance described in subsection (2) continues to exist, the General Manager may give a notice to the Review Board requesting it to hold a hearing, and shall promptly give the physician notice of the request.

Immediate referral for false claims by physician

(18) Despite subsection (17), the General Manager may give a notice to the Review Board requesting it to hold a hearing without giving a notice to the physician under subsection (15), but shall promptly afterwards give notice to the physician of the request for a hearing, if the General Manager is of the opinion that a circumstance described in subsection (2) exists in respect of one or more claims paid for services provided by the physician, and that the physician knew or ought to have known that the claims submitted to the Plan were false.

Settlement with physician

(19) Nothing in this section prevents the General Manager and physician from settling, at any time and despite any other provision of this Act, any disagreement between the General Manager and the physician with respect to accounts.

Payment unless alternative

(20) If as a result of a settlement with the General Manager or an order of the Review Board money is owed to the Plan, or where the General Manager is proceeding under clause (13) (b), the money shall be paid to the Plan through any method permitted under this Act unless the settlement or Review Board order provides an alternative method of payment.

9. Section 18.0.1 of the Act is repealed and the following substituted:

Physicians

18.0.1 (1) During the period that commences when section 9 of Schedule G to the Health System Improvements Act, 2007 comes into force and ends when this section is repealed, this section applies with respect to requests for review by the Review Board made by physicians and the General Manager.

Panel review

(2) Subject to the other provisions of this section, on the request of a physician pursuant to subsection 18 (13) or (16) or the General Manager pursuant to subsection 18 (5), (17) or (18), the Transitional Physician Audit Panel shall, in accordance with this section, conduct any review that would be conducted by the Review Board under this Act if this section were not in force.

If review requested

(3) If a physician or the General Manager requests a review under subsection (2), the chair of the Appeal Board shall designate members of the Transitional Physician Audit Panel to deal with the review and set a time for the review and the panel shall conduct the review and render its direction as expeditiously as may be reasonably possible, and in any case shall render its direction no more than 45 days after the last day on which evidence in the review was adduced before the panel, unless the General Manager and the physician consent to an extension.

Parties

(4) Only the General Manager and the physician are parties to a review by the Transitional Physician Audit Panel.

Directions

(5) Following the review, the Transitional Physician Audit Panel may give any of the following directions:

1. That the decision or opinion of the General Manager be confirmed.

2. That the General Manager make a payment in accordance with the submitted account.

3. That the General Manager pay a reduced amount, as calculated by the General Manager in accordance with the direction.

4. That the physician reimburse the Plan in the amount calculated by the General Manager in accordance with the direction.

Interest, payable by physician

(6) If, as a result of a direction by the Transitional Physician Audit Panel, an amount is payable by a physician, interest calculated in the prescribed manner is payable on the amount, payable from the date the account was paid by the Plan.

Interest, payable to physician

(7) If, as a result of a direction by the Transitional Physician Audit Panel, an amount is payable by the General Manager, interest calculated in the prescribed manner is payable on the amount, payable from the date the amount was recovered from the physician by the Plan.

Applicability of certain provisions

(8) The following provisions apply, with necessary modifications, to a review by the Transitional Physician Audit Panel:

1. Subsection 21 (2).

2. Subsections 23 (1) to (4) and (6).

3. Subsection 27.2 (1).

Appeal to Divisional Court

(9) Any party to a review before the Transitional Physician Audit Panel may appeal from the panel’s direction to the Divisional Court in accordance with the rules of court, but,

(a) personal health information contained in any document or evidence filed or adduced with regard to the appeal, or in any order or decision of the Court shall not be made accessible to the public; and

(b) the Divisional Court may edit any documents it releases to the public to remove any personal health information.

10. Section 18.0.4 of the Act is repealed and the following substituted:

Information confidential

18.0.4 Sections 38 and 39 apply with necessary modifications to the Transitional Physician Audit Panel, its members, employees and agents, if any.

Repeal

18.0.5 (1) The Lieutenant Governor may by one or more proclamations repeal sections 18.0.1, 18.0.2, 18.0.3 and 18.0.4 or any of them or any subsection or subsections within those sections on such day or days as may be named in any such proclamation.

Same

(2) This section is repealed when sections 18.0.1, 18.0.2, 18.0.3 and 18.0.4 have been entirely repealed.

11. (1) The Act is amended by adding the following section:

Settlement

18.0.6 Where, during the time that any of sections 18.0.1, 18.0.2, 18.0.3 and 18.0.4 and paragraph 3 of subsection 20 (1) are in force, the General Manager and a physician come to an agreement regarding a matter to which one of those sections applies, the General Manager shall be deemed to have had the authority to enter into the agreement, and no action shall, either during the time they are in force or after, be commenced against any of the following as a result of entering into the agreement:

1. The General Manager.

2. The Minister, the Crown in right of Ontario or an employee or agent of the Crown.

3. The Medical Review Committee, any of its members, inspectors or employees or agents, if any.

4. The Appeal Board or any of its members, employees or agents.

(2) Section 18.0.6 of the Act, as enacted by subsection (1), is amended by adding the following subsection:

Where no settlement

(2) If, immediately before section 18.0.1 came into force, a matter was referred to the Medical Review Committee under section 39.1 as it existed at that time, and where at the time this section comes into force there has been no agreement referred to in subsection (1) concerning the matter, the matter shall be deemed to have been withdrawn.

(3) Section 18.0.6 of the Act, as enacted by subsection (1) and amended by subsection (2), is amended by adding the following subsection:

Same

(3) If, during the time that section 18.0.1 was in force, a physician had requested a review by the Transitional Physician Audit Panel under subsection 18.0.1 (3), as it read before section 9 of Schedule G to the Health System Improvements Act, 2007 came into force, and where at the time this subsection comes into force there has been no agreement between the physician and the General Manager with respect to the matter, the decision of the General Manager referred to in subsection 18.0.1 (3) is deemed to be withdrawn and the General Manager is authorized to reimburse any amounts recovered plus interest, if applicable.

12. The Act is amended by adding the following section:

Transitional

18.0.7 (1) Where, by virtue of subsection 18.0.2 (11) as it existed during the time it was in force, payments to a physician continued to be suspended, the suspension shall remain in effect until the physician has complied with subsections 37 (1) and (3) to the satisfaction of the General Manager.

Same

(2) Where, during the time that section 18.0.1 was in force, the Transitional Physician Audit Panel commenced a review, it has the authority to complete the review and issue a direction in accordance with that section.

13. (1) Subsections 18.1 (1) and (2) of the Act are repealed.

(2) Subsection 18.1 (5) of the Act is amended by striking out “physician or”.

(3) Paragraph 2 of subsection 18.1 (6) of the Act is amended by striking out “(2) (a) or”

(4) Paragraph 4 of subsection 18.1 (6) of the Act is amended by striking out “physician or”.

(5) Subsection 18.1 (7) of the Act is repealed and the following substituted:

Same, reconsideration

(7) A person aggrieved by the direction given by the single committee member may request the applicable practitioner review committee to reconsider the matter.

(6) Subsection 18.1 (8) of the Act is amended by striking out “physician or”.

(7) Subsection 18.1 (9) of the Act is amended by striking out “physician or”.

(8) Subsection 18.1 (10) of the Act is amended by striking out “the Medical Review Committee or” in the portion before clause (a).

(9) Clause 18.1 (10) (d) of the Act is amended by striking out “physician or”.

(10) Subsection 18.1 (11) of the Act is amended by striking out “the Medical Review Committee or”.

(11) Subsection 18.1 (12) of the Act is amended by striking out “physician or”.

(12) Subsection 18.1 (14) of the Act is amended by striking out “physician or”.

(13) Subsection 18.1 (15) of the Act is amended by striking out “physician or” in the portion before clause (a) and in clauses (a) and (b).

(14) Subsection 18.1 (17) of the Act is amended by striking out “physician or”.

(15) Subsection 18.1 (18) of the Act is amended by striking out “physician or” wherever that expression appears.

14. Section 18.2 of the Act is repealed and the following substituted:

Review of referrals

18.2 (1) If the General Manager is of the opinion that a service performed by a physician, practitioner, health facility or independent health facility is not medically necessary, and that service was requested by another physician, the General Manager may give a notice to the Review Board requesting it to hold a hearing to review the provision of the service that was requested.

Where finding that not necessary

(2) If the Review Board finds that the requested service was not medically necessary, the physician who requested the provision of the service shall pay to the Plan the amount paid by the Plan to the physician, practitioner, health facility or independent health facility who performed the service, and the General Manager may require the amount owing be paid through any method permitted under this Act.

Physician payment review process

18.3 (1) Where under this Act a physician or the General Manager gives notice to the Review Board requesting it to hold a hearing, the matter shall be dealt with by the Review Board in accordance with this Act and Schedule 1.

Same

(2) A review panel of the Review Board may determine all issues relating to payments for insured services and may make orders for payments from the Plan that are authorized under this Act.

15. Paragraph 3 of subsection 20 (1) of the Act is repealed.

16. (1) Subsection 21 (1.0.1) of the Act is amended by striking out “the Medical Review Committee or a practice review committee” and substituting “or a practitioner review committee”.

(2) Subsection 21 (1.1) of the Act is amended by striking out “physician or” and “Medical Review Committee”.

17. Subsection 22 (2) of the Act is repealed.

18. Subsection 25 (1) of the Act is amended by striking out “physician or”.

19. Section 26 of the Act is repealed and the following substituted:

Service of notice

26. (1) Except where otherwise provided, any notice required by or provided for in this Act may be served,

(a) by personal service;

(b) by courier;

(d) by any other prescribed method.

When effective

(2) Service of a notice is effective,

(a) in the case of a notice under clauses (1) (a) to (c), on the day of delivery; and

(b) in the case of a notice under clause (1) (d), as provided for in the regulations.

Service by lettermail

(3) Where an attempt has been made to effect service by a method set out in subsection (1), and for any reason service could not be effected, service may be made by lettermail.

Same

(4) Service by lettermail shall be deemed to be effective 14 business days after the day of mailing, unless the person or entity on whom service is to be made establishes that the notice was not received until a later date for reasons that he, she or it could not control, in which case service is effective on the day that the notice is actually received.

20. Subsection 27.2 (2) of the Act is repealed and the following substituted:

Same

(2) The General Manager may obtain or recover money from a practitioner by set-off despite a review by the Medical Eligibility Committee or a practitioner review committee or an appeal to the Appeal Board from the practitioner review committee or a subsequent appeal to the Divisional Court from a decision of the Appeal Board concerning whether the money is owed to the Plan.

21. Sections 29.1 to 29.8 of the Act are repealed.

22. (1) Subsection 37 (1) of the Act is repealed and the following substituted:

General information requirement

(1) Every physician and practitioner shall give the General Manager such information, including personal information, as may be prescribed,

(a) for purposes related to the administration of this Act, the Commitment to the Future of Medicare Act, 2004 or the Independent Health Facilities Act; or

(b) for such other purposes as may be prescribed.

(2) Section 37 of the Act is amended by adding the following subsections:

Rules re providing records and information

(5) Where the General Manager requires a physician to provide records or any other information under subsection (1), the following rules apply:

1. The physician shall submit copies of the requested records or other information and, where required by the General Manager, shall include a signed certificate of authenticity and a signed copy of an audit trail for electronic records.

2. If the General Manager is not satisfied with the copies of the requested records or other information, the General Manager may require the physician to produce the original documents to the General Manager, and the documents shall be returned to the physician in a timely manner after copies have been made.

3. Where a physician fails to produce the copies or originals of records or other information required under this section, the General Manager may, on notice to the physician, apply to a provincial judge or justice of the peace for an order compelling production of the required records or other information and the provincial judge or justice of the peace may issue the order where he or she is satisfied that there are reasonable grounds for believing that the physician failed to produce the records or other information.

Electronic records

(6) Where records required to be kept by physicians for the purposes of this Act are in electronic form, they shall have the characteristics of electronic records set out in the regulations under the Medicine Act, 1991.

Certificate of authenticity

(7) A certificate of authenticity required under this section shall be in the form supplied by the General Manager unless otherwise prescribed.

23. (1) Subsection 37.1 (1) of the Act is amended by striking out “physician”.

(2) Subsection 37.1 (2) of the Act is amended by striking out “physician”.

(3) Subsection 37.1 (3) of the Act is repealed and the following substituted:

Same

(3) For the purposes of this Act, every health facility shall maintain such records as may be necessary to establish whether a service it has provided is medically necessary.

(4) Section 37.1 of the Act is amended by adding the following subsection:

Same

(4.1) For the purposes of this Act, every physician shall maintain records that,

(a) comply with any requirements respecting records set out in the regulations made under the Medicine Act, 1991; and

(b) comply with any additional requirements that may be provided for in the schedule of benefits.

(5) Subsection 37.1 (5) of the Act is repealed and the following substituted:

Prompt preparation

(5) The records described in subsections (1), (2), (3), (4) and (4.1) must be prepared promptly after the service is provided.

(6) Subsection 37.1 (6) of the Act is amended by striking out “physician” in the portion before paragraph 1.

(7) Paragraph 3 of subsection 37.1 (6) of the Act is repealed.

24. (1) Subsection 38 (1) of the Act is repealed and the following substituted:

Information confidential

(1) The persons listed in subsection (1.1) shall preserve secrecy with respect to all matters that come to their knowledge in the course of their employment or duties pertaining to insured persons and any insured services rendered and the payments made for those services, and shall not communicate any such matters to any other person except as otherwise provided in this Act, the Personal Health Information Protection Act, 2004 and the Freedom of Information and Protection of Privacy Act.

Persons referred to in subs. (1)

(1.1) The following are listed for the purposes of subsection (1):

1. The members of the Review Board, the Appeal Board, a practitioner review committee and the Medical Eligibility Committee.

2. The employees, agents and inspectors, if any, of the Review Board, the Appeal Board, a practitioner review committee and the Medical Eligibility Committee.

3. The General Manager and persons engaged in the administration of this Act.

(2) Subsections 38 (2) and (3) of the Act are repealed.

(3) Subsection 38 (4) of the Act is amended by striking out “the Medical Review Committee” wherever that expression appears in the portion before paragraph 1.

(4) Paragraph 1 of subsection 38 (4) of the Act is repealed and the following substituted:

1. Information pertaining to the date or dates on which insured services were provided and for whom, the name and address of the hospital and health facility or person who provided the services, the amounts paid or payable by the Plan for such services and the hospital, health facility or person to whom the money was paid or is payable.

25. Section 38.1 of the Act is repealed and the following substituted:

Filing with court

38.1 A copy of any of the following may be filed with the Superior Court of Justice after the time in which an appeal may be made has passed, and once filed shall be entered in the same way as a judgment or order of the Superior Court of Justice and is enforceable as an order of that court:

1. A decision of the Appeal Board made under this Act.

2. An order of the Review Board made under this Act.

3. An agreement to reimburse the Plan signed by a physician.

4. A direction to pay the Plan given by the General Manager under clause 18 (13) (b).

26. (1) Section 39 of the Act is repealed and the following substituted:

Protection from liability

39. (1) No action or other proceeding shall be instituted against any of the persons listed in subsection (2) for any act done in good faith in the performance or intended performance of the person’s duty or for any alleged neglect or default in the performance in good faith of the person’s duty.

Persons referred to in subs. (1)

(2) The following are listed for the purposes of subsection (1):

1. The members of the Review Board, a practitioner review committee, the joint committee and the Medical Eligibility Committee.

2. The employees, agents or inspectors, if any, of the Review Board, a practitioner review committee, the joint committee and the Medical Eligibility Committee.

3. The General Manager and persons engaged in the administration of this Act.

(2) Subsection 39 (2) of the Act, as enacted by subsection (1), is amended by adding the following paragraph:

2.1 Members, employees and agents, if any, of the payment committee.

27. (1) Subsection 39.1 (1) of the Act is repealed.

(2) Subsection 39.1 (5) of the Act is repealed and the following substituted:

Directions

(5) Following a review or following a reconsideration of a review by a single committee member, the practitioner review committee may direct the General Manager,

(a) to increase the amount paid to the practitioner for an insured service; or

(b) to require the practitioner to repay all or part of any payment made under the Plan.

(3) Subparagraph 2 i of subsection 39.1 (6) of the Act is repealed.

(4) Subsection 39.1 (8) of the Act is amended by striking out “physician or”.

28. Subsections 40 (1) and (2) of the Act are repealed.

29. (1) Paragraph 1 of subsection 40.1 (1) of the Act is amended by striking out “physician or”.

(2) Subsection 40.1 (3) of the Act is amended by striking out “physician”.

(3) Subsection 40.1 (9) of the Act is amended by striking out “physician”.

30. (1) Subsection 40.2 (2) of the Act is repealed.

(2) Subsection 40.2 (6) of the Act is repealed and the following substituted:

Suspension of payments

(6) The General Manager may suspend payments under the Plan to a practitioner during any period when he or she fails to comply with subsection (3) without just cause, whether or not the practitioner is convicted of an offence.

31. The Act is amended by adding the following section:

Suspension of payments

40.3 (1) The General Manager may give a notice to the Review Board requesting it to hold a hearing and issue an order suspending payments or a portion of payments to a physician from the Plan, during any period when he or she fails to comply with section 37 without just cause.

Expedited review

(2) The Review Board shall commence a hearing within 30 days of receiving notice under subsection (1).

Where does not submit directly to the Plan

(3) In the case of a physician who, by virtue of section 11 of the Commitment to the Future of Medicare Act, 2004, does not submit accounts directly to the Plan, or is a physician to whom section 18.0.7 applies, the Review Board may make a further order requiring him or her to temporarily submit accounts directly to the Plan for the purpose of suspending payments under the order made under subsection (1).

Not deemed election

(4) Where a physician is required to temporarily submit his or her accounts directly to the Plan under an order of the Review Board, the submission of the accounts is not a deemed election for the purposes of subsection 11 (6) of the Commitment to the Future of Medicare Act, 2004, but subsection 10 (3) of that Act applies to him or her during the time that he or she is temporarily required to submit accounts directly to the Plan.

32. Section 44 of the Act is amended by adding the following subsection:

No imprisonment for record-keeping offences

(1.1) Despite subsection (1), no person may be sentenced to a term of imprisonment for failing to keep or maintain records under section 37.1.

33. (1) Clause 45 (1) (c.1) of the Act is amended by striking out “clauses 5 (2) (a) and (b) and”.

(2) Clauses 45 (1) (r.1) and (r.2) of the Act are repealed and the following substituted:

(r.1) governing service for the purposes of section 26, including prescribing anything that may be prescribed under that section and providing for situations in which service shall be deemed to have been made;

(3) Clause 45 (1) (t) of the Act is amended by striking out “Medical Review Committee” and substituting “joint committee”.

(4) Clause 45 (1) (t) of the Act is amended by striking out “joint committee” and substituting “joint committee or payment committee”.

(5) Section 45 of the Act is amended by adding the following subsection:

Consultation

(1.3) The Lieutenant Governor in Council shall not make a regulation providing for additional requirements that physicians must comply with in maintaining records under clause 37.1 (4.1) (b) unless the Minister has first consulted either or both of the following:

1. The payment committee.

2. The Medical Services Payment Committee established by agreement between the Ontario Medical Association and the Crown in right of Ontario.

34. The Act is amended by adding the following Schedule:

Schedule 1
Physician Payment review Process

Purpose

1. The purpose of this Schedule is to establish procedures for the Physician Payment Review Board to hold hearings on payment matters that cannot be resolved between the General Manager and a physician through the provision of education and other assistance, and to provide for an appeal process from its decisions.

Definitions

2. In this Schedule,

“peer” means a physician who is a member of the same specialty group as the physician who is a party to a hearing by the Review Board; (“pair”)

“public member” means a member of the Review Board who is not a physician; (“représentant du public”)

“review panel” means a panel selected under subsection 3 (1); (“comité de révision”)

“specialty group” means one of the specialty groups set out in the Index to the Consultations and Visits section of the schedule of benefits; (“domaine de spécialité”)

“the Act” means the Health Insurance Act. (“la Loi”)

Request for a hearing, general

3. (1) When the Review Board receives a notice that requests a hearing under section 18, 18.2 or 40.3 of the Act and proof of service of the notice, the chair of the Review Board or, in his or her absence, a vice chair shall select a panel in accordance with section 6 to hear and determine the matter before it.

Timing of hearing

(2) A panel selected under subsection (1) shall conduct the hearing in a timely manner within the prescribed time, if any, and shall make an order with written reasons within 30 business days of the close of submissions or, if another time has been prescribed, within that time.

Parties

(3) The parties to a hearing under subsection (1) are the General Manager and the physician or physicians named in the notice that requests a hearing.

Order of Review Board

(4) An order of a review panel is for all purposes an order of the Review Board.

Expedited hearings

4. (1) When the Review Board has received a request for an expedited hearing under subsection 18 (5) of the Act, the chair of the Review Board or, in his or her absence, a vice chair shall promptly select a panel to deal with the request, and the panel shall hear the matter and make an order as expeditiously as possible or, if a time has been prescribed, within that time.

Same

(2) The Review Board may make rules respecting the holding of expedited hearings.

Period of review

5. (1) In the case of a hearing under subsection 18 (16), (17) or (18) of the Act, unless the panel orders otherwise in accordance with paragraph 5 of subsection 11 (1) of this Schedule, the physician under review shall only be required to reimburse the Plan for services provided in a period that is no more than 12 months in duration.

Restriction

(2) Despite subsection (1) and unless the panel orders otherwise in accordance with paragraph 5 of subsection 11 (1) of this Schedule, the period of review for reimbursement purposes cannot be for a period that begins prior to the later of,

(a) the date of notice, if any, given under subsection 18 (15) of the Act that services may be subject to reimbursement; and

(b) 18 months prior to the date of a request for a hearing under subsection 18 (17) or (18) of the Act.

Relevant evidence regardless of date

(3) Nothing in this section precludes a party to a hearing from submitting, nor prevents the Review Board from admitting as evidence, any document, record or other information that is relevant to the hearing regardless of the date of the document, record or other information.

Panels

6. (1) A review panel shall consist of four members of the Review Board selected as follows:

1. The chair of the Review Board or, in his or her absence, a vice chair shall select the members of the panel that will conduct the hearing and determine the matter before it. The chair or the vice chair may be a member of a panel.

2. Three of the members must be physician members.

3. One member must be a public member.

4. Subject to paragraph 5, one of the three members appointed under paragraph 2 must be a peer of the physician who is the subject of the hearing, as determined by the chair or the vice chair, as the case may be.

5. If the chair or vice chair determines that no peer is available, or if the physician who is the subject of the hearing raises a concern about the peer member of the Review Board, including whether the peer is also a member of the same specialty as defined by the Royal College of Physicians and Surgeons of Canada as the physician who is the subject of hearing, the chair or vice chair may, in his or her sole discretion, appoint a physician advisor under subsection 5.1 (11) of the Act to provide advice to the panel.

6. The chair or vice chair of the Review Board, as the case may be, shall designate one of the members of the review panel as the chair of the panel. The chair of a review panel shall not be the peer of the physician who is the subject of the hearing.

Death, termination of membership

(2) If a member of a review panel which has begun a hearing with respect to a particular matter dies, has their appointment to the Review Board terminated or becomes unable or unwilling to continue as a member before the matter is concluded, the remaining members of the panel may deal with the matter, unless the member is a peer member, in which case the chair of the panel shall determine how to deal with the matter.

Expiry of term

(3) If the appointment of a member of a review panel expires before the hearing with respect to a particular matter has been completed, the member shall continue to be a member of the Review Board for the purposes of dealing with that matter.

Hearing by review panel

7. (1) A review panel shall hear and determine the matter before it.

Members holding hearing not to have taken part in investigation, etc.

(2) Members of the review panel shall not have taken part before the hearing in any consideration of the matter that is the subject of the hearing and shall not communicate directly or indirectly in relation to the matter with any person or with any party or representative of a party except upon notice to and opportunity for the parties to participate.

Legal advice

(3) The review panel may seek legal advice from a person who is not counsel in the hearing and, in such case, the nature of the advice shall be made known to the parties in order that they may make submissions as to the law.

Conflict of interest

(4) A member of a review panel who has a conflict of interest shall, immediately upon discovery of the conflict, report the nature and extent of the conflict to the chair of the Review Board who shall determine what course of action to take in consequence.

If chair has conflict

(5) If the chair of the Review Board has a conflict of interest, he or she shall not assign himself or herself to a panel, and if he or she becomes aware of a conflict after already being assigned to a panel, he or she shall report the nature and extent of the conflict to a vice-chair who shall determine what course of action to take in consequence.

Majority determination

(6) The final determination of a matter before a review panel shall be by majority vote and, if there is a tie, the chair of the review panel’s vote shall decide the matter.

Only members at hearing to participate in decision

(7) No member of the review panel shall participate in a decision of the review panel following a hearing unless he or she was present throughout the hearing and heard the evidence and argument of the parties.

Findings of fact

8. The findings of fact of a review panel pursuant to a hearing shall be based exclusively on evidence admissible or matters that may be noticed under sections 15 and 16 of the Statutory Powers Procedure Act.

Recording of evidence

9. The oral evidence taken before the review panel at a hearing shall be recorded and, if so required, copies of a transcript of the evidence shall be furnished upon the same terms as in the Superior Court of Justice.

Release of documentary evidence

10. Documents and things put in evidence at a hearing shall, upon the request of the person who produced them, be released to the person by the Review Board within a reasonable time after the matter in issue has been finally determined.

Orders

11. (1) The review panel may, as an order of the Review Board, make any order that it considers appropriate, including, without being limited to, any one or more of the following:

1. An order determining the proper amount, if any, to be paid to the physician in accordance with the Act and the regulations for the service provided, and requiring that,

i. the General Manager pay the account in the amount set out in the order, or

ii. the physician reimburse the Plan for any amount paid by the Plan for the service that is in excess of the amount set out in the order.

2. An order that, in the future, the physician submit claims for insured services to the Plan or to insured persons in accordance with the order of the Review Board.

3. Where the physician has breached a previous order of the Review Board, an order that the General Manager refuse to pay, or pay a reduced amount as determined by the review panel, with respect to identical future claims submitted during a time period determined by the review panel.

4. An order that costs be awarded to either party in accordance with section 17 of the Statutory Powers Procedure Act.

5. An order that, despite subsections 5 (1) and (2), the period of review for reimbursement be for a period of more than 12 months, or that the period of review for reimbursement be for a period commencing prior to the date provided for in subsection 5 (2), or both, where the review panel determines that the physician knew or ought to have known that claims submitted to the Plan or to an insured person were false.

6. An order that the physician’s entitlement to submit claims for insured services to the Plan or to receive payments from an insured person cease or be suspended for a period of time provided for in the order if one or more of the circumstances set out in subsection (5) exists.

Additional orders

(2) The General Manager may enter in evidence before the review panel a random sample of claims submitted by the physician to the Plan in respect of a fee code during the period of review and, in addition to any other order it may make, the review panel may order that the General Manager calculate the amount to be reimbursed for that fee code for that period, or a portion of that period, by assuming the results observed in the random sample are representative of all the claims during the period in question, where the review panel determines that,

(a) the physician is liable to reimburse the Plan;

(b) there has been a previous finding or order by a review panel that the physician reimburse the Plan and the physician has continued to make billing errors despite documented efforts to educate the physician regarding billing requirements; and

Limit on statistical inference

(3) For greater certainty, a review panel may not order that the General Manager may apply statistical methods to amounts to be reimbursed to the Plan unless subsection (2) applies.

Limitation on costs

(4) Despite paragraph 4 of subsection (1), costs shall not be awarded against a physician unless there has been a finding by the Review Board that one or more of the following apply:

1. The physician unreasonably failed to provide information or produce records.

2. The physician unreasonably failed to co-operate with the Ministry.

3. The physician unreasonably failed to co-operate in the proceeding before the review panel.

4. The physician was responsible for long or frequent delays in the proceeding before the review panel.

5. The physician failed to comply with a previous order of the Review Board.

Suspension

(5) An order under paragraph 6 of subsection (1) shall not be made unless the review panel finds that the physician knew or ought to have known that the claims submitted to the Plan or to insured persons were false.

Effect of suspension, etc.

(6) If a physician is the subject of an order under paragraph 6 of subsection (1), all insured services rendered by him or her during the period the order is in effect are deemed to be insured services payable at nil.

Interest payable by physician

(7) If a physician is ordered to reimburse the Plan, interest will accrue on the amount found to be improperly paid to the physician from the date that the General Manager’s notice to the physician under the Act was effective.

Interest payable by General Manager

(8) Interest is payable by the General Manager to a physician in the circumstances set out in paragraphs 1 and 2, and in accordance with paragraph 3:

1. If the General Manager has sent notice of the General Manager’s opinion to the physician pursuant to subsection 18 (15) of the Act, and the physician has submitted claims in accordance with the opinion but requested a hearing concerning the General Manager’s opinion by the Review Board under subsection 18 (16) of the Act.

2. If the Review Board has concluded that the General Manager’s opinion was incorrect in the circumstances and directed the General Manager to pay those claims as they would have been submitted if it were not for the opinion.

3. Interest accrues from the date the claims were submitted in accordance with the General Manager’s opinion.

Report to College

(9) Where the Review Board is of the opinion, based on a hearing, that the physician may have committed an act of professional misconduct or may be incompetent or incapacitated, it shall file a report with the Registrar of the College of Physicians and Surgeons of Ontario.

Appeal

12. (1) A party to a hearing before the Review Board may appeal from its order to the Divisional Court in accordance with the rules of the court, but,

(a) personal health information contained in any document or evidence filed or adduced with regard to the appeal, or in any order or decision of the court shall not be made accessible to the public; and

(b) the Divisional Court may edit any documents it releases to the public to remove any personal health information.

Notice of appeal

(2) The appellant shall file a notice of appeal within 15 business days after receiving notice of the order of the Review Board.

Record to be filed in court

(3) Where any party appeals from an order of the Review Board, the Review Board shall forthwith file in the Divisional Court the record of the hearing in which the order was made, which, together with the transcript of evidence if it is not part of the Review Board’s record, shall constitute the record in the appeal.

Powers of court on appeal

(4) An appeal under this section may be made on questions of law or fact or both and the court may affirm or may rescind the order of the Review Board and may exercise all powers of the Review Board to direct the General Manager to take any action which the Review Board may direct the General Manager to take and as the court considers proper, and, for such purposes, the court may substitute its opinion for that of the Review Board.

Lift of stay

(5) Despite the Statutory Powers Procedure Act or any other Act, within 30 days of the physician filing an appeal to the Divisional Court under this section, the General Manager may bring a motion to the Divisional Court requesting it to lift the stay of an order made under paragraph 6 of subsection 11 (1) and the Divisional Court may order that the stay be lifted.

Medicine Act, 1991

35. Section 8 of the Medicine Act, 1991 is repealed.

Commencement

36. (1) Subject to subsection (2), this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Sections 1 to 35 come into force on a day to be named by proclamation of the Lieutenant Governor.

schedule H
Personal Health Information Protection Act, 2004

1. Paragraph 6 of the definition of “health information custodian” in subsection 3 (1) of the Personal Health Information Protection Act, 2004 is repealed and the following substituted:

6. A medical officer of health of a board of health within the meaning of the Health Protection and Promotion Act.

2. Clause (d) of the definition of “personal health information” in subsection 4 (1) of the Act is repealed and the following substituted:

(d) relates to payments or eligibility for health care, or eligibility for coverage for health care, in respect of the individual,

3. Section 7 of the Act is amended by adding the following subsection:

Crown bound

(5) For greater certainty, this Act binds the Crown, including all ministries, agencies and employees of the Crown.

4. Subsections 8 (1) and (2) of the Act are repealed and the following substituted:

Freedom of information legislation

(1) Subject to subsection (2), the Freedom of Information and Protection of Privacy Act and the Municipal Freedom of Information and Protection of Privacy Act do not apply to personal health information in the custody or under the control of a health information custodian unless this Act specifies otherwise.

Exceptions

(2) Sections 11, 12, 15, 16, 17, 33 and 34, subsection 35 (2) and sections 36 and 44 of the Freedom of Information and Protection of Privacy Act and sections 5, 9, 10, 25, 26 and 34 of the Municipal Freedom of Information and Protection of Privacy Act apply in respect of records of personal health information in the custody or under the control of a health information custodian that is an institution within the meaning of either of those Acts, as the case may be, or that is acting as part of such an institution.

5. Subsection 23 (1) of the Act is amended by adding “by a health information custodian” after “disclosure” in the portion before paragraph 1.

6. Section 24 of the Act is amended by adding the following subsection:

Deemed application concerning capacity

(2.1) An application to the Board under subsection (2) shall be deemed to include an application to the Board under subsection 22 (3) with respect to the individual’s capacity to consent to the collection, use or disclosure of his or her personal health information, unless the individual’s capacity has been determined by the Board within the previous six months.

7. Clause 26 (5) (b) of the Act is amended by striking out “paragraph 1 or 2” and substituting “paragraph 1, 2 or 3”.

8. Section 27 of the Act is amended by adding the following subsection:

Deemed application concerning capacity

(2.1) An application to the Board under subsection (1) or (2) shall be deemed to include an application to the Board under subsection 22 (3) with respect to the individual’s capacity to consent to the collection, use or disclosure of his or her personal health information, unless the individual’s capacity has been determined by the Board within the previous six months.

9. The French version of clause 32 (1) (b) of the Act is repealed and the following substituted:

b) le particulier y consent par consentement implicite et les renseignements se limitent au nom et aux genres prescrits de coordonnées de celui-ci.

10. Subsections 34 (2) and (3) of the Act are repealed and the following substituted:

Collection or use

(2) Despite subsection 49 (1), a person who is neither a health information custodian nor acting as an agent of a health information custodian shall not collect or use another person’s health number except,

(a) for purposes related to the provision of provincially funded health resources to that other person;

(b) for the purposes for which a health information custodian has disclosed the number to the person;

(c) if the person is the governing body of health care practitioners who provide provincially funded health resources and is collecting or using health numbers for purposes related to its duties or powers; or

(d) if the person is prescribed and is collecting or using the health number, as the case may be, for purposes related to health administration, health planning, health research or epidemiological studies.

Disclosure

(3) Despite subsection 49 (1) and subject to the exceptions and additional requirements, if any, that are prescribed, a person who is neither a health information custodian nor acting as an agent of a health information custodian shall not disclose a health number except as required by law.

11. Subclause 36 (1) (b) (i) of the Act is amended by adding “and complete” after “accurate”.

12. Clause 37 (1) (g) of the Act is repealed and the following substituted:

(g) for the purpose of seeking the individual’s consent, or the consent of the individual’s substitute decision-maker, when the personal health information used by the custodian for this purpose is limited to the name and contact information of the individual and the name and contact information of the substitute decision-maker, where applicable;

13. Clause 38 (1) (a) of the Act is amended by striking out “person” and substituting “health information custodian”.

14. Clause 39 (1) (a) of the Act is repealed and the following substituted:

(a) for the purpose of determining or verifying the eligibility of the individual to receive health care or related goods, services or benefits provided under an Act of Ontario or Canada and funded in whole or in part by the Government of Ontario or Canada, by a local health integration network or by a municipality, or to receive coverage with respect to such health care, goods, services or benefits;

15. Clause 43 (1) (f) of the Act is repealed and the following substituted:

(f) in the circumstances described in clause 42 (1) (c), (g) or (n) of the Freedom of Information and Protection of Privacy Act or clause 32 (c), (g) or (l) of the Municipal Freedom of Information and Protection of Privacy Act, if the custodian is an institution within the meaning of whichever of those Acts applies, or is acting as part of such an institution;

16. Subsection 44 (8) of the Act is repealed and the following substituted:

Transition

(8) Despite subsection (7), nothing in this section prevents a health information custodian that is an institution within the meaning of the Freedom of Information and Protection of Privacy Act or the Municipal Freedom of Information and Protection of Privacy Act or that is acting as part of such an institution from disclosing to a researcher personal health information, that is personal information within the meaning of those two Acts, if, before November 1, 2004, the researcher entered into an agreement with the custodian under subclause 21 (1) (e) (iii) of the Freedom of Information and Protection of Privacy Act or subclause 14 (1) (e) (iii) of the Municipal Freedom of Information and Protection of Privacy Act and the disclosure is within the scope of the agreement.

17. Subsection 49 (5) of the Act is repealed and the following substituted:

Freedom of information legislation

(5) Except as prescribed, subsections (1) to (4) do not apply to an institution within the meaning of the Freedom of Information and Protection of Privacy Act or the Municipal Freedom of Information and Protection of Privacy Act that is not a health information custodian or to a person employed by or acting for such an institution when the person is acting in that capacity.

Same

(6) Where this Act permits or requires a health information custodian to disclose personal health information to an institution within the meaning of the Freedom of Information and Protection of Privacy Act or the Municipal Freedom of Information and Protection of Privacy Act that is not a health information custodian, the institution may collect the information from the custodian.

18. Subsection 51 (3) of the Act is repealed and the following substituted:

Health care practitioner acting for an institution

(3) This Part does not apply to a record in the custody or under the control of a health care practitioner who is employed by or acting for an institution within the meaning of the Freedom of Information and Protection of Privacy Act or the Municipal Freedom of Information and Protection of Privacy Act that is not a health information custodian if the individual has the right to request access to the record under one of those Acts.

Permission to disclose

(4) When subsection (3) applies to a record, the health care practitioner may disclose the record to the institution to enable the institution to process the individual’s request under the Freedom of Information and Protection of Privacy Act or the Municipal Freedom of Information and Protection of Privacy Act, as the case may be, for access to the record.

19. The English version of clause 52 (1) (c) of the Act is repealed and the following substituted:

(c) the information in the record was collected or created primarily in anticipation of or for use in a proceeding, and the proceeding, together with all appeals or processes resulting from it, have not been concluded;

20. (1) Clause 54 (1) (b) of the Act is repealed and the following substituted:

(b) give a written notice to the individual stating that, after a reasonable search, the custodian has concluded that the record does not exist, cannot be found, or is not a record to which this Part applies, if that is the case;

(2) Clause 54 (1) (d) of the Act is repealed and the following substituted:

(d) subject to subsection (1.1), if the custodian is entitled to refuse the request, in whole or in part, under clause 52 (1) (c), (d) or (e), give a written notice to the individual stating that the individual is entitled to make a complaint about the refusal to the Commissioner under Part VI, and that the custodian is refusing,

(i) the request, in whole or in part, while citing which of clauses 52 (1) (c), (d) and (e) apply,

(ii) the request, in whole or in part, under one or more of clauses 52 (1) (c), (d) and (e), while not citing which of those provisions apply, or

(iii) to confirm or deny the existence of any record subject to clauses 52 (1) (c), (d) and (e).

(3) Section 54 of the Act is amended by adding the following subsection:

Providing reasons

(1.1) A custodian acting under clause (1) (d) shall not act under subclause (1) (d) (i) where doing so would reasonably be expected in the circumstances known to the person making the decision on behalf of the custodian to reveal to the individual, directly or indirectly, information to which the individual does not have a right of access.

21. Subsection 55 (1) of the Act is amended by striking out “has collected or used” and substituting “has collected, uses or has used”.

22. Subsection 60 (15) of the Act is repealed and the following substituted:

Document privileged

(15) A document or thing produced by a person in the course of a review is privileged in the same manner as if the review were a proceeding in a court.

Commencement

23. This Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

schedule I
Public Hospitals Act

1. Subsection 9.1 (2) of the Public Hospitals Act is repealed and the following substituted:

No proceeding against Crown

(2) No proceeding, other than a proceeding referred to in subsection 10 (2), shall be commenced against the Crown or the Minister with respect to a decision or direction under section 5, 6 or 9, the appointment of an investigator or a hospital supervisor under section 8 or 9 or an action or omission of an investigator or hospital supervisor done in good faith in the performance of a power or of an authority under either of those sections.

2. Section 10 of the Act is repealed and the following substituted:

Protection from personal liability

10. (1) No action or other proceeding for damages or otherwise shall be instituted against any of the following persons for any act done in good faith in the execution or intended execution of any duty or authority under this Act or the regulations or for any alleged neglect or default in the execution in good faith of any such duty or authority:

1. An investigator or a hospital supervisor appointed under section 8 or 9 or a person, persons or a body to whom the Minister’s powers have been assigned under clause 32 (1) (z.1).

2. The staff of anyone mentioned in paragraph 1.

Crown not relieved of liability

(2) Subsection (1) does not, by reason of subsections 5 (2) and (4) of the Proceedings Against the Crown Act, relieve the Crown of liability in respect of a tort committed by a person mentioned in paragraphs 1 and 2 of subsection (1) to which the Crown would otherwise be subject and the Crown is liable under that Act for any such tort in the same manner as if subsection (1) had not been enacted.

3. Subsection 32.1 (3) of the Act is amended by striking out “Ministry of Health” and substituting “Ministry”.

Commencement

4. This Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

SCHEDULE J
MAKING MISCELLANEOUS CORRECTIONS AND AMENDMENTS

Community Care Access Corporations Act, 2001

1. Subsection 22 (0.1) of the Community Care Access Corporations Act, 2001 is amended by adding the following clause:

(a.1) respecting matters that relate to or arise as a result of a transfer of assets, liabilities, rights and obligations of a community care access corporation under a Minister’s order made under clause 15 (3) (a), including matters related to present and future assets, liabilities, rights and obligations;

Laboratory and Specimen Collection Centre Licensing Act

2. The definition of “specimen collection centre” in section 5 of the Laboratory and Specimen Collection Centre Licensing Act is repealed and the following substituted:

“specimen collection centre” means a place where specimens are taken or collected from the human body for examination to obtain information for diagnosis, prophylaxis or treatment, but does not include,

(a) a place where a legally qualified medical practitioner is engaged in the practice of medicine or surgery,

(b) a place where a registered nurse who holds an extended certificate of registration under the Nursing Act, 1991 is engaged in the practice of nursing, or

Local Health System Integration Act, 2006

3. The French version of subsection 38 (1) of the Local Health System Integration Act, 2006 is amended by adding “ou le ministre” after “en conseil” in the portion before clause (a).

Smoke-Free Ontario Act

4. The Table to section 15 of the Smoke-Free Ontario Act is amended,

(a) by striking out “9, other than subsection (4)” in Column 1 and substituting “9 (1), 9 (2)”; and

(b) by adding the following item:

9 (3), 9 (6)	0	1,000	100,000
	1 or more	5,000	300,000

Sunnybrook and Women’s College Health Sciences Centre Act, 1998

5. The Sunnybrook and Women’s College Health Sciences Centre Act, 1998 is repealed.

Commencement

6. (1) Subject to subsection (2), this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Section 3 shall be deemed to have come into force on March 28, 2006.

schedule k
Ontario Agency for Health Protection and Promotion Act, 2007

part I
Interpretation

Purpose

1. The purpose of this Act is to enhance the protection and promotion of the health of Ontarians and to contribute to efforts to reduce health inequities through the establishment of an agency to provide scientific and technical advice and support to those working across sectors to protect and improve the health of Ontarians and to carry out and support activities such as population health assessment, public health research, surveillance, epidemiology, planning and evaluation.

Definitions

2. In this Act,

“board of directors” means the board of directors of the Corporation; (“conseil d’administration”)

“Chief Medical Officer of Health” means the Chief Medical Officer of Health under the Health Protection and Promotion Act; (“médecin-hygiéniste en chef”)

“Corporation” means the Ontario Agency for Health Protection and Promotion established under section 3; (“Agence”)

“fiscal year” means the period commencing on April 1 in each year and ending on March 31 of the following year; (“exercice”)

“Minister” means the Minister of Health and Long-Term Care or such other member of the Executive Council to whom the administration of this Act may be assigned under the Executive Council Act; (“ministre”)

“Ministry” means the Ministry of the Minister; (“ministère”)

“personal health information” has the same meaning as in the Personal Health Information Protection Act, 2004; (“renseignements personnels sur la santé”)

“personal information” has the same meaning as in the Freedom of Information and Protection of Privacy Act; (“renseignements personnels”)

“prescribed” means prescribed by regulation made under this Act, and “prescribe” has a corresponding meaning; (“prescrit”, “prescrire”)

“revenue” includes all money or money’s worth received by the Corporation, whether by grant, gift, contribution, income, profit or otherwise. (“recettes”)

part ii
Corporation

Corporation established

3. A corporation to be known in English as the Ontario Agency for Health Protection and Promotion and in French as Agence ontarienne de protection et de promotion de la santé is established as a corporation without share capital.

Crown agency and status

4. The Corporation is an agent of the Crown and may exercise its powers only as an agent of the Crown.

Corporations Act, Corporations Information Act

5. The Corporations Act and the Corporations Information Act do not apply to the Corporation except as prescribed.

Objects

6. The objects of the Corporation are,

(a) to provide scientific and technical advice and support to the health care system and the Government of Ontario in order to protect and promote the health of Ontarians and reduce health inequities;

(b) to develop, disseminate and advance public health knowledge, best practices, and research in the areas of population health assessment, infectious diseases, health promotion, chronic diseases, injury prevention, and environmental health;

(c) to inform and contribute to policy development processes across sectors of the health care system and within the Government of Ontario through advice and impact analysis of public health issues;

(d) to develop, collect, use, analyse and disclose data, including population health, surveillance and epidemiological data, across sectors, including human health, environmental, animal, agricultural, education, community and social services and housing sectors, in a manner that informs and enhances healthy public policy and public health planning, evaluation and action;

(e) to undertake, promote and co-ordinate public health research in co-operation with academic and research experts as well as the community;

(f) to provide education and professional development for public health professionals, scientists, researchers, and policymakers across sectors;

(g) to establish, operate and maintain laboratory centres and to provide laboratory services;

(h) to serve as a model for bridging the areas of infection control and occupational health and safety;

(i) to undertake research related to evaluating the modes of transmission of febrile respiratory illnesses and the risk to health workers;

(j) as directed by the Chief Medical Officer of Health, to provide scientific and technical advice and operational support to any person or entity in an emergency or outbreak situation that has health implications; and

(k) any additional objects the Lieutenant Governor in Council may prescribe.

Powers

7. (1) Except as limited by this Act, the Corporation has the capacity, rights and powers of a natural person for carrying out its objects.

Use of revenue

(2) The Corporation shall carry out its operations without the purpose of gain for its members and any profits, including all money or assets that it receives by grant, contribution or otherwise, shall be used for promoting its objects.

Revenues and investments

(3) Despite Part I of the Financial Administration Act, the revenues and investments of the Corporation do not form part of the Consolidated Revenue Fund.

Lieutenant Governor in Council approval

(4) The Corporation shall not exercise the following powers without the approval of the Lieutenant Governor in Council:

1. Acquiring, disposing, leasing, mortgaging, charging, hypothecating or otherwise transferring or encumbering any interest in real property, except for leasing office and laboratory space that is reasonably necessary for the purposes of the Corporation.

2. Borrowing or lending money.

3. Investing money.

4. Pledging, charging or encumbering any of its personal property.

5. Creating a subsidiary.

Additional limitations

8. The Lieutenant Governor in Council may prescribe additional limitations to the Corporation’s powers.

Board of directors

9. (1) The Corporation shall consist of no more than 13 members appointed by the Lieutenant Governor in Council who shall form the board of directors of the Corporation.

Areas of expertise

(2) In appointing the members of the board of directors, regard may be had to the desirability of appointing,

(a) persons with skills and expertise in the areas covered by the Corporation’s objects, or in corporate governance;

(b) a person with expertise in public accounting or with related financial experience; and

Term of office

(3) Subject to subsections (4) and (5), the members of the board of directors shall hold office at pleasure for a term determined by the Lieutenant Governor in Council.

Termination

(4) A member ceases to be a member of the board of directors if, before the term of the member expires,

(a) the Lieutenant Governor in Council revokes the member’s appointment; or

(b) the member dies, resigns or becomes bankrupt.

Successor’s term

(5) If a person ceases to be a member of the board of directors before the term of the member expires, the first term of the person’s successor shall be for the remainder of the person’s term.

Remuneration and expenses of directors

(6) The members of the board of directors shall receive the remuneration and reimbursement for the reasonable expenses that the Lieutenant Governor in Council determines.

Duty of care and indemnification

(7) Subsection 134 (1) and section 136 of the Business Corporations Act apply, with necessary modifications, to the Corporation, its board of directors and its officers.

First chair, vice-chairs

10. (1) The Minister shall designate one of the members of the first board of directors to serve as the first chair of the board of directors and one or more directors as first vice-chairs of the board of directors, and the duration of such a designation shall correspond to the duration of their initial terms as directors.

Subsequent chairs and vice-chairs

(2) At the end of the terms of the first chair and the first vice-chairs, respectively, the board of directors shall designate a chair and one or more vice-chairs from among themselves.

Chair’s role

11. (1) The chair shall preside over the meetings of the board of directors.

Acting chair

(2) If the chair is absent or otherwise unable to act or if the office of chair is vacant, the vice-chairs present at a meeting shall designate an acting chair from among themselves.

Same

(3) In the absence of the chair and the vice-chairs, the directors present at a meeting shall designate an acting chair from among themselves.

Powers and duties of the board

12. The affairs of the Corporation are under the management and control of its board of directors.

By-laws, resolutions re proceedings

13. The board of directors may pass by-laws and resolutions for conducting and managing the affairs of the Corporation.

Standing committees

14. (1) The board of directors shall by by-law establish the following standing committees:

1. A governance standing committee.

2. A strategic planning standing committee.

3. An audit standing committee.

Additional standing committees

(2) The board of directors may, by by-law, establish additional standing committees.

Composition, functions, etc.

(3) Subject to subsections (4), (5) and (6) and the regulations, a by-law establishing a standing committee shall provide for the committee’s composition, functions and operation, and may provide that persons who are not members of the board of directors may serve on standing committees.

Strategic planning standing committee

(4) The Chief Medical Officer of Health is by virtue of his or her office a member of the strategic planning standing committee, and may attend that committee personally or through a designate.

Governance standing committee

(5) Only members of the board of directors may be members of the governance standing committee.

Audit standing committee

(6) Only members of the board of directors and persons who are not employees of the Corporation may be members of the audit standing committee, and at least one member of the committee shall be both a director and an expert with public accounting or related financial experience.

Delegation of powers of the board

15. (1) The board of directors may by by-law delegate any of its powers to a standing committee.

Delegation subject to conditions and restrictions

(2) A delegation under subsection (1) is subject to any conditions or restrictions set out in the by-law.

Validity of acts of directors and officers

16. An act done by a director or by an officer is not invalid by reason only of any defect that is thereafter discovered in his or her appointment, election or qualification.

Conflict of interest

17. The board of directors shall develop, in consultation with the Minister, conflict of interest policies for the directors, officers and employees of the Corporation.

Meetings of board

18. (1) The board of directors shall meet regularly throughout the year and in any event shall hold at least four meetings in each calendar year.

Quorum

(2) A majority of the directors constitutes a quorum.

CMOH to be informed

(3) The Corporation shall provide the Chief Medical Officer of Health with,

(a) reasonable notice of any meeting of the board of directors;

(b) the agenda for that meeting; and

Attendance of CMOH

(4) The Chief Medical Officer of Health, or his or her designate, is entitled to attend and to participate in any meeting of the board of directors.

Chief executive officer

19. (1) The Corporation shall appoint a chief executive officer who shall be an employee of the Corporation and not a member of the board of directors.

Role

(2) The chief executive officer is responsible for the management and administration of the affairs of the Corporation, subject to the supervision and direction of the board of directors.

Audit

20. (1) The board of directors shall appoint an auditor licensed under the Public Accounting Act, 2004 to audit the accounts and the financial transactions of the Corporation annually.

Other audits

(2) In addition to the requirement for an annual audit,

(a) the Minister may, at any time, direct that one or more auditors licensed under the Public Accounting Act, 2004 audit the accounts and the financial transactions of the Corporation; and

(b) the Auditor General may, at any time, audit any aspect of the operations of the Corporation.

Annual business plan

21. (1) On or before April 1 in each year, or another date specified by the Minister, the board of directors shall adopt a business plan for the fiscal year.

Strategic objectives and rolling budget

(2) The business plan shall include a three-year rolling budget, the strategic objectives for the Corporation, and any performance measures the Corporation shall meet.

Submission to Minister

(3) On or before January 1 in each year, or another date specified by the Minister, the board of directors shall submit a copy of the business plan to the Minister for approval.

Annual report

22. (1) The Corporation shall submit to the Minister an annual report, within the time period that the Minister specifies, on its affairs and operations during its immediately preceding fiscal year.

Contents

(2) The annual report shall include,

(a) audited financial statements of the Corporation for the fiscal year of the Corporation to which the report relates;

(b) a description on how performance measures under subsection 21 (2) have been met;

(d) any other information, except personal information or personal health information, requested by the Minister.

Form

(3) The annual report shall be signed by the chair and one other member of the board of directors of the Corporation and shall be in the form that the Minister specifies.

Tabling

(4) The Minister shall,

(a) submit the annual report to the Lieutenant Governor in Council; and

(b) lay the report before the Assembly if it is in session or deposit the report with the Clerk of the Assembly if the Assembly is not in session.

Additional reports to Minister

23. The Corporation shall provide to the Minister, within the time and in the form that the Minister specifies, the plans, reports, financial statements, including audited financial statements and information that the Minister requires for the purposes of administering this Act.

PART III
directives

CMOH directives

24. (1) The Chief Medical Officer of Health may issue directives in writing to the Corporation for the Corporation to provide scientific and technical advice and operational support to any person or entity in an emergency or outbreak situation that has health implications.

Implementation

(2) The board of directors shall ensure that a directive of the Chief Medical Officer of Health under subsection (1) is carried out in accordance with its terms, this Act, and the regulations.

PART iV
TRANSFERs

Transfers

25. (1) Despite any other Act, but subject to the Financial Administration Act, the regulations, if any, under this Act and the approval of the Lieutenant Governor in Council, the Crown in right of Ontario may transfer to the Corporation any of its rights, obligations, assets and liabilities or any interest in or entitlement to a right, obligation, asset and liability, with or without consideration, on terms and conditions agreed upon between the Crown and the Corporation and, without restricting the generality of the foregoing, may transfer public health laboratory centres established by the Minister under section 79 of the Health Protection and Promotion Act.

Non-cash expenses

(2) A non-cash transfer under subsection (1) is an authorized non-cash expense for the purposes of section 11.1 of the Financial Administration Act.

Agreement assignable

(3) Where an agreement is the subject of a transfer under subsection (1), it shall be deemed to be assignable by the Minister without the consent of any party to the agreement.

Other agreements, etc.

(4) The Minister may enter into such other agreements, execute such documents and instruments, and do such other acts and things as the Minister considers necessary or advisable to effect a transfer authorized in subsection (1).

Immunity re transfer

(5) Despite subsection (1), no proceeding for damages or otherwise shall be commenced against the Corporation, a director or officer of the Corporation, a member of a standing committee, or any person employed by the Corporation in respect of a claim,

(a) that arises in connection with anything transferred under subsection (1); and

(b) that arises solely in connection with events that occurred prior to the effective date of the transfer.

PART V
IMMUNITY and UNPAID JUDGMENts

No actions or proceedings against Crown

26. No proceeding for damages or otherwise shall be commenced against the Crown, the Minister or any person employed by the Crown with respect to any act done or omitted to be done or any decision of the Corporation, a director or officer of the Corporation, a member of a standing committee or a person employed by the Corporation.

Immunity from civil action

27. (1) No proceeding for damages or otherwise shall be commenced against the Minister, the Minister of Finance, a director or officer of the Corporation, a member of a standing committee, or any person employed by the Crown or the Corporation, with respect to any act done or omitted to be done or any decision under this Act that is done in good faith in the execution or intended execution of a power or duty under this Act.

Corporation remains liable

(2) Subsection (1) does not relieve the Corporation of any liability to which it would otherwise be subject in respect of a tort committed by a director, officer or employee.

Crown remains liable in certain cases

(3) Despite subsections 5 (2) and (4) of the Proceedings Against the Crown Act, subsection (1) does not relieve the Crown of a liability to which it would otherwise be subject in respect of a tort committed by the Minister, the Minister of Finance or any person employed by the Crown.

Unpaid judgments against the Corporation

28. The Minister of Finance shall pay from the Consolidated Revenue Fund the amount of any judgment against the Corporation that remains unpaid after, as determined by the Lieutenant Governor in Council, the Corporation has made all reasonable efforts to pay the amount of the judgment.

PART Vi
dissolution

Dissolution

29. (1) The Minister may, on a date specified by the Minister, dissolve the Corporation.

Publication in The Ontario Gazette

(2) The Minister shall publish notice of the dissolution under subsection (1) in The Ontario Gazette.

PART vii
regulations

Regulations

30. (1) The Minister may make regulations,

(a) prescribing, for the purposes of section 5, provisions of the Corporations Act and the Corporations Information Act that apply to the Corporation, and any modifications to which those provisions are subject;

(b) prescribing provisions of the Business Corporations Act, other than those mentioned in subsection 9 (7), that apply to the Corporation, and any modifications to which those provisions are subject;

Same, LG in C

(2) The Lieutenant Governor in Council may make regulations,

(a) prescribing additional objects of the Corporation under clause 6 (k);

(b) prescribing additional limitations to the Corporation’s powers under section 8;

(c) respecting matters that relate to or arise as a result of a transfer under section 25, including matters related to present and future rights, obligations, privileges and liabilities;

(d) respecting provisions of the Laboratory and Specimen Collection Centre Licensing Act and regulations under that Act that do not apply to a laboratory centre established by the Corporation, and any modifications to which those provisions are subject;

(e) respecting any matter that the Lieutenant Governor in Council considers necessary or advisable to carry out effectively the intent and purpose of this Act.

PART vIIi
COMPLEMENTARY AMENDMENTs

Hospital Labour Disputes Arbitration Act

31. Section 1 of the Hospital Labour Disputes Arbitration Act is amended by adding the following subsection:

Ontario Agency for Health Protection and Promotion

(5) The Ontario Agency for Health Protection and Promotion established under the Ontario Agency for Health Protection and Promotion Act, 2007 shall be deemed to be a hospital for the purposes of this Act.

Personal Health Information Protection Act, 2004

32. Subsection 39 (2) of the Personal Health Information Protection Act, 2004 is amended by striking out “or” at the end of clause (a) and by adding the following clause:

(a.1) to the Ontario Agency for Health Protection and Promotion if the disclosure is made for a purpose of the Ontario Agency for Health Protection and Promotion Act, 2007; or

PART IX
commencement and short title

Commencement

33. The Act set out in this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Short title

34. The short title of the Act set out in this Schedule is the Ontario Agency for Health Protection and Promotion Act, 2007.

schedule L
Drug and Pharmacies Regulation Act

1. (1) Subsection 1 (1) of the Drug and Pharmacies Regulation Act is repealed and the following substituted:

Interpretation

(1) In this Act,

“Accreditation Committee” means the Accreditation Committee of the College; (“comité d’agrément”)

“by-laws” means the by-laws made under this Act; (“règlements administratifs”)

“certificate of accreditation” means a certificate of accreditation issued by the Registrar of the College under subsection 139 (2); (“certificat d’agrément”)

“certificate of authorization” has the same meaning as in the Regulated Health Professions Act, 1991; (“certificat d’autorisation”)

“certificate of registration” means a certificate of registration within the meaning of the Health Professions Procedural Code issued by the Registrar of the College; (“certificat d’inscription”)

“College” means the Ontario College of Pharmacists; (“Ordre”)

“Council” means the Council of the College; (“conseil”)

“designated manager” means the pharmacist designated by the owner of the pharmacy, in information provided to the College, as the pharmacist responsible for managing the pharmacy; (“gérant désigné”)

“Discipline Committee” means the Discipline Committee of the College; (“comité de discipline”)

“drug” means any substance or preparation containing any substance,

(a) manufactured, sold or represented for use in,

(i) the diagnosis, treatment, mitigation or prevention of a disease, disorder, abnormal physical or mental state or the symptoms thereof, in humans, animals or fowl, or

(ii) restoring, correcting or modifying functions in humans, animals or fowl,

(b) referred to in Schedule C, D, E, F, G or N,

(d) named in the regulations,

but does not include,

(e) any substance or preparation referred to in clause (a), (b) or (c) manufactured, offered for sale or sold as, or as part of, a food, drink or cosmetic,

(f) any “natural health product” as defined from time to time by the Natural Health Products Regulations under the Food and Drugs Act (Canada),

(g) a substance or preparation named in Schedule A or B; (“médicament”)

“health profession corporation” has the same meaning as in the Regulated Health Professions Act, 1991; (“société professionnelle de la santé”)

“Health Professions Procedural Code” means the Health Professions Procedural Code set out in Schedule 2 to the Regulated Health Professions Act, 1991; (“Code des professions de la santé”)

“intern” means a person who is registered as an intern under the Pharmacy Act, 1991; (“interne”)

“member” means a member of the College; (“membre”)

“Minister” means the Minister of Health and Long-Term Care; (“ministre”)

“pharmacist” means a person registered as a pharmacist under the Pharmacy Act, 1991; (“pharmacien”)

“pharmacy” means a premises in or in part of which prescriptions are compounded and dispensed for the public or drugs are sold by retail; (“pharmacie”)

“pharmacy technician” means a person registered as a pharmacy technician under the Pharmacy Act, 1991; (“technicien en pharmacie”)

“prescriber” means a person who is authorized under the laws of a province or territory of Canada to give a prescription within the scope of his or her practice of a health discipline; (“personne autorisée à prescrire des médicaments”)

“prescription” means a direction from a prescriber directing the dispensing of any drug or mixture of drugs for a designated person or animal; (“ordonnance”)

“proprietary misconduct” means proprietary misconduct as defined in the regulations; (“faute liée à la spécialité”)

“registered pharmacy student” means a person registered as a student under the Pharmacy Act, 1991; (“étudiant en pharmacie inscrit”)

“Registrar” means the Registrar of the College; (“registrateur”)

“regulations” means the regulations made under this Act. (“règlements”)

Schedules

(2) A reference in subsection (1) or in Part VI of this Act to Schedule A, B, C, D, E, F, G or N is a reference to such Schedule established by the regulations for the purposes of that Part.

References in other laws

(2.1) A reference in any other Act or regulation to a term as defined in subsection 117 (1) of this Act shall be deemed to be a reference to the same term as defined in subsection (1) of this section.

(2) The definition of “drug” in subsection 1 (1) of the Act, as enacted by subsection (1), is repealed and the following substituted:

“drug” means any substance or preparation containing any substance,

(a) manufactured, sold or represented for use in,

(i) the diagnosis, treatment, mitigation or prevention of a disease, disorder, abnormal physical or mental state or the symptoms thereof, in humans, animals or fowl, or

(ii) restoring, correcting or modifying functions in humans, animals or fowl,

(b) referred to in Schedule I, II or III,

(d) named in the regulations,

but does not include,

(e) any substance or preparation referred to in clause (a), (b), (c) or (d) manufactured, offered for sale or sold as, or as part of, a food, drink or cosmetic,

(f) any “natural health product” as defined from time to time by the Natural Health Products Regulations under the Food and Drugs Act (Canada), unless the product is a substance that is identified in the regulations as being a drug for the purposes of this Act despite this clause, either specifically or by its membership in a class or its listing or identification in a publication,

(g) a substance or preparation named in Schedule U,

(h) a substance or preparation listed in a publication named by the regulations, or

(i) a substance or preparation that the regulations provide is not a drug; (“médicament”)

(3) Subsection 1 (2) of the Act, as enacted by subsection (1), is repealed and the following substituted:

Schedules

(2) A reference in this Act to Schedule I, II, III or U is a reference to such Schedule established by the regulations.

2. Section 117 of the Act is repealed.

3. (1) Subsection 118 (1) of the Act is amended by striking out “Part” in the portion before clause (a) and substituting “Act”.

(2) Subsection 118 (2) of the Act is amended by striking out “Part” and substituting “Act”.

(3) Subsection 118 (3) of the Act is amended by striking out “Part” and substituting “Act”.

4. (1) Subsection 139 (2) of the Act is amended by striking out “this Part” and substituting “this Act”.

(2) Paragraph 1 of subsection 139 (5) of the Act is amended by striking out “2, 3 and 5” and substituting “2 and 3”.

5. (1) Subsection 140 (1) of the Act is repealed and the following substituted:

Revocation of certificate and other disciplinary measures

(1) Where the Accreditation Committee has reason to believe that a pharmacy or its operation fails to conform to the requirements of this Act and the regulations or to any term, condition or limitation to which its certificate of accreditation is subject, or that an act of proprietary misconduct has been committed, the Committee may refer the person who has been issued a certificate of accreditation, a designated manager of the pharmacy operated by the person who has been issued a certificate of accreditation or the directors of a corporation which has been issued a certificate of accreditation to the Discipline Committee for a hearing and determination.

(2) Section 140 of the Act is amended by adding the following subsection:

References in Code

(2.1) For greater certainty, and without in any way restricting the application of subsection (2), a reference in section 37 of the Health Professions Procedural Code,

(a) to a “member” includes a person mentioned in subsection (1); and

(b) to a “certificate of registration” includes a certificate of accreditation.

(3) Subsection 140 (3.1) of the Act is repealed and the following substituted:

Orders

(3.1) A panel of the Discipline Committee may make an order doing any one or more of the following if it finds that a person who has been issued a certificate of accreditation or the directors of a corporation which has been issued a certificate of accreditation have established or operated a pharmacy in contravention of this Act or the regulations, or have committed an act or acts of proprietary misconduct:

1. Directing the Registrar to revoke the certificate.

2. Directing the Registrar to suspend the certificate for a specified period of time.

3. Requiring the payment of a fine of not more than $100,000 to the Minister of Finance, and directing who shall make the payment.

4. Directing the Registrar to impose specified terms, conditions and limitations on the certificate for a specified period of time or indefinite period of time.

Same, designated manager

(3.2) Despite subsection (3), if a panel of the Discipline Committee finds that a designated manager has contravened a provision of this Act or the regulations, or has committed an act or acts of proprietary misconduct, the panel may make an order doing anything that may be done under subsection 51 (2) of the Health Professions Procedural Code, with any necessary modification.

(4) Subsection 140 (4) of the Act is repealed and the following substituted:

Cancellation for non-payment of fee

(4) The Registrar may revoke or suspend a certificate of accreditation for non-payment of the fee required under the by-laws after the person operating the pharmacy has been given at least 60 days notice of default and intention to revoke or suspend.

(5) Section 140 of the Act is amended by adding the following subsection:

Transitional

(5) A notice given by the Council under subsection (4) as it existed before the coming into force of subsection 5 (4) of Schedule L to the Health System Improvements Act, 2007 continues to be valid as if it had been made by the Registrar.

6. The Act is amended by adding the following section:

Publication of decisions

140.1 (1) The College shall publish a panel’s decision and its reasons, or a summary of its reasons, in its annual report and may publish the decision and reasons or summary in any other publication of the College.

Publication of name

(2) In publishing a decision and reasons or summary under subsection (1), the College shall publish the name of the person who has been issued a certificate of accreditation, designated manager or director who was the subject of the proceeding if,

(a) the results of the proceeding may be obtained by a member of the public from the College’s register; or

(b) the person, designated manager or director requests the publication of his or her name.

Withholding of name

(3) The College shall not publish the name of the person, designated manager or director who was the subject of the proceeding unless it is required to do so under subsection (2).

7. Subsection 142 (2) of the Act is amended by striking out “Ontario College of Pharmacists” at the end and substituting “College”.

8. Section 143 of the Act is amended by striking out “licence” in the portion before clause (a) and substituting “certificate of registration”.

9. (1) Clause 144 (2) (a) of the Act is amended by striking out “licence” and substituting “certificate of registration”.

(2) Clause 144 (2) (b) of the Act is amended by striking out “licence” and substituting “certificate of registration”.

10. (1) Clause 146 (1) (b) of the Act is repealed and the following substituted:

(b) it is managed by a pharmacist who is designated as the designated manager by the owner of the pharmacy.

(2) Section 146 of the Act is amended by adding the following subsection:

Designated manager

(1.1) Every owner of a pharmacy shall designate a designated manager for the pharmacy, and file notice of the designation with the College in accordance with the regulations.

(3) Subsection 146 (3) of the Act is repealed and the following substituted:

Display

(3) Every designated manager shall ensure that his or her name, certificate of registration, or both, are clearly and publicly displayed in the pharmacy.

11. (1) Subsection 148 (1) of the Act is amended by striking out “this Part” and substituting “this Act”.

(2) Subsection 148 (2) of the Act is repealed and the following substituted:

Documents and objects

(2) Any document or object that is kept in a pharmacy and is relevant to pharmacy practice and to an inspection under this Act shall be open to inspection by any inspector appointed under a by-law.

12. The Act is amended by adding the following sections:

Entries and searches

148.1 (1) A justice of the peace may, on the application of an inspector made without notice, issue a warrant authorizing an inspector to enter and search a place and examine any document or thing as specified in the warrant if the justice of the peace is satisfied that the inspector has been properly appointed and that there are reasonable and probable grounds established upon oath for believing that,

(a) a person has committed an act or proprietary misconduct or is in breach of this Act or the regulations; and

(b) there is something relevant to the inspection at the place.

Searches by day unless stated

(2) A warrant issued under subsection (1) may only be executed between 8 a.m. and 8 p.m., unless the warrant specifies otherwise.

Application for dwelling

(3) An application for a warrant under subsection (1) to enter a dwelling shall specifically indicate that the application relates to a dwelling.

Assistance and entry by force

(4) An inspector entering and searching a place under the authority of a warrant issued under subsection (1) may be assisted by other persons and may enter a place by force.

Inspector to show identification

(5) An inspector entering and searching a place under the authority of a warrant issued under subsection (1) shall produce his or her identification, on request, to any person at the place.

Copying of documents and objects

148.2 (1) An inspector may copy, at the College’s expense, a document or object that an inspector may examine under subsection 148 (2) or under the authority of a warrant issued under subsection 148.1 (1).

Removal of documents and objects

(2) An inspector may remove a document or object described in subsection (1) if,

(a) it is not practicable to copy it in the place where it is examined;

(b) a copy of it is not sufficient for the purposes of the inspection; or

Return of documents and objects or copies

(3) If it is practicable to copy a document or object removed under subsection (2), the inspector shall,

(a) if it was removed under clause (2) (a) or (c), return the document or object within a reasonable time; or

(b) if it was removed under clause (2) (b), provide the person who was in possession of the document or object with a copy of it within a reasonable time.

Copy as evidence

(4) A copy of a document or object certified by an inspector to be a true copy shall be received in evidence in any proceeding to the same extent and shall have the same evidentiary value as the document or object itself.

Definition

(5) In this section, and for the purposes of subsection 148 (2),

“document” means a record of information in any form and includes any part of it.

Commission powers

148.3 For the purpose of determining whether a person mentioned in subsection 140 (1) has committed an act of proprietary misconduct or is in breach of this Act or the regulations, an inspector has all the powers of the commission under Part II of the Public Inquiries Act.

No obstruction

148.4 No person shall obstruct an inspector acting under section 148, or under the authority of a warrant issued under subsection 148.1 (1), or conceal from an inspector or destroy anything that is relevant to an inspection.

13. (1) Subsection 149 (1) of the Act is repealed and the following substituted:

Dispensing of drugs

(1) Subject to subsection (2), no person shall compound, dispense or sell any drug in a pharmacy other than,

(a) a pharmacist;

(b) an intern acting under the supervision of a pharmacist who is physically present;

(d) a pharmacy technician acting under the supervision of a pharmacist who is physically present.

(2) Subsection 149 (2) of the Act is repealed and the following substituted:

Exception

(2) Where a pharmacist or an intern is present in the pharmacy and available to the purchaser for consultation, subsection (1) does not apply to the sale in a pharmacy of a drug listed in Schedule III.

14. Section 150 of the Act is repealed and the following substituted:

Misrepresentation

150. No person shall sell any drug under the representation or pretence that it is a particular drug when the person knows or ought to have known that it is not that drug, or does not contain any substance that the drug is meant to contain.

15. Section 151 of the Act is repealed.

16. Section 152 of the Act is repealed and the following substituted:

Mailing or delivering certain drugs

152. (1) Subject to subsection (2), a drug listed in Schedule I shall, if sent through the mail, only be sent by registered mail or, if delivered by another method, shall be delivered in a method that is both traceable and auditable, with a receipt for the drug signed by the patient or the patient’s agent.

Exception, federal law

(2) Where a law of Canada permits a method of delivery of a drug other than provided for in subsection (1), the law of Canada prevails.

17. Section 153 of the Act is repealed and the following substituted:

Records of pharmacy

153. The designated manager of every pharmacy shall keep or cause to be kept a record of every purchase and sale of a drug referred to in the Schedules to the Controlled Drugs and Substances Act (Canada) or the Schedule to the Narcotic Control Regulations (Canada) in such form or manner as the regulations may prescribe.

18. Section 154 of the Act is repealed.

19. Section 155 of the Act is repealed and the following substituted:

Prescription drugs

155. (1) Subject to the regulations, no person shall sell by retail any drug referred to in Schedule I, except on prescription given in such form, in such manner and under such conditions as the regulations prescribe.

Exception

(2) Subsection (1) does not apply to drugs listed in Schedule I that are sold in a container labelled by the manufacturer as for veterinary or agricultural use or sold in a form unsuitable for human use.

20. The French version of subsection 157 (1) of the Act is amended by striking out “une ordonnance à remplir” and substituting “une ordonnance à préparer”.

21. Section 158 of the Act is repealed and the following substituted:

Prescription from outside Ontario

158. A pharmacist may dispense a drug pursuant to a prescription authorized by a prescriber licensed to practise in a province or territory of Canada other than Ontario if, in the professional judgment of the pharmacist, the patient requires the drug.

22. Subsection 159 (2) of the Act is amended by striking out “Schedule A” and substituting “Schedule U”.

23. Section 160 of the Act is amended by adding the following subsection:

Location where drugs accepted

(4) No member and no pharmacy shall receive any drug from a wholesale distributor of drugs other than at the location of a pharmacy which ordered the drugs except where appropriate in the best interest of a patient or patients.

24. Clause 160.1 (1) (a) of the Act is repealed and the following substituted:

(a) requiring members or operators of pharmacies to give the College such information respecting pharmacies as may be set out in the by-laws, including the location of pharmacies, the name and address of pharmacies, the residential address of members and the name and address of owners and designated managers of pharmacies and, if the pharmacy is owned by a corporation, of the directors of the corporation, and any changes to the information;

25. (1) Clauses 161 (1) (a), (b) and (c) of the Act are repealed and the following substituted:

(a) establishing Schedules I, II, III and U for the purposes of this Act, and prescribing the substances that are to be included in those Schedules;

(b) naming or identifying substances for the purposes of the definition of “drug” in subsection 1 (1) and specifying the provisions of this Act that shall apply in respect of such substances;

(c) naming substances and preparations that are not drugs for the purposes of the definition of “drug” in subsection 1 (1);

(c.1) naming publications for the purposes of the definition of “drug” in subsection 1 (1) and specifying the provisions of this Act that shall apply in respect of substances named in those publications;

(c.2) governing matters relating to the sale in pharmacies of drugs or other specified substances or preparations;

(2) Clause 161 (1) (e) of the Act is repealed and the following substituted:

(e) prescribing the manner in which prescriptions shall be given in respect of the drugs referred to in Schedule I and the conditions under which such prescriptions may be given;

(3) Clause 161 (1) (g) of the Act is repealed and the following substituted:

(g) governing the manner in which records shall be kept of the purchase and sale of drugs or of any category or class of drug;

(4) Clauses 161 (1) (i) and (j) of the Act are repealed.

(5) Subsection 161 (1) of the Act is amended by adding the following clause:

(j.1) governing the designation of designated managers;

(6) Clause 161 (1) (k.1) of the Act is amended by adding “and information to be furnished” after “returns to be made”.

(7) Clause 161 (1) (n) of the Act is repealed and the following substituted:

(n) providing for applications for certificates of accreditation of pharmacies, the issuance, suspension, revocation, expiration and renewal of such certificates, and anything ancillary to such issuance, suspension, revocation, expiration and renewal;

(8) Subsection 161 (1) of the Act is amended by adding the following clause:

(u) defining “proprietary misconduct” for the purposes of this Act and governing what constitutes an act of proprietary misconduct.

(9) Subsection 161 (2) of the Act is amended by adding “made by a body or organization independent of the College” after “or publication”.

(10) Subsection 161 (4) of the Act is amended by adding “and shall, if it exists in electronic format, be posted on the College’s website or made available through a hyperlink at the College’s website” at the end.

26. Section 162 of the Act is amended by striking out “this Part” and substituting “this Act”.

27. The Act is amended by adding the following section:

Order where public at risk

162.1 (1) Despite anything in the Pharmacy Act, 1991, the Regulated Health Professions Act, 1991 or the Health Professions Procedural Code, where it appears to the College that the continued operation of a pharmacy places or may place the public at risk, the College may apply to a judge of the Superior Court of Justice for an order immediately revoking or suspending the certificate of accreditation of the pharmacy.

Same

(2) The judge of the Superior Court of Justice hearing the application may make an order revoking or suspending the certificate or placing terms, conditions or limitations on the certificate or may make such other order related to the operation of the pharmacy in the public interest as the judge sees fit.

Appeal

(3) An appeal lies to the Divisional Court from an order made under subsection (2).

28. Section 165 of the Act is repealed and the following substituted:

General offence

165. Every person who contravenes any provision of this Act or the regulations for which no penalty is otherwise provided is guilty of an offence and on conviction is liable,

(a) in the case of an individual, to a fine not exceeding $25,000 for a first offence or $50,000 for a second or subsequent offence; or

(b) in the case of a corporation, to a fine not exceeding $50,000 for a first offence or $200,000 for a second or subsequent offence.

29. Section 166 of the Act is repealed and the following substituted:

Responsibility of owner and designated manager

166. (1) Every owner and designated manager of a pharmacy, or either of them, is liable for every offence against this Act committed by any person in the employ of or under the supervision of the owner or designated manager with the owner’s or designated manager’s permission, consent or approval, express or implied, and every director of a corporation operating a pharmacy is liable for every offence against this Act committed by any person in the employ of the corporation with the director’s permission, consent or approval, express or implied.

Same

(2) Where any person operates a pharmacy contrary to this Act or the regulations, the owner and designated manager of such pharmacy, or either of them, or any director of a corporation operating a pharmacy, may be proceeded against, and prosecution or conviction of any of them is not a bar to prosecution or conviction of another.

Drug Interchangeability and Dispensing Fee Act

30. The definition of “drug” in subsection 1 (1) of the Drug Interchangeability and Dispensing Fee Act is amended by striking out “subsection 117 (1) of”.

Ontario Drug Benefit Act

31. The definition of “drug” in subsection 1 (1) of the Ontario Drug Benefit Act is amended by striking out “subsection 117 (1) of”.

Regulated Health Professions Act, 1991

32. Paragraph 8 of subsection 27 (2) of the Regulated Health Professions Act, 1991 is amended by striking out “subsection 117 (1) of”.

Commencement

33. (1) Subject to subsection (2), this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Subsections 1 (2) and (3) and 13 (2), sections 15, 16, 17, 18, 19, 22 and 24 and subsections 25 (1), (2), (3) and (4) come into force on,

(a) the first anniversary of the day the Health System Improvements Act, 2007 receives Royal Assent; or

(b) an earlier day to be named by proclamation of the Lieutenant Governor.

SCHEDULE M
REGULATED HEALTH PROFESSIONS ACT, 1991

1. Subsection 1 (1) of the Regulated Health Professions Act, 1991 is amended by adding the following definition:

“personal information” means personal information within the meaning of the Freedom of Information and Protection of Privacy Act. (“renseignements personnels”)

2. (1) Subsection 6 (2) of the Act is repealed.

(2) Section 6 of the Act is amended by adding the following subsections:

Content and form

(4) The Minister may specify the content and form of the annual reports submitted by the College and the Advisory Council and, where the Minister has done so, the annual reports shall contain that content and be in that form.

Minister may publish information

(5) The Minister may, in every year, publish information from the annual reports of the Colleges.

No personal information

(6) Information from the annual reports published by the Minister shall not include any personal information.

3. Subsection 9 (4) of the Act is repealed.

4. (1) Subsection 24 (2) of the Act is amended by striking out “subsection 28 (3)” and substituting “paragraph 3 of subsection 28 (5)”.

(2) Subsection 24 (4) of the Act is repealed and the following substituted:

Independence of experts

(4) A person engaged under subsection (3) shall be independent of the parties, and, in the case of a complaint review, of the Inquiries, Complaints and Reports Committee.

5. Section 26 of the Act is repealed.

6. Subsection 30 (1) of the Act is amended by striking out “physical” and substituting “bodily”.

7. (1) Subsection 36 (1) of the Act is repealed and the following substituted:

Confidentiality

(1) Every person employed, retained or appointed for the purposes of the administration of this Act, a health profession Act or the Drug and Pharmacies Regulation Act and every member of a Council or committee of a College shall keep confidential all information that comes to his or her knowledge in the course of his or her duties and shall not communicate any information to any other person except,

(a) to the extent that the information is available to the public under this Act, a health profession Act or the Drug and Pharmacies Regulation Act;

(b) in connection with the administration of this Act, a health profession Act or the Drug and Pharmacies Regulation Act, including, without limiting the generality of this, in connection with anything relating to the registration of members, complaints about members, allegations of members’ incapacity, incompetence or acts of professional misconduct or the governing of the profession;

(d) as may be required for the administration of the Drug Interchangeability and Dispensing Fee Act, the Healing Arts Radiation Protection Act, the Health Insurance Act, the Independent Health Facilities Act, the Laboratory and Specimen Collection Centre Licensing Act, the Ontario Drug Benefit Act, the Coroners Act, the Controlled Drugs and Substances Act (Canada) and the Food and Drugs Act (Canada);

(e) to a police officer to aid an investigation undertaken with a view to a law enforcement proceeding or from which a law enforcement proceeding is likely to result;

(f) to the counsel of the person who is required to keep the information confidential under this section;

(g) to confirm whether the College is investigating a member, if there is a compelling public interest in the disclosure of that information;

(h) where disclosure of the information is required by an Act of the Legislature or an Act of Parliament;

(i) if there are reasonable grounds to believe that the disclosure is necessary for the purpose of eliminating or reducing a significant risk of serious bodily harm to a person or group of persons; or

(j) with the written consent of the person to whom the information relates.

(2) Subsection 36 (1.2) of the Act is amended by striking out “clause (1) (d.1)” in the portion before the definition and substituting “clause (1) (e)”.

(3) Subsection 36 (1.3) of the Act is amended by striking out “clause (1) (d.1)” and substituting “clause (1) (e)”.

(4) Subsection 36 (1.4) of the Act is amended by striking out “clause (1) (d.1)” and substituting “clause (1) (e)”.

(5) Section 36 of the Act is amended by adding the following subsection:

Confirmation of investigation

(1.5) Information disclosed under clause (l) (g) shall be limited to the fact that an investigation is or is not underway and shall not include any other information.

8. The Act is amended by adding the following section:

Collection of personal information by College

36.1 (1) At the request of the Minister, a College shall collect information directly from members of the College as is reasonably necessary for the purpose of Ministry health human resources planning.

Unique identifiers

(2) At the request of the Minister, a College shall assign a unique identifier for each member of the College from whom information is collected under subsection (1).

Members to provide information

(3) A member of a College who receives a request for information for the purpose of subsection (1) shall provide the information to the College within the time period and in the form and manner specified by the College.

Disclosure to Minister

(4) A College shall disclose the information collected under subsection (1) to the Minister within the time period and in the form and manner specified by the Minister.

Use by Minister

(5) The Minister may use and disclose the information only for the purpose set out under subsection (1), and shall not use or collect personal information if other information will serve the purpose, and shall not use or collect more personal information than is necessary for the purpose.

Reports

(6) The Minister may publish reports and other documents using information provided to him or her by a College under this section for the purpose set out in subsection (1), and for that purpose only, but the Minister shall not include any personal information about a member of a College in such reports or documents.

Notice required by s. 39 (2) of FIPPA

(7) If the Minister requires a College to collect personal information from its members under subsection (1), the notice required by subsection 39 (2) of the Freedom of Information and Protection of Privacy Act is given by,

(a) a public notice posted on the Ministry’s website; or

(b) any other public method that may be prescribed.

Same

(8) If the Minister publishes a notice referred to under subsection (7), the Minister shall advise the College of the notice and the College shall also publish a notice about the collection on the College’s website within 20 days of receiving the advice from the Minister.

Definitions

(9) In this section,

“health human resources planning” means ensuring the sufficiency and appropriate distribution of health providers; (“planification des ressources humaines en santé”)

“information” includes personal information; (“renseignements”)

“Ministry” means the Ministry of Health and Long-Term Care. (“ministère”)

9. (1) Subsection 37 (2) of the Act is amended by striking out “under a health profession Act”.

(2) Section 37 of the Act is amended by adding the following subsection:

Injunctions

(3) Subsections (1) and (2) apply, with necessary modifications, to a person who is the subject of an application under section 87 of the Code.

10. Section 38 of the Act is amended by striking out “against the Advisory Council” and substituting “against the Crown, the Minister, an employee of the Crown, the Advisory Council”.

11. Section 39 of the Act is repealed and the following substituted:

Service

39. (1) A notice or decision to be given to a person under this Act, the Drug and Pharmacies Regulation Act or a health profession Act may be given by mail or by fax.

When notice or decision given by mail received

(2) If a notice or decision is sent by mail addressed to a person at the person’s last known address, there is a rebuttable presumption that it was received by the person on the fifth day after mailing.

When notice or decision given by fax received

(3) If a notice or decision is sent by fax to a person at the person’s last known fax number, there is a rebuttable presumption that it was received by the person,

(a) on the day it was faxed, if faxed after midnight and before 4 p.m.; or

(b) on the following day, if faxed at any other time.

12. Section 40 of the Act is repealed and the following substituted:

Offences

40. (1) Every person who contravenes subsection 27 (1) or 30 (1) is guilty of an offence and on conviction is liable,

(a) for a first offence, to a fine of not more than $25,000, or to imprisonment for a term of not more than one year, or both; and

(b) for a second or subsequent offence, to a fine of not more than $50,000, or to imprisonment for a term of not more than one year, or both.

Same

(2) Every individual who contravenes section 31, 32 or 33 or subsection 34 (2), 34.1 (2) or 36 (1) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

Same

(3) Every corporation that contravenes section 31, 32 or 33 or subsection 34 (1), 34.1 (1) or 36 (1) is guilty of an offence and on conviction is liable to a fine of not more than $50,000 for a first offence and not more than $200,000 for a second or subsequent offence.

13. Section 41 of the Act is amended by adding “for a first offence, and not more than $50,000 for a second or subsequent offence” at the end.

14. (1) Subsection 42 (1) of the Act is amended by adding “for a first offence, and not more than $50,000 for a second or subsequent offence” at the end.

(2) Subsection 42 (2) of the Act is amended by adding “for a first offence, and not more than $50,000 for a second or subsequent offence” at the end.

15. The Act is amended by adding the following section:

No limitation

42.1 Section 76 of the Provincial Offences Act does not apply to a prosecution under this Act, the Drug and Pharmacies Regulation Act or a health profession Act.

16. (1) Subsection 43 (1) of the Act is amended by adding the following clause:

(h) for the purposes of clause 36.1 (7) (b), prescribing alternative methods of giving the notice required by subsection 39 (2) of the Freedom of Information and Protection of Privacy Act.

(2) Subsection 43 (1) of the Act is amended by adding the following clause:

(i) prescribing information as information that is to be posted on a College website for the purposes of section 3.1 of the Code.

17. (1) Subsection 1 (1) of Schedule 2 to the Act is amended by adding the following definition:

“alternative dispute resolution process” means mediation, conciliation, negotiation, or any other means of facilitating the resolution of issues in dispute; (“processus de règlement extrajudiciaire des différends”)

(2) The English version of the definition of “health profession corporation” in subsection 1 (1) of the Schedule 2 to the Act is amended by striking out “certificate” and substituting “certificate of authorization”.

(3) The definition of “incapacitated” in subsection 1 (1) of the Schedule 2 to the Act is repealed and the following substituted:

“incapacitated” means, in relation to a member, that the member is suffering from a physical or mental condition or disorder that makes it desirable in the interest of the public that the member’s practice be subject to terms, conditions or limitations, or that the member no longer be permitted to practise; (“frappé d’incapacité”)

(4) The definition of “quality assurance program” in subsection 1 (1) of Schedule 2 to the Act is repealed and the following substituted:

“quality assurance program” means a program to assure the quality of the practice of the profession and to promote continuing evaluation, competence and improvement among the members; (“programme d’assurance de la qualité”)

18. (1) Paragraph 4 of subsection 3 (1) of Schedule 2 to the Act is repealed and the following substituted:

4. To develop, establish and maintain standards of knowledge and skill and programs to promote continuing evaluation, competence and improvement among the members.

(2) Paragraph 8 of subsection 3 (1) of Schedule 2 to the Act is repealed and the following substituted:

8. To promote and enhance relations between the College and its members, other health profession colleges, key stakeholders, and the public.

9. To promote inter-professional collaboration with other health profession colleges.

10. To develop, establish, and maintain standards and programs to promote the ability of members to respond to changes in practice environments, advances in technology and other emerging issues.

11. Any other objects relating to human health care that the Council considers desirable.

19. Schedule 2 to the Act is amended by adding the following section:

College website

3.1 (1) The College shall have a website, and shall include on its website information as may be prescribed in regulations made under clause 43 (1) (i) of the Regulated Health Professions Act, 1991.

Paper or electronic form

(2) Upon request and, if required by the College, the payment of a reasonable fee, the College shall provide the information required to be posted under subsection (1) in paper or electronic form.

20. (1) Subsection 7 (1) of Schedule 2 to the Act is repealed and the following substituted:

Meetings

(1) The meetings of the Council shall be open to the public and reasonable notice shall be given to the members of the College, to the Minister, and to the public.

(2) Clause 7 (2) (b) of Schedule 2 to the Act is repealed and the following substituted:

(b) financial or personal or other matters may be disclosed of such a nature that the harm created by the disclosure would outweigh the desirability of adhering to the principle that meetings be open to the public;

(3) The English version of subsection 7 (4) of Schedule 2 to the Act is repealed and the following substituted:

Grounds noted in minutes

(4) If the Council excludes the public from a meeting or makes an order under subsection (3), it shall have its grounds for doing so noted in the minutes of the meeting.

21. (1) Paragraph 3 of subsection 10 (1) of Schedule 2 to the Act is repealed and the following substituted:

3. Inquiries, Complaints and Reports Committee.

(2) Section 10 of Schedule 2 to the Act is amended by adding the following subsection:

Transitional

(1.1) For greater certainty, where, at the time subsection 21 (1) of Schedule M to the Health System Improvements Act, 2007 comes into force, any matter that is before the Board based on anything done by the Committee formerly known as the Complaints Committee shall proceed as if the Board had the authority to do anything it could have done before the coming into force of sections 30 to 32 of that Schedule.

22. Section 11 of Schedule 2 to the Act is repealed and the following substituted:

Annual reports

11. (1) Each committee named in subsection 10 (1) shall monitor and evaluate their processes and outcomes and shall annually submit a report of its activities to the Council in a form acceptable to the Council.

Exclusions from reports

(2) The Inquiries, Complaints and Reports Committee shall not submit a report that contains information, other than information of a general statistical nature, relating to,

(a) a referral by the Inquiries, Complaints and Reports Committee to the Discipline or Fitness to Practise Committee until a panel of the Discipline or Fitness to Practise Committee disposes of the matter;

(b) an approval for the Registrar to appoint an investigator until the investigation is completed and reported by the Registrar and the Inquiries, Complaints and Reports Committee decides not to make a referral with respect to the matter to the Discipline Committee or, if the Inquiries, Complaints and Reports Committee makes a referral with respect to the matter to the Discipline Committee, until a panel of the Discipline Committee disposes of the matter; or

(c) an interim order made by the Inquiries, Complaints and Reports Committee in respect of a member until a panel of the Discipline Committee disposes of the matter.

23. (1) Subsection 14 (1) of Schedule 2 to the Act is repealed and the following substituted:

Continuing jurisdiction

(1) A person whose certificate of registration is revoked or expires or who resigns as a member continues to be subject to the jurisdiction of the College for professional misconduct or incompetence referable to the time when the person was a member and may be investigated under section 75.

(2) Subsection 14 (2) of Schedule 2 to the Act is amended by adding “and may be investigated under section 75” at the end.

24. (1) The English version of subsection 17 (1) of Schedule 2 to the Act is amended by striking out “reviewed” and substituting “considered”.

(2) Subsection 17 (2) of Schedule 2 to the Act is repealed and the following substituted:

Composition of panels

(2) A panel shall be composed of at least three persons, at least one of whom shall be a person appointed to the Council by the Lieutenant Governor in Council.

25. (1) The English version of subsection 19 (3) of Schedule 2 to the Act is amended by striking out “reviewed” and substituting “considered”.

(2) Paragraph 3 of subsection 19 (6) of Schedule 2 to the Act is amended by striking out “impose” and substituting “modify”.

(3) Subsection 19 (7) of Schedule 2 to the Act is repealed and the following substituted:

Limitations on applications

(7) When an application has been disposed of under this section, the applicant may not make a new application under subsection (1) within six months of the disposition without leave of the Registrar.

Registrar’s leave

(8) The Registrar may only give leave for a new application to be made under subsection (7) if the Registrar is satisfied that there has been a material change in circumstances that justifies the giving of the leave.

26. Subsection 20 (2) of Schedule 2 to the Act is amended by adding “section 19 and of” after “provisions of”.

27. (1) Subsection 22 (4) of Schedule 2 to the Act is amended by striking out “sections 15 and 16” and substituting “sections 15, 15.1, 15.2 and 16”.

(2) Subsection 22 (5) of Schedule 2 to the Act is amended by striking out “sections 15 and 16” and substituting “sections 15, 15.1, 15.2 and 16”.

(3) Paragraph 4 of subsection 22 (6) of Schedule 2 to the Act is amended by adding “reasons and” after “together with any”.

28. Section 23 of Schedule 2 to the Act is repealed and the following substituted:

23. (1) The Registrar shall maintain a register.

Contents of register

(2) The register shall contain the following:

1. Each member’s name, business address and business telephone number, and, if applicable, the name of every health profession corporation of which the member is a shareholder.

2. The name, business address and business telephone number of every health profession corporation.

3. The names of the shareholders of each health profession corporation who are members of the College.

4. Each member’s class of registration and specialist status.

5. The terms, conditions and limitations that are in effect on each certificate of registration.

6. A notation of every matter that has been referred by the Inquiries, Complaints and Reports Committee to the Discipline Committee under section 26 and has not been finally resolved, until the matter has been resolved.

7. The result, including a synopsis of the decision, of every disciplinary and incapacity proceeding, unless a panel of the relevant committee makes no finding with regard to the proceeding.

8. A notation of every finding of professional negligence or malpractice, which may or may not relate to the member’s suitability to practise, made against the member, unless the finding is reversed on appeal.

9. A notation of every revocation or suspension of a certificate of registration.

10. A notation of every revocation or suspension of a certificate of authorization.

11. Information that a panel of the Registration, Discipline or Fitness to Practise Committee specifies shall be included.

12. Where findings of the Discipline Committee are appealed, a notation that they are under appeal, until the appeal is finally disposed of.

13. Where, during or as a result of a proceeding under section 25, a member has resigned and agreed never to practise again in Ontario, a notation of the resignation and agreement.

14. Information that is required to be kept in the register in accordance with the by-laws.

Publication ban

(3) No action shall be taken under this section which violates a publication ban, and nothing in this section requires or authorizes the violation of a publication ban.

Panels specifying information in register

(4) In disposing of a matter, a panel of the Registration, Discipline or Fitness to Practise Committee may, for the purposes of paragraph 11 of subsection (2), specify information that is to be included in the register in addition to the information specified in other paragraphs of subsection (2).

Access to information by the public

(5) All of the information required by paragraphs 1 to 13 of subsection (2) and all information designated as public in the by-laws shall, subject to subsections (6), (7), (8), (9) and (11), be made available to an individual during normal business hours, and shall be posted on the College’s website in a manner that is accessible to the public or in any other manner and form specified by the Minister.

When information may be withheld from the public

(6) The Registrar may refuse to disclose to an individual or to post on the College’s website an address or telephone number or other information designated as information to be withheld from the public in the by-laws if the Registrar has reasonable grounds to believe that disclosure may jeopardize the safety of an individual.

Same

(7) The Registrar may refuse to disclose to an individual or to post on the College’s website information that is available to the public under subsection (5), if the Registrar has reasonable grounds to believe that the information is obsolete and no longer relevant to the member’s suitability to practise.

Same, personal health information

(8) The Registrar shall not disclose to an individual or post on the College’s website information that is available to the public under subsection (5) that is personal health information, unless the personal health information is that of a member and it is in the public interest that the information be disclosed.

Restriction, personal health information

(9) The Registrar shall not disclose to an individual or post on the College’s website under subsection (8) more personal health information than is reasonably necessary.

Personal health information

(10) In subsections (8) and (9),

“personal health information” means information that identifies an individual and that is referred to in clauses (a) through (g) of the definition of “personal health information” in subsection 4 (1) of the Personal Health Information Protection Act, 2004.

Other cases when information may be withheld

(11) The Registrar shall refuse to disclose to an individual or to post on the College’s website information required by paragraph 7 of subsection (2) if,

(a) a finding of professional misconduct was made against the member and the order made was only a reprimand or only a fine, or a finding of incapacity was made against the member;

(b) more than six years have passed since the information was prepared or last updated;

(c) the member has made an application to the relevant committee for the removal of the information from public access because the information is no longer relevant to the member’s suitability to practise, and if,

(i) the relevant committee believes that a refusal to disclose the information outweighs the desirability of public access to the information in the interest of any person affected or the public interest, and

(ii) the relevant committee has directed the Registrar to remove the information from public access; and

(d) the information does not relate to disciplinary proceedings concerning sexual abuse as defined in clause (a) or (b) of the definition of “sexual abuse” in subsection 1 (3).

Information from register

(12) The Registrar shall provide to an individual a copy of any information in the register that the individual is entitled to obtain, upon the payment of a reasonable fee, if required.

Positive obligation

(13) Subject to subsection (11), where an individual inquires about a member, the Registrar shall make reasonable efforts to ensure that the individual is provided with a list of the information that is available to the public under subsection (5).

Meaning of results of proceeding

(14) For the purpose of this section and section 56,

“result”, when used in reference to a disciplinary or incapacity proceeding, means the panel’s finding, particulars of the grounds for the finding, and the order made, including any reprimand.

29. Section 24 of Schedule 2 to the Act is amended,

(a) by striking out “of default and”; and

(b) by striking out “two months” and substituting “30 days”.

30. The heading before section 25 and sections 25, 26, 27, 28 and 29 of Schedule 2 to the Act are repealed and the following substituted:

Complaints And Reports

Panel for investigation or consideration

25. (1) A panel shall be selected by the chair of the Inquiries, Complaints and Reports Committee from among the members of the Committee to investigate a complaint filed with the Registrar regarding the conduct or actions of a member or to consider a report that is made by the Registrar under clause 79 (a).

Composition

(2) A panel shall be composed of at least three persons, at least one of whom shall be a person appointed to the Council by the Lieutenant Governor in Council.

Quorum

(3) Three members of a panel constitute a quorum.

Complaint must be recorded

(4) A panel shall not be selected to investigate a complaint unless the complaint is in writing or is recorded on a tape, film, disk or other medium.

Complainant to be informed

(5) The Registrar shall give a complainant notice of receipt of his or her complaint and a general explanation of the processes of the College, including the jurisdiction and role of the Inquiries, Complaints and Reports Committee, together with a copy of the provisions of sections 28 to 29.

Notice to member

(6) The Registrar shall give the member, within 14 days of receipt of the complaint or the report,

(a) notice of the complaint, together with a copy of the provisions of sections 28 to 29, or notice of the receipt of the report;

(b) a copy of the provisions of section 25.2; and

(c) a copy of all available prior decisions involving the member unless the decision was to take no further action under subsection 26 (5).

Alternative dispute resolution with respect to a complaint

25.1 (1) The Registrar may, with the consent of both the complainant and the member, refer the complainant and the member to an alternative dispute resolution process,

(a) if the matter has not yet been referred to the Discipline Committee under section 26; and

(b) if the matter does not involve an allegation of sexual abuse.

Confidentiality

(2) Despite this or any other Act, all communications at an alternative dispute resolution process and the facilitator’s notes and records shall remain confidential and be deemed to have been made without prejudice to the parties in any proceeding.

Facilitator not to participate

(3) The person who acts as the alternative dispute resolution facilitator shall not participate in any proceeding concerning the same matter.

Ratification of resolution

(4) If the complainant and the member reach a resolution of the complaint through alternative dispute resolution, they shall advise the panel of the resolution, and the panel may,

(a) cease its investigation of the complaint and adopt the proposed resolution; or

(b) continue with its investigation of the complaint.

Submissions by member

25.2 (1) A member who is the subject of a complaint or a report may make written submissions to the Inquiries, Complaints and Reports Committee within 30 days of receiving notice under subsection 25 (6).

Exception

(2) The Inquiries, Complaints and Reports Committee may specify a period of time of less than 30 days in which the member may make written submissions, and inform the member to that effect, if the Committee is of the opinion, on reasonable and probable grounds, that the conduct of the member exposes or is likely to expose his or her patients to harm or injury.

What a panel may do

26. (1) A panel, after investigating a complaint or considering a report, considering the submissions of the member and making reasonable efforts to consider all records and documents it considers relevant to the complaint or the report, may do any one or more of the following:

1. Refer a specified allegation of the member’s professional misconduct or incompetence to the Discipline Committee if the allegation is related to the complaint or the report.

2. Refer the member to a panel of the Inquiries, Complaints and Reports Committee under section 58 for incapacity proceedings.

3. Require the member to appear before a panel of the Inquiries, Complaints and Reports Committee to be cautioned.

4. Take action it considers appropriate that is not inconsistent with the health profession Act, this Code, the regulations or by-laws.

Prior decisions

(2) A panel of the Inquiries, Complaints and Reports Committee shall, when investigating a complaint or considering a report currently before it, consider all of its available prior decisions involving the member, including decisions made when that committee was known as the Complaints Committee, and all available prior decisions involving the member of the Discipline Committee, the Fitness to Practise Committee and the Executive Committee, unless the decision was to take no further action under subsection (5).

Quality assurance

(3) In exercising its powers under paragraph 4 of subsection (1), the panel may not refer the matter to the Quality Assurance Committee, but may require a member to complete a specified continuing education or remediation program.

Complaint in bad faith, etc.

(4) If the panel considers a complaint to be frivolous, vexatious, made in bad faith, moot or otherwise an abuse of process, it shall give the complainant and the member notice that it intends to take no action with respect to the complaint and that the complainant and the member have a right to make written submissions within 30 days after receiving the notice.

Same

(5) If the panel is satisfied, after considering the written submissions of the complainant and the member, that a complaint was frivolous, vexatious, made in bad faith, moot or otherwise an abuse of process, the panel shall not take action with respect to the complaint.

Notice of decision

27. (1) A panel shall give the complainant and the member who is the subject of the complaint,

(a) a copy of its decision;

(b) a copy of its reasons, if the panel acted under paragraph 3 or 4 of subsection 26 (1); and

(c) a notice advising the member and the complainant of any right to request a review they may have under subsection 29 (2).

Same, report

(2) A panel shall give the member, in the case of a report,

(a) a copy of its decision; and

(b) a copy of its reasons, if the panel acted under paragraph 3 or 4 of subsection 26 (1).

Timely disposal

28. (1) A panel shall dispose of a complaint within 150 days after the filing of the complaint.

Not affected by ADR

(2) A referral to an alternative dispute resolution process under section 25.1 does not affect the time requirements under this section.

If complaint not disposed of

(3) If a panel has not disposed of a complaint within 150 days after the complaint was filed, the Registrar shall provide the complainant with written notice of that fact and an expected date of disposition which shall be no more than 60 days from the date of the written notice.

If further delay

(4) If a panel has not disposed of the complaint by the expected date of disposition described in subsection (3), the Registrar shall,

(a) provide the member and complainant with written notice and reasons for the delay and the new expected date of disposition which shall be no more than 30 days from the date of the revised notice or from the expected date of disposition described in subsection (3), whichever is sooner; and

(b) provide the Board with written notice of and reasons for the delay as were provided to the member and complainant.

Powers of the Board

(5) The Board, on application of the member or the complainant, shall consider the written reasons for the delay and shall do any one of the following:

1. Direct the Inquiries, Complaints and Reports Committee to continue the investigation.

2. Make recommendations the Board considers appropriate to the Inquiries, Complaints and Reports Committee.

3. Investigate the complaint and make an order under subsection (9) within 120 days of the decision to investigate the complaint.

Board’s investigatory powers

(6) In investigating a complaint under paragraph 3 of subsection (5), the Board has all the powers of a panel of the Inquiries, Complaints and Reports Committee and of the Registrar with respect to the investigation of the matter and may appoint an investigator under clause 75 (1) (c).

Continuing power of Inquiries, Complaints and Reports Committee

(7) The Inquiries, Complaints and Reports Committee may take action under section 26 at any time before the Board completes its investigation.

Same

(8) For greater certainty, if the Inquiries, Complaints and Reports Committee takes action as provided for in subsection (7), the Board no longer has jurisdiction to take action under section 26.

Powers of Board re an investigation

(9) After an investigation, the Board may do any one or more of the following:

1. Refer the matter to the Inquiries, Complaints and Reports Committee.

2. Make recommendations the Board considers appropriate to the Inquiries, Complaints and Reports Committee.

3. Require the Inquiries, Complaints and Reports Committee or a panel to do anything the Committee or a panel may do under the health profession Act and this Code except to request the Registrar to conduct an investigation.

Powers of Board re time limits

28.1 If the Board is satisfied that no person will be unduly prejudiced, it may, on reasonable grounds, extend any time limit with respect to,

(a) a requirement, under subsection 21 (1), for a review or hearing by the Board;

(b) a request, under subsection 29 (2), for a review by the Board; or

(c) the Registrar’s obligation to give to the Board, under subsection 32 (1), a record of an investigation of a complaint against a member and all relevant documents and things.

Review by Board

29. (1) Subject to section 30, the Board shall review a decision of a panel of the Inquiries, Complaints and Reports Committee if the Board receives a request under subsection (2).

Request for review

(2) The complainant or the member who is the subject of the complaint may request the Board to review a decision of a panel of the Inquiries, Complaints and Reports Committee unless the decision was,

(a) to refer an allegation of professional misconduct or incompetence to the Discipline Committee; or

(b) to refer the member to a panel of the Inquiries, Complaints and Reports Committee under section 58 for incapacity proceedings.

Time limit

(3) A request for a review may be made only within 30 days after the receipt of the notice of the right to request a review given under clause 27 (1) (c).

Limitation

(4) The Board shall not, under section 28.1, extend the time limit set out in subsection (3) for more than 60 days.

Parties

(5) The complainant and the member who is the subject of the complaint are parties to a review.

31. (1) Subsection 30 (2) of Schedule 2 to the Act is amended by striking out “bad faith or” and substituting “bad faith, moot or”.

(2) Subsection 30 (3) of Schedule 2 to the Act is amended by striking out “bad faith or” and substituting “bad faith, moot or”.

32. (1) Paragraph 2 of subsection 35 (1) of Schedule 2 to the Act is amended by striking out “Complaints Committee” and substituting “Inquiries, Complaints and Reports Committee”.

(2) Paragraph 3 of subsection 35 (1) of Schedule 2 to the Act is amended by striking out “Complaints Committee” and substituting “Inquiries, Complaints and Reports Committee”.

(3) Subsection 35 (2) of Schedule 2 to the Act is amended by striking out “Complaints Committee” and substituting “Inquiries, Complaints and Reports Committee”.

33. (1) Subsection 36 (1) of Schedule 2 to the Act is repealed and the following substituted:

Inquiries, Complaints and Reports Committee referral

(1) The Inquiries, Complaints and Reports Committee may refer a specified allegation of a member’s professional misconduct or incompetence to the Discipline Committee.

(2) Subsection 36 (2) of Schedule 2 to the Act is amended by striking out “Executive Committee” and substituting “Inquiries, Complaints and Reports Committee”.

34. (1) Subsection 37 (1) of Schedule 2 to the Act is amended by striking out “Executive Committee” in the portion before clause (a) and substituting “Inquiries, Complaints and Reports Committee”.

(2) Subsection 37 (2) of Schedule 2 to the Act is amended by striking out “Executive Committee” in the portion before clause (a) and substituting “Inquiries, Complaints and Reports Committee”.

(3) Subsection 37 (5) of Schedule 2 to the Act is repealed and the following substituted:

Restrictions on orders

(5) No order shall be made under subsection (1) unless the member has been given,

(a) notice of the Committee’s intention to make the order; and

(b) at least 14 days to make written submissions to the Committee.

Extraordinary action to protect public

(6) Despite subsection (5), an order may be made under subsection (1) without notice to the member, subject to the right of the member to make submissions while the suspension or the terms, conditions or limitations are in place, if the Committee is of the opinion, on reasonable and probable grounds, that the conduct of the member exposes or is likely to expose his or her patients to harm or injury and urgent intervention is needed.

35. Subsection 38 (1) of Schedule 2 to the Act is amended by striking out “Executive or Complaints Committee” at the end and substituting “Inquiries, Complaints and Reports Committee”.

36. Subsection 41.1 (1) of Schedule 2 to the Act is amended by striking out the portion before clause (a) and substituting the following:

Non-party participation in hearings

(1) A panel, on application by a person who is not a party, may allow the person to participate in a hearing if,

. . . . .

37. Clause 45 (2) (b) of Schedule 2 to the Act is repealed and the following substituted:

(b) financial or personal or other matters may be disclosed at the hearing of such a nature that the harm created by disclosure would outweigh the desirability of adhering to the principle that hearings be open to the public;

38. Section 46 of Schedule 2 to the Act is repealed and the following substituted:

Exception to closed hearings

46. If a panel makes an order under subsection 45 (2) wholly or partly in relation to a person, the panel may allow the person and his or her personal representative to attend the hearing and may, in its discretion, allow another person to attend if, in the opinion of the panel, to do so does not undermine the reasons for making the order and does not cause undue prejudice to a party.

39. (1) Subsection 51 (1) of Schedule 2 to the Act is amended by adding the following clause:

(b.0.1) the member has failed to co-operate with the Quality Assurance Committee or any assessor appointed by that committee;

(2) Subsection 51 (4) of Schedule 2 to the Act is amended by striking out “an order” and substituting “all or part of an order”.

40. (1) Subsection 52 (1) of Schedule 2 to the Act is amended by striking out “or disregard for the welfare of the patient”.

(2) The English version of paragraph 3 of subsection 52 (2) of Schedule 2 to the Act is amended by striking out “or indefinite period of time” at the end and substituting “period of time or indefinite period of time”.

(3) Subsection 52 (3) of Schedule 2 to the Act is amended by adding “paragraph 2 or 3 of” after “order under”.

41. Section 54 of Schedule 2 to the Act is amended by striking out “Complaints Committee” and substituting “Inquiries, Complaints and Reports Committee”.

42. Section 57 of Schedule 2 to the Act is amended by striking out “Executive Committee” at the end and substituting “Inquiries, Complaints and Reports Committee”.

43. Section 58 of Schedule 2 to the Act is repealed and the following substituted:

Panel shall inquire

58. (1) A panel selected by the chair of the Inquiries, Complaints and Reports Committee from among the members of the Committee shall inquire into whether a member is incapacitated if,

(a) the Inquiries, Complaints and Reports Committee receives a report from the Registrar under section 57; or

(b) a referral is made from a panel of the Inquiries, Complaints and Reports Committee under paragraph 2 of subsection 26 (1).

Notice to member

(2) The Inquiries, Complaints and Reports Committee shall give a member notice that it intends to inquire into whether the member is incapacitated.

Transitional

(3) A board of inquiry that was constituted under this section, as it existed immediately before the coming into force of section 43 of Schedule M to the Health System Improvements Act, 2007, shall be deemed to continue to be validly constituted and to have the authority to do anything that it could have done before the coming into force of section 44 of that Schedule, and where the board of inquiry was to give a copy of a report to the Executive Committee, that Committee may continue to act with respect to that matter and shall have the authority to do anything it could have done before the coming into force of sections 44 to 47 of that Schedule.

44. Sections 59, 60 and 61 of Schedule 2 to the Act are repealed and the following substituted:

Inquiries by panel

59. (1) A panel shall make the inquiries it considers appropriate.

Physical or mental examinations

(2) If, after making inquiries, a panel has reasonable and probable grounds to believe that the member who is the subject of the inquiry is incapacitated, the panel may require the member to submit to physical or mental examinations conducted or ordered by a health professional specified by the panel and may, subject to section 63, make an order directing the Registrar to suspend the member’s certificate of registration until he or she submits to the examinations.

Panel’s report

60. The panel shall give a copy of its report and a copy of any report on an examination required under subsection 59 (2) to the member who was the subject of the inquiry.

Referral to Fitness to Practise Committee

61. After giving a copy of its report and copy of any report on an examination required under subsection 59 (2) to the member, the panel may refer the matter to the Fitness to Practise Committee.

45. (1) Subsection 62 (1) of Schedule 2 to the Act is amended by striking out “The Executive Committee” at the beginning of the portion before clause (a) and substituting “The panel”.

(2) Subsection 62 (2) of Schedule 2 to the Act is amended by striking out “by the Executive Committee” in the portion before clause (a).

46. Section 63 of Schedule 2 to the Act is repealed and the following substituted:

Restrictions on orders

63. (1) No order shall be made with respect to a member under subsection 59 (2) or 62 (1) unless the member has been given,

(a) notice of the intention to make the order;

(b) at least 14 days to make written submissions to the panel; and

Extraordinary action to protect the public

(2) Despite subsection (1), an order may be made without notice to the member, subject to the right of the member to make submissions while the suspension is in place to the panel that made the order, if the panel is of the opinion on reasonable and probable grounds that the physical or mental state of the member exposes or is likely to expose his or her patients to harm or injury and urgent intervention is needed.

47. (1) Subsection 64 (1) of Schedule 2 to the Act is amended by striking out “the Executive Committee” at the end and substituting “a panel of the Inquiries, Complaints and Reports Committee”.

(2) Subsection 64 (2) of Schedule 2 to the Act is amended by striking out “one” and substituting “at least one”.

48. Section 67 of Schedule 2 to the Act is amended by striking out “panel” in the portion before paragraph 1 and substituting “panel of the Fitness to Practise Committee”.

49. (1) Subsection 68 (1) of Schedule 2 to the Act is amended by adding “by a panel of the Fitness to Practise Committee” after “hearing”.

(2) Clause 68 (2) (b) of Schedule 2 to the Act is repealed and the following substituted:

(b) financial or personal matters or other matters may be disclosed at the hearing of such a nature that the harm created by disclosure would outweigh the desirability of adhering to the principle that hearings be open to the public;

50. (1) The English version of paragraph 3 of subsection 69 (1) of Schedule 2 to the Act is amended by striking out “or indefinite period of time” at the end and substituting “period of time or indefinite period of time”.

(2) Subsection 69 (2) of Schedule 2 to the Act is amended by adding “paragraph 2 or 3 of” after “order under”.

(3) Section 69 of Schedule 2 to the Act is amended by adding the following subsections:

Varying

(3) A member or the College may apply to the Fitness to Practise Committee for an order directing the Registrar to remove or modify any term, condition or limitation imposed on the member’s certificate of registration as a result of paragraph 3 of subsection (1) and the chair may select a panel to deal with the application.

Limitations

(4) The right to apply under subsection (3) is subject to any limitation in the order or to which the member consented and to any limitation made under subsection (5) in the disposition of a previous application to vary.

Limitations on applications

(5) The panel, in disposing of an application by a member under subsection (3), may fix a period of time not longer than six months during which the member may not make a further application.

51. Schedule 2 to the Act is amended by adding the following section:

Order where public at risk

71.2 If the conduct of the member exposes or is likely to expose his or her patients to harm or injury and urgent intervention is needed, the College may apply to a judge of the Superior Court of Justice for an order declaring that an order that was made by a panel of the Discipline Committee on the grounds of professional misconduct and that directs the Registrar to revoke, suspend or impose terms, conditions or limitations on a member’s certificate shall take effect immediately despite any appeal and any other Act.

52. Subsections 72 (2) and (3) of Schedule 2 to the Act are repealed and the following substituted:

Time of application

(2) An application under subsection (1) shall not be made earlier than,

(a) one year after the date on which the certificate of registration was revoked or suspended; or

(b) six months after a decision has been made in a previous application under subsection (1).

Time of application, sexual abuse cases

(3) An application under subsection (1), in relation to a revocation for sexual abuse of a patient, shall not be made earlier than,

(a) five years after the date on which the certificate of registration was revoked; or

(b) six months after a decision has been made in a previous application under subsection (1).

Notice where complainant

(4) The Registrar shall give the complainant in the original proceeding notice of an application under subsection (1).

Reasons for reinstatement

(5) The person making the application under subsection (1) shall provide reasons why the certificate should be issued or the suspension be removed.

53. Section 75 of Schedule 2 to the Act is repealed and the following substituted:

Investigators

75. (1) The Registrar may appoint one or more investigators to determine whether a member has committed an act of professional misconduct or is incompetent if,

(a) the Registrar believes on reasonable and probable grounds that the member has committed an act of professional misconduct or is incompetent and the Inquiries, Complaints and Reports Committee approves of the appointment;

(b) the Inquiries, Complaints and Reports Committee has received information about a member from the Quality Assurance Committee under paragraph 4 of subsection 80.2 (1) and has requested the Registrar to conduct an investigation; or

(c) the Inquiries, Complaints and Reports Committee has received a written complaint about the member and has requested the Registrar to conduct an investigation.

Emergencies

(2) The Registrar may appoint an investigator if,

(a) the Registrar believes on reasonable and probable grounds that the conduct of the member exposes or is likely to expose his or her patients to harm or injury, and that the investigator should be appointed immediately; and

(b) there is not time to seek approval from the Inquiries, Complaints and Reports Committee.

Report

(3) Where an investigator has been appointed under subsection (2), the Registrar shall report the appointment of the investigator to the Inquiries, Complaints and Reports Committee within five days.

54. Subsection 76 (2) of Schedule 2 to the Act is amended by striking out “the business premises of the member” and substituting “the place of practice of the member”.

55. Subsections 77 (1) and (2) of Schedule 2 to the Act are repealed and the following substituted:

Entries and searches

(1) A justice of the peace may, on the application of the investigator made without notice, issue a warrant authorizing an investigator to enter and search a place and examine any document or thing specified in the warrant if the justice of the peace is satisfied that the investigator has been properly appointed and that there are reasonable and probable grounds established upon oath for believing that,

(a) the member being investigated has committed an act of professional misconduct or is incompetent; and

(b) there is something relevant to the investigation at the place.

Hours of execution

(2) A warrant issued under subsection (1) may be executed only between 8 a.m. and 8 p.m. unless the warrant specifies otherwise.

Application for dwelling

(2.1) An application for a warrant under subsection (1) to enter a dwelling shall specifically indicate that the application relates to a dwelling.

56. Section 79 of Schedule 2 to the Act is repealed and the following substituted:

Report of investigation

79. The Registrar shall report the results of an investigation to,

(a) the Inquiries, Complaints and Reports Committee if the investigator was appointed under clause 75 (1) (a) or (b) or subsection 75 (2);

(b) the Inquiries, Complaints and Reports Committee if the investigator was appointed under clause 75 (1) (c), at the request of the Inquiries, Complaints and Reports Committee; or

(c) the Board if the investigator was appointed under clause 75 (1) (c) by the Board exercising the Registrar’s powers under subsection 28 (6).

57. Section 79.1 of Schedule 2 to the Act is repealed.

58. Schedule 2 to the Act is amended by adding the following sections:

Minimum requirements for quality assurance program

80.1 A quality assurance program prescribed under section 80 shall include,

(a) continuing education or professional development designed to,

(i) promote continuing competence and continuing quality improvement among the members,

(ii) address changes in practice environments, and

(iii) incorporate standards of practice, advances in technology, changes made to entry to practice competencies and other relevant issues in the discretion of the Council;

(b) self, peer and practice assessments; and

(c) a mechanism for the College to monitor members’ participation in, and compliance with, the quality assurance program.

Powers of the Committee

80.2 (1) The Quality Assurance Committee may do only one or more of the following:

1. Require individual members whose knowledge, skill and judgment have been assessed under section 82 and found to be unsatisfactory to participate in specified continuing education or remediation programs.

2. Direct the Registrar to impose terms, conditions or limitations for a specified period to be determined by the Committee on the certificate of registration of a member,

i. whose knowledge, skill and judgment have been assessed or reassessed under section 82 and have been found to be unsatisfactory, or

ii. who has been directed to participate in specified continuing education or remediation programs as required by the Committee under paragraph 1 and has not completed those programs successfully.

3. Direct the Registrar to remove terms, conditions or limitations before the end of the specified period, if the Committee is satisfied that the member’s knowledge, skill and judgment are now satisfactory.

4. Disclose the name of the member and allegations against the member to the Inquiries, Complaints and Reports Committee if the Quality Assurance Committee is of the opinion that the member may have committed an act of professional misconduct, or may be incompetent or incapacitated.

Notice

(2) No direction shall be given to the Registrar under paragraph 2 of subsection (1) unless the member has been given notice of the Quality Assurance Committee’s intention to give direction, and at least 14 days to make written submissions to the Committee.

59. (1) Subsection 83 (1) of Schedule 2 to the Act is amended by striking out “Except as provided in this section” at the beginning of the portion before clause (a) and substituting “Except as provided in section 80.2 and in this section”.

(2) Subsection 83 (2) of Schedule 2 to the Act is repealed and the following substituted:

Exception if member gave false information

(2) Where relevant to a proceeding before a committee, information described in subsection (1) may be disclosed to that committee for the purpose of showing that the member knowingly gave false information to the Quality Assurance Committee or an assessor.

(3) Subsection 83 (3) of Schedule 2 to the Act is repealed.

60. (1) Subsection 84 (2) of Schedule 2 to the Act is amended by striking out “preventing or” and substituting “preventing and”.

(2) Subsection 84 (3) of Schedule 2 to the Act is amended by striking out “preventing or” in the portion before clause (a) and substituting “preventing and”.

61. Subsection 85.2 (1) of Schedule 2 to the Act is amended by striking out “has sexually abused a patient” at the end and substituting “is incompetent, incapacitated, or has sexually abused a patient”.

62. (1) Subsection 85.3 (2) of Schedule 2 to the Act is repealed and the following substituted:

Timing of report

(2) The report must be filed within 30 days after the obligation to report arises unless the person who is required to file the report has reasonable grounds to believe that the member will continue to sexually abuse the patient or will sexually abuse other patients, or that the incompetence or the incapacity of the member is likely to expose a patient to harm or injury and there is urgent need for intervention, in which case the report must be filed forthwith.

(2) Clause 85.3 (3) (c) of Schedule 2 to the Act is repealed and the following substituted:

63. Schedule 2 to the Act is amended by adding the following sections:

Reporting by members re: offences

85.6.1 (1) A member shall file a report in writing if the member has been found guilty of an offence.

Timing of report

(2) The report must be filed as soon as reasonably practicable after the member receives notice of the finding of guilt.

Contents of report

(3) The report must contain,

(a) the name of the member filing the report;

(b) the nature of, and a description of the offence;

(d) the name and location of the court that found the member guilty of the offence; and

(e) the status of any appeal initiated respecting the finding of guilt.

Publication ban

(4) The report shall not contain any information that violates a publication ban.

Same

(5) No action shall be taken under this section which violates a publication ban and nothing in this section requires or authorizes the violation of a publication ban.

Additional reports

(6) A member who files a report under subsection (1) shall file an additional report if there is a change in status of the finding of guilt as the result of an appeal.

Reporting by members re: professional negligence and malpractice

85.6.2 (1) A member shall file a report in writing if there has been a finding of professional negligence or malpractice made against the member.

Timing of report

(2) The report must be filed as soon as reasonably practicable after the member receives notice of the finding made against the member.

Contents of report

(3) The report must contain,

(a) the name of the member filing the report;

(b) the nature of, and a description of the finding;

(d) the name and location of the court that made the finding against the member; and

(e) the status of any appeal initiated respecting the finding made against the member.

Publication ban

(4) The report shall not contain any information that violates a publication ban.

Same

(5) No action shall be taken under this section which violates a publication ban and nothing in this section requires or authorizes the violation of a publication ban.

Additional reports

(6) A member who files a report under subsection (1) shall file an additional report if there is a change in status of the finding made against the member as the result of an appeal.

64. Subsection 85.7 (10) of Schedule 2 to the Act is repealed and the following substituted:

Same

(10) Funding may be used to pay for therapy or counselling that was provided at any time after the sexual abuse took place.

65. Paragraphs 1 and 2 of section 85.10 of Schedule 2 to the Act are repealed and the following substituted:

1. The Regulated Health Professions Act, 1991 and the regulations made under that Act.

2. The health profession Act governing the member’s health profession and the regulations and by-laws made under that Act.

66. Paragraph 6 of subsection 85.11 (2) of Schedule 2 to the Act is repealed and the following substituted:

6. An inquiry by a panel of the Inquiries, Complaints and Reports Committee.

67. Clauses 85.14 (2) (a) and (b) of Schedule 2 to the Act are repealed and the following substituted:

(a) the Regulated Health Professions Act, 1991 and the regulations made under that Act; or

(b) the health profession Act governing the member’s health profession and the regulations and by-laws made under that Act.

68. Section 86 of Schedule 2 to the Act is amended by adding the following subsection:

Language preferences

(1.1) The College shall identify and record the language preference of each College member and identify the language preference of each member of the public who has dealings with the College.

69. Section 85.9 of Schedule 2 to the Act is amended by adding “who are members of the College” at the end.

70. Section 91 of Schedule 2 to the Act is repealed.

71. Section 92 of Schedule 2 to the Act is repealed and the following substituted:

Making false representations to obtain certificates

92. (1) Every person who makes a representation, knowing it to be false,

(a) for the purpose of having a certificate of registration issued is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence; or

(b) for the purpose of having a certificate of authorization issued is guilty of an offence and on conviction is liable to a fine of not more than $50,000 for a first offence and not more than $200,000 for a second or subsequent offence.

Assisting the making of false representation

(2) Every person who knowingly assists a person in committing an offence under subsection (1) is guilty of an offence and on conviction is liable,

(a) in the case of an individual, to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence; or

(b) in the case of a corporation, to a fine of not more than $50,000 for a first offence and not more than $200,000 for a second or subsequent offence.

72. Section 93 of Schedule 2 to the Act is repealed and the following substituted:

Offence

93. (1) Every person who contravenes an order made under subsection 7 (3), or section 45 or 47, or subsection 76 (3), 82 (2) or (3), or who contravenes subsection 85.2 (1), 85.5 (1) or (2) or section 92.1 is guilty of an offence and on conviction is liable,

(a) in the case of an individual to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence; or

(b) in the case of a corporation to a fine of not more than $50,000 for a first offence and not more than $200,000 for a second or subsequent offence.

Same

(2) Every person who contravenes subsection 85.1 (1) or 85.4 (1) is guilty of an offence and on conviction is liable to a fine of not more than $25,000 for a first offence and not more than $50,000 for a second or subsequent offence.

73. (1) Clause 94 (1) (l.1) of Schedule 2 to the Act is amended by striking out “subsection 23 (3)” at the end and substituting “section 23”.

(2) Clause 94 (1) (l.2) of Schedule 2 to the Act is repealed and the following substituted:

(1.2) prescribing information as information to be kept in the register for the purposes of paragraph 14 of subsection 23 (2), designating information kept in the register as public for the purposes of subsection 23 (5), and designating information kept in the register as public for the purposes of subsection 23 (5) that may be withheld from the public for the purposes of subsection 23 (6);

(3) Subsection 94 (3) of Schedule 2 to the Act is repealed and the following substituted:

Copies of by-laws, etc.

(3) A copy of the by-laws and standards of practice made by the Council, and any documents that are referred to in the by-laws and regulations made by the Council shall be given to the Minister and to each member and shall be made available to the public during normal business hours in the office of the College.

Public copies

(3.1) Any person is entitled to a copy of any by-law, standard of practice or other document mentioned in subsection (3) on the payment of a reasonable fee, if required, to the Registrar.

74. (1) Clause 95 (1) (f) of Schedule 2 to the Act is amended by striking out “as set” and substituting “as set and approved”.

(2) Subsections 95 (1.2) and (1.3) of Schedule 2 to the Act are repealed and the following substituted:

Rolling incorporation

(1.2) If a regulation under subsection (1.1) so provides, a scientific, administrative or technical document adopted by reference shall be a reference to it, as amended from time to time, and whether the amendment was made before or after the regulation was made.

Third party external document

(1.2.1) A document adopted under subsection (1.2) must be a document created by a recognized body and must not be a document created by the College.

Exception

(1.2.2) Despite subsection (1.2.1), the incorporation by reference of a document created by the College that was made before the coming into force of that subsection remains valid until it is revoked.

Copies available for inspection

(1.3) A copy of every code, standard or guideline adopted by reference under subsection (1.1) shall be available for public inspection during normal business hours in the office of the College and shall be posted on the College’s website or be available through a hyperlink at the College’s website.

(3) Section 95 of Schedule 2 to the Act is amended by adding the following subsection:

Adopted documents

(1.7) Subsections (1.4) and (1.6) apply with necessary modifications to an amendment to a scientific, administrative or technical document adopted by reference under subsection (1.1).

(4) Subsections 95 (2.1) and (2.2) of Schedule 2 to the Act are repealed.

Commencement

75. (1) Subject to subsection (2), this Schedule comes into force on,

(a) the second anniversary of the day the Health System Improvements Act, 2007 receives Royal Assent; or

(b) an earlier day to be named by proclamation of the Lieutenant Governor.

Same

(2) This section, sections 1, 7, 8 and 10 to 15, subsections 16 (1), 17 (3) and 27 (1) and (2) and sections 54, 55, 70, 71 and 72 come into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

schedule N
Chase McEachern Act (Heart Defibrillator Civil Liability), 2007

Definitions

1. In this Act,

“defibrillator” means an automated external medical heart monitor and defibrillator that is capable of,

(a) recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia,

(b) determining, without intervention by an operator, whether defibrillation should be performed,

(c) automatically charging and requesting delivery of an electrical impulse to an individual’s heart as medically required, and

(d) satisfying any other criteria that may be prescribed by regulation; (“défibrillateur”)

“emergency” means a situation during which the behaviour of an individual reasonably leads another individual to believe that the first individual is experiencing a life-threatening event that requires the provision of immediate care to assist the heart or other cardiopulmonary functioning of that person; (“situation d’urgence”)

“health care professional” means,

(a) a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991,

(b) such other persons or classes of persons as may be prescribed. (“professionnel de la santé”)

Protection from civil liability, user of defibrillator

2. (1) Despite the rules of common law, a person described in subsection (2) who, in good faith, voluntarily and without reasonable expectation of compensation or reward uses a defibrillator on a person experiencing an emergency is not liable for damages that result from the person’s negligence in acting or failing to act while using the defibrillator, unless it is established that the damages were caused by the gross negligence of the person.

Persons covered

(2) Subsection (1) applies to,

(a) a health care professional, if the health care professional does not use the defibrillator at a hospital or other place having appropriate health care facilities and equipment for the purpose of defibrillation; and

(b) an individual, other than a health care professional described in clause (a), who uses a defibrillator at the immediate scene of an emergency.

Reimbursement of expenses

(3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in using a defibrillator shall be deemed not to be compensation or reward for the purpose of subsection (1).

Protection from civil liability, owner or operator of premises

3. (1) Despite the Occupiers’ Liability Act and the rules of common law, any person who owns or occupies premises where a defibrillator is made available for use and who acts in good faith with respect to the availability or use of the defibrillator is exempt from civil liability for any harm or damage that may occur from the use of the defibrillator.

Exception

(2) Subsection (1) does not exempt the person who owns or occupies the premises where a defibrillator is made available for use from civil liability if,

(a) that person acts with gross negligence with respect to making the defibrillator available;

(b) that person fails to properly maintain the defibrillator; or

(c) the premises where the defibrillator is made available for use is a hospital or other premises used primarily for the purpose of providing health care to individuals.

Regulations

4. The Lieutenant Governor in Council may make regulations,

(a) prescribing criteria for the purpose of the definition of “defibrillator” in section 1;

(b) prescribing persons or classes of persons for the purposes of the definition of “health care professional” in section 1;

(d) respecting any matter necessary or advisable to carry out effectively the purposes of this Act.

Applies to the Crown

5. This Act applies to the Crown and any agency of the Crown.

Commencement

6. (1) Subject to subsection (2), the Act set out in this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Sections 1 to 5 come into force on a day to be named by proclamation of the Lieutenant Governor.

Short title

7. The short title of the Act set out in this Schedule is the Chase McEachern Act (Heart Defibrillator Civil Liability), 2007.

schedule o
Kinesiology Act, 2007

Definitions

1. In this Act,

“College” means the College of Kinesiologists of Ontario; (“Ordre”)

“Health Professions Procedural Code” means the Health Professions Procedural Code set out in Schedule 2 to the Regulated Health Professions Act, 1991; (“Code des professions de la santé”)

“member” means a member of the College; (“membre”)

“profession” means the profession of kinesiology; (“profession”)

“this Act” includes the Health Professions Procedural Code. (“la présente loi”)

Health Professions Procedural Code

2. (1) The Health Professions Procedural Code shall be deemed to be part of this Act.

Same, interpretation

(2) In the Health Professions Procedural Code, as it applies in respect of this Act,

“College” means the College of Kinesiologists of Ontario; (“ordre”)

“health profession Act” means this Act; (“loi sur une profession de la santé”)

“profession” means the profession of kinesiology; (“profession”)

“regulations” means the regulations under this Act. (“règlements”)

Definitions in Code

(3) Definitions in the Health Professions Procedural Code apply with necessary modifications to terms in this Act.

Scope of practice

3. The practice of kinesiology is the assessment of human movement and performance and its rehabilitation and management to maintain, rehabilitate or enhance movement and performance.

College established

4. The College is established under the name College of Kinesiologists of Ontario in English and Ordre des kinésiologues de l’Ontario in French.

Council

5. (1) The Council shall be composed of,

(a) at least seven and no more than nine persons who are members elected in accordance with the by-laws;

(b) at least six and no more than eight persons appointed by the Lieutenant Governor in Council who are not,

(i) members,

(ii) members of a College as defined in the Regulated Health Professions Act, 1991, or

(iii) members of a Council as defined in the Regulated Health Professions Act, 1991;

(c) one person selected, in accordance with a by-law made under section 10, from among members who are members of a faculty or department of kinesiology of a university in Ontario.

Who can vote in elections

(2) Subject to the by-laws, every member who practises or resides in Ontario and who is not in default of payment of the annual membership fee is entitled to vote in an election of members of the Council.

President and Vice-President

6. The Council shall have a President and Vice-President who shall be elected annually by the Council from among the Council’s members.

Restricted titles

7. (1) No person other than a member shall use the title “kinesiologist”, a variation or abbreviation or an equivalent in another language.

Representations of qualification, etc.

(2) No person other than a member shall hold himself or herself out as a person who is qualified to practise in Ontario as a kinesiologist or in a specialty of kinesiology.

Definition

(3) In this section,

“abbreviation” includes an abbreviation of a variation.

Notice if suggestions referred to Advisory Council

8. (1) The Registrar shall give a notice to each member if the Minister refers to the Advisory Council, as defined in the Regulated Health Professions Act, 1991, a suggested,

(a) amendment to this Act;

(b) amendment to a regulation made by the Council; or

Requirements re notice

(2) A notice mentioned in subsection (1) shall set out the suggestion referred to the Advisory Council and the notice shall be given within 30 days after the Council of the College receives the Minister’s notice of the suggestion.

Offence

By-laws

10. The Council may make by-laws respecting the qualifications, selection and terms of office of Council members who are selected.

Transition before certain provisions in force

11. (1) The Lieutenant Governor in Council may appoint a transitional Council.

Powers of transitional Council

(2) Before section 5 comes into force, the transitional Council and its employees and committees may do anything that is necessary or advisable for the implementation of this Act and anything that the Council and its employees and committees could do under this Act.

Same

(3) Without limiting the generality of subsection (2), the transitional Council and the Council’s committees may accept and process applications for the issuance of certificates of registration, charge application fees and issue certificates of registration.

Powers of the Minister

(4) The Minister may,

(a) review the transitional Council’s activities and require the transitional Council to provide reports and information;

(b) require the transitional Council to make, amend or revoke a regulation under this Act;

(c) require the transitional Council to do anything that, in the opinion of the Minister, is necessary or advisable to carry out the intent of this Act and the Regulated Health Professions Act, 1991.

Transitional Council to comply with Minister’s request

(5) If the Minister requires the transitional Council to do anything under subsection (4), the transitional Council shall, within the time and in the manner specified by the Minister, comply with the requirement and submit a report.

Regulations

(6) If the Minister requires the transitional Council to make, amend or revoke a regulation under clause (4) (b) and the transitional Council does not do so within 60 days, the Lieutenant Governor in Council may make, amend or revoke the regulation.

Same

(7) Subsection (6) does not give the Lieutenant Governor in Council authority to do anything that the transitional Council does not have authority to do.

Expenses

(8) The Minister may pay the transitional Council for expenses incurred in complying with a requirement under subsection (4).

Transition after certain provisions in force

12. After section 5 comes into force, the transitional Council shall be the Council of the College if it is constituted in accordance with subsection 5 (1) or, if it is not, it shall be deemed to be the Council of the College until a new Council is constituted in accordance with subsection 5 (1).

Complementary Amendments

Health Care Consent Act, 1996

13. The definition of “health practitioner” in subsection 2 (1) of the Health Care Consent Act, 1996 is amended by adding the following clause:

(g.1) a member of the College of Kinesiologists of Ontario,

Regulated Health Professions Act, 1991

14. Schedule 1 to the Regulated Health Professions Act, 1991 is amended by adding the following:

Kinesiology Act, 2007

Kinesiology

Commencement

15. (1) Subject to subsection (2), the Act set out in this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Sections 3 to 10 and 12 to 14 come into force on a day to be named by proclamation of the Lieutenant Governor.

Short title

16. The short title of the Act set out in this Schedule is the Kinesiology Act, 2007.

schedule p
Naturopathy Act, 2007

Definitions

1. In this Act,

“College” means the College of Naturopaths of Ontario; (“Ordre”)

“Health Professions Procedural Code” means the Health Professions Procedural Code set out in Schedule 2 to the Regulated Health Professions Act, 1991; (“Code des professions de la santé”)

“member” means a member of the College; (“membre”)

“prescribed” means prescribed in the regulations; (“prescrit”)

“profession” means the profession of naturopathy; (“profession”)

“this Act” includes the Health Professions Procedural Code. (“la présente loi”)

Health Professions Procedural Code

2. (1) The Health Professions Procedural Code shall be deemed to be part of this Act.

Same, interpretation

(2) In the Health Professions Procedural Code, as it applies in respect of this Act,

“College” means the College of Naturopaths of Ontario; (“ordre”)

“health profession Act” means this Act; (“loi sur une profession de la santé”)

“profession” means the profession of naturopathy; (“profession”)

“regulations” means the regulations under this Act. (“règlements”)

Definitions in Code

(3) Definitions in the Health Professions Procedural Code apply with necessary modifications to terms in this Act.

Scope of practice

3. The practice of naturopathy is the assessment of diseases, disorders and dysfunctions and the naturopathic diagnosis and treatment of diseases, disorders and dysfunctions using naturopathic techniques to promote, maintain or restore health.

Authorized acts

4. (1) In the course of engaging in the practice of naturopathy, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following:

1. Putting an instrument, hand or finger beyond the labia majora but not beyond the cervix.

2. Putting an instrument, hand or finger beyond the anal verge but not beyond the rectal-sigmoidal junction.

3. Administering, by injection or inhalation, a prescribed substance.

4. Performing prescribed procedures involving moving the joints of the spine beyond the individual’s usual physiological range of motion using a fast, low amplitude thrust.

5. Communicating a naturopathic diagnosis identifying, as the cause of an individual’s symptoms, a disease, disorder or dysfunction that may be identified through an assessment that uses naturopathic techniques.

6. Taking blood samples from veins or by skin pricking for the purpose of prescribed naturopathic examinations on the samples.

Additional requirements for authorized acts

(2) A member shall not perform a procedure under the authority of subsection (1) unless the member performs the procedure in accordance with the regulations.

Grounds for misconduct

College established

5. The College is established under the name College of Naturopaths of Ontario in English and Ordre des naturopathes de l’Ontario in French.

Council

6. (1) The Council shall be composed of,

(a) at least six and no more than nine persons who are members elected in accordance with the by-laws;

(b) at least five and no more than eight persons appointed by the Lieutenant Governor in Council who are not,

(i) members,

(ii) members of a College as defined in the Regulated Health Professions Act, 1991, or

(iii) members of a Council as defined in the Regulated Health Professions Act, 1991.

Who can vote in elections

President and Vice-President

7. The Council shall have a President and a Vice-President who shall be elected annually by the Council from among the Council’s members.

Restricted titles

8. (1) No person other than a member shall use the title “naturopath”, a variation or abbreviation or an equivalent in another language.

Representations of qualification, etc.

(2) No person other than a member shall hold himself or herself out as a person who is qualified to practise in Ontario as a naturopath or in a specialty of naturopathy.

Definition

(3) In this section,

“abbreviation” includes an abbreviation of a variation.

Notice if suggestions referred to Advisory Council

9. (1) The Registrar shall give a notice to each member if the Minister refers to the Advisory Council, as defined in the Regulated Health Professions Act, 1991, a suggested,

(a) amendment to this Act;

(b) amendment to a regulation made by the Council; or

Requirements re notice

Offence

Regulations

11. Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations,

(a) prescribing standards of practice respecting the circumstances in which naturopaths shall make referrals to members of other regulated health professions;

(b) prescribing therapies involving the practice of naturopathy, governing the use of prescribed therapies and prohibiting the use of therapies other than the prescribed therapies in the course of the practice of naturopathy;

(c) governing the performance of a procedure under paragraphs 1 and 2 of subsection 4 (1) and prescribing the purposes for which, or the circumstances in which, the procedure may be performed;

(d) prescribing the substances that a member may administer by injection or inhalation for the purpose of paragraph 3 of subsection 4 (1) and prescribing the purposes for which, or the circumstances in which, the prescribed substances may be administered;

(e) prescribing procedures that may be performed under paragraph 4 of subsection 4 (1), governing the performance of the procedures and prescribing the purposes for which, or the circumstances in which, the prescribed procedures may be performed and prohibiting the performance of procedures other than the prescribed procedures;

(f) prescribing naturopathic examinations for the purposes of paragraph 6 of subsection 4 (1), prescribing the purposes for which, or the circumstances in which, the prescribed naturopathic examinations may be performed and prohibiting the performance of examinations other than the prescribed naturopathic examinations.

Transition before certain provisions in force

12. (1) The Lieutenant Governor in Council may appoint a transitional Council.

Certain members

(2) Without restricting the generality of subsection (1), the Lieutenant Governor in Council shall appoint as members of the transitional Council every person who is a member of The Board of Directors of Drugless Therapy under the Drugless Practitioners Act on the day this section comes into force, and every person who subsequently becomes a member of that Board, and may set their terms of office for the purposes of this Act.

Registrar

(3) The Lieutenant Governor in Council may appoint a Registrar who may do anything that the Registrar may do under the Regulated Health Professions Act, 1991.

Powers of transitional Council and Registrar

(4) Before section 6 comes into force, the Registrar, the transitional Council and its employees and committees may do anything that is necessary or advisable for the implementation of this Act and anything that the Registrar, the Council, and its employees and committees could do under this Act.

Same

(5) Without limiting the generality of subsection (4), the transitional Council and the Registrar and the Council’s committees may accept and process applications for the issuance of certificates of registration, charge application fees and issue certificates of registration.

Powers of the Minister

(6) The Minister may,

(a) review the transitional Council’s activities and require the transitional Council to provide reports and information;

(b) require the transitional Council to make, amend or revoke a regulation under this Act;

Transitional Council to comply with Minister’s request

(7) If the Minister requires the transitional Council to do anything under subsection (6), the transitional Council shall, within the time and in the manner specified by the Minister, comply with the requirement and submit a report.

Regulations

(8) If the Minister requires the transitional Council to make, amend or revoke a regulation under clause (6) (b) and the transitional Council does not do so within 60 days, the Lieutenant Governor in Council may make, amend or revoke the regulation.

Same

(9) Subsection (8) does not give the Lieutenant Governor in Council authority to do anything that the transitional Council does not have authority to do.

Expenses

(10) The Minister may pay the transitional Council for expenses incurred in complying with a requirement under subsection (6).

Transition after certain provisions in force

13. (1) After section 6 comes into force, the transitional Council shall be the Council of the College if it is constituted in accordance with subsection 6 (1) or, if it is not, it shall be deemed to be the Council of the College until a new Council is constituted in accordance with subsection 6 (1).

Registrar

(2) After section 6 comes into force, the Registrar appointed by the Lieutenant Governor in Council shall be deemed to be the Registrar until a new Registrar is appointed by the Council constituted under subsection 6 (1).

Transitional, certain members

(3) A person who was registered to practise under the Drugless Practitioners Act by The Board of Directors of Drugless Therapy immediately before section 6 came into force shall be deemed to be a holder of a certificate of registration issued under this Act, subject to any term, condition, limitation, suspension or cancellation to which the person’s certificate of registration was subject.

Same – investigation or discipline

(4) Where, before section 6 comes into force, an investigation or proceeding respecting an allegation of misconduct, incompetence or other discipline matter was commenced under the Drugless Practitioners Act and its regulations by The Board of Directors of Drugless Therapy, on the day section 6 comes into force,

(a) the investigation or proceeding shall be taken up and continued under this Act so far as consistently may be;

(b) The Board of Directors of Drugless Therapy, as it existed immediately before the coming into force of section 6 shall be deemed to be the appropriate committee under this Act to deal with the investigation or proceeding until others are appointed in their stead; and

(c) in the recovery or enforcement of penalties and in the enforcement of rights existing under the Drugless Practitioners Act, the procedure established under this Act shall be followed so far as it may be adapted.

Same – assets and liabilities

(5) After section 6 comes into force, the assets owned by or under the management and control of, and the liabilities of The Board of Directors of Drugless Therapy under the Drugless Practitioners Act immediately before the coming into force are, without compensation, assets owned by or under the management and control and liabilities of the College.

Complementary Amendments and Repeal

Drugless Practitioners Act

14. (1) The Drugless Practitioners Act is repealed.

(2) Regulation 278 of the Revised Regulations of Ontario, 1990 (General) is revoked.

Health Care Consent Act, 1996

15. Clause (s) of the definition of “health practitioner” in subsection 2 (1) of the Health Care Consent Act, 1996 is repealed and the following substituted:

(s) a member of the College of Naturopaths of Ontario, or

Health Insurance Act

16. Subsection 37 (4) of the Health Insurance Act is amended by striking out “the Drugless Practitioners Act”.

Health Protection and Promotion Act

17. Clause (f) of the definition of “practitioner” in subsection 25 (2) of the Health Protection and Promotion Act is repealed and the following substituted:

(f) a member of the College of Naturopaths of Ontario.

Laboratory and Specimen Collection Centre Licensing Act

18. The definitions of “laboratory” and “specimen collection centre” in section 5 of the Laboratory and Specimen Collection Centre Licensing Act are repealed and the following substituted:

“laboratory” means an institution, building or place in which operations and procedures for the microbiological, serological, chemical, hematological, biophysical, immunohematological, cytological, pathological, cytogenetic, molecular genetic or genetic examination, or such other examinations as are prescribed by the regulations, of specimens taken from the human body are performed to obtain information for medical diagnosis, prophylaxis or treatment; (“laboratoire”)

“specimen collection centre” means a place where specimens are taken or collected from the human body for examination to obtain information for medical diagnosis, prophylaxis or treatment, but does not include,

(a) a place where a legally qualified medical practitioner is engaged in the practice of medicine or surgery,

(b) a place where a registered nurse who holds an extended certificate of registration under the Nursing Act, 1991 is engaged in the practice of nursing, or

Personal Health Information Protection Act, 2004

19. Clause (b) of the definition of “health care practitioner” in section 2 of the Personal Health Information Protection Act, 2004 is repealed.

Regulated Health Professions Act, 1991

20. (1) Section 33 of the Regulated Health Professions Act, 1991 is amended by adding the following subsections:

Same

(1.1) Subsection (1) does not apply to a person who is a member of the College of Naturopaths of Ontario.

Naturopathic doctor

(1.2) A member referred to in subsection (1.1) shall not use the title “doctor” in written format without using the phrase, “naturopathic doctor”, immediately following his or her name.

(2) The Table to the Act is amended by adding the following item:

7.1

person registered under the Drugless Practitioners Act

member of the College of Naturopaths of Ontario

(3) Schedule 1 to the Act is amended by adding the following:

Naturopathy Act, 2007

Naturopathy

Commencement

21. (1) Subject to subsection (2), the Act set out in this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Sections 1 to 20 come into force on a day to be named by proclamation of the Lieutenant Governor.

Short title

22. The short title of the Act set out in this Schedule is the Naturopathy Act, 2007.

schedule Q
Homeopathy Act, 2007

Definitions

1. In this Act,

“College” means the College of Homeopaths of Ontario; (“Ordre”)

“Health Professions Procedural Code” means the Health Professions Procedural Code set out in Schedule 2 to the Regulated Health Professions Act, 1991; (“Code des professions de la santé”)

“member” means a member of the College; (“membre”)

“prescribed” means prescribed in the regulations; (“prescrit”)

“profession” means the profession of homeopathy; (“profession”)

“this Act” includes the Health Professions Procedural Code. (“la présente loi”)

Health Professions Procedural Code

2. (1) The Health Professions Procedural Code shall be deemed to be part of this Act.

Same, interpretation

(2) In the Health Professions Procedural Code, as it applies in respect of this Act,

“College” means the College of Homeopaths of Ontario; (“ordre”)

“health profession Act” means this Act; (“loi sur une profession de la santé”)

“profession” means the profession of homeopathy; (“profession”)

“regulations” means the regulations under this Act. (“règlements”)

Definitions in Code

(3) Definitions in the Health Professions Procedural Code apply with necessary modifications to terms in this Act.

Scope of practice

3. The practice of homeopathy is the assessment of body system disorders and treatment using homeopathic techniques to promote, maintain or restore health.

College established

4. The College is established under the name College of Homeopaths of Ontario in English and Ordre des homéopathes de l’Ontario in French.

Council

5. (1) The Council shall be composed of,

(a) at least six and no more than nine persons who are members elected in accordance with the by-laws;

(b) at least five and no more than eight persons appointed by the Lieutenant Governor in Council who are not,

(i) members,

(ii) members of a College as defined in the Regulated Health Professions Act, 1991, or

(iii) members of a Council as defined in the Regulated Health Professions Act, 1991.

Who can vote in elections

President and Vice-President

6. The Council shall have a President and a Vice-President who shall be elected annually by the Council from among the Council’s members.

Restricted titles

7. (1) No person other than a member shall use the title “homeopath”, a variation or abbreviation or an equivalent in another language.

Representations of qualification, etc.

(2) No person other than a member shall hold himself or herself out as a person who is qualified to practise in Ontario as a homeopath or in a specialty of homeopathy.

Definition

(3) In this section,

“abbreviation” includes an abbreviation of a variation.

Notice if suggestions referred to Advisory Council

8. (1) The Registrar shall give a notice to each member if the Minister refers to the Advisory Council, as defined in the Regulated Health Professions Act, 1991, a suggested,

(a) amendment to this Act;

(b) amendment to a regulation made by the Council; or

Requirements re notice

Offence

Regulations

10. Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations,

(a) prescribing standards of practice respecting the circumstances in which homeopaths shall make referrals to members of other regulated health professions;

Transition before certain provisions in force

11. (1) The Lieutenant Governor in Council may appoint a transitional Council.

Registrar

(2) The Lieutenant Governor in Council may appoint a Registrar who may do anything that the Registrar may do under the Regulated Health Professions Act, 1991.

Powers of transitional Council and Registrar

(3) Before section 5 comes into force, the Registrar, the transitional Council and its employees and committees may do anything that is necessary or advisable for the implementation of this Act and anything that the Registrar, the Council, and its employees and committees could do under this Act.

Same

(4) Without limiting the generality of subsection (3), the transitional Council and the Registrar and the Council’s committees may accept and process applications for the issuance of certificates of registration, charge application fees and issue certificates of registration.

Powers of the Minister

(5) The Minister may,

(a) review the transitional Council’s activities and require the transitional Council to provide reports and information;

(b) require the transitional Council to make, amend or revoke a regulation under this Act;

Transitional Council to comply with Minister’s request

(6) If the Minister requires the transitional Council to do anything under subsection (5), the transitional Council shall, within the time and in the manner specified by the Minister, comply with the requirement and submit a report.

Regulations

(7) If the Minister requires the transitional Council to make, amend or revoke a regulation under clause (5) (b) and the transitional Council does not do so within 60 days, the Lieutenant Governor in Council may make, amend or revoke the regulation.

Same

(8) Subsection (7) does not give the Lieutenant Governor in Council authority to do anything that the transitional Council does not have authority to do.

Expenses

(9) The Minister may pay the transitional Council for expenses incurred in complying with a requirement under subsection (5).

Transition after certain provisions in force

12. (1) After section 5 comes into force, the transitional Council shall be the Council of the College if it is constituted in accordance with subsection 5 (1) or, if it is not, it shall be deemed to be the Council of the College until a new Council is constituted in accordance with subsection 5 (1).

Registrar

(2) After section 5 comes into force, the Registrar appointed by the Lieutenant Governor in Council shall be deemed to be the Registrar until a new Registrar is appointed by the Council constituted under subsection 5 (1).

Complementary Amendments

Health Care Consent Act, 1996

13. The definition of “health practitioner” in subsection 2 (1) of the Health Care Consent Act, 1996 is amended by adding the following clause:

(g.1) a member of the College of Homeopaths of Ontario,

Regulated Health Professions Act, 1991

14. Schedule 1 to the Regulated Health Professions Act, 1991 is amended by adding the following:

Homeopathy Act, 2007

Homeopathy

Commencement

15. (1) Subject to subsection (2), the Act set out in this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Sections 3 to 10 and 12 to 14 come into force on a day to be named by proclamation of the Lieutenant Governor.

Short title

16. The short title of the Act set out in this Schedule is the Homeopathy Act, 2007.

schedule R
psychotherapy act, 2007

Definitions

1. In this Act,

“College” means the College of Psychotherapists and Registered Mental Health Therapists of Ontario; (“Ordre”)

“Health Professions Procedural Code” means the Health Professions Procedural Code set out in Schedule 2 to the Regulated Health Professions Act, 1991; (“Code des professions de la santé”)

“member” means a member of the College; (“membre”)

“profession” means the profession of psychotherapy; (“profession”)

“this Act” includes the Health Professions Procedural Code. (“la présente loi”)

Health Professions Procedural Code

2. (1) The Health Professions Procedural Code shall be deemed to be part of this Act.

Same, interpretation

(2) In the Health Professions Procedural Code, as it applies in respect of this Act,

“College” means the College of Psychotherapists and Registered Mental Health Therapists of Ontario; (“ordre”)

“health profession Act” means this Act; (“loi sur une profession de la santé”)

“profession” means the profession of psychotherapy; (“profession”)

“regulations” means the regulations under this Act. (“règlements”)

Definitions in Code

(3) Definitions in the Health Professions Procedural Code apply with necessary modifications to terms in this Act.

Scope of practice

3. The practice of psychotherapy is the assessment and treatment of cognitive, emotional or behavioural disturbances by psychotherapeutic means, delivered through a therapeutic relationship based primarily on verbal or non-verbal communication.

Authorized Act

4. In the course of engaging in the practice of psychotherapy, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to treat, 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.

College established

5. The College is established under the name College of Psychotherapists and Registered Mental Health Therapists of Ontario in English and Ordre des psychothérapeutes et des thérapeutes autorisés en santé mentale de l’Ontario in French.

Council

6. (1) The Council shall be composed of,

(a) at least six and no more than nine persons who are members elected in accordance with the by-laws;

(b) at least five and no more than eight persons appointed by the Lieutenant Governor in Council who are not,

(i) members,

(ii) members of a College as defined in the Regulated Health Professions Act, 1991, or

(iii) members of a Council as defined in the Regulated Health Professions Act, 1991.

Who can vote in elections

President and Vice-President

7. The Council shall have a President and Vice-President who shall be elected annually by the Council from among the Council’s members.

Restricted titles

8. (1) No person other than a member shall use the title “psychotherapist” or “registered mental health therapist”, a variation or abbreviation or an equivalent in another language.

Representations of qualification, etc.

(2) No person other than a member shall hold himself or herself out as a person who is qualified to practise in Ontario as a psychotherapist or a registered mental health therapist.

Definition

(3) In this section,

“abbreviation” includes an abbreviation of a variation.

Notice if suggestions referred to Advisory Council

9. (1) The Registrar shall give a notice to each member if the Minister refers to the Advisory Council, as defined in the Regulated Health Professions Act, 1991, a suggested,

(a) amendment to this Act;

(b) amendment to a regulation made by the Council; or

Requirements re notice

Offence

Regulations

11. Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations prescribing therapies involving the practice of psychotherapy, governing the use of prescribed therapies and prohibiting the use of therapies other than the prescribed therapies in the course of the practice of psychotherapy.

Transition before certain provisions in force

12. (1) The Lieutenant Governor in Council may appoint a transitional Council.

Registrar

(2) The Lieutenant Governor in Council may appoint a Registrar who may do anything that the Registrar may do under the Regulated Health Professions Act, 1991.

Powers of transitional Council and Registrar

(3) Before section 6 comes into force, the Registrar, the transitional Council and its employees and committees may do anything that is necessary or advisable for the implementation of this Act and anything that the Registrar, the Council, and its employees and committees could do under this Act.

Same

Powers of the Minister

(5) The Minister may,

(a) review the transitional Council’s activities and require the transitional Council to provide reports and information;

(b) require the transitional Council to make, amend or revoke a regulation under this Act;

Transitional Council to comply with Minister’s request

Regulations

Same

(8) Subsection (7) does not give the Lieutenant Governor in Council authority to do anything that the transitional Council does not have authority to do.

Expenses

(9) The Minister may pay the transitional Council for expenses incurred in complying with a requirement under subsection (5).

Transition after certain provisions in force

Registrar

Complementary Amendments

Health Care Consent Act, 1996

14. The definition of “health practitioner” in subsection 2 (1) of the Health Care Consent Act, 1996 is amended by adding the following clause:

(q.1) a member of the College of Psychotherapists and Registered Mental Health Therapists of Ontario,

Medicine Act, 1991

15. Section 4 of the Medicine Act, 1991 is amended by adding the following paragraph:

13. 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.

Nursing Act, 1991

16. Section 4 of the Nursing Act, 1991 is amended by adding the following paragraph:

4. 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.

Occupational Therapy Act, 1991

17. (1) The Occupational Therapy Act, 1991 is amended by adding the following section:

Authorized act

3.1 (1) A member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to treat, 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.

Additional requirements for authorized act

(2) A member shall not perform the procedure provided for in subsection (1) unless the member performs the procedure in accordance with the regulations.

Grounds for misconduct

(2) The Act is amended by adding the following section:

Regulations

10.1 Subject to the approval of the Lieutenant Governor in Council and with prior review by the Minister, the Council may make regulations governing the performance of the procedure provided for in subsection 3.1 (1) and prescribing the purposes for which, or the circumstances in which, the procedure may be performed.

Psychology Act, 1991

18. Section 4 of the Psychology Act, 1991 is repealed and the following substituted:

Authorized acts

4. In the course of engaging in the practice of psychology, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following:

1. To communicate a diagnosis identifying, as the cause of a person’s symptoms, a neuropsychological disorder or psychologically based psychotic, neurotic or personality disorder.

2. To treat, 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.

Regulated Health Professions Act, 1991

19. (1) Subsection 27 (2) of the Regulated Health Professions Act, 1991 is amended by adding the following paragraph:

14. 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.

(2) Section 27 of the Act is amended by adding the following subsection:

Same

(4) Despite subsection (1), a member of the Ontario College of Social Workers and Social Service Workers is authorized to perform the controlled act set out in paragraph 14 of subsection (2), in compliance with the Social Work and Social Service Work Act, 1998, its regulations and by-laws.

(3) Schedule 1 to the Act is amended by adding the following:

Psychotherapy Act, 2007

Psychotherapy

Commencement

20. (1) Subject to subsection (2), the Act set out in this Schedule comes into force on the day the Health System Improvements Act, 2007 receives Royal Assent.

Same

(2) Sections 3 to 11 and 13 to 19 come into force on a day to be named by proclamation of the Lieutenant Governor.

Short title

21. The short title of the Act set out in this Schedule is the Psychotherapy Act, 2007.

Français

Health System Improvements Act, 2007, S.O. 2007, c. 10 - Bill 171

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