On June 2nd, 2016 the Ontario government introduced proposed legislation, the Patients First Act, also known as Bill 210. If enacted, Bill 210 would significantly amend the Local Health System Integration Act, 2006 and would also amend 19 other statutes[1].
The government's stated goal for proposing Bill 210 is to create an integrated, patient-focused health care system. The government states that Bill 210, if enacted, will:
- make it easier for patients to find a new care provider;
- simplify the process of transferring patients between hospitals, home care and other service providers; and
- improve communications between family doctors, hospitals and community care centres so as to make it easier for patients to access needed care.
One major element of Bill 210 would affect Ontario's 14 Local Health Integration Networks (LHINs): the Minister of Health and Long-Term Care (Minister) would be empowered to make an order transferring Community Care Access Corporations (CCACs) to the LHINs. Another major element would involve providing the LHINs with an expanded role in the areas of primary care and home and community care.
If enacted, Bill 210 would also repeal the Community Care Access Corporations Act, 2001, thereby affecting several other statutes that would require the removal of reference to CCACs.
Some of the other proposed amendments include:
- Permitting the Minister to approve and fund LHINs to provide the services currently provided by CCACs;
- Allowing the Minister to make an order to transfer CCACs (including assets, liabilities, rights and obligations, and employees) to the LHINs of a similar geographic area;
- Allowing the Minister to make LHINs agents of the Minister for the purpose of certain funding arrangements;
- Giving the Minister the power to issue operational or policy directives to the LHINs. The LHINs would be required to comply with these directives;
- Giving the Minister the power to issue provincial standards for the provision of health services. LHINs and health service providers would be required to comply with these standards;
- Allowing a LHIN to issue operational or policy directives to a health service provider to which it provides funding. The health service provider would be required to comply with these directives;
- Permitting the Minister to issue operational or policy directives to the board of a hospital and making every directive available to the public. The board would be required to carry out every directive of the Minister;
- Where an investigation and report on the quality of the management and administration of a public hospital is made, the Minister would be required to make the report publicly available;
- Where a review or audit is performed on the operations, accounts, records and other affairs of a public hospital and a report is written, the Minister would be required to make such report public; and
- Giving the Minister the power to issue operational or policy directives to a licensee of a private hospital. Compliance with these directives would be required.
Bill 210, if enacted, would also affect health service providers. The current list of health service providers under the Local Health System Integration Act, 2006 includes:
- Public and private hospitals;
- Persons or entities that operate psychiatric facilities within the meaning of the Mental Health Act, subject to certain exceptions;
- The University of Ottawa Heart Institute;
- Long-term care homes;
- Persons or entities approved under the Home Care and Community Services Act, 1994 to provide services;
- Not-for- profit corporations without share capital incorporated under Part III of the Corporations Act that operate community health centres; and
- Not-for- profit entities that provide community mental health and addiction services.
In addition to the list above, Bill 210 proposes to introduce new categories of health service providers. These categories include: [2]
- Not-for- profit entities that operate family health teams, nurse-practitioner-led clinics, or Aboriginal health access centres;
- Persons or entities that provide primary care nursing services, maternal care or inter-professional primary care programs and services;
- Not-for- profit entities that provide palliative care services, including hospices;
- Persons or entities that provide physiotherapy services in a clinic setting that are not otherwise health service providers; and
- Any other person or entity or class of persons or entities that is prescribed in regulations.
The Bill 210 proposal is available for viewing (PDF). Fasken Martineau will report further on developments related to Bill 210.
[1] The other affected Acts would include: Broader Public Sector Accountability Act, 2010; Broader Public Sector Executive Compensation Act, 2014; Commitment to the Future of Medicare Act, 2004; Community Care Access Corporations Act, 2001; Electronic Cigarettes Act, 2015; Employment Standards Act, 2000; Excellent Care for All Act, 2010; Health Insurance Act; Health Protection and Promotion Act; Home Care and Community Services Act, 1994; Ministry of Health and Long-Term Care Act; Ombudsman Act; Personal Health Information Protection Act, 2004; Poverty Reduction Act, 2009; Private Hospitals Act; Public Hospitals Act; Public Sector Labour Relations Transition Act, 1997; Retirement Homes Act, 2010; Smoke-Free Ontario Act.
[2] Bill 210 also proposes to remove CCACs from the definition of "health service provider".