Canada: Introduction of Bill 74: The People's Health Care Act, 2019

Health Law Bulletin
Last Updated: March 13 2019
Article by Lynne Golding and Jordana Keslassy

On February 26, 2019, the Ontario Minister of Health and Long-Term Care (Minister) introduced Bill 74  (Bill) (PDF), The People's Health Care Act, which will enact the Connecting Care Act, 2019 (CCA) and amend and repeal a number of existing acts and regulations.

If passed, the legislation would create a central agency to oversee Ontario's healthcare system intended to, among other things, remove duplication. In addition, the changes contemplated by the Bill are intended to create a healthcare system that will:

  • direct public funding to frontline services to continuously improve the patent experience;
  • build a sustainable, digitally-enabled, publically funded healthcare system;
  • establish a new model of integrated public health care delivery which will put each patient at the centre of a connected care system anchored in the community;
  • empower providers to work directly with one another to offer co-ordinated care; and
  • recognize diversity within Ontario's communities.

This bulletin provides an overview of key provisions of the Bill. Over the coming weeks, Fasken will issue a series of bulletins that will describe specific aspects of the Bill in greater detail.

The Agency

The Bill unveils the super-agency (the Agency), which would be formed by combining the 14 existing Local Health Integration Networks (LHINs) with the following six provincial health agencies:

  • Cancer Care Ontario
  • eHealth Ontario
  • Trillium Gift of Life Network
  • Health Shared Services Ontario
  • Health Quality Ontario
  • HealthForce Ontario Marketing and Recruitment Agency (collectively, with the LHINs "Organizations")

The proposed objects of the Agency, are, among others, to:

  • manage health service needs across Ontario consistent with the health strategies of the Ministry of Health and Long Term Care (Ministry) in order to ensure the quality and sustainability of the Ontario health system;
  • plan, co-ordinate, undertake and support activities related to tissue donation and transplantation in accordance with the Trillium Gift of Life Network Act;
  • support the patient ombudsman in carrying out its functions in accordance with the Excellent Care for All Act, 2010;
  • support or provide supply chain management services to health service providers and related organizations;
  • provide advice, recommendations and information to the Minister and other participants in the Ontario healthcare system; and
  • promote health service integration to enable appropriate, co-ordinated and effective health service delivery.

Integrations

The Bill introduces the term "integrated care delivery systems" meaning a person or entity or group of persons or entities designated under the CCA that deliver three or more prescribed health care services.

Similar to the model that currently applies to LHINs and health service providers under the Local Health System Integration Act, 2006, under the CCA the Agency may integrate the healthcare system through funding, facilitating, negotiating and ordering integrations of health service providers.

Under the CCA, the power of the LHINs to appoint investigators of health service providers is continued in respect of the Agency. The Agency is also able to appoint investigators of integrated care delivery systems. The Minister has the authority to appoint supervisors of health service providers and integrated care delivery systems.

Funding and Accountability

Similar to the current processes for LHINs, the Minister may provide funding to the Agency, and the Agency may provide funding to health services providers and integrated care delivery systems.

Transfers and Dissolutions

Under the CCA, the Minister is given the power to transfer all or part of the assets, liabilities, rights, obligations and employees of the Organizations (and other organizations that may be prescribed) to the Agency, a health service provider or an integrated care delivery system. The CCA also provides for the consequences of such a transfer on the assets, liabilities, rights, obligations and employees of the Organizations. A transfer can be effected by an order of the Minister. The transferor and transferee will be provided with advance notice of the transfer order.

The Minister is also given the power to dissolve an Organization under the CCA. Members of the Organization would cease to be its members on the dissolution.

Regulations

It is proposed that, under the CCA, the Lieutenant Governor in Council may make regulations, among other things:

  • exempting the Agency, a health service provider, an integrated care delivery system or any other person or entity from any provision of the CCA or the regulations;
  • governing funding that the Agency provides to a healthcare provider, integrated care delivery system or any other person or entity to which the Agency may provide funding;
  • governing the content or terms and conditions of a service accountability agreement;
  • governing designations of integrated care delivery systems;
  • governing and respecting matters that relate to or arise as a result of transfer orders; and
  • governing certain compensation payable under the CCA.

Proposed Significant Amendments

The Bill provides for the amendment and repeal of a number of existing acts and regulations.

Among the proposed amendments are amendments to the Ministry of Health and Long-Term Care Act to provide for the creation of an Indigenous health council and a French language health services advisory council to advise the Minister.

These amendments will be the topic of future bulletins.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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