Ontario Bill 7 (43rd Parliament, 1st Session)
Bill 7, 43-1
Ontario — Bills
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Bill 7, More Beds, Better Care Act, 2022
Calandra, Hon. Paul Minister of Long-Term Care
Royal Assent received. Statutes of Ontario 2022,
chapter 16
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Bill 7 Royal Assent (PDF)
EXPLANATORY
NOTE
This Explanatory Note was written as a reader’s
aid to Bill 7 and does not form part of the law.
Bill 7 has been enacted as
Chapter 16 of the Statutes of Ontario, 2022.
The
Bill amends the Fixing Long-Term Care Act, 2021 to
add a new provision for patients who occupy a bed in a public hospital and are
designated by an attending clinician as requiring an alternate level of care.
This new provision authorizes certain actions to be carried out without the
consent of these patients. The actions include having a placement co-ordinator
determine the patient’s eligibility for a long-term care home, select a home
and authorize their admission to the home. They also include having certain persons
conduct assessments for the purpose of determining a patient’s eligibility, requiring
the licensee to admit the patient to the home when certain conditions have been
met and allowing persons to collect, use and disclose personal health information,
if it is necessary to carry out the actions. Sections 49 to 54 of the Act do
not apply to these actions, and instead they shall be carried out in accordance
with the regulations.
Certain
limitations apply. The actions cannot be performed without first making
reasonable efforts to obtain the patient’s consent. If consent is later
provided by an ALC patient, the parts of the process that have been consented
to must be conducted in accordance with sections 49 to 54 of the Act, subject
to the regulations. The
section does not authorize the use of restraints in
order to carry out the actions or the physical transfer of an ALC patient to a
long-term care home without their consent. Regulation-making powers are set out
in relation to this new provision and the actions it authorizes.
Other
minor amendments to the Act are made. These include setting out a general
definition of “personal health information” that applies throughout the Act and
making related consequential amendments.
consequential amendment is made to
section 47 of the Health
Care Consent Act, 1996 to clarify the relationship between crisis
admissions under that
section and admissions under the new provision of the Fixing Long-Term Care Act, 2021 .
Bill 7 2022
Act to amend the Fixing Long-Term Care Act, 2021 with respect to patients
requiring an alternate level of care and other matters and to make a consequential
amendment to the Health Care Consent Act, 1996
Her
Majesty, by and with the advice and consent of the Legislative Assembly of the
Province of Ontario, enacts as follows:
Subsection 2 (1) of the Fixing Long-Term Care Act, 2021
is amended by adding the following definition:
“personal
health information” has the same meaning as in the Personal
Health Information Protection Act, 2004 ; (“renseignements personnels sur
la santé”)
The Act is amended by adding the following section:
ALC
patients
60.1
(1) This
section applies to a person who,
(
a) occupies
a bed in a hospital under the Public Hospitals Act ;
and
(
b) has
been designated by an attending clinician in the hospital as requiring an
alternate level of care because, in the clinician’s opinion, the person does
not require the intensity of resources or services provided in the hospital
care setting.
Definitions
(2) For
the purposes of this section,
“ALC
patient” means a person described in subsection (1); (“patient en NSD”)
“attending
clinician” means a person who is authorized under the Public
Hospitals Act to issue a discharge order for the ALC patient. (“clinicien
traitant”)
Certain
actions may be performed without consent
(3) This
section authorizes the following actions, or any part thereof, to be performed
in respect of an ALC patient without their consent or the consent of their
substitute decision-maker, despite any other provision of this Act, the
regulations or any other Act:
1. An attending clinician who reasonably
believes that an ALC patient may be eligible for admission to a long-term care
home may request that a placement co-ordinator carry out any of the actions
listed in subparagraphs 2 i to iv.
2. A
placement co-ordinator may do the following, with or without a request from an
attending clinician:
i. Determine
the ALC patient’s eligibility for admission to a long-term care home.
ii. Select
a long-term care home or homes for the ALC patient in accordance with the
geographic restrictions that are prescribed by the regulations.
iii. Provide
to the licensee of a long-term care home the assessments and information set
out in the regulations, which may include personal health information.
iv. Authorize
the ALC patient’s admission to a home.
v. Transfer
responsibility for the placement of the ALC patient to another placement co-ordinator
who, for greater certainty, may carry out the actions listed in this paragraph
with respect to the ALC patient.
3. A
physician, registered nurse or person described in paragraph 3 of subsection 50
(5) may conduct an assessment of the ALC patient for the purpose of determining
the ALC patient’s eligibility for admission to a long-term care home.
4. A
licensee of a long-term care home must do the following:
i. Review
the assessments and information provided by the placement co-ordinator in
respect of the ALC patient.
ii. Approve
the ALC patient for admission as a resident of the home after reviewing the
assessments and information provided by the placement co-ordinator, unless a
condition for not approving the admission listed in subsection 51 (7) is met.
iii. Admit
the approved ALC patient when they present themselves at the home as a resident
after,
A. the
placement co-ordinator has determined the patient’s eligibility for admission
to the home,
B. a
bed becomes available, and
C. the
placement co-ordinator has authorized the patient’s admission to the home.
5. A
person with authority to carry out an action listed in paragraph 1, 2, 3 or 4, a
hospital within the meaning of the Public Hospitals Act
or any other person prescribed by the regulations may collect, use or disclose
personal health information if it is necessary to carry out an action listed in
paragraph 1, 2, 3 or 4.
Limitation,
reasonable efforts to obtain consent required
(4) The
actions listed in subsection (3) may only be performed without consent if
reasonable efforts have been made to obtain the consent of the ALC patient or
their substitute decision-maker.
Actions
to be performed in accordance with regulations
(5) Subject
to subsection (6), sections 49 to 54 do not apply to the actions listed in
subsection (3), and instead the actions shall be performed in accordance with
the procedures, requirements, criteria, restrictions and conditions, if any, that
are set out in the regulations.
consent provided
(6) An
ALC patient or their substitute decision-maker may provide their consent to any
stage of the process described in this
section and, if the consent is provided,
the relevant portions of sections 49 to 54 and the regulations apply to the stages
of the process to which they have consented, subject to any modifications or
exemptions set out in the regulations.
Limitation
(7) Nothing
in this
section authorizes any person to restrain an ALC patient to carry out the
actions listed in subsection (3) or to physically transfer an ALC patient to a
long-term care home without the consent of the ALC patient or their substitute
decision-maker.
Review
of determination of ineligibility
(8) An
ALC patient may apply to the Appeal Board for a review of a determination of
ineligibility made by a placement co-ordinator under this section, and the
Appeal Board shall deal with the appeal in accordance with
section 59.
Interaction
with Residents’ Bill of Rights
(9) Despite
subsection 3 (2), this
section and any regulations made under clause 61 (2)
(h.1) or (h.2) shall not be interpreted or construed as being inconsistent with
the Residents’ Bill of Rights.
Subsection 61 (2) of the Act is amended by adding the following clauses:
(h.1) governing
the actions that may be performed under
section 60.1 with respect to ALC
patients, including,
(
i) prescribing
and governing any procedures that must be followed in performing the actions,
(ii) specifying
any requirements, criteria, restrictions or conditions that apply to the
actions,
(iii) modifying
the application of any provision of this Act or the regulations to the actions,
subject to any requirements, restrictions or conditions that may be set out,
(iv) providing
exemptions from any provisions of this Act or the regulations in relation to
the actions, subject to any requirements, restrictions or conditions that may
be set out,
(
v) governing
the collection, use and disclosure of personal health information as described
in paragraph 5 of subsection 60.1 (3), which may include prescribing additional
persons who can collect, use or disclose personal health information in
accordance with that paragraph;
(h.2) modifying
the application of any provision of sections 49 to 54 or the regulations, or providing
exemptions from them, with respect to ALC patients who have consented to the
application process as described in subsection 60.1 (6);
The following provisions of the Act are amended by striking out “section 104
and subject to
section 105” wherever it appears and substituting in each case
“section 100 and subject to
section 101”:
Section
2. Subsection
103 (1).
3. Subsection
108 (3).
Paragraph 2 of subsection 113 (4) of the Act is amended by striking out “section
100” and substituting “section 101”.
Paragraph 2 of subsection 116 (4) of the Act is amended by striking out
“section 104” and substituting “section 100”.
The definition of “record” in subsection 150 (9) of the Act is amended by
striking out “within the meaning of the Personal Health
Information Protection Act, 2004 ” at the end.
Subsection 192 (9) of the Act is repealed.
Health
Care Consent Act, 1996
(1) Subsection 47 (1) of the Health Care
Consent Act, 1996 is amended by striking out “Despite any law to the
contrary” at the beginning and substituting “Despite any law to the contrary,
but subject to subsections (3) and (4)”.
(2) Section
47 of the Act is amended by adding the following subsections:
Exception
(3) Subsections
(1) and (2) do not apply to an authorization by a placement co-ordinator of an
ALC patient’s admission to a long-term care home in accordance with
section
60.1 of the Fixing Long-Term Care Act, 2021 .
Distinct
from ALC patient admission
(4) For
greater certainty, an admission of an ALC patient to a long-term care home
under
section 60.1 of the Fixing Long-Term Care Act, 2021
is distinct from, and does not preclude, an admission to a care facility under
this section.
Commencement
(1) Except as otherwise provided in this section, this Act comes
into force on the day it receives Royal Assent.
(2) Sections
2, 3 and 9 of the Act come into force on a day to be named by proclamation of
the Lieutenant Governor.
Short
title
The
short title of this Act is the More Beds, Better Care
Act, 2022 .
Bill 7 Original (PDF)
EXPLANATORY NOTE
The Bill amends the Fixing Long-Term Care Act, 2021 to add a new provision for patients who occupy a bed in a public hospital and are designated by an attending clinician as requiring an alternate level of care. This new provision authorizes certain actions to be carried out without the consent of these patients. The actions include having a placement co-ordinator determine the patient’s eligibility for a long-term care home, select a home and authorize their admission to the home.
They also include having certain persons conduct assessments for the purpose of determining a patient’s eligibility, requiring the licensee to admit the patient to the home when certain conditions have been met and allowing persons to collect, use and disclose personal health information, if it is necessary to carry out the actions. Sections 49 to 54 of the Act do not apply to these actions, and instead they shall be carried out in accordance with the regulations.
Certain limitations apply. The actions cannot be performed without first making reasonable efforts to obtain the patient’s consent. If consent is later provided by an ALC patient, the parts of the process that have been consented to must be conducted in accordance with sections 49 to 54 of the Act, subject to the regulations. The
section does not authorize the use of restraints in order to carry out the actions or the physical transfer of an ALC patient to a long-term care home without their consent. Regulation-making powers are set out in relation to this new provision and the actions it authorizes.
Other minor amendments to the Act are made. These include setting out a general definition of “personal health information” that applies throughout the Act and making related consequential amendments.
A consequential amendment is made to
section 47 of the Health Care Consent Act, 1996 to clarify the relationship between crisis admissions under that
section and admissions under the new provision of the Fixing Long-Term Care Act, 2021 .
Bill 7 2022
An Act to amend the Fixing Long-Term Care Act, 2021 with respect to patients requiring an alternate level of care and other matters and to make a consequential amendment to the Health Care Consent Act, 1996
Her Majesty, by and with the advice and consent of the Legislative Assembly of the Province of Ontario, enacts as follows:
1 Subsection 2 (1) of the Fixing Long-Term Care Act, 2021 is amended by adding the following definition:
“personal health information” has the same meaning as in the Personal Health Information Protection Act, 2004 ; (“renseignements personnels sur la santé”)
2 The Act is amended by adding the following section:
ALC patients
60.1
(1) This
section applies to a person who,
(
a) occupies a bed in a hospital under the Public Hospitals Act ; and
(
b) has been designated by an attending clinician in the hospital as requiring an alternate level of care because, in the clinician’s opinion, the person does not require the intensity of resources or services provided in the hospital care setting.
Definitions
(2) For the purposes of this section,
“ALC patient” means a person described in subsection (1); (“patient en NSD”)
“attending clinician” means a person who is authorized under the Public Hospitals Act to issue a discharge order for the ALC patient. (“clinicien traitant”)
Certain actions may be performed without consent
(3) This
section authorizes the following actions, or any part thereof, to be performed in respect of an ALC patient without their consent or the consent of their substitute decision-maker, despite any other provision of this Act, the regulations or any other Act:
1. An attending clinician who reasonably believes that an ALC patient may be eligible for admission to a long-term care home may request that a placement co-ordinator carry out any of the actions listed in subparagraphs 2 i to iv.
2. A placement co-ordinator may do the following, with or without a request from an attending clinician:
i. Determine the ALC patient’s eligibility for admission to a long-term care home.
ii. Select a long-term care home or homes for the ALC patient in accordance with the geographic restrictions that are prescribed by the regulations.
iii. Provide to the licensee of a long-term care home the assessments and information set out in the regulations, which may include personal health information.
iv. Authorize the ALC patient’s admission to a home.
v. Transfer responsibility for the placement of the ALC patient to another placement co-ordinator who, for greater certainty, may carry out the actions listed in this paragraph with respect to the ALC patient.
3. A physician, registered nurse or person described in paragraph 3 of subsection 50 (5) may conduct an assessment of the ALC patient for the purpose of determining the ALC patient’s eligibility for admission to a long-term care home.
4. A licensee of a long-term care home must do the following:
i. Review the assessments and information provided by the placement co-ordinator in respect of the ALC patient.
ii. Approve the ALC patient for admission as a resident of the home after reviewing the assessments and information provided by the placement co-ordinator, unless a condition for not approving the admission listed in subsection 51 (7) is met.
iii. Admit the approved ALC patient when they present themselves at the home as a resident after,
A. the placement co-ordinator has determined the patient’s eligibility for admission to the home,
B. a bed becomes available, and
C. the placement co-ordinator has authorized the patient’s admission to the home.
5. A person with authority to carry out an action listed in paragraph 1, 2, 3 or 4, a hospital within the meaning of the Public Hospitals Act or any other person prescribed by the regulations may collect, use or disclose personal health information if it is necessary to carry out an action listed in paragraph 1, 2, 3 or 4.
Limitation, reasonable efforts to obtain consent required
(4) The actions listed in subsection (3) may only be performed without consent if reasonable efforts have been made to obtain the consent of the ALC patient or their substitute decision-maker.
Actions to be performed in accordance with regulations
(5) Subject to subsection (6), sections 49 to 54 do not apply to the actions listed in subsection (3), and instead the actions shall be performed in accordance with the procedures, requirements, criteria, restrictions and conditions, if any, that are set out in the regulations.
If consent provided
(6) An ALC patient or their substitute decision-maker may provide their consent to any stage of the process described in this
section and, if the consent is provided, the relevant portions of sections 49 to 54 and the regulations apply to the stages of the process to which they have consented, subject to any modifications or exemptions set out in the regulations.
Limitation
(7) Nothing in this
section authorizes any person to restrain an ALC patient to carry out the actions listed in subsection (3) or to physically transfer an ALC patient to a long-term care home without the consent of the ALC patient or their substitute decision-maker.
Review of determination of ineligibility
(8) An ALC patient may apply to the Appeal Board for a review of a determination of ineligibility made by a placement co-ordinator under this section, and the Appeal Board shall deal with the appeal in accordance with
section 59.
Interaction with Residents’ Bill of Rights
(9) Despite subsection 3 (2), this
section and any regulations made under clause 61 (2) (h.1) or (h.2) shall not be interpreted or construed as being inconsistent with the Residents’ Bill of Rights.
3 Subsection 61 (2) of the Act is amended by adding the following clauses:
(h.1) governing the actions that may be performed under
section 60.1 with respect to ALC patients, including,
(
i) prescribing and governing any procedures that must be followed in performing the actions,
(ii) specifying any requirements, criteria, restrictions or conditions that apply to the actions,
(iii) modifying the application of any provision of this Act or the regulations to the actions, subject to any requirements, restrictions or conditions that may be set out,
(iv) providing exemptions from any provisions of this Act or the regulations in relation to the actions, subject to any requirements, restrictions or conditions that may be set out,
(
v) governing the collection, use and disclosure of personal health information as described in paragraph 5 of subsection 60.1 (3), which may include prescribing additional persons who can collect, use or disclose personal health information in accordance with that paragraph;
(h.2) modifying the application of any provision of sections 49 to 54 or the regulations, or providing exemptions from them, with respect to ALC patients who have consented to the application process as described in subsection 60.1 (6);
4 The following provisions of the Act are amended by striking out “section 104 and subject to
section 105” wherever it appears and substituting in each case “section 100 and subject to
section 101”:
Section 102.
2. Subsection 103 (1).
3. Subsection 108 (3).
5 Paragraph 2 of subsection 113 (4) of the Act is amended by striking out “section 100” and substituting “section 101”.
6 Paragraph 2 of subsection 116 (4) of the Act is amended by striking out “section 104” and substituting “section 100”.
7 The definition of “record” in subsection 150 (9) of the Act is amended by striking out “within the meaning of the Personal Health Information Protection Act, 2004 ” at the end.
8 Subsection 192 (9) of the Act is repealed.
Health Care Consent Act, 1996
9 (1) Subsection 47 (1) of the Health Care Consent Act, 1996 is amended by striking out “Despite any law to the contrary” at the beginning and substituting “Despite any law to the contrary, but subject to subsections (3) and (4)”.
(2) Section 47 of the Act is amended by adding the following subsections:
Exception
(3) Subsections (1) and (2) do not apply to an authorization by a placement co-ordinator of an ALC patient’s admission to a long-term care home in accordance with
section 60.1 of the Fixing Long-Term Care Act, 2021 .
Distinct from ALC patient admission
(4) For greater certainty, an admission of an ALC patient to a long-term care home under
section 60.1 of the Fixing Long-Term Care Act, 2021 is distinct from, and does not preclude, an admission to a care facility under this section.
Commencement
(1) Except as otherwise provided in this section, this Act comes into force on the day it receives Royal Assent.
(2) Sections 2, 3 and 9 of the Act come into force on a day to be named by proclamation of the Lieutenant Governor.
Short title
11 The
short title of this Act is the More Beds, Better Care Act, 2022 .
Date Bill stage Event Outcome Committee
August 31, 2022
Royal Assent
Royal Assent received
August 31, 2022
Third Reading
Vote
Carried on division
August 30, 2022
Third Reading
Question put
Vote deferred
August 30, 2022
Third Reading
Debated
August 30, 2022
Second Reading
Ordered for Third Reading pursuant to the Order of the House
August 30, 2022
Second Reading
Vote
Carried on division
August 29, 2022
Second Reading
Question put
Vote deferred
August 29, 2022
Second Reading
Time allocated
August 24, 2022
Second Reading
Debated
Debate adjourned
August 24, 2022
Second Reading
Debated
Debate adjourned
August 24, 2022
Second Reading
Debated
Debate adjourned
August 23, 2022
Second Reading
Debated
Debate adjourned
August 23, 2022
Second Reading
Debated
Debate adjourned
August 18, 2022
First Reading
Ordered for Second Reading
August 18, 2022
First Reading
Vote
Carried
First Reading
August 18, 2022
Carried
Second Reading
August 23, 2022
Principal Debaters
Calandra, Hon. Paul
Markham—Stouffville
Cuzzetto, Rudy
Mississauga—Lakeshore
Fraser, John
Ottawa South
Gates, Wayne
Niagara Falls
Gélinas, France
Nickel Belt
Jordan, John
Lanark—Frontenac—Kingston
Kusendova-Bashta, Natalia
Mississauga Centre
Pierre, Natalie
Burlington
Romano, Ross
Sault Ste. Marie
Questions and Responses
Begum, Doly
Scarborough Southwest
Dowie, Andrew
Windsor—Tecumseh
Ke, Vincent
Don Valley North
Mamakwa, Sol
Kiiwetinoong
Mantha, Michael
Algoma—Manitoulin
McCarthy, Todd
Durham
Pang, Billy
Markham—Unionville
Pasma, Chandra
Ottawa West—Nepean
Rakocevic, Tom
Humber River—Black Creek
Sattler, Peggy
London West
Stevens, Jennifer (Jennie)
St. Catharines
Taylor, Monique
Hamilton Mountain
Wong-Tam, Kristyn
Toronto Centre
August 23, 2022
Debated
August 24, 2022
Principal Debaters
Barnes, Patrice
Ajax
Begum, Doly
Scarborough Southwest
Harris, Mike
Kitchener—Conestoga
Romano, Ross
Sault Ste. Marie
Sarrazin, Stéphane
Glengarry—Prescott—Russell
Sattler, Peggy
London West
Schreiner, Mike
Guelph
Stiles, Marit
Davenport
Vaugeois, Lise
Thunder Bay—Superior North
Yakabuski, John
Renfrew—Nipissing—Pembroke
Questions and Responses
Bourgouin, Guy
Mushkegowuk—James Bay
Calandra, Hon. Paul
Markham—Stouffville
Coe, Lorne
Whitby
Cuzzetto, Rudy
Mississauga—Lakeshore
Gates, Wayne
Niagara Falls
Ghamari, Goldie
Carleton
Glover, Chris
Spadina—Fort York
Harris, Mike
Kitchener—Conestoga
Hogarth, Christine
Etobicoke—Lakeshore
Leardi, Anthony
Essex
Mantha, Michael
Algoma—Manitoulin
Martin, Robin
Eglinton—Lawrence
McGregor, Graham
Brampton North
Sandhu, Amarjot
Brampton West
Shaw, Sandy
Hamilton West—Ancaster—Dundas
Smith, Hon. Todd
Bay of Quinte
Taylor, Monique
Hamilton Mountain
Wai, Daisy
Richmond Hill
Yakabuski, John
Renfrew—Nipissing—Pembroke
August 24, 2022
Debated
August 29, 2022
Time allocated
August 29, 2022
Question put
August 30, 2022
Carried on division
Ordered for Third Reading pursuant to the Order of the House
Third Reading
August 30, 2022
Principal Debaters
Begum, Doly
Scarborough Southwest
Bell, Jessica
University—Rosedale
Calandra, Hon. Paul
Markham—Stouffville
Fraser, John
Ottawa South
Gates, Wayne
Niagara Falls
Gélinas, France
Nickel Belt
Gretzky, Lisa
Windsor West
Harden, Joel
Ottawa Centre
Hunter, Mitzie
Scarborough—Guildwood
Jordan, John
Lanark—Frontenac—Kingston
Parsa, Hon. Michael
Aurora—Oak Ridges—Richmond Hill
Schreiner, Mike
Guelph
Shamji, Adil
Don Valley East
Vanthof, John
Timiskaming—Cochrane
Vaugeois, Lise
Thunder Bay—Superior North
Wong-Tam, Kristyn
Toronto Centre
Question put
August 31, 2022
Carried on division
Royal Assent
August 31, 2022
Royal Assent received