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Bill 60, Your Health Act, 2023

Jones, Hon. Sylvia Minister of Health

Royal Assent received. Statutes of Ontario 2023,

chapter 4

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Bill 60 Royal Assent (PDF)

EXPLANATORY

NOTE

This Explanatory Note was written as a reader’s

aid to Bill 60 and does not form part of the law.

Bill 60 has been enacted as

Chapter 4 of the Statutes of Ontario, 2023.

SCHEDULE 1

INTEGRATED COMMUNITY HEALTH SERVICES CENTRES ACT, 2023

The

Schedule enacts the Integrated Community Health Services Centres

Act, 2023 and makes consequential and related amendments to several

other Acts. The major elements of the Act are described below.

Part

I sets out interpretive provisions that apply to the Act and the application of

the Act.

Part

II provides for the appointment of one or more Directors, who have various

functions, duties and powers under the Act.

Part

III provides for the licensing of integrated community health services centres

and related matters. It provides a prohibition for establishing and operating

such a centre without a licence. It also sets out the process for applying for

licences, the considerations in issuing licences and the processes for the

renewal, relocation or transfer of licences. Provisions are provided for orders

by the Director to take control of a centre in certain circumstances and for

the revocation, suspension or amendment of licences. It also sets out

requirements on all licensees, including the requirement to comply with

requirements under this Act and to comply with the applicable quality and

safety standards.

Part

IV establishes the rules that apply with respect to payments and financial

accountability. It permits the Minister to pay for facility costs or other

operating costs of integrated community health services centres. It establishes

a prohibition on charging a facility cost without a licence and provides that facility

costs may only be charged to, and accepted from, the Minister or a prescribed

person. It creates prohibitions on charging or accepting payments for providing

a preference in obtaining access to an insured service at an integrated

community health services centre. It also prohibits refusing to provide insured

services to a person who chooses not to pay for any product, device or service

offered at the integrated community health services centre. It also sets out situations

in which payments may be refused or where the Minister may require

reimbursement of payments, such as when the service was not in fact rendered,

and provides for appeals from those payment decisions.

Part

V establishes the procedures for inspections and the issuance of compliance

orders. Inspectors may be appointed by the Minister, the Director or an

organization that is prescribed as an inspecting body under the Act. Inspecting

bodies are charged with several responsibilities, including performing

inspections and establishing and publishing quality and safety standards. The

powers of inspectors to conduct inspections are set out. The Director and

inspecting bodies are given powers to issue compliance orders to require

licensees to achieve compliance with the Act.

Part

VI sets out a number of miscellaneous provisions, including provisions

respecting service, the confidentiality of information and the liability of the

Crown.

Part

VII sets out offences under the Act and establishes the penalty for committing

an offence. It also empowers the Attorney General to seek a restraining order

for contraventions of

section 4 or 29.

Part

VIII sets out the power to make regulations under the Act.

Part

IX provides for the repeal of the Independent Health

Facilities Act , the revocation of the regulations made under that Act

and the repeal of the Oversight of Health Facilities and

Devices Act, 2017 .

Part

X sets out consequential and related amendments.

Part

XI sets out the commencement and

short title of the Act set out in the

Schedule.

SCHEDULE 2

REGULATED PROFESSIONS AMENDMENTS

The

Schedule makes amendments to several Acts.

the Commitment to the Future of Medicare Act, 2004 ,

the Fixing Long-Term Care Act, 2021 , the Gift of Life Act , the Health

Insurance Act and the Public Hospitals Act ,

the

definitions of “physician” are expanded to allow persons prescribed in the

regulations to meet those

definitions. The amendments to the Fixing Long-Term Care Act, 2021 also allow prescribed

persons to meet the definition for different classes of nurses, and include a

regulation-making power to set conditions on the manner in which prescribed

persons may carry out their duties and responsibilities under the Act.

The

Healing Arts Radiation Protection Act is amended to

allow for the operation of an x-ray machine in accordance with a prescription

from a prescribed person.

The

Medical Laboratory Technology Act, 1991 , the Medicine Act, 1991 , the Nursing Act,

1991 and the Respiratory Therapy Act, 1991

are amended to add a new power allowing the Minister of Health, with the

approval of the Lieutenant Governor in Council, to make regulations exempting

persons from the restricted title provisions and the holding out provisions of

those Acts.

The

Narcotics Safety and Awareness Act, 2010 is amended

to expand the definition of “dispenser” and “prescriber” to include prescribed

persons. Persons who are prescribed as a “prescriber” are exempt from the

requirement to record their health profession College registration number on a

prescription.

The

application of the Ontario Medical Association Dues Act,

1991 is expanded so that the Act applies to prescribed persons who are

engaged in the practice of medicine in Ontario.

The

Pharmacy Act, 1991 is amended to expand

pharmacists’ scope of practice to include the assessment of conditions for the

purposes of providing medication therapies.

SCHEDULE 3

FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT

The

Schedule amends the Freedom of Information and Protection

of Privacy Act to extend the application of the Act to extra-ministerial

data integration units that are not institutions under the Act, or part of such

institutions. In such cases, the Act applies to extra-ministerial data

integration units with specified modifications, including any modifications

prescribed by the regulations. A new requirement is imposed on senior officers

of such extra-ministerial data integration units to publish specified

information on an annual basis.

Bill 60 2023

Act to amend and enact various Acts with respect to the health system

CONTENTS

Contents

of this Act

Commencement

Short

title

Schedule 1

Integrated

Community Health Services Centres Act, 2023

Schedule 2

Regulated

Professions Amendments

Schedule 3

Freedom

of Information and Protection of Privacy Act

His

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

(1) Except

as otherwise provided in this section, this Act comes into force on the day it

receives Royal Assent.

(2) The

Schedules to this Act come into force as provided in each Schedule.

(3) If

a

Schedule to this Act provides that any provisions are to come into force on a

day to be named by proclamation of the Lieutenant Governor, a proclamation may

apply to one or more of those provisions, and proclamations may be issued at

different times with respect to any of those provisions.

Short

title

3 The

short title of this Act is the Your

Health Act, 2023 .

SCHEDULE 1

INTEGRATED COMMUNITY HEALTH SERVICES CENTRES ACT, 2023

CONTENTS

Preamble

PART I

INTERPRETATION AND APPLICATION

Interpretation

Application

of Act

PART II

DIRECTOR

Director

PART III

LICENSING AND RELATED MATTERS

Licence Applications

Licence

required

Call

for applications

Issuance

of licence

Minister

may direct refusal to issue licence in respect of call for applications

Expiry

and surrender of licence

Renewal, Relocation, Transfer,

Etc.

Renewal

of licence

Relocation

Transfer

of licence

Order

by Director to take control

Revocations, Suspensions,

Refusals to Renew and Licence Amendments

Revocation

or suspension of licence

Amendments

to conditions of licence

Process

where Director refuses renewal, revokes or suspends, etc.

Hearings

before the Board

Appeal

from decision of Board

Minister’s

direction

Licensee Requirements

Requirements

for all applications

Requirements

on licensee

Truthfulness

Complaints

process

Incident

review process

Posting

Licence

not to be used as security

Contracts

Share

transfer

Duty

of corporation to notify Director

PART IV

PAYMENTS AND ACCOUNTABILITY

Payments

and facility costs

Record-keeping

Refusal

to pay if not required form, etc.

Refusal

to pay, pay reduced amount or substitute amount: circumstances

Reimbursement,

non-entitled person

Debt

Transition

Settlement

Interest

Hearing

by Board

Powers

of Board

Appeal

to Board

Ontario

Health Insurance

PART V

INSPECTIONS AND COMPLIANCE ORDERS

Inspections

Inspectors

Inspecting

bodies

Inspections

Copy

constitutes evidence

Order

to enter

Obstruction

offence

Production

order

Compliance Orders

Compliance

orders

PART VI

MISCELLANEOUS

Consideration

of past conduct

Service

of notice

Not

compellable witness

Protection

of information

Certain

documents

Filing

with court

Publication

Confidentiality

for inspecting body and inspectors

Personal

information

Disclosure

of information to the Director

Crown

liability

compensation

Transition

PART VII

OFFENCES AND COMPLIANCE

Offences

Restraining

order

PART VIII

REGULATIONS

Regulations

PART IX

REPEALS AND REVOCATIONS

Independent

Health Facilities Act

Oversight

of Health Facilities and Devices Act, 2017

PART X

CONSEQUENTIAL AND RELATED AMENDMENTS

Commitment

to the Future of Medicare Act, 2004

Connecting

Care Act, 2019

Excellent

Care for All Act, 2010

Health

Insurance Act

Health

Protection and Promotion Act

Ministry

of Health and Long-Term Care Appeal and Review Boards Act, 1998

Opioid

Damages and Health Care Costs Recovery Act, 2019

Personal

Health Information Protection Act, 2004

Plan

to Build Ontario Together Act, 2019

Private

Hospitals Act

Protecting

What Matters Most Act (Budget Measures), 2019

Providing

More Care, Protecting Seniors, and Building More Beds Act, 2021

Public

Hospitals Act

Quality

of Care Information Protection Act, 2016

Regulated

Health Professions Act, 1991

Simpler,

Faster, Better Services Act, 2019

Social

Contract Act, 1993

Substitute

Decisions Act, 1992

The

People’s Health Care Act, 2019

Tobacco

Damages and Health Care Costs Recovery Act, 2009

PART XI

COMMENCEMENT AND

SHORT TITLE

Commencement

Short

title

Preamble

The people of Ontario

and their Government:

Share

a vision for connected and convenient care, where the health and wellbeing of

all OHIP-insured Ontarians is enabled through health services that are

available at no cost to patients;

Commit

to supporting access to safe, effective, equitable, efficient and person-centred

care;

Recognize

the value of a healthcare system that collaboratively integrates publicly

funded, community-based health services with local and regional health system

partners;

Intend

to expand access to publicly funded community-based health services to improve

patient wait times, patient experience and access to care in a way that

considers the needs of diverse, vulnerable, priority and underserviced

populations, taking into account linguistic needs; and

Acknowledge

the importance of advancing initiatives to optimize health human resources

today and in the future.

PART I

INTERPRETATION AND APPLICATION

Interpretation

(1) In this

Act,

“Board”

means the Health Services Appeal and Review Board under the Ministry of Health and Long-Term Care Appeal and Review Boards

Act, 1998 ; (“Commission”)

“compliance

order” means an order made under

section 49; (“ordre de conformité”)

“Director”

means the Director or Directors appointed under

section 3 and, where more than

one Director has been appointed, means the Director or Directors that have been

assigned the power, function or duty in the provision in which the term

appears; (“directeur”)

“facility

cost” means,

(

a) a

charge, fee or payment for or in respect of a service or operating cost that,

(

i) supports,

assists and is a necessary adjunct, or any of them, to an insured service, and

(ii) is

not part of the insured service, or

(

b) any

other charge, fee or payment that is prescribed as a facility cost; (“coûts

d’établissement”)

“health

facility” means a place in which one or more members of

the public receive health services and includes an integrated community

health services centre; (“établissement de santé”)

“inspecting

body” means an organization that is prescribed as an inspecting body in

accordance with the regulations; (“organisme d’inspection”)

“inspector”

means an inspector appointed under

section 42 or 43; (“inspecteur”)

“insured

person” has the same meaning as in the Health Insurance

Act ; (“assuré”)

“insured

service” means,

(

a) a

service rendered by a physician for which an amount payable is prescribed by

the regulations under the Health Insurance Act , or

(

b) a

service prescribed as an insured service under the Health

Insurance Act rendered by a practitioner within the meaning of that Act;

(“service assuré”)

“integrated

community health services centre” means, subject to any exemptions set out in

the regulations,

(

a) a

health facility, including a community surgical and diagnostic centre, in which

one or more members of the public receive services for or in respect of which facility

costs are charged or paid, or

(

b) a

health facility, including a community surgical and diagnostic centre, or a

class of health facilities, that is prescribed; (“centre de services de santé

communautaire intégré”)

“justice”

has the same meaning as in the Provincial Offences Act ;

(“juge”)

“licence”

means a licence issued by the Director under this Act; (“permis”)

“licensee”

means the holder of a licence; (“titulaire de permis”)

“Minister”

means the Minister of Health or such other member of the Executive Council as

may be assigned the administration of this Act under the Executive

Council Act ; (“ministre”)

“Ministry”

means the ministry of the Minister; (“ministère”)

“patient”

means a person who receives health services in a health facility; (“patient”)

“personal

information” means personal information as defined in the Freedom

of Information and Protection of Privacy Act and includes personal

health information as defined in the Personal Health

Information Protection Act, 2004 ; (“renseignements personnels”)

“physician”

has the same meaning as in the Health Insurance Act ;

(“médecin”)

“Plan”

means the Ontario Health Insurance Plan referred to in

section 10 of the Health Insurance Act ; (“Régime”)

“prescribed”

means prescribed by the regulations; (“prescrit”)

“provincial

offences officer” has the same meaning as in the Provincial

Offences Act ; (“agent des infractions provinciales”)

“quality

and safety standards” means,

(

a) the

quality and safety standards established by an inspecting body under paragraph

1 of subsection 43 (3),

(

b) any

additional quality and safety standards that may be prescribed, and

(

c) any

other applicable generally accepted quality and safety standards; (“normes de

qualité et de sécurité”)

“regulated

health professional” means a health professional whose profession is regulated

under the Regulated Health Professions Act, 1991 ; (“membre

d’une profession de la santé réglementée”)

“regulations”

means regulations made under this Act; (“règlements”)

“requirement

under this Act” means,

(

a) a

requirement contained in this Act or its regulations,

(

b) a

requirement set out in a compliance order or other order authorized under this

Act, or

(

c) a

requirement that is a limitation and condition of a licence or condition of

receiving funding. (“exigence que prévoit la présente loi”)

Interest

affecting the control of a corporation

(2) A

person shall be deemed to have an interest affecting the control of a

corporation if the person, alone or with one or more associates, directly or

indirectly beneficially owns or controls the lesser of,

(

a) voting

shares in the corporation in a sufficient number to permit that person, either

alone or with one or more associates, to direct the management and policies of

the corporation; or

(

b) voting

shares to which are attached 10 per cent or more of the voting rights attached

to all issued and outstanding voting shares of the corporation.

Associates

(3) Persons

shall be deemed to be associates of each other if,

(

a) one

person is a corporation of which the other person is an officer or director;

(

b) one

person is a partner of the other person;

(

c) one

person is a corporation of which the other person beneficially owns, directly

or indirectly, voting shares carrying more than 10 per cent of the voting

rights attached to all voting shares of the corporation for the time being

outstanding;

(

d) both

persons are members of a voting trust where the trust relates to shares of a

corporation;

(

e) one

person is the father, mother, brother, sister, child or spouse of the other

person or is another relative who has the same home as the other person; or

(

f) both

persons are associates within the meaning of clauses (

a) to (

e) of the same person.

Corporations

without share capital

(4) For

the purposes of this Act, the provisions of this Act related to corporations,

their control, and the ownership, control and voting of shares apply with

necessary modifications in respect of corporations to which the Not-for-Profit Corporations Act, 2010 applies.

Application

of Act

2 This Act does not apply

to a place, service or class of services, health facility or class of health

facilities or person or class of persons that is exempted by the regulations.

PART

DIRECTOR

Director

(1) The

Minister shall appoint one or more persons as the Director for integrated

community health services centres.

Director

may be individual or other entity

(2) A

Director may be an individual or another entity.

more than one Director appointed

(3) Where

more than one person is appointed as Director, the appointment may specify the

functions and duties of each person who is appointed.

Director’s

powers

(4) Subject

to this Act and the regulations, the Director has the power to perform any

functions or duties that the Director has under this Act.

PART

III

LICENSING AND RELATED MATTERS

Licence Applications

Licence

required

4 No person shall

establish or operate an integrated community health services centre except

under the authority of a licence.

Call for applications

(1) The

Minister may at any time authorize the Director to call for one or more

applications for the establishment and operation of one or more integrated

community health services centres by,

(

a) sending

a call for applications to one or more specified persons; or

(

b) publishing

a call for applications in any manner the Director considers appropriate.

Contents

of call for applications

(2) A

call for applications shall specify,

(

a) the

service or services to be provided in the integrated community health services

centre;

(

b) the

locality in which the integrated community health services centre is to be

located;

(

c) such

other requirements and limitations as the Minister considers relevant; and

(

d) the

final date for submission of applications.

Submission

of applications

(3) Any

person may respond to a call for applications by submitting an application to

the Director.

Required

contents for licence application

(4) A

licence application must be in the form specified by the Director and must

include, but is not limited to,

(

a) a

detailed description of the service or services to be provided in the proposed integrated

community health services centre and how it will provide connected and

convenient care, including the applicant’s,

(

i) capacity

to improve patient wait times,

(ii) plans

to improve patient experiences and access to care in the proposed integrated

community health services centre, and

(iii) plans

to integrate with the health system;

(

b) details

of the applicant’s quality assurance and continuous quality improvement

programming, including policies for infection prevention and control;

(

c) the

business, clinical and professional experience of the applicant, including how

the applicant will meet all governance and management responsibilities of the proposed

integrated community health services centre;

(

d) details

of the physical nature of the proposed integrated community health services

centre, including its address and distance to other integrated community health

services centres and hospitals;

(

e) a

detailed staffing model for the proposed integrated community health services

centre and evidence of the sustainability of this model, including,

(

i) staff

classification with rates of compensation and ranges of compensation, as

applicable,

(ii) the

number of staff required for each position,

(iii) the

model for staffing anaesthesia delivery, if applicable, and

(iv) information

regarding the hospital privileges of physicians who provide services at the

centre, if applicable;

(

f) a

description of how the applicant has consulted with health system partners in

the development of the application, including any endorsement of the

application by health system partners;

(

g) a

description of current linkages with health system partners and how the

applicant will maintain and improve those linkages to promote optimal patient

care pathways;

(

h) a

description of how the proposed integrated community health services centre

will address the health equity needs of diverse, vulnerable, priority and

underserviced populations, taking into account linguistic needs, in the region

specified in the call for applications;

(

i) a

description of any uninsured services that are being provided or will be provided

at the proposed integrated community health services centre, including,

(

i) a

description of any charges for the uninsured services, and

(ii) a

detailed description of the processes for providing information and obtaining

patient consent in connection with any uninsured services; and

(

j) such

other information as is specified in the call for applications.

Consideration

of applications

(5) The

Director shall consider all applications submitted in response to a call for

applications.

Issuance

of licence

(1) The

Director may issue a licence to a person who has submitted an application for

the establishment and operation of an integrated community health services

centre if the Director is of the opinion that,

(

a) the

applicant provided all of the information required in subsection 5 (4);

(

b) the

licence should be issued, taking into account the considerations set out in

subsection (2);

(

c) the

integrated community health services centre will be operated in accordance with

this Act and the regulations and any other applicable Act or regulation;

(

d) the

persons listed in subsection (3) will operate the integrated community health

services centre competently and in a responsible manner in accordance with this

Act and the regulations, will ensure that the specified services are provided

and will comply with the quality and safety standards;

(

e) the

past conduct relating to the operation of an integrated community health

services centre or any other matter or business of a person listed in subsection

(3) affords reasonable grounds to believe that,

(

i) the

centre will be operated with honesty and integrity and in accordance with the

law, and

(ii) the

centre will not be operated in a manner that is prejudicial to the health,

safety or welfare of any person; and

(

f) there

is no other reason that the person should not be issued a licence.

Considerations

in assessing application

(2) In

deciding whether to issue a licence, the Director shall consider,

(

a) the

nature of the services to be provided in the proposed integrated community

health services centre;

(

b) the

extent to which the services are already available in Ontario or in any part of

Ontario;

(

c) the

extent to which the services to be provided in the proposed integrated

community health services centre will promote connected and convenient care,

including the applicant’s,

(

i) capacity

to improve patient wait times,

(ii) plans

to improve patient experiences and access to care in the proposed integrated

community health services centre, and

(iii) plans

to integrate with the health system;

(

d) the

current and future need for the service or services in Ontario or any part of

Ontario, taking into account the needs of diverse, vulnerable, priority and

underserviced populations and linguistic needs;

(

e) the

potential impact on health system planning, including the availability of

sustainable health human resources;

(

f) whether

the issuing of the licence would improve the availability of the services in

the region specified in the call for applications;

(

g) the

potential impact on the co-ordination of health services, based on

consultations with health system partners;

(

h) the

projected cost in public money for the operation of the proposed integrated

community health services centre;

(

i) the

availability of public money to pay for the operation of the proposed integrated

community health services centre; and

(

j) any

other matter that the Director considers relevant to the management of the

health care system.

Relevant

persons

(3) The

following are the persons listed for the purposes of clauses (1) (

d) and (e):

1. The

person who submitted the application.

2. If

the person who submitted the application is a corporation, the officers and

directors of the corporation and any other person with an interest affecting

control of the corporation.

3. If

the person with an interest affecting control mentioned in paragraph 2 is a

corporation, the officers and directors of the corporation.

4. Any

other prescribed persons.

Discretion

(4) The

issuance of a licence is discretionary, and the Director,

(

a) is

not required to issue a licence to any person; and

(

b) may

prefer any application over other applications.

Limitation

on licence issuance

(5) The

Director shall not issue a licence for the operation of an integrated community

health services centre that is located,

(

a) within

the same building as, or in a building that is adjacent to, a private hospital

within the meaning of the Private Hospitals Act ; or

(

b) at

any other prescribed place.

Limitations

and conditions

(6) A

licence may be subject to such limitations and conditions as may be prescribed

or as may be specified by the Director and set out in the licence.

Same

(7) The

Director may specify as a limitation or condition of a licence the list of

services or types of services in respect of which the integrated community

health services centre is licensed.

licences issued to exempted persons

(8) The

Director shall not issue a licence to any person who is exempt from the

application of this Act.

Term

limits

(9) A

licence shall be issued or renewed for a term of no more than five years unless

a longer maximum term is provided for in the regulations.

Minister

may direct refusal to issue licence in respect of call for applications

(1) At any

time after the Minister authorizes the Director to request one or more calls

for applications for the establishment and operation of an integrated community

health services centre, and before any or all of the licences are issued, the

Minister may direct the Director, in writing, not to issue a licence or

licences in respect of the call for applications.

Notice

of direction not to license

(2) Upon

receipt of a direction under subsection (1), the Director shall give written

notice of the Minister’s direction to each person who submitted an application

in response to the call for applications.

Public

notice

(3) If

the Minister issues a direction under this

section before the final day for the

submission of applications, the Director shall, in addition to giving notice

under subsection (2), publish notice of the direction in the same manner in

which the call for applications was published.

Expiry

and surrender of licence

(1) Every

licence expires on the expiry date specified on the licence unless it is

revoked or is surrendered to the Director before that date.

Surrender

(2) A

licensee may surrender their licence to the Director but shall give the

Director at least six months notice before doing so.

Renewal, Relocation,

Transfer, Etc.

Renewal

of licence

(1) A

licence is renewable, subject to the approval of the Director.

Application

required

(2) A

licensee may apply to the Director for the renewal of their licence.

Compliance

with requirements

(3) The

Director has the authority to approve an application for the renewal of a

licence, subject to the licensee’s compliance with any requirements the

Director considers necessary or advisable.

Director’s

decision

(4) In

deciding whether to approve an application for the renewal of a licence, the

Director shall take into consideration the following matters, as well as any

matters that the Director would be entitled to take into consideration if the

Director were making a decision under subsection 13 (1):

1. The

licensee’s past conduct with respect to compliance with requirements under this

Act.

2. Any

actions taken by the licensee in response to a compliance order.

Additional

limitations and conditions

(5) At

the time of renewing a licence, the Director may impose any limitations and

conditions on the licence that the Director considers necessary or advisable in

the circumstances.

Continuation

of licence pending renewal

(6) Where,

before the expiry of the licence, a licensee has applied for renewal of the

licence, the licence shall be deemed to continue,

(

a) until

the renewal is approved; or

(

b) if

the licensee is served with notice that the Director does not approve the

renewal of a licence under this section, until the date specified by the

Director in the notice.

Relocation

(1) A

licensee shall not relocate an integrated community health services centre

without the prior approval of the Director.

Application

(2) A

licensee may apply to the Director for approval to relocate an integrated

community health services centre.

Approval

(3) The

Director may approve the relocation subject to such limitations and conditions

as the Director considers necessary or advisable.

appeal

(4) For

greater certainty,

section 15 does not apply to a decision to not approve a

relocation.

Limitation

on relocation

(5) The

Director shall not approve the relocation of an integrated community health

services centre to a location described in subsection 6 (5).

Transfer

of licence

(1) A

licence is not transferable without the prior approval of the Director.

Application

(2) A

licensee may apply to the Director for approval of the transfer of a licence.

Criteria

(3) In

deciding whether to approve an application for the transfer of a licence, the

Director shall treat the proposed transferee of the licence as if the proposed

transferee were an applicant for a licence and, for the purpose, subsection 6

(1) applies with necessary modifications.

Considerations

not required

(4) Despite

subsection (3), clause 6 (1) (

a) does not apply to the decision to approve the

transfer and, for greater certainty, the Director is not required to take into

account the considerations set out in subsection 6 (2).

Compliance

with requirements

(5) The

Director may conditionally approve a transfer subject to compliance by the licensee

or the proposed transferee with any requirements the Director considers

necessary or advisable.

Approval

(6) The

Director may approve the transfer of a licence subject to such limitations and

conditions as the Director considers necessary or advisable.

Order

by Director to take control

(1) Where

the Director is of the opinion that an integrated community health services

centre should continue to operate after the expiry, surrender, suspension or

revocation of the licence, after the death of the licensee or after the

licensee ceases to operate the centre, the Director, by a written order, may

take control of and operate the centre for a period not exceeding one year.

Authority

of Director

(2) Where

the Director takes control of and operates an integrated community health

services centre under subsection (1), the Director has all the powers of the

licensee and the Director may appoint one or more persons to operate the centre

and each person so appointed is a representative of the Director.

Payment

for services and compensation for property

(3) Where

the Director takes control of an integrated community health services centre,

the licensee, former licensee or estate of the licensee, as the case may be,

(

a) is

not entitled to payment for any service that is provided by the centre while

the centre is under the control of the Director; and

(

b) is

entitled to reasonable compensation from the Crown for the use of property of

the licensee, former licensee or estate of the licensee while the centre is

under the control of the Director.

Order

effective immediately

(4) An

order under subsection (1) takes effect immediately and is final.

Revocations,

Suspensions, Refusals to Renew and Licence Amendments

Revocation

or suspension of licence

(1) The

Director may revoke or suspend a licence where,

(

a) the

licensee, any member of the licensee’s staff, an employee of the licensee or

any regulated health professional affiliated with the integrated community

health services centre is in contravention of any of the following,

(

i) the

requirements under this Act,

(ii) any

other Act or regulation of Ontario, or

(iii) any

Act or regulation of Canada;

(

b) there

is a breach of a limitation or condition of the licence;

(

c) any

person has made a false or misleading statement in any application made under

this Act;

(

d) any

person has made a false or misleading statement in any report or document, or

in any other information, that is requested by the Director or that is

otherwise required to be furnished by this Act or the regulations or any other

Act or regulation that applies to the integrated community health services

centre;

(

e) the

Director is of the opinion that there is reasonable ground for belief that the integrated

community health services centre is not being or will not be operated in

accordance with the law and with honesty and integrity;

(

f) the

Director is of the opinion that there is reasonable ground for belief that the integrated

community health services centre is not being or will not be operated

competently and in a responsible manner in accordance with this Act or the

regulations or any other Act or regulation that applies to the centre;

(

g) the

Director is of the opinion that there is reasonable ground for belief that the integrated

community health services centre is not being operated in compliance with the

quality and safety standards, having regard to any factors the Director

considers relevant, including, without limitation,

(

i) the

nature of risks revealed in the course of inspections, and

(ii) the

actions taken by the licensee in response to compliance orders;

(

h) the

licensed services have not been provided at the integrated community health

services centre for a period of at least six months;

(

i) the

licensee has entered into a contract described in

section 26 contrary to that

section, whether or not the licensee has been convicted of an offence under

that section;

(

j) the

licensee is a corporation that has not complied with the requirements in

section 27, whether or not the licensee has been convicted of an offence under

that section;

(

k) the

licensee is a corporation that has failed to notify the Director contrary to

section 28;

(

l) the

licensee, any member of the licensee’s staff, any employee of the licensee or

any regulated health professional affiliated with the integrated community

health services centre has failed to co-operate with an inspector under

section

44;

(

m) the

Director is of the opinion upon reasonable grounds that the integrated

community health services centre is being operated or will be operated in a

manner that poses a risk of serious harm to a person’s health and safety;

(

n) the

licensee has failed to comply with a request for information under

section 59,

whether or not the licensee has been convicted of an offence under that

section;

(

o) the

licensee has failed to comply with a compliance order, whether or not the

licensee has been convicted of an offence under

section 63; or

(

p) any

other ground that may be prescribed applies.

When

effective

(2) A

decision of the Director under subsection (1) takes effect immediately upon

notice of the decision being served upon the licensee, or, if another date is

stipulated in the decision, upon that date.

Due

diligence, mistakes do not prevent action

(3) The

authority to take an action under subsection (1) may be exercised with respect

to a licensee who has not complied with a requirement under this Act whether or

not,

(

a) the

licensee took all reasonable steps to prevent the non-compliance; or

(

b) at

the time of the non-compliance, the licensee had an honest and reasonable

belief in a set of facts that, if true, would have resulted in there not being

any non-compliance.

Transition

(4) The

period of six months referred to in clause (1) (

h) includes any period of time

in which the integrated community health services centre was licensed as an

independent health facility under the Independent Health

Facilities Act , before that Act was repealed, and was not providing

licensed services.

Amendments

to conditions of licence

(1) The

Director may at any time amend the limitations and conditions of a licence,

which may include adding or eliminating a service from the list of services in

respect of which an integrated community health services centre is licensed.

Application

(2) A

licensee may submit an application to the Director to amend the limitations and

conditions of their licence by adding a service to the list of services in

respect of which the integrated community health services centre is licensed.

Approval

(3) The

Director may approve an application under subsection (2) subject to such

limitations and conditions as the Director considers necessary or advisable.

Eliminating

service

(4) Despite

subsection (1), the Director shall not amend the limitations and conditions of

a licence to eliminate a service from the list of services in respect of which

an integrated community health services centre is licensed unless,

(

a) the

Director is of the opinion that there is reasonable ground for belief that the

eliminated service is not being provided, or will not be provided, in a

responsible manner in accordance with this Act or the regulations, or any other

Act or regulation that applies to the centre;

(

b) the

Director is of the opinion that there is reasonable ground for belief that the

eliminated service is being provided, or will be provided, in a manner that is

prejudicial to the health, safety or welfare of any person;

(

c) the

licensed service has not been provided at the integrated community health

services centre for a period of at least six months; or

(

d) any

other prescribed circumstances apply.

Amendment

takes effect immediately

(5) An

amendment under subsection (1) that eliminates a service takes effect

immediately upon notice being served under subsection (6).

Notice

of amendment

(6) The

Director shall serve notice of an amendment under subsection (1) that

eliminates a service, together with reasons for the decision, on the licensee.

appeal of decision to not add service

(7) For

greater certainty,

section 15 does not apply to a decision by the Director to

not approve an application under subsection (2) of this

section by adding a

service to the list of services in respect of which the integrated community

health services centre is licensed.

Transition

(8) The

period of six months referred to in clause (4) (

c) includes any period of time

in which the integrated community health services centre was licensed as an

independent health facility under the Independent Health

Facilities Act , before that Act was repealed, and was not providing a

licensed service.

Process

where Director refuses renewal, revokes or suspends, etc.

(1) If the

Director does not approve the renewal of a licence under

section 9, revokes or

suspends a licence under subsection 13 (1) or amends the limitations and

conditions of a licence under subsection 14 (1) to eliminate a service from the

list of services in respect of which an integrated community health services

centre is licensed, the Director shall serve notice of the decision, together

with written reasons, on the licensee.

Notice

requiring hearing by Board

(2) A

notice under subsection (1) shall inform the licensee that the licensee is

entitled to a hearing by the Board if the licensee mails or delivers, within 15

days after the notice under subsection (1) is served on the licensee, notice in

writing requiring a hearing to the Director and the Board, and the licensee may

so require such a hearing.

stay

(3) Despite

section 25 of the Statutory Powers Procedure Act , a

request for a hearing by the Board made in accordance with subsection (2) of

this section, or an appeal to Divisional Court of the Board’s decision under

section 17 of this Act, shall not operate as a stay of a decision of the

Director mentioned in subsection (1) of this section.

interim stay

(4) Despite

section 16.1 of the Statutory Powers Procedure Act ,

the Board shall not make an interim order to stay a decision of the Director

mentioned in subsection (1) of this section.

Onus

(5) In

a hearing under this section, the onus is on the licensee to establish that the

decision of the Director is not in accordance with this Act and the

regulations.

Powers

of Board where hearing

(6) Where

a licensee requires a hearing by the Board, the Board shall appoint a time for

and hold the hearing and the Board may, by order, direct the Director to carry

out the proposed action or refrain from carrying out the proposed action and to

take such action as the Board considers the Director ought to take in

accordance with this Act and the regulations, and for such purposes the Board

may substitute its opinion for that of the Director.

Opportunity

to comply

(7) Where

the Board is required to hold a hearing, it shall proceed promptly to hold the

hearing unless the licensee satisfies the Board that the licensee has not been

given a reasonable opportunity to comply with all the applicable lawful

requirements and that it would be just and reasonable to give the licensee that

opportunity.

Extension

of time for requiring hearing

(8) The

Board may extend the time for the giving of notice requiring a hearing by a

licensee under this section, either before or after expiration of such time,

where it is satisfied that there are grounds for granting relief to the

licensee and that there are reasonable grounds for applying for the extension,

and the Board may give such directions as it considers proper regarding the

extension.

Notice

when licence transfer not approved

(9) Subsections

(1) to (8) apply with necessary modifications where the Director does not

approve the transfer of a licence and, for the purpose,

(

a) the

Director shall serve the notice under subsection (1) upon both the licensee and

the proposed transferee; and

(

b) the

licensee and the proposed transferee, or either of them, may require the

hearing by the Board, but if they each require such a hearing, the Board shall

combine the applications into one proceeding.

Hearings

before the Board

(1) The

Director, the person who has requested the hearing and any other person the

Board may specify are parties to proceedings before the Board under this Act.

Submissions

(2) The

Board may permit any person who is not a party before it to make written or

oral submissions to the Board and, where it does so, those submissions may be

made either personally or through a person authorized under the Law Society Act to represent the non-party.

Examination

of documentary evidence

(3) A

party to proceedings shall be afforded an opportunity to examine, before the

hearing, any written or documentary evidence that will be produced or any

report the contents of which will be given in evidence at the hearing.

Members

holding hearing not to have taken

part in investigation, etc.

(4) Members

of the Board holding a hearing shall not have taken part before the hearing in

any investigation or consideration of the subject-matter of the hearing and

shall not communicate directly or indirectly in relation to the subject-matter

of the hearing with any person or with any party or party’s representative

except upon notice to and opportunity for all parties to participate, but the

Board may seek legal advice from an adviser independent from the parties and,

in such case, the nature of the advice shall be made known to the parties so

that the parties may make submissions as to the law.

Recording

of evidence

(5) Any

oral evidence taken before the Board at a hearing shall be recorded and, if so

required, copies of a transcript of that evidence shall be provided upon the

same terms as in the Superior Court of Justice.

Findings

of fact

(6) The

findings of fact of the Board in a hearing shall be based exclusively on

evidence admissible or matters that may be noticed under the Statutory Powers Procedure Act .

Release

of documentary evidence

(7) Documents

and things put in evidence at the hearing shall, upon the request of the person

who produced them, be released to that person by the Board within a reasonable

time after the matter in issue has been finally determined.

Appeal

from decision of Board

(1) Any

party to proceedings before the Board may appeal from its decision or order to

the Divisional Court on a question of law alone.

Record

to be filed in court

(2) Where

any party appeals under subsection (1), the Board shall promptly file in the

Divisional Court the record of the proceedings before it in which the decision

was made, which, together with the transcript of evidence if it is not part of

the Board’s record, shall constitute the record in the appeal.

Powers

of court on appeal

(3) On

an appeal under subsection (1), the Divisional Court may affirm or may rescind

the decision of the Board or the court may refer the matter back to the Board

for rehearing, in whole or in part, in accordance with such directions as the

court considers proper.

Final

decision

(4) The

decision of the Divisional Court under this

section is final.

Minister’s

direction

(1) The

Minister may direct the Director in writing to,

(

a) revoke

or refuse to renew a licence; or

(

b) amend

the limitations and conditions of a licence to eliminate a service from the

list of services in respect of which the integrated community health services

centre is licensed.

Matters

to be considered

(2) In

deciding whether or not to issue a direction under subsection (1), the Minister

shall take into account the considerations listed in subsection 6 (2).

Notice

to licensee

(3) Upon

receipt of a direction under subsection (1), the Director must give the

licensee at least six months written notice of the revocation, refusal to renew

or elimination of services from the list of services in respect of which an integrated

community health services centre is licensed.

appeal

(4) For

greater certainty,

section 15 does not apply to a refusal to renew a licence, a

revocation of a licence or an elimination of services under this section.

Licensee Requirements

Requirements

for all applications

(1) Every

application under this Part must,

(

a) be

in a form acceptable to the Director; and

(

b) contain

any information, which may include personal information, that the Director

considers necessary or advisable.

Director

may request additional information

(2) The

Director may request additional information from any person in respect of any

application under this Part.

Information

deemed to be supplied in confidence

(3) Any

information that the Director collects in relation to an application submitted under

this Part shall be deemed, for the purposes of

section 17 of the Freedom of Information and Protection of Privacy Act , to

have been supplied in confidence to the Director.

Requirements

on licensee

(1) Every

licensee shall comply with every applicable requirement under this Act.

Quality

and safety standards

(2) Every

licensee shall comply with the applicable quality and safety standards.

Licensee

responsible

(3) If

the Director or an inspector is of the opinion that any person under the

control of a licensee is failing to comply with a requirement under this Act,

the licensee shall be deemed not to have complied with the relevant

requirement, and the Director or inspector may take any action permitted under

this Act in consequence.

Truthfulness

21 Every licensee shall

provide truthful, complete and accurate information in any application, report,

document or in any other information required or requested under this Act or as

a limitation and condition of a licence or of receiving funding.

Complaints

process

22 Every licensee shall,

in accordance with the requirements provided for in the regulations, establish

and maintain a process for receiving and responding to patient complaints.

Incident

review process

(1) Every licensee

shall, in accordance with the requirements provided for in the regulations, if

any, establish and maintain a process for the review of incidents.

Reporting

of incidents

(2) Every

licensee shall, in accordance with the requirements provided for in the

regulations, if any, report incidents to the Director, and the report may

include any necessary personal information related to such incidents.

Definition

(3) In

this section,

“incident”

means any unintended event that occurs when a patient receives services in an integrated

community health services centre that,

(

a) results

in death, or serious disability, injury or harm to the patient, and

(

b) does

not result primarily from the patient’s underlying medical condition or from a

known risk inherent in providing the service.

Posting

(1) Every

licensee shall post any prescribed documents and information in a prominent

place clearly visible to members of the public at or near the entrance of the integrated

community health services centre and on the centre’s website, if any.

Compliance

with regulations

(2) The

prescribed documents and information must be posted in compliance with the

requirements provided for in the regulations, if any.

Licence

not to be used as security

25 A licence shall not be

used as security for the payment or performance of an obligation, and any

transaction purporting to use a licence as security for the payment or

performance of an obligation is void.

Contracts

(1) A

licensee shall not enter into a contract that may result in,

(

a) a

change in the beneficial ownership of the licence without a corresponding

transfer of the licence; or

(

b) in

the case of a licensee that is a corporation, a person acquiring or increasing

an interest affecting the control of the corporation while it is a licensee.

Exception

(2) Subsection

(1) does not apply if the licence includes a limitation or condition as to the

ownership or control of the licensee and the contract would not result in a

breach of a limitation or condition.

Share

transfer

27 A licensee that is a

private company as defined in the Securities Act

shall not permit an issue or transfer of its voting shares except in accordance

with the limitations and conditions of the licence.

Duty

of corporation to notify Director

(1) A

licensee that is a corporation shall notify the Director in writing within 15

days of any change in the officers or directors of the corporation.

Same

(2) Where

a corporation has an interest in a licence and there is reasonable ground for

belief that an event will occur whereby a person would acquire an interest or

increase an interest affecting the control of the corporation while the

corporation has an interest in the licence, the corporation shall immediately

notify the Director.

PART

PAYMENTS AND ACCOUNTABILITY

Payments

and facility costs

(1) The

Minister may pay all or part of the facility costs or other operating costs of

an integrated community health services centre.

Other

prescribed costs

(2) The

Minister may pay any other prescribed costs of an integrated community health

services centre.

Prohibition

on charging of facility costs

(3) No

person shall charge a facility cost, or accept payment of a facility cost, for

or in respect of a service provided in an integrated community health services

centre unless the centre is operated by a licensee.

Facility

costs may only be charged to Minister or prescribed person

(4) No

person shall charge or accept payment of a facility cost unless the facility

cost is charged to, and the payment accepted from, the Minister or a prescribed

person.

preferences

(5) No

person shall,

(

a) charge

or accept payment for providing an insured person with a preference in

obtaining access to an insured service at an integrated community health

services centre;

(

b) obtain

or accept a benefit, direct or indirect, for providing an insured person with a

preference in obtaining access to an insured service at an integrated community

health services centre; or

(

c) offer

to do anything referred to in clause (

a) or (b).

refusal for choice not to pay

(6) No

person shall refuse to provide or refuse to continue to provide an insured

service to an insured person for any reason relating to the insured person’s

choice not to pay, or not to provide a direct or indirect benefit, for any

product, device or service offered at the integrated community health services

centre.

Obtaining

funding to which not entitled

(7) No

person shall obtain, receive or attempt to obtain or receive any of the

following that the person is not entitled to obtain or receive under this Act:

1. Payment

for or in respect of an integrated community health services centre.

2. Payment

for or in respect of a service provided in an integrated community health

services centre.

Regulation

(8) A

regulation made in respect of subsection (4) shall not prescribe an insured

person who receives an insured service as a person to whom a facility cost may

be charged, or from whom payment of a facility cost may be received, in respect

of the service.

Record-keeping

(1) For the

purposes of this Act, every licensee shall maintain such records as may be

necessary to establish whether they have provided a service to a person for or

in respect of which a facility cost is charged or paid.

Same,

providing service

(2) For

the purposes of this Act, every licensee shall maintain such records as may be

necessary to demonstrate that a service for which they prepare or submit a

claim for payment is the service that they provided.

Same,

necessary service

(3) For

the purposes of this Act, every licensee shall maintain such records as may be

necessary to establish whether a service they have provided is medically or

therapeutically necessary.

Prompt

preparation

(4) The

records described in subsections (1), (2) and (3) must be prepared promptly

when the service is provided.

Presumption

(5) In

the absence of a record described in subsection (1) or (3), it is presumed that

a service for or in respect of which a facility cost is charged or paid was

provided and that the amount payable is nil.

Different

service provided

(6) In

the absence of a record described in subsection (2), the service that was

provided is presumed to be the service, if any, that the Minister considers to

be described in the records as having been provided and not the service for

which the claim for payment was prepared or submitted.

Refusal

to pay if not required form, etc.

31 The Minister shall

refuse to pay if the claim for payment is not prepared in the required form,

does not meet the prescribed requirements or is not submitted to the Minister

within the prescribed time. However, the Minister may pay if, in the Minister’s

opinion, there are extenuating circumstances.

Refusal

to pay, pay reduced amount or substitute amount: circumstances

(1) Under

any of the following circumstances, the Minister may, with respect to a claim

for payment for a service provided by a licensee, refuse to pay for the

service, pay a reduced amount for the service, pay for the service the Minister

considers to have been provided and not the service described in the claim that

was submitted or require reimbursement of the amount paid for the service:

1. If

the Minister is of the opinion that any or all of the following apply:

i. All

or part of the service was not in fact rendered.

ii. The

service has not been rendered in accordance with a requirement under this Act.

iii. There

is an absence of a record described in

section 30.

2. If

the Minister is of the opinion that the nature of the service is

misrepresented, whether deliberately or inadvertently.

3. If

the Minister is of the opinion that all or part of the service was not provided

in accordance with the quality and safety standards.

4. In

such other circumstances as may be prescribed.

Statistical

methods

(2) The

Minister may, in determining amounts to be reimbursed under this section, use a

random sample with a reasonable confidence interval of claims submitted by the

licensee in respect of a service during a specified period of time and

calculate the amount to be reimbursed for that service for that period or a

portion of that period by assuming the results observed in the random sample

are representative of all of the claims submitted by the licensee for that

service during the period in question.

Pre-payment

refusal to pay, pay reduced amount or substitute amount

(3) Where

the Minister is of the opinion that a circumstance described in subsection

(1) exists and has made a decision to refuse to pay or pay a reduced amount to a

licensee, or to pay for the service the Minister considers to have been

provided and not the service described in the claim, the Minister shall notify

the licensee of the decision and the action taken.

Post-payment

notice that reimbursement is required

(4) Where

the Minister has made a payment to a licensee and the Minister is of the

opinion that a circumstance described in subsection (1) exists and that

reimbursement to the Minister is required, the Minister shall notify the

licensee of the decision to require reimbursement and the amount of

reimbursement that is required.

Recovery

by Minister

(5) The

Minister may obtain or recover money that, in the opinion of the Minister, a

licensee owes to the Minister by any method, including, without being limited

to, set-off against any money payable to them under this Act or, in the event

that the licensee is a physician, any money payable to them under the Plan,

unless another method of payment is agreed to by the Minister.

Not

a decision

(6) For

greater certainty, a refusal to pay under

section 31 is not a decision for the

purposes of this section.

Patient

not to pay

(7) No

person shall charge or accept payment or other benefit from an insured person

for a service that is the subject of a decision of the Minister under this

section, except as may be provided for in the regulations, if any.

Reimbursement,

non-entitled person

33 The Minister may

require reimbursement from a person for an amount paid under this Act in

support of an insured service rendered to the person if, after the payment is

made, the Minister determines that the person was not an insured person and was

not entitled to have a payment made under this Act with respect to the service.

Debt

34 The requirement to

reimburse the Minister under

section 32 or 33 creates a debt owed to the Crown

in right of Ontario in the amount set out in the decision of the Minister.

Transition

35 Sections 32, 33 and 34

apply, with necessary modifications, to services or payments that occurred

under the Independent Health Facilities Act before

that Act was repealed.

Settlement

36 Nothing in this Act

prevents the Minister and a licensee from entering into an agreement at any

time, and despite any other provision of this Act, with respect to amounts to

be paid or recovered with respect to claims for services. However, for greater

certainty, the Minister is not required to enter into any such agreement.

Interest

37 Where the Minister has

required payment under

section 32, interest accrues on the amount that is

required to be paid commencing on the date of the Minister’s decision, at the

rate for postjudgment interest provided for under

section 127 of the Courts of Justice Act .

Hearing

by Board

(1) The

following persons may request a hearing by the Board with respect to the

following matters:

1. A

licensee may request a hearing to review a decision of the Minister under

subsection 32 (3) or (4).

2. A

person may request a hearing to review a decision of the Minister under

section

Notice

of request

(2) The

person requesting a hearing shall file a notice of the request within 30 days

after receiving notice of the decision of the Minister.

Restrictions

on hearing requests

(3) For

greater certainty,

(

a) a

licensee may request a hearing only for those matters provided for under

subsection 32 (3) or (4) and with respect to them and only those matters may be

the subject of a hearing by the Board in accordance with this Act; and

(

b) a

licensee may not request a hearing with respect to a decision by the Minister

to pursue a remedy in contract or otherwise by operation of law.

Powers

of Board

(1) If a

person requests a hearing, the Board shall appoint a time for and hold the

hearing and following the hearing may, by order, direct the Minister to take

such action as the Board considers the Minister should take in accordance with

this Act and the regulations.

Extension

of time for hearing

(2) The

Board may extend the time for the giving of notice by a person requesting a

hearing under this section, either before or after expiration of such time,

where it is satisfied that there are apparent grounds for granting relief to

the claimant pursuant to a hearing and that there are reasonable grounds for

applying for the extension, and the Board may give such directions as it

considers proper regarding the extension.

Onus

(3) In

any hearing under this section, the onus is on the licensee or other person to

establish that the decision of the Minister is not in accordance with this Act

and the regulations.

Costs

(4) In

a hearing under paragraph 1 of subsection 38 (1), the Board may make an order

granting costs to any party, subject to any rules or limitations that may be

provided for in the regulations, and despite any other rules of the Board

respecting costs and despite the Statutory Powers

Procedure Act .

Interest

payable by Minister

(5) If

the Board has concluded that an amount is payable by the Minister to a licensee

or any other person, interest calculated at the rate provided for postjudgment

interest under

section 127 of the Courts of Justice Act

accrues from the date of recovery under subsection 32 (5) of this Act.

stay

(6) Despite

section 25 of the Statutory Powers Procedure Act , a

request for a hearing under paragraph 1 of subsection 38 (1) of this Act does

not have the effect of staying the decision with respect to which the request

was made.

interim order to stay

(7) Despite

section 16.1 of the Statutory Powers Procedure Act ,

the Board shall not make an interim order to stay the decision with respect to

which the request was made.

May

only order authorized payments

(8) For

greater certainty, the Board may only order payments that are authorized under

this Act.

Minister

and Director are parties

(9) The

Minister and the Director, as applicable, are parties to a hearing under this

section.

Appeal

to Board

(1) Any

party to the proceedings before the Board under

section 39 may appeal from its

decision or order to the Divisional Court in accordance with the rules of

court.

Record

to be filed in court

(2) Where

any party appeals from a decision or order of the Board, the Board shall

promptly file in the Divisional Court the record of the proceedings before it

in which the decision was made, which, together with the transcript of

evidence, if it is not part of the Board’s record, shall constitute the record

in the appeal.

Powers

of court on appeal

(3) 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 decision of the Board and may exercise

all powers of the Board to direct the Minister to take any action which the

Board may direct the Minister to take and as the court considers proper and for

such purposes the court may substitute its opinion for that of the Minister or

of the Board, or the court may refer the matter back to the Board for

rehearing, in whole or in part, in accordance with such directions as the court

considers proper.

stay

(4) Despite

section 25 of the Statutory Powers Procedure Act ,

an appeal under this

section does not have the effect of staying the decision

with respect to which the appeal is made.

Ontario

Health Insurance

(1) In this

section,

“Plan”

means the Ontario Health Insurance Plan referred to in

section 10 of the Health Insurance Act .

Plan

to reimburse facility cost

(2) Where

the Director is satisfied that a person has paid a facility cost, all or part

of which was charged in contravention of

section 29, the Director may direct

that the amount of the facility cost that was charged in contravention of

section 29 be paid to the person out of the Plan.

Fee

is debt to Plan

(3) The

person who charged the facility cost referred to in subsection (2) is indebted

to the Plan for an amount equal to the amount paid out of the Plan under

subsection (2) and the administrative charge prescribed by the regulations.

Set-off

against Plan

(4) If

the person who charged the facility cost referred to in subsection (2) is a

person who submits accounts directly to the Plan, then, subject to subsections

(5), (6) and (8), part or all of the money owed to the Plan under subsection

(3) may be recovered by set-off against any money payable to the person by the

Plan.

Notice

of proposed set-off

(5) The

Director shall serve notice of the proposed set-off referred to in subsection

(4), together with written reasons, on the person who is indebted to the Plan.

Notice

requiring hearing by Board

(6) A

notice under subsection (5) shall inform the person that they are entitled to a

hearing by the Board if the person mails or delivers, within 15 days after the

notice under subsection (5) is served on the person, notice in writing

requiring a hearing to the Director and the Board, and the person may so

require a hearing.

Powers

where no hearing

(7) Where

a person does not require a hearing by the Board in accordance with subsection

(6), the proposed set-off stated in the notice under subsection (5) may be

carried out.

Powers

of Board where hearing

(8) Where

a person requires a hearing by the Board, the Board shall appoint a time for

and hold the hearing and the Board may, by order, direct that the proposed

set-off be carried out or refrained from being carried out, and for such

purposes, the Board may substitute its opinion for that of the Director.

Extension

of time for requiring hearing

(9) The

Board may extend the time for the giving of notice requiring a hearing by a

person under this section, either before or after expiration of such time,

where it is satisfied that there are grounds for granting relief to the person

and that there are reasonable grounds for applying for the extension, and the

Board may give such directions as it considers proper regarding the extension.

Application

of ss. 16, 17

(10) Sections

16 and 17 apply with necessary modifications to a hearing and decision by the

Board under this section.

Disclosure

of information

(11) Despite

subsection 38 (1) of the Health Insurance Act , the

General Manager may, for the purpose of this section, provide information regarding

the nature of the services provided, the date or dates on which the services

were provided and for whom, the name and address of the person who provided the

services, the amounts paid or payable by the Plan for such services and the

persons to whom the fee for the insured service and the facility cost were paid

or are payable to,

(

a) a

member of the Board;

(

b) the

person who was charged or who paid the facility cost;

(

c) the

person who charged or accepted payment of the facility cost and counsel for the

person;

(

d) any

person engaged in the administration of this Act or the regulations or any

proceedings under this Act; or

(

e) any

other person with the consent of the person to whom the services were provided

in respect of which the facility cost was charged.

PART

INSPECTIONS AND COMPLIANCE ORDERS

Inspections

Inspectors

(1) The

Minister or the Director may appoint, in writing, one or more persons, or the

members of any class of persons, as inspectors for the purpose of ensuring

compliance with this Act and the regulations, subject to any limitations the

Minister or Director may provide for in the appointment.

Inspectors

by virtue of office

(2) Every

reviewer appointed under the Health Insurance Act

is, by virtue of office, an inspector for the purposes of this Act and shall be

deemed to have been appointed for the purpose mentioned in subsection (1).

Certificate

of appointment

(3) The

Minister or Director shall issue to every inspector appointed under subsection

(1) a certificate of appointment which the inspector shall produce, upon request,

when acting in the performance of their duties. An inspector mentioned in

subsection (2) shall produce their certificate of appointment issued under the Health Insurance Act .

Inspection

upon notice

(4) If

the Director considers it necessary or advisable that an inspection be carried

out of an integrated community health services centre’s compliance with this

Act and the regulations, the Director may give notice in writing to an

inspector to conduct an inspection and the inspector shall comply with the

notice.

Inspecting

bodies

(1) The

regulations may prescribe one or more organizations as inspecting bodies of integrated

community health services centres for the purposes of this Act and the

regulations.

Power

to act

(2) Every

organization that is prescribed as an inspecting body is deemed to have among

its objects all the powers necessary to act as an inspecting body for the

purposes of this Act and the regulations.

Responsibilities

of inspecting bodies

(3) Subject

to the regulations, an inspecting body has the following powers and

responsibilities with respect to the integrated community health services

centres that are provided for in the regulations:

1. Establishing,

maintaining and publishing quality and safety standards for integrated community

health services centres.

2. Establishing

schedules for the regular inspection of integrated community health services

centres.

3. Providing

for the inspection of integrated community health services centres as the

inspecting body considers advisable or as requested by the Director.

4. Appointing

inspectors to carry out the responsibilities of inspectors under this Act. In

the appointment, the inspecting body may limit the authority of an inspector in

such manner as the inspecting body considers necessary or advisable.

5. Submitting

reports of inspections and other information, which may include personal

information, to the Director and to other prescribed persons or entities.

6. Providing

reports at such times, in such form, in such detail and with such supporting

material as is required by the Director.

7. Making

summaries of inspection reports available to the public.

8. Making

compliance orders under clauses 49 (1) (

a) and (b).

9. Making

compliance orders issued by the inspecting body available to the public.

10. Establishing

committees to carry out any functions of the inspecting body, or any function

required by the Director.

11. Establishing

and collecting fees for any activity that the inspecting body is required or

permitted to carry out under this Act, including fees for administrative and

overhead costs related to the activity, from licence applicants and licensees.

12. Exercising

any power and carrying out any responsibility provided for in the regulations.

Certificate

of appointment

(4) An

inspecting body shall issue to every inspector appointed under paragraph 4 of

subsection (3) a certificate of appointment which the inspector shall produce,

upon request, when acting in the performance of their duties.

personal health information

(5) Before

making a compliance order, or a

summary of a report, available to the public

under subsection (3), the inspecting body shall remove all personal health

information from the order or

summary that it intends to make public.

Inspection

upon notice

(6) If

the Director considers it necessary or advisable that an inspection be carried

out of an integrated community health services centre’s compliance with the

quality and safety standards, the Director may give notice in writing to an

inspecting body and the inspecting body shall direct an inspector to conduct an

inspection.

Shall

carry out responsibilities

(7) An

inspecting body shall exercise its powers and carry out its responsibilities

according to the requirements provided for in this Act and in the regulations.

Requiring

information

(8) An

inspecting body may request that a licensee, an applicant for a licence or a

prescribed person provide the inspecting body with any information or reports

that the inspecting body considers necessary or advisable for the purpose of

carrying out its functions, and the licensee, applicant or prescribed person

shall comply with the request in the manner and within the time set by the

inspecting body.

Not

Crown Agency

(9) Despite

the Crown Agency Act , an inspecting body is not an

agent of the Crown for any purpose and shall not hold itself out as such.

Same

(10) The

following persons are not agents of the Crown and shall not hold themselves out

as such:

1. Persons

who are employed or whose services are retained by an inspecting body.

2. Members,

officers and agents of an inspecting body.

3. Members

of the board of an inspecting body, including those appointed by the Minister,

if any.

Inspections

(1) An inspector

acting within the scope of their appointment may enter any of the following

places at any reasonable time to conduct inspections in accordance with the

purpose for which the inspector was appointed:

1. A

licensed integrated community health services centre, or a place in respect of

which an application for or related to a licence has been made.

2. Any

business premises of a person or entity that owns or operates one or more integrated

community health services centres.

3. Any

place that the inspector suspects, on reasonable grounds, is operating as an integrated

community health services centre.

4. Any

place where a licensee or other person who may be operating an integrated

community health services centre maintains records that relate in any way to,

i. the

charging and accepting of facility costs, or

ii. the

provision of services at an integrated community health services centre.

Dwellings

(2) No

inspector shall enter a part of a place that is being used as a dwelling,

except with the consent of the occupier of the part of the place or under the

authority of an order under

section 46.

Use

of force

(3) An

inspector is not entitled to use force to enter and inspect a place.

Powers

of inspector

(4) An

inspector conducting an inspection may, if the inspector considers it to be

relevant to the inspection,

(

a) examine

records or anything else;

(

b) demand

the production of a record or any other thing;

(

c) upon

providing a receipt, remove a record or any other thing for review, examination

or copying;

(

d) in

order to produce a record in readable form, use data storage, information

processing or retrieval devices or systems that are normally used in carrying

on business in the place;

(

e) take

photographs or make any other kind of recording but only in a manner that does

not intercept any private communication and that is in keeping with reasonable

expectations of privacy;

(

f) question

a person about a matter relevant to the inspection;

(

g) call

upon experts who may enter the premises and provide assistance to the inspector

in carrying out the inspection in any manner that the inspector considers necessary

or advisable; and

(

h) if

the consent of the person who is to receive the services has been obtained,

observe the staff of the centre in providing services to members of the public.

Written

demand

(5) A

demand under this

section that a record or any other thing be produced must be

in writing and must include,

(

a) a

statement of the nature of the record or thing required; and

(

b) a

statement of when the records and other things are to be produced.

Obligation

to produce and assist

(6) If

an inspector demands that a record or any other thing be produced under this

section, the person who has custody of the record or thing shall produce it

and, in the case of a record, shall, on request, provide any assistance that is

reasonably necessary to interpret the record or to produce it in a readable

form.

Records

and things removed from place

(7) A

record or other thing that has been removed for review, examination or copying

shall,

(

a) be

made available to the person from whom it was removed on request and at a time

and place that are convenient for the person and for the inspector; and

(

b) be

returned to the person within a reasonable time.

Co-operation

(8) Every

person shall give all reasonable assistance to an inspector in the exercise of

the inspector’s powers or the performance of the inspector’s duties under this

Act.

Inspection

report

(9) Within

a reasonable period of time after completing an inspection, an inspector shall

make a report in writing to the Director or, in the case of an inspector

appointed by an inspecting body, to the inspecting body.

Director

may require information

(10) The

Director may, in writing, require an inspector or the inspecting body to

provide the Director with information respecting an inspection at any time, and

the inspector or inspecting body shall comply with the requirement.

Record

(11) In

this section,

“record”

means any document or record of information, in any form, including a record

that contains personal information.

Copy

constitutes evidence

(1) In any

proceeding, other than a prosecution, a copy of an inspection report that

appears to be signed by an inspector or the Director, or a copy of a decision

of the Director made under this Act, is admissible as evidence of the

inspection report or decision and of the facts appearing in the document

without further proof.

Same

(2) In

any proceeding, other than a prosecution, a copy of a record or thing made

under clause 44 (4) (

c) that appears to be certified as a true copy of the

original by an inspector is admissible as evidence of the record or thing and

of the facts appearing in it without further proof.

Same,

prosecution

(3) In

any prosecution, a copy of a decision, direction or inspection report made

under this Act that appears to be signed by an inspector or the Director is

admissible as evidence, in the absence of evidence to the contrary, of the

decision, direction or inspection report and of the facts appearing in the

document without further proof.

Same

(4) In

any prosecution, a copy of a record or thing made under clause 44 (4) (

c) that

appears to be certified as a true copy of the original by an inspector is

admissible as evidence, in the absence of evidence to the contrary, of the

record or thing and of the facts appearing in it without further proof.

Order

to enter

(1) On

application without notice, a justice may issue an order authorizing an

inspector named in the order to enter a place specified in the order and to

exercise any of the powers mentioned in subsection 44 (4), if the justice is

satisfied on information under oath that the inspector has been prevented from

entering a place that may be entered under

section 44, or has been prevented

from exercising a power mentioned in subsection 44 (4), or that there are

reasonable grounds to believe that the inspector will be prevented from

entering the place or exercising the power.

Expiry

(2) An

order shall name a date on which it expires, which shall not be later than 30

days after the order is issued.

Extension

of time

(3) A

justice may extend the date on which an order expires for an additional period

of no more than 30 days, upon application without notice by the inspector named

in the order.

Police

assistance

(4) An

inspector named in an order may call upon a police officer for assistance in

executing the order and the police officer may use whatever force the police

officer considers necessary to execute the order.

Time

of execution

(5) An

order may be executed only between 6 a.m. and 9 p.m. unless the order specifies

otherwise.

Other

matters

(6) Subsections

44 (2) and (4) to (9) apply, with necessary modifications, to the execution of

an order.

Obstruction

offence

47 Where an inspector is

conducting an inspection under

section 44 or executing an order under

section

46 or where a provincial offences officer is executing a warrant under

section

158 or 158.1 of the Provincial Offences Act with

respect to a matter relevant to this Act, no person shall,

(

a) hinder,

obstruct or interfere with the inspector or officer, or otherwise impede the

inspector or officer;

(

b) destroy

or alter a record or other thing that has been demanded under clause 44 (4) (

b) or that is subject of a warrant under

section 158 or 158.1 of the Provincial Offences Act ; or

(

c) fail

to do anything required under subsections 44 (6) or (8) or subsection 48 (7).

Production

order

(1) On

application without notice by a provincial offences officer, a justice may

issue a production order to a person, other than a person under investigation

for an offence, requiring the person to,

(

a) produce

documents or copies of documents, certified by affidavit to be true copies, or

produce data; or

(

b) prepare

a document based on documents or data already in existence and produce it.

Contents

of order

(2) A

production order must stipulate when, where and how the documents or data are

to be produced, and to whom they are to be produced.

Grounds

(3) A

justice may make a production order if satisfied by information given under

oath or affirmation that there are reasonable grounds to believe that,

(

a) an

offence under this Act has been or is being committed;

(

b) the

document or data will provide evidence respecting the offence or suspected

offence; and

(

c) the

person who is subject to the order has possession or control of the document or

data.

Conditions

(4) A

production order may contain any conditions the justice considers advisable.

Evidence

(5) A

copy of a document or data produced under this section, on proof by affidavit

that it is a true copy, is admissible in evidence in proceedings under this Act

and has the same probative force as the original document or data would have if

it had been proved in the ordinary way.

return of copies

(6) Copies

of documents or data produced under this

section are not required to be

returned to the person who provided them.

Compliance

required

(7) A

person to whom a production order is directed shall comply with the order

according to its terms.

Compliance Orders

Compliance

orders

(1) The

Director may order a licensee to,

(

a) do

anything, or refrain from doing anything, to achieve compliance with a

requirement under this Act;

(

b) prepare,

submit and implement a plan for achieving compliance with a requirement under

this Act; or

(

c) ensure

that specified licensed services are not provided at the integrated community

health services centre until the licensee achieves compliance with a

requirement under this Act.

Same,

inspecting body

(2) An

inspecting body may order a licensee to do anything set out in clause (1) (

a) or (b).

Grounds

(3) A

compliance order under subsection (1) or (2) may be made if, in the opinion of

the Director or inspecting body, after considering any factors provided for in

this Act or the regulations, the licensee has not complied with a requirement

under this Act or, if in the opinion of the Director or inspecting body, it is

necessary or advisable to protect the health or safety of any person.

Time

of validity

(4) A

compliance order issued under this

section is valid until the date set out in

the order or until the conditions specified in the order have been met,

whichever is earlier.

Due

diligence, mistakes do not prevent action

(5) The

authority to make a compliance order under this

section may be exercised with

respect to a licensee who has not complied with a requirement under this Act

whether or not,

(

a) the

licensee took all reasonable steps to prevent the non-compliance; or

(

b) at

the time of the non-compliance, the licensee had an honest and reasonable

belief in a set of facts that, if true, would have resulted in there not being

any non-compliance.

PART

MISCELLANEOUS

Consideration

of past conduct

50 Where the Minister or

Director makes a decision under this Act, they may consider any person’s

current or past failures to comply with a requirement under this Act or under

any other Act that they may consider relevant.

Service

of notice

(1) Except

where otherwise provided, any notice required by or provided for in this Act

may be served by,

(

a) personal

service;

(

b) courier;

(

c) registered

mail;

(

d) electronic

means; or

(

e) 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 (d), on the day of delivery; and

(

b) in

the case of a notice under clause (1) (e), 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 they could

not control, in which case service is effective on the day that the notice is

actually received.

Not

compellable witness

52 No person, including an

inspector or a person who, at the request of an inspector, accompanies an

inspector in doing anything authorized under this Act, is a compellable witness

in a civil suit or any proceeding respecting any information or material

furnished, obtained, made or received by them in the course of performing a

function or duty or exercising a power under this Act.

Protection

of information

53 In a prosecution for an

offence under this Act or where documents or materials provided for under

section 48 of this Act or sections 158 to 160 of the Provincial

Offences Act are filed with a court in relation to an inspection or an

investigation into an offence under this Act, the court may, at any time, take

precautions to avoid the disclosure by the court or any person of any personal

information about an individual, including, where appropriate,

(

a) removing

the identifying information of any person whose personal information is

referred to in any documents or materials;

(

b) receiving

representations without notice;

(

c) conducting

hearings or parts of hearings in private; or

(

d) sealing

all or part of the court files.

Certain

documents

(1) In any

proceeding under this Act, the Health Insurance Act

or the Commitment to the Future of Medicare Act, 2004 ,

a document purporting to be an extract of data or information from any database

maintained and used by the Ministry in the ordinary course of business to

record and track information about claims made under this Act or the Health Insurance Act and payments made under this Act or

that Act that appears to be certified as a true extract by the Director or by

the General Manager under the Health Insurance Act

is admissible as evidence of the information contained in the extract and of

the facts appearing in it without further proof.

Prosecutions

(2) Subsection

(1) does not apply in respect of a prosecution.

Filing

with court

(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 Board made under this Act.

2. An

agreement to reimburse the Minister or the Plan signed by a licensee.

3. A

decision of the Minister under

section 32 or 33.

Personal

property charge

(2) Anything

that may be filed under subsection (1) may also be entered as a lien and charge

with the registrar under the Personal Property Security

Act .

Set-off

(3) For

greater certainty, nothing under this

section affects any right of set-off that

the Minister possesses under this Act.

Publication

(1) Subject

to the regulations, if any, the Minister is authorized to publish information,

including personal information other than personal health information, that

relates to any payments under this Act to a licensee.

Same,

Director

(2) The

Director is authorized to publish any information that relates to compliance

with licensing and quality and safety standards under this Act, including

personal information other than personal health information.

Confidentiality

for inspecting body and inspectors

(1) Every

inspecting body and every inspector appointed by an inspecting body shall keep

confidential all information that comes to their knowledge in the course of

performing a function or duty or exercising a power related to the

administration of this Act, subject to subsection (2).

Disclosure

(2) An

inspecting body or inspector appointed by an inspecting body may disclose

information described in subsection (1),

(

a) to

the Director, upon request of the Director or for purposes related to this Act,

the Health Insurance Act or the Commitment to the Future of Medicare Act, 2004 ;

(

b) to

comply with any requirement under this Act to post the information or to make

the information public;

(

c) where

the person to whom the information relates has consented to the disclosure;

(

d) where

the disclosure of the information is required or permitted by a law of Ontario

or Canada;

(

e) where

disclosure is required in a proceeding before the Board;

(

f) where

the inspecting body has 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

(

g) in

such circumstances as may be prescribed.

Personal

information

(1) The

Minister may directly or indirectly collect personal information or use

personal information, subject to such conditions as may be prescribed, for

purposes related to the administration of this Act, the Health

Insurance Act or the Commitment to the Future of

Medicare Act, 2004 or for such other purposes as may be prescribed.

Disclosure

(2) The

Minister shall disclose personal information, subject to such conditions as may

be prescribed, if the disclosure is necessary for purposes related to the

administration of this Act, the Health Insurance Act

or the Commitment to the Future of Medicare Act, 2004

or for such other purposes as may be prescribed, but shall not disclose the

information if, in the Minister’s opinion, the disclosure is not necessary for

those purposes.

Does

not limit other use or disclosure

(3) Subsections

(1) and (2) do not limit the Minister’s authority to use and disclose personal

information collected under subsection (1) if the use or disclosure, as the

case may be, is permitted by the Personal Health

Information Protection Act, 2004 or the Freedom of

Information and Protection of Privacy Act .

Disclosure

to Minister

(4) A

person is authorized to disclose any personal information to the Minister for a

purpose set out in subsection (1).

Collection

and use of personal information by inspecting body

(5) An

inspecting body may directly or indirectly collect personal information or use

personal information, subject to such conditions as may be prescribed, for

purposes related to the administration of this Act or for such other purposes

as may be prescribed.

Limitation

(6) In

the course of performing a function or duty or exercising a power related to

the administration of this Act, an inspecting body or inspector appointed by an

inspecting body shall not,

(

a) collect,

use or disclose personal information if other information will serve the

purpose of the collection, use or disclosure; and

(

b) collect,

use or disclose more personal information than is reasonably necessary to meet

the purposes of the collection, use or disclosure.

Disclosure

to health college

(7) Where

the Director, the Minister or an inspecting body determines that it is

advisable to do so, the Director, Minister or inspecting body shall disclose

personal information to a College within the meaning of the Regulated Health Professions Act, 1991 for the purpose of

the administration of that Act or

an Act named in

Schedule 1 to that Act.

Notification

if inspecting body

(8) An

inspecting body shall notify the Director when making a disclosure under

subsection (7).

Disclosure

of information to the Director

(1) The

Director may request, at any time, that a licensee or other person disclose to

the Director, or to a person specified by the Director, any information or

reports that the Director considers necessary or advisable for purposes related

to the administration of this Act or the Health Insurance

Act or for other prescribed purposes, and the licensee or other person

shall comply with the request.

Same

(2) The

information referred to under subsection (1) may include personal information.

Application

(3) This

section applies despite anything in the Regulated Health

Professions Act, 1991 ,

an Act listed in

Schedule 1 to the Regulated Health Professions Act, 1991 or any regulations

made under those Acts.

Form

and time

(4) The

information referred to in subsection (1) shall be provided in the form, and

within the time, specified by the Director.

Rules

re providing records and information

(5) Where

the Director requires a licensee or other person to provide information under

subsection (1), the following rules apply:

1. The

licensee or other person shall submit copies of the requested information and,

where required by the Director, shall include a signed certificate of

authenticity and a signed copy of an audit trail for electronic records.

2. If

the Director is not satisfied with the copies of the requested information, the

Director may require the licensee or other person to produce the original

documents to the Director, and the documents shall be returned to the licensee

or other person in a timely manner after copies have been made.

3. Where

a licensee or other person fails to produce the copies or originals of

information required under this section, the Director may, on notice to the

licensee or other person, apply to a justice or a provincial judge for an order

compelling production of the required information and the justice or provincial

judge may issue the order if they are satisfied that there are reasonable

grounds for believing that the licensee or other person failed to produce the

information.

Certificate

of authenticity

(6) A

certificate of authenticity required under this

section shall be in a form

acceptable to the Director unless otherwise prescribed.

Crown

liability

personal liability

(1) No cause

of action arises against any current or former member of the Executive Council,

the Director, an inspector appointed under this Act, an inspecting body or an

officer, employee or agent of the Crown for any act done in good faith in the

exercise or performance, or intended exercise or performance, of the person’s

powers, duties or functions under this Act or for any alleged neglect, default

or other omission in the exercise or performance in good faith of those powers,

duties, functions or authority under this Act.

Crown

remains vicariously liable

(2) Despite

subsection 8 (3) of the Crown Liability and Proceedings

Act, 2019 , subsection (1) of this

section does not relieve the Crown of

liability to which it would otherwise be subject as a result of the acts or

omissions of a person specified in subsection (1).

Proceedings

barred

(3) No

proceeding shall be commenced against any person specified in subsection (1) in

respect of a matter referred to in that subsection.

Same

(4) Subsection

(3) does not apply with respect to an application for judicial review or any

proceeding that is specifically provided for under this Act, but does apply

with respect to any other court, administrative or arbitral proceeding claiming

any remedy or relief, including specific performance, an injunction,

declaratory relief, a remedy in contract, restitution, unjust enrichment or

tort, a remedy for breach of trust or fiduciary obligation or any equitable

remedy, enforcement of a judgment, order or award made outside Ontario or any

form of compensation or damages including loss of revenue or profit.

Proceedings

by Crown not prevented

(5) This

section does not apply with respect to proceedings brought by the Crown.

compensation

61 No compensation shall

be payable by the Crown, the Minister, the Director or any other person engaged

in the administration of this Act in respect of any loss suffered as a result

of,

(

a) the

Director refusing to issue or renew a licence, revoking or suspending a

licence, imposing limitations and conditions on a licence, amending limitations

and conditions on a licence or refusing to approve the transfer of a licence;

(

b) the

Director approving or refusing to approve the relocation of an integrated

community health services centre;

(

c) enforcement

of the prohibitions under

section 4 or 29; or

(

d) a

compliance order issued under

section 49.

Transition

(1) The

following rules apply to any inspection, assessment or related proceeding under

the Independent Health Facilities Act that was not

finally determined on the day that Act was repealed:

1. The

inspection, assessment or proceeding, and any related proceedings, are

continued.

2. The

inspection, assessment or proceeding, and any related proceedings, shall be

dealt with in accordance with the Independent Health

Facilities Act , as it read immediately before its repeal.

3. The

appointments of any persons under the Independent Health

Facilities Act are continued for the purpose of disposing of the

inspection, assessment or proceeding and any related proceeding until those

issues have been finally determined.

Same

(2) When

this subsection comes into force, every licence for an independent health

facility under the Independent Health Facilities Act

that was in force immediately before this subsection came into force continues

under this Act, subject to the same limitations and conditions that applied to

the licence under the Independent Health Facilities Act .

PART

VII

OFFENCES AND COMPLIANCE

Offences

(1) Every

person who contravenes

section 4, 10, 11, subsection 20 (2) or

section 25, 26,

27, 29, 47 or 57 is guilty of an offence.

Same

(2) Every

person is guilty of an offence who fails to comply with,

(

a) a

request for information under

section 59; or

(

b) a

compliance order.

Breach

of regulations

(3) Every

person who contravenes the regulations is guilty of an offence.

Penalty,

individual

(4) Every

individual who is convicted of an offence under this

section is liable, for

each day or part of a day on which the offence occurs or continues,

(

a) for

a first offence, to a fine of not more than $50,000 or, subject to subsection

(6), to imprisonment for a term of not more than 12 months, or to both; and

(

b) for

a subsequent offence, to a fine of not more than $100,000 or, subject to

subsection (6), to imprisonment for a term of not more than 12 months, or to both.

Same,

corporation

(5) Every

corporation that is convicted of an offence under this

section is liable, for

each day or part of a day on which the offence occurs or continues, to a fine

of not more than $100,000 for a first offence and to a fine of not more than

$500,000 for a subsequent offence.

imprisonment

(6) Despite

anything else in this Act, an individual convicted of an offence under clause

(2) (

b) is not liable to imprisonment, or to a warrant of committal under

subsection 69 (14) of the Provincial Offences Act ,

as a result of the conviction or as a result of default in payment of the fine

resulting from the conviction.

Due

diligence, mistake not a defence

(7) It

is not a defence to a charge under clause (2) (

b) that the person took all

reasonable steps to prevent any failure to comply with this Act or, at the time

of the failure, the person had an honest and reasonable belief in a set of

facts that, if true, would have resulted in there not being any non-compliance.

Presiding

judge

(8) The

Crown may, by notice to the clerk of the Ontario Court of Justice, require that

a provincial judge preside over a proceeding in respect of an offence under

this section.

Compensation

or restitution

(9) The

court that convicts a person of an offence under this

section may, in addition

to any other penalty, order that the person pay compensation or make

restitution to any person who suffered a loss as a result of the offence.

limitation

(10) Section

76 of the Provincial Offences Act does not apply to

a prosecution under this section.

Restraining

order

(1) In

addition to any other remedy and to any penalty imposed by law, a contravention

section 4 or 29 may be restrained by action at the instance of the Attorney

General.

Restraining

order upon conviction

(2) Upon

its own initiative or upon application by counsel for the prosecutor, the court

that convicts a person of an offence under this Act, in addition to any other

remedy and to any penalty imposed by law, may make an order prohibiting the

continuation or repetition by the person of the action that constitutes the

offence.

PART

VIII

REGULATIONS

Regulations

(1) The

Lieutenant Governor in Council may make regulations,

1. providing

for and governing anything that this Act refers to as being prescribed or

provided for in the regulations, or as being required to be done in accordance

with the regulations or as being subject to the regulations;

2. defining

or clarifying the meaning of any word or expression used in this Act that is

not otherwise defined in this Act;

3. providing

for exemptions from this Act or any provision of this Act, subject to any

conditions that may be set out in the regulation;

4. prescribing

charges, fees or payments that are or are not facility costs for the purposes

of this Act;

5. prescribing

health facilities that are or are not integrated community health services

centres for the purposes of this Act;

6. providing

for additional powers, functions and duties of the Director;

7. governing

the issuance, renewal, transfer, suspension and revocation of licences,

including governing refusals to renew licences;

8. establishing

and governing rules respecting the permitted locations of integrated community

health services centres;

9. prescribing

limitations and conditions that attach to licences of integrated community

health services centres;

10. governing

the relocation of integrated community health services centres under

section

time at which the application must be made;

11. governing

any application that may be made or submitted under this Act, including the

process for submitting applications;

12. respecting

forms and their use;

13. classifying

integrated community health services centres;

14. governing

the care, treatment and services provided in integrated community health

services centres, including governing safety, quality management programs, and

prescribing quality and safety standards;

15. governing

the requirements for staff and employees of integrated community health

services centres;

16. governing

the process licensees must have for receiving and responding to patient

complaints;

17. governing

payments by the Minister under

section 29, including prescribing the method of

determining the amounts and prescribing conditions for the payment of such

amounts;

18. governing

claims made for the purposes of payment under

section 29, including requiring

claims to be made in the prescribed manner and at the prescribed time and

prescribing conditions for the making of claims;

19. governing

the books, records and accounts to be kept by licensees including their form

and content and the place or places where they are to be kept;

20. requiring

the accounts of integrated community health services centres to be audited and

requiring the licensees to furnish information or accounts required by the

Director;

21. governing

the records to be kept by licensees with respect to the care and treatment of

patients of the integrated community health services centre;

22. governing

reports and returns to be made to the Director by licensees;

23. requiring

and governing a system or systems to be used by licensees to monitor the

results of the services provided in integrated community health services centres;

24. governing

access to patient or drug records and specifying persons who may have access to

such records;

25. prescribing

inspecting bodies and governing the exercise of their responsibilities under

this Act;

26. governing

inspections, including the actions to be taken by an inspector or inspecting

body;

27. requiring

licensees or applicants for a licence to pay fees established by an inspecting

body for any activity the inspecting body is required or permitted to carry out

under this Act, including fees for administrative and overhead costs related to

the activity;

28. governing

compliance orders, including factors that must be considered before issuing a

compliance order and actions to be taken in connection with the issuance of a

compliance order;

29. governing

and restricting the disposition and transfer of the assets of integrated

community health services centres;

30. governing

transitional or similar matters that may arise due to the enactment of

Schedule

1 to the Your Health Act, 2023 ;

31. generally

for carrying out what the Lieutenant Governor in Council considers to be the

purposes, provisions and intent of this Act.

Nil

amount

(2) An

amount, cost or fee prescribed or provided for under subsection (1) may be a

nil amount.

Rolling

incorporation by reference

(3) If

a regulation adopts by reference any code, standard, guideline or similar

document, the regulation may require compliance with the code, standard or

guideline, as amended from time to time, whether the amendment was made before

or after the regulation was made.

Retroactive

effect

(4) A

regulation made under this Act is, if it so provides, effective with reference

to a period before the day it is filed.

PART

REPEALS AND REVOCATIONS

Independent

Health Facilities Act

(1) The Independent Health Facilities Act is repealed.

(2) The

following regulations made under the Act are revoked:

1. Regulation

649 of the Revised Regulations of Ontario, 1990 (Application and Exemptions).

2. Regulation

650 of the Revised Regulations of Ontario, 1990 (Facility Fees).

3. Ontario

Regulation 57/92 (General).

4. Ontario

Regulation 353/13 (Prescribed Persons).

Oversight

of Health Facilities and Devices Act, 2017

Schedule 9 (the “ Oversight of Health Facilities and Devices Act, 2017 ”) to

the Strengthening Quality and Accountability for Patients

Act, 2017 is repealed.

PART

CONSEQUENTIAL AND RELATED AMENDMENTS

Commitment

to the Future of Medicare Act, 2004

68 (1) Subsection

13 (5) of the Commitment to the Future of Medicare Act,

2004 is amended by striking out “the Independent

Health Facilities Act ” and substituting “the Integrated

Community Health Services Centres Act, 2023 ”.

(2) Subsections

15 (1) to (3) of the Act are amended by striking out “the Independent

Health Facilities Act ” wherever it appears and substituting in each case

“the Integrated Community Health Services Centres Act,

2023 ”.

(3) Paragraph

3 of subsection 16 (1) of the Act is repealed and the following substituted:

Section

4 of the Integrated Community Health Services Centres Act,

2023 .

(4) Subsections

16 (5) and (6) of the Act are amended by striking out “the Independent Health Facilities Act ” wherever it appears

and substituting in each case “the Integrated Community

Health Services Centres Act, 2023 ”.

Connecting

Care Act, 2019

(1) Paragraph

15 of subsection 1 (2) of the Connecting Care Act, 2019

is repealed and the following substituted:

15. An

integrated community health services centre within the meaning of the Integrated Community Health Services Centres Act, 2023 .

(2) Section

6 of the Act is amended by adding the following clause:

(b.2) to

support or undertake any functions, powers or duties that may be conferred on

the Agency, or an employee of the Agency, under the Integrated

Community Health Services Centres Act, 2023 ;

(3) Subsection

35 (4) of the Act is amended by striking out “the Independent

Health Facilities Act ” and substituting “the Integrated

Community Health Services Centres Act, 2023 ”.

(4) Subsection

46 (1) of the Act is amended by striking out “the Gift of

Life Act ” in the portion before paragraph 1 and substituting “the Gift of Life Act , the Integrated

Community Health Services Centres Act, 2023 ”.

(5) Subsections

49 (1), (2) and (5) of the Act are repealed.

Excellent

Care for All Act, 2010

(1) The definition of “health

sector organization” in

section 1 of the Excellent Care

for All Act, 2010 is amended by adding the following clause:

(b.1) an

integrated community health services centre within the meaning of the Integrated Community Health Services Centres Act, 2023 , unless

the centre is subject to an exemption provided for by the regulations,

(2) The

definition of “patient or former patient” in subsection 13.1 (9) of the Act is

amended by adding the following clause:

(b.1) a

person who receives or has received services from an integrated community

health services centre, unless the person is subject to an exemption provided

for by the regulations,

Health

Insurance Act

(1) Section

1 of the Health Insurance Act is amended by adding

the following definition:

“integrated

community health services centre” means an integrated community health services

centre within the meaning of the Integrated Community

Health Services Centres Act, 2023 ; (“centre de services de santé

communautaire intégré”)

(2) Subsections

4.1 (1) to (3) of the Act are amended by striking out “ Independent

Health Facilities Act ” wherever it appears and substituting in each case

“ Integrated Community Health Services Centres Act, 2023 ”.

(3) Subsection

17.3 (1) of the Act is repealed and the following substituted:

Information

(1) Every

physician, practitioner, health facility, hospital and integrated community

health services centre shall give the General Manager records or other

information, including personal information, that the General Manager may

require,

(

a) for

purposes related to the administration of this Act, the Commitment

to the Future of Medicare Act, 2004 or the Integrated

Community Health Services Centres Act, 2023 ; or

(

b) for

other prescribed purposes.

(4) Section

18.2 of the Act is amended by striking out “independent health facility” and

substituting “an integrated community health services centre”.

(5) Subsection

36.1 (3) of the Act is amended by striking out “or an independent health

facility as defined in the Independent Health Facilities

Act ” at the end and substituting “or an integrated community health services

centre within the meaning of the Integrated Community

Health Services Centres Act, 2023 ”.

(6) Subsections

41 (2) and (3) of the Act are amended by striking out “ Independent

Health Facilities Act ” wherever it appears and substituting in each case

“ Integrated Community Health Services Centres Act, 2023 ”.

(7) Subsection

42.6 (1) of the Act is amended by striking out “ Independent

Health Facilities Act ” wherever it appears and substituting in each case

“ Integrated Community Health Services Centres Act, 2023 ”.

(8) Subsection

45 (5) of the Act is repealed.

Health

Protection and Promotion Act

72 Paragraph 4 of the

definition of “health care provider or health care entity” in subsection 77.7

(6) of the Health Protection and Promotion Act is

amended by striking out “or an independent health facility within the meaning

of the Independent Health Facilities Act ” at the

end and substituting “or an integrated community health services centre within the

meaning of the Integrated Community Health Services Centres

Act, 2023 ”.

Ministry

of Health and Long-Term Care Appeal and Review Boards Act, 1998

73 Paragraph 10 of

subsection 6 (1) of the Ministry of Health and Long-Term

Care Appeal and Review Boards Act, 1998 is repealed and the following

substituted:

10. The

Integrated Community Health Services Centres Act, 2023 .

Opioid

Damages and Health Care Costs Recovery Act, 2019

(1) Clause

(

d) of the definition of “health care benefits” in subsection 1 (1) of the Opioid Damages and Health Care Costs Recovery Act, 2019

is repealed and the following substituted:

(

d) services

for which a facility cost is payable under the Integrated

Community Health Services Centres Act, 2023 ,

(2) The

definition of “health care benefits” in subsection 1 (1) of the Act is amended

by adding the following clause:

(g.1) services

for which a facility fee was payable under the Independent

Health Facilities Act before its repeal,

(3) Section

14 of the Act is repealed.

(4) Subsection

16 (2) of the Act is repealed.

Personal

Health Information Protection Act, 2004

75 Subparagraph 4 i of

subsection 3 (1) of the Personal Health Information

Protection Act, 2004 is amended by striking out “an independent health

facility within the meaning of the Independent Health

Facilities Act ” at the end and substituting “an integrated community

health services centre within the meaning of the Integrated

Community Health Services Centres Act, 2023 ”.

Plan

to Build Ontario Together Act, 2019

76 (1) Subsection

3 (2) of

Schedule 15 to the Plan to Build Ontario Together

Act, 2019 is repealed.

(2) Subsection

15 (2) of

Schedule 15 to the Act is repealed.

(3) Subsections

31 (2) and (3) of

Schedule 15 to the Act are repealed.

Private

Hospitals Act

77 Clause (

a) of the

definition of “private hospital” in

section 1 of the Private

Hospitals Act is amended by striking out “an independent health facility

within the meaning of the Independent Health Facilities

Act ” at the beginning and substituting “an integrated community health

services centre within the meaning of the Integrated

Community Health Services Centres Act, 2023 ”.

Protecting

What Matters Most Act (Budget Measures), 2019

(1) Section

32 of

Schedule 17 to the Protecting What Matters Most Act

(Budget Measures), 2019 is repealed.

(2) Subsection

172 (2) of

Schedule 17 to the Act is repealed.

(3) Section

8 of

Schedule 56 to the Act is repealed.

Providing

More Care, Protecting Seniors, and Building More Beds Act, 2021

79 (1) Subsection

203 (20) of

Schedule 1 to the Providing More Care,

Protecting Seniors, and Building More Beds Act, 2021 is repealed.

(2) Subsection

4 (6) of

Schedule 2 to the Act is repealed.

(3) Subsection

23 (2) of

Schedule 2 to the Act is repealed.

Public

Hospitals Act

Section 2 of the Public Hospitals Act is amended by striking out “an

independent health facility under the Independent Health

Facilities Act ” at the end and substituting “an integrated community

health services centre within the meaning of the Integrated

Community Health Services Centres Act, 2023 ”.

Quality

of Care Information Protection Act, 2016

81 Clause (

d) of the

definition of “health facility” in subsection 2 (1) of the Quality of Care Information Protection Act, 2016 is

repealed and the following substituted:

(

d) an

integrated community health services centre within the meaning of the Integrated Community Health Services Centres Act, 2023 ,

Regulated Health Professions Act, 1