Significant Health System Changes in Effect December 2, 2019

December 5, 2019 | Kathryn M. Frelick, Karima Kanani, Kristen Vandenberg

The past several weeks have been busy for the Ontario health industry, as the Government of Ontario has implemented a number of changes under the Connecting Care Act, 2019, S.O. 2019 and introduced legislative amendments in its quest to build a connected health care system. The following changes took effect on December 2, 2019.

Transfer Orders

The Ministry of Health has issued Transfer Orders pursuant to s. 40 under the Connecting Care Act, 2019.

Consolidation of Provincial Agencies

The first set of Transfer Orders issued by the Ministry of Health integrated multiple provincial agencies into Ontario Health, specifically, Cancer Care Ontario, Health Quality Ontario, eHealth Ontario, Health Shared Services Ontario, and HealthForceOntario Marketing and Recruitment Agency.

The Transfer Orders provided for the transfer of “all assets, liabilities, rights and obligations, and all records relating thereto” and “all employees […] and related records, rights and obligations” to Ontario Health.

Partial Transfer of LHIN Employees

On the heels of the agency transfers, the Ministry of Health issued a second set of Transfer Orders to all fourteen Local Health Integration Networks (“LHINs”). These Transfer Orders directed the transfer of certain management positions (other than CEOs) from each LHIN to Ontario Health.

The full text of the Transfer Orders for each of the transferring provincial agencies and LHIN employees are publicly available and can be accessed on both the Ministry of Health and Ontario Health websites.

Changes to Legislation

Regulations were also passed that took effect December 2nd.

Additional Objects for Ontario Health

A new Regulation 376/19 (Additional Objects of the Agency) under the Connecting Care Act, 2019 sets out additional prescribed objects for Ontario Health pursuant to section 6(i) of the Act as follows:

  • Providing shared services to LHINs, approved agencies under the Home Care and Community Services Act, 1994 and placement co-ordinators under the Long-Term Care Homes Act, 2007
  • Conducting or funding research programs that are specified in the accountability agreement between Ontario Health and the Minister

“Shared services” are defined under the Regulation to include the following:

  • Human resource management, including employee benefits and assistance
  • Labour relations and collective bargaining
  • Oversight and management of provincial patient care technology platforms
  • Finance and administration, including accounts payable and inventory management
  • Communications and public relations
  • Support for policy development and implementation and quality improvement

Changes to PHIPA

Provisions have also been added to Regulation 329/04 (General) under the Personal Health Information Protection Act, 2004, S.O. 2004 (“PHIPA”), the effect of which is as follows:

  • Ontario Health has assumed certain responsibilities of eHealth Ontario under the Regulation in respect of administrative, technical and physical safeguards, practices and procedures to protect the privacy of individuals to whom it provides services.
  • Ontario Health, having assumed the operations, activities and affairs of eHealth Ontario, is subject to the same requirements as eHealth Ontario in respect of creating or maintaining electronic health records, as set out in the regulation.
  • Ontario Health is a “prescribed person” under section 13(1) of the regulation, meaning that health information custodians (“HICs”) may disclose personal health information (“PHI”) to Ontario Health for the purposes of the Ontario Cancer Screening Registry.
  • Ontario Health is a “prescribed entity” under section 18(1) of the regulation, meaning HICs may disclose PHI to Ontario Health for the purpose of analysis or compiling statistical information with respect to the management, evaluation or monitoring of, the allocation of resources to or planning for the health system, including the delivery of services. As a prescribed entity, Ontario Health will also be subject to the same safeguards and protections as other prescribed entities under PHIPA.

More Legislative Amendments to Come

The Government of Ontario has passed a number of other legislative amendments that have not yet come into force. Miller Thomson will continue to monitor these developments. Look for future updates through our Health Communiques or join our Health System Transformation webinar series mailing list for regular updates and advice to support your organization’s health transformation journey.


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