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CONFIDENTIAL
GOV2018.193.B


Health System Ef?ciency Act, 2019

EXPLANATORY NOTE

[Explanatory note will be added in later draft]

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Bill 201 9

An Act to create ef?ciencies in the health system, to establish the
Super Agency and to make consequential and related
amendments

[Placeholder for Table of Contents]

Her 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
2. (1) Subject to subsections (2) and (3), 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 Health System
Ef?ciency Act, 2019.

Note: I ?m proposing to set this up as an omnibus Act with several
Schedules. It sounds like there will be more than enough content
to justify this approach.

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SCHEDULE 1
SUPER AGENCY ACT, 2019

[Placeholder for Table of Contents]

Note: ?Super Agency? is arsed in this draft as a placeholder for the
Agency name.

Note: Since things are probebtv stilt going to move around, I ?ve
ant}? bothered mtmbering the ?rst two sections and Parts. All
cross-references to other sections are placeholders. I have tried to
highlight them in green and to indicate the Izeadaote ofthe cross-
referenced section in each such cross-reference.

PART I
INTERPRETATION AND GENERAL

Interpretation
1. (1) In this Act,

?accountability agreement? means the accountability agreement that
the Minister and the Super Agency are required to enter into
under subsection 26 (1) (?entente de responsabilisation?)

?health sector organization? means,

a hospital within the meaning of the Public
Hospitals Act,

a licensee Within the meaning of the Long-Term
Care Homes Act, 200 7,

a local health integration network, but only
with respect to,

professional services, personal support
services and homemaking services as de?ned in
the Home Care and Commth Services Act, 1994
provided by or arranged by a local health
integration network under that Act,

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(ii) the placement of a person into,

(A) a long?term care home within
the meaning of the Long- erm Care
Homes Act, 2007,

(B) a supportive housing program
funded by the Ministry of Health and
Long?Term Care or a local health
integration network under the Home
Care and Community Services Act, 1994,

(C) a chronic care or
rehabilitation bed in a hospital within the
meaning of the Public Hospitais Act, or

(D) an adult day program that is
provided under the Home Care and
Community Services Act, .7994, or

. any other services that are prescribed,
and

any other organization that is provided for in
the regulations and that receives public funding;
'(?organisme du secteur de la sant??)

?health service provider? has the meaning set out in subsection 
(?fournisseur de services de sant??)

?integrate? includes,

to co-ordinate services and interactions between
different persons and entities,

to partner with another person or entity in
providing services or in operating,

(0) to transfer, merge or aerial gamete services,
operations, persons or entities,

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to start or cease providing services,

to cease to Operate or to dissolve or wind up the
operations of a person or entity,

and ?integration? has a similar meaning; (?i11t?grer?, ?int?gration?)

?integrated care delivery system? means a person or entity, or a
group of persons or entities, designated under subsection 9 


?local health integration network? means a local health integration
network as de?ned in section 2 of the Local Health Integration
Act, 2006, and if that Act has been repealed, means such a
as it was de?ned immediately before the repeal; (?r?seau
local d?int?gration des services de sant??)

[does this work?

?patient ombudsman? means the patient ombudsman appointed
under Part xx.1; (?ombudsman des patients?)
[may decide to move this to be Port-specific}

?personal health information? has the same meaning as in the
Personai Health Information Protection Act, 2004;
(?renseignements personnels sur la sant??)

?personal information? has the same meaning as in the Freedom of
Information cited Protection of Privacy Act; (?renseignements
personnels?)

?Minister? means the Minister of Health and Long-Term Care or
such other member of the Executive Council to whom the
administration of this Act is assigned under the Executive
Coaacii Act; (?ministre?)

?Ministry? means the Ministry of the Minister; (?ministere?)

?operational plan? means the plan that the Super Agency develops
under section 23; (?plan de services de sant? int?gr?s?)

?personal health information? has the same meaning as in section 4

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of the Personal Health Information Protection A ct, 2004;
(?renseignements personnels sur la sant??)

?prescribed? means prescribed by the regulations; (?prescrit?)

?provincial strategic plan? means the provincial strategic plan
developed by the Minister under section 8.1 of the Ministry of
Health and Loag~Term Care Act; 

?regulations? means the regulations made under this Act;
(?reglements?)

?service accountability agreement? means the service accountability
agreement that the Super Agency is required to enter into with a
health service provider or an integrated care delivery system
under section 28; (?entente de responsabilisation en mattere de
services?)

?Super Agency? means the corporation continued by section 4.


Health service provider
(2) In this Act,

?health seivice provider? means the following persons and entities:

1. A person or entity that operates a hospital within
the meaning of the Public Hospitals Act or a private
hospital Within the meaning of the Private Hospitals Act.

2. A person or entity that operates a 
facility within the meaning of the Mental Health Act
except if the facility is,

i. a correctional institution operated or
maintained by a member of the Executive Council,
other than the Minister, or

ii. a prison or penitentiaty operated or
maintained by the Government of Canada.

nntm'in an Imam/Weld}? enduVimuRn?v nq?v9t?zat?rkrir?lzp GA A A A 01 [94/901 0

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3. The University of Ottawa Heart Institute/Institut
de cardiologie de l?Universit? d?Ottawa.

4. A licensee within the meaning of the Long?Term
Care Homes Act, 200 7, other than a municipality or board
of management described in paragraph 5.

5. A municipality or board of management that
maintains a long-term care home under Part of the
Loag~Term Care Homes Act, 200 7.

6. A person or entity approved under the Home
Care and Community Services Act, 1994 to provide
services.

NTD: It?s possible this paragraph might have to change if
extensive amendments are made to the CCSA.

7. A not for pro?t entity that operates a community
health centre.

8. A not for pro?t entity that provides community
mental health and addiction services.

9. A not for pro?t entity that operates a family
health team.

10. A not for pro?t entity that operates a nurse-
practitioner-led clinic.

11. A not for pro?t entity that operates an
Aboriginal health access centre.

12. A person or entity that provides primary care
nursing services, maternal care or inter-professional
primary care programs and services.

13. A not for pro?t entity that provides palliative
care services, including a hospice.

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14. A person or entity that provides physiotherapy
services in a clinic setting that is not otherwise a health
service provider.

15. An independent health facility Within the
meaning of the Independent Health Facilities Act.

16. Any other person or entity or class of persons or
entities that is prescribed.
TC LSB Note to draft: The current prohibition on
physicians being HSPS as set out in 5.2(3) has
not been included]

Exclusion, community services

(3) A person or entity that provides, as a service provider
within the meaning of the Home Care and Community Services Act,
1994, a community service that has been purchased by a health
service provider or an integrated care delivery system, is not a health
service provider Within the meaning of this Act in respect of the
provision of the purchased service.

Delegation

2. (I) The Minister may, in writing, delegate any of the
Minister?s powers or duties under this Act or any other Act for
which the Minister is responsible, other than the power to make
regulations, to the Super Agency.

Deeming

(2) Where the Minister has made a delegation under
subsection (1), a reference in an Act or the regulations to the
Minister is deemed, with respect to the power or duty that has been
delegated, to be a reference to the Super Agency.

Integrated care delivery systems

3. Any obligation or decision that, under this Act, applies to
an integrated care delivery system applies to, and is binding on, each
constituent person or entity of the integrated care delivery system to
the extent necessary to make the obligation or decision practicable.

PART II

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SUPER AGENCY
CONTINUATION AND APPLICATION

Super Agency

4. The corporation that was incorporated under the
Corporations Act under the name Health Program Initiatives in
English and Initiatives pour les programmes de sant? in French on
the date is continued as a corporation without share capital
under the name Super Agency in English and in French.

NTD: This corporation is yet to be incorporated. Name of
establish ed corporation to be con?rmed once it is made.

Crown Agency
5. The Super Agency is an agent of the Crown and may
exercise its powers only as an agent of the Crown.

Application of other Acts
Corporations Act and Corporations Act

6. (I) The Corporations Act and the Corporations
Information Act do not apply to the Super Agency except as may be
prescribed.

Charities Accounts-2g Act
(2) The Charities Accounting Act does not apply to the Super
Agency.

No charitable property
(3) The property of the Super Agency is not charitable

property.

Non-application of single employer rule
(4) Subsection 1 (4) Of the Labour Relations Act, 1995 does
not apply to the Super Agency.

OBJECTS AND GENERAL POWERS

Objects of the Super Agency.
7. The objects of the Super Agency are,

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to implement the health system strategies
developed by the Ministry;

to manage health service needs across Ontario
consistent with the Ministry?s health system strategies to
ensure the sustainability of the Ontario health system
through.

(1) health system operational management
and coordination,

(ii) health system performance
measurement and management, evaluation,
monitoring and reporting,

health system quality improvement

(iv) clinical standards development for
patient care and quality standards for patient
safety,

(V) knowledge dissemination,

(Vi) patient engagement and patient
relations,

(vii) digital health, information technology
and data management services, and

. support of health care practitioner
recruitment and retention;

(0) to undertake and support activities related to
tissue donation and transplantation;

to support the patient ombudsman in carrying
out their functions;

to provide supply chain management services to
health serwces prowders and related organizations;

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to provide advice, recommendations and
information to the Minister and other partiCipants in the
Ontario health care system in respect of issues related to
health care that the Minister may specify;

to promote health service integration to enable
appropriate, coordinated and effective health service
delivery; and

any other prescribed objects.

Genera] powers

8. (1) Except as limited by this Act, the Super Agency has
the capacity, rights and powers of a natural person for carrying out
its objects.

Use of revenue

(2) The Super Agency shall carry out its operations without
the purpose of gain and shall not use its revenue, including all
money or assets it receives by grant, contribution or otherwise, for
any purpose other than to further its objects.

Cabinet approval
(3) The Super Agency shall not exercise the following
powers Without the approval of the Lieutenant Governor in Council:

1. Acquiring, disposing, leasing, mortgaging,
charging, hypothecating or otherwise transferring or
encumbering any interest in real property, except for
leasing office space that is reasonably necessary for the
purposes of the Super Agency.

2. Borrowing or lending money.

3. Pledging, charging or encumbering any of its
personal property.

4. Creating a subsidiary.

5. Selling any of its services, including any
analyses it has prepared of any information it has

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collected.

6. Doing anything else that is prescribed as being a
power that the Super Agency may not exercise without
such approval.

Approval of two Ministers

(3) The Super Agency shall not exercise the following 
powers without the approval of both the Minister and the Minister of
Finance:

1. Receiving money or assets from any person or
entity except the Crown in right of Ontario, with the
exception of money or assets that are received pursuant to
a transfer order.

2. Acting in association with a person or entity that
conducts any fundraising activities or programs, directly
or indirectly, for the Super Agency.

Approval of Minister
(5) The Super Agency shall not exercise the following
powers without the approval of the Minister:

1. Making charitable donations except as
authorized by this Act.

2. Applying for or obtaining registration as a
registered charity under the Income Tax Act (Canada).

3. Entering into an agreement with any person,
entity or government for the provision of services outside
Ontario.

4. Entering into an agreement with any government
or government agency outside Ontario, including the
Government of Canada or the government of a province or
territory of Canada.

No political donations
(6) The Super Agency shall not make any political donations.

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Integrated care delivery system

9. The Super Agency may designate a person or entity,
or a group of persons or entities, as an integrated care delivery
system.

Restriction
(2) The Super Agency shall not make a designation under
subsection (1) unless,

any prescribed conditions or requirements have
been met; and

the person, entity or group of persons or entities has the ability

to deliver, in an integrated and coordinated manner, at
least two of the following types of health services to a
patient:

hospital services,

(ii) primary care services,

mental health or addictions services,

(iv) home care or community services,

long-term care home services,

(vi) palliative care services,

(vii) any other prescribed health care
service.

Publication

(3) The Super Agency shall publish a list of integrated care
delivery systems that have been designated under subsection (1) on
its website.

BOARD OF DIRECTORS, CHIEF EXECUTIVE OFFICER AND
EMPLOYEES

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Board of Directors

10. (I) The Super Agency shall consist of not more than 15
members appointed by the Lieutenant Governor in Council who
shall form the board of directors of the Super Agency.

Term

(2) Subject to subsection (3), the following provisions apply
respecting the term of members of the board of directors of the
Super Agency:

1. Each member shall hold of?ce for a term of up
to three years at the pleasure of the Lieutenant Governor in
Council and may be reappointed for any number of terms
of up to three years.

2. Despite paragraph 1, no person may be a
member for more than six years in total,

3. Despite paragraph 2, a member who is
designated as chair under subsection (7) after serving at
least three years as a member may, despite anything else
in subsection (7), be appointed for one further term of up
to three years while designated as chair.

Termination
(3) A member ceases to be a member of the Super Agency if,
before the term of the member expires,

the Lieutenant Governor in Council revokes the
member?s appointment; or

the member dies, resigns as a member of the
board of directors or becomes a bankrupt.

Successor?s term

(5) If a person ceases to be a member of the board of
directors before the term of the member expires, the ?rst term of the
person?s successor shall be for the remainder of the ?rst person?s
term.

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i

Expenses

(6) The members of the Super Agency shall receive the
remuneration and reimbursement for reasonable expenses that the
Lieutenant Governor in Council determines.

Chair

(7) Subject to subsection (10), the Lieutenant Governor in
Council shall designate a chair from among the members of the
board of directors.

Vice-chair
(8) The board of directors may, as provided for in by-law,
designate one or more members to act as vice-chairs.

Chair?s role
(9) The chair shall preside over the meetings of the board of
directors.

Vice-chair

(10) If the chair is absent or otherwise unable to act or if the
of?ce is vacant, a vice-chair has all the powers and shall perform the
duties of the chair.

Absence of chair and vice-chairs

(l 1) In the absence of the chair and, if applicable, the vice?
chairs, a director that the board of directors designates shall act as
the chair.

Where no designation

(12) If the Lieutenant Governor in Council has not designated
a chair, the members of the board of directors may select a chair
from among their members to hold of?ce as provided for by by-law,
until such time as the Lieutenant Governor in Council makes a
designation.

Board meetings

11. (1) The board of directors of the Super Agency shall
meet regularly throughout the year and in any event shall hold at
least four meetings in each calendar year.

Quorum

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(2) A majority of the board of directors constitutes a quorum
for the conduct of the business of the board.

Chief Executive Of?cer
12. I) The Super Agency shall appoint and employ a chief
executive of?cer.

Role

(2) The chief executive of?cer is responsible for the
management and administration of the affairs of the Super Agency,
subject to the supervision and direction of its board of directors.

Restriction
(3) The chief executive of?cer shall not be a member of the
board of directors of the Super Agency.

Transition

(4) A chief executive of?cer who held of?ce in the Super
Agency that was incorporated under the Corporations Act under the
name Health Program Initiatives in English and Initiatives pour les
programmes de sant? in French immediately before the coming into
force of this section continues to hold that office in the Super
Agency until their position otherwise ends.

Remuneration

(5) The Minister may ?x ranges for the salary or other
remuneration and bene?ts of a chief executive of?cer and the Super
Agency shall provide a salary or other remuneration and bene?ts to
its chief executive of?cer within the ranges, if any, that the Minister
?xes.

Other employees

13. (I) The chief executive of?cer may appoint and employ
such employees as are considered necessary for the prOper conduct
of the affairs of the Super Agency.

Same

(2) Any employees who were employed by the corporation
that was incorporated under the Corporations Act under the name
Health Programs Initiatives in English and Initiatives pour les
programmes de sant? in French immediately before the coming into

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force of this section continue to be employees of the Super
Agency until their employment otherwise ends.

TD: Name of corporation to be con?rmed.
AFFAIRS OF THE SUPER AGENCY

Affairs of Super Agency
14. (1) The affairs of the Super Agency are under the
management and control of its board of directors.

Delegation

(2) The board of directors may delegate any of its powers or
duties under this Act or any other Act to such employees of the
Agency as the board considers appropriate and may impose
conditions and restrictions with respect to the delegation.

Bya-laws and resolutions

15. (1) Subject to subsections (4) and (5), the board of
directors may make by-laws and pass resolutions regulating its
proceedings and generally for the conduct and management of the
affairs of the Super Agency, including establishing committees.

Of?cers

(2) Without limiting the generality of subsection (1), the
board of directors may make lay-laws or pass resolutions to appoint
of?cers and assign to them such powers and duties as the board
considers appropriate. A

Committees
(3) The board of directors of the Super Agency shall,

establish, by by-law, the committees of the
board that the Minister, by regulation, specifies;

appoint as members of those committees the
persons who meet the quali?cations, if any, that the
Minister speci?es in the regulation; and

ensure that those committees operate in

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accordance with the other requirements, if any, that
the Minister speci?es in the regulation.

Minister?s approval 
(4) The Minister may require the board of directors to submit
. a. proposed by?law to the Minister for approval before making the
by-law concerned and if so, the board shall not make the by-law
concerned until the Minister approves it.

Same, after making
(5) The Minister may require the board of directors to submit
a by-law to the Minister for approval and if so,

the lay?law concerned ceases to be effective
from the time that the Minister imposes the requirement
until the Minister approves the by-law;

anything that the board has done in compliance
with the by-law concerned before the Minister imposes the
requirement is valid; and

the board may do anything that, before the
Minister imposes the requirement, it has agreed to do.

LIABILITY, INDEMNIFICATION AND JUDGMENTs

Duty of care and indemnification

17. (1) Subject to subsection (2), subsection 134 (1) and
section 136 of the Business Corporations Act apply with necessary
modi?cations to the Super Agency, its board of directors and its
of?cers.

Approval of indemnity

(2) The Super Agency shall not give an indemnity under
section 136 of the Business Corporations Act to any person unless
the indemnity has been approved in accordance with section 28 of
the Financia! Administration Act.

Unpaid judgments against the Super Agency
18. The Minister of Finance shall pay from the Consolidated

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Revenue Fund the amount of any judgment against the Super
Agency that remains unpaid after the Super Agency has made all
reasonable efforts, including liquidating its assets, to pay the amount
of the judgment. .

DIRECTIVES AND STANDARDS

Directives by Minister

19. (1) Where the Minister considers it to be in the public
interest to do so, the Minister may issue operational or policy
directives to any or all of the following:

1. The Super Agency.
2. A health service provider.
3. An integrated care deliver system.

Included power

(2) For greater certainty, and Without in any way restricting
the generality of subsection (1), the power to make operational and
policy directives under that subsection includes the-pOWer to make
directives requiring a health service provider or integrated care
delivery system to use the procurement and supply chain services
provided by the Agency or another speci?ed organization.

Binding

(3) The Super Agency, health service provider or integrated
care delivery system shall comply with every directive of the
Minister.

General or particular

(4) An operational or policy directive of the Minister may be
general or particular in its application.
Non?application of Legislation Act, 2006

(5) Part (Regulations) of the Legislation Act, 2006 does
not apply to operational or policy directives.

Public availability

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(5) The Minister shall publish every directive under this
section on a website.

Law prevails

(6) For greater certainty, in the event of a con?ict between a
directive issued under this section and a provision of any applicable
Act or role of any applicable law, the Act or rule prevails.

Provincial standards

20. The Minister may issue provincial standards for the
provision of health services that are provided or arranged by health
service providers or integrated care delivery systems where the
Minister considers it to be in the public interest to do so.

General or particular
(2) A standard of the Minister may be general or particular in
its application.

Obligations re standards

(3) Every health service provider and integrated care delivery
system to which a standard under this section is directed shall
comply with the standard.

Non-application of LegislationAct, 2006
(4) Part (Regulations) of the Legislation Act, 2006 does
not apply to a standard under this section.

Resolving differences over priorities

(5) If a standard of a health service provider or an integrated
care delivery system con?icts with a provincial standard, the
provincial standard prevails.

Same

(6) In the event of a con?ict between a standard issued under
this section and a provision of any applicable Act or rule of any
applicable law, the Act or rule prevails.

Public availability

(7) The Minister shall publish every standard under this
section on a website.

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Fiscal year
21.1 The ?scal year of the Super Agency commences on
April 1 in each year and ends on March 31 of the following year.

Audits and appointment of Auditor
Audit

22. (1) The board of directors of the Super Agency shall
appoint an auditor licensed under the Public Accounting Act, 2004 to
audit the accounts and ?nancial transactions of the Super Agency
annually.

Other audits
(2) In addition to the requirement for an annual audit,

the Minister may, at any time, review or audit
any aspect of the operations of the Super Agency; and

the Auditor General may, at any time, audit any
aspect of the operations of the Super Agency.

Consultations

24. (1) The Super Agency, integrated care delivery systems
and health service providers shall establish mechanisms for
consulting with patients, families, caregivers, health sector
employees and others as part of their operational planning processes
in accordance with the regulations, if any.

Duties

(2) As part of the consultation mechanisms under subsection
(1), the Super Agency shall engage, with respect to the matters
provided for in the regulations,

the prescribed Indigenous health planning
entities; and

the prescribed French language health planning
entitiesPage 23 of81

PART 
FUNDING AND ACCOUNTABILITY

Funding of Super Agency

25. The Minister may provide funding to the Super
Agency on the terms and conditions that the Minister considers
appropriate.

Savings

(2) When determining the funding to be provided to the
Super Agency under subsection (1) for a ?scal year, the Minister
shall consider Whether to adjust the funding to take into account a
portion of any savings from ef?ciencies that the Super Agency
generated in the previous ?scal year and that the Super Agency
proposes to spend on patient care in subsequent ?scal years[in
accordance with the accountability agreement.

Accountability of Super Agency
26. (1) The Minister and the Super Agency shall enter into
an accountability agreement in respect of the health system.

Accountability agreement g.
(2) The accountability agreement shall be for more than one i
?scal year and shall include,

performance goals and objectives for the Super
Agency and the health system;

performance standards, targets and measures for
the Super Agency and the health system;

requirements for the Super Agency to report on
the performance of the Super Agency and the health
system;

(01) a plan for spending the funding that the Super
Agency receives under section 25, which spending shall
be in accordance with the appropriation from which the
Minister has provided the funding to the Super Agency;

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a progressive performance management process
for the Super Agency; and

all other prescribed matters, if any.

If no agreement

(3) If the Minister and the Super Agency are unable to
conclude an accountability agreement through negotiations, the
Minister may set the terms of the agreement which shall include the
matters set out in clauses (2) to 

Reports to Minister

(4) The Super Agency shall provide to the Minister, within
the time and in the form that the Minister specifies, the plans,
reports, ?nancial statements, including audited ?nancial statements,
and information, other than personal health information, that the
Minister requires for the purposes of administering this Act.

Publication
(5) The Super Agency shall publish a current copy of the
accountability agreement on its website.

Funding

27. (1) The Super Agency may provide funding to a health
service provider or integrated care delivery system in respect of
services that the service provider or delivery system provides.

Non-health services

(2) The Super Agency may provide funding to a health
service provider, integrated care delivery system or other person or
entity in respect of non?health services.

Terms and conditions

(3) The funding that the Super Agency provides under this
section shall be on the terms and conditions that the Super Agency
considers appropriate and in accordance with the funding that the
Super Agency receives under section 25, the Super Agency?s
accountability agreement and the prescribed requirements, if any.

Assignment of agreements
(4) The Minister may assign to the Super Agency, integrated

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care delivery system, or another person or entity the
Minister?s rights and obligations under all or part of an agreement
between the Minister and a health service provider, an integrated
care delivery system or a person or entity that supports the provision
of health care, including an agreement to which a person or entity
that is not a health service provider, an integrated care delivery
system or a person or person or entity that supports the provision of
health services is also a party.

Termination date

(5) In an assignment under subsection (4), the Minister may
provide that the agreement, or the part of it assigned, terminates on
the earliest of,

the date set out in the agreement;

the date that the Super Agency and the health
service provider, integrated care delivery system or person
or entity that supports the provision of health care enter
into a service accountability agreement; and

the date, as the Minister specifies, that the Super
Agency and the health service provider, integrated care
delivery system or person or entity that supports the
provision of health care have to enter into a service
accountability agreement.
[please review, I am losing track of who all has to do who: here]

Service accountability agreement

28. Where the Super Agency proposes to provide funding to
a health service provider, integrated care delivery system or other
person or entity or amend a service accountability agreement with a
health service provider, integrated care delivery system or other
person or entity, the Super Agency and the provider, system, person
or entity shall enter into a service accountability agreement or amend
such an agreement in accordance with the requirements provided for
in the regulations, if any.

No restriction on patient mobility
29. (1) None of the following shall enter into any agreement

nn?mrin A A A manmo

Page 26 of 81 

or other arrangement that restricts or prevents an individual
from receivmg servrces based on the geographic area in which the
indiv1dual res1des:

1. The Super Agency.
2. A health service provider.
3. An integrated care delivery system.

4. Any other person or entity that receives funding
under section 27.

Geographic restrictions for homecare services

(2) For greater certainty, subsection (1) applies to a service
accountability agreement in respect of ?nding provided by the
Super Agency for the delivery of services by a health service
provider or an integrated care delively system under section 28, but
it does not apply to any agreement entered into under the Home Care
and Community Services Act, 1994 that requires a health service
provider or integrated care delivery system to deliver services in a
speci?ed geographic area.

Audits, reviews, etc.

30. The Super Agency may at anytime direct that any health
service provider, integrated care delivery system or other person or
entity that receives funding from the Super Agency under section 27,

engage or permit one or more auditors licensed
under the Public Accounting Act, 2004 to audit the
accounts and ?nancial transactions of the health service
provider, integrated care delivery system or person or
entity; or

engage in or permit an operational review or
peer review of the activities of the health service provider,
integrated care delivery system or person or entity.

Information and reports

31. (1) The Super Agency may require that any health 
service provider, integrated care delivery system or other person or 

01/24/2019

Page 27 of 81

entity to which the Super Agency provides funding or
proposes to provide funding under section 27 provide to the Super
Agency the plans, reports, ?nancial statements and other
information, other than personal health information, that the Super
Agency requires for the purposes of exercising its powers and duties
under this Act or for the purposes that are prescribed.

Form of reports

(2) A health service provider, integrated care delivery system
or other person or entity that is required to provide plans, reports,
?nancial statements or information under subsection (1) shall
provide them within the time and in the form that the Super Agency
specifies.

Disclosure of information

(4) The Super Agency may disclose information that it
collects under this section to the Minister, if the Minister requires the
information for the purposes of exercising powers and duties under
this Act.

Investigators

31.1 (1) The Super Agency may, where it considers it in the
public interested to do so, appoint one or more investigators to
investigate and report on,

the quality of the management of a health
service provider, integrated care delivery system or other
person or entity that receives ?mding under section 27;

the quality of the care and treatment of persons
by a health service provider or an integrated care delivery
system that receives ?lnding under section 27; or

any other matter relating to a health service
provider, integrated care delivery system or other person
or entity that receives funding under section 27,

Exclusion

(2) Subsection (1) does not apply to a licensee within the
meaning of the Long-Term Care HOMES Act, 2007, and Where a
licensee within the meaning of that Act is among the persons or

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Page 28 of 81

entities comprising an integrated care delivery system, this
section only applies to the services and operations of the delivery
system that are not governed under that Act.

Notice of appointment

(3) Before appointing an investigator, the Super Agency shall
give notice of its intention to appoint an investigator to the Minister 
and the health service provider, integrated care delivery system or
person or entity.

Powers
(4) An investigator may, without a warrant and at reasonable
times,

enter the premises of a health service provider,
integrated care delivery system or person or entity that
may be investigated under this section;

subject to subsection (5), enter any premises
where a health service provider, integrated care delivery
system or person or entity that may be investigated under
this section provides services; and

inspect the premises, the services provided on
the premises and the records that the investigator
determines are relevant to the investigation.

Dwellings
(5) No investigator shall enter a place that is being used as a
dwelling, except with the consent of the occupier.

Identi?cation
(6) An investigator conducting an investigation shall
produce, on request, evidence of their appointment.

Powers of investigator conducting investigation
(7) An investigator conducting an investigation may,

require the production of records or anything

else that the investigator determines is relevant to the
investigation, including books of account, documents,

01/24/2019

Page 29 of 8]

bank accounts, vouchers, correspondence and
payroll records, records of staff hours worked and records
of personal health information;

examine and copy any record or thing required
under clause 

(0) upon giving a receipt and showing the evidence
of appointment, remove a record or anything else that is
relevant to the investigation for review or copying, as long
as the review or COpying is carried outwith reasonable
dispatch and the record or thing is returned;

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; and

question a person on matters the investigator
determines are relevant to the investigation.

Obligation to produce and assist

(8) If an investigator requires the production of a record or
anything else that the investigator determines is relevant to the
investigation under this section, any of the following 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:

1. The health service provider, integrated care
delivery system or other person or entity that may be
investigated under this section.

2. Any person employed by the provider, system,
person or entity.

3. Any person performing services for the provider,
system, person or entity.

Obligation to comply with questioning
(9) A person who is questioned by an investigator under clause (Page 30 of 81

shall co-operate fully with the investigator.

Same
(10) If an investigator accesses personal health information
under subsection (9), the investigator,

shall not collect, use or disclose the personal
health information if other information will serve the
purpose of the inspection;

shall not collect, use or disclose more personal
health information than is reasonably necessary for the
purpose of the inSpection; and

shall comply with any conditions or
requirements that may be prescribed.

Con?dentiality

(11) An investigator and the investigator?s agents shall keep
con?dential all information that comes to the investigator?s
knowledge in the course of an investigation under this Act and shall
not communicate any information to any other person except as
required by law or except where the communication is to the Super
Agency or a person employed in or performing services for the
Super Agency.

Report of investigator
(12) The investigator shall, upon completion of an
investigation, make a report in writing to the Super Agency.

Die-identification of personal health information

(13) Before providing a report to the Super Agency under I
subsection (12), the investigator shall ensure that all personal health 
information is de?identi?ed. 

Same

(14) The Super Agency shall cause a copy of the report of an
investigation, with all personal health information tie-identi?ed, to
be delivered to the health service provide, integrated care delivery
system or other person that is the subject of the investigation.

.. 01/24/201 9

Page3l of81

Public availability
(15) The Super Agency shall make every report of an
investigation available to the public.

Supervisor

31.2 (1) On the recommendation of the Minister, the
Lieutenant Governor in Council may appoint a person as a
supervisor of a health service provider or an integrated care delivery
system Where the Lieutenant Governor in Council considers it in the
public interest to do so.

Notice of appointment

(2) The Minister shall give the health service provider or
integrated care delivery system at least 14 days notice before
recommending to the Lieutenant Governor in Council that a
supervisor be appointed.

Immediate appointment

(3) Subsection (2) does not apply in respect of a health
service provider or integrated delivery system that is governed by a
board if there are not enough members on the board to form a
quorum.



Term of of?ce
(4) The appointment of a supervisor is valid until terminated
by order of the Lieutenant Governor in Council.

Powers of supervisor

(5) Unless the appointment provides otherwise, a supervisor
has the exclusive right to exercise all of the powers of a health
service provider or integrated care delivery system and, where the
health service provider or integrated care delivery system is owned
or operated by a corporation, of the corporation, its board, its
officers, members and shareholders.

Same

(6) The Lieutenant Governor in Council may specify the
powers and duties of a supervisor appointed under this section and
the terms and conditions governing those powers and duties.

Additional powers of supervisor

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Page 32 of 81

(7) If, under the order of the Lieutenant Governor in Council,
the board of a health service provider or integrated care delivery
system continues to have the right to act with regard to any matters,
any such act of the board is valid only if approved in writing by the
supervisor.

Right of access

(8) A supervisor appointed for a health service provider or an
integrated care delivery system has the same rights as the board and
the administrator of the provider or system in respect of the
documents, records and information of the provider or system.

Report to Minister
(9) A supervisor shall report to the Minister as required by the
Minister.

Disclosure
(10) The Minister shall make any report provided to the
Minister under subsection (9) public.

Personal health information to be removed
(11) Before making the report public, the Minister shall
ensure that all personal health information in the report is redacted.

Minister?s directions
(12) The Minister may issue directions to a supervisor with
regard to any matter within the of the supervisor.

Directions to be followed
(13) A supervisor shall carry out every direction of the
Minister.

PART VI
INTEGRATION

De?nition
32. In this Part,

?facilitation decision? means a decision of the Super Agency under

.ca/owa/WebReadyViewB 01/24/2019

section 35;
66' 9?
integration demsron means,
a facilitation decision;

an integration order by the Minister under
section 36; or

a decision by the Minister under subsection 3 8
(8) that orders a health service provider not to proceed
with the integration described in the decision.

?service? includes,

a service or program that is provided directly to
people,

a service or program, other than a service or
program described in clause that supports a service or
program described in that clause, or

a function that supports the operations of a
person or entity that provides a service or program
described in clause or 

Identifying integration opportunities

33. The Super Agency and each health service provider and
integrated care delivery system shall separately and in conjunction
with each other identify opportunities to integrate the services of the
health system to provide appropriate, co-ordinated, effective and
ef?cient services.

Integration by Super Agency
34. The Super Agency may integrate the health system

by,
providing or changing funding to a health

service provider or integrated care delivery system under
section 27;

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Page 33 of81

01/94/9010

Page 34 of 81

facilitating and negotiating,

the integration of persons or entities
where at least one of the persons or entities is a
health service provider or integrated care delivery
system, or

(ii) the integration of services between
health service providers or integrated care delivery
systems or between a provider or a system and a
person or entity that is not a provider or a system;

Facilitation decision
35. The Super Agency shall issue a facilitation decision when
the Super Agency facilitates or negotiates,

the integration of persons or entities where at
least one of the persons or entities is a health service
provider or an integrated care delivery system, or

the integration of services between health
service providers or integrated care delivery systems or
between a health service provider or integrated care
deliver system and a person or entity that is neither a
health service provider nor an integrated care delivery
system and the parties reach an agreement with respect to
that integration.

Required integration

36. (1) The Minister may, if the Minister considers it in the
public interest to do so and subject to the other provisions of this
section, order one or more health service providers or integrated care
delivery systems that receives funding from the Super Agency and
that carry on operations on a for pro?t or not for pro?t basis to do
anything to integrate the health system on or after the date set out in
the order, including any or all of the following:

1. To provide all or part of a service or to cease to
provide all or part of a service.

2. To provide a service to a certain level, quantity

.. 01/24/201 9

Page 35 ot?81

or extent.

3. To transfer all or part of a service from one
location to another.

4. To transfer all or part of a service to or to receive
all or part ofa service from another person or entity.

5. To carry out another type of integration of
services that is prescribed.

6. To cease operating, to dissolve or to wind up its
Operations.

7. To amalgamate with one or more health service
providers or integrated care delivery systems that receive
funding from the Super Agency under subsection 27 

8. To transfer all or substantially all of its
operations to one or more persons or entities.

.9. To do anything or refrain from doing anything
necessary for them to achieve anything under any of
paragraphs 1 to 8, including to transfer property to or to
receive prOperty from another person or entity in respect
of the services or operations affected by the decision.

Restrictions
(2) Despite subsection (1), the Minister shall not,

issue an order under that subsection that
unjusti?ably, as determined under section 1 of the
Canadian Charter ofRigitts and Freedoms, requires a
religious organization to provide a service that is contrary
to the religion related to the organization;

issue an order under that subsection that
requires the transfer of preperty held for a charitable
purpose to a person or entity that is not a charity;

issue an order under that subsection that

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Page 36 of81

requires a person or entity that is not a charity to
receive property from a person or entity that is a charity
and to hold the property for a charitable purpose;

issue an order under that subsection to a board
of management described in paragraph 5 of the de?nition
of?health service provider? in subsection 1 (2) or a
municipality;

issue an order under that subsection to a health
service provider described in paragraph 4 of the definition
of ?health service provider? in subsection 1 (2), if the
service provider is not also described in another paragraph
of that de?nition;

[for now I have removed the reference to icds here, since it seems
to me that it would be caught in its capacity as an trap in the
situation you described. Ifyoa have doubts, let me know and I will
try to draft it thro ugh]

(0 issue an order under paragraph 1 of that
subsection, in respect of the operation of a long-term care
home, to a health service provider described in paragraph
4 of the de?nition of ?health service provider? in
subsection 1 (2), if the service provider or is also
described in another paragraph of that de?nition;

issue an order under paragraph 2 of that
subsection to a health service provider or integrated care
delivery system that carries on operations on a not for
pro?t basis to amalgamate with one or more health service
providers or integrated care delivery systems that carries
on operations on a for pro?t basis;

issue an order under paragraph 3 of that
subsection to a health service provider or integrated care
delivery systems that carries on operations on a not for
pro?t basis to transfer all or substantially all of its
operations to one or more persons or entities that carries
on operations on a for pro?t basis; or

01/24/2019

Page 37 of 81

issue an order under that subsection that require
a health service provider or integrated care delivery
system to do anything else that is prescribed.

Notice of proposed order

(3) At least 30 days before issuing an order under subsection
(1), the Minister shall,

notify a health service provider or integrated
care delivery system that the Minister intends to issue the
order;

provide a copy of the proposed order to the
service provider or delivery system; and

publish the proposed order on a website.

Submissions

(4) Any person may make written submissions about the
preposed order to the Minister no later than 30 days after the
Minister publishes the proposed order on a website.

Issuing a decision

(5) If at least 30 days have passed since the Minister gave the
notice required under subsection (3) and after the Minister has
considered any written submissions made under subsection (4), the
Minister may issue an integration order under subsection (1), and
subsections (3) and (4) do not apply to the issuance of the order.

Variance

(6) An integration order mentioned in subsection (5) may be
different from the proposed decision that was the subject ofthe
notice mentioned in subsection (3).

Compliance
36.1 (1) A person or entity that is a party to an integration
order shall comply with it.

Corporate powers

(2) Despite any Act, regulation or other instrument related to
the eclporate governance of a corporation that is subject ?AOhotl bat/7m 

Page 38 of81

integration order, including the Business Corporations Act,
the Corporations Act, any articles of incorporation, any letters
patent, any supplementary letters patent or any by-laws, the
corporation shall be deemed to haVe the necessary powers to comply
with the order, as the case may be, and for greater certainty, a
corporation shall comply with an integration order despite any
requirement for any meeting or approval of any member,
shareholder or director of a corporation under any Act, regulation, or
other instrument related to the corporate governance of the
corporation.

Court order

(3) The Minister may apply to the Superior Court of Justice
for an order directing a person or entity that is a party to an
integration order to comply with it.

Transfer of property held for charitable purpose

36.2 (I) If an integration order made under section 36 directs
a health service provider or integrated care delivery system to
transfer to a transferee property that it holds for a charitable purpose,
all gi?s, trusts, bequests, devises and grants of property that form
part of the property being transferred shall be deemed to be gifts,
trusts, bequests, devises and grants of property to the transferee.

Speci?ed purpose

(2) If a will, deed or other document by which a gift, trust,
bequest, devise or grant mentioned in subsection (1) is made
indicates that the property being transferred is to be used for a
speci?ed purpose, the transferee shall use it for the speci?ed

purpose.

Application 

(3) Subsections (1) and (2) apply whether the will, deed or
document by which the gift, trust, bequest, devise or grant is made,
is made before or after this section comes into force.

No compensation

36.3 (1) Despite any other Act and subject to subsection (3),
no health service provider, integrated care delivery system or other
person or entity is entitled to any compensation for any loss or
damages, including loss of revenue or loss of pro?t, arising from any

01/24/2019

Page 39 of 81

direct or indirect action that the Minister or the Agency takes
under this Act, including an integration order made under section 36.

Same, transfer of property

(2) Despite any other Act and subject to subsection (3), no
person or entity, including a health service provider or integrated
care delivery system is entitled to compensation for any loss or
damages, including loss of use, loss cf revenue and loss of pro?t,
arising from the transfer of property under an integration order made
under section 36.

Exception

(3) If an integration order made under section 36 directs a
health service provider or integrated care delivery system to transfer
property to or to receive property from a person or entity, a person or
entity, including a health service provider or integrated care delivery
system, who suffers a loss resulting from the trans fer is entitled to
compensation as prescribed in respect of the portion of the loss that
relates to the portion of the value of the property that was not
acquired with money received from the Government of Ontario, the
Super Agency, or any other agency of the Government, whether or
not it is a Crown agent.

No expropriation

(4) Nothing in this Act and nothing done or not done in
accordance with this Act constitutes an expropriation or injurious
affection for the purposes of the ExpropriationsAct or otherwise at
law.

Rules re integration decisions
Prohibition

37. (1) No integration decision shall permit a transfer of
services that results in a requirement for an individual to pay for
those services, except as otherwise permitted by law.

Form of decision
(2) An integration decision shall set out,

the purpose and nature of the integration or
proposed integration 

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Page 40 of 81

the parties to the decision;

the actions that the parties to the decision are
required to take or not to take, including any time period
for doing so;

a requirement that the parties to the decision
develop a human resources adjustment plan in respect of
the integration;

the effective date of all transfers of services
involved in the integration, if any; and

any other matter that the Super Agency or the
Minister, as the case may he, considers relevant.

Notice of decision

(3) On issuing an integration decision, the Super Agency or
the Minister, as the case may he, shall give the decision to the parties
to the decision and publish it on a website.

Non-application of other Act
(4) The Statutory Powers Procedure Act does not apply to an
integration decision.

Not a regulation
(5) An integration decision is not a regulation as de?ned in
Part (Regulations) of the Legislation Act, 2006.

[for new, dropped the amendment and revocation provisions, as
they had become very complicated to work into the provisions as
they developed. They should be fairly simple to work back in once
the policy is clarified]

Integration by providers and systems

38. A health service provider or integrated care delivery
system may integrate its services with those of another person or
entity.

Application of other Act
(2) Nothing in this Act shall be interpreted as preventing the

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Page 41 of81

application of the Public Sector Labour Reiatz'ons Transition
Act, 1997, in accordance with the terms of that Act, to an integration
mentioned in subsection (1).

Notice

(3) If the integration mentioned in subsection (1) relates to
services that are funded, in whole or in part, by the Super Agency,
the health service provider or integrated care delivery system,

shall give notice of the integration to the
Minister, unless the regulations provide otherwise;

may proceed with the integration if the service
provider or delivery system is not required to give the
notice mentioned in clause 

(0) shall not proceed with the integration until 90
days have passed since giving the notice mentioned in
clause if the service provider or delivery system is
required to give the notice and the Minister does not give
notice under subsection 

shall not proceed with the integration until 90
days have passed since the Minister gives notice under
subsection (6), if,

the service provider or delivery system
is required to give notice under clause 

(ii) the Minister gives notice under
subsection (6), and

the Minister does not issue a decision
under subsection 

despite clauses and may proceed with
the integration at any time if the Minister noti?es the
provider or delivery system that the Minister does not
intend to give notice of a proposed decision under
subsection (6) or issue a decision under subsection 
and

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Page 42 ot'81

shall not proceed with the integration that is the
subject of a decision under subsection (8), if the Minister
issues such a decision.

Exceptions

(4) Subsection (3) does not apply to an integration that
requires a decision of the Minister or a director under the
Independent Health Facilities Act or the Long-Term Care Homes
Act, 2007.

Required contents
(5) A notice under clause (3) must include,

a description of the proposed integration,
including the identity of the parties involved with the
integration;

the health service provider?s or integrated care
delivery system?s analysis of any ?nancial implications,
service delivery implications, health system implication or
human resource implications of the proposed integration,
where applicable;

Where applicable, a description of any
community engagement processes that the provider or
system used to consider the proposed integration, and a
description of any issues that were raised in those
consultation processes and the provider?s or system?s
analysis, if any, of those issues;

a description of the proposed timing or staging
of the implementation of the proposed integration; and

a description of the level of approval received
by the provider or system within its organization.

Notice of proposed decision

(6) No later than 90 days after the health service provider or
integrated care delivery system gives the notice required under
subsection (3), the Minister may,

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.. . ..

Page 43 of 81

request more information about the proposed
integration from the provider or system and Where such a
request has been made,

the provider or system shall provide the
information within 30 days of the request by the
Minister, and -

(ii) the time limit for the Minister to take
the steps set out in clauses and (0) shall be
extended, once only, by an additional 60 days;

notify a health service provider or integrated
care deliveiy system that the Minister proposes to issue a
decision under subsection 

provide a copy of the preposed decision to the
service provider or integrated care delivery system; and

publish the proposed decision on a website.

Submissions

(7) Any person may make written submissions about the
proposed decision to the Minister no later than 30 days after the
Minister publishes the proposed decision on a website.

Issuing a decision

(8) If more than 30 days, but no more than 90 days, have
passed after the Minister gives notice under subsection (6) and after
the Minister has considered any written submissions made under
subsection (7), the Minister may, if the Minister considers it in the
public interest to do so, issue a decision ordering the health service
provider not to proceed with the integration mentioned in the notice
under clause (3) or a part of the integration.

Matters to consider

(9) In issuing a decision under subsection (8), the Minister
shall consider the extent to which the integration is not consistent
with the Minister?s operational plan and any other matter that the
Minister considers relevantmanna n1 {onion 1 

Page 44 of 81

Variance

(10) An integration decision mentioned in subsection (8) may
be different from the proposed decision that was the subject of the
notice given under subsection (3).
[what does this mean in the context of an order not to proceed?]

Transfers, application of other Act
38.3 (1) The Public Sector Labour Relations Transition Act,
I 997 applies when an integration occurs that is,

the transfer of all or part of a service of a
person or entity under a facilitation decision of the Super
Agency under section 35 or a required integration order of
the Minister under section 36;

the transfer of all or substantially all of the
operations of a health service provider or integrated care
delivery system under a facilitation decision of the Super
Agency under section 35 or a required integration order of
the Minister under section 36;

the amalgamation of two or more persons or
entities under a facilitation decision of the Super Agency
under section 35 or under a required integration order
made by the Minister under section 36.

Same
(2) For the purposes of the application of the Public Sector
Labour Relations Transition Act, 1997,

the changeover date is the effective date of the
integration described in subsection (1) as set out in the
facilitation decision or the required integration order, as
the case may be;

the predecessor employer or employers are,
each person or entity from which the

service or operations is or are transferred, in the
case of an integration described in clause (1) or

01/24/2019

Page 45 of 81

01'

(ii) each of the persons or entities that is
amalgamated, in the case of an integration
described in clause (1) and

the successor employer or employers are,

each person or entity to which the
service or operations is or are transferred, in the
case of an integration described in clause (1) or
or

(ii) the person or entity that exists when
the amalgamation takes effect, in the case of an
integration described in clause (1) (0).

Exception

(3) Despite subsection (1) but subject to subsection (5), the
Public Sector Labour Rciazions Transition Act, 1997 does not apply
when an integration described in subsection (1) occurs if the
following describes the person or entity who would be the successor
employer if that Act appliedThat person or entity is not a health service
provider or an integrated care delivery system.

2. The primary function of that person or entity is
not the provision of services Within or to the health
services sector.

Same, consent of all parties

(4) Despite subsection 1) but subject to subsection (5), the
Public Sector Labour ReZaz?z?ons Transition Act, 1997 does not apply
when an integration described in subsection (1) occurs if all of the
following agree in writing that that Act does not apply to the
integration:

1. The person or entity who would be the successor
employer if that Act applied.

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Page 46 of 81

2. Every bargaining agent that has bargaining
rights in respect of a bargaining unit at the person or entity
who would be the successor employer if that Act applied.

3. Every bargaining agent that would have
bargaining rights in reSpect of a bargaining unit at the
person or entity who would be the successor employer if
that Act applied.

Certain provisions still apply

(5) Where the Public Sector Labour Relations Fansition Act,
1997 does not apply to an integration described in subsection (1) by
virtue of subsection (3) or an agreement entered into under
subsection (4), sections 12 and 36 of that Act are not affected and, if
applicable, apply to the integration in question.

De?nition
(6) In subsections (7) to (21),

?Board? means the Ontario Labour Relations Board.

Application to Board

Any person, entity or bargaining agent described in
paragraph 1, 2 or 3 of subsection (4) may request the Board to make
an order declaring that the Public Sector Labour Relations Transition
Act, 1997 does not apply to an integration described in subsection

(1).

Board order

(8) If requested to do so under subsection (7), the Board may
by order declare that the Public Sector Labour Relations Transition
Act, 199 7, other than sections 12 and 36 of that Act, does not,
despite subsection (1), apply to the integration in question.

Factors to consider

(9) When deciding whether to make an order under
subsection (8), the Board shall consider the factors set out in
subsection 9 (3) of the Public Sector Labour Relations {Domitian
Act, 1997 and the other matters that it considers relevant.

Certain provisions still apply

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(10) If the Board makes an order under subsection (8), the
order shall specify that it does not affect sections 12 and 36 of the
Public Sector Labour Relations Yi?tmsitz?on Act, 1997 and that, if
applicable, those provisions apply to the integration.

Proceedings before the Board

(11) Subject to subsections (12) to (19), sections 110 to 118
of the Labour Reiations Act, 1995 apply, with necessary
modi?cations, with respect to anything the Board does under this
section.

No panels .
(12) If the Board is given authority to make a decision,
determination or order under this section, it shall be made,

by the chair or, if the chair is absent or unable
to act, by the alternate chair; or

by a vice?chair selected by the chair in the
Chair?s sole discretion or, if the chair is absent or unable to
act, selected by the alternate chair in the alternate chair?s
sole discretion.

.. .. .. ..

Labour relations officers

(13) The Board may authorize a labour relations of?cer to
inquire into any matter that comes before it under this section and to
endeavour to settle the matter.

Rules to expedite proceedings

(14) The Board has, in relation to any proceedings under this
section, the same powers to make rules to expedite proceedings as
the Board has under subsection 1 10 (18) of the Labour Relations
Act, 1995.

Non-application of other Act
(15) Rules made under subsection (14) apply desPite anything
in the Statutory Powers Procedure Act.

Not regulations

(16) Rules made under subsection (14) are not regulations
within the meaning of Part (Regulations) of the Legisiation Act,

nnfm-in aqr?lv?nnan?In?u nit A A A A {011.1301 0

2006.

Interim orders

(17) The Board may make interim orders with respect to a
matter that is or will be the subject of a pending or intended
proceeding.

Timing
(18) The Board shall make decisions, determinations and
orders under this Act in an expeditious fashion.

No appeal
(19) A decision, determination or order made by the Board is
?nal and binding for all purposes.

Application of other provisions

(20) Subsections 96 (6) and (7) and sections 122 and 123 of
the Labour Relations Act, 1995 apply, with necessary modi?cations,
with respect to proceedings before the Board and its decisions,
determinations and orders under this section.

Non-application of Arbitration Act, 1991
(21) The Arbitration Act, 1991 does not apply with respect to
a proceeding before the Board under this section.

Devolution

38.4 (1) Despite any other Act, and except as provided in
subsection (2), the Lieutenant Governor in Council may, by
regulation, devolve to the Super Agency any of the powers, duties or
?mctions, under any other Act for whose administration the Minister
is responsible at the time of making the regulation, of the Minister or
a person appointed by the Minister or the Lieutenant Governor in
Council.

Exceptions 

(2) A regulation made under subsection (1) shall not devolve
to the Super Agency a power to make regulations under any other
Act for whose administration the Minister is responsible

Conditions on devolution
(3) A regulation under subsection (1) may devolve all or part

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of a power, duty or function to the Super Agency and may set
out conditions on the exercise by the Super Agency ofthe power,
duty or function and the modi?cations with which the power, duty or
function is to apply.

Effect of devolution
(4) If a regulation under subsection (1) devolves a power,
duty or function under an Act to the Super Agency,

(21) the person or entity on which the Act confers
the power, duty or function,

shall no longer perform the power, duty
or function to the extent that the regulation
devolves it to the Super Agency, and

(ii) is released from any liability with
respect to the power, duty or ?inction to the extent
that the regulation devolves it to the Super Agency
if the liability arises on or after the day on which
the regulation comes into force;

the Super Agency,

has the authority to exercise the power,
duty or function to the extent that the regulation
devolves it if it does so in accordance with the
Act, and

(ii) has the rights and immunities of the
person or entity on which the Act confers the
power, duty or function to the extent that the
regulation devolves it to Super Agency, as if the
Super Agency were that person or entity under
that Act; and

the powers, duties or functions of any other
person in respect of the devolved power, duty or ?mction
shall be read as if the Act provided that the Super Agency
had the power, duty or function.

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Page 50 off?

PART 
TRANSFERS

De?nitions
39. In this Part,

?transfer? means a transfer pursuant to an order under subsection 40
(French)

?transferor? means an organization or local health integration
network from which assets, liabilities, rights, obligations or
employees are being transferred pursuant to an order under
subsection 40 (French)

?transfer recipient? means the Super Agency, integrated care
delivery system, person or entity to which assets, liabilities,
rights, obligations or employees are being transferred pursuant to
an order under subsection 40 1). (French) -

Transfer order

40. (1) Despite anything in any other Act, but subject to the
processes and requirements set out in this Part and any regulations
made under this Part, the Minister may make an order,

transferring all or part of the assets, liabilities,
rights and obligations including, for greater certainty, any
rights or obligations under a funding agreement or
accountability agreement,

of an organization listed in subsection
(ii) of a local health integration network to
an integrated care delivery system or other person
or entity; and

transferring all or some of the employees,

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of an organization listed in subsection
(2) to the Super Agency, or

(ii) of a local health integration network to
an integrated care delivery system or other person
or entity.

Organizations
(2) The following are the organizations for the purposes of
subsection (1):
1. Cancer Care Ontario.
2. eHealth Ontario.

3. HealthForceOntario Marketing and Recruitment
Agency. 

4. Ontario Health Quality Council.
5. Trillium Gift of Life Network.
6. Any local health integration network.
7. Any other prescribed organization.
Notification requirement
(3) Before the Minister makes an order under subsection (1),
the Minister shall notify the Super Agency and each affected

organization, network, delivery system, person or entity.

Contents of order
(4) An order made under subsection (1), 

shall provide for the assets, liabilities, rights,
obligations or employees that are to be transferred;

shall specify a date on which the transfer of

assets, liabilities, rights, obligations or employees, as the
case may be, takes effect; and

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may specify that issues arising out of the
interpretation of the order be resolved by the method
speci?ed in the order.

on?application of Legislation Act, 2006
(5) Part (Regulations) of the Legislation Act, 2006 does
not apply to an order made under subsection (1).

Notice of order

(6) The Minister shall provide the Super Agency and each
affected organization, network, delivery system, person or entity
with a copy of the order, and shall publish the order on a website.
[re-drafted notice provisions to apply to both transforms and
transfer reamients, since probably everybody is interested]

Same

(7) The Super Agency and each organization, network,
delivery system, person or entity that receives a copy of an order
provided under subsection (5) shall,

provide notice of the order and make copies
available to affected employees and their bargaining
agents and to other persons or entities whose contracts are
affected by the order; and

publish the order on a website.

Assumption of rights, obligations, etc.
41. (I) If the Minister makes an order under section 40,

the transfer recipient assumes the operations,
activities and affairs of the transferor, as of the date of the
transfer; and

the assets, liabilities, rights and obligations of
the transferor that are provided for in the order, including
contractual rights, interests, approvals, registrations and
entitlements that exist immediately before the transfer date
continue as the assets, liabilities, rights and obligations of
the transfer recipient and are transferred to the transfer
recipient Without compensation.

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Convictions, rulings etc.

(2) A conviction against, or ruling, order or judgment in
favour of or against a transferor may be enforced by or against the
transfer recipient.

Civil actions, etc.

(3) The transfer recipient shall be deemed to be the party
plaintiff or the party defendant, as the case may be, in any civil
action commenced by or against a transferor before the date of the
transfer.

Note: Same concern as above.

No change of control
(4) A transfer shall not constitute a change of control of the
transferor.

No breach, etc.
(5) A transfer is deemed not to,

constitute a breach, termination, repudiation or
frustration of any contract, including a contract of
employment or insurance or a collective agreement;

constitute a breach of any Act, regulation or
municipal by-law;

constitute an event of default or force majeure;

give rise to a breach, termination, repudiation or
frustration of any licence, permit or other right;

give rise to any right to terminate or repudiate a
contract, licence, permit or other right; or

give rise to any estoppel.
No new cause of action

(6) A transfer does not create any new cause of action in
favour of,

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Page 54 of 81

a holder of a debt instrument that was issued by
a transferor before the transfer; or

a party to a contract with a transferor that was
entered into before the transfer.

Transfer binding

(7) Despite any other Act that requires notice or registration
of a transfer, a transfer is binding on the transfer recipient and all
other persons.

Non-application of other Acts
(8) The Land ?ange? Tax Act and the Retail Sales Tax Act
do not apply to the transfer.

Transfer of property held for speci?ed charitable purpose

(9) If a Minister?s order transfers to a transfer recipient
property that a transferor holds for a speci?ed charitable purpose, the
transfer recipient shall use it for the speci?ed charitable purpose.

Application

(10) Subsection (9) applies whether the will, deed or other
document by which the gift, trust, bequest, devise or grant is made,
is executed before or after this section comes into force.

Regulations
(11) The Lieutenant Governor in Council may make
regulations, 

prescribing contracts to which subsections (5)
and (6) do not apply;

prescribing Acts, in addition to those listed in
subsection (8), that do not apply to the transfer.

No expropriation

(14) Nothing in this Part and nothing done or not done in
accordance with this Part constitutes an expropriation or injurious
affection for the purposes of the Expropriations Act or otherwise at
law.

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Immunity re transfer

(15) No proceeding for damages or otherwise shall be
commenced against a director, of?cer or employee of a transfer or
transfer recipient in respect of a claim arising in connection with a
transfer.

Employees continued

42. (1) Persons who are employees of a transferor
immediately before the transfer become employees of the transfer
recipient as of the date of the transfer.

Same

(2) For all purposes, the employment of the employees
described in subsection (1) immediately before and after the transfer
is continuous.

Same

(3) For all purposes, including the purposes of an
employment contract, a collective agreement and the Employment
Standards Act, 2000, the employment of the employees described in
subsection (1) is not terminated or severed and those employees are
not constructively dismissed because of the transfer.

Terms of employment

(4) All rights, duties and liabilities relating to all employees
and former employees of a transferor that are vested in or bind the
transferor immediately before the effective date of the transfer are
vested in or bind the transfer recipient instead of the transferor
immediately after the transfer.

Application of s. 69 of Labour Relations Act, 1995

(5) A transfer is deemed to be a sale of a business under
section 69 of the Labour Relations Act, l995 and that section applies
to the transfer.

Note: Please con?rm wlzether this will work if only a few
employees are transferred and the LHIN still Operates. S. 69 oftke
LRA also appears to apply to the sale of ?part of? a business, so
maybe this would work as if only ?nest? of the LHIN It as been
sold?

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Pay Equity Act

(6) A transfer is deemed to be a sale of business under
section 13.1 of the Pay Equity Act and that section is deemed to
apply to the transfer.

Note: Same as above - please con?rm it works for partial transfers.
I think it might, but we may need additional rules or ?with
necessary rami?cations? language to make it?t.

Dissolution order
43. (1) The Minister may make an order to dissolve an
organization that is listed in subsection 40 (2).

Dissolution of prescribed organization

(2) If the Minister makes an order under subsection (1), the
organization affected by the order is dissolved as of the date
speci?ed in the order, despite any requirement that would otherwise
apply under any other Act.

Members terminated

(3) The persons who are the members of the prescribed
organization affected by the order immediately before the
dissolution cease to be members on the day of the dissolution.

Directors terminated

(4) The terms of of?ce of the directors and of?cers of the
organization affected by the order who are in of?ce immediately
before its dissolution are terminated on the day of the dissolution.

Final annual report

(5) Despite the dissolution of an organization affected by an
order, the chair and chief executive of?cer of the Super Agency shall
prepare and deliver the annual report for every ?scal year of a
prescribed organization affected by the order before its dissolution
for which the annual report has not already been delivered.

Same

(6) For the purposes of subsection (5), if an organization
affected by the order is dissolved in any year on a date other than
March 31, its last ?scal year is deemed to be from the preceding
April 1 to the date of its dissolution.

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Other ?lings

(7) The chair and chief executive of?cer of the Super Agency
shall make any other ?lings or reports that the organization may
have made or that it would have been required to make immediately
before its dissolution, and the chair and chief executive of?cer are
deemed to have all the rights of a member, director or of?cer of the
prescribed organization to make the ?lings or reports.

No change of control

(8) The dissolution of an organization affected by the order
shall not constitute a change of control of the organization in respect
of its assets, liabilities, rights or obligations.

Transfer of home care agreements with local health integration
networks

Note to dm?: We need to do more work on this to include
more (it on just agreements, and more than home care].

44. (1) Despite anything in any other Act, but subject to the
processes and requirements set out in this Part and any regulations
made under this Part, the Minister may make an order transferring to
a person or entity, including an integrated care delivery system, the
liabilities, rights and obligations of a local health integration network
set out in,

an agreement made between the network and a
service provider, Within the meaning of the Home Care
and Community Services Act, 1994, to have the service
provider provide a community service; or

an agreement under section 28.5 of the Home
Care and Community Services Act, 1994 to provide
funding to or on behalf of a person.

Noti?cation requirement

(2) Before the Minister makes an order under subsection (1),
the Minister shall notify the affected person or entity and local health
integration network.

Contents of order

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rage be or 251

(3) An order made under subsection (1),

shall specify a date on which the transfer of
assets, liabilities, rights, obligations or employees, as the
case may be, takes effect; and

may specify that issues arising out of the
interpretation of the order be resolved by the method
speci?ed in the order.

Non-application of Legislation Act, 2006
(4) Part (Regulations) of the Legislation Act, 2006 does
not apply to an order made under subsection (1).

Notice of order

(5) The Minister shall provide each affected person or entity
and local health integration network with a copy of the order, and
shall publish the order on a website .

Same, duties
(6) Each person, entity and local health integration network
that receives a copy of an order provided under subsection (5) shall,

provide notice of the order and make copies
available to affected employees and their bargaining
agents and to other persons or entities whose contracts are
affected by the order; and

publish the order on a website.

De?nition
(7) In this section,

Note: I ?m act coamletelp sure about this, but I think it may be
worth having a definition of a LHIN that would be proclaimed
when LHSIA is eventually repealed.

Note: Do we need aaythiag else set out in this Part to apply to
these transfers? For instance, the other sections ia this Part set out
what happens when rights, obligations, and liabilities are assumed,
and clarify what happens on the traasfar ofemplayees, etc. (which

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Page 59 of 81

presumabty this doesn ?t involve)? Do any ofthe other rule sin this
Part need to apply here?

Note: Presumably, this is going to require substantial amendments
to the Home Care Act. Do we need to do about
transferring community services that are directly provided by
LHINS under Part VIIJ of that Act?

PART IX
MISCELLANEOUS

Public interest

45. In making a decision in the public interest under this Act,
the Lieutenant Governor in Council, the Minister or the Super
Agency, as the case may be, may consider any matter they regard as
relevant including, Without limiting the generality of the foregoing,

the quality of the management and
administration of the Super Agency or the health service
provider, as the case may be;

the proper management of the health care
system in general;

(0) the availability of ?nancial resources for the
management of the health care system and for the delivery
of health care services;

the accessibility to health services in the
geographic area or region where the health service
provider is located; and

the quality of the care and treatment of patients.

No liability

45.01, (1) No proceeding for damages or otherwise, other
than an application forjudicial review under the Judicial Review
Procedure Act shall be commenced against any of the following
with respect to any act done or omitted to be done or any decision,
directive, standard or order made or issued under this Act that-is
done in good faith in the execution or intended execution of a power

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Page 60 of 81

or duty under this Act:
1. The Crown.
2. The Minister.
3. The Super Agency.

4. Any member, director or of?cer of the Super
Agency or an agent or a volunteer of the Super Agency.

5 . Any person employed by the Crown, the
Minister or the Super Agency.

No protection re negligent health service delivery

(2) Nothing in subsection (1) prevents a claim for
compensation with respect to the delivery of services by the Super
Agency or the delivery of services arranged by the Super Agency,
and, for greater certainty, the Super Agency does not deliver
services, and services are not arranged by the Super Agency, when
the Super Agency funds services under section 27 to be delivered by
a health service provider or integrated care delivery system.

PART XX
PATIENT 0MBUDSMAN

Definitions
45.1 In this Part,

?proceeding? includes a proceeding held in, before or under the rules
of a court, a tribunal, a commission, a justice of the peace, a
coroner, a committee of a College within the meaning of the
Regufated Health Professions Act, 1991, a committee of the
Board of Regents continued under the Drargiess Practitioners
Act, a committee of the Ontario College of Social Workers and
Social Service Workers under the Social Work and Soda! Service
WorkAct, 1998, an arbitrator or a mediator; (?French?)

?patient or former patient? includes,

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Page 61 of81 

a patient or former patient of a hospital,

a resident or former resident of a long-term
care home,

(0) a client or former client of a community care
access corporation,

a person who receives or has received services 
from a local health integration network, but only with
respect to matters described in clause of the de?nition
of ?health sector organization? in subsection 1 (1)

any other individual provided for in the
regulations, and -

f) in respect of an individual mentioned in clause
or who is or was incapable with respect
to a treatment or another matter, a person with the 
authority to consent to the treatment or the other matter on i
behalf of that patient or former patient in accordance with i
the Health Care Consent/let, 1996.

Patient ombudsman
45.2 (I) The Lieutenant Governor in Council shall appoint a
person to be the patient ombudsman.

Functions of the patient ombudsman
(2) The functions of the patient ombudsman are,

to receive and respond to complaints from
patients and former patients of a health sector organization
and their caregivers, and from any other prescribed
persons;

to facilitate the resolution of complaints made
by patients and former patients of a health sector
organization and their caregivers, and by any other
prescribed persons;

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to undertake investigations of complaints made
by patients and former patients of a health sector
organization and their caregivers, and by any other
prescribed persons, and to undertake investigations of
health sector organizations on the patient ombudsman?s
own initiative;

to make recommendations to health sector
organizations following the conclusion of investigations;
and

to do anything else provided for in the
regulations.

Employee of Super Agency

(3) The Super Agency shall employ as the patient
ombudsman the person appointed by the Lieutenant Governor in
Council and shall terminate that person?s employment as patient
ombudsman when the term of the appointment expires, or if the
Lieutenant Governor in Council revokes the person?s appointment.

Salary, etc.

(4) The Lieutenant Governor in Council shall ?x the salary or
other remuneration and the benefits, including rights relating to
severance, termination, retirement and superannuation, of the patient
ombudsman, and the Super Agency shall provide the salary or other
remuneration and those benefits to the patient ombudsman.

Delegation
(S) The patient ombudsman may, in writing, delegate any or
all of their powers to one or more employees of the Super Agency as
the patient ombudsman considers appropriate, and where the patient
ombudsman has done so, the acts of the delegate are deemed to be
the acts of the patient ombudsman for the purposes of this Act.

Term of of?ce
(6) The patient ombudsman shall be appointed for a term of
?ve years and may be reappointed for one further term of ?ve years.

Same
(7) The Lieutenant Governor in Council may revoke the

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appointment of the patient ombudsman for cause.

Temporary appointment

(8) If the position of patient ombudsman is vacant or if for
any reason the patient ombudsman is unable or unwilling to ful?l the
duties of the office, the Lieutenant Governor in Council may appoint
a temporary patient ombudsman for a term of up to six months.

Designation by patient ombudsman

45.3 The Patient Ombudsman shall designate an
individual from among the employees of the Super Agency who
shall have the powers and duties of the Patient Ombudsman if the
Patient Ombudsman is absent or unable to ful?l the duties of the
of?ce or if the of?ce becomes vacant.

Designation in writing
(2) A designation under subsection (1) shall be in writing.

Powers and duties

(3) The individual designated under subsection (1) shall have
the powers and duties of the Patient Ombudsman unless a temporary
Patient Ombudsman is appointed.

Salary

(4) The Lieutenant Governor in Council may increase the
salary of an individual who assumes the powers and duties of the
Ombudsman under subsection (1) in such circumstances as the
Lieutenant Governor in Council considers appropriate.

Removal or susPension

(5) Subsection 45.2 (7) (Same) applies in respect of an
individual who assumes the powers and duties of the Patient
Ombudsman under subsection (1).

Complaints

45.4 (1) Subject to any prescribed limitations with respect to
time, a patient or a former patient of a health sector organization, a
caregiver of a patient or former patient, and any other prescribed
person, may make a complaint in writing to the patient ombudsman
about actions or inactions of a health sector organization that relate,

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Page 64 of 81

in the case of a patient or former patient, to the
care and health care experience of the patient or former
patient;

(13) in the case of a caregiver, to the care and health
care experience of the patient or former patient to whom
the caregiver provides or provided care; or

in the case of another prescribed person, to the
care and health care experience of another person provided
for in the regulations.

Facilitated resolution

(2) The patient ombudsman shall work with the patient,
former patient, caregiver or other prescribed person, the health sector
organization and, when appropriate, the relevant local health
integration network, to attempt to facilitate a resolution of a
complaint made under subsection (1) unless, in the opinion of the
patient ombudsman,

the complaint relates to a matter that is within
thejnrisdiction of another person or body or is the subject
of a proceeding;

the subj ect matter of the complaint is trivial;

the complaint is frivolous or vexatious;

the complaint is not made in good faith;

the patient, former patient, caregiver or other
prescribed person has not sought to resolve the complaint
directly with the health sector organization; or

the patient, former patient, caregiver or other
prescribed person does not have a suf?cient personal
interest in the subject matter of the complaint.

Referral to appropriate body

(3) Where the complaint relates to a matter that is within the
jurisdiction of another person or body, the patient ombudsman shall

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refer the patient, former patient, caregiver or other prescribed
person to that person or body.

Patient to be informed

(4)111 any case where the patient ombudsman determines that
they will not attempt to facilitate a resolution of a complaint in
accordance with subsection (2), the patient ombudsman shall inform
the patient, former patient, caregiver or other prescribed person in
writing of that determination and state the reasons for that
determination.

Investigation

45.5 (1) Where, after attempting to facilitate the resolution of
a complaint under section 45.4, the patient ombudsman believes that
the complaint should be investigated, the patient ombudsman may
investigate the complaint. -

May decide not to investigate

(2) Without limiting the generality of the powers conferred on
the patient ombudsman by this Act, the patient ombudsman may, in
the patient ombudsman?s discretion, decide not to investigate, or, as
the case may require, not to further investigate any complaint for any
reason for which the patient ombudsman could have determined not
to attempt to facilitate the resolution of the complaint under section
45.4.

 ..

Patient to be informed

(3) In any case where the patient ombudsman makes a
determination not to investigate or further investigate a complaint,
the patient ombudsman shall inform the patient, former patient,
caregiver or other prescribed person in writing of that decision and
state the reasons for that decision.

Investigations on own initiative

(4) The patient ombudsman may also commence an
investigation of the actions or inactions of one or more health sector
organizations that relate to the patient care or health care experience
provided by the organization or organizations in any case where the
patient ombudsman believes that the matter should be investigated.

Restriction

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(5) Despite subsection (4), the patient ombudsman shall not
commence an investigation under that subsection in connection with
a matter that is within the jurisdiction of another person or body or is
the subject of a proceeding.

Organization and patient-to be informed

(6) Before investigating any matter, the patient ombudsman
shall inform the relevant health sector organization and the patient,
former patient, caregiver or other prescribed person, if any, who
made the complaint that led to the investigation of the patient
ombudsman?s intention to make the investigation.

Investigations are private
(7) Every investigation by the patient ombudsman shall be
conducted in private.

Exception, other persons and bodies

(8) Despite subsection (7), Where the patient ombudsman
obtains information in the course of an investigation that relates to a
matter within the jurisdiction of another person or body, the patient
omdbudsman may provide that information to the other person or
bo y.

Obtaining information, etc.

(9) The patient ombudsman may hear or obtain information
from any persons he or she thinks tit, and may make any inquiries he
or she thinks 

Opportunity to be heard

(10) The patient ombudsman is not required to hold any
hearing and no person is entitled as of right to be heard by the
patient ombudsman, but, if at any time during the course of an
investigation, it appears to the patient ombudsman that there may be
suf?cient grounds for him or her to make any report or
recommendation that may adversely affect any person or entity, the
patient ombudsman shall give to that person or entity an opportunity
to make representations respecting the adverse report or
recommendation, either personally or by counsel.

Requiring information
(11) The patient ombudsman may from time to time require

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any officer, employee, director, shareholder or member of any
health sector organization, or any other person who provides
services through or on behalf of a health sector organization, who, in
the patient opinion, is able to give any information
relating to any matter that is being investigated by the patient
ombudsman,

to furnish the patient ombudsman with the
information; and

to produce any documents or things that in the
patient ombudsman's opinion rotate to the matter and that
may be in the person?s possession or under the person?s
control. 

Examination under oath
(12) The patient ombudsman may summon before the patient
ombudsman and examine under oath,

any patient, former patient, caregiver or other
prescribed person who has made a complaint under this
Act; or

any person who is mentioned in subsection

(11).

Contain other Acts

(13) A person who is subject to the Freedom of Information
and Protection of Privacy Act, the Mantel}?ch Freedom of
Information and Protection ofPrivaey Act or the Personal Health
Protection Act, 2004 is not prevented by any provisions
in those Acts from providing personal information or personal health
information to the patient ombudsman, when the patient ombudsman
requires the person to provide the information under this section.

Privilege preserved

(14) Every person to whom this section appiies has the same
privileges in relation to the giving of infonnation, the answering of
questions, and the production of documents and things as witnesses
have in any court.

not A A A A 0/39th or lemon 1 

rage as or at

Statements not admissible

(15) Except on the trial of any person for an offence in
respect of the person?s sworn testimony, no statement made or
answer given by that or any other person in the course of any
investigation by the patient ombudsman is admissible in evidence
against any person in any court or at any inquiry or in any other
proceedings, and no evidence in respect of proceedings before the
patient ombudsman shall be given against any person.

Right to object to self-incrimination

(16) A person giving a statement or answer in the course of
any investigation before the patient ombudsman shall be informed
by the patient ombudsman of the right to object to answer any
question under section 5 of the Canada Evidence Act.

Protection from liability

(17) No person is liable to prosecution for an offence against
any Act, by reason of their compliance with any requirement of the
patient ombudsman under this section.

Fees, allowances, etc.

(18) Where any person is required by the patient ombudsman
to attend before the patient ombudsman for the purposes of this
section, the person is entitled to the same fees, allowances and
expenses as if the person were a witness in the Superior Court of
Justice, and the provisions of any relevant Act, regulation or rule
apply accordingly, with necessary modi?cation.

Compliance

(19) Every person who is summoned by the patient
ombudsman under this section, or is required to furnish or produce
documents or information, shall comply with the summons or
furnish or produce the documents or information, as the case may be.

Entry
(20) For the purposes of an investigation under this section,
the patient ombudsman may at any time enter upon any premises of
a health sector organization and inspect the premises.

Restriction
(21) Despite subsection (20), the patient ombudsman shall not

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enter any premises of a health sector organization, except
with the consent of the health sector organization or under the
authority of a warrant issued under subsection (23).

Private dwellings

(22) Despite subsection (20), the patient ombudsman shall not
enter any premises that is being used as a dwelling, except with the
consent of the occupier or under the authority of a warrant issued
under subsection (23).

-Warrant

(23) A justice of the peace may issue a warrant authorizing
the patient ombudsman or another person to enter any premises of a
health sector organization if the justice is satis?ed, on evidence
under oath or af?rmation, that there are reasonable grounds to
believe that it is necessary to enter the premises for the purposes of
an investigation under this section.

Obstruction forbidden

(24) No person shall, without lawful-justi?cation or excuse,
wilfully obstruct, hinder or resist the patient ombudsman 01' a
delegate of the patient ombudsman in the performance of their
functions under this Act.

Recommendations

45.6 (1) After making an investigation, the patient
ombudsman may make any recommendations to a health sector
organization that was the subject of the investigation that the patient
ombudsman sees 

Copy to patient

(2) Where the patient ombudsman makes recommendations to
a health sector organization under subsection (1), the patient
ombudsman shall also provide a copy of the recommendations to the
patient, former patient, caregiver or other prescribed person who
made the complaint, if any.

Personal information to be removed

(3) Subject to any prescribed exceptions, the patient
ombudsman shall, before providing the copy of recommendations
under subsection (2), ensure that all personal information and

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Page 70 of 81

personal health information about anyone other than the
patient, former patient, caregiver or other prescribed person is
redacted.

Reports by patient ombudsman

45.7 (1) The patient ombudsmanJSuper Agency shall report to
the Minister on the activities and recommendations of the patient
ombudsman at least annually, and otherwise as the patient
ombudsman considers appropriate.

Reports to LHINs

(2) The patient ombudsman shall provide reports to local
health integration networks on the activities of the patient
ombudsman and their recommendations as the patient ombudsman
considers appropriate

No personal information

(3) The patient ombudsman and the Super Agency shall not
include any personal information or personal health information in
any reports made under this section.

Reports to be public

(4) The Super Agency shall make the reports under this
section available to the public, through publication on the Agency?s
website and any other means the patient ombudsman may consider
appropriate.

Application of Freedom of Information and Protection of
Privacy Act

45.8 The Freedom of Information and Protection of Privacy
Act does not apply to records in the Super Agency?s custody or
control that contain information obtained or prepared by the patient
ombudsman in the course of conducting an investigation under this
Part

Immunity

45.9 (1) No proceeding shall be commenced against the
patient ombudsman or any employee of the Super Agency for any
act done or omitted in good faith in the execution or intended
execution of the patient ombudsman?s functions under this Act.

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Testimony

(2) Neither the patient ombudsman nor anyone employed by
the Super Agency is a competent or compellable witness in a civil
proceeding outside this Act in connection with anything done under
sections.

Regulations
45.10 The Lieutenant Governor in Council may make
regulations for the purposes of this Part,

providing for additional functions of the patient
ombudsman for the purposes of clause 45.2 (2) 

further de?ning, specifying or clarifying the
meaning of ?patient or former patient? and similar
expressions.

[may rrzove this to general reg-making powers, especiaih: since I
don ?t (kink is necessary]

PARTX
REGULATIONS
Regulations
46. (I) The Lieutenant Governor in Council may make
regulations,

[dissolving the Super Agency and doing
anything necessary to effect the dissolution, including
dealing with the assets and liabilities of the Super Agency

by,
providing for the liquidation or sale of

the assets and paying the proceeds into the
Consolidated Revenue Fund,

(ii) providing for a trans?n? of the assets or
liabilities to the Crown or an agency of the Crown,
or

providing fora transfer of the Super

an a sanctum rm mm 

Page 72 of 81

Agency?s employees to the Crown or an
agency of the Crown;]

specifying persons or entities that are excluded
from the de?nition of ?health service provider? in
subsection 1 

governing and clarifying the application of
subsection 9 (2) [restrictions]

the Super Agency, 21 health service
provider or an integrated care delivery system from any
provision of this Act or the regulations, and specifying
circumstances in which the exemption applies;

prescribing provisions of the Coiporatz'ons Act
and the Corporations Information Act or any successor to
those Acts that apply to the Super Agency and the
modifications with which those provisions are to so apply;

specifying persons who may not be appointed as
members of the Super Agency;

governing consultation mechanisms under
section 24;

governing funding that the Super Agency
provides to a health service provider or to an integrated
care delivery system;

requiring a health service provider to institute a
system for reconciling the funding that it receives from the
Super Agency on the basis set out in the regulation,
including,

requiring the service provider to pay the
Super Agency for any excess payment of funding,
and

(ii) allowing the Super Agency to recover
any excess payment of funding by deducting the

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excess from subsequent payments to the
service provider; .

establishing the process for making a service
accountability agreement under section 28 and governing
the content or terms and conditions of such an agreement;

respecting matters that relate to or arise as a
result of a transfer of property under an integration
decision under Part VI, including matters related to
present and future rights, privileges and liabilities;

de?ning, for the purposes of this Act, any word
or expression used in this Act that has not already been
expressly de?ned in this Act; 

(n1) respecting any matter that this Act describes as
being prescribed or provided for in the regulations;

(11) governing transitional matters that may arise
due to the enactment of this Act or any amendments made
by the Signer Agency Establishment Act, 2019;

respecting any other matter that the Lieutenant
Governor in Council consider necessary or desirable for
carrying out the purposes and provisions of this Act.

Information and reports
(2) The Lieutenant Governor in Council may make
regulations respecting the provision of information, other than
personal health information, from prescribed persons and entities to
the Super Agency in order to support collaboration between health
service providers, integrated care delivery systems, physicians and
others in the health care system, and to support planning of primary
care services, including physician services, that ensure timely access
and improve patient outcomes, including information to facilitate
understanding by the Super Agency of,

transitions in practice, including opening,
closing, retirements and extended leaves; and

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Page 74 of 81

practice and service capacity to address
pepulation health needs.

Minister?s regulation
(3) The Minister may make regulations governing any matter
that may be dealt with by regulation under section 15.

Con?ict

(4) If there is a con?ict between a regulation made under
clause (1) and any Act or any other regulation, the regulation
made under that clause prevails, unless the Act or other regulation
specifies that it prevails.

PART XI
AMENDMENTS TO THIS ACT

Amendments to this Act .

47. (1) Paragraph 1 of the de?nition of ?health service
provider? in subsection 1 (2) of this Act is amended by striking
out ?or a private hospital within the meaning of the Private
Hospitals Act? at the end and substituting ?a community health
facility within the meaning of the Oversight ofHeaZtIz Facilities
and Devices Act, 201 7 that was formerly licensed under the
Private Hospitals Act?.

Note: I ?m trying to carry over outstanding amendments that woeful
have been made to the comparable LHSIA provisions.

(2) Paragraph 15 of the de?nition of ?health service
provider? in subsection 1 (2) of this Act is repealed and the
following substituted:

15. A community health facility within the meaning
of the Oversight of Health Facilities and Devices Act,
201 7.

Note: Is this the correct way to replace the new reference to
independent heoith facilities in this de?nition?

(3) Subsection 6 (1) of this Act is repealed and the
following substituted:

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Page 75 of 81

Other Acts

(2) The Not-for-Pro?t Corporations Act, 2010 and the
Corporations Information Act do not apply to the Super Agency,
except as prescribed.

(4) Subsection 38 (4) of this Act is repealed and the
following substituted:

Exceptions

(4) Subsection (3) does not apply to an integration that
requires a decision of the Minister, a director or the executive of?cer
under the Oversight of Health Facilities and Devices Act, 20] 7 or
the Long-Term Care Homes Act, 2007.

(5) Clause 46 (1) of this Act is amended by striking out
?the Corporations Act? and substituting ?the Not-for-Pro?t
Corporations Act, 2010?.

PART XII
CONSEQUENTIAL AND RELATED AMENDMENTS

Note: As this project grows, it might make sense for most of ti: ese
conseqttentlal amendments (but maybe not lite soy-amendment) to
be moved into a separate Schedule.

Note: In. an ideal world, we should also repeal any outstanding
ameadmeats to the Acts th at we?re repealing. For example, there
are numerous outstanding amendments to LHSIA that should also
be repealed when LHSIA itself is repealed. However, I know that
we have sometimes not done this in. the past and just allowed the
outstanding amendments to drop away, and the pace of this project
might suggest that we may not have time to actually get around to
these. I ?ll leave this issue to be decided in a later dra?.

CancerAct
x. (1) The C'aacerActis repealed.

(2) A proclamation may provide for the repeal of
different provisions of this Act on different dates.

Note: The Legislation Act allows as to selectively proclaim
provisions of (in Act, but that would limit as to proclaimingomega . tilt/90 I 

Page '76 of 81 

example, this section ?s instruction to repeal the entire Cancer Act.
It would]: ?t allow us to only proclaim the repeal of certain parts of
the CancerAct. I tried to deal with this in subsection (2), above.

Another way of getting around this would he to structure this

pro vision to include the repeals we want in separate subsections.
For example, subsection (1) could repeal certain provisions of the
Cancer Act, while subsection (2) could repeal the remainder of the
Cancer Act, allowing you to cleanly do it in stages.

The approach I ?ve set outcomes with a signi?cant drawback. If
we?re only going to repeal certain sections of the Cancer Act, the
Cancer Act as a whole still needs to make sense at each stage. This
means that, for example, we coaldn ?t repeal certain sections of the
Cancer Act by proclamation if other provisions of the Act directly
cross-reference it or clearly rely on its continued existence.

It would be worth looking at the Acts you want to repeal in stages
and determining wit at you want them to look like at each stage.
You can use this to assess whether a repeal of the undesired
provisions will be sufficient, or whether we?re also going to need to 
amend the Acts to remove ineffective cross-references or otherwise
deal with thorny transitional issues. i

[removed the regnlation revocations, which are probably more
conveniently handled under their Act]

Excellent Carefor All Act, 2010

x. (1) The de?nitions of ?caregiver?, ?council?, ?health
sector organization?, ?local health integration network?,
?patient ombudsman?, ?personal information? and ?personal
health information? in section 1 of the Excellent Care for All Act,
2010 are repealed.
[is there a chance these will not all be repealed at the same time?!

(2) Subsections 8 (4) and (5) of the Act are repealed and
the following substituted:

Copy to Agency

(5) Every health care organization shall provide a copy of its
annual quality improvement plan to the [Super Agency] in a format

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Page 77 of 81

established by the Agency that permits province-wide
comparison of and reporting on a minimum set of quality indicators.

(2) Sections 10 to 13.7 of the Act are repealed.
(3) Clauses 16 (1) to of the Act-are repealed.

Note: I?m trying to repeat the related reg. powers here.

(5) A proclamation may provide for the repeal of
different provisions of this A on different dates.

Local Health System Integration Act, 2006
x. (1) The Local Health. System Integration Act, 2006 is
repealed.

(2) Ontario Regulation 417i06 (Committees of the Board
of Directors of a Local Health Integration Network), made
under the Act, is revoked.

(3) Ontario Regulation 162/07 (French Language Health
Services Advisory Council), made under the Act, is revoked.

(4) Ontario Regulation 264107 (General), made under the
Act, is revoked.

(5) Ontario Regulation 515/09 (Engagement with the
Francophone Community under Section 16 of the Act), made
under the Act, is revoked.

(6) Ontario Regulation 456/ 16 (Health Shared Services
Ontario), made under the Act, is revoked.

(7) A proclamation may provide for the repeal of
different provisions of this Act or of any of these regulations on
different dates.

Note: You indicated a desire to have LHINs continue to operate in
a mach more limited capacity a?er many of their ?inctioas have
been. transferred to the Super Agency. If this is the case, I think
you. will want to review the LHSIA Act to see which provisions still

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Page 78 of 81

need to be left in and which shoald be repealed or, possibly,
amended I think you probably want to imnrerliateh) repeal the
??i?rovinelal strategic plan section, which has now been moved
over to the MOHL TC Act. Bat also want to repeal some
or all of the Planning and Community Engagement, Integration
and Devolution and Transfer of CCA provisions? Wouldyon
want the LHEVs to contin ac to have those [Emotions even after
they?ve been stripped of most of their staff? It may be possible to .do
this through staged repeals of dW?erent sections of the Act, but we
may need to make some amendments to certain provisions to
ensare that it still works or that it doesn ?t cross-reference non-
existent pro visions.

The purpose clause of LHSIA also stands out to me - it says that
the Act is to provide for the ?effective and e?'icient management of
the health system at the local level by local health integration
networks?. It seems like that may no longer be the purpose of the
Act after the LHINs have been stripped of most of their ?tnctions.
Should it be changed during the interim phase when LHSIA still
exists in a limited capacity?

Lang Health Act, 2 0i 7
x. (1) The Lang Health Act, 201 7 is repealed.

(2) A proclamation may provide for the repeal of
different provisions of this Act on different dates.

Public Hospitals Act
xx. Subsection 32(1) of the Public Hospitals Act is
amended by adding the following clause:

(e3) exempting a hospital or group of hospitals 
from any provisions of this Act or the regulations and 
prescribing any conditions that may apply to such
exemption;

NT D: arther consequential instructions are BI). I understand
there will be amendments to references to agencies and the LHINs
in other legislation, amendments related to the Patient
Ombudsman, possible home care amendments, etc.

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PART XX
COMMENCEMENT AND SHORT TITLE

Commencement
x. The Act set out in this Schedule comes into a force on a
day to be named by proclamation of the Lieutenant Governor.

Note: As above, it will be worth looking through this bill as it gets
closer to completion and determining what you want it to look like
at each ?stage?. It?s possible that some provisions may need to be
rewritten or revised (for instance, ifo ?stage I provision contains
a cross-reference to a. provision that won ?1 come into force for a
while, etc.) 

Short title
x. The short title of the Act set out in this Schedule is the

Szgper Agency A cl, 2019.

0A A A A .

01/74/7019

rage so or ?51

SCHEDULE 2
MINISTRY OF HEALTH AND CARE ACT

The Ministry ofHealz?lr and Long? Term Care Act is
amended by adding the following sections:

Provincial strategic plan

8.1 (1) The Minister shall develop a provincial strategic plan
for the health system that includes a vision, priorities and strategic
directions for the health system.

Councils
(2) The Minister shall establish the following councils:

1. An Aboriginal and First Nations health council
to advise the Minister about health and service delivery
issues related to Aboriginal and First Nations peoples and
priorities and strategies for the provincial strategic plan
related to those peoples.

2. A French language health services advisory
council to advise the Minister about health and service
delivery issues related to francophone communities and
priorities and strategies for the provincial strategic plan
related to those communities.

Members

(3) The Minister shall appoint the members of each of the
councils established under subsection (2) who shall he
representatives of the organizations that are prescribed.

Consultation

(4) In developing priorities and strategic directions for the
health system in the provincial strategic plan, the Minister shall seek
the advice of province-wide health planning organizations that are
mandated by the Government of Ontario.

Note: Removed the reference to ?the health system and the local

health systems? that is currently included in LHSIA, as ?local
health systems? doesn ?t seem to be as memziag?rlly de?ned

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Page 81 of 81

anymore.

This provision requires the advice of ?jorovinceoritle health
planning organizations?. Will thutjust be the Super Agency? Will
other ?jprovince-wide health planning organizations? exist?

Adhering to French Language Services Act

(5) In deveIOping priorities and strategic directions for the
health system in the provincial strategic plan, the Minister shall
ensure that the priorities and strategic directions foster the provision
of health services in a way that meets the requirements of the French
Language Services Act.

Publication

(6) The Minister shall publish the provincial strategic plan on
a Government website. 
[unless you have a definite plan for transition, you mop want to
leave that to the regulations, given the difference between the
LHINs consultations and province-wide onesl

2. Section 12 of the Act is amended by adding the
following clause:

prescribing organizations for the purposes of
subsection 8.1 

Note: I think this is necessary because the OHLTC Act doesn ?t
have a general power to make regulations for ?anything that is
prescribed?.

Commencement 
3. This Schedule comes into force on a day to be named '1
by proclamation of the Lieutenant Governor.

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