Summary#

Bill 116, the Foundations for Promoting and Protecting Mental Health and Addictions Services Act, 2019, enacts two new Acts and amends the Connecting Care Act, 2019 and the Limitations Act, 2002. Its stated goal is to support an Ontario mental health and addictions strategy and allow the province to recover health care costs linked to opioid-related wrongdoing. The bill was enacted in 2019; the Mental Health and Addictions Centre provisions start on a date set by proclamation, which is not given in the supplied material.

• The Minister of Health must develop and maintain a mental health and addictions strategy.
• Ontario Health must establish and maintain a Centre of Excellence within Ontario Health. It must put the strategy into operation, develop clinical, quality and service standards, monitor system performance measures, provide resources and support to health service providers, integrated care delivery systems and others, and carry out other functions the Minister directs.
• The Centre is a division within Ontario Health, not a new independent agency. Ontario Health must include information about its work in its annual reports, subject to Management Board of Cabinet directives.
• Ontario gains a direct legal action against opioid manufacturers and wholesalers to recover health care costs caused or contributed to by an opioid-related wrong. It may claim costs for individuals or for a population as a whole.
• For qualifying population-wide claims, courts must apply specified presumptions about exposure and resulting harm, and allocate liability by market share. Defendants may prove that their breach did not cause or contribute to the exposure or harm to reduce or adjust liability.
• The opioid law applies retroactively. It also sets a limitation-period rule for covered proceedings: they are not barred if started before the rule takes effect or within 15 years after it takes effect.

What it means for you#

• People using health or addictions services: The bill does not itself create a new treatment service, guarantee access to care, or change eligibility for care. It creates a centre whose work includes supporting providers and setting standards.
• Health service providers and integrated care delivery systems: Ontario Health’s Centre must provide resources and support related to mental health and addictions. The bill does not set out a process for requesting support or require providers to follow particular new standards in this Act.
• Ontario taxpayers: The province may seek repayment of health care costs from manufacturers or wholesalers. The money is recoverable by Ontario; the Act does not create a direct compensation payment to patients.
• Opioid manufacturers and wholesalers: They may face claims for Ontario’s past and estimated future health care costs. “Manufacturer” includes some businesses involved in promoting products, and certain trade associations; the Act also defines which wholesalers are covered.
• Other Canadian governments: Ontario may bring a class action for itself and other Canadian governments or government payment agencies. A class member may opt out under the Class Proceedings Act, 1992.

Money#

The bill requires Ontario Health to supply and maintain the Centre, but no cost estimate is available.

• The bill gives no staffing level, budget, or funding amount for the Centre or the strategy.
• The province may seek recovery of past and estimated future health care costs, but the material gives no estimate of legal costs, likely recoveries, or when any recovery might occur.
• The bill does not set a new tax, fee, or fine.

What is unclear#

• The supplied text does not give the proclamation date for the Centre provisions.
• The strategy’s content, timeline, targets and funding are not specified.
• The bill does not state how providers or other groups can obtain support from the Centre, or how its standards will be applied.
• The supplied material does not include the full current Connecting Care Act or Limitations Act. I could not verify how the amendments interact with every rule in those Acts.
• The material does not estimate how many claims Ontario may bring or what they may cost.

Case for#

• The bill appears intended to address gaps in coordination and support for mental health and addictions care. A centre inside Ontario Health could connect strategy, standards, performance measures and provider support within one existing organization.
• Ontario pays for a wide range of health care benefits. A direct claim could let the province seek repayment from businesses found responsible for costs caused or contributed to by opioid-related wrongdoing.
• Population-wide claims can proceed without identifying every affected person or proving each person’s individual health care costs. That may make it possible to pursue costs that would be difficult to prove one person at a time, while allowing defendants to challenge their share.

Case against#

• The Centre must perform broad functions, but the Act does not set its budget, staffing, deadlines or measurable goals. It is therefore unclear what practical improvements the law itself will produce.
• Population-wide claims use presumptions and market-share calculations rather than requiring proof of each person’s case. This may make claims more workable, but it also creates a complex way to decide responsibility and costs.
• The Act gives Ontario a broad, retroactive route to seek recovery. The supplied material does not estimate litigation costs or explain how any recovered money would be used.