Summary#

Bill 231, the More Convenient Care Act, 2024, would amend six existing Acts and create the Health Care Staffing Agency Reporting Act, 2024. Its stated goal is to make care more convenient and connected, and to strengthen health-system oversight and transparency; these are goals, not guaranteed results.

• Hamilton public health: It would establish a board of health for the city. The city would appoint all members, provide the public health employees it considers necessary, and keep authority over appointing, reappointing and dismissing the medical officer of health, associate medical officers and auditor.
• French-language services: It would make the French Language Services Act apply to the Service Organization under the Connecting Care Act, 2019, as if it were a government agency.
• Staffing agencies: Agencies assigning prescribed workers to covered health facilities would have to report aggregate administrative, billing or pay-rate information to the Minister of Health at least every six months, unless regulations set another schedule. They would also have to keep certain contracts and invoices for three years. The Minister may publish prescribed report information.
• Public-health orders: A medical officer of health could direct a class order to people in their health unit only after notifying the Chief Medical Officer of Health and receiving written approval.
• Blood tests: Nurse practitioners could take on many roles currently assigned to physicians under the Mandatory Blood Testing Act, 2006, including preparing reports and taking blood samples under an order.
• Digital health identifiers: A prescribed organization could carry out activities such as creating and managing unique health identifiers. The bill sets privacy duties and gives the Minister directive powers, but regulations may change some privacy and consent rules.

What it means for you#

• Hamilton residents: A board of health would carry out the board’s duties under the Health Protection and Promotion Act. At the city’s request, it would also make recommendations on public-health issues within the city’s jurisdiction and report to the city annually.
• People who use health services: The bill does not require anyone to get or use a digital health identifier. The organization may collect or use personal health information for these activities with the person’s express consent, and may disclose it to the Minister for validation and verification with express consent. Regulations could set exceptions, including circumstances where consent is not required.
• Patients and health information custodians: The bill adds privacy protections and breach-notification duties for digital health identifier records. It also removes an individual’s right to request correction of certain records held by the prescribed organization, or of certain related records held by a health information custodian.
• Staffing agencies and covered health facilities: Agencies would face new reporting and record-keeping duties. Contravening the new Act or its regulations could lead to a fine of up to $10,000 for an individual or $25,000 for a corporation.
• People affected by class orders: Medical officers of health would need written approval from the Chief Medical Officer of Health before issuing a class order.
• Current-law comparison: The bill’s explanatory note says Hamilton itself currently has the powers and duties of a board of health. The supplied material does not include the full amended Acts, so other details of current law could not be checked against them.

Money#

No cost information is in the available material.

• The bill requires the City of Hamilton to provide the board with the public-health employees the city considers necessary, but gives no staffing level or cost estimate.
• Staffing agencies would have reporting and record-keeping costs; no estimate is provided.
• The bill does not set out a new appropriation, tax, fee or benefit.

What is unclear#

• Which organization will be prescribed to provide digital health identifiers, and which individuals or groups will be eligible.
• What information staffing agencies must report, which workers are “prescribed persons,” and what information the Minister may publish. Regulations would set these details.
• How privacy and consent rules may be changed by regulation, and how those changes would interact with existing programs.
• When the staffing-agency law and most digital-identifier provisions will start. They require proclamation, and no dates are provided. The nurse-practitioner changes cannot start before July 1, 2025.
• No publicly available information.

Case for#

• The reporting duty could give the Minister more information about staffing-agency billing and pay rates in covered health facilities.
• Allowing nurse practitioners to perform specified functions could give the blood-testing process another qualified health professional to rely on.
• A digital identifier could help people confirm their identity when accessing health services. The bill pairs that authority with privacy practices, security steps and breach notices.
• A Hamilton board could provide a distinct local body for public-health work while keeping specified appointment powers with the city.

Case against#

• The bill leaves important digital-identifier details to future regulations, including possible exceptions to consent requirements.
• Individuals would not have a right to request correction of certain records connected to the prescribed organization, and the Freedom of Information and Protection of Privacy Act would not apply to its personal health information unless the law or regulations provide otherwise.
• The Minister could issue binding directives on eligibility, security and technology. The bill requires consultation on drafts, but the organization must comply with directives.
• The reporting law’s exact information requirements and publication rules are not set in the bill, so its effect on transparency and agency costs is uncertain.