Ontario to End Agency Staffing in Care

Summary#

• This bill creates new rules for healthcare staffing agencies in Ontario and for hospitals and long‑term care homes that use them. The goal is to sharply reduce and then end the use of agency staff within two years in most places, add oversight for publicly funded agencies, and curb high pay premiums and poaching.
• Key changes:
  • Hospitals and long‑term care homes in towns and cities with 8,000+ people must publish a plan to cut agency spending on a set schedule and stop using agencies within 24 months.
  • New staffing agencies formed after the law takes effect must be not‑for‑profit.
  • Agencies that receive more than $400,000 from the Ontario government or its funding bodies face oversight by watchdogs, and their employees go on the public Sunshine List (names and pay disclosed if over the threshold).
  • Agency workers assigned to a site cannot be paid more than 10% above that site’s pay rate for the same job; travel and per‑diem costs must be public and paid directly to the worker, with possible limits set by the Minister.
  • Agencies cannot poach staff from hospitals or long‑term care homes and face fines up to $1,000,000 for violations; they also cannot assign workers back into the same or nearby local health team area if the worker is currently employed there or left within the past 12 months.
  • Each plan must be led by the top nursing leader and include steps to keep care safe and humane during the transition.

What it means for you#

• Patients and long‑term care residents

  • You may see fewer agency staff over the next two years, especially in larger cities. The aim is more permanent staff and more stable care teams.
  • Hospitals and homes must explain how they will keep care safe and humane while they reduce agency use.

• Hospital and long‑term care staff

  • Your employer must post a public plan and update it every six months showing agency spending and other staffing costs.
  • The head of nursing must help lead the plan.
  • Agencies cannot recruit (“poach”) you from your employer. If you leave, an agency cannot assign you back to the same or nearby local health team area for 12 months.
  • Agency worker pay at your site is capped at 10% above your site’s rate for the same job.

• Healthcare staffing agency workers

  • Your hourly pay for assigned shifts at a hospital or long‑term care home cannot be more than 10% above that site’s rate for your role.
  • Travel, lodging, and per‑diem payments must be made public and paid directly to you; the government may set limits on these amounts.
  • If your agency gets more than $400,000 from the province or its funding bodies, your name and pay may appear on the Sunshine List.
  • You cannot be assigned to a hospital or long‑term care home in the same or a nearby local health team area if you currently work there or left within the last year.
  • Agency shifts will likely shrink over time in places with 8,000+ people, ending within two years.

• Hospitals and long‑term care homes

  • If your municipality has 8,000+ people, you must publish a plan within six months, update it every six months, and meet strict caps:
    • Pop. 500,000+: after 6 months, agency spend ≤1% of staffing; after 12 months, ≤0.5%; after 24 months, 0%.
    • Pop. 100,000–499,999: after 6 months, ≤2%; after 12 months, ≤1%; after 24 months, 0%.
    • Pop. 8,000–99,999: after 6 months, ≤5%; after 12 months, ≤3%; after 24 months, 0%.
  • Your plan must show expected vs. actual agency spending, non‑agency staffing costs, and steps to protect care quality.
  • Any travel, lodging, and per‑diem charges for agency staff must be public and paid directly to the worker, not to the agency, and may be subject to government limits.

• Healthcare staffing agencies

  • New agencies formed after the law takes effect must be not‑for‑profit.
  • If you receive over $400,000 from the Ontario government or its transfer payment bodies, you are subject to oversight by the Auditor General, Patient Ombudsman, Ontario Ombudsman, and Integrity Commissioner; your employees are added to the Sunshine List.
  • You cannot pay assigned workers more than 10% above the host site’s rate for that role.
  • You cannot poach employees from hospitals or long‑term care homes; violations can bring fines up to $1,000,000, with fine revenue going to hospitals and homes.
  • You cannot assign workers who are currently employed by, or who left within the past 12 months, to the same or adjacent local health team area.

• Small municipalities under 8,000 people

  • The plan and spending‑cap rules do not apply. Other rules for agencies (pay cap, anti‑poaching, assignment limits, and oversight triggers) still apply province‑wide.

Expenses#

No publicly available information.

Proponents' View#

• Reduces high agency fees and overtime premiums, saving public money that can be used for permanent hires and patient care.
• Helps stabilize the workforce by curbing poaching and limiting large pay gaps between agency and in‑house staff.
• Improves continuity of care and patient safety by relying more on permanent teams and less on short‑term staff.
• Adds transparency and accountability when agencies receive significant public funds, including public reporting of pay and expenses.
• Direct payment of travel and per‑diems to workers reduces markups and ensures the funds go to the worker.
• A clear two‑year timeline pushes hospitals and homes to invest in recruitment, retention, and better working conditions.

Opponents' View#

• Timelines may be too fast and could lead to staffing gaps if hospitals and homes cannot hire enough permanent staff in time.
• The 10% pay cap and assignment limits may reduce the supply of agency workers willing to take shifts, especially for nights, weekends, remote areas, or hard‑to‑fill roles.
• Fully ending agency use within two years could be risky for facilities that rely on agencies to cover sudden absences or surges in demand.
• New oversight rules and Sunshine List inclusion may deter agencies and workers, adding administrative burden without clear benefits.
• Banning poaching and restricting assignments may limit worker choice and earning power, and could complicate career moves between employers.
• Requiring new agencies to be not‑for‑profit may reduce competition and flexibility in the staffing market.