September 27, 2017

Later today, the Ministry of Health and Long-Term Care (MOHLTC) will introduce omnibus legislation to amend a number of acts relevant to municipal government including the Ambulance Act, Long-Term Care Homes Act, and the Health Protection and Promotion Act.

The government announcement with information and context about the introduction of the Strengthening Quality and Accountability for Patients Act, 2017 is on the government newsroom website.

Ambulance Act
We understand that this draft Ambulance Act legislation will open the door to the use of the fire-medic model. The MOHLTC Minister, the Honourable Dr. Hoskins, has committed that two pilot projects will test the use of firefighters certified as paramedics to respond to low-acuity calls in willing municipalities. Appropriate regulations and program design, along with municipal council approval, will be required before any such pilot projects can begin.

Over the last two years there have been strong AMO/municipal leaders’ demands for this legislation to include language to prohibit arbitrators from replicating these pilot projects to protect unwilling municipal governments, if or when they are launched. If this is not in today’s draft legislation, AMO and municipal elected leaders will continue to insist that the Province must address the labour relations concerns of municipal employers prior to these pilots’ introduction by concurrently amending the Fire Protection and Prevention Act and any other required legislation, as it amends the Ambulance Act.

Additionally through these Ambulance Act amendments, the Province is seeking to provide paramedics with increased flexibility to deliver alternative care options on-scene to patients. If adopted, paramedics will have the ability and authority to refer patients to destinations other than hospitals, as is currently required by law. This approach should benefit patients and reduce low-acuity emergency room visits. However, there are serious municipal/DSSAB questions about standards, training, and liability that need to be worked out before proceeding with any implementation.

The proposed legislative amendments do not address all long-standing issues of municipal concern. AMO and its municipal partners will continue to urge MOHLTC to make immediate improvements to the call triaging and dispatch system, as well as addressing the current non-urgent transfer requirements on an emergency service. Both matters are part of the MOHLTC Phase 2 plan to enhance emergency services in Ontario.

Long-Term Care Homes Act
The amendments to this Act are intended to enhance Ontario’s quality and safety inspection program for Long-Term Care Homes. This would include new enforcement tools that the government could apply including financial penalties and new provincial offences for non-compliance with the Act and regulations.

Municipal governments are proud of our solid record in providing quality long-term care and want a system that will enhance that tradition. Analysis of the proposed amendments is required. Generally, there is support of enforcement steps to deal with homes that chronically do not meet standards as long as the response is proportionate to the action and the process is sound.

Health Protection and Promotion Act
The proposed changes to the Act would enable the permitting of regulations of recreational water facilities. This would include splash pads, wading pools and other personal service settings like nail salons, barber shops and tattoo parlours.

AMO and our members will consider the impact of the proposed changes and assess their ability to better prevent infection in these settings in a cost effective manner.

The omnibus bill also proposed to amend the following Acts:
  • Health Sector Payment Transparency Act
  • Retirement Homes Act
  • Oversight of Health Facilities and Devices Act
  • Medical Radiation and Imaging Technology Act
  • Excellent Care for All Act
  • Ontario Drug Benefit Act
  • Ontario Mental Health Foundation Act.
A high-level explanation of the proposed changes to the 10 pieces of legislation are found also on the government website in a backgrounder.

AMO staff and the AMO Health Task Force will review all these legislative amendments in detail to assess the municipal impacts. Further information to members will be provided when available.