Summary#

Bill 60, Your Health Act, 2023, was enacted as an Ontario law. It creates the Integrated Community Health Services Centres Act, 2023, replaces the Independent Health Facilities Act when the new Act takes effect, and amends laws on regulated professions and access to information. Its stated goal is to expand access to publicly funded community health services and improve wait times and access to care.

• A Minister-appointed Director may license community health services centres. A centre covered by the Act must have a licence; the Director may set licence conditions, and licences may run for up to five years unless regulations allow longer.
• The Minister may pay some or all facility and operating costs. A centre may charge facility costs only if licensed, and only to the Minister or a person named in regulations—not to an insured patient for an insured service.
• The Act bars selling priority access to insured services and refusing an insured service because a patient declines to pay for a product, device or service offered at the centre.
• Inspectors may examine records and premises, and the Director or an inspecting body may issue compliance orders. The Act also allows licence suspension or revocation and creates offences with fines.
• Other amendments allow regulations to recognize prescribed people in some health-profession roles, expand pharmacists’ scope to assess conditions for medication therapy, and extend freedom-of-information rules to certain data integration units.

What it means for you#

• Patients: The Act bars charges for priority access to an insured service and bars denying an insured service because you decline an optional product, device or service. It does not, by itself, make every service at a centre insured or free; it permits facility costs to be charged to the Minister or a prescribed person.
• Community health centres and applicants: Covered centres must be licensed and meet applicable quality and safety standards. Applications must address matters including staffing, costs, links with the health system, and access for diverse and underserved populations. The Director decides whether to issue a licence and may prefer one application over another.
• Workers and pharmacists: Regulations may allow prescribed people to count as physicians, nurses or other specified health workers under certain Acts, or exempt people from some rules on using professional titles or presenting themselves as professionals. The bill does not itself identify those people or set the conditions. Pharmacists’ scope is expanded to include assessing conditions to provide medication therapy.
• Data integration units and the public: Certain extra-ministerial units that are not already covered by Ontario’s freedom-of-information law are treated as institutions for personal information collected under the relevant data-integration rules. Their senior officers must publish contact, function and record-type information each year.
• Taxpayers and the public: The Act gives government oversight powers, including inspections and compliance orders. Individuals and corporations can face fines for listed offences; maximum fines are $50,000 for an individual’s first offence and $100,000 for a corporation’s first offence, per day or part-day. Higher maximums apply to later offences. Some offences can also carry up to 12 months’ imprisonment for individuals.

Money#

No publicly available information on the bill’s estimated net public cost.

• The Minister may pay some or all facility costs and other operating costs, but the Act does not require payment at a stated amount.
• Inspecting bodies may set fees for applicants and licensees, including fees for administrative and overhead costs.
• The Director’s office, inspections and related administration require resources; the supplied material gives no staffing or cost estimate.

What is unclear#

• The Act’s main licensing and oversight provisions take effect on dates set by proclamation. The supplied material does not say which proclamation dates have occurred.
• Regulations will set important details, including covered or exempt facilities, payment rules, standards, inspection arrangements and fees. Those details are not included here.
• The bill does not name the people who may be prescribed for expanded health-profession roles or set the conditions for their work.
• The parent Acts and current regulations were not supplied, so the full before-and-after effect of the amendments could not be checked.
• No cost estimate or forecast of how many centres, patients or workers would be affected is provided.

Case for#

• The bill appears intended to add publicly funded community services while requiring centres to meet licensing and safety rules.
• A possible argument for the model is that the Director can consider local service needs, wait times, staffing and public cost before issuing licences.
• The bans on priority-access payments and on conditioning insured care on optional purchases are intended to protect patients from paying for preferential access or losing insured care for refusing an extra purchase.
• A single licensing law could bring centre oversight, inspections and payment accountability under one statute.

Case against#

• The Act gives the Minister and Director significant discretion over licences, licence conditions and service coverage. The bill does not set detailed decision rules or guarantee that a licence will be issued where demand exists.
• The Minister may fund operating costs, and inspecting bodies may charge fees, but the bill supplies no cost estimate or limits in dollars.
• Important details depend on future regulations, including which facilities and workers are covered and how inspections and fees will work.
• The text permits collection and disclosure of personal information for specified purposes; the practical safeguards and extent of use depend partly on regulations.