Regulation - LGIC

Proposed Regulatory Amendments to Allow Out-Of-Province Regulated Health Professionals to Temporarily Practice in Ontario Without Registration with an Ontario Regulatory College

Regulation Number(s):
Instrument Type:
Regulation - LGIC
Bill or Act:
Medicine Act, 1991 and as below
Summary of Decision:
On July 24, 2023, Schedule 2 under Bill 60: Your Health Act, 2023, came into force which introduced new "As of Right" rules for certain out-of-province regulated health professionals (OPRHPs). Also coming into force are regulatory amendments made under four health profession Acts and a variety of supporting Acts that will support "As of Right" implementation.

With these new "As of Right" rules, the Ontario government will allow out-of-province physicians, nurses, medical laboratory technologists, and respiratory therapists registered in other provinces and territories and who meet specified conditions to immediately start working in Ontario's public hospitals and long-term care homes, without having to first register with one of Ontario's health regulatory colleges. This change will reduce registration barriers for certain health care workers registered in other provinces and territories, making it faster and easier for them to begin practice in Ontario.
Analysis of Regulatory Impact:
To practice in Ontario, individuals from other Canadian jurisdictions must register with the applicable Ontario health regulatory College to practice. While the Canadian Free Trade Agreement (CFTA) allows for expedited mobility between jurisdictions, there remain certain administrative barriers associated with the registration process (e.g., validating credentials, assessing for competence) that can take a significant amount of time and delay an individual's ability to work immediately.
The proposed regulatory amendments are focused on eliminating barriers to registration for the selected OPRHPs to allow for expedited employment in hospitals and long-term care homes. While waiting for their application to be assessed, these professionals will be able to begin working immediately.
If approved, the proposed regulations would result in increased capacity in Ontario's hospitals and long-term care homes. This would help reduce staffing shortages, burnout, and long wait times for health services to provide more comprehensive health care services for Ontarians. Additionally, the proposed regulations could pave the way for future initiatives such as a national approach to registration.
Further Information:
Proposal Number:
Posting Date:
June 9, 2023
Summary of Proposal:
Main Regulations:
Regulations under the Medical Laboratory Technology Act, 1991, Medicine Act, 1991, Nursing Act, 1991, and Respiratory Therapy Act, 1991, to permit out-of-province regulated health professionals (OPRHPs) to use the protected titles and hold themselves out to be competent to practise their respective professions, subject to conditions, which include:

1. The person is registered with a regulatory authority in a Canadian jurisdiction, other than Ontario, and holds in that jurisdiction the equivalent of a certificate of registration authorizing independent practice in Ontario.

2. A regulatory authority in a Canadian jurisdiction has not refused to grant the person a certificate of registration in the profession within the last two years.

3. A finding of professional misconduct, incompetence or incapacity has not been made against the person as a result of a proceeding.

4. The person must not be the subject of any current professional misconduct, incompetence, or incapacity proceeding.

5. In Ontario, the person only provides services in public hospital or long-term care home.

6. The person has submitted to the college an application for a certificate of registration prior to providing professional services.

OPRHPs would lose the exemption under select circumstances, including:

1. The person has not been issued a certificate of registration by the college within 6 months after the person first began to provide professional services in Ontario.

Regulatory amendments to Ontario Regulation 246/22 under the Fixing the Long-Term Care Act to enable out-of-province (OOP) physicians, registered nurses, nurse practitioners (NPs), registered practical nurses, and respiratory therapists to provide services in long-term care homes. Per subsections 194 (1) to (5) of the Fixing the Long-Term Care Act, public consultation is required.

Supporting Regulations:
1. Commitment to the Future of Medicare Act, 2004: to prohibit extra billing from OOP physicians and to include OOP physicians and NPs in the reporting requirements related to queue jumping.
2. Gift of Life Act: To make the rules and authorities that apply to physicians under the Gift of Life Act applicable to OOP physicians.
3. Healing Arts Radiation Protection Act: to enable OOP physicians and nurse practitioners to order x-rays.
4. Health Protection and Promotion Act: To require OOP physicians and nurses to report diseases of public health significance to medical officers.
5. Health Insurance Act: To include OOP physicians and NPs in definitions for compensation and reporting purposes.
6. Laboratory and Specimen Collection Centre Licensing Act: To permit OOP physicians and certain nurses to requisition or perform certain laboratory services. To permit OOP medical laboratory technologists to work in a laboratory.
7. Narcotics Safety and Awareness Act, 2010: To designate OOP physicians and NPs as "prescribers" and "dispensers"
8. Ontario Medical Association Dues Act, 1991: To enable the collection of OMA dues from OOP physicians.
9. Public Hospitals Act: To enable OOP physicians and nurses to provide professional services in a hospital.
10. Regulated Health Professions Act, 1991: To enable OPRHPs access to controlled acts and to enable OOP physicians to use the "doctor" title.
Contact Address:
Health Workforce Regulatory Oversight Branch, 438 University Ave, 10th Floor, Toronto, ON M7A 1N3
Effective Date:
August 21, 2023