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2nd Session, 42nd Legislature

This HTML version is provided for ease of use and is based on the bilingual version that was distributed in the Legislature after First Reading.

Bill 10

THE REGIONAL HEALTH AUTHORITIES AMENDMENT ACT (HEALTH SYSTEM GOVERNANCE AND ACCOUNTABILITY)


  Bilingual version (PDF) Explanatory Note

(Assented to                                         )

HER MAJESTY, by and with the advice and consent of the Legislative Assembly of Manitoba, enacts as follows:

PART 1

THE REGIONAL HEALTH AUTHORITIES ACT

C.C.S.M. c. R34 amended

1           The Regional Health Authorities Act is amended by this Part.

2           The title is replaced with "THE HEALTH SYSTEM GOVERNANCE AND ACCOUNTABILITY ACT".

3(1)        Section 1 is amended

(a) in the definition "board", by striking out "regional";

(b) in the definition "health care provider", by striking out "regional" wherever it occurs;

(c) in clause (c) of the definition "health corporation", in the part before subclause (i), by adding ", other than a health authority," after "a corporation";

(d) in the definition "regional health authority", by striking out "continued" and substituting "designated";

(e) by replacing the definitions "health care organization" and "hospital" with the following:

"health care organization" means a person or group of persons that delivers health services, but does not include a health authority, health corporation or health care provider; (« organisme de soins de santé »)

"hospital" means a hospital as defined in The Health Services Insurance Act; (« hôpital »)

(f) in the English version, by replacing the definition "prescribed" with the following:

"prescribed" means prescribed by a regulation under this Act;

(g) by adding the following definitions:

"accountability agreement" means an accountability agreement that a health authority is required to enter into with the minister under subsection 43.1(1); (« accord sur l'obligation redditionnelle »)

"cancer authority" means the cancer authority established or designated under this Act; (« office des soins contre le cancer »)

"health authority" means any of the following:

(a) the provincial health authority,

(b) the cancer authority,

(c) a regional health authority; (« office de la santé »)

"personal health information" means personal health information as defined in The Personal Health Information Act; (« renseignements médicaux personnels »)

"personal information" means personal information as defined in The Freedom of Information and Protection of Privacy Act; (« renseignements personnels »)

"prescribed standards" means standards prescribed by the minister for the provision of health services; (« normes réglementaires »)

"provincial administrative and support services" means the administrative and support services the provincial health authority is to administer, deliver or provide for, as determined by the minister under subsection 3(2); (« services provinciaux d'administration et de soutien »)

"provincial clinical and preventive services plan" means a plan referred to in clause 23(2)(b); (« plan provincial des services cliniques et préventifs »)

"provincial health authority" means the provincial health authority established or designated under this Act; (« office provincial de la santé »)

"provincial health human resources plan" means a plan respecting human resource requirements for the delivery of health services in Manitoba as set out in the provincial clinical and preventive services plan and in this Act, including workforce planning, labour relations and recruitment and retention of health care providers and other professionals; (« plan provincial des ressources humaines en matière de santé »)

"provincial health services" means the health services the provincial health authority is to administer, deliver or provide for, as determined by the minister under subsection 3(2); (« services de santé  provinciaux »)

"strategic and operational plan" means a plan approved or amended under section 24. (« plan stratégique et opérationnel »)

(h) by repealing the definitions "local health involvement group", "prescribed health services" and "regional health plan".

3(2)        Section 1 is further amended by renumbering it as subsection 1(1) and adding the following as subsection 1(2):

Reference to "this Act" includes regulations

1(2)        In this Act, a reference to "this Act" includes the regulations made under this Act.

4(1)        Subsection 2(1) is replaced with the following:

Purposes

2(1)        The purposes of this Act are to

(a) govern the planning, administration and delivery of health services in Manitoba;

(b) establish the health authorities and their responsibilities, duties and powers; and

(c) establish an accountability framework for the health authorities and the entities funded by the authorities.

4(2)        Subsection 2(3) is amended, in the part before clause (a),

(a) by striking out "or the regulations"; and

(b) by striking out "and the regulations".

5           Subsections 3(2) and (3) are replaced with the following:

Minister may determine service provider

3(2)        The minister may determine which health services and which administrative and support services are to be administered, delivered or provided for by the provincial health authority and which are to be administered, delivered or provided for by regional health authorities within their health regions. In doing so, the minister may consider any factors the minister considers relevant.

Regulations re standards

3(3)        The minister may, by regulation, prescribe standards for the provision of health services in Manitoba.

Directions to health authority

3(4)        The minister may give directions to a health authority that the minister considers appropriate to achieve the purposes of this Act, including directions respecting

(a) provincial objectives and priorities;

(b) the types of health services to be provided or made available by the authority;

(c) the coordination of the authority's activities with the activities of the government, a government agency or any other person;

(d) the manner in which the authority is to carry out its responsibilities, perform its duties and exercise its powers under this Act or under its accountability agreement; and

(e) the management or administration of the authority.

6           Clause 4(a) is amended by striking out "regional".

7           Subsection 5(1) is amended

(a) in the part before clause (a), by striking out "and the regulations"; and

(b) in clause (e), by striking out "regional".

8           Clauses 6(a) and (b) are amended by striking out "regional".

9           Part 3 is replaced with the following:

PART 3

HEALTH AUTHORITIES AND HEALTH REGIONS

ESTABLISHMENT OR DESIGNATION

Establishment or designation of health authorities

8(1)        The Lieutenant Governor in Council may, by regulation, establish or designate

(a) a provincial health authority;

(b) a cancer authority; and

(c) a regional health authority for each health region.

Contents of regulation

8(2)        A regulation establishing or designating a health authority must

(a) name the authority;

(b) in the case of a regional health authority, specify its health region; and

(c) in the case of a health authority being established, specify the organization and composition of the authority, including the composition of its board of directors and the number of directors on it.

Effect of designation

8(3)        If a corporation is designated as a health authority, it is continued under this Act and a director or chairperson of the corporation's board of directors who holds office on the effective date of the designation is deemed to be a first director or chairperson, as the case may be, of the health authority as if they were appointed under section 15 and continues to hold office until their successor is appointed in accordance with section 14.

Establishment of health regions

9           The Lieutenant Governor in Council may, by regulation, establish one or more health regions in the province.

VARIATION OF AUTHORITY OR REGION

Variation

10          The Lieutenant Governor in Council may, by regulation,

(a) vary any aspect of the organization or composition of a health authority, including the composition of its board;

(b) vary the size or boundaries of a health region;

(c) provide for such matters as the Lieutenant Governor in Council considers necessary to facilitate the variation.

GENERAL

Consultations

10.1        If the minister considers it advisable to do so, the minister may carry out such consultations respecting the subject matter of a proposed regulation under this Part as the minister considers appropriate and may carry them out in any manner the minister sees fit.

10          The heading for Part 4 is amended by striking out "REGIONAL".

11          Sections 11 and 12 are replaced with the following:

Corporate status

11(1)       Each health authority is established or continued as a corporation without share capital and consists of the members of its board appointed in accordance with this Act.

Corporate powers

11(2)       Subject to this Act, a health authority has all the rights, powers and privileges of a natural person for the purposes of carrying out its responsibilities, performing its duties and exercising its powers under this Act.

Restriction on payments and benefits to directors

12          No part of the income or property of a health authority may be paid to, or made available for the personal benefit of, any of its directors except as permitted or required under section 16.

12          Section 13 is amended by striking out "regional".

13(1)       Subsection 14(1) is amended

(a) in the section heading and in the section, by striking out "regional"; and

(b) by striking out "or elected in accordance with this Act and the regulations" and substituting "in accordance with this Act".

13(2)       Subsection 14(4) is amended by striking out "regional".

13(3)       Subsection 14(5) is repealed.

14(1)       Subsection 15(1) is amended

(a) in clauses (a) and (b), by striking out "regional"; and

(b) in clause (c), by striking out "or elected".

14(2)       Subsection 15(2) is amended

(a) by striking out "regional"; and

(b) by striking out "or elected".

15          Section 16 is amended by striking out "regional".

16          Section 17 is replaced with the following:

Duties of directors

17          A director of a health authority's board must

(a) act honestly and in good faith with a view to the best interests of the health authority and the public interest; and

(b) exercise the care, diligence and skill that a reasonable and prudent person would exercise in comparable circumstances, and carry out their duties in accordance with this Act.

17(1)       Subsection 18(1) is replaced with the following:

By-laws and policies

18(1)       The board of a health authority must make by-laws and policies not inconsistent with this Act regarding its internal organization and proceedings and for the general conduct and management of the affairs of the authority.

17(2)       Subsection 18(2) of the English version is amended, in the part before clause (a), by striking out "shall" and substituting "must".

17(3)       Subsection 18(4) is amended

(a) by striking out "a board shall" and substituting "the board of a health authority must"; and

(b) by striking out "regional health".

18          Section 20 is amended by striking out "and elected".

19(1)       Subsection 21(1) is amended

(a) by striking out "A board shall" and substituting "The board of a health authority must"; and

(b) by striking out "regional health".

19(2)       Subsection 21(2) is amended by striking out "regional health" wherever it occurs.

20          Section 22 is amended

(a) by striking out "and the regulations, a board" and substituting ", the board of a health authority"; and

(b) by striking out "regional health".

21          Section 22.1 is amended by striking out "regional".

22          The Division heading after section 22.1 and sections 23 to 24 are replaced with the following:

DIVISION 2

RESPONSIBILITIES, DUTIES AND POWERS OF HEALTH AUTHORITIES

PROVINCIAL HEALTH AUTHORITY

Responsibilities

23(1)       The provincial health authority is responsible for

(a) planning in relation to the provincial health system as set out in subsection (2);

(b) administering and delivering, or providing for the delivery of, provincial health services in accordance with this Act, the provincial clinical and preventive services plan and the authority's strategic and operational plan; and

(c) administering and delivering, or providing for the delivery of, provincial administrative and support services.

Duties

23(2)       In carrying out its responsibilities and any other function assigned to it by or under this Act, the provincial health authority must

(a) comply with its accountability agreement;

(b) prepare for the minister's approval

(i) successive five-year provincial clinical and preventive services plans respecting the delivery of health services in Manitoba, and

(ii) annual updates to those plans and any additional updates required by the minister;

(c) establish clinical standards for the delivery of health services provided or funded by the government or a health authority, and update those standards;

(d) implement its strategic and operational plan as approved by the minister under section 24;

(e) manage and allocate resources, including funding provided by the government for health services, in accordance with this Act and the authority's strategic and operational plan;

(f) in administering and delivering or providing for the delivery of health services,

(i) ensure that health services are delivered in accordance with directions given by the minister,

(ii) comply with, and ensure compliance with, prescribed standards and clinical standards, and

(iii) ensure that there is reasonable access to health services;

(g) monitor and evaluate

(i) the implementation of the provincial clinical and preventive services plan by the provincial health authority and the other health authorities, and by health corporations and health care organizations,

(ii) compliance with prescribed standards and clinical standards by the provincial health authority and by the regional health authorities, health corporations and health care organizations, and

(iii) the provincial health authority's delivery of health services and its compliance with provincial objectives and priorities;

(h) prepare for the minister's approval an annual provincial health capital plan that is based on the provincial clinical and preventive services plan;

(i) assist the cancer authority and regional health authorities with the development of their proposals for capital projects;

(j) at the minister's request, review the following and make recommendations to the minister:

(i) proposals for capital projects submitted by the cancer authority or regional health authorities,

(ii) proposals submitted by the cancer authority, regional health authorities, health corporations or health care organizations for the disposition of facilities that have received capital funding or operational funding directly or indirectly from the government;

(k) oversee the construction of facilities by the cancer authority, regional health authorities, health corporations and health care organizations if at least 2/3 of the cost of the construction is funded directly or indirectly by the government;

(l) oversee the expansion or major renovation of facilities by the cancer authority, regional health authorities, health corporations and health care organizations if at least 2/3 of the cost of the expansion or renovation is funded directly or indirectly by the government and the cost exceeds an amount determined by the minister;

(m) develop provincial health human resources plans for approval by the minister;

(n) provide provincial administrative and support services to the cancer authority, regional health authorities, health corporations and health care organizations;

(o) provide facilities for undergraduate and postgraduate study relating to health conditions and health services;

(p) train technical personnel to assist in the provision of health services; and

(q) comply with any directions given by the minister.

Consultations

23(3)       In preparing and updating a provincial clinical and preventive services plan for the minister's approval, the provincial health authority must carry out consultations respecting the plan as directed by the minister.

Ownership of hospital or other facility

23(4)       To carry out its responsibilities and perform its duties, the provincial health authority may, with the minister's approval, own or operate a facility in any health region.

Establishment of standards committees

23.1(1)     The provincial health authority may establish one or more standards committees for the purpose of

(a) reviewing the professional competence of health care providers; and

(b) based on one or more reviews under clause (a), making recommendations respecting

(i) additional education or training that should be provided to an individual health care provider, or

(ii) actions or systemic changes that should be made to improve the quality of patient care or services provided by a health authority, health corporation, health care organization or health care provider.

Designation of standards committee

23.1(2)     The provincial health authority may

(a) designate a subcommittee established under subsection 182(1) of The Regulated Health Professions Act as a standards committee for the purposes of this section; and

(b) request the College of Physicians and Surgeons of Manitoba to establish a subcommittee under subsection 182(1) of The Regulated Health Professions Act for designation under clause (a).

Consultation

23.1(3)     When establishing or designating a standards committee, the provincial health authority must consult with the following entities:

(a) if the committee relates to medical services, the College of Physicians and Surgeons of Manitoba;

(b) if the committee relates to other health services, the college or association that is responsible for regulating the practice of the health profession relating to those health services under The Regulated Health Professions Act or an Act listed in Schedule 2 of that Act.

Limit on access to records

23.1(4)     No person has a right of access under any Act or regulation — including under Part 2 of The Freedom of Information and Protection of Privacy Act or Part 2 of The Personal Health Information Act — to

(a) a record or information, including an opinion or advice, prepared solely for use by a standards committee; or

(b) a record or information collected, compiled or prepared by a standards committee for the sole purpose of performing its duties.

Exception

23.1(5)     The limit on the right of access in subsection (4) does not apply to

(a) information in a record created or maintained for the purpose of providing health services to an individual; or

(b) information in a record required by law to be created or maintained by the owner, operator or person in charge of a facility or by a health care provider.

CANCER AUTHORITY

Responsibilities

23.2(1)     The cancer authority is responsible for

(a) administering and delivering, or providing for the delivery of, health services relating to the prevention, diagnosis and treatment of cancer in accordance with the provincial clinical and preventive services plan and the cancer authority's strategic and operational plan;

(b) facilitating or conducting cancer research;

(c) facilitating or providing public education regarding the prevention, diagnosis and treatment of cancer; and

(d) studying hazards arising from the use of ionizing radiation equipment and radioactive materials in Manitoba and developing measures to address those hazards.

Duties

23.2(2)     In carrying out its responsibilities and any other function assigned to it by or under this Act, the cancer authority must

(a) comply with its accountability agreement;

(b) participate in the preparation and updating of provincial clinical and preventive services plans;

(c) establish clinical standards for the delivery of health services related to the prevention, diagnosis and treatment of cancer, and update those standards;

(d) implement its strategic and operational plan as approved by the minister under section 24;

(e) manage and allocate resources, including funding provided by the government for health services, in accordance with this Act and the cancer authority's strategic and operational plan;

(f) in administering and delivering or providing for the delivery of health services,

(i) ensure that health services are delivered in accordance with directions given by the minister,

(ii) comply with, and ensure compliance with, prescribed standards and clinical standards as they relate to the health services for which the cancer authority is responsible, and

(iii) ensure that there is reasonable access to cancer-related health services;

(g) cooperate with others, including government departments and agencies, in the delivery of cancer-related health services;

(h) report cases of cancer and record, compile and analyse data relating to cancer;

(i) monitor and evaluate

(i) the delivery of cancer-related health services by the cancer authority and the other health authorities, and by health corporations, and

(ii) compliance with the provincial clinical and preventive services plan, provincial objectives and priorities, prescribed standards and clinical standards by the cancer authority and, insofar as it relates to cancer-related health services, by the other health authorities and by health corporations;

(j) participate in the delivery of provincial administrative and support services by the provincial health authority;

(k) provide facilities for undergraduate and postgraduate study relating to health conditions and health services;

(l) train technical personnel to assist in the provision of health services; and

(m) comply with any directions given by the minister.

REGIONAL HEALTH AUTHORITIES

Responsibilities

23.3(1)     A regional health authority is responsible for administering and delivering, or providing for the delivery of, health services in its health region in accordance with this Act, the provincial clinical and preventive services plan and the regional health authority's strategic and operational plan.

Duties

23.3(2)     In carrying out its responsibilities and any other function assigned to it by or under this Act, a regional health authority must

(a) comply with its accountability agreement;

(b) participate in the preparation and updating of provincial clinical and preventive services plans;

(c) promote and protect the health of the population of its health region and develop and implement measures for the prevention of disease and injury in accordance with the provincial clinical and preventive services plan;

(d) implement its strategic and operational plan as approved by the minister under section 24;

(e) manage and allocate resources, including funding provided by the government for health services, in accordance with this Act and the authority's strategic and operational plan;

(f) in administering and delivering or providing for the delivery of health services,

(i) ensure that health services are delivered in accordance with directions given by the minister,

(ii) comply with, and ensure compliance with, prescribed standards and clinical standards as they relate to the health services for which the regional health authority is responsible, and

(iii) ensure that there is reasonable access to the health services for which the regional health authority is responsible;

(g) cooperate with others, including government departments and agencies,

(i) in the delivery of health services, and

(ii) in the coordination of health services and facilities in the province;

(h) monitor and evaluate

(i) the delivery of health services by that regional health authority and by any health corporation or health care organization delivering health services on its behalf, and

(ii) compliance with the provincial clinical and preventive services plan, provincial objectives and priorities, prescribed standards and clinical standards by that regional health authority, and by any health corporation or health care organization delivering health services on its behalf;

(i) participate in the delivery of provincial administrative and support services by the provincial health authority;

(j) provide facilities for undergraduate and postgraduate study relating to health conditions and health services;

(k) train technical personnel to assist in the provision of health services; and

(l) comply with any directions given by the minister.

ACCREDITATION

Accreditation of health authority

23.4(1)     A health authority must, in accordance with any directions of the minister, ensure that it is accredited by the health accreditation body or bodies approved by the minister, and that its accreditation is maintained at all times.

Duty to participate

23.4(2)     A health corporation or health care organization that delivers health services and receives funding from a health authority must participate in the authority's accreditation process as required by the authority in order for it to obtain accreditation.

Copy of accreditation report to be made public

23.4(3)     Within 60 days after receiving a final report about accreditation from an approved health accreditation body, a health authority must

(a) provide a copy of the report to the minister; and

(b) publish the report on the authority's website.

Strategic and operational plan

24(1)       For each fiscal year, within the time and in the form specified by the minister, a health authority must prepare a strategic and operational plan in accordance with this section and submit it to the minister for approval.

Consultations

24(2)       In the course of preparing the plan, the authority must undertake consultations as directed by the minister.

Content of plan

24(3)       The plan must be consistent with the provincial clinical and preventive services plan, the provincial health human resources plan and the provincial capital plan and must

(a) state the authority's objectives and priorities (which must incorporate any applicable provincial objectives and priorities) for the provision of health services for which it is responsible;

(b) describe how the authority proposes to administer and deliver or provide for the delivery of the health services for which it is responsible and how the authority proposes to measure its performance in carrying out that responsibility;

(c) include a comprehensive financial plan, which must include a statement of how the authority's financial, human and other resources will be allocated; and

(d) deal with any other matters and contain any other information as the minister requires.

Approval of proposed plan

24(4)       After receiving the plan, the minister may

(a) approve the plan as submitted; or

(b) refer the plan back to the authority for changes to be made in accordance with any directions the minister considers appropriate.

Action if plan is referred back

24(5)       If the plan is referred back to the authority, the authority must comply with the minister's directions and resubmit the plan to the minister for approval.

Revision to be approved

24(6)       Any proposed revision of the plan after it has been approved must be submitted to the minister for approval. Subsections (4) and (5) apply to the proposed revision.

Minister may require revision to approved plan

24(7)       The minister may require a health authority to revise an approved plan. After receiving such a request, the health authority must revise the plan as required and submit it to the minister for approval within the time specified by the minister. Subsections (4) and (5) apply to the proposed revision.

23          The centred heading "OTHER POWERS AND RESTRICTIONS" is added before section 25.

24          Section 25 is amended

(a) in the section heading, by striking out "regional health authority" and substituting "health authorities";

(b) by replacing the part before clause (a) with "Subject to this Act, a health authority may";

(c) in clause (a), by adding "deliver or" before "provide";

(d) in clause (f), by striking out "the residents of the health region" and substituting "the public interest as it relates to health services"; and

(e) in clause (g) of the English version, by striking out "and the regulations".

25          Section 26 is replaced with the following:

Power to provide additional health services

26          Subject to this Act, a health authority may deliver or provide for the delivery of health services in addition to those for which it is responsible under this Act if

(a) there is a need for the additional services;

(b) the additional health services are included in an approved strategic and operational plan or have otherwise been approved by the minister;

(c) the provision of the additional services will not impair or interfere with the delivery of or access to the health services it is required to deliver or provide for; and

(d) sufficient resources are available to the authority and can be allocated in a manner that ensures that all health services delivered by it or on its behalf meet the prescribed standards, clinical standards and all applicable requirements under this or any other Act or regulation.

26          Section 27 is amended

(a) by replacing the part before clause (a) with "With the approval of the minister, a health authority may";

(b) in clause (a), by striking out everything after "its purposes"; and

(c) in clause (c),

(i) by striking out "regional", and

(ii) by striking out "interests of the health region" and substituting "public interest".

27(1)       Subsections 28(1) and (2) are replaced with the following:

Approval required for certain facilities

28(1)       A person must not acquire, establish, construct, operate, renovate, expand, convert or relocate a hospital or personal care home without the approval of

(a) the provincial health authority if operational funding for the hospital or personal care home is, or is to be, provided by that authority; or

(b) in any other case, the regional health authority for the health region in which the hospital or personal care home is, or is to be, located.

Approval required for sale of facilities

28(2)       If the government or a health authority has provided funding for the acquisition, establishment, construction, operation, major renovation, expansion, conversion or relocation of a facility, a person must not sell, lease or otherwise dispose of it or any real property associated with it without the approval of

(a) the provincial health authority if operational funding for the facility is, or most recently has been, provided by the provincial health authority; or

(b) the regional health authority for the health region in which the facility is located if operational funding for the facility is, or most recently has been, provided by the regional health authority.

27(2)       Subsection 28(3) is amended by striking out "regional".

28          Section 28.1 is repealed.

29          The following is added as sections 28.2 and 28.3:

Acquisition of equipment, software, etc.

28.2        Subject to the regulations, a health authority must not, without the minister's prior approval, purchase, lease, accept by donation or otherwise acquire

(a) equipment that will result in increased operating or capital costs; or

(b) computer or telecommunications software or equipment, whether or not it will result in increased operating or capital costs.

Patents

28.3        With the approval of the minister, a health authority may

(a) apply for or acquire, by purchase, licence or otherwise, any patent relating to a medical treatment or a medical diagnostic procedure or device; or

(b) sell, license or assign any rights it holds under a patent.

30          Section 29 is replaced with the following:

Health authority may require reports

29(1)       Subject to section 30.1, a health authority may require any person to whom it provides payments or funding (including a health corporation, health care organization or health care provider) to provide it with such information, reports, returns and financial statements, including audited financial statements, as it requires for the purpose of carrying out its responsibilities, performing its duties or exercising its powers under this Act.

Form of reports

29(2)       Information or a report, return or financial statement required under subsection (1) must be provided within the time and in the form specified by the health authority.

31(1)       Subsections 29.1(1) and (2) are replaced with the following:

Direction to health corporation

29.1(1)     A health authority may give a direction to a health corporation if it provides operational funding to the corporation.

Content of direction

29.1(2)     The direction may relate only to one or more of the following:

(a) the implementation of the provincial clinical and preventive services plan;

(b) the compliance with prescribed standards or clinical standards;

(c) in the case of a direction of the provincial health authority, matters that have an impact on its responsibility to administer and deliver, or provide for the delivery of, provincial health services;

(d) in the case of a regional health authority's direction, matters that have a region-wide impact on its responsibility to administer and deliver, or provide for the delivery of, health services in its health region.

31(2)       Subsection 29.1(3) is amended

(a) in the English version, by replacing the part before clause (a) with "The direction may not"; and

(b) in clause (a), by striking out "regional".

31(3)       Subsection 29.1(4) is replaced with the following:

Requirements for direction

29.1(4)     The direction must

(a) be in writing;

(b) contain reasons;

(c) be signed by the chief executive officer of the health authority giving it;

(d) be delivered to the corporation; and

(e) be filed with the minister.

31(4)       Clause 29.1(5)(b) is amended by striking out "regional".

32(1)       Subsection 29.3(1) is amended

(a) in the part before clause (a) of the French version, by striking out "ou est gérée par un tel organisme" and substituting "et dont un tel organisme assure la gestion"; and

(b) in clauses (a) and (b) of the English version, by striking out "health" wherever it occurs.

32(2)       Subsection 29.3(2) is amended

(a) in the French version, by striking out "ou est gérée par un tel organisme" and substituting "et dont un tel organisme assure la gestion"; and

(b) by striking out "regional health authority" and substituting "health authority that gave the direction".

33          Section 30 is replaced with the following:

Minister may require reports

30(1)       Subject to section 30.1, the minister may require a health authority to provide any information, reports, returns and financial statements, including audited financial statements, to the minister for the purposes of

(a) monitoring or evaluating

(i) the provision of health services or administrative and support services, or

(ii) compliance with the authority's accountability agreement;

(b) conducting research or planning that relates to the provision of health services or the payment for health services; or

(c) the administration of this Act.

Provincial health authority may require reports

30(2)       Subject to section 30.1, the provincial health authority may require the cancer authority or a regional health authority to provide any information and reports to the provincial health authority for the purpose of carrying out its responsibilities, performing its duties or exercising its powers under this Act.

Cancer authority may require reports

30(3)       Subject to section 30.1, the cancer authority may require the provincial health authority or a regional health authority to provide any information and reports relating to the prevention, diagnosis or treatment of cancer to the cancer authority for the purpose of carrying out its responsibilities, performing its duties or exercising its powers under this Act.

Timing and form of information or documentation

30(4)       Information or a report, return or financial statement required under this section must be provided within the time and in the form specified by the person requiring it to be provided.

Disclosure of personal information or personal health information

30.1(1)     A request to provide information or a report, return or financial statement under section 29 or 30 may require the disclosure of personal information or personal health information, but only if

(a) in the opinion of the minister or health authority making the request, the purpose of the request cannot be accomplished without the disclosure of personal information or personal health information; and

(b) the amount of personal information and personal health information required to be provided is limited to the minimum amount that, in the opinion of the minister or health authority making the request, is necessary to accomplish the purpose of the request.

Information subject to solicitor-client privilege

30.1(2)     A request to provide information or a report, return or financial statement under section 29 or 30 does not apply to information that is subject to solicitor-client privilege.

34          Section 31 is amended

(a) in the part before clause (a),

(i) by striking out "regional", and

(ii) by striking out "and the regulations" wherever it occurs; and

(b) in clause (e), by striking out "regional".

35          Section 32 is repealed.

36          Section 33 is amended, in the section heading and in the section,

(a) by adding "government" before "funding"; and

(b) by striking out "regional".

37          Section 33.1 is repealed.

38          Section 34 is amended by striking out "regional" wherever it occurs.

39          Section 35 is amended

(a) by striking out "regional" wherever it occurs; and

(b) by striking out "and the regulations".

40          Section 36 is amended

(a) in the section heading, by striking out "Regional health" and substituting "Health"; and

(b) in the section,

(i) by striking out "regional" wherever it occurs, and

(ii) by striking out "and the regulations".

41          Section 37 is amended by striking out "regional" in the section heading and in the section.

42(1)       Subsection 37.1(1) is amended by striking out "regional".

42(2)       Subsection 37.1(2) is amended by striking out ", as those terms are defined in section 53.1".

43(1)       Subsection 38(1) is amended by striking out "regional".

43(2)       Subsection 38(2) is amended

(a) in clauses (a) and (c) of the English version, by striking out "regional" wherever it occurs; and

(b) by repealing clauses (b) and (b.2).

44(1)       Subsections 38.1(1) and (2) are replaced with the following:

Health authority's publication of payments to CEO

38.1(1)     A health authority must publish on its website, in accordance with the regulations, information about expenses paid by it to or for the benefit of its chief executive officer or designated senior officer and about the expense claims resulting in those payments.

Health corporation's publication of payments to CEO

38.1(2)     If a health corporation receives operational funding from a health authority, the authority must publish on its website, in accordance with the regulations, information about expenses paid by the corporation to or for the benefit of its chief executive officer or designated senior officer and about the expense claims resulting in those payments.

Timing of publication

38.1(2.1)   The information to be published under subsection (1) or (2) must be published no later than June 30 following the end of the fiscal year in which the expenses were paid.

44(2)       Subsection 38.1(4) is amended

(a) in the section heading, by striking out "to RHA"; and

(b) by striking out "regional" wherever it occurs.

45(1)       Subsection 39(1) is amended by striking out "regional" wherever it occurs.

45(2)       Subsection 39(2) is replaced with the following:

Restrictions re appointment of auditor — provincial health authority and cancer authority

39(2)       The provincial health authority and the cancer authority must not appoint an individual as auditor, and no individual may act as auditor of the authority, if, in the fiscal year the appointment is made or in the immediately preceding fiscal year, the individual

(a) is or was a director of any health authority;

(b) is or was a director of a health corporation that received operational funding from the authority;

(c) has or had a direct or indirect interest in an agreement or contract entered into by the authority, other than a contract respecting the audit; or

(d) is or was employed by the authority in a capacity other than as auditor.

Restrictions re appointment of auditor — regional health authority

39(3)       A regional health authority must not appoint an individual as auditor, and no individual may act as auditor of a regional health authority, if, in the fiscal year the appointment is made or in the immediately preceding fiscal year, the individual

(a) is or was a director of the same regional health authority, the provincial health authority or the cancer authority;

(b) is or was a director of a health corporation providing health services in the health region;

(c) has or had a direct or indirect interest in an agreement or contract entered into by the same regional health authority, other than a contract respecting the audit; or

(d) is or was employed by the same regional health authority in a capacity other than as auditor.

46          Section 40 is amended by striking out "regional".

47          Section 41 is repealed.

48          Section 42 is amended

(a) by striking out "regional health authority provides or funds" and substituting "health authority delivers or provides funding for"; and

(b) in the English version, by striking out "the regional health authority" and substituting "the authority".

49(1)       Subsection 43(1) is replaced with the following:

Borrowing

43(1)       Subject to the regulations, a health authority may borrow money for its purposes and may pledge its assets as security for money borrowed, but it may do so only with the approval of the minister.

49(2)       Subsection 43(2) is amended by striking out "regional".

50          The following is added after section 43:

Accountability agreement required

43.1(1)      Each health authority must enter into an accountability agreement with the minister within the time specified by the minister.

Terms of accountability agreement

43.1(2)     The terms of an accountability agreement may be negotiated between the parties. But the agreement must be for a period of at least one fiscal year and include terms

(a) ensuring that the health authority will operate within the annual budget allocated to it by the minister;

(b) requiring any operating agreement or service purchase agreement entered into by the health authority with a health corporation or health care organization to be in a form approved by the minister;

(c) ensuring that funding provided by the health authority for salaries of the executive management of health corporations and health care organizations will be in accordance with guidelines approved by the minister;

(d) requiring the minister's approval before the health authority assumes any debt or payment obligations from a foundation or other third party;

(e) confirming that any non-compliance with the accountability agreement by the health authority is a failure by that authority to properly carry out its responsibilities, perform its duties or exercise its powers under this Act; and

(f) addressing any other matters as directed by the minister.

Exception

43.1(3)     Despite the terms in an agreement addressing clause (2)(a), a request by a health authority for funding from the government in excess of its allocated annual budget for unexpected costs, and the receipt of such funding by the authority, does not constitute non-compliance with the agreement.

If negotiations fail

43.1(4)     If the minister is unable to conclude an accountability agreement with a health authority through negotiations, the minister may impose the terms of the agreement, which must include the matters set out in clauses (2)(a) to (f).

Availability to the public

43.1(5)     Each accountability agreement must be published on

(a) the government's website; and

(b) the health authority's website.

51          Section 44 is repealed.

52          Divisions 3.1 and 4 of Part 4 are replaced with the following:

DIVISION 3.1

FUNDING AGREEMENTS

Requirement for funding agreement

44.1(1)     The provincial health authority or a regional health authority may provide operational funding to a health corporation or to a prescribed health care organization only if the authority and the corporation or organization have entered into a written funding agreement in the form specified by the minister.

Consistency with other agreements

44.1(2)     If the agreement is with a health corporation, it must be consistent with any agreement under subsection 5(2) that applies to the corporation.

Agreements with religious organizations

44.1(3)     An agreement under this section with a health corporation that is owned and operated by a religious organization must be consistent with

(a) any agreement that the corporation has entered into under subsection 5(2); and

(b) the following principles:

1.  The corporation may continue to respond to the spiritual and religious needs of its patients or residents and to provide care and services in a manner that is consistent with the fundamental principles of the religion or faith to which it adheres.

2.  The corporation may continue

(i) to own and operate its facilities,

(ii) to retain the identity of the facilities as faith-sponsored facilities, and

(iii) to be governed by a board of directors appointed or elected by the religious organization.

Funding during negotiations

44.1(4)     Despite subsection (1), the authority may, with the minister's approval, provide funding to the corporation while the funding agreement is being negotiated.

Resolution if negotiations unsuccessful

44.1(5)     If the parties to the negotiation are unable to conclude an agreement within a time that the minister considers reasonable, the minister may resolve the matters in dispute if the minister considers it to be in the public interest to do so.

Resolution binding

44.1(6)     A resolution of the minister is to be interpreted, applied and enforced as though it had been arrived at by agreement between the parties under subsection (1).

Limitation

44.1(7)     A resolution of the minister relating to health services to be delivered by a health corporation that is owned and operated by a religious organization must be consistent with the principles set out in clause (3)(b).

Extension of existing agreement

44.2(1)     When an agreement under section 44.1 is about to expire and a new agreement has not been entered into, any party to the agreement may request the minister to extend the term of the agreement for not more than 90 days.

Term of agreement extended

44.2(2)     If the minister grants an extension, the term of the agreement is deemed to be extended for the period specified.

Division applies despite other Acts

44.3        An agreement may be entered into or a resolution made by the minister under this Division despite any other Act, including a private Act, or any regulation, articles of incorporation or by-law.

DIVISION 4

TRANSFER OF OPERATIONS TO A HEALTH AUTHORITY

Definitions

45          The following definitions apply in this Division.

"transfer agreement" means an agreement under section 46 between a health corporation or health care organization and a health authority for the transfer of some or all of the corporation's or organization's operations, activities, property, rights, debts, obligations or liabilities to the authority. (« accord de prise en charge »)

"transferor" means the transferor under a transfer agreement and, in relation to a proposed transfer agreement, includes the party that will be the transferor if the agreement is concluded. (« cédant »)

Transfer agreement

46(1)       Despite any other Act, including a private Act, a health authority may enter into a transfer agreement with a health corporation or health care organization.

Terms of transfer agreement

46(2)       A transfer agreement must

(a) address all matters specified by the minister;

(b) specify the operations, activities and property that will be transferred;

(c) specify any rights, debts, obligations or liabilities of the transferor relating to the operations, activities or property to be transferred that will not be transferred;

(d) require that any unfunded outstanding debt of the transferor charged to municipalities under section 35.1 of The District Health and Social Services Act because of the transfer agreement be paid to the authority;

(e) specify the effective date of the transfer; and

(f) be in the form specified by the minister.

Approvals required

46(3)       A transfer agreement has no force or effect unless it is approved by

(a) the board of the authority;

(b) the board of the transferor and, if required by law, by the members or shareholders of the transferor; and

(c) the minister, in writing.

Transfer not a breach or default

46(4)       A transfer under a transfer agreement is deemed not to be a breach, default or contravention of or under any lease, agreement, contract of insurance, licence, permit or other instrument, and subject to subsection (3), no prohibition or absence of consent affects the validity of a transfer under a transfer agreement.

Restrictions during negotiation

47          After negotiations for a transfer agreement have begun, the transferor must not make any commitment or incur any debt, obligation or liability relating to the operations, activities or property to be transferred unless

(a) the health authority consents to it; or

(b) either party has notified the other that it is ceasing the negotiations.

Effect of agreement

48          Despite any other Act, including a private Act, or the terms of any other agreement, and unless the transfer agreement provides otherwise, on the effective date of the transfer specified in a transfer agreement,

(a) subject to this Act,

(i) the authority assumes the operations and activities to be transferred to it under the agreement,

(ii) the property to be transferred under the agreement becomes the property of the authority, and

(iii) the rights of the transferor relating to the transferred operations, activities or property become the rights of the authority;

(b) without limiting subclauses (a)(i) and (ii), any amount apportioned and charged to a municipality as a result of an apportionment by the transferor under section 35.1 of The District Health and Social Services Act becomes payable by the municipality to the health authority, despite that section, within such time as the authority and municipality agree, which must be no later than one year after the date a request for payment is received by the municipality;

(c) all debts, obligations and liabilities of the transferor relating to the operations, activities or property transferred under the agreement become the debts, obligations and liabilities of the health authority;

(d) an existing cause of action, claim or liability to prosecution relating to the operations, activities or property transferred under the agreement is unaffected;

(e) a civil, criminal or administrative action or proceeding pending by or against the transferor relating to the operations, activities or property transferred under the agreement may be continued by or against the health authority; and

(f) a fine or penalty imposed on, or ruling, order or judgment in favour of or against, the transferor relating to the operations, activities or property transferred under the agreement may be enforced by or against the health authority.

Dissolution and disestablishment of transferor

49          If a transfer agreement provides for the transfer of all of the transferor's operations, activities, property, rights, debts, obligations and liabilities, on the effective date of the transfer,

(a) if the transferor is established under The District Health and Social Services Act, despite that Act, the minister may dissolve and disestablish the transferor, its board and its corresponding district, and the Lieutenant Governor in Council or the minister, as the case may be, may repeal or amend any regulations under that Act to achieve this purpose;

(b) if the transferor is incorporated under The Corporations Act, it must take steps to dissolve under that Act; and

(c) in any other case, the transferor must take reasonable steps to dissolve or disestablish.

Use of grants, gifts, etc.

50(1)       If any grant, gift, donation or bequest of real or personal property, including money, or of any interest in real or personal property, made to a health corporation or health care organization for the purposes of a specified facility or for other specified purposes becomes the property of a health authority as the result of a transfer agreement, the health authority must use the grant, gift, donation or bequest for the purposes of that specified facility or for the specified purposes.

Bequests to transferor

50(2)       If all the transferor's operations, activities, property, rights, debts, obligations and liabilities are transferred to a health authority under a transfer agreement and the transferor is named as a beneficiary in a will, codicil, trust indenture, instrument, gift or other document, regardless of when it was made or when it becomes effective, any reference to the transferor is to be read as a reference to the health authority.

Transfer to health authority by order in council

50.1(1)     Despite any other provision of this Act, any other Act, including a private Act, or the terms of any agreement, the Lieutenant Governor in Council may, by order,

(a) subject to any terms and conditions that may be set out in the order, transfer or assign to, and vest in, a health authority any operations, activities, property, rights, debts, obligations or liabilities of the government, a government agency or another health authority relating to the delivery of health services; and

(b) address any other matter or thing that the Lieutenant Governor in Council considers necessary or advisable to effect the transfer, assignment or vesting or remedy any difficulty encountered in relation to the transfer, assignment or vesting.

Effect of order

50.1(2)     An order under subsection (1) constitutes, for all purposes, a legal and valid transfer, assignment or vesting of the operations, activities, property, rights, debts, obligations and liabilities set out in the order in accordance with the terms and conditions of the order.

Rights or claims may be continued

50.1(3)     Any person who may have a right or claim in relation to anything that has been transferred or assigned to, or vested in, a health authority under subsection (1) may continue to assert that right or claim against that authority.

Transfer or assignment valid

50.1(4)     No prohibition of any transfer, assignment or vesting, nor the absence of any required consent or approval, voids or affects the validity of a transfer, assignment or vesting under this section.

Transfer or assignment not a breach or default

50.1(5)     A transfer, assignment or vesting under this section is deemed not to be a breach, default or contravention of or under any lease, agreement, contract of insurance, licence, permit or other instrument.

53           Subsection 51(7) is amended

(a) by striking out "or elected"; and

(b) by striking out "and the regulations".

54          Section 51.2 is replaced with the following:

Directions re terms and conditions of employment

51.2(1)     The minister may give directions to a health authority respecting the terms and conditions of employment of the chief executive officer and designated senior officers of the authority.

Review of proposed employment contract

51.2(2)     When a direction issued under subsection (1) is in effect, a health authority must not appoint or enter into an employment contract with a chief executive officer or a designated senior officer unless

(a) the authority has submitted the proposed employment contract to the chief financial officer of the minister's department for review; and

(b) the chief financial officer has determined that the proposed employment contract is consistent with the direction.

Inconsistent provision not enforceable

51.2(3)     A provision of an employment contract to be reviewed under subsection (2) is void and unenforceable, and the authority must not make any payment under it unless the chief financial officer of the minister's department has determined that it is consistent with the direction.

55(1)       Subsection 51.4(1) is replaced with the following:

Restriction — health authority contracts with senior officers

51.4(1)     Except with the minister's approval, a health authority must not enter into an employment contract with, or provide compensation or make a payment under any contract or other arrangement to, a person who was formerly a chief executive officer or a designated senior officer of the authority within one year after the person's employment terminated.

55(2)       Subsection 51.4(3) is amended by striking out "regional".

56(1)       Subsection 51.5(1) is replaced with the following:

Restriction — health corporation, etc. contracts with former officers

51.5(1)     A health corporation or a designated health care organization must not enter into an employment contract with, or provide compensation or make a payment under any contract or other arrangement to, a person who was formerly a chief executive officer or a designated senior officer of that corporation or organization, within one year after the person's employment terminated, except with the approval of the health authority that is providing operational funding to the corporation or organization.

56(2)       Subsection 51.5(2) is amended by striking out "regional".

57(1)       Subsection 52(1) is amended

(a) by striking out "regional" wherever it occurs; and

(b) in clause (a), by striking out "or the regulations,".

57(2)       Subsections 52(2), (3), (5) and (6) are amended by striking out "regional" wherever it occurs.

58(1)       Subsection 53(1) is amended by replacing clauses (a) and (b) with the following:

(a) order that a regional health authority be wound up and appoint a person to wind up its affairs; and

(b) by regulation, disestablish the regional health authority;

58(2)       Subsection 53(1.1) is replaced with the following:

Disestablishment of region or designation of provincial health authority

53(1.1)     If a regional health authority is wound up and disestablished under subsection (1), the Lieutenant Governor in Council may

(a) by regulation, disestablish the authority's health region; or

(b) by order, designate the provincial health authority as the regional health authority for the corresponding health region.

Reference to RHA means provincial health authority

53(1.2)     If the provincial health authority is designated as the regional health authority for a health region under clause (1.1)(b), any reference in this or any other Act or regulation to a regional health authority must be read, in respect of the health region for which the designation was made, as referring to the provincial health authority in its capacity as the regional health authority for the health region.

58(3)       Subsection 53(3) is replaced with the following:

Effect of disestablishment

53(3)       On the winding up and disestablishment of a regional health authority,

(a) the regional health authority is disestablished and its board is dissolved;

(b) all the rights and property of the regional health authority become the rights and property of the government or, by order of the Lieutenant Governor in Council, of the provincial health authority; and

(c) all the debts, obligations and liabilities of the regional health authority become the debts, obligations and liabilities of the government or, by order of the Lieutenant Governor in Council, of the provincial health authority.

59          Section 53.1 is amended by repealing the definitions "personal health information" and "personal information".

60(1)       Subsection 53.2(1) is amended by striking out "Regional health" and substituting "Health".

60(2)       Subsection 53.2(2) of the English version is amended, in the part before clause (a), by striking out "regional".

61(1)       Subsection 53.3(1) is amended, in the part before clause (a), by striking out "subsection (6)" and substituting "subsections (6) and (7)".

61(2)       Subsection 53.3(6) is amended by striking out everything after "Instead," and substituting the following:

(a) the designated organization must notify and report to the minister, rather than the health authority, if a critical incident occurs; and

(b) section 53.4 applies in respect of the critical incident as if the organization were the health authority.

61(3)       The following is added after subsection 53.3(6):

Exception: health corporations and organizations funded by provincial health authority

53.3(7)     If a health corporation or health care organization receives operational funding from the provincial health authority, each instance in subsections (1) to (6) of "authority", "regional health authority" and "regional health authority for the health region" must be read as "provincial health authority".

62(1)       Subsection 53.4(1) is amended, in the section heading and in the part before clause (a), by striking out "regional".

62(2)       Subsection 53.4(2) is amended

(a) in the part before clause (a), by striking out "regional"; and

(b) in clauses (a) and (b), by striking out "regional health".

62(3)       Subsection 53.4(3) is amended by striking out "regional".

63          Sections 53.4.1 and 53.6 are amended by striking out "regional" wherever it occurs.

64          Clauses 53.8(a) and 53.10(1)(c) are amended by striking out "regional".

65(1)       Section 54 is amended

(a) in the part before clause (a) and in clauses (c) and (e), by striking out "regional";

(b) in clause (a), by striking out "and the regulations";

(c) by replacing clause (b.1) with the following:

(b.1) shall, if it receives operational funding from a health authority,

(i) ensure that it participates in the authority's accreditation process as required to enable the authority to obtain accreditation, and

(ii) if required by the minister, ensure that it is accredited by an accreditation body approved by the minister;

(d) by adding the following after clause (d):

(d.1) subject to the regulations, shall not, where the person is a health corporation operating a hospital, do any of the following without the approval of the health authority providing operational funding to the corporation:

(i) provide hospital services other than those funded by the authority,

(ii) purchase, lease, accept by donation or otherwise acquire

(A) equipment that will result in increased operating or capital costs, or

(B) computer or telecommunications software or equipment, whether or not it will result in increased operating or capital costs;

(e) in clause (f), by striking out "in a health region".

65(2)       Section 54 is further amended by renumbering it as subsection 54(1) and adding the following as subsection 54(2):

Health authority to seek minister's approval

54(2)       Subject to the regulations, a health authority shall not approve a purchase, lease, donation or other acquisition under subclause (1)(d.1)(ii) without having obtained the prior approval of the minister.

66          Section 55 is amended

(a) by striking out "regional"; and

(b) by striking out "or the regulations".

67(1)       Subsection 56(1) is amended by striking out "and the regulations".

67(2)       Subsection 56(2) is amended

(a) in clause (a), by striking out "in a health region"; and

(b) in clause (b),

(i) by striking out "regional" wherever it occurs, and

(ii) by striking out "in a health region".

68          Subclause 56.1(a)(v) is amended by striking out "or the regulations,".

69          Section 57 is repealed.

70          Section 58 is amended

(a) in clause (a), by striking out "regional"; and

(b) in clause (d) and in the part after clause (d), by striking out "or the regulations" wherever it occurs.

71          Section 59 is amended

(a) in clause (d), by striking out "regional";

(b) in clause (e),

(i) by striking out "or elected", and

(ii) by striking out "regional";

(c) in clause (f), by striking out "regional";

(d) by repealing clause (g);

(e) in clause (h), by striking out "regional";

(f) in clauses (j) and (k), by striking out "regional" wherever it occurs;

(g) by renumbering clause (k.1) as clause (k.2) and adding the following as clause (k.1):

(k.1) prescribing health care organizations to which Division 3.1 of Part 4 (funding agreements) applies;

(h) in clauses (k.2), (l), (m), (n) and (o), by striking out "regional" wherever it occurs;

(i) by replacing subclause (p)(i) with the following:

(i) the establishment, designation or variation of a health authority or health region under this Act,

(j) in clause (p.1), by striking out "regional" wherever it occurs.

72          Section 60 is amended

(a) by replacing clause (a) with the following:

(a) specifying functions to be performed by a health authority in addition to the functions assigned to it under this Act;

(b) by repealing clause (b.1);

(c) in clause (c), by striking out "and the regulations";

(d) in clauses (c.1) to (e), by striking out "regional" wherever it occurs;

(e) by repealing clause (e.1);

(f) by replacing clause (f) with the following:

(f) respecting the power of a health authority to deliver or provide for the delivery of additional health services under section 26;

(f.1) for the purpose of section 28.2 or subclause 54(1)(d.1)(ii), defining the terms "equipment" and "computer or telecommunications software or equipment", unless they are defined by regulation under clause 59(a);

(f.2) specifying software or equipment that is exempt from section 28.2 or subclause 54(1)(d.1)(ii);

(f.3) respecting the circumstances when the minister's approval under section 28.2 is not required;

(f.4) respecting the circumstances when a health authority's approval under subclause 54(1)(d.1)(ii) is not required or when a health authority is not required to seek the minister's prior approval under subsection 54(2);

(g) in clauses (g) to (i), by striking out "regional" wherever it occurs;

(h) in clause (l),

(i) in the part before subclause (i), by striking out "regional health authorities and for members of local health involvement groups" and substituting "health authorities", and

(ii) in subclause (ii), by striking out "regional";

(i) in clauses (m) and (n), by striking out "regional" wherever it occurs;

(j) in clause (o), by striking out "or the regulations" wherever it occurs; and

(k) in clause (p), by striking out "regional" wherever it occurs.

73          Section 78 is amended by striking out "regional" wherever it occurs.

74          The following is added as Part 6.1:

PART 6.1

TRANSITIONAL PROVISIONS RESPECTING HEALTH AUTHORITIES

PROVINCIAL HEALTH AUTHORITY

Continuation of Shared Health

79.1        On the coming into force of this section,

(a) Shared Health Inc., a corporation incorporated under The Corporations Act, is continued under this Act under the name "Shared Health" and designated as the provincial health authority; and

(b) a director or chairperson of Shared Health's board of directors is deemed to be a first director or chairperson, as the case may be, of the provincial health authority as if they were appointed under section 15 and continues to hold office until their successor is appointed in accordance with section 14.

CANCER AUTHORITY

Continuation of CancerCare Manitoba

79.2(1)     On the coming into force of this section,

(a) CancerCare Manitoba continued under The CancerCare Manitoba Act is continued under this Act and designated as the cancer authority;

(b) a director or chairperson of CancerCare Manitoba's board of directors is deemed to be a first director or chairperson, as the case may be, of the cancer authority as if they were appointed under section 15 and continues to hold office until their successor is appointed in accordance with section 14; and

(c) a direction given by the minister under section 8.1 of The CancerCare Manitoba Act

(i) is deemed to be a direction given to the cancer authority under subsection 3(4) of this Act, and

(ii) continues until revoked, varied or replaced by the minister.

Advisory medical board dissolved

79.2(2)     On the coming into force of this section,

(a) the advisory medical board established under section 5 of The CancerCare Manitoba Act is dissolved; and

(b) the appointments of the members of the advisory medical board are terminated and all rights and obligations of the members in relation to or under those appointments are extinguished.

ADDICTIONS FOUNDATION OF MANITOBA

Definition

79.3(1)     In this section, "foundation" means The Addictions Foundation of Manitoba continued under The Addictions Foundation Act.

Addictions Foundation dissolved

79.3(2)     On the coming into force of this section,

(a) the foundation is dissolved;

(b) the appointments of the members of the board of governors of the foundation and any members of a committee appointed under subsection 5(6) of The Addictions Foundation Act are terminated and all rights and obligations of the members in relation to or under those appointments are extinguished;

(c) the rights and property of the foundation are transferred to the provincial health authority, and all of the foundation's debts, obligations and liabilities are assumed by the provincial health authority;

(d) a legal proceeding or action that has been commenced or may be commenced by or against the foundation may be continued or commenced by or against the provincial health authority; and

(e) any trust funds managed or administered by the foundation are to be managed or administered by the provincial health authority in the same manner in which they were required to be managed or administered by the foundation, unless the instrument under which the trust was established specifies what is to happen to the funds in the event that the foundation is dissolved, in which case the provisions of the instrument govern.

Use of foundation's bequests by provincial health authority

79.3(3)     On the coming into force of this section,

(a) any reference to the foundation as a beneficiary or trustee in a will, codicil, trust indenture, instrument, gift or other document is to be read as a reference to the provincial health authority, unless the instrument specifies what is to happen in the event that the foundation is dissolved, in which case the provisions of the instrument govern; and

(b) subject to the express provisions of an instrument referred to in clause (a), any grant, gift, donation or bequest to the provincial health authority, or a trust to be managed or administered by the authority, under an instrument referred to in clause (a) must be used by the provincial health authority for one or more of the following purposes:

(i) to assist individuals with problems involving the abuse or misuse of alcohol and other drugs and substances to make the most effective use possible of existing and potential facilities and services for the treatment and rehabilitation of those with chemical dependencies available through the provincial health authority or through other agencies, groups and associations,

(ii) to disseminate information respecting the recognition, prevention and treatment of the abuse or misuse of alcohol and other drugs and substances, and respecting the services provided by the provincial health authority and other agencies, groups and associations concerned with chemical dependencies,

(iii) to initiate, sponsor, conduct and promote a program of research in the field of prevention of chemical dependency and the treatment and rehabilitation of individuals with chemical dependencies, and experimentation in methods of treating and rehabilitating individuals with problems involving the abuse or misuse of alcohol and other drugs and substances.

HOSPITALS AND MENTAL HEALTH FACILITIES

Hospital licences, by-laws, etc.

79.4(1)     On the coming into force of this section,

(a) every licence issued under The Hospitals Act is hereby cancelled; and

(b) any by-law, regulation or rule made by a health corporation under section 5 of The Hospitals Act in its capacity as the operator of a hospital continues until it is varied, repealed or replaced.

Standards committees continued

79.4(2)     On the coming into force of this section,

(a) a standards committee established under section 24 of The Hospitals Act or section 116 of The Mental Health Act is continued as a standards committee under section 23.1 of this Act;

(b) any member of the committee continues to be a member until their appointment expires or is revoked; and

(c) any terms of reference of the committee continue, with necessary changes, until they are amended, repealed or replaced in accordance with this Act.

Regulations — transitional matters

79.5(1)     The Lieutenant Governor in Council may make regulations to remedy any difficulty, inconsistency or impossibility resulting from this Part.

Retroactivity

79.5(2)     A regulation made under subsection (1) may be made retroactive to the extent set out in the regulation.

75          Section 87 is replaced with the following:

C.C.S.M. reference

87          This Act may be referred to as chapter H26.5 of the Continuing Consolidation of the Statutes of Manitoba.

76          Section 88 is repealed.

PART 2

RELATED AND CONSEQUENTIAL AMENDMENTS

C.C.S.M. ACTS

C.C.S.M. c. A6.7 amended

77          Clauses 22(a), 23(2)(d), 27(4)(d) and 38(d) of The Advocate for Children and Youth Act are amended by striking out "regional".

C.C.S.M. c. A150 amended

78          The definition "hospital" in section 1 of The Manitoba Assistance Act is replaced with the following:

"hospital" means a hospital as defined in The Health Services Insurance Act or The Mental Health Act; (« hôpital »)

C.C.S.M. c. C100 amended

79          Subsection 53.2(6) of The Chiropractic Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. D30 amended

80          Subsection 36.2(6) of The Dental Association Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. D34 amended

81          Subsection 66(6) of The Dental Hygienists Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. D35 amended

82          Subsection 21.2(6) of The Denturists Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. D104 amended

83(1)       The Drivers and Vehicles Act is amended by this section.

83(2)       Clause (a) of the definition "recognized agency" in subsection 1(1) is replaced with the following:

(a) the provincial health authority as defined in The Health System Governance and Accountability Act; or

83(3)       Clause 126(4)(d) is amended by striking out "the Addictions Foundation of Manitoba or".

C.C.S.M. c. E146 amended

84          Clause 3(1)(a) of The Essential Services Act (Health Care) is amended

(a) by replacing subclause (iii) with the following:

(iii) a health authority as defined in The Health System Governance and Accountability Act,

(b) by repealing subclauses (v) and (vi).

C.C.S.M. c. E150 amended

85(1)       The Manitoba Evidence Act is amended by this section.

85(2)       Subsection 9(1) is amended

(a) in the definition "committee",

(i) in clause (a), by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act",

(ii) by adding the following after clause (a):

(a.1) a standards committee established or designated under section 23.1 of The Health System Governance and Accountability Act;

(iii) by repealing clause (c);

(b) in the definitions "critical incident", "facility", "health care provider" and "health services", by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act"; and

(c) by replacing the definition "hospital" with the following:

"hospital" means a hospital as defined in The Health Services Insurance Act. (« hôpital »)

85(3)       Subclause 9(2)(b)(iii) is amended

(a) by striking out "regional"; and

(b) by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act".

C.C.S.M. c. F157 amended

86(1)       The Francophone Community Enhancement and Support Act is amended by this section.

86(2)       The definition "government agency" in subsection 1(1) is amended by striking out "regional" in clause (b).

86(3)       Subsection 11(3) is amended by striking out "regional health authority under The Regional Health Authorities Act" and substituting "health authority under The Health System Governance and Accountability Act".

86(4)       Schedule B is amended in the second paragraph under the heading "Health care sector" by striking out "regional".

C.C.S.M. c. F175 amended

87          The definition "health care body" in subsection 1(1) of The Freedom of Information and Protection of Privacy Act is amended by replacing clause (b) with the following:

(b) a health authority as defined in The Health System Governance and Accountability Act,

C.C.S.M. c. G125 amended

88(1)       The Gunshot and Stab Wounds Mandatory Reporting Act is amended by this section.

88(2)       The definition "regional health authority" in section 1 is replaced with the following:

"health authority" means a health authority as defined in The Health System Governance and Accountability Act. (« office de la santé »)

88(3)       Section 4 is amended by striking out "regional".

C.C.S.M. c. H26 amended

89(1)       The District Health and Social Services Act is amended by this section.

89(2)       The following provisions are amended by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act":

(a) in subsection (1), the definitions "health region", "health services", "regional health authority" and "social services";

(b) subsection 6(3);

(c) clause 8(d);

(d) section 10;

(e) section 20;

(f) subsection 21(2).

89(3)       Subsection 23(1) is amended by striking out "A board" and substituting "Subject to subsection (2), a board".

89(4)       Subsection 23(2) is amended

(a) in the section heading, by striking out "Purchase" and substituting "Acquisition"; and

(b) by striking out "or otherwise acquire for consideration equipment" and substituting ", accept by donation or otherwise acquire equipment, including computer or telecommunications software or equipment,".

89(5)       Sections 24 and 35.1 are amended by striking out "The Regional Health Authorities Act" wherever it occurs and substituting "The Health System Governance and Accountability Act".

89(6)       Subsection 36(2) and section 37 are repealed.

C.C.S.M. c. H29 amended

90          Subsection 1(1) of The Health Sector Bargaining Unit Review Act is amended

(a) in the definition "health region", by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act";

(b) in the definition "province-wide health employer", by striking out "Shared Health Inc." and substituting "the provincial health authority as defined in The Health System Governance and Accountability Act"; and

(c) in the definition "regional health authority", by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act".

C.C.S.M. c. H35 amended

91(1)       The Health Services Insurance Act is amended by this section.

91(2)       Subsection 2(1) is amended

(a) in the definitions "health region" and "regional health authority", by striking out "established or continued under The Regional Health Authorities Act" and substituting "as defined in The Health System Governance and Accountability Act"; and

(b) by adding the following definitions:

"health authority" means a health authority as defined in The Health System Governance and Accountability Act; (« office de la santé »)

"provincial health authority" means the provincial health authority as defined in The Health System Governance and Accountability Act; (« office provincial de la santé »)

91(3)       Section 33.1 is amended by striking out "regional".

91(4)       Subsection 48(1) is amended

(a) in clause (a), by striking out "regional health authority responsible for" and substituting "health authority responsible for providing for the delivery of";

(b) in clause (b), by striking out "regional"; and

(c) by replacing clause (c) with the following:

(c) an insured person who has received out-patient services in a surgical facility that is a party to an agreement under section 64.1 is entitled to have the minister or the health authority that is a party to the agreement pay the amounts due for the services to the operator of the facility.

91(5)       Subsection 48(2) is amended by striking out "regional".

91(6)       Subsections 50(2) to (3.1) are replaced with the following:

Payment for hospital services

50(2)       Subject to the regulations, the minister must pay for hospital services provided to an insured person by a hospital that is not owned or operated by the Government of Canada out of the fund in accordance with subsection (3).

How payment to be made

50(3)       Payments under subsection (2) must be made in accordance with the following rules:

1.  If the hospital that provided the hospital services is operated by a health authority, the minister must pay that health authority.

2.  If the hospital that provided the hospital services is not operated by a health authority,

(a) the minister must pay the health authority responsible for providing for the delivery of the services; and

(b) on receipt of payment from the minister, the health authority must pay the operator of the hospital in accordance with the terms of the authority's agreement with the operator under section 64.

Withholding of payments for non-compliance

50(4)       If the operator of a hospital fails to keep the books or records or make the returns required under this Act or the regulations,

(a) the minister may withhold payments for hospital services provided by the hospital owing under subsection (2) until the operator complies with this Act and the regulations; and

(b) a health authority from which the minister is withholding payments under clause (a) is not required to pay the operator until it has been paid by the minister.

91(7)       Section 51 is replaced with the following:

Effect of making payments

51          Payments made under subsection 50(2) are deemed to be payment in full for the hospital services to which they relate, except for authorized charges.

91(8)       Subsection 64(1) is replaced with the following:

Rates of payments to hospitals and personal care homes

64(1)       Payments for hospital services or personal care services provided to insured persons by a hospital or personal care home must be made to the operator of the hospital or personal care home in accordance with the funding agreement that the operator entered into under section 44.1 of The Health System Governance and Accountability Act.

91(9)       Subsection 64(2) is amended, in the part before clause (a), by striking out "regional".

91(10)      Subsection 64.1(1) is amended

(a) in the section heading, by adding "and health authority" at the end; and

(b) by adding "and a health authority" after "surgical facility".

91(11)      Subsection 70(1) is amended

(a) in the part before clause (a), by striking out "regional"; and

(b) by replacing clauses (a) and (b) with the following:

(a) the provincial health authority if operational funding for the hospital, personal care home or facility is, or most recently has been, provided by the provincial health authority; or

(b) the regional health authority for the health region in which the hospital, personal care home or facility is situated if operational funding for it is, or most recently has been, provided by the regional health authority.

91(12)      Subsection 70(2) is replaced with the following:

Health authority requires approval of minister

70(2)       A health authority must not provide an approval under subsection (1) without the prior approval of the minister.

91(13)      Subsection 70(3) is amended

(a) by striking out "regional"; and

(b) in the French version, by striking out "de la présente loi ou de ses règlements" and substituting "du présent article".

91(14)      Subsection 75(2) is amended by adding "a health authority or" after "or through".

91(15)      Subsection 75(3) is amended by striking out "prescribed in the regulations" and substituting "approved by the minister".

91(16)      The following is added after subsection 75(3):

Minister's approval required

75(4)       A health authority and the operator of a hospital must not enter into an agreement with a practitioner for the provision of medical services or other health services without the prior approval of the minister.

Unapproved agreement

75(5)       An agreement requiring the minister's approval under subsection (4) and entered into without that approval has no force or effect.

91(17)      Section 75.1.1 is amended by striking out "with the particulars of" and substituting "or an inspector appointed under subsection 75.2(1) with the particulars of and documentation supporting".

91(18)      Subsection 75.2(1) is amended

(a) in the part before clause (a), by striking out everything before "may, at any reasonable time" and substituting "An inspector appointed under subsection (1)"; and

(b) by renumbering it as subsection 75.2(1.1) and adding the following as subsection 75.2(1):

Appointment of inspectors

75.2(1)     The minister may, in writing, appoint inspectors for the purpose of auditing claims for benefits for insured services submitted by practitioners under this Act.

91(19)      Subsection 75.2(2) is amended, in the part before clause (a), by striking out "inspection or examination" and substituting "audit".

91(20)      Subsection 95.1(2) is amended, in the part before clause (a), by adding "the minister determines that" at the end.

91(21)      Subsection 95.1(3) is amended

(a) in the part before clause (a), by adding "the minister determines, based on an audit under section 75.2, that" at the end; and

(b) in clause (c), by adding "or documentation" after "the information".

91(22)      Subsection 95.1(4) is replaced with the following:

Manner of recovery

95.1(4)     The minister may recover a debt referred to in this section from a person or practitioner by

(a) agreement with the person or practitioner;

(b) action; or

(c) set-off against money owing or that becomes owing by the minister to the person or practitioner.

91(23)      Subsection 113(1) is amended

(a) by repealing clause (t.1);

(b) in clause (t.2),

(i) by adding "or documentation" after "information" wherever it occurs, and

(ii) by adding "or provide to an inspector" after "the minister";

(c) in clause (t.3), by striking out "file information" and substituting "file or provide information or documentation";

(d) in clause (t.5), by striking out "books and records" and substituting "books, records and other documentation"; and

(e) in clause (u), by striking out "by the minister".

91(24)      Subsection 113(2) is amended by striking out ", (t) or (t.1)" and substituting "or (t)".

91(25)      Subsection 118(3) is amended

(a) in the section heading, by striking out "Regional health" and substituting "Health"; and

(b) by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act".

C.C.S.M. c. H60 amended

92(1)       The Highway Traffic Act is amended by this section.

92(2)       Clause (a) of the definition "recognized agency" in subsection 1(1) is replaced with the following:

(a) the provincial health authority as defined in The Health System Governance and Accountability Act; or

92(3)       Clause 322(3)(d) is amended by striking out "the Addictions Foundation of Manitoba or".

C.C.S.M. c. I10 amended

93          Subsection 5.11(1) of The Income Tax Act is amended in the definition "home care services" by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act".

C.C.S.M. c. L125 amended

94          Subsection 63.1(6) of The Licensed Practical Nurses Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. M100 amended

95          Subsection 60.1(6) of The Medical Laboratory Technologists Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. M110 amended

96(1)       The Mental Health Act is amended by this section.

96(2)       Subsection 36(2) is amended

(a) in clause (k), by striking out "the standards committee of the facility" and substituting "a standards committee established or designated under section 23.1 of The Health System Governance and Accountability Act"; and

(b) in clause (k.1), by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act".

96(3)       Section 116 and the centred heading before it are repealed.

C.C.S.M. c. M125 amended

97          Subsection 60.2(6) of The Midwifery Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. M226 amended

98           Clauses 22(1)(c.1) and (c.2) of The Municipal Assessment Act are amended by striking out "the Winnipeg Regional Health Authority" wherever it occurs and substituting "Shared Health".

C.C.S.M. c. N80 amended

99          Subsection 26(6) of The Naturopathic Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. O5 amended

100         Subsection 62.1(6) of The Occupational Therapists Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. O60 amended

101         Subsection 26(6) of The Opticians Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. O70 amended

102         Subsection 23(6) of The Optometry Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. P60 amended

103         Subsection 95(6) of The Pharmaceutical Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. P65 amended

104         Subsection 62.1(6) of The Physiotherapists Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. P93 amended

105         Subsection 60.1(6) of The Podiatrists Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. P130 amended

106         The definition "private hospital" in section 1 of The Private Hospitals Act is amended by striking out "The Hospitals Act" and substituting "The Health Services Insurance Act".

C.C.S.M. c. P144 amended

107         Subsection 8.1(3) of The Protection for Persons in Care Act is replaced with the following:

Definition of employer

8.1(3)      If a health facility or a health authority as defined in The Health System Governance and Accountability Act has granted privileges to a person, the facility or authority that granted the privileges is deemed to be the person's employer for the purpose of this section.

C.C.S.M. c. P190 amended

108(1)      The Psychologists Registration Act is amended by this section.

108(2)      Subsection 11(2) is amended by striking out "The Hospitals Act" and substituting "The Health Services Insurance Act".

108(3)      Subsection 17(6) is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. P205 amended

109(1)      The Public Guardian and Trustee Act is amended by this section.

109(2)      The definition "regional health authority" in section 1 is replaced with the following:

"health authority" means a health authority as defined in The Health System Governance and Accountability Act. (« office de la santé »)

109(3)      Section 20 is amended by striking out "regional".

C.C.S.M. c. P210 amended

110(1)      The Public Health Act is amended by this section.

110(2)      Subsection 1(1) is amended

(a) by adding the following definition:

"health authority" means a health authority as defined in The Health System Governance and Accountability Act. (« office de la santé »)

(b) in the definitions ""health care organization" and "health corporation"" and "health region", by striking out "The Regional Health Authorities Act" and substituting "The Health System Governance and Accountability Act".

110(3)      Section 6 is amended

(a) in the section heading and in the section, by striking out "regional"; and

(b) by striking out "in its health region".

110(4)      Section 7 is amended

(a) in the section heading, by striking out "RHA" and substituting "health authority"; and

(b) by striking out "regional".

110(5)      Clauses 8(a) and 67(2)(a) and subsections 78(2) and 109(1) are amended by striking out "regional".

C.C.S.M. c. P215 amended

111         Section 51 of The Manitoba Public Insurance Corporation Act is amended by striking out "The Hospitals Act" and substituting "The Health Services Insurance Act".

C.C.S.M. c. P217 amended

112         The definition "government body" in section 2 of The Public Interest Disclosure (Whistleblower Protection) Act is amended by replacing clause (b) with the following:

(b) a health authority as defined in The Health System Governance and Accountability Act;

C.C.S.M. c. P265 amended

113         The Schedule to The Public Sector Compensation Disclosure Act is amended in clause (b) by striking out "The Hospitals Act" and substituting "The Health Services Insurance Act".

C.C.S.M. c. R39 amended

114         Subsection 62.1(6) of The Registered Dietitians Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. R45 amended

115         Subsection 63.1(6) of The Registered Psychiatric Nurses Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. R115 amended

116         Subsection 57(6) of The Registered Respiratory Therapists Act is amended

(a) by replacing clause (a) with the following:

(a) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clause (c).

C.C.S.M. c. R117 amended

117(1)      The Regulated Health Professions Act is amended by this section.

117(2)      Subsection 1(1) is amended

(a) by repealing the definition "regional health authority"; and

(b) by adding the following definition:

"health authority" means a health authority as defined in The Health System Governance and Accountability Act. (« office de la santé »)

117(3)      Clauses 49(1)(c), 134(c) and 140(2)(g) and (h) are amended by striking out "regional".

117(4)      Subsection 141(6) is amended

(a) by replacing clause (a) with the following:

(a) a health authority;

(b) by repealing clause (c).

117(5)      Subsection 168(2) is amended by striking out "regional" in the section heading and in the section.

C.C.S.M. c. R119 amended

118         The definition "tenant services" in subsection 1(1) of The Residential Tenancies Act is amended, in the part after clause (i), by striking out "regional health authority established under The Regional Health Authorities Act" and substituting "health authority as defined in The Health System Governance and Accountability Act".

C.C.S.M. c. S12 amended

119         Section 15 of The Sanatorium Board of Manitoba Act is repealed.

CITY OF WINNIPEG CHARTER

S.M. 2002, c. 39 amended

120         Clause 442(2)(d) of The City of Winnipeg Charter is amended by striking out "The Hospitals Act" and substituting "The Health Services Insurance Act".

PRIVATE ACTS

R.S.M. 1990, c. 39 amended

121(1)      The Concordia Hospital Incorporation Act is amended by this section.

121(2)      Section 1 is amended by striking out "and The Hospitals Act, or either of them".

121(3)      Clause 4(a) and subsection 6(1) are amended by striking out "The Hospitals Act" and substituting "The Health System Governance and Accountability Act".

R.S.M. 1990, c. 110 amended

122         Clause 2(a) of The Misericordia General Hospital Incorporation Act is amended by striking out "The Hospitals Act" and substituting "The Health System Governance and Accountability Act".

R.S.M. 1990, c. 111 amended

123         Subclause 2(a)(ii) of The Misericordia Sisters of Winnipeg Incorporation Act is amended by striking out "The Hospitals Act" and substituting "The Health Services Insurance Act".

R.S.M. 1990, c. 120 amended

124         Clause 8(b) of The Mount Carmel Clinic Act is amended by striking out "The Hospitals Act" and substituting "The Health System Governance and Accountability Act".

R.S.M. 1990, c. 180 amended

125         Clause 3(a), section 5 and subsection 7(2) of The Seven Oaks General Hospital Incorporation Act are amended by striking out "The Hospitals Act" and substituting "The Health System Governance and Accountability Act".

R.S.M. 1990, c. 187 amended

126         Clause 6(a) of The Soeurs du Sauveur Incorporation Act is amended by striking out "The Hospitals Act" and substituting "The Health System Governance and Accountability Act".

UNPROCLAIMED PROVISIONS

S.M. 2017, c. 8 amended

127         Subsections 21(1) and (3) of The Advocate for Children and Youth Act, S.M. 2017, c. 8, are amended by striking out "regional".

S.M. 2018, c. 8 amended

128(1)      The Boards, Committees, Councils and Commissions Streamlining Act (Various Acts Amended or Repealed), S.M. 2018, c. 8, is amended by this section.

128(2)      Section 2 and the centred heading before it, which amend The Addictions Foundation Act, are repealed.

S.M. 2017, c. 13 amended

129(1)      The Emergency Medical Response and Stretcher Transportation Amendment Act, as enacted by S.M. 2017, c. 13, is amended by this section.

129(2)      Clause 2(c) is replaced with the following:

(c) by adding the following definition:

"provincial health authority" means the provincial health authority as defined in The Health System Governance and Accountability Act; (« office provincial de la santé »)

129(3)      Section 6 is replaced with the following:

6           Section 7 is amended

(a) by striking out "each municipality in the area where the applicant proposes to operate the system or service" and substituting "the provincial health authority"; and

(b) by adding "where the applicant proposes to operate" at the end.

129(4)      Section 8 is replaced with the following:

8           The following is added after section 10:

Required equipment — emergency medical response system

10.1        A licence holder that operates an emergency medical response system must store or install in each ambulance or other vehicle or aircraft used as part of the emergency medical response system the drugs, equipment, apparatus and other items that are reasonably required to enable the provision of emergency medical response services by the emergency medical response system.

129(5)      Subsection 11(1) is replaced with the following:

11(1)       Subsections 19(1) and (2) are replaced with the following:

Minister may fund provincial health authority

19(1)       From and out of the fund, the minister may provide funding to the provincial health authority in respect of the provision of emergency medical response services.

Provincial health authority may fund licence holders

19(2)       The provincial health authority may provide funding to a person holding a licence to operate an emergency medical response system if the authority and the licence holder have entered into a written agreement in a form approved by the minister.

Funding during negotiations

19(2.1)     Despite subsection (2), the provincial health authority may, with the minister's approval, provide funding to a licence holder even though an agreement has not been entered into if the parties are in the process of negotiating such an agreement.

129(6)      Section 12 and clause 13(1)(d) are repealed.

S.M. 2015, c. 41 amended

130         Subsection 43(1) of The Radiation Protection Act, as enacted by S.M. 2015, c. 41, is amended

(a) by replacing clause (c) with the following:

(c) a health authority as defined in The Health System Governance and Accountability Act;

(b) by repealing clauses (d) and (e).

S.M. 2011, c. 28 amended

131         The following provisions of The Regional Health Authorities Amendment Act (Accountability and Transparency), S.M. 2011, c. 28, are repealed:

(a) section 4;

(b) subsection 7(2) insofar as it enacts clause 38(2)(b.1);

(c) clause 10(f).

S.M. 2012, c. 8 amended

132         The following provisions of The Regional Health Authorities Amendment Act (Improved Fiscal Responsibility and Community Involvement), S.M. 2012, c. 8, are repealed:

(a) section 8;

(b) section 12 insofar as it enacts section 51.3;

(c) section 13 insofar as it enacts clause 59(k.2).

S.M. 2009, c. 15 amended

133         Section 237 of The Regulated Health Professions Act, S.M. 2009, c. 15, which amends The Hospitals Act, is repealed.

PART 3

REPEALS AND COMING INTO FORCE REPEALS

Acts repealed

134         The following are repealed:

(a) The Addictions Foundation Act, R.S.M. 1987, c. A60;

(b) The CancerCare Manitoba Act, R.S.M. 1987, c. C20;

(c) The Hospitals Act, R.S.M. 1987, c. H120, and the regulations under that Act.

COMING INTO FORCE

Coming into force

135(1)      Subject to subsection (2), this Act comes into force on a day to be fixed by proclamation.

Coming into force — royal assent

135(2)      Sections 127 to 133 come into force on the day this Act receives royal assent.

Explanatory Note

This Bill amends The Regional Health Authorities Act to consolidate administrative services related to health care and to centralize the delivery of certain health services across Manitoba.

The Act is renamed The Health System Governance and Accountability Act.

The following are the key changes.

Governance

The Manitoba health system is restructured. A provincial health authority is established and given responsibility for strategic health planning, the provision of administrative and support services to regional health authorities, the delivery of provincial health services and the establishment of standards committees. The Addictions Foundation of Manitoba is eliminated and the provincial health authority assumes its responsibilities in providing addictions services. Shared Health is designated as the provincial health authority.

CancerCare Manitoba is designated as the cancer authority under the Act and remains responsible for administering and delivering cancer-related health services.

Regional health authorities remain responsible for administering and delivering health services in their health regions.

Cabinet may, by order, transfer government responsibilities to a health authority.

Accountability

Each health authority must enter into an accountability agreement with the minister and prepare an annual strategic and operational plan for the minister's approval. An entity that provides health services in Manitoba must enter into a funding agreement with the health authority that funds it.

A health authority must obtain the approval of the minister to acquire certain equipment.

Current provisions regulating regional health authorities are expanded to apply to the provincial health authority and the cancer authority. These include provisions related to

  • health authority accreditation by a body approved by the minister;
  • binding directions issued by the minister to a health authority;
  • binding directions that a health authority may give to health corporations to which it provides funding;
  • the transfer of operations from a health corporation or health care organization to a health authority by way of agreement;
  • restrictions on the hiring of former senior managers or auditors by a health authority; and
  • the publication of expenses paid to a chief executive officer of a health authority.

All health authorities are authorized to acquire, sell, license or assign patents with the minister's approval.

The separate accreditation requirement for mammography equipment is repealed.

Other amendments

The Bill makes amendments to several other Acts, including amendments to

  • The Health Services Insurance Act to require payments for hospital services to be made through the responsible health authority and to clarify audit powers under that Act; and
  • unproclaimed changes to The Emergency Medical Response and Stretcher Transportation Act to transfer certain responsibilities under that Act to the provincial health authority.
The Addictions Foundation Act, The CancerCare Manitoba Act and The Hospitals Act are repealed.