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The Regional Health Authorities and Consequential Amendments Act

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S.M. 1996, c. 53

THE REGIONAL HEALTH AUTHORITIES AND CONSEQUENTIAL AMENDMENTS ACT


Table of Contents

(Assented to November 19, 1996)

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

PART 1

INTERPRETATION

Definitions

1         In this Act,

"board" means the board of directors of a regional health authority; (« conseil d'administration »)

"district health advisory council" means a district health advisory council established by a regional health authority under section 32; (« conseil de district de santé »)

"facility" means premises, and equipment in or associated with the premises, used to provide health services, social services or both and includes hospitals, personal care homes, laboratories and clinics; (« établissement »)

"health care organization" means a person or group of persons other than a health corporation or a health care provider who provides health services; (« organisme de soins de santé »)

"health care provider" means

(a) a duly qualified medical practitioner who receives funding or payment, including payment by way of fee for services rendered or salary, from a regional health authority or the government for the provision of health services, and

(b) any other individual who

(i) is employed by a regional health authority, or by a health care organization or health corporation in a health region, to provide health services,

(ii) is under contract to a regional health authority, or a health care organization or health corporation, to provide health services, or

(iii) receives funding or payment from the government for the provision of health services; (« fournisseur de soins de santé »)

"health corporation" means

(a) the board of a health and social services district established under The District Health and Social Services Act,

(b) the board of a hospital district, the board of a medical nursing unit district and the board of a medical service unit district established under The Health Services Act,

(c) a corporation which owns, operates or maintains a hospital or personal care home and which

(i) is a municipality,

(ii) is incorporated or registered under The Corporations Act, or

(iii) is established or continued under an Act of the Legislature, including a private Act, and

(d) a prescribed body corporate; (« personne morale dispensant des soins de santé »)

"health region" means a health region established or continued under this Act; (« région sanitaire »)

"health services" means

(a) community health services,

(b) emergency medical response services,

(c) home care services,

(d) hospital services,

(e) medical services,

(f) medical laboratory services,

(g) mental health services,

(h) nursing services,

(i) personal care services,

(j) provision of drugs, medical supplies and surgical supplies,

(k) public health services,

(l) diagnostic imaging services, and

(m) other goods and services respecting health promotion and protection or respecting the care, treatment or transportation of sick, infirm or injured individuals as may be prescribed in the regulations; (« services de santé »)

"hospital" has the same meaning as in The Hospitals Act; (« hôpital »)

"Indian Band" means a band as defined in the Indian Act (Canada); (« bande indienne »)

"minister" means the member of the Executive Council charged by the Lieutenant Governor in Council with the administration of this Act; (« ministre »)

"municipality" includes a local government district; (« municipalité »)

"personal care home" means premises in which personal care services are provided to residents in the premises, but does not include a private residence in which care is provided by an individual to his or her family member; (« foyer de soins personnels »)

"prescribed" means prescribed in the regulations;

"prescribed health services" means the health services or categories of health services, including the level and extent of health services, which a regional health authority must provide or make available, as prescribed by the minister; (« services de santé obligatoires »)

"provincial objectives and priorities" means the objectives and priorities for the provision of health services in the province, or in areas of the province, established by the minister under subsection 3(1); (« objectifs et priorités d'application provinciale »)

"regional health authority" means a regional health authority established or continued under this Act; (« office régional de la santé »)

"regional health plan" means a plan approved or amended under section 24; (« plan sanitaire régional »)

"securities" has the same meaning as in The Hospital Capital Financing Authority Act. (« valeurs mobilières »)

Purpose of Act

2(1)      The purpose of this Act is to create regional authorities with responsibility for providing for the delivery of and administering health services in specified geographic areas.

Canada Health Act criteria

2(2)      This Act shall be administered in a manner that complies with section 7 of the Canada Health Act, which sets out the criteria of comprehensiveness, universality, portability, accessibility and public administration in relation to the operation of the Manitoba Health Services Insurance Plan.

Conflict with other legislation

2(3)      Where there is a conflict between this Act or the regulations and any of the following, the provisions of this Act and the regulations prevail:

(a) The District Health and Social Services Act or the regulations under that Act;

(b) The Health Services Act or the regulations under that Act;

(c) an Act, including a private Act, establishing or respecting a facility or health corporation;

(d) the articles of incorporation or by-laws of a facility or health corporation.

End of Part 1

PART 2

POWERS OF THE MINISTER

Provincial objectives and priorities

3(1)      The minister may establish provincial objectives and priorities for the provision of health services in the province or in areas of the province.

Prescribed health services and standards

3(2)      The minister may prescribe

(a) health services which must be provided or made available by a regional health authority; and

(b) standards for the provision of health services.

Directions to regional health authorities

3(3)      The minister may give directions to a regional health authority to achieve the purposes of this Act and the regulations, including but not limited to directions for the purpose of

(a) achieving provincial objectives and priorities;

(b) providing guidelines for the regional health authority to follow in carrying out and exercising its responsibilities, duties and powers; and

(c) coordinating the work of the regional health authority with the programs, policies and work of the government, the agencies of the government and other persons in the provision of health services.

Provision of health services by minister

4         Notwithstanding the provisions of this or any other Act or regulation, if the minister considers it is in the public interest to do so, the minister may

(a) provide or arrange for the provision of health services in any area of the province, whether or not health services are being provided in that area by a municipality, regional health authority, health care organization, health corporation or any other person; and

(b) do any other thing that the minister considers necessary to promote and ensure the provision of health services in the province.

Agreements

5(1)      The minister may enter into agreements for the purposes of this Act and the regulations with

(a) the Government of Canada, or an agency of the Government of Canada, with the approval of the Lieutenant Governor in Council;

(b) the government of another province, territory or jurisdiction, or an agency of one of those governments, with the approval of the Lieutenant Governor in Council;

(c) an Indian Band, with the approval of the Lieutenant Governor in Council;

(d) a municipality;

(e) a regional health authority; or

(f) any other person or group of persons.

Agreements with health corporations

5(2)      Without limiting the generality of subsection (1), the minister may enter into agreements with a health corporation, or an organization representing health corporations, respecting the preservation of corporate ownership, autonomy, governance and mission of the health corporation or health corporations.

Expropriation by minister

6         The minister may

(a) acquire, for and on behalf of a regional health authority, by purchase, lease, expropriation or otherwise, lands, buildings or both for the purposes of acquiring, constructing, expanding, converting or relocating a facility or providing health services under this Act; and

(b) upon acquisition, dispose of the lands, buildings or both to the regional health authority on such terms and conditions as the minister considers appropriate.

Delegation by minister

7         The minister may, in writing, delegate to any person any of the powers, duties and functions conferred or imposed on the minister under this Act.

End of Part 2

PART 3

ESTABLISHMENT OF HEALTH REGIONS AND REGIONAL HEALTH AUTHORITIES

Establishment of health regions and regional health authorities

8(1)      The Lieutenant Governor in Council, by regulation,

(a) may establish one or more health regions in the province; and

(b) shall establish a regional health authority for each health region, to provide for the delivery of and administer health services in the health region.

Proposal and consultations

8(2)      Prior to the establishment of a health region and a regional health authority by the Lieutenant Governor in Council under subsection (1), the minister may, if he or she considers it advisable,

(a) cause a proposal to be prepared; and

(b) carry out consultations in the manner and to the extent that the minister considers appropriate;

respecting the proposed establishment of the health region and of the regional health authority for the health region.

Contents of regulation

8(3)      A regulation under subsection (1)

(a) shall name the health region and describe its boundaries;

(b) shall name the regional health authority for the health region;

(c) shall specify the organization and composition of the regional health authority, including but not limited to the composition of the board and the number of directors on it; and

(d) may be made effective retroactively to a date specified in the regulation.

Corporations continued as regional health authorities

9(1)      The Lieutenant Governor in Council may, by regulation,

(a) continue an area of the province, described in the regulation, as a health region under this Act with the boundaries described and under the name set out in the regulation;

(b) continue a corporation, described in the regulation, as a regional health authority under this Act for an area continued as a health region under clause (a); and

(c) provide for the organization and composition of a corporation continued as a regional health authority under clause (b), including but not limited to the composition of the board and the number of directors on it.

Effect of continuation

9(2)      A health region and a regional health authority continued by regulation under subsection (1) are deemed to have been established under this Act.

Directors continued as first directors

9(3)      A director or chairperson of a regional health authority continued by regulation under subsection (1) who holds office on the coming into force of this Act is deemed to be a first director or chairperson of the regional health authority appointed under section 15 and continues to hold office until his or her successor is appointed or elected in accordance with section 14.

Variation of health region or regional health authority

10(1)     The Lieutenant Governor in Council may, by regulation,

(a) vary the size or boundaries of a health region established or continued under this Act;

(b) vary any aspect of the organization or composition of a regional health authority established or continued under this Act, including but not limited to the composition of the board and the number of directors on it;

(c) change the name of a health region, a regional health authority, or both; and

(d) provide for such matters as the Lieutenant Governor in Council considers necessary to facilitate the variation or to protect the interests of creditors and other affected persons.

Proposal and consultations

10(2)      Prior to the making of a regulation by the Lieutenant Governor in Council under subsection (1), the minister may, if he or she considers it advisable,

(a) cause a proposal to be prepared; and

(b) carry out consultations in the manner and to the extent that the minister considers appropriate;

respecting the proposed variation or name change.

Retroactive effect

10(3)     A regulation made under subsection (1) may be made effective retroactively to a date specified in the regulation.

End of Part 3

PART 4

REGIONAL HEALTH AUTHORITIES

DIVISION 1

STRUCTURE AND ADMINISTRATION

Corporate status

11        A regional health authority is a corporation, and, subject to this Act and the regulations, has all the rights, powers and privileges of a natural person of full capacity for the purposes of carrying out and exercising its responsibilities, duties and powers under this Act and the regulations.

Corporation without share capital

12        A regional health authority is established to operate exclusively as a corporation without share capital, and no part of the income or property of a regional health authority shall be paid to, or otherwise made available for, the personal benefit of any director of the regional health authority except as permitted by section 16.

Applicability of The Corporations Act

13        The Corporations Act shall not apply to a regional health authority except to the extent prescribed by the Lieutenant Governor in Council.

Board of regional health authority

14(1)     The management and affairs of a regional health authority established or continued under this Act shall be directed by a board of directors consisting of the prescribed number of directors who are appointed or elected in accordance with this Act and the regulations.

Terms of office

14(2)     The terms of office of the directors are as determined by the Lieutenant Governor in Council.

Vacancy

14(3)     A board may act despite a vacancy in its membership.

Chairperson and executive members

14(4)     A chairperson shall be appointed by the minister from among the directors, and a vice-chairperson and other executive members shall be elected from among the directors in accordance with the by-laws of the board.

First directors

15(1)     Notwithstanding section 14, the minister may

(a) appoint the number of persons the minister considers appropriate as the first directors of a regional health authority;

(b) appoint one of the first directors as the first chairperson of the board of the regional health authority; and

(c) make subsequent appointments to fill vacancies on the board until directors are appointed or elected under subsection 14(1), and a person appointed under this clause is deemed to be a first director.

Terms of office of first directors

15(2)     The terms of office of a first director and the first chairperson of a regional health authority continue until their successors are appointed or elected under section 14.

Remuneration and expenses of directors

16        A regional health authority shall pay its directors the remuneration and expenses that the Lieutenant Governor in Council determines.

Duties of directors

17        A director on a board of a regional health authority shall

(a) ensure that the business and activities of the regional health authority are carried out in accordance with this Act and the regulations;

(b) act honestly and in good faith with a view to the best interests of the regional health authority and the health region; and

(c) exercise the care, diligence and skill that a reasonable and prudent person would exercise in comparable circumstances.

By-laws and policies

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

Approval of by-laws by minister

18(2)     The by-laws made by a board, and all amendments to them, shall

(a) comply with any model by-laws, guidelines or directions provided or approved by the minister; and

(b) be submitted to the minister for approval in accordance with the procedures established by the minister.

By-laws not effective until approved

18(3)     A by-law of a board has no force or effect until approved by the minister.

By-laws and policies open to public

18(4)     All by-laws and policies made by a board shall be open for inspection by the public during the normal office hours of the regional health authority.

Meetings

19        A board shall hold

(a) an annual meeting, which shall be open to the public, at the time and in accordance with the requirements prescribed in the regulations; and

(b) other meetings in accordance with the by-laws of the board.

Quorum

20        Unless otherwise prescribed, a majority of the directors appointed and elected to a board constitutes a quorum for the transaction of business.

Appointment of chief executive officer

21(1)     A board shall appoint, and determine the terms and conditions of employment of, a chief executive officer for the regional health authority.

Responsibilities of chief executive officer

21(2)     The chief executive officer is responsible for the general management and conduct of the affairs of the regional health authority in accordance with the by-laws, rules, policies and directions of the board, which includes responsibility for

(a) carrying out the policies and programs of the regional health authority;

(b) managing the business affairs of the regional health authority; and

(c) such other matters as may be delegated by the board to the chief executive officer.

Officers and employees

22        Subject to this Act and the regulations, a board may appoint any officers and engage any employees and other persons it considers necessary to carry out and exercise the responsibilities, duties and powers of the regional health authority.

DIVISION 2

RESPONSIBILITIES, DUTIES AND POWERS OF REGIONAL HEALTH AUTHORITIES

Responsibilities of regional health authority

23(1)     A regional health authority is responsible for providing for the delivery of and administering health services to meet the health needs in its health region in accordance with this Act and the regulations.

Duties of regional health authority

23(2)     In carrying out its responsibilities, a regional health authority shall

(a) promote and protect the health of the population of the health region and develop and implement measures for the prevention of disease and injury;

(b) assess health needs in the health region on an ongoing basis;

(c) develop objectives and priorities for the provision of health services which meet the health needs in the health region and which are consistent with provincial objectives and priorities;

(d) prepare and implement a regional health plan;

(e) review and revise the regional health plan at least once a year, and more frequently if required by the minister;

(f) manage and allocate resources, including, but not limited to, funds provided by the government for health services, in accordance with this Act, the regulations, and the regional health plan;

(g) in providing for the delivery of health services,

(i) ensure that the prescribed health services are provided or made available,

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

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

(h) ensure that health services are provided in a manner which is responsive to the needs of individuals and communities in the health region and which coordinates and integrates health services and facilities;

(i) cooperate with other persons, including but not limited to government departments and agencies, to coordinate health services and facilities in the province and to achieve provincial objectives and priorities;

(j) comply with any directions given by the minister; and

(k) monitor and evaluate the delivery of health services and compliance with prescribed standards and provincial objectives and priorities, in accordance with guidelines provided or prescribed by the minister.

Proposed regional health plan

24(1)     A regional health authority shall, within the time and in the form specified by the minister, prepare and submit to the minister a proposed regional health plan for the health region.

Consultations

24(2)     In the course of preparing a proposed regional health plan, the regional health authority shall consult with such persons, including municipalities, Indian Bands, and government departments and agencies, as the regional health authority considers appropriate.

Content of proposed regional health plan

24(3)     A proposed regional health plan shall

(a) state the objectives and priorities developed by the regional health authority for the provision of health services to meet the health needs in the health region, which shall incorporate provincial objectives and priorities;

(b) state how the regional health authority proposes to carry out and exercise its responsibilities, duties and powers under this Act and the regulations and to measure its performance in carrying out and exercising those responsibilities, duties and powers;

(c) include a comprehensive financial plan which shall include a statement of how resources, including but not limited to financial resources, will be allocated to meet the objectives and priorities developed by the regional health authority and provincial objectives and priorities; and

(d) deal with such other matters and contain such other information as the minister may require.

Approval of proposed regional health plan

24(4)     The minister may

(a) approve, for the upcoming fiscal year, a proposed regional health plan as submitted; or

(b) refer a proposed regional health plan back to the regional health authority for further action, with any directions the minister considers appropriate.

Action where plan is referred back

24(5)     A proposed regional health plan that is referred back to a regional health authority under clause (4)(b) must be resubmitted as directed by the minister, and when it is resubmitted, subsection (4) applies.

Revisions and amendments

24(6)     A regional health authority shall submit to the minister, for approval,

(a) any revisions or amendments to an approved regional health plan proposed by the regional health authority from time to time; and

(b) proposed revisions or amendments to an approved regional health plan respecting matters specified by the minister, within the time specified by the minister;

and subsections (4) and (5) apply to any proposed revisions or amendments submitted to the minister under this subsection.

General powers of regional health authority

25        Subject to this Act and the regulations, a regional health authority may

(a) provide for the delivery of social services, with the approval of the minister;

(b) purchase, lease or otherwise acquire personal property;

(c) sell, lease or otherwise dispose of personal property;

(d) accept grants, gifts, donations and bequests of real or personal property, including money, or of any interest in real or personal property, from any source, and, where the grant, gift, donation or bequest is made subject to directions or conditions, the regional health authority shall comply with and give effect to the directions or conditions;

(e) where authorized by regulation, charge fees for health services, or categories of health services, directly to the person who received the services, at the rates fixed in, or calculated in accordance with, the regulations;

(f) establish and apply to register charitable foundations, as that term is defined in the Income Tax Act (Canada), to benefit, directly or indirectly, the residents of the health region; and

(g) exercise any other powers that are necessary to carry out and exercise its responsibilities and duties under this Act and the regulations, unless otherwise directed by the minister.

Power to provide additional health services

26        Subject to this Act and the regulations, a regional health authority may provide for the delivery of health services in addition to the prescribed health services if

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

(b) the additional health services are included in an approved regional health plan;

(c) provision of the additional health services is consistent with provincial objectives and priorities and the objectives and priorities set by the regional health authority for the health region;

(d) provision of the additional health services will not impair or interfere with the delivery or availability of prescribed health services; and

(e) sufficient resources are available to the regional health authority and can be allocated in a manner which will ensure that all health services provided in the health region meet the health needs in the health region, prescribed standards and applicable standards and requirements under any other Act or regulation.

Powers respecting real property

27         Subject to the approval of the minister, a regional health authority may

(a) purchase, lease or otherwise acquire for consideration real property, including a facility, or an interest in real property, that it considers necessary for its purposes, provided that, where the real property is in another health region, the regional health authority for that other health region consents to the purchase, lease or acquisition;

(b) construct, renovate, expand, convert or relocate buildings or structures, including facilities; and

(c) sell, lease or otherwise dispose of real property, including a facility, or an interest in real property, when the real property is no longer required for its purposes or when the regional health authority considers that it is in the interests of the health region to do so.

Regional health authority to approve certain facilities

28(1)     No person may construct, establish, operate, renovate, expand, convert or relocate a hospital or personal care home in a health region without the approval of the regional health authority for that health region.

Restrictions respecting sale of facilities

28(2)     No person may sell, lease or otherwise dispose of a facility, or real property associated with the facility, without the approval of the regional health authority for the health region in which the facility is located, if the government or a regional health authority has provided funds respecting the acquisition, construction, expansion, conversion or relocation of, or major renovations to, the facility.

Approval of minister

28(3)     A regional health authority shall not provide an approval under subsection (1) or (2) without the prior approval of the minister.

Approval additional to other requirements

28(4)     The requirements for approvals under subsections (1), (2) and (3) are in addition to the requirements under any other Act or regulation.

Regional health authority may require reports

29(1)     A regional health authority may require that a health care organization, health care provider, health corporation or other person in receipt of payments or funding from the regional health authority provide to the regional health authority any reports, returns, financial statements, including audited financial statements, and statistical information that the regional health authority may require from time to time for the purposes of carrying out and exercising its responsibilities, duties and powers under this Act and the regulations.

Form of reports

29(2)     Reports, returns, statements and statistical information required to be provided under subsection (1) shall be provided within the time and in the form specified by the regional health authority.

Reports to minister by regional health authority

30(1)     A regional health authority shall provide to the minister any reports, returns and statistical information that the minister may require from time to time for the purposes of this Act and the regulations.

Form of reports

30(2)     Reports, returns and statistical information required to be provided under subsection (1) shall be provided within the time and in the form specified by the minister.

Agreements

31        Subject to this Act and the regulations, a regional health authority may enter into agreements for the purposes of this Act and the regulations with

(a) the government or an agency of the government;

(b) the government of Canada or of another province or territory, or an agency of one of those governments, with the consent of the minister;

(c) an Indian Band, with the consent of the minister;

(d) a municipality;

(e) another regional health authority; or

(f) any other person or group of persons.

District health advisory councils

32(1)     Unless the minister approves otherwise, a regional health authority shall establish at least one and no more than four district health advisory councils to advise and assist the board of the regional health authority.

Composition of council

32(2)     A district health advisory council shall be composed of the number of members prescribed by the minister, who shall be selected, by appointment, election or otherwise, in accordance with the regulations.

DIVISION 3

FINANCIAL MATTERS

Minister may provide funding to regional health authority

33        The minister may provide funding to a regional health authority for the purposes of this Act out of money appropriated by the Legislature for those purposes.

Grants or payments under other enactments

34        Notwithstanding any other Act or regulation, where another Act or regulation provides that the minister shall or may provide grants or payments respecting health services or facilities to any person, including a health care organization, health care provider or health corporation, the minister may instead provide those grants or payments to a regional health authority and, subject to any terms and conditions the minister considers appropriate, the minister may delegate to the regional health authority the minister's powers in respect of the provision of the grants or payments.

Minister may withhold payments to regional health authority

35        Notwithstanding this or any other Act or regulation, the minister may withhold any payment, or any part of a payment, to a regional health authority under this or any other Act or regulation until the regional health authority has complied with this Act and the regulations.

Regional health authority may withhold payments

36        Notwithstanding this or any other Act or regulation, or any agreement entered into by the regional health authority, a regional health authority may withhold any payment, or any part of a payment, to a health care organization or health corporation under this or any other Act or regulation until the health care organization or health corporation has complied with this Act and the regulations.

Fiscal year of regional health authority

37        The fiscal year of a regional health authority is April 1 to the following March 31.

Annual report

38(1)     A regional health authority shall, within six months after the end of each fiscal year, submit to the minister an annual report respecting that fiscal year in the form and at the time specified by the minister.

Content of annual report

38(2)     An annual report submitted under subsection (1) shall contain

(a) a report respecting the activities of the regional health authority, including but not limited to the health services provided or funded by the regional health authority, and the costs of these activities;

(b) a report respecting the health status of the population of the health region and the effectiveness of the health services provided or funded by the regional health authority;

(c) the audited financial statement of the regional health authority respecting the fiscal year covered by the annual report, in the form specified by the minister; and

(d) such other information as may be required by the minister.

Auditor

39(1)     A regional health authority shall appoint an external auditor who shall audit the records, accounts and financial transactions of the regional health authority annually.

Restrictions respecting appointment of auditor

39(2)     A regional health authority shall not appoint a person as auditor, and no person shall act as auditor of a regional health authority, if in the fiscal year in which the appointment is made, or in the preceding fiscal year, the person

(a) is or was a director on the board of the regional health authority or a director or member of the board of a health corporation providing services in the health region;

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

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

Financial information

40        A regional health authority shall, within the time specified by the minister, provide to the minister any financial information that is requested by the minister.

Limit on financial commitments

41        Except with the approval of the minister, a regional health authority shall not make any expenditures or expenditure commitments that are not within the financial limits set in the regional health plan for the regional health authority approved under section 24.

Financial responsibility for unfunded services

42        If a regional health authority provides or funds health services or social services that are not provided under a program supported by financial assistance from the government, the regional health authority shall be responsible for all costs of the health services and social services that are not funded by the government.

Borrowing

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

Securities

43(2)     Subject to the regulations and to The Hospital Capital Financing Authority Act, a regional health authority may issue securities.

Assignment of funds by regional health authority

44(1)     A regional health authority may enter into an agreement with the minister

(a) by which the regional health authority assigns to the minister, out of funds payable by the government for health services to the regional health authority in each fiscal year, an amount that is equal to the total of the principal and interest payable by the regional health authority in that fiscal year on securities issued by it or by a health corporation providing health services in the health region, or for sinking funds created in respect thereof; and

(b) in which the minister undertakes to hold the money so assigned in trust, for the payment of the principal and interest on the securities, as these amounts become payable from that money, or for sinking funds created in respect thereof.

Assignment of funds by health corporation

44(2)     Notwithstanding the provisions of this or any other Act or regulation, the minister may, in each fiscal year, withhold from any funds payable to a regional health authority for a health region the amounts assigned by a health corporation in the health region to the minister in an agreement entered into prior to the coming into force of this Act under section 69 of The Health Services Insurance Act or subsection 55(1) of The Health Services Act (as those provisions existed prior to the coming into force of this Act), for the payment of principal and interest on securities issued by the health corporation in accordance with the agreement, or for sinking funds created in respect thereof.

DIVISION 4

AGREEMENT TO WIND UP CERTAIN HEALTH CORPORATIONS

Definition of "health corporation"

45        For the purposes of this Division, "health corporation" does not include a corporation with share capital or a municipality.

Agreement to transfer operations

46(1)     Notwithstanding the provisions of The Corporations Act or of any other Act, including a private Act, establishing or respecting a health corporation, a health corporation may enter into an agreement with a regional health authority under which the operations, property, liabilities and obligations of the health corporation will be transferred to and assumed by the regional health authority and the health corporation will be wound up.

Content of agreement

46(2)     An agreement under subsection (1) shall

(a) be in the form required by the minister;

(b) address all matters that are necessary to accomplish the purposes set out in subsection (1);

(c) include any apportionment under subsection (3);

(d) address all matters required by the minister;

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

(f) be approved by the board of the regional health authority and by the board or, where applicable, by the board and by the membership of, the health corporation, by a resolution passed by a majority of not less than 2/3 of the votes cast.

Apportionment of debt

46(3)     Where a health corporation and a regional health authority propose to enter into an agreement under this section,

(a) if the health corporation is established under The District Health and Social Services Act, it may, in accordance with section 35 of that Act, apportion among, and charge to, the affected municipalities (as defined in that Act) all or part of the outstanding debts of the health corporation which are unapproved by the minister and which accrued before the coming into force of this Act; and

(b) if the health corporation is established under The Health Services Act, it may, in accordance with subsections 54(1) and 54(2) of that Act, apportion among, and charge to, the included municipalities (as defined in that Act) all or part of the capital expenditures and outstanding operating deficits of the health corporation which accrued before the coming into force of this Act.

Approval of minister

46(4)     An agreement under this section has no force or effect until it is approved in writing by the minister.

Restrictions on activities of health corporation

47        Where a health corporation and a regional health authority propose to enter into an agreement under section 46, the health corporation shall

(a) not make any commitment or incur any liability, obligation or debt without the consent of the regional health authority; and

(b) take steps to facilitate the transfer of its operations, property, liabilities and obligations to the regional health authority and to wind up its affairs.

Effect of agreement

48        Notwithstanding the provisions of The Corporations Act or of any other Act, including a private Act, establishing or respecting a health corporation, unless the agreement provides otherwise, on the effective date of an agreement under section 46

(a) subject to this Act and the regulations, the regional health authority assumes the operations, activities and affairs of the health corporation;

(b) subject to this Act and the regulations, all the rights and property of the health corporation become the rights and property of the regional health authority;

(c) without limiting clause (b), any amount apportioned and charged to a municipality as a result of an apportionment by the health corporation under subsection 46(3) shall be paid by the municipality to the regional health authority within such time as the regional health authority and the municipality may agree, which shall be no later than one year from the date a request for payment is received by the municipality;

(d) all the debts, obligations and liabilities of the health corporation become the debts, obligations and liabilities of the regional health authority;

(e) an existing cause of action, claim or liability to prosecution is unaffected;

(f) a civil, criminal or administrative action or proceeding pending by or against the health corporation may be continued by or against the regional health authority; and

(g) a conviction against, or ruling, order or judgment in favour of or against, the health corporation may be enforced by or against the regional health authority.

Dissolution and disestablishment of health corporations

49        On the effective date of an agreement under section 46,

(a) where the health corporation is established under The District Health and Social Services Act or The Health Services Act, notwithstanding either of those Acts, the minister may dissolve and disestablish the health corporation, 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 those Acts to achieve this purpose;

(b) where the health corporation is established under The Corporations Act, the health corporation shall take steps to dissolve under that Act; and

(c) where clauses (a) and (b) do not apply, the health corporation shall take reasonable steps to dissolve or disestablish.

Use of grants, gifts, etc.

50        Where 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 for the purposes of a specified facility or for other specified purposes becomes, as a result of an agreement under section 46, the property of a regional health authority, the regional health authority shall use the grant, gift, donation or bequest for the purposes of that specified facility or for the specified purposes.

DIVISION 5

AMALGAMATION OF REGIONAL HEALTH AUTHORITIES

Proposal to amalgamate regional health authorities

51(1)     Two or more regional health authorities may submit to the minister a proposal to amalgamate to form a new regional health authority and a new health region.

Content of proposal

51(2)     A proposal to amalgamate submitted under subsection (1) shall

(a) be in the form and shall contain the information required by the minister;

(b) be approved by the board of each regional health authority affected, by a resolution passed by a majority of not less than 2/3 of the votes cast by the directors on the boards; and

(c) specify the proposed effective date of the amalgamation.

Consultations

51(3)     On receipt of a proposal to amalgamate, the minister may carry out, and may require the regional health authorities proposing to amalgamate to carry out, consultations in the manner and to the extent the minister considers appropriate.

Expiration of proposal

51(4)     If a new regional health authority is not established under subsection (5) within two years after a proposal to amalgamate under subsection (1) is submitted to the minister, the proposal expires.

Establishment of new regional health authority

51(5)     The Lieutenant Governor in Council, on the recommendation of the minister, may by regulation amalgamate regional health authorities which have submitted a proposal under subsection (1), and their corresponding health regions, to establish a new regional health authority and a new health region in their place.

Content of regulation

51(6)     A regulation under subsection (5) shall

(a) disestablish the regional health authorities that are amalgamated, and their corresponding health regions;

(b) dissolve the boards of the regional health authorities that are amalgamated;

(c) name the new health region and describe its boundaries;

(d) name the new regional health authority for the new health region;

(e) specify the effective date of the establishment of the new regional health authority and the new health region;

(f) specify the organization and composition of the new regional health authority, including but not limited to the composition of its board and the number of directors on it; and

(g) deal with such other matters as may be necessary to facilitate the amalgamation.

Board

51(7)     The directors of the board of a new regional health authority established under subsection (5) shall be appointed or elected in accordance with this Act and the regulations.

Interim board

51(8)     Notwithstanding subsection (7), where such action is necessary to ensure that the administration and provision of health services in the new health region will not be interrupted, the minister may appoint an interim board for the new regional health authority to carry out and exercise the responsibilities, duties and powers of the new regional health authority until directors are appointed or elected in accordance with subsection (7).

Effect of amalgamation

51(9)     On the effective date of the establishment of a new regional health authority under subsection (5),

(a) all the rights and property of the regional health authorities that are amalgamated become the rights and property of the new regional health authority established in their place;

(b) all the debts, obligations and liabilities of the regional health authorities that are amalgamated become the debts, obligations and liabilities of the new regional health authority established in their place;

(c) an existing cause of action, claim or liability to prosecution is unaffected;

(d) a civil, criminal or administrative action or proceeding pending by or against the regional health authorities which are amalgamated may be continued by or against the new regional health authority established in their place; and

(e) a conviction against, or ruling, order or judgment in favour of or against, the regional health authorities which are amalgamated may be enforced by or against the new regional health authority established in their place.

DIVISION 6

APPOINTMENT OF OFFICIAL ADMINISTRATOR AND DISESTABLISHMENT OF REGIONAL HEALTH AUTHORITIES

Appointment of official administrator

52(1)     The minister may at any time, by order, appoint a person as official administrator of a health region to act in the place of the regional health authority and the board for that health region, if the minister is of the opinion that

(a) the regional health authority or its board is not properly carrying out or exercising its responsibilities, duties or powers under this Act and the regulations; or

(b) it is in the public interest to do so.

Powers of official administrator

52(2)     Unless the order under subsection (1) provides otherwise, and subject to the direction of the minister, an official administrator appointed for a health region under subsection (1)

(a) has the exclusive right to exercise all the powers and authority of the regional health authority and its board, including but not limited to the power to deal with and dispose of the property of the regional health authority;  

(b) shall carry out all the responsibilities and duties of the regional health authority and its board; and

(c) shall be paid, out of the funds of the regional health authority, the remuneration and expenses determined by the minister.

Directors cease to hold office

52(3)     Unless the order under subsection (1) provides otherwise, on the appointment of an official administrator for a health region, the directors on the board of the regional health authority cease to hold office and shall cease to perform any duties or exercise any powers assigned to them under this or any other Act or regulation.

Directors may continue to act

52(4)     If, under the order under subsection (1), some or all of the directors continue to have the right to act with respect to any matter, any such act of the directors is valid only if approved by the official administrator.

Directors to assist official administrator

52(5)     Where an official administrator is appointed for a health region, the directors or former directors on the board of the regional health authority shall

(a) immediately deliver to the official administrator all funds, and all books, records and documents respecting the management and activities, of the regional health authority; and

(b) give the official administrator all information and assistance required to enable the official administrator to carry out and exercise his or her responsibilities, duties and powers.

Termination of appointment

52(6)     If, in the opinion of the minister, an official administrator is no longer required for a health region, the minister may do one or both of the following:

(a) terminate the appointment of the official administrator on such terms and conditions as the minister considers advisable;

(b) order the appointment or election of a new board for the regional health authority in accordance with the regulations.

Disestablishment of regional health authority

53(1)     The Lieutenant Governor in Council may, where it is in the public interest, order the disestablishment and winding up of a regional health authority and its corresponding health region on the terms and conditions that the Lieutenant Governor in Council considers appropriate, and may appoint a person to wind up the affairs of the regional health authority and its corresponding health region.

Powers of person appointed to wind up affairs

53(2)     A person appointed by the Lieutenant Governor in Council to wind up the affairs of a regional health authority under subsection (1) has all the power and authority of the regional health authority and its board for this purpose.

Effect of disestablishment

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

(a) the regional health authority and its corresponding health region are 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; and

(c) all the debts, obligations and liabilities of the regional health authority become the debts, obligations and liabilities of the government.

End of Part 4

PART 5

GENERAL PROVISIONS

Duties and powers of health corporations, etc.

54        Notwithstanding any other Act, including a private Act, or any regulation, articles of incorporation or by-law, a health care organization, health care provider, health corporation or other person in receipt of payments or funding from a regional health authority

(a) shall comply with this Act and the regulations;

(b) shall comply with prescribed standards;

(c) shall submit reports, returns, financial statements, including audited financial statements, and statistical information as required by a regional health authority under section 29 or by the regulations;

(d) shall, where the person is a health corporation, comply with any requirements or restrictions respecting borrowing or investments set out in the regulations;

(e) subject to the regulations, may enter into agreements or other arrangements with a regional health authority respecting the delivery of health services; and

(f) where authorized by regulation, may charge fees at the rates fixed in, or calculated in accordance with, the regulations for health services, or categories of health services, provided in a health region directly to the person who received the health services.

Approvals may be subject to conditions

55        An approval or consent given by the minister or a regional health authority under this Act or the regulations may be subject to terms and conditions.

Appointment of inspectors by minister

56(1)     The minister may appoint any person as an inspector for the purposes of this Act and the regulations.

Power to enter, inspect and require production

56(2)     An inspector appointed under subsection (1) may, at any reasonable time and upon presentation of identification,

(a) enter and inspect a facility in a health region;

(b) subject to section 26.9 of The Mental Health Act, require a regional health authority, or a health care organization, health care provider, health corporation or other person providing health services in a health region, to produce for examination, audit or copying, any records, documents and things relating to its business and activities, including the provision of health services, which are in the possession or under the control of the regional health authority, health care organization, health care provider, health corporation or person.

Use of data processing system and copying equipment

56(3)     In carrying out an inspection, examination or audit under this Act, an inspector may

(a) use a data processing system at the facility or the place where the records, documents or things are kept to examine any data contained in or available to the system;

(b) reproduce, in the form of a print-out or other intelligible output, any record from the data contained in or available to a data processing system at the facility or in the place; and

(c) use any copying equipment at the facility or place to make copies of any record or document.

Assistance to inspectors

56(4)     Any person who owns, operates or is in charge of a facility or who has custody or control of a record, document or thing referred to in subsection (2) shall give an inspector appointed under this Act all reasonable assistance to enable the inspector to carry out his or her duties and shall furnish to the inspector any information the inspector may reasonably require.

Warrant by justice

56(5)     A justice, who is satisfied by information on oath that an inspector appointed under this Act has been prevented from exercising his or her powers under this Act, may at any time issue a warrant authorizing the inspector and any other person named in the warrant to exercise the powers granted.

Confidentiality of information

57        Except for the purpose of the administration or enforcement of this Act and the regulations, information obtained by or provided to the minister, an inspector appointed under this Act, a regional health authority or any other person engaged in the administration or enforcement of, or in the provision of health services under, this Act or the regulations and relating to

(a) the relationship between a health care provider and his or her patient; or

(b) health services provided to, or the medical condition of, an individual;

is confidential and shall not be communicated to any person not entitled by law to that information without the consent of the patient or individual.

Protection from liability

58        No action for damages or other proceedings lie or may be brought personally against

(a) a director of a regional health authority or a person acting on the instructions of a director;

(b) an official administrator appointed under section 52, a person appointed to wind up a regional health authority under section 53, or any person acting on their instructions;

(c) a commissioner appointed under Part 6; or

(d) any other person acting under the authority of, or engaged in the administration or enforcement of, this Act or the regulations;

for anything done or omitted in good faith in the performance or exercise, or intended performance or exercise, of any duty or power under this Act or the regulations, or for any neglect or default in the performance or exercise, or intended performance or exercise, in good faith of a duty or power under this Act or the regulations.

Regulations by Lieutenant Governor in Council

59        The Lieutenant Governor in Council may make regulations

(a) defining words and phrases that are used in this Act but are not defined in this Act;

(b) prescribing bodies corporate for the purposes of the definition "health corporation";

(c) prescribing other goods and services for the purposes of the definition "health services";

(d) prescribing provisions of The Corporations Act which apply to regional health authorities;

(e) prescribing the number of directors to be appointed or elected to the board of a regional health authority;

(f) respecting the appointment of directors to the board of a regional health authority, including but not limited to nomination procedures;

(g) respecting the election of directors to the board of a regional health authority, including but not limited to

(i) establishing electoral areas within a health region and, where this is done, specifying the number of directors to be elected from each electoral area,

(ii) specifying when elections are to be held,

(iii) specifying the qualifications of electors and candidates,

(iv) respecting the nomination of candidates and the conduct of elections, and

(v) respecting the filling of vacancies, by by-election, appointment or otherwise;

(h) prescribing a quorum for a board of a regional health authority under section 20;

(i) authorizing the charging of fees for health services, or categories of health services, directly to the person who received the health services, including but not limited to

(i) specifying who may charge and collect such fees, and

(ii) fixing, or setting the method of calculating, the fees which may be charged;

(j) respecting the establishment of charitable foundations by regional health authorities, including but not limited to the functions, powers and duties of foundations;

(k) respecting the funding of regional health authorities, including but not limited to

(i) the manner of determining funding to regional health authorities,

(ii) the allocation of funds,

(iii) advances and the recovery of overpayments;

(l) respecting the borrowing and investment powers of regional health authorities and health corporations, including but not limited to restrictions on borrowing and investment;

(m) respecting the issuing of securities by regional health authorities and health corporations;

(n) respecting capital projects undertaken or approved by a regional health authority;

(o) respecting capital expenditures by or approved by regional health authorities;

(p) respecting any transitional or other problems resulting from

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

(ii) the amalgamation of regional health authorities under Division 5 of Part 4 of this Act, or

(iii) the winding-up of the affairs of a regional health authority which is disestablished under section 53;

(q) prescribing any matter or thing that may be or is to be prescribed under this Act;

(r) respecting any other matter that the Lieutenant Governor in Council considers necessary or advisable.

Regulations by minister

60        The minister may make regulations

(a) prescribing health services or categories of health services, including the level and extent of health services, which must be provided or made available by a regional health authority;

(b) prescribing standards for the provision of health services and the operation of facilities;

(c) respecting the monitoring and enforcement of standards and of compliance with this Act and the regulations;

(d) respecting the annual public meeting of a regional health authority, including but not limited to specifying when the meeting is to be held, notice requirements, matters to be dealt with and procedures to be followed;

(e) respecting the acquisition and disposal of personal property by a regional health authority;

(f) respecting the health services which may be provided by a regional health authority in addition to prescribed health services;

(g) respecting agreements between regional health authorities and health care organizations, health care providers, health corporations and other persons;

(h) requiring books, registers, accounts, files and records to be kept by regional health authorities;

(i) respecting reporting requirements by a regional health authority to the minister;

(j) respecting district health advisory councils, including

(i) prescribing the number of members on a district health advisory council,

(ii) the method of selection, by appointment, election or otherwise, of members of a district health advisory council, and

(iii) the duties and functions of district health advisory councils;

(k) respecting advisory committees, including but not limited to service provider advisory committees;

(l) respecting conflicts of interest for directors, officers and employees of regional health authorities and for members of district health advisory councils, including but not limited to

(i) prescribing those things which constitute a conflict of interest, and

(ii) requiring regional health authorities to make by-laws respecting conflicts of interest and respecting the contents of those by-laws;

(m) respecting reporting requirements by a health care organization, health corporation or other person in receipt of payments or funding from a regional health authority to the regional health authority;

(n) establishing a procedure to mediate and resolve disputes between a regional health authority and a health care organization, health care provider, health corporation or other person;

(o) respecting confidentiality requirements to be observed by a person with respect to information obtained in the administration of this Act or the regulations or in providing health services under this Act or the regulations;

(p) respecting information management, including but not limited to

(i) information technology and systems to be used by a regional health authority and the standards that such technology and systems must meet, and

(ii) the retention, storage, transmission and destruction of all clinical, administrative and other records, in whatever form, by a regional health authority or any other person;

(q) respecting the sharing of information among regional health authorities, health corporations, health care organizations, health care providers and other persons.

Regulations may create categories

61(1)     The power to make regulations under this Act in relation to any person, matter or thing includes the power to create categories of those persons, matters or things and to make different regulations for each of those categories.

Regulations may incorporate by reference

61(2)     A regulation made under this Act may incorporate, by reference or otherwise, the provisions of any other Act or regulation.

End of Part 5

PART 6

TRANSITIONAL PROVISIONS RESPECTING LABOUR RELATIONS AND EMPLOYEES

Definitions

62(1)     In this Part,

"commission" means the labour relations commission appointed under section 63; (« Commission »)

"The Manitoba Labour Board" means The Manitoba Labour Board continued under The Labour Relations Act. (« Commission des relations du travail »)

Labour Relations Act definitions

62(2)     In this Part, "bargaining agent", "collective agreement", and "union" have the same meaning as in The Labour Relations Act, unless a contrary intention appears.

Appointment of commission

63(1)     The Lieutenant Governor in Council may appoint a commission of three persons to inquire into and make recommendations respecting trade union representation and jurisdiction in the health sector in the context of the transition to regional health authorities under this Act.

Chairperson

63(2)     The Lieutenant Governor in Council shall appoint one of the commissioners as the chairperson.

Knowledge and experience of commissioners

63(3)     As to the appointment of the other two commissioners,

(a) one must be a person who, in the opinion of the Lieutenant Governor in Council, has knowledge and experience related to the management of health services delivery in the province; and

(b) one must be a person who, in the opinion of the Lieutenant Governor in Council, has knowledge and experience related to the representation of employees in the health sector in the province.

Consultation regarding appointment

63(4)     For the purpose of making the appointments referred to in subsection (3), the Lieutenant Governor in Council shall consult with

(a) regional health authorities;

(b) trade unions representing workers in the health sector; and

(c) health corporations.

Term of appointment

63(5)     The commissioners shall be appointed for a term to be prescribed by the Lieutenant Governor in Council.

Remuneration

63(6)     The Lieutenant Governor in Council shall determine the remuneration of the commissioners, which shall be charged to and paid out of the Consolidated Fund.

Expenses

63(7)     The commissioners shall be paid such travelling and out of pocket expenses incurred by them in the performance of their duties as may be determined by Lieutenant Governor in Council.

Recommendations

63(8)     If the commissioners cannot reach a unanimous agreement with respect to a recommendation under this Part, the recommendation of the chairperson shall be the recommendation of the commission.

Considerations

64        The commission shall consider the following:

(a) the new employment relationships that may be established as a result of the operation of this Act;

(b) the need to promote integration of health care delivery, and to enable and encourage development over time of consistency within the province of terms and conditions of employment in the health sector;

(c) the history of union representation in the health sector;

(d) any consensus reached by unions representing all, or a majority of, employees who may fall within the bargaining units determined under this Act; and

(e) such other matters as may be prescribed by the Lieutenant Governor in Council.

Recommendations re bargaining units and bargaining agents

65(1)     The commission shall make recommendations for each regional health authority established or continued under this Act respecting

(a) the composition of appropriate bargaining units that would address the considerations set out in section 64;

(b) which union shall be certified as the bargaining agent for the employees in each such bargaining unit;

(c) the advisability of, or necessity for, multi-employer certification and councils of trade unions for the health sector; and

(d) such other matters as the commission considers appropriate in the circumstances.

Further submissions

65(2)     Prior to making any recommendation under subsection (1), the commission shall notify in writing those unions and employers directly affected by the recommendation, and shall provide an opportunity for any further submissions to be made to the commission in the form, manner and time period which the commission shall, in its sole discretion, direct.

Reconsideration, etc. by commission

65(3)     Nothing in this Part prevents the commission from reconsidering from time to time any matter that has been the subject of a recommendation from the commission to the minister, and from rescinding, altering or amending any recommendation previously made, or making any further or supplementary recommendation to the minister.

Vote

66        The commission may, if it considers it advisable or necessary to do so, order a vote to determine the wishes of the employees in a bargaining unit or units, in which event subsections 48(2) and (3) of The Labour Relations Act apply with necessary modifications.

Interim collective agreement

67        Unless otherwise prescribed by regulation under this Part or recommended by the commission,

(a) the collective agreement governing the terms and conditions of all or a majority of the employees who are represented by the union determined to be the bargaining agent under section 65 shall be the collective agreement governing the rights and obligations of each regional health authority and its employees within the bargaining unit until replaced by a new collective agreement;

(b) in the event the bargaining agent to be certified under section 65 does not represent any employees falling within the bargaining unit, the collective agreement governing the terms and conditions of the majority of the employees within the bargaining unit under section 65 shall continue to govern the rights and obligations of each regional health authority and its employees within the bargaining unit until replaced by a new collective agreement;

(c) the commencement date upon which all employees within the bargaining units are governed by the terms and conditions of a collective agreement made applicable under clause (a) or (b) shall be

(i) the later of the date of employment and the effective date of the regulation made under section 8 or 9 of this Act establishing or continuing the regional health authority, or

(ii) in the event of a transfer and winding up under Division 4 of Part 4, or of an amalgamation under Division 5 of Part 4, the effective date thereof.

Further recommendations

68(1)     The commission shall, if required, make recommendations, which will be binding on employees, employers and unions who are affected by a regulation made under section 8 or 9 of this Act or by a transfer and winding up under Division 4 of Part 4 or an amalgamation under Division 5 of Part 4, as of the later of the date of employment and the effective date of the establishment or continuation of the regional health authority, or as of the proposed effective date of the transfer and winding up or of the amalgamation, to

(a) amend, to the extent the commission considers necessary, any certificate issued to a bargaining agent under The Labour Relations Act, or if there is no certificate, any provision in the collective agreement, which describes the scope of the unit covered by the collective agreement;

(b) prescribe, as the commission considers necessary or advisable, such modifications to, or restrictions on, the operation or effect of any of the provisions of any collective agreement which is binding on the employees in the units determined to be appropriate under section 65;

(c) give any further direction the commission considers necessary or advisable as to the interpretation or application of a collective agreement affecting the employees in a unit affected by a transfer and winding up under Division 4 of Part 4 or an amalgamation under Division 5 of Part 4.

Additional considerations

68(2)     In making any recommendations under subsection (1), the commission shall take into account the extent to which, and the fairness with which, those provisions have been, or could be, applied to the employees affected in order to

(a) remove any inconsistencies or conflicts between two or more collective agreements, or resulting from any intermingling; and

(b) define or redefine the seniority rights under a collective agreement of the employees affected by a transfer and winding up or an amalgamation.

Powers under Part V of The Evidence Act

69        The commissioners have the protection and powers of a commissioner appointed under Part V of The Manitoba Evidence Act, but section 85 of The Manitoba Evidence Act does not apply to the commission, and no notice of appointment, of the purpose and scope of inquiries to be made by the commission, or of the time and place of the holding of any hearing or inquiry by the commission need be published as required under section 86 of The Manitoba Evidence Act.

Recommendations to be reported to the minister

70        The commission shall report the recommendations to the minister within the time established by the minister.

New collective agreement

71(1)     Within six months of the later of the date of employment of the first employee and the effective date of the establishment or continuation of a regional health authority under section 8 or 9, or of the effective date of a transfer and winding up under Division 4 of Part 4 or an amalgamation under Division 5 of Part 4, the regional health authority and the bargaining agents determined under section 65 may serve notice on the other of an intent to commence collective bargaining with a view to the revision of the collective agreement or the conclusion of a new collective agreement, and thereupon the collective agreement in effect at the time the notice is given terminates, unless it is renewed prior thereto, on the earlier of

(a) the date of expiry of the collective agreement; or

(b) 90 days after the day on which the notice to commence collective bargaining is served upon either party.

Where new collective agreement not reached

71(2)     In the event an agreement is not reached under subsection (1) prior to termination of the collective agreement, the regional health authority and the bargaining agents may thereafter exercise any rights under the existing collective agreement and The Labour Relations Act so as to effect a new collective agreement.

Implementation of recommendations

72(1)     After the minister receives any report under section 70, the Lieutenant Governor in Council may make regulations to implement recommendations in the report.

Regulations

72(2)     Without limiting subsection (1), the Lieutenant Governor in Council may make regulations

(a) determining that a group or groups of employees constitute one or more units appropriate for collective bargaining under The Labour Relations Act;

(b) determining the union or unions which are to be certified as the bargaining agent for the employees in each such bargaining unit; and

(c) respecting multi-employer certification and councils of trade unions for the health sector.

Included in bargaining unit

73        A recommendation made under section 65 or 68, and a regulation under this Part, may include in a bargaining unit only those units where the employees are represented by a trade union or an employee association voluntarily recognized for collective bargaining purposes.

General jurisdiction

74(1)     The commission, in making recommendations under sections 65 and 68, has the exclusive jurisdiction to investigate, recommend and determine all matters and questions arising under this Part, and as to any matter or thing in respect of which any power, authority or discretion is conferred upon the commission, and the action or decision of the commission thereon is final and conclusive and is not open to question or review in any court; and no proceedings by or before the commission shall be restrained by injunction, prohibition or other process or proceeding in any court, or are removable by certiorari or otherwise into any court.

Judicial review

74(2)     Notwithstanding subsection (1), a recommendation, action or decision of the commission may be reviewed by a court of competetent jurisdiction if the commission has committed an error of law or acted beyond or refused to exercise its jurisidiction.

Conflict with Labour Relations Act

75        If there is a conflict or inconsistency between a regulation under this Part and The Labour Relations Act, any regulation under that Act, or any proceedings or orders made under that Act before the enactment of the regulation under this Part, the regulation under this Part applies.

Effect of regulation

76(1)     A regulation made under this Part has the same force and effect as a certification or other decision made by The Manitoba Labour Board.

Regulation may be retroactive

76(2)     A regulation under this Part may be made effective retroactively to a date specified in the regulation.

Regulations Act does not apply

76(3)     The Regulations Act does not apply to a power exercised by the minister or a regulation made by the Lieutenant Governor in Council under this Part.

Jurisdiction of Manitoba Labour Board

77        Except as specifically provided in sections 72 to 75 and in this Part, The Manitoba Labour Board has exclusive jurisdiction to determine a matter arising under sections 72 to 75 and this Part, and The Labour Relations Act applies with respect to such a determination.

Transfer of employees in civil service

78(1)     The Lieutenant Governor in Council may transfer employees in the civil service to a regional health authority and cause them to become employees of the regional health authority.

Application of Civil Service Superannuation Act

78(2)     The Lieutenant Governor in Council may, by regulation, designate employees transferred to the employ of a regional health authority under subsection (1) as employees within the meaning of The Civil Service Superannuation Act.

Status of transferred employees

78(3)     For the purposes of The Civil Service Superannuation Act, a regional health authority is an agency of the government and that Act may be made to apply to all or some of the employees of the regional health authority as though the regional health authority was an agency of the government.

Application of Labour Relations Act

78(4)     For the purposes of this Part, section 59 of The Labour Relations Act relating to common control or direction of associated or related activities or businesses does not apply to a regional health authority or to the Crown in right of Manitoba.

Repeal

79        This Part is repealed on April 1, 2002.

End of Part 6

PART 7

CONSEQUENTIAL AMENDMENTS AND COMING INTO FORCE

The District Health and Social Services Act

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

80(1)      The District Health and Social Services Act is amended by this section.

80(2)      Section 1 is amended

(a) by repealing the definitions "fund" and "proposal";

(b) by adding the following definitions in alphabetical order:

"health region" means a health region established or continued under The Regional Health Authorities Act; (« région sanitaire » )

"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act; (« office régional de la santé »)

(c) by repealing the definitions "health services" and "social services" and substituting the following:

"health services" has the same meaning as under The Regional Health Authorities Act; (« services de santé » )

"social services" has the same meaning as under The Regional Health Authorities Act. (« services sociaux » )

80(3)      Subsection 1(3) is amended by striking out "A proposal or a regulation" and substituting "A regulation".

80(4)      Sections 2, 3, 4 and 5 are repealed.

80(5)      Subsection 6(2) is amended by striking out "that a board is authorized or required to provide in its district" and substituting "provided by a board in its district".

80(6)      The following is added after subsection 6(2):

Limitation respecting establishment of districts

6(3)      A health and social services district shall not be established after the coming into force of The Regional Health Authorities Act.

80(7)      Section 8 is amended

(a) by repealing clauses (b) and (c); and

(b) in clause (d), by striking out "in the minister's reviews of the budgets of the board" and substituting "and that were incurred or made prior to the coming into force of The Regional Health Authorities Act".

80(8)      Section 10 is repealed and the following is substituted:  

Restriction on repeal

10        Except where a board has transferred its operations, property, liabilities and obligations to a regional health authority and the board and its district have been dissolved and disestablished under Division 4 of Part 4 of The Regional Health Authorities Act, the Lieutenant Governor in Council shall not repeal a regulation made under section 6 unless not less than ½ of the affected municipalities within the district have, by resolution of the council thereof, approved the proposed repeal.

80(9)      Sections 11 to 16 are repealed.  

80(10)     Section 19 is repealed and the following is substituted:

Authorized health services

19(1)     Notwithstanding any regulation under this Act, a board of a district shall only provide health services which are funded or approved by the regional health authority for the health region in which the district is located.

Authorized social services

19(2)     Notwithstanding any regulation under this Act, a board of a district shall only provide social services which

(a) are funded by the government; or

(b) are funded or approved by the regional health authority for the health region in which the district is located.

Agreements

19(3)     For the purposes of providing health services or social services under subsections (1) and (2), a board of a district may enter into agreements with

(a) the regional health authority for the health region in which the district is located;

(b) the government; or

(c) any other person or group of persons.

80(11)     Section 20 is amended by adding "or The Regional Health Authorities Act" at the end.

80(12)     Section 21 is repealed and the following is substituted:

Board may engage employees and others

21(1)     Where a board is authorized to provide health services or social services under section 19, the board may employ or contract with such persons as are necessary for those purposes.

Authorized charges for services

21(2)     Where authorized by The Regional Health Authorities Act or a regulation under that Act, a board may charge fees for health services directly to the person receiving the health services, at the rates fixed in, or calculated in accordance with, the regulations under that Act.

80(13)     Section 22 is repealed and the following is substituted:

Powers respecting real property

22(1)     With the approval of the regional health authority for the health region in which the district is located, a board of a district may

(a) purchase, lease or otherwise acquire for consideration lands, buildings or structures, including facilities, in the health region necessary for its purposes; and

(b) construct, renovate, expand, convert or relocate buildings or structures, including facilities.

Restrictions respecting sale

22(2)     Where the government or a regional health authority has provided funds respecting the acquisition, expansion, conversion or relocation of, or major renovations to, a facility, a board of a district shall not sell, lease or otherwise dispose of the facility, or real property associated with the facility, without the approval of the regional health authority for the health region in which the facility is located.

Minister's approval required

22(3)     A regional health authority shall not provide an approval under subsection (1) or (2) without the prior approval of the minister.

80(14)     Section 23 is repealed and the following is substituted:

Grants, gifts, etc.

23(1)     A board of a district may accept grants, gifts, donations and bequests of real or personal property, including money, or of any interest in real or personal property, from any source, and, where the grant, gift, donation or bequest is made subject to directions or conditions, the board shall comply with and give effect to the directions or conditions.

Purchase of equipment

23(2)     With the approval of the regional health authority for the health region in which the district is located, a board of a district may purchase, lease or otherwise acquire for consideration equipment for use in providing the services authorized under section 19.

Minister's approval required

23(3)     A regional health authority shall not provide an approval under subsection (2) without the prior approval of the minister.

80(15)     Section 24 is repealed and the following is substituted:

Borrowing

24(1)     Subject to The Regional Health Authorities Act and the regulations under that Act, a board of a district may borrow money for the purposes of the board, and may pledge assets of the board as security for money borrowed.

Securities

24(2)     Subject to The Hospital Capital Financing Authority Act and The Regional Health Authorities Act and the regulations under that Act, a board of a district may issue securities.

Investments

24(3)     A board of a district shall comply with any requirements and restrictions respecting investment of funds under The Regional Health Authorities Act and the regulations under that Act.

80(16)     The following is added after section 24:

Approvals may be subject to conditions

24.1      An approval given by the minister or a regional health authority under this Act may be subject to terms and conditions.

80(17)     Sections 27 to 34 are repealed.

80(18)     Section 35 is repealed and the following is substituted:

Apportionment of debts

35(1)     A board of a district may calculate the amount of any outstanding debts of the board which are unapproved by the minister and which accrued before the coming into force of The Regional Health Authorities Act, and may apportion among, and charge to, the affected municipalities all or part of this amount in accordance with the regulations.

Payment by affected municipalities

35(2)     Each affected municipality shall pay to the board or, where the board has been dissolved and disestablished under The Regional Health Authorities Act, to the regional health authority for the health region in which the district was located, the amount apportioned and charged to it under subsection (1) within such time as the board or the regional health authority, as the case may be, and the municipality may agree, which shall be no later than one year from the date a request for payment is received by the municipality.

80(19)     Clauses 38 (a) and (b) are repealed.

80(20)     Section 39 is amended:

(a) by repealing clauses (c) and (d);

(b) in clause (k), by striking out "or is required to provide"; and

(c) by repealing clause (l).

The Health Services Act

C.C.S.M. c. H30 amended

81(1)      The Health Services Act is amended by this section.

81(2)      Section 1 is amended

(a) by repealing the definitions "local health unit", "medical director" and "medical care district"; and

(b) by adding the following definitions in alphabetical order:

"health region" means a health region established or continued under The Regional Health Authorities Act; (« région sanitaire »)

"health services" has the same meaning as under The Regional Health Authorities Act; (« services de santé »)

"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act; (« office régional de la santé »)

"social services" has the same meaning as under The Regional Health Authorities Act. (« services sociaux »)

81(3)      Section 2 is repealed.

81(4)      Section 4 is amended

(a) by repealing clauses 4(a) and (b);

(b) in clause (c), by adding "medical nursing unit districts" after "hospital districts" wherever it occurs; and

(c) in clause (c), by striking out "that he may designate" and substituting "that the minister may designate".

81(5)      Clauses 6(2)(a), (b) and (e) are repealed.

81(6)      Part 1 (Local Health Units) and Part 2 (Medical Care District) are repealed.

81(7)      Section 28 is amended by renumbering it as subsection 28(1) and by adding the following as subsection 28(2):

Limitation respecting establishment of districts

28(2)     A plan under subsection (1) shall not be prepared, and a hospital district, medical nursing unit district or medical service unit district shall not be established, after the coming into force of The Regional Health Authorities Act.

81(8)      The following is added after subsection 39(10):

Limitation respecting apportionment

39(11)    Notwithstanding any provision of this Act, the regulations or a scheme under this Act, a board shall not make any apportionment under subsection (5) among the included municipalities of any capital expenditure incurred after the coming into force of The Regional Health Authorities Act.  

81(9)      Section 48 is repealed.

81(10)     The following is added after section 53:

Authorized health services

53.1(1)   Notwithstanding any provision of this Act or of any regulation or scheme under this Act, a board of a district shall only provide health services which are funded or approved by the regional health authority for the health region in which the district is located.

Authorized social services

53.1(2)   Notwithstanding any provision of this Act or of any regulation or scheme under this Act, a board of a district shall only provide social services which

(a) are funded by the government; or

(b) are funded or approved by the regional health authority for the health region in which the district is located.

81(11)     Subsections 54(1) and (2) are repealed and the following is substituted:

Apportionment of expenditures and debts

54(1)     A board may apportion among, and charge to, the included municipalities, in the manner provided in the scheme, all or part of

(a) the amount of capital expenditure for building and equipping the hospital and interest thereon, including the interest and principal or sinking fund payments payable in respect of debentures issued to secure the expenditure, incurred prior to the coming into force of The Regional Health Authorities Act; and  

(b) the amount of any outstanding debts on account of operating deficits which accrued before the coming into force of The Regional Health Authorities Act.

Payment by included municipalities

54(2)     Each of the included municipalities shall pay the amounts apportioned and charged to it under subsection (1)

(a) to the board of a district; or

(b) where the board has been dissolved and disestablished under The Regional Health Authorities Act, to the regional health authority for the health region in which the district was located;

within such time as the board or the regional health authority, as the case may be, and the municipality agree, which shall be no later than one year from the date a request for payment is received by the municipality.

81(12)     Subsection 54(3) is amended by striking out "subsections (4) and (5)" and substituting "subsection (5)".

81(13)     Subsection 54(4) is repealed.

81(14)     Subsection 54(6) is amended by striking out "subsection (7) or (8)" and substituting "subsection (7)".

81(15)     Subsection 54(7) is repealed and the following is substituted:

Disposition of excess revenue

54(7)     Where in any year the revenue derived from the operation of the hospital exceeds the expenditure on the maintenance and operation thereof, any of the excess revenue not deposited as provided in subsection (3) shall be applied by the board of the district as directed by the regional health authority for the health region in which the district is located.

81(16)     Subsections 54(8) and 54(9) and sections 55 and 56 are repealed.

81(17)     Subsection 57(1) is repealed, and the following is substituted:

Levy of hospital taxes to pay apportionment

57(1)     Where amounts are apportioned and charged to included municipalities under section 54, the board shall provide to each included municipality a statement of the amounts apportioned and charged to it, and each municipality may levy and collect, as a special rate, hospital tax on the assessed value of the lands or other rateable property, or both, within the included area for the purpose of paying the amounts apportioned and charged to it in accordance with subsection 54(2).

81(18)     Subsection 57(3) is repealed.

81(19)     Subsection 57(4) is amended by striking out "annually".

81(20)     Section 58 is amended

(a) by striking out "subsection 54(2)" and substituting "section 54";

(b) by striking out "on the written approval of the minister" and substituting "on the written approval of the regional health authority for the health region in which the district is located"; and

(c) by striking out "permissible under this Act, including an increase in its working capital" and substituting "approved by the regional health authority".

81(21)     Section 59 is repealed and the following is substituted:

Borrowing

59(1)     Subject to The Regional Health Authorities Act and the regulations under that Act, a board of a district may borrow money for the purposes of the board, and may pledge assets of the board as security for money borrowed.

Securities

59(2)     Subject to The Hospital Capital Financing Authority Act and The Regional Health Authorities Act and the regulations under that Act, a board of a district may issue securities.

81(22)     The following is added after section 59:

Purchase of equipment

59.1(1)   With the approval of the regional health authority for the health region in which the district is located, a board of a district may purchase, lease or otherwise acquire for consideration equipment for use in providing health services.

Minister's approval required

59.1(2)   A regional health authority shall not provide an approval under subsection (1) without the prior approval of the minister.

81(23)     Section 60 is repealed and the following is substituted:

Powers respecting real property

60(1)     With the approval of the regional health authority for the health region in which the district is located, a board of a district may

(a) purchase, lease or otherwise acquire for consideration lands and buildings or structures, including hospitals and personal care homes, in the health region necessary for its purposes; and

(b) construct, renovate, expand, convert or relocate buildings or structures, including hospitals and personal care homes.

Restrictions respecting sale

60(2)     Where the government or a regional health authority has provided funds respecting the acquisition, construction, expansion, conversion or relocation of, or major renovations to, a building or structure, including a hospital or personal care home, a board of a district shall not sell, lease or otherwise dispose of the building or structure, or real property associated with the building or structure, without the approval of the regional health authority for the health region in which the building or structure is located.

Minister's approval required

60(3)     A regional health authority shall not provide an approval under subsection (1) or (2) without the prior approval of the minister.

81(24)     Section 61 is repealed and the following is substituted:

Grants, gifts, etc.

61(1)     A board of a district may accept grants, gifts, donations and bequests of real or personal property, including money, or of any interest in real or personal property, from any source, and, where the grant, gift, donation or bequest is made subject to terms and conditions, the board shall comply with and give effect to the directions or conditions.

Investments

61(2)     A board of a district shall comply with any requirements and restrictions respecting investment of funds in The Regional Health Authorities Act or the regulations under that Act.

81(25)     The following is added after section 61:

Approvals may be subject to conditions

61.1      An approval given by the minister or a regional health authority under this Act may be subject to terms and conditions.

81(26)     Subsection 62(1) is amended by striking out "annually".

81(27)     Section 63 is amended by striking out "annually".

81(28)     Section 64 is repealed and the following is substituted:

Grants by municipality to pay apportionment

64        An included municipality may, without submitting them to a vote of the ratepayers, pass by-laws authorizing and providing for the making of grants for the purpose of paying, either alone or in conjunction with any other included municipality, in accordance with subsection 54(2), any amount apportioned and charged to the municipality under section 54.

81(29)     Sections 66 and 67 are repealed.

81(30)     Subsection 68(2) is repealed and the following is substituted:

Submission of supplementary scheme

68(2)     Where a board has prepared a supplementary scheme under subsection (1), the board shall submit the supplementary scheme to the minister, as provided in subsection 41(1).

Approval of scheme

68(2.1)   The minister, if satisfied with the supplementary scheme, may

(a) approve it in writing; and

(b) if the minister considers it necessary or advisable, cause it to be published in a newspaper or in such other manner as the minister may direct;

and the minister shall send a copy of the approved scheme, with his or her approval endorsed thereon, to each included municipality and to the board.

Approval by by-law

68(2.2)   On receipt of a supplementary scheme approved under subsection (2.1), the council of each included municipality may finally pass a by-law, with the supplementary scheme attached as a schedule, approving the supplementary scheme, and it is not necessary to submit the by-law for approval by The Municipal Board.

81(31)     Subsection 68(5) is amended by striking out "in subsection 67(5)" and substituting "in subsection (2.2)".

81(32)     Subsection 69(1) is amended

(a) in the part following clause (b), by striking out "the minister may, in his absolute discretion" and substituting "the regional health authority for the health district in which the hospital building is located may, with the prior approval of the minister"; and

(b) in the part following clause (d), by striking out "as the minister may deem expedient" and substituting "as the regional health authority may consider expedient."

81(33)     Subsection 69(2) is repealed.

81(34)     Subsection 69(3) is repealed and the following is substituted:

Use of revenue

69(3)     Where a hospital building, or a part thereof, is used for another purpose under subsection (1), any money payable to the district by reason of such use shall be used as directed by the regional health authority for the health region in which the hospital building is located.

81(35)     Sections 71 to 73, sections 76 and 77, subsections 78(3) and 81(2) and sections 85 and 86 are repealed.

The Health Services Insurance Act

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

82(1)      The Health Services Insurance Act is amended by this section.

82(2)      Subsection 2(1) is amended by adding the following definitions in alphabetical order:

"health region" means a health region established or continued under The Regional Health Authorities Act; (« région sanitaire »)

"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act. (« office régional de la santé »)

82(3)      Section 48 is repealed and the following is substituted:

Right to payment for hospital services

48(1)     Subject to this Act and the regulations, every insured person is entitled to have the minister pay amounts due in respect of hospital services which the insured person has received to

(a) the hospital providing the hospital services; or

(b) where the hospital providing the hospital services is in a health region, to the regional health authority for that health region.

No charge to insured person

48(2)     No hospital providing hospital services to an insured person and no regional health authority shall make any charge to an insured person for providing the hospital services, other than authorized charges.

82(4)      The following is added after subsection 50(2):

Payments to regional health authority

50(2.1)   Notwithstanding subsection 59(2) and subject to subsection 50(3.1) and section 64,

(a) where a hospital providing hospital services to an insured person is in a health region and the operator of the hospital is the regional health authority for the health region, the minister shall pay from the fund any amounts due under subsection (2) to the regional health authority; and

(b) where a hospital providing hospital services to an insured person is in a health region and the regional health authority is not the operator of the hospital, the minister shall pay from the fund any amounts due under subsection (2) to the regional health authority for payment to the hospital in accordance with any agreement reached between the regional health authority and the operator of the hospital under section 64.

82(5)      The following is added after subsection 50(3):

Withholding of payments where hospital is in a health region

50(3.1)   Notwithstanding subsection 50(3), where a hospital in a health region fails to keep the books or records or make the returns required under this Act or the regulations, the minister may,

(a) where the operator of the hospital is the regional health authority for the health region, withhold the payments due to the regional health authority until the regional health authority complies with this Act and the regulations; and

(b) where the operator of the hospital is not the regional health authority, withhold the payments due to the regional health authority for payment to the hospital, and the regional health authority is not required to make payments to the hospital under clause 50(2.1)(b), until the hospital complies with this Act and the regulations.

82(6)      Section 51 is amended by renumbering it as subsection 51(1) and by adding the following as subsection 51(2):

Effect of making payments to regional health authority

51(2)     Payments made under subsection 50(2.1) shall be accepted by the hospital and the regional health authority, as, and shall be conclusively deemed to be, payment in full for the hospital services provided to the insured person for whom the payments are made, except for authorized charges.

82(7)      Section 55 is amended by adding "which is not in a health region" after "In making payments to a hospital".

82(8)      Clause 57(1)(a) is amended by adding "and that is not in a health region" at the end.

82(9)      Section 61 is amended by adding "and that is not in a health region" at the end.

82(10)     Section 64 is repealed and the following is substituted:

Rates of payments to hospitals and personal care homes in health regions

64        Payments for services provided to insured persons

(a) by a hospital or personal care home in a health region shall be made to the hospital or personal care home in accordance with any agreement between the regional health authority for the health region and the operator of the hospital or personal care home; and

(b) by a hospital or personal care home which is not in a health region and to which subsection 57(1.1) does not apply shall be at the rates set by the minister.

82(11)     Section 69 is amended

(a) in the part preceding clause (a), by adding "which is not in a health region" after "agreement with any hospital";

(b) in clauses (a) and (b), by striking out "debentures" and substituting "securities";

(c) in clause (a), by adding ", or for sinking funds created in respect thereof;" after "issued by it"; and

(d) in clause (b), by adding ", or the sinking funds created in respect thereof" after "as it becomes payable".

82(12)    Section 70 is repealed and the following is substituted:

Restrictions respecting sale of facilities

70(1)     Where the government or a regional health authority has provided funds under this Act respecting the construction, expansion, conversion or relocation of, or major renovations to, a hospital, personal care home or facility, no person may sell, lease or otherwise dispose of the hospital, personal care home or other health facility, or real property associated with the hospital, personal care home or other health facility, without the approval of

(a) the minister; or

(b) where the hospital, personal care home or other health facility is in a health region, the regional health authority for that health region.

Regional health authority requires approval of minister

70(2)     A regional health authority shall not provide an approval under clause (1)(b) without the prior approval of the minister.

Approvals may be subject to conditions

70(3)     An approval given by the minister or a regional health authority under this section may be subject to terms and conditions.

The Hospitals Act

C.C.S.M. c. H120 amended

83(1)      The Hospitals Act is amended by this section.

83(2)      Section 1 is amended by adding the following definitions in alphabetical order:

"health region" means a health region established or continued under The Regional Health Authorities Act; (« région sanitaire »)

"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act. (« office régional de la santé »)

83(3)      Section 4 is amended

(a) by renumbering it as subsection 4(1);

(b) by adding "Subject to subsection (2)," at the beginning of subsection (1); and

(c) by adding the following as subsection 4(2):

Hospitals in health regions

4(2)      Where a hospital is in a health region, the operator of the hospital

(a) shall operate the hospital in accordance with the requirements of The Regional Health Authorities Act and the regulations under that Act, in addition to the requirements of this Act and the regulations;

(b) notwithstanding subsection (1), shall provide only such hospital care, treatment and services as are funded or approved by the regional health authority for the health region; and

(c) in providing hospital care, treatment and services, shall comply with the standards in The Regional Health Authorities Act and the regulations under that Act, in addition to the requirements of this Act and the regulations.

83(4)      Subsection 5(2) is repealed and the following is substituted:

Enactment of by-laws

5(2)      Without restricting the generality of subsection (1), the operator of a hospital shall enact and put into force suitable general hospital by-laws and medical staff by-laws, regulations and rules, and all by-laws, regulations and rules under this subsection and subsection (1) shall comply with any model by-laws, regulations and rules, and directions or guidelines, provided or approved by the minister.

83(5)      Subsection 5(4) is repealed and the following is substituted:

Approval of by-laws, etc.

5(4)      Within two weeks after making any by-law, regulation or rule under subsection (1) or (2), or any amendment or repeal thereof, the operator of the hospital shall,

(a) where the hospital is not in a health region or where the operator of the hospital is a regional health authority, submit the by-law, regulation, rule, amendment or repeal to the minister for approval; and

(b) where the hospital is in a health region and the operator of the hospital is not a regional health authority, submit the by-law, regulation, rule, amendment or repeal to the regional health authority for the health region for approval.

83(6)      The following is added after subsection 5(4):

Restrictions on approval by regional health authority

5(5)      A regional health authority shall not approve any by-law, regulation or rule, or amendment or repeal thereof, unless it complies with subsection (2).

By-law, etc. has no force or effect

5(6)      A by-law, regulation or rule, or any amendment or repeal thereof, has no force or effect unless approved in writing by the minister or the regional health authority as required under subsection (4).

83(7)      Section 7 is amended by adding "or, where the hospital is in a health region, to the regional health authority for the health region," after "submit to the minister".

83(8)      The following is added after subsection 8(2):

Auditor where operator is regional health authority

8(2.1)    Where the operator of a hospital is a regional health authority, the appointment of an auditor shall be in accordance with The Regional Health Authorities Act and subsections (1) and (2) do not apply.

83(9)      The following is added after subsection 8(4):

Not applicable to hospital in health region

8(5)      Subsections (3) and (4) do not apply where the hospital is in a health region.

83(10)     The following is added after subsection 10(2):

Inspection of hospitals in health regions

10(3)     Subsections (1) and (2) do not apply to a hospital in a health region, which shall be inspected in accordance with the provisions of The Regional Health Authorities Act, and the regulations and any agreements under that Act.

83(11)     The following is added after section 14:

Sections do not apply to hospital in health region

14.1       Sections 12, 13 and 14 do not apply to a hospital, or the operator of a hospital, which is in a health region.

83(12)     Section 16 is amended by adding the following after clause (c):

(d) Such other securities or forms of investment as may be prescribed in the regulations.

83(13)     Subsection 29(1) is amended

(a) in clause (m), by adding "or categories of hospitals" at the end;

(b) by repealing clause (x);

(c) in clause (aa), by adding "or a regional health authority" at the end;

(d) by striking out "and" at the end of clause (cc);

(e) by adding "and" at the end of clause (dd); and

(f) by adding the following after clause (dd):

(ee) respecting the borrowing and investment powers of operators of hospitals, including but not limited to prescribing restrictions on borrowing and prescribing securities or forms of investment for the purposes of clause 16(d).

The Hospital Capital Financing Authority Act

C.C.S.M. c. H125 amended

84(1)      The Hospital Capital Financing Authority Act is amended by this section.

84(2)      Section 1 is amended by adding the following definitions in alphabetical order:

"health region" means a health region established or continued under The Regional Health Authorities Act; (« région sanitaire »)

"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act. (« office régional de la santé »)

84(3)      Subsection 10(1) is amended by adding "or, where a hospital is in a health region, to the regional health authority for the health region, " after "to operators of hospitals".

84(4)      Section 11 is amended by adding "which is not in a health region" after "Where payments made to an operator of a hospital".

The Public Health Act

C.C.S.M. c P210 amended

85(1)      The Public Health Act is amended by this section.

85(2)      Section 1 is amended

(a) by repealing the definition "health unit"; and

(b) by adding the following definitions in alphabetical order:

"health region" means a health region established or continued under The Regional Health Authorities Act; (« région sanitaire »)

"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act. (« office régional de la santé »)

85(3)      Clause 2(1)(d) is amended by striking out "health units,".

85(4)     Subsections 4(1) to 4(7) are repealed and the following is substituted:

Appointment of medical officers of health and deputy medical officers

4(1)      Subject to subsection (2), the minister may appoint medical officers of health and deputy medical officers of health for the province.

Appointment for City of Winnipeg

4(2)      The council of The City of Winnipeg shall appoint a medical officer of health as required under section 64 of The City of Winnipeg Act, and may appoint deputy medical officers of health for The City of Winnipeg.

Duties and powers of deputy medical officer of health

4(3)       A deputy medical officer of health shall act at the request of the medical officer of health or where the medical officer of health is absent or unable or unwilling to act, and when so acting a deputy medical officer of health has all the powers and authority of a medical officer of health.

Remuneration and dismissal

4(4)      A medical officer of health or a deputy medical officer of health

(a) appointed by the minister

(i) shall be paid such remuneration out of the Consolidated Fund as the minister may set, and

(ii) may be dismissed by the minister; and

(b) appointed by the council of The City of Winnipeg

(i) shall be paid such remuneration by The City of Winnipeg as the council may set, and

(ii) may be dismissed by the council.

85(5)      Subsection 4(8) is repealed and the following is substituted:

Duly qualified medical practitioner

4(8)      A person appointed as a medical officer of health or as a deputy medical officer of health must be a duly qualified medical practitioner.

85(6)      Subsection 7(2) is repealed and the following is substituted:

Conference expenses

7(2)      The expenses incurred by a medical officer of health in attending a conference convened by the minister under subsection (1) are payable in addition to his or her remuneration under subsection 4(3), and

(a) where the medical officer of health is appointed by The City of Winnipeg, these expenses are payable by The City of Winnipeg;

(b) where the medical officer of health is appointed by the minister, these expenses are payable out of the Consolidated Fund.

85(7)      Subsection 8(1) is amended

(a) by striking out "of which any portion is not within a health unit"; and

(b) by striking out "or that part thereof or that portion thereof that is not included in a health unit".

85(8)      Subsection 8(3) is amended

(a) by striking out the section heading and substituting "Appointment by minister"; and

(b) by striking out "The minister may appoint a public health inspector for a health unit or for a district that is not included in a municipality or a health unit" and substituting "The minister may appoint a public health inspector where a municipality has not made an appointment under subsection (1),".

85(9)      Section 9 is amended by striking out ", health unit,".

85(10)     Section 10 is repealed and the following is substituted:

Appointment of public health nurses by municipality

10(1)     A municipality that is not in a health region may appoint public health nurses for the municipality.

Appointment of public health nurses by regional health authority

10(2)     A regional health authority may appoint public health nurses for its health region.

Registered nurse

10(3)     A person appointed as a public health nurse shall be a registered nurse under The Registered Nurses Act.

Remuneration

10(4)     A public health nurse

(a) appointed by a municipality shall be paid such remuneration by the municipality as the council of the municipality may set;

(b) appointed by a regional health authority shall be paid such remuneration by the regional health authority as its board may set.

85(11)     Subsection 39(2) is amended

(a) by striking out "All expenses" and substituting "Subject to subsection (3), subsection 7(2) and the regulations, all expenses"; and

(b) by striking out "or a part thereof that is not in a health unit".

85(12)     The following is added after subsection 39(2):

Responsibility of regional health authority

39(3)     Subject to subsection 7(2) and the regulations, any expenses incurred by a medical officer of health or by a public health nurse in the performance of duties or the exercise of powers under this or any other Act, or under any regulations, in a health region shall be paid by the regional health authority for the health region.

The Vulnerable Persons Living with a Mental Disability and Consequential Amendments Act

86        Section 183 of The Vulnerable Persons Living with a Mental Disability and Consequential Amendments Act, as enacted by S.M. 1993, c. 29, is repealed.

C.C.S.M. reference

87        This Act may be cited as The Regional Health Authorities Act and referred to as chapter R34 of the Continuing Consolidation of the Statutes of Manitoba.

Coming into force

88(1)     This Act, except for Part 6, comes into force on April 1, 1997.

Coming into force: Part 6

88(2)     Part 6 of this Act comes into force on the day this Act receives royal assent.