Bill 144 explained in plain English
Healthcare Staffing Agencies Act, 2023
Ontario legislature bill summary, status, timeline, sponsor, votes, and official sources.
At a glance
Official Legislative Assembly of Ontario snapshot for 43rd Parliament, 1st Session. Representative vote breakdowns appear when the Assembly publishes an Ayes and Nays page for the bill.
Our plain-language take, written for civic education.
Source: By PoliticalData.ca
Bill 144 establishes rules for healthcare staffing agencies in Ontario, requiring hospitals and long-term care homes to reduce their use of such agencies, and requiring new agencies to operate as not-for-profit organizations.
Bill 144, the Healthcare Staffing Agencies Act, 2023, creates new rules for how hospitals and long-term care homes use temporary healthcare staffing agencies. The main parts are: **Spending Limits:** Hospitals and long-term care homes in municipalities with 8,000 or more people must create plans to reduce how much they spend on staffing agencies. The timelines and targets depend on the size of the municipality. For example, in large cities (500,000+ people), facilities must cut agency spending to 1% of total staffing costs after 6 months, then 0.5% after 12 months, and stop using agencies entirely within 24 months. Smaller communities have longer timelines but must also eventually stop using agencies. **Public Plans:** These spending reduction plans must be made public and updated every six months. The nursing leader at each facility must help develop the plan. **New Agencies Must Be Non-Profit:** Any healthcare staffing agency created after this law takes effect must be organized as a not-for-profit corporation. **Pay Rules:** Staffing agencies cannot pay their workers more than 10% above what the hospital or long-term care home normally pays for that type of work. Charges for travel, housing, and meal allowances must be made public, paid directly to workers, and follow any government limits. **Oversight:** Staffing agencies that receive more than $400,000 from Ontario or its agencies must allow oversight by the Auditor General, Patient Ombudsman, Ontario Ombudsman, and Integrity Commissioner. Their employees would be listed on the Sunshine List (public salary records). **Restrictions on Recruiting:** Staffing agencies cannot recruit or hire people who currently work at, or recently left (within 12 months), a hospital or long-term care home in the same or nearby Ontario Health Team area. **Penalties:** Staffing agencies that violate the rules against recruiting employees can be fined up to $1,000,000. Any fines collected go to hospitals and long-term care homes. The law comes into effect when it receives Royal Assent.
- Creates the Healthcare Staffing Agencies Act, 2023
- Requires hospitals and long-term care homes in municipalities with 8,000+ people to develop plans limiting spending on healthcare staffing agencies
- Sets specific spending reduction targets based on municipality size, with all facilities required to eliminate use of agencies within 24 months
- Requires plans to be made publicly available and updated every six months
- Establishes that all healthcare staffing agencies created after the Act comes into force must operate as not-for-profit organizations
- Requires new agencies to follow the Not-for-Profit Corporations Act, 2010
- Sets a wage cap: staffing agencies cannot pay workers more than 10% above the facility's normal rate for that profession
- Requires transparency and direct payment of transportation, accommodation, and per diem charges to workers
- Subjects staffing agencies receiving over $400,000 from Ontario to oversight by the Auditor General, Patient Ombudsman, Ontario Ombudsman, and Integrity Commissioner
- Places employees of agencies receiving over $400,000 in government funding on the Sunshine List
- Prohibits staffing agencies from recruiting or 'poaching' employees from hospitals or long-term care homes
- Prohibits staffing agencies from assigning workers who currently work or recently worked (within 12 months) at hospitals or long-term care homes in the same or adjacent Ontario Health Team
- Creates a maximum fine of $1,000,000 for violation of poaching prohibition
- Directs collected fines to fund hospitals and long-term care homes
- Gives the Minister authority to make regulations prescribing limits on charges
- Hospitals in municipalities with 8,000 or more people
- Long-term care homes in municipalities with 8,000 or more people
- Healthcare staffing agencies (particularly new ones created after the Act comes into force)
- Healthcare workers employed by staffing agencies
- Healthcare workers employed directly by hospitals and long-term care homes
- Nursing leadership at hospitals and long-term care homes (responsible for developing spending plans)
- The Auditor General, Patient Ombudsman, Ontario Ombudsman, and Integrity Commissioner (given new oversight responsibilities for certain agencies)
- The public (plans must be made publicly available)
- Hospitals and long-term care homes in eligible municipalities must develop spending reduction plans within 6 months of the Act coming into force
- Hospitals and long-term care homes must make their spending plans publicly available
- Hospitals and long-term care homes must update their spending plans every 6 months
- Hospitals and long-term care homes must meet progressively stricter spending reduction targets based on municipality size, reaching zero use of agencies within 24 months
- Nursing leaders at hospitals and long-term care homes must have a leadership role in developing the spending plan
- Plans must address measures to ensure patients receive safe, quality, and humane care during the transition away from staffing agencies
- New healthcare staffing agencies must operate as not-for-profit organizations
- Healthcare staffing agencies must not pay workers more than 10% above the facility's existing rate for that profession
- Charges for transportation, accommodation, and per diem must be made public, paid directly to workers, and follow prescribed limits
- Healthcare staffing agencies must not recruit employees from hospitals or long-term care homes
- Healthcare staffing agencies must not assign workers who currently work or worked within the past 12 months at hospitals or long-term care homes in the same or adjacent Ontario Health Team
- The Act comes into force on the day it receives Royal Assent
- Hospitals and long-term care homes have 6 months from the day Section 2 comes into force to develop their first spending plan
- After 6 months: initial spending reduction targets take effect (1-5% depending on municipality size)
- After 12 months: stricter spending reduction targets take effect (0.5-3% depending on municipality size)
- After 24 months: hospitals and long-term care homes must no longer use healthcare staffing agencies
- Plans must be updated every 6 months after initial development
- Healthcare staffing agencies receiving more than $400,000 from Ontario will be subject to increased oversight costs
- Hospitals and long-term care homes must develop and maintain spending reduction plans
- Hospitals and long-term care homes will face progressive spending reductions on agency staffing, eventually reaching zero within 24 months
- Fines collected from violations of the poaching prohibition will be directed to hospitals and long-term care homes
- Minister may prescribe limits on charges for transportation, accommodation, and per diem (financial impact depends on regulations)
- Healthcare staffing agencies that violate the prohibition on poaching employees are guilty of an offence and liable to a fine not exceeding $1,000,000
- Fines collected are directed to fund hospitals and long-term care homes
- Healthcare staffing agencies receiving more than $400,000 from Ontario are subject to oversight by the Auditor General, Patient Ombudsman, Ontario Ombudsman, and Integrity Commissioner
- The bill does not specify how the spending reduction targets will be enforced or what penalties exist for non-compliance with the spending plans (only poaching violations have specified penalties)
- The bill does not define what constitutes 'poaching' beyond the prohibition itself
- The bill does not clarify how 'adjacent' Ontario Health Teams are determined for the purposes of Section 7
- The bill does not specify which transfer payment agencies are included in the definition of 'Government of Ontario or any of its transfer payments agencies' for oversight purposes
- The bill does not specify what 'safe, quality and humane care' means for purposes of the transition plan requirement
- The bill does not specify enforcement mechanisms for wage caps (Section 5(1)) or requirements for direct payment of allowances (Section 5(2))
- The bill does not define 'municipality with a population' - it is unclear whether this refers to census data, current estimates, or another measure, or how frequently this should be verified
- The Minister's regulatory powers are limited to prescribing limits on charges (Section 8); it is unclear whether other details may be addressed through regulation
Healthcare staffing agencies established after this Act comes into force must comply with the Not-for-Profit Corporations Act, 2010 structure and requirements
Source: Section 3
The Auditor General gains oversight authority over healthcare staffing agencies that receive more than $400,000 from Ontario or its transfer payment agencies
Source: Section 4(1)
The Patient Ombudsman gains oversight authority over healthcare staffing agencies that receive more than $400,000 from Ontario or its transfer payment agencies
Source: Section 4(2)
The Ontario Ombudsman gains oversight authority over healthcare staffing agencies that receive more than $400,000 from Ontario or its transfer payment agencies
Source: Section 4(3)
The Integrity Commissioner gains oversight authority over healthcare staffing agencies that receive more than $400,000 from Ontario or its transfer payment agencies
Source: Section 4(4)
Employees of healthcare staffing agencies that receive more than $400,000 from Ontario or its transfer payment agencies must be included on the Sunshine List (public disclosure of salaries)
Source: Section 4(5)
Generated using AI from official bill text. Not legal advice. It is written by PoliticalData.ca for civic education, automatically checked and spot-reviewed before publishing.
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Official sources
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