Bill 231 explained in plain English
More Convenient Care Act, 2024
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
Ontario's More Convenient Care Act, 2024 makes changes to health laws related to boards of health, health worker reporting, class orders, nurse practitioners' duties, and the creation of digital health identifiers to help people access their health information online.
Bill 231, the More Convenient Care Act, 2024, is a collection of changes to multiple Ontario health laws. The bill came into force on royal assent in December 2024. The bill makes several key changes: **City of Hamilton's Board of Health (Schedule 1):** The City of Hamilton now has its own board of health instead of the city government itself holding those powers. All board members are appointed by the city. **French Language Services (Schedule 2):** The Ontario Health Service Organization must now provide French language services like other government agencies. **Health Care Staffing Agency Reporting (Schedule 3):** Temporary help agencies that place workers in hospitals, long-term care homes and other health facilities must now report information about their pay rates and billing practices to the Minister of Health at least every six months. The Minister can publish some of this information. Agencies must keep copies of contracts for three years after they end, and copies of invoices for three years after they are issued. Breaking these rules is an offence with fines up to $10,000 for individuals and $25,000 for corporations. **Medical Officer of Health Class Orders (Schedule 4):** When a medical officer of health wants to issue an order that applies to a whole class or group of people (such as requiring quarantine), they must now notify the Chief Medical Officer of Health and get written approval first. **Nurse Practitioners in Blood Testing (Schedule 5):** The Mandatory Blood Testing Act is changed to let nurse practitioners do many tasks that only doctors could do before, including taking blood samples, preparing reports, and giving approval for orders. This change takes effect on July 1, 2025 or when the bill receives royal assent, whichever is later. **Digital Health Identifiers and Health Information Privacy (Schedule 6):** This is the most complex part. The bill creates a new "prescribed organization" (details to be set out in regulations) that will manage digital health identifiers—unique online IDs that people can use to access their health records. The prescribed organization can collect personal health information to create and manage these digital identifiers, but only with people's consent. The prescribed organization must have privacy practices approved by the Privacy Commissioner. People can view their own health records through this system (with some limits on their ability to request corrections). The prescribed organization must notify people if their information is stolen or misused. The Minister of Health can issue directives to the prescribed organization about how it operates, and new regulations can set out more details about what information can be collected and how it is protected. One new offence is created: intentionally destroying health records to avoid a request for access is now illegal.
- Establishes a separate board of health for the City of Hamilton, appointed entirely by the city, with the board deemed to be a board under the Health Protection and Promotion Act
- Requires the Ontario Health Service Organization to provide French language services as though it were a government agency
- Creates the Health Care Staffing Agency Reporting Act, requiring temporary help agencies in health care to report pay rate and billing information at least every six months, maintain contracts and invoices for three years, and comply with penalties for violations
- Allows the Minister to publish some information from agency reports in prescribed forms and timelines
- Requires medical officers of health to notify the Chief Medical Officer of Health and obtain written approval before issuing class orders (orders directed at a class of persons)
- Expands the Mandatory Blood Testing Act to allow nurse practitioners (registered nurses with extended certificates) to perform functions previously limited to physicians, including taking blood samples, preparing reports, and managing orders
- Creates a new 'prescribed organization' to manage digital health identifiers—unique online identifiers that individuals can use to access their health information
- Allows the prescribed organization to collect personal health information with consent for digital health identifier activities such as validation, verification, authentication, and account management
- Requires the prescribed organization to have privacy practices approved by the Privacy Commissioner and to protect digital health identifier records against theft, loss, and unauthorized use
- Requires the prescribed organization to notify individuals of privacy breaches and to dispose of inactive digital health identifiers after two or more years of inactivity
- Allows individuals to access their health records through the prescribed organization's electronic health record system, with some restrictions on requesting corrections to certain records
- Gives the Minister power to issue directives to the prescribed organization regarding eligibility, privacy and security measures, audit requirements, and technology changes
- Creates new regulation-making powers for rules about digital health identifier activities, conditions for collection and use of health information, and application of privacy protections
- Makes it an offence to intentionally destroy health records to avoid responding to an access request from the prescribed organization
- Exempts the prescribed organization's personal health information from the Freedom of Information and Protection of Privacy Act unless regulations provide otherwise
- City of Hamilton residents and the City of Hamilton government (due to establishment of separate board of health)
- The Ontario Health Service Organization and people seeking services in French
- Temporary help agencies (staffing agencies) that assign workers to hospitals, long-term care homes, and other health care facilities
- The Minister of Health (responsible for enforcing the staffing agency reporting requirements and managing directives to the prescribed organization)
- Medical officers of health and the Chief Medical Officer of Health (due to new approval requirements for class orders)
- Nurse practitioners in Ontario (who may now perform functions previously limited to physicians in mandatory blood testing contexts)
- Physicians in Ontario (whose exclusive duties under the Mandatory Blood Testing Act are now shared with nurse practitioners)
- Ontario residents and patients (who will gain the ability to access their health records online through digital health identifiers, though the prescribed organization is not yet named in the bill)
- The prescribed organization (a to-be-determined entity that will manage digital health identifiers and must comply with privacy and security requirements)
- The Privacy Commissioner of Ontario (who must approve privacy practices of the prescribed organization and review complaints about its activities)
- Health care staffing agencies must submit reports to the Minister at least every six months containing prescribed information about pay rates and billing practices
- Health care staffing agencies must retain copies of contracts for three years after they expire and copies of invoices for three years after issuance
- The Minister may publish prescribed information from staffing agency reports
- Medical officers of health must notify the Chief Medical Officer of Health before issuing any class order and obtain written approval
- The prescribed organization may carry out digital health identifier activities with individuals' express consent
- The prescribed organization must have privacy practices and procedures in place and approved by the Privacy Commissioner
- The prescribed organization must protect digital health identifier records against theft, loss, and unauthorized use or disclosure
- The prescribed organization must dispose of inactive digital health identifiers securely after two or more years of inactivity
- The prescribed organization must notify individuals of breaches involving theft, loss, or unauthorized use of digital health identifier records
- The prescribed organization must publish a summary of its approved privacy practices on its website
- The prescribed organization must provide plain language descriptions of its digital health identifier activities and security safeguards to the public
- The prescribed organization must perform assessments regarding threats, vulnerabilities, risks, and privacy impacts of its digital health identifier activities
- The prescribed organization must comply with any directives issued by the Minister regarding digital health identifier activities
- Individuals may access health information accessible through the prescribed organization's electronic health record system, with certain limitations on requesting corrections
- Individuals may withdraw consent for digital health identifier activities by notifying the prescribed organization
- Individuals are entitled to make complaints to the Privacy Commissioner if they believe the prescribed organization has breached privacy rules
- It is an offence to dispose of health records with intent to evade an access request from the prescribed organization
- Schedule 1 (City of Hamilton Act, 1999): comes into force on royal assent
- Schedule 2 (Connecting Care Act, 2019 amendment): comes into force on royal assent
- Schedule 3 (Health Care Staffing Agency Reporting Act, 2024): comes into force on a day to be named by proclamation of the Lieutenant Governor
- Schedule 4 (Health Protection and Promotion Act amendment): comes into force on royal assent
- Schedule 5 (Mandatory Blood Testing Act, 2006 amendment): comes into force on the later of July 1, 2025 and royal assent
- Schedule 6 (Personal Health Information Protection Act, 2004 amendments): most provisions come into force on royal assent; sections 1 to 9, subsections 10 (1), (2) and (3), and sections 11 to 13 come into force on a day to be named by proclamation of the Lieutenant Governor
- Health care staffing agencies are required to compile and submit reports containing administrative and billing information, which may create administrative costs for those agencies
- The Minister may publish prescribed information from staffing agency reports; the costs of publication are not specified
- Penalties for non-compliance with the Health Care Staffing Agency Reporting Act are fines up to $10,000 for individuals and $25,000 for corporations
- The prescribed organization will require funding to establish and maintain privacy practices, security measures, digital infrastructure for digital health identifiers, and breach notification procedures; details on funding are not provided in the bill
- No person is entitled to compensation as a result of the enactment of the Health Care Staffing Agency Reporting Act or the collection, use, disclosure, or publication of information authorized under that Act
- Contravention of the Health Care Staffing Agency Reporting Act or its regulations is an offence with penalties of a fine not exceeding $10,000 for individuals and not exceeding $25,000 for corporations (Section 8 of Schedule 3)
- Disposing of a record of personal health information with intent to evade a request for access is an offence under the Personal Health Information Protection Act, with penalties to be determined by existing offence provisions (new clause 72 (1) (d.1))
- Individuals may make complaints to the Privacy Commissioner regarding the prescribed organization's practices under Part V.2
- The Privacy Commissioner may order the prescribed organization to grant access to records, change its practices, or take other corrective actions following a review of complaints
- The Commissioner may order agents acting on the prescribed organization's behalf to take or refrain from taking actions if necessary to ensure the prescribed organization's compliance
- The identity and specific functions of the 'prescribed organization' that will manage digital health identifiers are not specified in the bill; these details will be set out in future regulations
- The specific health care facilities and staffing agency workers whose information must be reported is not fully specified; these details will be 'prescribed' in future regulations
- The specific forms, manners, and timelines for staffing agency reports are not detailed in the bill; these will be prescribed in regulations
- The specific information the Minister may publish from staffing agency reports is not detailed; the bill states only that 'prescribed' information may be published in a 'prescribed' form and manner
- The Health Care Staffing Agency Reporting Act comes into force on a proclamation date not yet named; the effective date is uncertain
- Most substantive amendments to the Personal Health Information Protection Act related to digital health identifiers (Schedule 6, sections 1-9, 10(1)-(3), and 11-13) come into force on a proclamation date not yet named; the effective date is uncertain
- The specific privacy practices and procedures the prescribed organization must implement are not detailed in the bill; these will be determined through Commissioner approval and regulations
- The specific information the prescribed organization may collect, use, and disclose is limited by consent and 'reasonableness' requirements, but the precise boundaries are not fully defined in the bill
- The bill does not specify which provincial or federal health authority or agency will serve as the prescribed organization
- The bill does not specify how many digital health identifier accounts the prescribed organization is expected to create or manage
- The specific costs to implement the staffing agency reporting system and the digital health identifier system are not provided in the bill
Section 11 is replaced to establish a board of health for Hamilton that is separate from the city government, with all members appointed by the city. The board has the powers and duties of a board of health under the Health Protection and Promotion Act.
Section 27.5 is amended to add a new subsection requiring the Service Organization to provide services in accordance with the French Language Services Act as though it were a government agency.
A new Ontario law is created requiring temporary help agencies in health care to submit reports to the Minister at least every six months containing aggregate pay rate and billing information, maintain contracts and invoices for three years, and face penalties (fines up to $10,000 for individuals, $25,000 for corporations) for non-compliance. The Minister may publish prescribed information from these reports.
Subsection 22 (5.0.1) is replaced to require that a medical officer of health must notify the Chief Medical Officer of Health and obtain written approval before issuing any class order (an order directed at a class of persons in the health unit).
The Act is amended to allow nurse practitioners (registered nurses with extended certificates) to perform many functions previously reserved for physicians. This includes taking blood samples, preparing required reports, and managing orders. Nurse practitioners are now included wherever the Act refers to physicians in these contexts. The change takes effect on July 1, 2025 or royal assent, whichever is later.
Multiple amendments add definitions for digital health identifiers and related activities, create a new Part V.2 governing digital health identifier activities, amend Part V to apply to the prescribed organization as if it were a health information custodian for certain records, add new offences for intentional destruction of health records to evade access requests, exempt the prescribed organization from the Freedom of Information and Protection of Privacy Act, and expand regulation-making powers to govern the prescribed organization and digital health identifier activities.
The definition of 'nurse practitioner' in the Mandatory Blood Testing Act is updated to mean a registered nurse who holds an extended certificate of registration under the Nursing Act, 1991.
Subsection 1 (10) of Schedule 1 is repealed.
Personal health information in the custody of the prescribed organization is exempted from the Freedom of Information and Protection of Privacy Act unless the Personal Health Information Protection Act or regulations provide otherwise.
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.
Official textProcess Snapshot
Vote Summary
Representative Voting Breakdown
Vote badges include text labels so the table stays readable for everyone, even without color cues alone.
| Representative | Role | Riding | Party | Vote | Notes |
|---|---|---|---|---|---|
MPP | MPP | Don Valley East | Ontario Liberal Party | Yes | Recorded without an additional note. |
| MPP | Kitchener Centre | Green Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Brampton West | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Essex | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Scarborough—Agincourt | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Parkdale—High Park | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Markham—Unionville | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Cambridge | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Ottawa West—Nepean | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Spadina—Fort York | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Richmond Hill | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Scarborough Centre | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Newmarket—Aurora | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Oakville North—Burlington | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Nickel Belt | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Mushkegowuk—James Bay | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | York—Simcoe | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Brampton Centre | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Flamborough—Glanbrook | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Barrie—Springwater—Oro-Medonte | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Brampton North | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Parry Sound—Muskoka | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Simcoe North | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Thunder Bay—Atikokan | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Etobicoke Centre | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Huron—Bruce | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Vaughan—Woodbridge | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Aurora—Oak Ridges—Richmond Hill | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | York Centre | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Kitchener—Conestoga | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Mississauga Centre | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Hamilton East—Stoney Creek | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Mississauga—Streetsville | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Stormont—Dundas—South Glengarry | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Markham—Stouffville | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Pickering—Uxbridge | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Brampton South | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Scarborough North | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Elgin—Middlesex—London | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Niagara West | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Willowdale | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | King—Vaughan | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Leeds—Grenville—Thousand Islands and Rideau Lakes | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Dufferin—Caledon | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Durham | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Chatham-Kent—Leamington | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Nipissing | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Scarborough—Rouge Park | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | St. Catharines | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | University—Rosedale | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Toronto—St. Paul's | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Ottawa South | Ontario Liberal Party | Yes | Recorded without an additional note. |
MPP | MPP | Lanark—Frontenac—Kingston | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Timiskaming—Cochrane | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Renfrew—Nipissing—Pembroke | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Toronto Centre | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Thornhill | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Windsor West | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Thunder Bay—Superior North | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Markham—Thornhill | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Whitby | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Ottawa—Vanier | Ontario Liberal Party | Yes | Recorded without an additional note. | |
MPP | MPP | Davenport | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Beaches—East York | Ontario Liberal Party | Yes | Recorded without an additional note. | |
MPP | MPP | Perth—Wellington | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Guelph | Green Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Hamilton Mountain | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Burlington | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Toronto—Danforth | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Hastings—Lennox and Addington | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Bruce—Grey—Owen Sound | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Sarnia—Lambton | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Eglinton—Lawrence | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Sault Ste. Marie | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. |
MPP | MPP | Hamilton West—Ancaster—Dundas | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Mississauga—Erin Mills | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Kiiwetinoong | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
| MPP | Glengarry—Prescott—Russell | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Don Valley West | Ontario Liberal Party | Yes | Recorded without an additional note. | |
| MPP | Orléans | Ontario Liberal Party | Yes | Recorded without an additional note. | |
| MPP | Lambton—Kent—Middlesex | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Kingston and the Islands | Ontario Liberal Party | Yes | Recorded without an additional note. |
| MPP | London—Fanshawe | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Humber River—Black Creek | New Democratic Party of Ontario | Yes | Recorded without an additional note. | |
| MPP | Bay of Quinte | Progressive Conservative Party of Ontario | Yes | Recorded without an additional note. | |
MPP | MPP | Don Valley North | Independent | Yes | Recorded without an additional note. |
MPP | MPP | Niagara Falls | New Democratic Party of Ontario | Yes | Recorded without an additional note. |
Official sources
Status, sponsor, votes, and timeline on this page are drawn from these official legislative sources and public records. Each summary above is attributed to its own source.
How this data is sourced