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ontario regulation 200/23

made under the

Regulated Health Professions Act, 1991

Made: July 17, 2023
Approved: July 20, 2023
Filed: July 24, 2023
Published on e-Laws: July 24, 2023
Published in The Ontario Gazette: August 12, 2023

Amending O. Reg. 107/96

(CONTROLLED ACTS)

1. Section 0.1 of Ontario Regulation 107/96 is amended by adding the following definitions:

“out of province medical laboratory technologist” means a person who is exempted from subsections 9 (1) and (2) of the Medical Laboratory Technology Act, 1991 by a regulation made under that Act; (“technologiste de laboratoire médical hors province”)

“out of province physician” means a person who is exempted from subsections 9 (1) and (3) of the Medicine Act, 1991 by a regulation made under that Act; (“médecin hors province”)

“out of province registered nurse in the extended class” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds, in another Canadian jurisdiction, the equivalent of a certificate of registration in the extended class for registered nurses in Ontario; (“infirmière autorisée ou infirmier autorisé de la catégorie supérieure hors province”)

“out of province registered nurse in the general class” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds, in another Canadian jurisdiction, the equivalent of a certificate of registration in the general class for registered nurses in Ontario; (“infirmière autorisée ou infirmier autorisé de la catégorie générale hors province”)

“out of province registered practical nurse” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds, in another Canadian jurisdiction, the equivalent of a certificate of registration in the general class for registered practical nurses in Ontario; (“infirmière auxiliaire autorisée ou infirmier auxiliaire autorisé hors province”)

“out of province respiratory therapist” means a person who is exempted from subsections 9 (1) and (2) of the Respiratory Therapy Act, 1991 by a regulation made under that Act; (“thérapeute respiratoire hors province”)

2. (1) The Regulation is amended by adding the following sections immediately after the heading “Exemptions”:

1.1 (1) In the course of engaging in the practice of medical laboratory technology, an out of province medical laboratory technologist is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under section 4 of the Medical Laboratory Technology Act, 1991 that a member of the College of Medical Laboratory Technologists of Ontario would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members.

(2) A member of the College of Medical Laboratory Technologists of Ontario or an out of province medical laboratory technologist is exempt from subsection 27 (1) of the Act with respect to taking blood samples from veins or by skin pricking if,

(a)  the procedure is ordered by an out of province physician or an out of province registered nurse in the extended class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Medical Laboratory Technology Act, 1991 and in any regulation made under that Act that apply to members of the College of Medical Laboratory Technologists of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario or by a member of the College of Nurses of Ontario who is a registered nurse in the extended class, as applicable.

1.2 A member of the College of Medical Radiation and Imaging Technologists of Ontario is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under paragraphs 1 to 4 of section 4 of the Medical Radiation and Imaging Technology Act, 2017 if,

(a)  the procedure is ordered by an out of province physician; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Medical Radiation and Imaging Technology Act, 2017 and in any regulation made under that Act that apply to members of the College of Medical Radiation and Imaging Technologists of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario.

1.3. In the course of engaging in the practice of medicine, an out of province physician is exempt from subsection 27 (1) of the Act with respect to performing any acts under section 4 of the Medicine Act, 1991 that a member of the College of Physicians and Surgeons of Ontario would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members.

1.4 (1) In the course of engaging in the practice of nursing, an out of province registered nurse in the general class is exempt from subsection 27 (1) of the Act with respect to performing any acts under section 4 of the Nursing Act, 1991 that a member of the College of Nurses of Ontario who is a registered nurse in the general class would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members.

(2) Subject to subsection (3), in the course of engaging in the practice of nursing, an out of province registered nurse in the extended class is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under section 5.1 of the Nursing Act, 1991 that a members of the College of Nurses of Ontario who is a registered nurse in the extended class would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members.

(3) The requirement in subsection (2) for an out of province registered nurse in the extended class to comply with the regulations made under the Nursing Act, 1991 applies subject to the following modification:

1.  The requirement in subparagraph 3 iv of subsection 17 (1) of Ontario Regulation 275/94 (General), made under the Nursing Act, 1991, to record a registration number issued by the College on a prescription does not apply to the out of province registered nurse in the extended class.

(4) In the course of engaging in the practice of nursing, an out of province registered practical nurse is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under section 4 of the Nursing Act, 1991 that a member of the College of Nurses of Ontario who is a registered practical nurse in the general class would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members.

(5) A member of the College of Nurses of Ontario who is a registered nurse in the general class or an out of province registered nurse in the general class is exempt from subsection 27 (1) of the Act with respect to a procedure listed in section 4 of the Nursing Act, 1991 if,

(a)  the procedure is ordered by an out of province physician or an out of province registered nurse in the extended class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Nursing Act, 1991 and in any regulation made under that Act that apply to members of the College of Nurses of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario or by a member of the College of Nurses of Ontario who is a registered nurse in the extended class, as applicable.

(6) A member of the College of Nurses of Ontario who is a registered practical nurse in the general class or an out of province registered practical nurse is exempt from subsection 27 (1) of the Act with respect to a procedure listed in section 4 of the Nursing Act, 1991 if,

(a)  the procedure is ordered by an out of province physician, an out of province registered nurse in the extended class or an out of province registered nurse in the general class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Nursing Act, 1991 and in any regulation made under that Act that apply to members of the College of Nurses of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario or by a member of the College of Nurses of Ontario who is a registered nurse in the general or extended class, as applicable.

(7) A member of the College of Nurses of Ontario or an out of province registered practical nurse is exempt from subsection 27 (1) of the Act with respect to a procedure listed in subsection 15 (4) of Ontario Regulation 275/ 94 (General) made under the Nursing Act, 1991 if,

(a)  the procedure is ordered by an out of province registered nurse in the general class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Nursing Act, 1991 and in any regulation made under that Act that apply to members of the College of Nurses of Ontario, other than the requirement that the procedure be ordered by a member of the College of Nurses of Ontario who is a registered nurse in the general class.

(8) A member of the College of Nurses of Ontario who is a registered nurse in the extended class or an out of province registered nurse in the extended class is exempt from subsection 27 (1) of the Act with respect to administering a substance by injection or inhalation if,

(a)  the procedure is ordered by an out of province physician; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Nursing Act, 1991 and in any regulation made under that Act that apply to equivalent members of the College of Nurses of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario.

1.5 (1) In the course of engaging in the practice of respiratory therapy, an out of province respiratory therapist is exempt from subsection 27 (1) of the Act with respect to performing any acts authorized under section 4 of the Respiratory Therapy Act, 1991 that a member of the College of Respiratory Therapists of Ontario would be authorized to perform, subject to any restrictions, conditions and requirements in that Act and in any regulation made under that Act that apply to those members.

(2) A member of the College of Respiratory Therapists of Ontario or an out of province respiratory therapist is exempt from subsection 27 (1) of the Act with respect to a procedure listed in paragraph 1, 2 or 4 of section 4 of the Respiratory Therapy Act, 1991 if,

(a)  the procedure is ordered by an out of province physician or by an out of province registered nurse in the extended class; and

(b)  the procedure is performed in accordance with any restrictions, conditions and requirements in the Respiratory Therapy Act, 1991 and in any regulation made under that Act that apply to members of the College of Respiratory Therapists of Ontario, other than the requirement that the procedure be ordered by a member of the College of Physicians and Surgeons of Ontario or by a member of the College of Nurses of Ontario who is a registered nurse in the extended class, as applicable.

(2) Subsection 1.4 (1) of the Regulation, as made by subsection (1), is amended by striking out “section 4” and substituting “section 4.1”.

(3) Subsection 1.4 (5) of the Regulation, as made by subsection (1), is amended by striking out “section 4” in the portion before clause (a) and substituting “section 4.1”.

3. Section 3.1 of the Regulation is amended by striking out the portion before clause (a) and substituting the following:

3.1 A member of the College of Medical Radiation and Imaging Technologists of Ontario is exempt from subsection 27 (1) of the Act for the purpose of applying electromagnetism if the application is ordered by a member of the College of Physicians and Surgeons of Ontario, an out of province physician, a member of the Royal College of Dental Surgeons of Ontario who holds a specialty certificate of registration authorizing the practice of the specialty of Oral and Maxillofacial Surgery, a member of the College of Nurses of Ontario who is a registered nurse in the extended class or an out of province registered nurse in the extended class and,

4. Section 4.1 of the Regulation is revoked and the following substituted:

4.1 (1) A member of the College of Nurses of Ontario, other than a registered nurse in the extended class, an out of province registered nurse in the general class or an out of province registered practical nurse is exempt from subsection 27 (1) of the Act for the purpose of applying soundwaves for diagnostic ultrasound, as long as the member, out of province registered nurse in the general class or out of province registered practical nurse has a therapeutic nurse-patient relationship with the person to whom the soundwaves are being applied and the soundwaves are being applied for the purpose of conducting one or more routine nursing assessments of a patient to assist in the development or implementation of the patient’s plan of care.

(2) A member of the College of Nurses of Ontario who is a registered nurse in the extended class, or a person who is an out of province registered nurse in the extended class, is exempt from subsection 27 (1) of the Act for the purpose of applying, or ordering the application of, soundwaves for diagnostic ultrasound.

5. (1) Subsection 5 (1) of the Regulation is revoked and the following substituted:

5. (1) A member of the College of Physicians and Surgeons of Ontario or an out of province physician is exempt from subsection 27 (1) of the Act for the purpose of applying, or ordering the application of, electricity for a procedure listed in paragraph 1 of section 1 or soundwaves for a procedure listed in paragraph 3 of section 1.

(2) Subsection 5 (2) of the Regulation is amended by striking out the portion before clause (a) and substituting the following:

(2) A member of the College of Physicians and Surgeons of Ontario or an out of province physician is exempt from subsection 27 (1) of the Act for the purpose of applying or ordering the application of electromagnetism if,

. . . . .

6. Section 7 of the Regulation is revoked and the following substituted:

7. A person is exempt from subsection 27 (1) of the Act for the purpose of applying electricity for aversive conditioning if the application is ordered and directed by a member of the College of Physicians and Surgeons of Ontario, by an out of province physician or by a member of the College of Psychologists of Ontario.

7. (1) Subsection 7.1 (1) of the Regulation is amended by striking out the portion before clause (a) and substituting the following:

(1) A member of the College of Medical Radiation and Imaging Technologists of Ontario, a member of the College of Respiratory Therapists of Ontario, an out of province respiratory therapist, an out of province registered nurse in the general class, an out of province registered practical nurse or a member of the College of Nurses of Ontario, other than a member who is a registered nurse in the extended class, is exempt from subsection 27 (1) of the Act for the purpose of applying soundwaves for diagnostic ultrasound if the application is ordered by a member with ordering authority, and the soundwaves for diagnostic ultrasound are applied,

. . . . .

(2) Clauses (b) and (c) of the definition of “member with ordering authority” in subsection 7.1 (2) of the Regulation are revoked and the following substituted:

(b)  a member of the College of Nurses of Ontario who is a registered nurse in the extended class or an out of province registered nurse in the extended class, with respect to ordering the application of soundwaves for diagnostic ultrasound, or

(c)  a member of the College of Physicians and Surgeons of Ontario or an out of province physician, with respect to ordering the application of soundwaves for diagnostic ultrasound.

8. Section 7.4 of the Regulation is amended by striking out the portion before clause (a) and substituting the following:

7.4 A member of the Royal College of Dental Surgeons of Ontario who holds a specialty certificate of registration authorizing the practice of the specialty of Oral and Maxillofacial Surgery, a member of the College of Nurses of Ontario who is a registered nurse in the extended class or an out of province registered nurse in the extended class is exempt from subsection 27 (1) of the Act for the purpose of ordering the application of electromagnetism if,

. . . . .

9. Sections 13 and 14 of the Regulation are revoked and the following substituted:

13. A member of the College of Nurses of Ontario who holds a general certificate of registration as a registered nurse or an out of province registered nurse in the general class is exempt from subsection 27 (1) of the Act for the purpose of prescribing a solution of normal saline (0.9 per cent) for venipuncture performed to establish peripheral intravenous access and maintain patency.

14. (1) Subject to subsection (4), a member of the College of Respiratory Therapists of Ontario who holds a general or graduate certificate of registration or an out of province respiratory therapist is exempt from subsection 27 (1) of the Act for the purpose of performing a tracheostomy tube change for a stoma that is more than 24 hours old.

(2) Subject to subsection (4), a member of the College of Respiratory Therapists of Ontario who holds a limited certificate of registration is exempt from subsection 27 (1) of the Act for the purpose of performing a tracheostomy tube change for a stoma that is more than 24 hours old, as long as the performance of the procedure is permitted by the terms and conditions of the member’s certificate of registration.

(3) Subject to subsection (4), a member of the College of Respiratory Therapists of Ontario who holds a general certificate of registration or an out of province respiratory therapist is exempt from subsection 27 (1) of the Act for the purpose of performing a tracheostomy tube change for a stoma that is less than 24 hours old.

(4) A member of the College of Respiratory Therapists of Ontario or an out of province respiratory therapist shall not perform a procedure described in subsection (1), (2) or (3) unless the procedure is ordered by,

(a)  a member of the College of Physicians and Surgeons of Ontario or an out of province physician, the College of Midwives of Ontario or the Royal College of Dental Surgeons of Ontario; or

(b)  a member of the College of Nurses of Ontario who holds an extended certificate of registration under the Nursing Act, 1991 or an out of province registered nurse in the extended class.

10. (1) Subsection 15 (1) of the Regulation is amended by adding the following paragraph:

2.1  An out of province registered nurse in the general class, an out of province registered nurse in the extended class or an out of province registered practical nurse.

(2) Paragraphs 1 and 2 of subsection 15 (1.1) of the Regulation are revoked and the following substituted:

1.  A member of the College of Physicians and Surgeons of Ontario or an out of province physician.

2.  A member of the College of Nurses of Ontario who is a registered nurse in the general or extended class.

2.1  An out of province registered nurse in the general class or an out of province registered nurse in the extended class.

Commencement

11. (1) Except as otherwise provided in this section, this Regulation comes into force on the day it is filed.

(2) Section 1, subsection 2 (1) and sections 3 to 10 come into force on the later of the day section 1 of Schedule 2 to the Your Health Act, 2023 comes into force and the day this Regulation is filed.

(3) Subsections 2 (2) and (3) come into force on the latest of the following days:

1.  The day section 1 of Schedule 2 to the Your Health Act, 2023 comes into force.

2.  The day subsection 2 (1) of Schedule 22 to the Stronger, Healthier Ontario Act (Budget Measures), 2017 comes into force.

3.  The day this Regulation is filed.

Made by:
Pris par :

La ministre de la Santé,

Sylvia Jones

Minister of Health

Date made: July 17, 2023
Pris le : 17 juillet 2023

 

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