O. Reg. 449/07: GENERAL

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Mandatory Blood Testing Act, 2006

ONTARIO REGULATION 449/07

General

Consolidation Period:  From July 1, 2023 to the e-Laws currency date.

Last amendment: 537/22.

Legislative History: 244/08, 455/08, 218/09, 506/09, 119/17, 77/18, 537/22.

This is the English version of a bilingual regulation.

Definitions

1. (1) For the purposes of paragraph 1 of section 2 of the Act,

“victim of a crime” means a victim of an alleged crime under the Criminal Code (Canada).  O. Reg. 449/07, s. 1 (1).

(2) In this Regulation,

“Central Public Health Laboratory” means the Ontario Agency for Health Protection and Promotion’s Public Health Lab – Toronto; (“Laboratoire central de santé publique”)

“health unit” has the same meaning as in the Health Protection and Promotion Act; (“circonscription sanitaire”)

“laboratory requisition” means an order for a blood sample in the form required by the Minister under section 12 of the Act; (“demande d’analyse en laboratoire”)

“occurrence” means the events alleged by an applicant to have resulted in their coming into contact with a bodily substance of another person; (“événement”)

“personal health information” has the same meaning as in the Personal Health Information Protection Act, 2004; (“renseignements personnels sur la santé”)

“personal information” has the same meaning as in the Freedom of Information and Protection of Privacy Act; (“renseignements personnels”)

“reporting physician” means the physician who prepares a physician report. (“médecin rapporteur”)  O. Reg. 449/07, s. 1 (2); O. Reg. 506/09, s. 1; O. Reg. 537/22, s. 1.

Other evidence of seropositivity

2. For the purposes of the Act and this Regulation, a respondent may provide a laboratory report or a report or letter signed by a physician as other evidence of the respondent’s seropositivity respecting a listed communicable disease.  O. Reg. 449/07, s. 2; O. Reg. 537/22, s. 2.

Additional persons who can apply under the Act

3. The following are prescribed as classes of persons who may make an application under section 2 of the Act:

1. Persons who are employed in a correctional institution as defined in the Ministry of Correctional Services Act, or in a place of open custody or place of secure custody, as those terms are defined in the Child, Youth and Family Services Act, 2017.

2. Police officers as defined in the Police Services Act, employees of a police force who are not police officers, First Nations Constables and auxiliary members of a police force.

3. Firefighters, as defined in subsection 1 (1) of the Fire Protection and Prevention Act, 1997.

4. Paramedics and emergency medical attendants, as those terms are defined in the Ambulance Act.

5. Paramedic students engaged in field training.

6. Members of the College of Nurses of Ontario.

6.1 Nursing students engaged in training.

7. Members of the College of Physicians and Surgeons of Ontario.

8. Medical students engaged in training.

9. Special constables appointed under section 53 of the Police Services Act who are not employees of a police force.  O. Reg. 449/07, s. 3; O. Reg. 244/08, s. 1; O. Reg. 455/08, s. 1; O. Reg. 218/09, s. 1; O. Reg. 119/17, s. 1; O. Reg. 77/18, s. 1.

Submission of application

4. (1) An application under section 2 of the Act must include,

(a) an applicant report, completed as required by section 5; and

(b) a physician report, completed as required by section 6.  O. Reg. 449/07, s. 4 (1).

(2) An application must be received by the office of the medical officer of health in the health unit for the area where the respondent lives no more than 30 days after the date of the occurrence.  O. Reg. 449/07, s. 4 (2); O. Reg. 537/22, s. 3 (1).

(3) If the deadline under subsection (2) falls on a Saturday or a Sunday or other holiday, the deadline shall be extended to the next business day.  O. Reg. 449/07, s. 4 (3); O. Reg. 537/22, s. 3 (2).

(4) If an application is submitted to an office of the medical officer of health in a health unit other than the health unit for the area where the respondent lives, the office that receives the application shall immediately forward it to the office of the medical officer of health in the health unit for the area where the respondent lives.  O. Reg. 449/07, s. 4 (4).

(5) The office of the medical officer of health that receives an application directly from the applicant shall record the date and time that it received the application and assign a unique file identifier and file number to it.  O. Reg. 537/22, s. 3 (3).

(6) The date of the occurrence set out in the physician report is deemed to be the date of the occurrence for the purposes of this Regulation, despite any other information in the application respecting the date of the occurrence.  O. Reg. 449/07, s. 4 (6).

(7) An application that is faxed or sent by electronic transmission to an office of a medical officer of health is deemed to be received by that office,

(a) on the day it is sent, if it is sent before 4 p.m. on a business day; or

(b) on the next business day, if sent at any other time. O. Reg. 537/22, s. 3 (4).

(8) The following rules apply in respect of an application submitted to an office of the medical officer of health in a health unit other than the health unit for the area where the respondent lives:

1. The application is deemed to comply with subsection (2) if it is received by an office of the medical officer of health in a health unit other than the health unit for the area where the respondent lives within the time required by that subsection.

2. Revoked: O. Reg. 537/22, s. 3 (5).

O. Reg. 449/07, s. 4 (8); O. Reg. 537/22, s. 3 (5).

Applicant report — contents

5. (1) An applicant report must include,

(a) the applicant’s name, address, telephone number, e-mail address, OHIP number, age and date of birth;

(b) the respondent’s name and address and, if known, the respondent’s telephone number, e-mail address, age and date of birth;

(c) a description of the occurrence, including the date and time it occurred, any injuries sustained by the applicant and whether the applicant took any precautions before the occurrence;

(d) the name, office address, office telephone number, office fax number, if applicable, and office e-mail address, if applicable, of the applicant’s family physician, if different from the reporting physician;

(e) the statement that the applicant consented to an examination by the reporting physician;

(f) the statement that the applicant consented to counselling respecting the occurrence, including counselling respecting prophylaxis and treatment;

(g) the statement that the applicant consented to the base line testing on the applicant’s blood for the listed communicable diseases ordered by the reporting physician;

(h) the applicant’s consent to the release of their personal information and personal health information relating to the application to the Board. O. Reg. 449/07, s. 5 (1); O. Reg. 537/22, s. 4 (1-3).

(2) Where the applicant is applying as a victim of a crime, the applicant report must state that the applicant,

(a) reported the alleged crime to the police; and

(b) has consented to the release by the police of any information from the police report to the Board.  O. Reg. 449/07, s. 5 (2); O. Reg. 537/22, s. 4 (4).

(3) An applicant report must be signed and dated by the applicant. O. Reg. 449/07, s. 5 (3).

(4) The applicant shall submit the results of their base line testing to the Board as soon as they are available. O. Reg. 537/22, s. 4 (5).

Physician report — contents

6. (1) A physician report must include,

(a) the name, office address, office telephone number, office fax number, if applicable, and office e-mail address, if applicable, of the reporting physician;

(b) the applicant’s name, address, telephone number, OHIP number, age and date of birth;

(c) the name, office address, office telephone number, office fax number, if applicable, and office e-mail address, if applicable, of the applicant’s family physician, if different from the reporting physician;

(d) a description of the occurrence, including the date and time of the occurrence;

(e) a statement regarding the type of exposure the applicant experienced and the type of bodily substance with which the applicant had contact;

(f) the reporting physician’s findings of examinations related to the occurrence, including an assessment of any injuries sustained by the applicant;

(g) the applicant’s immunization history and serostatus for the listed communicable diseases, if known;

(h) a description of all base line testing for the listed communicable diseases ordered by the reporting physician and, if the applicant refused any such base line testing, a description of the base line testing that the applicant refused;

(i) a description of all prophylaxis and treatment recommended by the reporting physician, including a statement regarding whether the applicant refused any such prophylaxis or treatment;

(j) a statement that the applicant consented to counselling respecting the occurrence, including counselling respecting prophylaxis and treatment;

(k) the name, office address, office telephone number, office fax number, if applicable, and office e-mail address, if applicable, of the physician or physicians to whom the reporting physician referred the applicant for prophylaxis, treatment and follow-up, if applicable; and

(l) the reporting physician’s assessment of the applicant’s risk of exposure to the listed communicable diseases as potentially significant, non-significant or indeterminate.  O. Reg. 449/07, s. 6 (1); O. Reg. 537/22, s. 5.

(2) A physician report must be signed and dated by the reporting physician.  O. Reg. 449/07, s. 6 (2).

(3) A reporting physician shall order base line testing of the applicant for all of the listed communicable diseases; however, a reporting physician is not required to order base line testing for a listed communicable disease if the reporting physician has other evidence, satisfactory to the reporting physician, of the applicant’s seropositivity respecting that disease.  O. Reg. 449/07, s. 6 (3).

Application not proceeded with

7. (1) If an application under section 2 of the Act does not meet the requirements of section 4 of this Regulation, the medical officer of health shall not take any of the steps set out in section 3 of the Act.  O. Reg. 449/07, s. 7 (1).

(2) If the medical officer of health determines that the application does not meet the requirements of section 4, the medical officer of health shall notify,

(a) the applicant; and,

(b) the Board, if the application has already been sent to the Board. O. Reg. 537/22, s. 6.

(3) An applicant who receives notice that their application does not meet the requirements of section 4 may correct the application and resubmit it. O. Reg. 537/22, s. 6.

Request for voluntary compliance

8. (1) When making a request under section 3 of the Act that a respondent voluntarily provide a blood sample or other evidence of their seropositivity respecting the listed communicable diseases, the medical officer of health shall,

(a) follow standard public health practices and procedures;

(b) disclose the details of the occurrence, as described in the applicant and physician reports, to the respondent, without disclosing the applicant’s personal information; and

(c) make reasonable attempts to deliver to the respondent a blank respondent report. O. Reg. 537/22, s. 7.

(2) If the respondent does not provide a blood sample or other evidence of their seropositivity respecting the listed communicable diseases, the medical officer of health shall make reasonable attempts to request that the respondent voluntarily provide such a sample or evidence until the day that is five business days after the day the medical officer of health received the application or the day the Board renders its decision under section 5 of the Act, whichever is earlier. O. Reg. 537/22, s. 7.

Voluntary compliance

9. If the respondent voluntarily agrees to provide a blood sample, the respondent shall,

(a) go to a physician or person belonging to a class prescribed by section 13;

(b) request that a blood sample be taken; and

(c) advise the physician or other person that the sample is being provided pursuant to a request made by a medical officer of health under section 3 of the Act. O. Reg. 537/22, s. 8.

Immediate notification

10. If the respondent voluntarily provides a blood sample or other evidence of their seropositivity respecting the listed communicable diseases, the medical officer of health shall immediately, and in writing, notify the Board that the sample was taken or that evidence of their seropositivity was provided, as applicable. O. Reg. 537/22, s. 8.

Withdrawal of application by applicant

11. (1) An applicant who withdraws their application under subsection 3 (4) of the Act shall follow the Board’s Rules of Practice for the withdrawal of an application. O. Reg. 537/22, s. 8.

(2) The withdrawal of an application does not prevent the applicant from submitting a new application respecting the same matter in accordance with the Act. O. Reg. 537/22, s. 8.

Exceptional circumstances

12. The prescribed circumstances for the purposes of subsections 4 (4) and 5 (4) of the Act are circumstances where it is impossible or impracticable for the Board, the applicant or the respondent to comply with the applicable time period set out in the Act. O. Reg. 537/22, s. 8.

Additional persons who may take a blood sample

13. The following are prescribed as classes of persons who may take a blood sample pursuant to an order made by the Board under section 5 of the Act:

1. Members of the College of Medical Laboratory Technologists of Ontario.

2. Members of the College of Nurses of Ontario who are registered nurses and who hold extended certificates of registration under the Nursing Act, 1991. 

3. Individuals employed in a specimen collection centre licensed under the Laboratory and Specimen Collection Centre Licensing Act. O. Reg. 449/07, s. 13; O. Reg. 537/22, s. 9.

Verification of respondent’s identity before taking blood sample

14. (1) A physician or other person to whom a person goes for the taking of a blood sample pursuant to a request made under section 3 of the Act or an order made under section 5 of the Act shall, before taking the blood sample, ensure that the person verifies that they are the respondent using one of the following methods:

1. Producing photo identification that identifies them as the respondent.

2. If the person does not have photo identification, producing two pieces of identification that have the person’s name and either their signature or date of birth, which must both correspond with the information on the requisition or order.

3. If the person does not have any identification described in paragraph 1 or 2, producing a person who is familiar with the respondent and who verbally attests that the person who is presenting themselves to have a blood sample taken is the respondent. O. Reg. 537/22, s. 10.

(2) Despite anything in an order made under section 5 of the Act, if verification is not provided as required under subsection (1) or if the physician or other person is not satisfied that the person who is presenting themselves to have a blood sample taken is the respondent, the physician or other person,

(a) shall not take the blood sample;

(b) shall indicate on the laboratory requisition that they did not take the blood sample and the reason for not doing so; and

(c) shall provide notice to the medical officer of health in the health unit for the area where the respondent lives that the physician or other person did not take the blood. O. Reg. 537/22, s. 10.

(3) Upon receiving the notice sent under clause (2) (c), the medical officer of health shall notify the applicant in writing, sent by courier or electronically, that the blood sample was not taken for the reason provided under clause (2) (b). O. Reg. 537/22, s. 10.

Procedures for taking blood sample

15. (1) A physician or other person who takes a blood sample from a respondent pursuant to a request made under section 3 of the Act or an order made under section 5 of the Act shall,

(a) attach to each of the vacutainers containing blood taken from the respondent a label that lists the respondent’s name, date of birth and the date on which the sample was collected;

(b) immediately put all the vacutainers into a biohazard bag;

(c) Revoked: O. Reg. 537/22, s. 11 (1);

(d) write the respondent’s name and date of birth on the biohazard bag;

(e) attach the unique file identifier assigned to the application under subsection 4 (5) to the laboratory requisition, which must appear on the original and all copies of the laboratory requisition;

(f) indicate on the laboratory requisition that the identity of the respondent was verified in accordance with section 14;

(g) write their own name and sign and date the laboratory requisition;

(h) provide the respondent with a copy of the completed laboratory requisition;

(i) retain one copy of the completed laboratory requisition for their records; and

(j) provide notice to the medical officer of health in the health unit for the area where the respondent lives that a blood sample was taken. O. Reg. 449/07, s. 15 (1); O. Reg. 537/22, s. 11 (1-6).

(2) A physician or other person who takes a blood sample from a respondent shall immediately deliver the blood sample, packaged as required by subsection (1), and the original completed laboratory requisition by courier to the Central Public Health Laboratory for analysis there.  O. Reg. 449/07, s. 15 (2).

(3) Revoked: O. Reg. 537/22, s. 11 (7).

Damage or delay

16. (1) No analysis shall be performed on a blood sample taken from a respondent if, on arrival at the Central Public Health Laboratory, an official of the Central Public Health Laboratory determines that the sample does not meet the criteria for sample analysis set out under the quality management program required by the Laboratory and Specimen Collection Centre Licensing Act. O. Reg. 537/22, s. 12.

(2) If the official determines that no analysis should be performed on a sample, the official shall,

(a) indicate on the laboratory requisition that no analysis of the respondent’s blood sample has been performed and the reason for not performing the analysis; and

(b) send the laboratory requisition, with the indication required by clause (a), to the medical officer of health in the health unit for the area where the respondent lives. O. Reg. 537/22, s. 12.

(3) Upon receiving the laboratory requisition sent under clause (2) (b), the medical officer of health shall notify the applicant in writing that the blood sample was provided but not analysed for the reason provided under clause (2) (a). O. Reg. 537/22, s. 12.

(4) The notification under subsection (3) shall be sent by courier or electronically and is deemed to be received by the applicant 24 hours after it was sent, unless the applicant establishes that they did not, acting in good faith, through absence, accident, illness or other cause beyond their control, receive the notification until a later date and time than the deemed time of receipt. O. Reg. 537/22, s. 12.

Analysis of blood sample

17. (1) The analyst who analyses a blood sample taken from a respondent pursuant to a request made under section 3 of the Act or an order made under section 5 of the Act shall do so in accordance with the requirements specified on the laboratory requisition and in accordance with standard laboratory protocol.  O. Reg. 449/07, s. 17 (1).

(2) The analyst who analyses a blood sample taken from a respondent pursuant to a request made under section 3 of the Act or an order made under section 5 of the Act shall prepare a blood analysis report and shall sign the report to indicate that the blood sample was analysed in accordance with the requirements specified on the laboratory requisition and in accordance with standard laboratory protocol.  O. Reg. 449/07, s. 17 (2); O. Reg. 537/22, s. 13 (1).

(3) If the blood sample was provided pursuant to a request made under section 3 of the Act, the analyst shall,

(a) deliver the report on the results of the analysis to the medical officer of health in the health unit for the area where the respondent lives;

(b) make reasonable attempts to deliver the report on the results of the analysis to the respondent’s physician, if requested by the respondent; and

(c) if the respondent requested that the report on the results of the analysis be delivered to their physician, make reasonable attempts to deliver to the respondent,

(i) a notice that the analyst delivered the report on the results of the analysis to the respondent’s physician or made reasonable attempts to do so, and

(ii) a recommendation that the respondent consult their physician for a proper interpretation of the results of the analysis. O. Reg. 449/07, s. 17 (3); O. Reg. 537/22, s. 13 (2).

(4) Revoked: O. Reg. 537/22, s. 13 (3).

(5) Upon receipt of the report under clause (3) (a), the medical officer of health shall,

(a) make reasonable attempts to deliver the report to the applicant’s physician; and

(b) make reasonable attempts to deliver to the applicant,

(i) a notice that the medical officer of health delivered the report on the results of the analysis to the applicant’s physician or made reasonable attempts to do so, and

(ii) a recommendation that the applicant consult their physician for a proper interpretation of the results of the analysis.  O. Reg. 449/07, s. 17 (5); O. Reg. 537/22, s. 13 (4).

Application resubmitted

18. (1) This section applies to an applicant who is notified under subsection 14 (3) that a sample has not been taken because the respondent’s identity could not be verified or who is notified under subsection 16 (3) that the respondent provided a blood sample that was not analysed. O. Reg. 537/22, s. 14.

(2) The applicant may, within seven days after receiving a notification described in subsection (1), resubmit their application to a medical officer of health. O. Reg. 537/22, s. 14.

(3) The resubmitted application must include,

(a) the name of the applicant and the unique file identifier assigned to the original application under subsection 4 (5); and

(b) a copy of the written notice given by the medical officer of health under subsection 14 (3) or 16 (3), as applicable. O. Reg. 537/22, s. 14.

(4) The resubmitted application must be received by the office of the medical officer of health in the health unit for the area where the respondent lives no more than seven days after the date on which the applicant received the notice given by the medical officer of health under subsection 14 (3) or 16 (3), as applicable. O. Reg. 537/22, s. 14.

(5) The medical officer of health shall review the resubmitted application and determine whether a new application must be made or whether a previous laboratory requisition can be reissued. O. Reg. 537/22, s. 14.

(6) If a previous laboratory requisition is reissued under this section, sections 8 to 18 of this Regulation and the relevant provisions of the Act apply with necessary modifications in respect of the re-issued requisition. O. Reg. 537/22, s. 14.

19. Omitted (provides for coming into force of provisions of this Regulation).  O. Reg. 449/07, s. 19.

 

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