Public Health Regulations Quiz

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Questions and Answers

What is the primary responsibility of the Ministry of Health and Long Term Care?

Occupational health standards

Food safety regulations

Health Protection and Promotion Act (HPPA) (correct)

Environmental assessments

Which doctrine states that federal law takes precedence over provincial law in case of conflicts?

Concurrent jurisdiction principle

Subordination principle

Paramountcy doctrine (correct)

Federal supremacy clause

Who is responsible for the enforcement of the Occupational Health and Safety Act (OHSA)?

Ministry of Labour (correct)

Health Canada

Ministry of Health and Long Term Care

Ministry of Environment and Climate Change

What jurisdiction does the Constitution Act, section 92 NOT cover?

Public education Signup and view all the answers

In Southern Ontario, who typically leads the local health units?

Local Medical Officer of Health Signup and view all the answers

Which of the following best describes the overlap of HPPA with the Ministry of Labour?

Health hazards affecting workers in public spaces Signup and view all the answers

What defines the jurisdiction of Boards of Health?

Local health hazards within their districts Signup and view all the answers

Which group is NOT typically represented on the boards of health?

Local business leaders Signup and view all the answers

Which of the following best describes a 'public pool'?

A facility containing artificial water for recreational purposes. Signup and view all the answers

What action must be taken if an examination indicates that a health hazard is present?

Destroy or dispose of the item Signup and view all the answers

What is the role of a 'public health inspector'?

To conduct inspections and enforce health regulations. Signup and view all the answers

Under which circumstance can food be destroyed without further investigation?

When there are reasonable grounds to believe it is a health hazard Signup and view all the answers

What defines a 'small drinking water system'?

A water system serving a small population specified by regulation. Signup and view all the answers

Which statement is true concerning 'reportable diseases'?

They include diseases specified by regulation made by the Minister. Signup and view all the answers

What must owners of residential buildings provide for residents?

Potable water and sanitary facilities Signup and view all the answers

What is the definition of 'sanitary facilities'?

Rooms that contain toilets and washbasins. Signup and view all the answers

What should happen to an item pending an examination if the owner requests it?

The item is detained until the examination is completed Signup and view all the answers

How is a 'school board' defined?

A board defined in the Education Act. Signup and view all the answers

What is a potential consequence if a medical officer finds a health hazard does not exist?

The item is returned to the owner Signup and view all the answers

Which disease falls under the category of 'sexually transmitted disease'?

Chlamydia Signup and view all the answers

Which of the following is NOT considered a 'disease of public health significance'?

A chronic illness Signup and view all the answers

What is required for a board of health to provide an additional health program or service?

The board must consider the needs of the area. Signup and view all the answers

Which of the following is NOT included in the inspections mandated for medical officers of health?

Beauty salons Signup and view all the answers

What primary duty does a medical officer of health have according to the regulations?

To inspect the health unit for health hazards. Signup and view all the answers

What action may a medical officer of health direct in respect to a health hazard?

They may direct the board's agents to take specified action. Signup and view all the answers

If a health hazard complaint is received, what is the initial action of the medical officer of health?

Notify the appropriate ministry and investigate. Signup and view all the answers

Which of the following is NOT a potential direction listed in Section 14?

Implementing educational programs for the community. Signup and view all the answers

What can be included in the directions regarding the health hazard?

Requiring the destruction of specified items. Signup and view all the answers

What must the medical officer of health refrain from including in their report to the complainant?

Personal health information of others. Signup and view all the answers

If expenses related to a health hazard are not paid within sixty days, what can the board of health do?

Transmit a statement of expenses to the municipal clerk. Signup and view all the answers

Which type of establishment is required to be inspected by the medical officer of health?

Food premises Signup and view all the answers

What must be considered before a board of health approves a new health program?

The needs of the area population. Signup and view all the answers

Who can the board of health recover expenses from regarding a health hazard?

The owner or occupier of the premises. Signup and view all the answers

What is the definition of a 'communicable disease'?

A disease specified as communicable by regulation made by the Minister Signup and view all the answers

What is one of the requirements under Section 14 directions related to premises?

Requiring specified work to be done on the premises. Signup and view all the answers

Which of the following is not classified as a virulent disease?

Ebola Signup and view all the answers

Who is responsible for conducting health inspections in community settings?

Medical officers of health Signup and view all the answers

What may be required regarding the cleaning or disinfecting duties outlined in the directions?

Both cleaning and disinfecting of specified premises. Signup and view all the answers

What are the implications of an order requiring the closing of premises under the Act?

Only certain specified persons may access the premises Signup and view all the answers

Which regulation outlines the designation of diseases of public health significance?

O.Reg. 135/18 Signup and view all the answers

In what case can the board of health recover costs through action in court?

For expenses related to health hazards on any premises. Signup and view all the answers

What is meant by 'disease of public health significance'?

A disease designated by regulation made by the Minister Signup and view all the answers

Which of the following diseases is included in the list of virulent diseases?

Tuberculosis Signup and view all the answers

According to the regulations, which of the following is true about a virulent disease?

It is designated by regulation made by the Minister Signup and view all the answers

When can an order to close premises be implemented according to the Act?

To prevent access by any person unless specified otherwise Signup and view all the answers

Study Notes

Health Law - ENH 121 - Unit 9 - HPPA -1

Course name: Health Law
Unit number: 9
Topic: HPPA -1
Author: Daniel Huynh
Year: 2024
Source: Dr. Peter Strahlendorf's slides

Health Protection and Promotion Act

Act name: Health Protection and Promotion Act
Act reference: R.S.O. 1990, Chapter H.7 (Parts 1-3)
Last revised: September 2023

Main Changes (2009, c.33)

Amendment to the Chief Medical Officer of Health's powers regarding personal information and health information
Clarification of when certain class orders are considered made under section 106
Amendment to the Ministry of Health Appeal and Review Boards Act, 1998; renaming it to the Ministry of Health and Long-Term Care Appeal and Review Boards Act, 1998, and updating related acts correspondingly

Unit 9 - Contents

History/Purpose/Scope of HPPA
Health Units, Boards of Health, MOH, PHI Definitions
HPPA Programs and Services
Public Health Standards
Community Health Protection (sections 13 Order/14 Direction, Duties, Seizure Power)

HPPA: History

Formerly known as the "Public Health Act"
Public Health Involvement in Occupational Health and Safety
Nuisance vs. Health Hazard
New HPPA passed in 1983
Few amendments since then

HPPA: Structure

Interpretation (Definitions)
Health Programs and Services
Community Health Protection
Communicable Diseases
Rights of Entry and Appeals from Orders
Health Units and Boards of Health
Administration
Regulations
Enforcement
Transition

Purpose (Section 2)

Organize and deliver public health programs and services
Prevent the spread of disease
Promote and protect the health of Ontarians

Purpose: Clarification

Focuses on public health issues, not individual problems
Issues must concern a significant portion of the public

Jurisdiction

Public health is a multifaceted topic, with shared responsibility between federal and provincial governments
Often, overlapping laws exist at both levels of government (e.g. food safety, water quality, quarantine)
Paramountcy doctrine applies: Federal law overrides conflicting provincial law

Provincial Jurisdiction (Constitution Act, section 92)

Municipal institutions
Licenses for shops, taverns, etc
Local works and undertakings
Property and civil rights
Matters purely local or private

Administrative Jurisdiction

Ministry of Health and Long-Term Care: HPPA
Ministry of Labour: OHSA
Ministry of Environment and Climate Change: EPA, OWRA

What is Public Health: General Rule

HPPA covers public places or parts of the public
Overlaps with Ministry of Labour (MOL) when workers are involved
Overlaps with Ministry of Environment (MOE) for hazards outside of built structures

Peculiarity

OHSA inspectors are employees of MOL
EPA inspectors are employees of the Ministry of Environment
Public Health Inspectors, Local Medical Officers of Health, and Public Health Nurses are employees of local Boards of Health
In Northern Ontario, Chief Medical Officers of Health are employees of MOHLTC

Boards of Health

Southern Ontario is divided geographically into local health units
Each local health unit has a board of health headed by a local Medical Officer of Health
Jurisdictions are confined to their health unit, except for emergencies
Guidance to boards of health in regards to health programs is provided by MOHLTC
Boards structured by MOHLTC, MOH, Inspectors

Definitions (Part I)

Board: Health Services Appeal and Review Board(under 1998 Ministry of Health Appeal and Review Boards Act)
Board of Health: Regional municipalities of Durham, Halton, Niagara, Peel, Waterloo, York, and the County of Oxford, a single-tier municipality having the local board of health powers
Chief Medical Officer of Health
Communicable diseases: Specified diseases by regulation
Disease of public health significance: Specified diseases by regulation
Dwelling unit: Real property used as a home
Food: Food or drink for human consumption, including ingredients
Food premise: Premises where food or milk is processed, prepared, stored etc.
Health hazard: Conditions, substances, plants/animals outside of a human affecting health

Definitions

Further details on the definitions, including terms like "health unit," "mandatory," "medical officer of health," "milk," "minister," "municipality member," "obligated municipality," "occupier," "operator," "person," "personal service setting," "premises," "public health inspector," "public health nurse," "public health standard," "public pool," and "regulations."

Definitions (cont.)

Reportable disease: Diseases specified by regulation as reportable
Residential building: Structure containing one or more dwelling units
Sanitary facilities: Rooms/spaces with toilets and washbasins.
School: A private school or one as defined in the Education Act, and school board as defined in the Education Act.
Sexually transmitted disease: Infections spread during sexual contact
Small drinking water system: Small drinking water systems as specified by regulation

Diseases

Disease of public health significance (formerly 'reportable disease')
Communicable diseases
Virulent diseases

HPPA: Diseases of Public Health Significance

O.Reg. 432/01 (and amended to 135/18) outlines these diseases, specifically those detailed within Column 1 of the relevant table

Communicable Diseases

Two related regulations cover all communicable diseases, including General Communicable Diseases regulation (R.R.O. 1990, Regulation 557, and most recent amendment O.Reg. 68/23, then further, Designation of Diseases - O. Reg. 135/18 with a recent amendment, O. Reg 171/23)

Communicable Diseases; Designation

A disease set out in the designated column 1 of the referenced table's column is designated as a public health significance and (a) it is a communicable disease if identified in column 2 of the referenced table,
(including further disease types that are communicable, with their status noted in the referenced table).

Virulent Diseases

Diseases specifically designated as virulent by regulation.

Back to HPPA: Closing of Premises (section 13 subsections)

Orders under this act require premise closure
Shut down premises to halt entrance or access
Halt any enterprise or activity on the premises
Exceptions are specified in the order

Act Binds Crown

This regulation has binding effect on the Crown.

Part II - Health Programs & Services

Every board of health is required to provide the health programs and services prescribed by MOHLTC and Public Health Standards.
Boards may develop additional programs contingent on needs within the unit.

Part III - Programs relevant to schools

Immunization services, oral hygiene and fluoride treatment programs for children
Preschool and school health care services
Nutrition services and public health education programs.

Programs (Section 4 subsections)

Every board oversees health programs and services
Responsibilities include sanitation, maintaining hazards, and safe drinking water for the area's residents
Additional duties as outlined in other regulations

Mandatory Programs & Services (Section 5)

Community sanitation (safe drinking water by small drinking water systems)
Infectious diseases and public health significance (immunization for children/adults)
Health promotion, protection, and disease/injury prevention (cardiovascular disease, cancer, AIDS, etc.)
Family health (counseling services, family planning services for high-risk groups like infants, pregnant women, and the elderly; preschool and school health services, including dental care; screening programs to reduce disease morbidity/mortality).
Data collection on epidemiological data
Additional health programs/services according to regulations

Part III - School Pupils (section 6)

Boards of health provide regulated health programs/services to pupils
Exemptions apply to schools that have already agreed to provide these services/programs.
Regulations specify pupil classification according to services/programs.
Further prohibitions on health program provision without board approval

MHLTC Public Health Standards (Section 7)

Standards established by the minister are required for mandatory health program/service compliance by boards of health
Public health standards are transmitted to health boards/accessible to the public in the Ministry
Regulations override conflicting health standards
Health standards can adopt codes, formulas, protocols, or procedures by reference (with necessary changes/modifications)
Amendment of health standards goes into effect upon notice from the ministry to all boards of health

Extent of Programs & Services (Section 8)

Boards of health are not required to provide/ensure services except for those specified by the regulation/public health standards.

Optional Programs & Services (Section 9)

Boards of health may provide additional programs and services if approved and desired in accordance with the needs/desires of the community and by the municipality councils in the area

Part III - Community Health – Duty to Inspect (Section 10)

Medical officer of health inspects conditions relevant to health risks in their health unit
Includes responsibility for food premises, equipment, boarding, and lodging houses, food handling, restaurants/daycare centres etc
Responsibility for food premises, equipment, inspection of boarding, lodging houses, etc, also included

Part III – Community Health: Complaint (Section 11)

Reporting mechanisms when a complaint is filed about a health hazard in the health unit
Ministry notification to determine if the hazard exists

Part III – Community Health - Report (Section 11 subsections):

Reports on health hazards
Exclusion of personal health information unless there's consent (under the Personal Health Information Protection Act).

Part III - Community Health – Conflict (Section 11 subsection):

Prioritization of HPPA in case of conflicting issues with other legislation.

Duty of M.O.H. re occupational and environmental health (Section 12 subsections)

Keeping informed about occupational and environmental health issues
Obtaining info from related branches of government/municipalities regarding relevant risks to health.
Authorizing to vary/establish interim requirements for small water systems if necessary.
Restrictions on variation/establishment of interim requirements concerning risk to users

Section 13 Orders (including subsections 1, 2, 3):

Medical officers of health and public health inspectors can issue written orders for actions regarding health hazards
Specific criteria are required before issuing orders (probable grounds, need to diminish/eliminate the hazard, etc.)
Timeframes in which the orders must be complied with are specified
Contingent on health hazards (not breaches of regulation)
Including specific actions that may be included in written orders

Section 14 Direction (including subsections 1, 2, 3, 4)

Medical officer of health provides direction for health hazards to those who have agreed to cooperation in accordance to applicable guidelines (other staff, etc)
Situations in which orders in section 13 are to be implemented

Recovery of Expenses by Action (Section 15 subsections)

Recovery of expenses from owners/occupiers (including statements to the clerk, collection from taxes)

Duty - Food Premises (Section 16)

Food premise operators' duties to maintain facilities according, including notice of intent requirement to the medical officer, and regulations for their employees.

General Duty – Food (Section 17)

Selling unfit food is prohibited
Not contingent on specific regulation

Unpasteurized or unsterilized milk (Sections 18(1), 18(2), 18(3), 18(4))

Regulations regarding the sale of unpasteurized/unsterilized milk

Seizure Power (Section 19 subsections):

Medical officer or public health inspector can seize substances causing health hazards.
Further detailing of the process of examination, return of items if not hazardous, destruction of items if hazardous.

Facilities Required in Residential Buildings (Section 20)

Owners of residential buildings must provide potable water and sanitary facilities for residents.

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Test your knowledge on public health responsibilities, laws, and practices in Ontario. This quiz covers topics such as the Ministry of Health, Occupational Health and Safety Act, and jurisdiction of health units. Perfect for students and professionals in the field of health care and policy.