Policy and Political Action

Policy & Political Action


  • April 1, 2019

    RNAO appreciates the opportunity to provide feedback to the Standing Committee on Social Policy on Bill 74, An Act concerning the provision of health care, continuing Ontario Health and making consequential and related amendments and repeals, known in its short title as, The People's Health Care Act, 2019.

    Each day across the province, many Ontarians receive life-saving and wellness-enhancing health services thanks to Canada's Medicare – a universal, single-payer health insurance system cherished by its citizenry. The support and care of a person's chosen family aligned with the knowledge, skill, and judgment of dedicated health professionals has allowed many Ontarians to have a high-quality life and a peaceful death. While acknowledging these strengths, there is much left to do. For many years RNAO has been urging the provincial government to recalibrate the balance between life-saving and wellness-enhancing services (strengthening the later), and address flaws that result in barriers to access with inequitable health outcomes, hallway health care, and other detrimental experiences.

    RNAO supports a health system transformation that will enable a person-centred, seamless health system that will promote health, prevent disease, and provide personalized wrap-around services to manage acute, chronic, and palliative care needs. In order to realize this objective, RNAO is pleased to offer the following pragmatic, solution-focused recommendations:

  • March 15, 2019

    RNAO wishes to respond on two levels to Bill 66, the Restoring Ontario's Competitiveness Act, 2018.  First, we oppose the use of omnibus bills like Bill 66: they bundle together many unrelated legislative changes and that does not allow a reasonable discussion of the different issues that arise. There are 12 very different schedules in Bill 66, and we focus on just two of them in this submission: Schedules 5 and 10.  Both present significant threats to health and the environment. In fact, RNAO devoted many years to helping promote the very health and environmental protections which Bill 66 would weaken or eliminate, and we have a great deal invested in those protections. We urge the complete withdrawal of both Schedules 5 and 10.

  • February 14, 2019

    RNAO is pleased to respond to the consultation by the Canadian Nuclear Safety Commission (CNSC) on the draft terms of reference of its Potassium Iodide (KI) Pill Working Group. RNAO welcomes the commitment to form a working group to "provide clarity on the existing plans and associated responsible authorities to distribute KI Pills (in the Ingestion Planning Zone, within a 50-km radius) in the event of an emergency at the Pickering Nuclear Generating Station."

  • January 30, 2019

    Summary of RNAO Recommendations

    Recommendation 1. The College of Nurses of Ontario (CNO) enables independent RN prescribing by:
    a) Specifying under regulation 17. (1) that an RN in the General class is authorized to prescribe any medication for the treatment of non-complex health conditions within their clinical competency area, with the exception of controlled drugs and substances.
    b) Removing “Schedule 4 Individual drugs and categories of drugs that may be prescribed” and all references to a schedule.
    c) Adding the authority for RNs to order and where appropriate perform diagnostic testing, inclusive of laboratory testing and point-of-care testing.

    Recommendation 2. CNO include an additional clause under 17. (6) that education approved by Council to educate RNs in prescribing medications may be independent of or part of the education and training required to become an RN.

    Recommendation 3. Indicate on the public Find-a-Nurse register that an RN has met CNO’s requirements to prescribe medication by including the notation the nurse is “authorized to prescribe”.

  • January 28, 2019

    RNAO's recommendations focus on improving access to nursing and health care; strengthening our Medicare system; boosting living standards; protecting the environment; and being able to pay for these improvements by making our tax system fairer and more progressive. In the view of nurses, these are public investments that will keep Ontarians healthy and productive.

    The full submission is available here, or at the bottom of this document.


    Summary of recommendations

    1. Provide hospitals with funding earmarked to immediately fill 10,000 RN vacancies.
    2. Require all new nursing hires in acute care and cancer care hospitals to be RNs. 
    3. Require all first home care assessments be conducted by an RN.
    4. Relocate the 4,500 RN care co-ordinators currently in LHINs to primary care.
    5. Implement independent RN prescribing in all sectors, inclusive of diagnostic tests by 2019,
      and integrate RN prescribing into the curriculum for baccalaureate nursing by 2020.
    6. Ensure RNs are allowed to continue to initiate and perform the controlled act of psychotherapy.
    7. Dedicate additional funds to ensure that new and existing NPs in primary care receive compensation equivalent to that received by NPs in hospitals.
    8. Remove legislative, regulatory, and practice environment barriers to NPs’ scope of practice
      as follows:
      • Ensure NPs are enabled to act as most responsible providers in hospital.
      • Authorize NPs to perform point-of-care testing.
      • Authorize NPs to order additional forms of energy (e.g., CT, MRI, nuclear medicine procedures, non-invasive EEGs, and ECGs in all situations).
      • Authorize NPs to apply specified forms of energy (e.g., defibrillation).
      • Expand NPs’ authority to certify a death.
      • Authorize NPs to complete Forms 1, 2, 3, 4, 5, 14 and 28 for mental health services under the Mental Health Act.
    9. Transform funding models in LTC to account for complexity of resident care needs and quality outcomes. LTC homes that improve residents’ outcomes due to evidence-based care and decrease acuity should retain all funding to reinvest in additional staffing for residents.
    10. Mandate the implementation of relevant RNAO BPGs when MOHLTC inspectors find homes are non-compliant.
    11. Legislate a minimum of four hours of nursing and personal care per resident per day in
      long-term care.
    12. Legislate minimum nursing and personal care staffing and skill mix standards in LTC, accompanied by the necessary funding to support these changes. We call for no less than one attending NP for every 120 residents, and a skill mix of RNs, RPNs, and unregulated care providers consisting of at least 20 per cent RNs, 25 per cent RPNs, and no more than 55 per cent PSWs. This ratio would guarantee LTC residents receive care when they need it from the most appropriate provider.
    13. Release funding for the outstanding attending NP in LTC positions. Hold LTC homes accountable for hiring attending NPs in the manner specified by the MOHLTC role description and funding policy.
    14. Expedite the implementation of a new program of dental care for low income seniors by increasing funding for dental services in community health centres, Aboriginal health access centres, and public health units. Provide a clear timeline to invest in new public dental services in underserviced areas, including the use of mobile dental buses.
    15. Develop and maintain a strategy to make personal health records available to all patients after consulting with patients, families, caregivers, RNs, NPs, and other health providers.
    16. Continue to fund RNAO to strengthen its partnerships with Indigenous communities to co-create clinical best practice guidelines and to expand the Indigenous-focused Best Practice Spotlight Organizations to address the health needs of Indigenous persons.
    17. Expedite the authorizing and funding of Consumption and Treatment Services (CTS) across the province where they are needed to save lives.
      • Immediately increase access to CTS to all communities in need.
      • Streamline and expedite the CTS application process to increase access to this life-saving health service.
      • Invest sufficient funding in the CTS program to help prevent deaths from overdose. In addition, provide funding and support for the treatment services required by the CTS model because there is now a shortage of treatment, recovery and mental health and addiction services.
    18. Develop a climate change plan that, at a minimum, meets Ontario’s legislated GHG reduction targets of 15 per cent below 1990 levels by 2020, 37 per cent by 2030 and 80 per cent by 2050.
    19. Take all necessary steps to:
      • Work with federal and municipal partners to ensure dedicated and sustainable revenue sources to pay for ongoing operation and substantial expansion of transit and active transportation in Ontario.
      • Support cost-effective and expeditious delivery of those expansions, implemented by transparent governance and informed expert opinion.
      • Don’t fund transit expansion by selling public assets such as Hydro One.
    20. Build a more progressive tax system and don’t cut taxes so Ontario develops the fiscal capacity to deliver all essential health, health care, social, and environmental services.
    21. Make polluters pay for the full cost of the pollution they create, including their carbon emissions. Support the national carbon pricing initiative. Increase revenue sources in ways that are fair and equitable, and that encourage environmental and societal responsibility.
  • November 15, 2018

    The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses (RN), nurse practitioners (NP), and nursing students in all roles and sectors across Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses' contributions to shaping the health system, and influenced decisions that affect nurses and the public they serve.

    RNAO appreciates the opportunity to provide feedback to the Standing Committee on Finance and Economic Affairs on Bill 47, An Act to amend the Employment Standards Act, 2000, the Labour Relations Act, 1995 and the Ontario College of Trades and Apprenticeship Act, 2009 and make complementary amendments to other Acts, known in its short title as, Making Ontario Open for Business Act, 2018.

    Nurses see, in their daily work, the impact of poverty on people’s ill-health. To improve health and decrease health inequities, RNAO has been advocating for more than 15 years that the minimum wage be increased and labour laws be strengthened and enforced. Ontario's $14 per hour minimum wage is scheduled to increase to $15 per hour on Jan. 1, 2019 and then be indexed to inflation every October. RNAO has consistently supported this increase to the minimum wage that became law under Bill 148, Fair Workplaces, Better Jobs Act, 2017 as well as other regulatory safeguards to support workers' health such as paid sick days.

    Fair wages and decent work are essential for the health of individuals, families, communities, and our province. Decent work and wages advance Ontario's "vision of a province where every person has the opportunity to achieve his or her full potential" as envisioned by the Poverty Reduction Act, unanimously passed by all parties in May 6, 2009. As RNAO previously testified in our Changing Workplaces Review submission, decent work with fair wages is an important issue to RNAO and its more than 42,000 members – it affects their multi-faceted lives as health professionals, family members, workers, employers, neighbours, and citizens.

  • November 14, 2018

    RNAO welcomes the opportunity to provide feedback to the College of Nurses of Ontario (CNO) on RN prescribing competencies. RNAO has long advocated for independent RN prescribing. RNs are autonomous health professionals who practise independently and collaboratively within interprofessional teams. With more than 100,000 RNs registered to practise with the CNO, RN prescribing has huge potential to increase access to care across the province.

  • September 26, 2018

    RNAO is pleased to participate in this national consultation on how to implement affordable national pharmacare. RNAO also welcomes the appointment of Dr. Eric Hoskins as the Chair of the Advisory Council on the Implementation of National Pharmacare (the Council). Dr. Hoskins has an excellent understanding of the importance of pharmacare. We urge the federal government to move quickly on this long overdue expansion of the Canada Health Act.

  • May 7, 2018

    RNAO welcomes this opportunity offered by the Canadian Nuclear Safety Commission (CNSC) to respond to Ontario Power Generation's (OPG) application to renew its nuclear power reactor operating licence for the Pickering Nuclear Generating Station (Ref. 2018-H-03). OPG is requesting the renewal of its licence from its current expiry date of August 31, 2018 for ten years. OPG plans to end commercial operations at Pickering by December 31, 2024. The issue matters a great deal to nurses because of its health implications and because they are heavily involved in any disaster responses (see the appendix). RNAO urges the CNSC to adopt a precautionary approach that prioritizes human  health.

  • April 27, 2018