Bill 46 is a broad restructuring of Alberta’s health statutes. It repeals the Hospitals Act and moves its hospital-governance, hospital-insurance and hospital-foundation rules into Part 2.1 of the Health Facilities Act.
It also renames the ABC Benefits Corporation Act as the Alberta Blue Cross Act and updates cross-references throughout provincial legislation.
The bill’s more consequential changes sit in the Health Information Act and Health Professions Act. Alberta’s Department of Health becomes the operator and gatekeeper of the Alberta Electronic Health Record, while health regulators receive a new statutory framework for restricted activities, continuing competence, professional titles, registration scrutiny and organizational independence.
The result is a more centralized architecture for both health-data administration and professional oversight.
At a Glance
What It Does
The bill transfers the Hospitals Act into a new Part 2.1 of the Health Facilities Act, preserving and reorganizing rules for hospital approval, governance, medical staff privileges, insured hospital services and foundations. It places the Alberta EHR under Department management, creates access logs and new access-request routes, and expands the regulatory framework for health professions and restricted activities.
Who It Affects
Regional health authorities, non-regional hospitals, hospital boards, medical staff, health-information custodians, researchers and users of the Alberta EHR face new or revised statutory rules. Colleges and regulated members—including licensed practical nurses, health care aides, counselling therapists, addiction counsellors and child and youth care counsellors—also receive new governance, registration and title requirements.
Why It Matters
The bill moves important operational decisions away from dispersed statutory schemes and professional bodies toward the Minister, the Department and standards of practice. It also makes health-information access easier to administer centrally while attaching new audit, logging, privacy, competency and disclosure consequences to that centralization.
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What This Bill Actually Does
Part 1 is largely corporate and consequential. It changes the name and chapter number of the statute governing Alberta Blue Cross and updates references in tax and health-insurance legislation.
These amendments modernize the statutory label without changing the bill’s broader health-system architecture.
Part 2 is the bill’s hospital-law rewrite. The former Hospitals Act is repealed and its substance is recreated as Part 2.1 of the Health Facilities Act.
The new Part preserves rules for approved and non-regional hospitals, including governing boards, hospital bylaws, medical-staff appointment and privileges, utilization review, hospital records, inspections, hospital charges, insured services, hospital foundations and ministerial grants. A cross-reference rule treats references to the repealed Hospitals Act as references to the corresponding provisions in the new Part, reducing disruption across Alberta’s statute book.The hospital framework gives the Minister significant supervisory tools.
The Minister can approve hospitals, set or regulate service standards, require information, inspect management and records, appoint inquiry committees, withhold grants for non-compliance and intervene where a required act is not performed. Medical staff receive a dedicated Hospital Privileges Appeal Board process: eligible members can appeal non-appointment, suspension, termination or changes to privileges within 90 days, with a further appeal to the Court of Queen’s Bench on a question of law within 30 days.Part 3 changes the operating model for health information.
It requires written consent before a custodian uses a device that may be invisible to the individual, broadens certain disclosure authorities, strengthens research-agreement requirements and increases maximum fines under the Health Information Act to $200,000 for an individual and $1 million for another person. Researchers must follow both their custodian agreement and the research ethics board’s conditions; a breach cancels the agreement and requires destruction or return of the information.The Alberta EHR provisions place the Department in charge of operation, eligibility, access decisions, safeguards, audits, investigations and access reporting.
Authorized custodians may access information through the EHR for purposes available under the Act, while individuals receive routes to request their own EHR information. The bill also exempts certain information-sharing among specified custodians from privacy-impact-assessment requirements unless a new or changed information system is involved, and it ends existing EHR information-manager agreements and the Alberta Netcare information-exchange protocol when the relevant provision takes effect.Part 4 moves the statutory list of restricted health activities from Schedule 7.1 of the Government Organization Act into the Health Professions Act.
It preserves activities such as invasive procedures, prescribing or dispensing specified drugs, administering vaccines, ordering imaging and managing labour as restricted, while allowing regulations and ministerial orders to authorize additional people or categories of people. Unauthorized performance can lead to escalating fines, imprisonment for repeat offences and an injunction.
The same Part separates colleges from professional-association functions, expands regulator control over registration and competence, and formally recognizes health care aides and counselling-related professions.
The Five Things You Need to Know
The Hospitals Act is repealed and replaced by Part 2.1 of the Health Facilities Act, with a statutory rule preserving references to the former Act across Alberta legislation.
A medical-staff member generally has 90 days to appeal a hospital board decision affecting appointment or privileges to the Hospital Privileges Appeal Board; an appeal to the Court of Queen’s Bench is limited to a matter of law and must be filed within 30 days.
The Department must keep an electronic log of each Alberta EHR access, including the user’s identity, the date and time, the health information accessed and any prescribed additional information.
A researcher who breaches a health-information agreement or research ethics board conditions loses authorization to use the information and must destroy it or return it to the custodian.
The Health Professions Act creates escalating penalties for unauthorized restricted activities: fines of up to $5,000 for a first offence, $10,000 for a second, and $25,000 or six months’ imprisonment for a third or later offence.
Section-by-Section Breakdown
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Renaming Alberta Blue Cross legislation
The bill repeals the title and chapter number of the ABC Benefits Corporation Act and replaces them with the Alberta Blue Cross Act. It updates references in the Alberta Corporate Tax Act and Alberta Health Care Insurance Act, primarily preventing the name change from leaving obsolete statutory terminology in place.
Rebuilding the Hospitals Act inside the Health Facilities Act
This Part adds a new Part 2.1 to the Health Facilities Act and repeals the standalone Hospitals Act. It carries forward the core hospital framework, including approved-hospital designations, governing boards, hospital bylaws, medical-staff governance, patient records, insured services, hospital charges, hospital foundations and ministerial oversight.
The structure matters because the new Part is not merely a terminology update. It consolidates hospital law with the Health Facilities Act and gives the Minister continuing authority over approvals, standards, inspections, inquiries, grants and compliance. Non-regional hospitals can participate in minister-approved plans with regional health authorities, including plans that integrate operations, management and financing across a health region.
Hospital boards, medical staff and privilege appeals
Every approved hospital must have a governing board with final authority over hospital operations and medical-staff appointments. Boards must maintain general bylaws, while medical staff must operate under bylaws covering appointments, privileges, review procedures, patient-care input, ethics, evidence-based decisions and continuing medical education. Medical-staff bylaws require both board and Minister approval, and the Minister can resolve disputes between a board and its medical staff.
The Hospital Privileges Appeal Board provides a specialized appeal route for affected medical and dental staff. Its seven-member structure includes physicians, a legal or judicial member, a senior public-sector administrator, a registered-nursing member and two other members. The Board can confirm, vary or reverse decisions concerning appointment, suspension or privileges.
Centralizing Alberta EHR administration and tightening data controls
The bill makes the Department responsible for operating the Alberta EHR. The Department determines eligibility, grants or restricts access, maintains safeguards, responds to access requests, provides access reports and may audit or investigate unauthorized access, data integrity and patient-safety issues. It can also facilitate access for medical examiners and, subject to regulations, health providers outside Alberta treating Alberta residents.
The bill separates EHR access from the Act’s ordinary concepts of collection and disclosure, which simplifies system administration but makes the statutory access controls and regulations especially important. It requires the Department—not individual custodians—to maintain the EHR access log and establishes new routes for individuals to request their records. The bill also authorizes regulations to incorporate external codes, standards and guidelines, including materials that may change over time, without applying the Regulations Act to those incorporated materials.
Making research and disclosure obligations more concrete
Research terminology changes from a research “proposal” to a proposed research “protocol,” and researchers must comply with both the custodian agreement and the research ethics board’s response. A breach cancels the agreement and ends the researcher’s authority to use the health information, with destruction or return required.
The bill also authorizes disclosure where another Alberta or Canadian enactment permits it, replaces “imminent danger” with “significant risk of harm” in one disclosure exception, and permits certain successor custodians to receive records. These changes broaden or clarify several operational pathways while leaving custodians responsible for applying the Act’s conditions.
Recasting restricted activities and professional regulation
The bill moves the restricted-activities regime into a new Part 0.1 of the Health Professions Act and repeals Schedule 7.1 of the Government Organization Act. It defines the activities, authorization routes, supervision rules, emergency exception, offence provisions and ministerial power to authorize categories of people during a public-health emergency.
The Part also changes how colleges regulate members. Colleges must separate themselves from professional-association functions, and officers or senior employees of relevant professional associations or labour unions cannot hold specified regulatory positions. Registration and practice-permit processes can demand more information about character, reputation, fitness, hospital privileges and prior discipline. Standards of practice replace regulations for many competence and title questions, and regulators receive expanded authority to impose supervision, practice limits, reporting, assessment and non-solo-practice conditions.
Recognizing health care aides and counselling professions
The College of Licensed Practical Nurses of Alberta becomes the College of Licensed Practical Nurses and Health Care Aides of Alberta. The Act recognizes health care aides as regulated members, sets out their permitted professional functions and transitions people already enrolled in the Health Care Aide Directory into the new regulatory structure.
The bill also continues the Association of Counselling Therapy of Alberta as the College of Counselling Therapy of Alberta and recognizes counselling therapists, addiction counsellors and child and youth care counsellors. It reserves related titles, including “psychotherapist,” for authorized users and distinguishes regulated counselling relationships from ordinary emotional, social or practical support among people with a shared lived experience.
Staged commencement by proclamation
The bill does not make every Part operative at the same time. The coming-into-force clause identifies the hospital provisions, most EHR changes and Part 4 for proclamation, while excluding one professional-regulation amendment from that immediate group. This creates implementation dependencies for departments, hospitals, colleges, custodians and regulated members, particularly where regulations, standards of practice or transitional arrangements must be prepared.
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Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Patients using multiple health providers benefit from a system designed to make relevant records available through one provincial EHR, subject to access limits, logging and prescribed safeguards.
- Medical staff whose hospital privileges are restricted, suspended or not renewed gain a dedicated appeal process with authority to reinstate or vary privileges.
- Researchers and health-system analysts receive clearer statutory pathways for approved data use, including defined agreements, ethics conditions and successor-custodian transfers.
- Health care aides gain formal recognition within the regulated-health-profession framework, including a defined college, titles and practice scope.
- Albertans receiving counselling, addiction or child-and-youth services gain a regulated professional structure and reserved titles for the newly recognized counselling professions.
Who Bears the Cost
- The Department of Health assumes direct operational responsibility for the Alberta EHR, including eligibility decisions, safeguards, logging, audits, investigations, access requests and reporting.
- Hospitals and regional health authorities must update bylaws, governance documents, records practices, medical-staff processes and cross-references to operate under the new Health Facilities Act structure.
- Health-information custodians and researchers face more prescriptive compliance duties, including written-consent, protocol, agreement, logging and destruction-or-return requirements, with substantially higher potential fines.
- Professional colleges must separate regulatory functions from professional-association functions, revise standards and bylaws, collect more member information and build new competence and title-governance processes.
- Health professionals and other people performing restricted activities face clearer authorization requirements, an accused-bears-the-proof provision and escalating penalties for unauthorized practice.
Key Issues
The Core Tension
Bill 46 tries to make Alberta’s health system more coherent by centralizing information, hospital oversight and professional rules, but centralization can place more consequential decisions farther from patients, local hospital boards and professional members. The same structure that enables consistent standards and rapid system-wide action can also magnify the effects of a flawed regulation, access decision or ministerial intervention.
The bill centralizes authority, but much of the practical rulebook remains delegated. The Alberta EHR framework leaves regulations to define accessible classes of information, eligibility, safeguards, audit procedures, limitations and outside-Alberta access.
The Health Professions Act likewise shifts many details from regulations into standards of practice and gives the Minister a direct role in adding or removing restricted activities. Compliance therefore depends not only on the statute but on subordinate instruments that may vary by profession or system function.
The EHR provisions also create a deliberate legal distinction between making information accessible, accessing it, using it and disclosing it. That distinction may reduce duplication in a shared system, but it can make accountability harder to map when information moves among custodians, affiliates, authorized users and the Department.
The Department is not treated as an information manager merely because it operates the EHR, while it receives broad powers to audit and control access. Organizations will need clear responsibility matrices rather than assuming that central operation shifts all privacy duties away from custodians.
The hospital and professional-regulation changes raise a similar institutional question. Boards retain final authority over hospitals and appointments, but the Minister approves medical-staff bylaws, resolves disputes, appoints the Hospital Privileges Appeal Board and can intervene in hospital administration.
Colleges retain regulatory functions, but they must give up professional-association roles and operate under stronger ministerial and statutory direction. The bill creates review mechanisms, but it also concentrates decision-making power in actors whose operational capacity and procedural safeguards will determine how the framework works in practice.
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