The Nancy Rose Act requires the Minister of Health to develop and implement a provincial paediatric hospice palliative care strategy aimed at improving access and quality across Ontario.
The Act mandates public reporting on the strategy and gives the Minister authority to update it over time to achieve equity of access to high-quality paediatric hospice palliative care.
At a Glance
What It Does
The bill directs the Minister to create and implement a province-wide paediatric hospice palliative care strategy, to publish a report setting out the strategy within one year of Royal Assent, and to continually assess and amend the strategy as needed. It also establishes a statutory Paediatric Hospice Palliative Care Advisory Committee to advise the Minister and produce annual public reports.
Who It Affects
Provincial health planners and the Ministry of Health will lead development and implementation; paediatric hospices, hospitals, community palliative providers, and mental health services will be affected operationally; families of children receiving hospice palliative care will be directly impacted by targeted supports the strategy must include.
Why It Matters
The Act creates a formal, public framework for provincial coordination where none currently exists, embeds annual public accountability through committee reports, and requires explicit consideration of family supports—potentially shifting how regional services are planned and funded to meet equity goals.
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What This Bill Actually Does
The Act makes the Minister of Health responsible for producing a single, province-wide paediatric hospice palliative care strategy whose stated purpose is to improve access and quality and to achieve equity across Ontario. The strategy must include targeted supports for families—explicitly listing mental health supports as an example—and the Minister must prepare and publish a report that sets out the strategy within one year of Royal Assent.
After initial publication, the Minister must continually assess whether the strategy is working to achieve equity of access and make amendments when necessary; any amended strategy must also be reported and published. This creates an ongoing, iterative obligation rather than a one-time planning exercise, and it ties transparency to both initial and subsequent versions through required online publication.The Act establishes a statutory advisory committee whose role is to advise the Minister on developing, implementing and evaluating the strategy and to produce an annual report of recommendations by May 4 each year.
The committee must review the 2011 "Report of the Paediatric Palliative Care Work Group" and may adopt those earlier recommendations, in whole or with changes. Membership rules require between five and nine appointees, a majority of whom are regulated health professionals with paediatric palliative expertise, with the remaining seats reserved for family members of children who are or have been in hospice palliative care; the statute also prescribes geographic representation from specified communities.The Minister may make regulations to prescribe geographic regions for committee composition, set committee procedures (including how recommendations are made), and define the duties of members.
The Act comes into force on Royal Assent and includes a short title naming the legislation.
The Five Things You Need to Know
The Minister must prepare and publish a report setting out the paediatric hospice palliative care strategy on a Government of Ontario website within one year of Royal Assent.
The strategy is required to include targeted supports for families of children receiving hospice palliative care, explicitly including mental health supports.
The Paediatric Hospice Palliative Care Advisory Committee will have between five and nine members; a majority must be regulated health professionals with paediatric palliative expertise and the rest must be family members of children who are receiving or have received such care.
The Committee must review the October 4, 2011 "Report of the Paediatric Palliative Care Work Group" and may adopt its recommendations with or without modifications.
The Committee must prepare an annual report of recommendations on or before May 4 each year; the Minister must publish each annual report online and table it in the Legislative Assembly as soon as possible after receipt.
Section-by-Section Breakdown
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Minister must develop, publish and amend a provincial strategy
This provision creates the core duty: the Minister must develop and implement a paediatric hospice palliative care strategy focused on improving access and quality to create equity across the province. It mandates the inclusion of family supports and places a one-year deadline for producing and publishing a report that sets out the strategy; it further requires ongoing assessment and public reporting of any amendments. Practically, this shifts responsibility for coordinating paediatric hospice palliative services to the provincial level and ties implementation to explicit transparency obligations.
Establishes a statutory advisory committee with a precise mandate
This section creates the Paediatric Hospice Palliative Care Advisory Committee and defines its duties: advising the Minister on development, implementation and effectiveness of the strategy and producing an annual report of recommendations by May 4. It requires the Committee to review a prior 2011 work group report and gives it authority to adopt those recommendations as appropriate. Membership rules (5–9 members, majority regulated health professionals, specified geographic representation, family-member seats) are statutory, making the committee a permanent, structured mechanism for stakeholder input rather than an ad hoc advisory table.
Regulations to fill in operational detail
The Minister may make regulations to prescribe geographic regions for committee composition, set committee procedures (including how recommendations are made), and prescribe duties and responsibilities of committee members. These delegated powers are broad and designed to operationalize the Act’s framework, but they also leave significant implementation detail to regulation rather than the statute itself.
Coming into force and short title
The Act comes into force on Royal Assent and is formally titled the Nancy Rose Act (Paediatric Hospice Palliative Care Strategy), 2026. The immediate commencement means the one-year clock for the report begins on assent and creates a fixed deadline for the Minister’s first public strategy document.
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Explore this topic in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Children who need hospice palliative care — a province-wide strategy aims to standardize access and quality so children in underserved regions may receive care comparable to urban centres.
- Families of children receiving palliative care — the statute requires targeted family supports, including mental health services, which should increase available psychosocial resources and caregiver supports.
- Paediatric palliative clinicians and program planners — a formal strategy and advisory committee create clearer expectations and avenues to influence provincial priorities and funding decisions, improving coordination across hospitals, hospices and community providers.
Who Bears the Cost
- Ministry of Health — responsible for drafting, implementing, continually assessing and amending the strategy, publishing reports, and administering the advisory committee; this will demand staff time and potential new program management costs.
- Hospitals, hospices and community providers — may face expectations to expand services or meet new provincial standards without guaranteed new funding, creating operational and fiscal pressure on local providers.
- Regulated health professionals and family members who sit on the advisory committee — will incur time commitments for committee work and reporting; the committee structure may also require travel or administrative support funded by the government.
Key Issues
The Core Tension
The central dilemma is between establishing a province-wide, accountable framework to promote equity and preserving local flexibility and resource realities: the Act mandates a transparent strategy and advisory process but gives no funding floor or objective metrics, so the government must choose whether to use the new powers to set binding standards (which could strain local providers) or to produce a permissive roadmap that risks limited change on the ground.
The Act creates a framework for provincial leadership but stops short of providing funding or prescribing standards, leaving the most consequential choices—service levels, staffing, eligibility and financing—to the Minister and future regulations. That gap means the strategy’s impact will depend on policy choices and budgetary commitments made after the initial report, not on the Act itself.
The combination of a tight one-year deadline for producing the strategy and an open-ended requirement to continually amend it risks producing an initial plan that prioritizes speed over detailed implementation design.
The advisory committee’s composition and mandate embed both technical expertise and lived experience, but the statutory requirement that a majority be regulated health professionals creates a potential imbalance between clinical priorities and family-centered perspectives. The regulations clause gives the Minister broad authority to set geographic regions and committee procedures, which is necessary for operational detail but concentrates significant discretion in the executive branch; the statute does not prescribe metrics for measuring "equity of access," leaving measurement choices and accountability criteria to future policy work.
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