This Bill creates a statutory framework to reduce Ontario hospitals’ and long‑term care homes’ reliance on for‑profit staffing agencies and to increase public oversight of agencies that receive government money. It requires each eligible care provider to produce and publish a time‑bound plan to limit agency spending and sets new structural rules for the staffing sector.
The measure is consequential for workforce strategy: it rewrites market incentives (by limiting premium pay and restricting recruiting practices), imposes reporting and transparency duties, and brings some agencies under provincial watchdogs. Compliance and transition planning will be immediate operational priorities for health employers and staffing providers.
At a Glance
What It Does
The Act requires eligible hospitals and long‑term care homes to prepare publicly available, regularly updated plans that progressively reduce their spending on third‑party staffing until agencies are no longer used. It also imposes conditions on staffing agencies—new agencies must be not‑for‑profit, some agencies face enhanced oversight, and the bill caps how much agencies may pay workers assigned into public facilities.
Who It Affects
Directly affects Ontario hospitals and long‑term care homes located in municipalities of 8,000 people or more, private and not‑for‑profit staffing agencies that supply those facilities, and agency workers deployed into the public sector. Provincial oversight bodies and ministry regulators will also gain new supervisory responsibilities.
Why It Matters
The Act changes both demand‑side rules for employers and supply‑side structure for agencies, shifting incentives away from short‑term, premium staffing. For compliance officers and procurement leads, the bill creates near‑term planning, reporting, and operational constraints; for agency operators it creates new organizational and financial limits.
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What This Bill Actually Does
The bill makes three linked moves: require planning and public transparency from care providers, reconfigure the legal and oversight status of staffing agencies, and set behavioural limits on how agencies operate in public facilities. Hospitals and long‑term care homes in municipalities with at least 8,000 residents must produce a publicly accessible plan within six months of the Act coming into force and update it every six months.
Each plan must explain prior projected and actual spending on agency staff, non‑agency staffing expenditures for the same period, and specific measures to keep patient care safe during the transition away from agencies. The nurse leader (the individual in charge of nursing care) must play a leadership role in drafting the plan.
The substance of the plans is prescriptive: they must implement a stepped reduction in agency spending based on municipality size, with progressively tighter caps at six and 12 months and a full cessation of agency use after 24 months. The bill sets different percentages for large, medium and smaller municipalities, and requires facilities to follow those timelines in their plans.
During the transition, hospitals and homes must report on and make public the amounts expected and actually spent on agency staffing.The bill also alters the structure and oversight of the staffing market. Any staffing agency created after the Act comes into force must operate as a not‑for‑profit corporation.
Agencies that receive above a statutory threshold of provincial funds become subject to oversight by multiple watchdogs named in the Act and must have their employees listed on Ontario’s public “Sunshine List.” The Act limits the premium an agency may pay a worker assigned into a hospital or long‑term care home (it cannot exceed a specified percentage above the facility’s existing rate) and requires that transportation, accommodation and per diem charges billed to facilities be disclosed, paid directly to the worker, and subject to ministerial limits. The bill bans agencies from recruiting (poaching) current facility employees and prohibits assigning workers who currently work for, or left within the past 12 months from, a facility in the same or adjacent Ontario Health Team.Enforcement is primarily penal: violating the anti‑poaching rule triggers an offence provision with a significant maximum fine and the Act directs that collected fines be used to support hospitals and long‑term care homes.
The Minister of Health may make regulations to prescribe limits on charges. The Act takes effect on Royal Assent.
The Five Things You Need to Know
Hospitals and long‑term care homes in municipalities with populations of 8,000 or more must publish a plan within six months and update it every six months.
The plans must follow a three‑step reduction schedule that ends with a prohibition on using staffing agencies after 24 months (the caps differ by municipality size).
Any staffing agency created after the Act’s commencement must be incorporated as a not‑for‑profit under the Not‑for‑Profit Corporations Act, 2010.
An agency that receives more than $400,000 in total from the Government of Ontario or its transfer payment agencies becomes subject to oversight by the Auditor General, Patient Ombudsman, Ontario Ombudsman and Integrity Commissioner and must include its employees on the Sunshine List.
The Act bans poaching, forbids assigning workers who still work for or recently left (within 12 months) a facility in the same or adjacent Ontario Health Team, caps premium pay for assigned workers (no more than 10% above the facility’s rate), and exposes violators to fines up to $1,000,000.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
Definition of 'healthcare staffing agency'
This short definitional provision focuses the Act on agencies that provide workers to hospitals or long‑term care homes for a fee. That scope excludes staffing arrangements that do not involve fee‑for‑service agencies and anchors later prohibitions and obligations to this class of provider.
Plans to limit agency spending — who, timing and content
Hospitals and long‑term care homes in municipalities of 8,000+ must create public plans to limit agency spending. The provision prescribes a strict schedule: develop within six months, update every six months, and include: expected vs actual agency spending for the previous six months, staffing spending excluding agencies, and transition measures to protect patient care. The Act gives the nurse leader a defined leadership role in plan development, which channels responsibility into clinical leadership rather than solely finance or procurement.
Population‑based spending caps and phase‑out timeline
This subsection sets the numeric glide path: three tiers based on municipal population (500,000+, 100,000–499,999, and 8,000–99,999). Each tier has specific percentage caps at six and 12 months and then requires cessation of agency use at 24 months. The prescriptive nature forces facilities to convert temporary staffing strategies into near‑term recruitment and retention plans or seek ministry relief mechanisms not included in the text.
New agencies must operate as not‑for‑profits
Any agency incorporated after the Act’s commencement must be organized under the Not‑for‑Profit Corporations Act, 2010. That structural rule aims to change market incentives by removing for‑profit status from new entrants, but it does not directly retroactively alter existing for‑profit agencies.
Oversight triggers and transparency for government‑funded agencies
An agency that receives over $400,000 in total from the provincial government or transfer payment agencies falls within expanded oversight: the Auditor General, Patient Ombudsman, Ontario Ombudsman and Integrity Commissioner all obtain oversight roles. The section also requires inclusion of the agency’s employees on the Sunshine List, increasing public visibility into pay when an agency is materially supported by government funds.
Pay caps, charge rules, assignment limits and anti‑poaching offence
The Act caps how much an agency can pay a worker assigned into a facility (no more than a fixed percent above the facility’s existing rate) and requires that travel, accommodation and per diem charges billed to facilities be disclosed, paid directly to staff, and subject to ministerial limits. Agencies are forbidden from poaching current facility employees; assigning staff who still work for, or left within the past 12 months from, the same or adjacent Ontario Health Team is expressly banned. The anti‑poaching prohibition is criminalized with a maximum fine of $1,000,000 and fines are earmarked to fund hospitals and long‑term care homes.
Regulations, commencement and short title
The Minister may make regulations prescribing limits to charges (which implements the per diem/transport/accommodation disclosure rule). The Act commences on Royal Assent and carries a short title. There is no express delegation of exemptions, temporary waivers, or hardship relief within the text — the regulation power is the primary operational tool to fill gaps.
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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
- Hospitals and long‑term care homes (financial control): Facilities gain statutory tools to reduce agency spending and will receive any fines collected to support operations, which can help reallocate funds to core staffing and care delivery.
- Permanent clinical staff and unions: Existing employees gain protection from active recruitment by agencies and from being assigned away under the Act’s assignment and anti‑poaching rules, strengthening employer retention efforts.
- Patients and the public: The requirement for publicly available plans and increased oversight of government‑funded agencies raises transparency and creates a statutory imperative to plan for continuity of safe care during workforce transitions.
Who Bears the Cost
- For‑profit staffing agencies (business model disruption): Existing agencies face reduced demand from public facilities, new entrants must incorporate as not‑for‑profits, and those receiving government funds face heavier oversight and disclosure requirements.
- Agency workers seeking premium short‑term income: The pay cap (a fixed percent above facility rates) reduces the financial upside of agency shifts in public facilities and may limit earning opportunities that previously attracted casual agency staff.
- Hospitals and long‑term care homes (operational transition): Although the Act targets agency use, facilities must shoulder recruitment, onboarding, scheduling and potentially increased HR and payroll costs to replace agencies; they also must produce and update substantive plans every six months.
Key Issues
The Core Tension
The central dilemma is between controlling public spending and protecting system capacity: the Act forces a rapid retreat from costly agency labour to curb expenditures and increase transparency, but doing so without guaranteed alternative staffing supply or transition funding risks harming patient access and frontline capacity—especially in smaller communities and specialized services.
Implementation raises several operational and legal questions the Act leaves unresolved. The 24‑month prohibition on agency use treats agency staffing as a temporary contingency rather than an ongoing market feature; in jurisdictions or specialties with chronic shortages (e.g., rural nursing, specialized allied health), a hard date to end agency use risks service gaps unless the province or facilities deploy parallel recruitment and retention funding.
The Act gives facilities an obligation to plan and report but does not include dedicated transition funding, explicit temporary exemptions for surge events (pandemics, mass absences), or an appeals process for facilities that cannot meet the numeric glide path.
The structural interventions also create enforcement and definitional challenges. The anti‑poaching and assignment bans hinge on terms like "poach," "assign," "adjacent Ontario Health Team," and what counts as the facility’s "existing rate"—each a likely source of disputes, grievance filings under collective agreements, and judicial interpretation.
The oversight threshold ($400,000) focuses scrutiny on agencies that receive sizable provincial funding but leaves many private agencies that operate largely on market revenue outside the enhanced oversight regime. Finally, the rule that new agencies must be not‑for‑profit will reshape capital, ownership and investment models for the sector, but the Act offers no transitional framework for existing for‑profit firms nor guidance on how government contracting practices will change to reflect the new landscape.
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