What is the Mandatory Blood Testing Act?
The Mandatory Blood Testing Act, 2006 (MBTA) allows eligible persons (the “Applicant”) who have come into contact with the blood and body fluids of another person to apply, within 30 days of exposure, to the Medical Officer of Health to have a blood sample of the person whose bodily substance they have come into contact with (the “Respondent”) tested for HIV, hepatitis B, and hepatitis C.
Who does the MBTA apply to?
The MBTA applies to persons who have come in contact with another’s blood or body fluids in any of the following circumstances:
- As a result of being the victim of a crime.
- While providing emergency health care services or emergency first aid to the person, if the person was ill, injured, or unconscious as a result of an accident or other emergency.
- In the course of their duties, if the person belongs to the following groups:
- Persons working in a correctional institution, in a place of open custody, or place of secure custody;
- Police officers, employees of a police force who are not police officers, First Nations Constables, and auxiliary members of a police force;
- Special constables who are not employees of a police force.
- Firefighters (including volunteer firefighters);
- Paramedics and emergency medical attendants;
- Paramedic students in field training;
- Members of the College of Nurses of Ontario;
- Nursing students engaged in training;
- Members of the College of Physicians and Surgeons of Ontario; and
- Medical students engaged in training.
Application Process
Anyone who believes they have been exposed to a communicable disease as a result of coming into contact with blood or body fluid of another person should immediately contact a medical professional who can help assess the risk of infection and decide whether to start treatment or preventive measures.
Applications must be submitted to the Medical Officer of Health in the health unit where the Respondent lives.
Role of the Medical Officer of Health (MOH)
The Medical Officer of Health (MOH) screens applications to make sure they meet the requirements of the Act. If the requirements are met, the MOH shall,
a) immediately refer the application to the Consent and Capacity Board (CCB);
b) attempt to contact the Respondent
- request the Respondent to provide either a voluntary blood sample or other evidence of seropositivity;
- advise the Respondent that the application has been referred to the Board; and
- if the Respondent fails to provide a blood sample or other evidence voluntarily, the CCB may make an order requiring the Respondent to provide the blood sample.
Role of the Consent and Capacity Board
The CCB is an independent body that conducts hearings under the Mental Health Act, the Health Care Consent Act, the Personal Health Information Protection Act and the Substitute Decisions Act. The members of the Board include psychiatrists, lawyers, and members of the public.
The CCB will begin and complete the hearing and make its decision within five business days after receiving a referral of an application. In certain circumstances, the CCB may begin or complete the hearing within a longer period than the five business days.
The CCB will provide the Applicant, the Respondent and the MOH with a copy of the CCB’s decision and a copy of any order made by the CCB.
- A decision of the CCB is final. There is no right of appeal. However, both the Applicant and the Respondent have the right to apply for a judicial review of the decision by the Superior Court of Justice.
- The Respondent has two business days from the date the order is made to comply.
- If the Respondent voluntarily complies, they get a blood sample taken by a health care provider. The Respondent may also provide other evidence of whether they are infected with one of the listed communicable diseases. This evidence may include a Laboratory Report, or a report or letter signed by a physician.
- If the Respondent does not comply with an order made by the CCB, the Applicant may apply to a judge of the Superior Court of Justice for an order requiring the Respondent to comply with the order of the CCB.
Withdrawal of Application
The Applicant may withdraw their application at any time prior to a Board hearing taking place. The Applicant must follow the CCB’s Rules of Practice by informing the health unit where the application was submitted and the CCB in writing (preferably by email, or by fax). If an Applicant has done so the CCB shall terminate the hearing.
Blood Sample Process
The following processes are applicable to blood samples provided both voluntarily or by order of the CCB.
Identification of Respondent
At the time of the blood test, the Respondent must present valid photo identification. If the Respondent does not have photo identification they will be required to provide two pieces of identification with both their name and signature. If proper identification is not produced, the blood sample will not be taken.
Notification Protocol for Blood Sample Results
The Public Health Ontario Laboratory will send the results of the blood test to the Applicant’s and Respondent’s physicians. At the same time, notice is sent to the Applicant and Respondent that the results of the blood test have been sent to their respective physicians.
Penalty for non-compliance
Anyone who fails to obey an order made by the CCB is guilty of an offence and is liable on conviction to a fine of not more than $10,000 for every day or part of a day on which the offence occurs or continues (up from $5,000 per day) and an added term of up to 6 months imprisonment.
Questions?
If you have further questions about the MBTA, please call 519-258-2146 extension 1420, to speak to a Public Health Nurse.
Forms
All relevant forms such as those listed below can be accessed via the Government of Ontario's Central Forms Repository. All forms are now bilingual, electronic, and AODA compliant.
- Physician Report (Form 1) - As a physician, your role may vary within the process. Nurse practitioners or physicians may take blood in the voluntary process or in the event of an order. However, only physicians can complete the physician report.
- Applicant Report (Form 2)
- Respondent Report (Form 3)
- Laboratory Requisition Form (Form 4)
The forms are to be faxed to the WECHU - Infectious Disease Prevention Department at 226-783-2132.
Other forms
- MBTA: Ontario Central Forms Repository - Form Search Results (gov.on.ca)
- WSIB: Forms: Business | WSIB
- Workplace Incidents and Illnesses: Reporting workplace incidents and illnesses | ontario.ca
References
- Government of Ontario. (2023). Mandatory Blood Testing Act, 2006, S.O. 2006, c. 26. Retrieved from https://www.ontario.ca/laws/statute/06m26
- Ontario Hospital Association., & Ontario Medical Association Joint Communicable Diseases Surveillance Protocols Committee. (2018, November). Blood-borne Diseases Surveillance Protocol for Ontario Hospitals.
For more information
Ontario: Mandatory Blood Testing Act, 2006
Ontario Ministry of Health https://www.ontario.ca/page/mandatory-blood-testing