Sexual Health

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Questions and Answers

Why does the Mandatory Blood Testing Act Exist?
History and Legislation and Help
Definition Applicant
Definition Respondent
What is the role of the Consent and Capacity Board?
How do I submit an Application?
How is an application processed?
How can I protect myself before an exposure occurs?
Information for the Respondent
More Information and Links


Why does the Mandatory Blood Testing Act (MBTA) exist?

The intention of the MBTA is to protect those who may have been exposed to the blood or body fluids of others. It allows individuals who are eligible to apply to request the person whose blood they were exposed to, to submit to a blood test and to share the results. Where the person refuses the request, an order may be written to make the person submit to the testing and to share the results.

Under the Act, testing can be ordered for hepatitis B, C and HIV, although the Act allows for the addition of other diseases.

What is the process for mandatory blood testing?

The process is complex and must follow strict procedures and timelines. For example, if you are eligible to apply, you must submit your application to the medical officer of health within 7 days of your exposure.

Whether you are an applicant, applying to request testing of another’s blood, or the person named to have blood tested, called the respondent, you will find information on this site which explains:

Additional links are provided throughout the question and answer section to help you find forms, look for more information, or learn where to get help.

If you have experienced an exposure to another person’s blood or body fluids, it is important that you be assessed by a health care provider to determine your risk to infection and to get appropriate and timely treatment to prevent transmission of disease.

Staff at the Simcoe Muskoka District health Unit can provide information and support related to an accidental exposure to another person’s blood or body fluids.

Call the health unit at 705-721-7520 or 1-877-721-7520 Monday to Friday 8:30 -4:30 and ask to speak with a nurse in the sexual health program. For after-hours help about an exposure, call 1-888-225-7851.

History, Legislation and Help

History of Bill 105

Bill 105 was a Private Member’s Bill introduced in 2001 in response to calls from first response providers (fire, police and ambulance personnel) for compulsory testing for hepatitis B and C and HIV in persons who are believed to be the source of occupational exposure, and who refuse to be tested on a voluntary basis.

The bill received royal assent on December 14, 2001. Ontario Regulation 166/03, made under the Act, set the requirements and procedures with respect to an application. The amendment to the Health Protection and Promotion Act and regulation went into effect in September 2003

The Mandatory Blood Testing Act, 2006

In August of 2007, the section 22.1 of the HPPA was repealed. The new Mandatory Blood Testing Act and its regulation then came into effect. The intent of this new legislation is to shorten the time needed to obtain a mandatory blood test and to broaden eligibility to apply. .

The new law enables police officers, firefighters, correctional services staff, paramedics, nurses and others who in the course of their work may be exposed to the blood or body fluid of others, to apply to request information about the source person’s blood with respect to hepatitis B, C and HIV. Under the legislation, good Samaritans are eligible to apply as well, when an exposure to blood or body fluids has occurred while providing emergency first aid of health care.

Legislation Documents

The Mandatory Blood Testing Act which directs the process for blood testing is available online at www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_06m26_e.htm

Ontario Regulation 449/07, made under the act, sets the requirements and procedures which must be followed with respect to an order for compulsory blood testing; it is available online at:
www.e-laws.gov.on.ca/html/regs/english/elaws_regs_070449_e.htm

Where to get help

The Ministry of Community Safety and Correctional Services provides additional information at http://www.mcscs.jus.gov.on.ca/english/LinksResources/MandatoryBloodTesting/
blood_testing.html
.

Simcoe Muskoka District Health Unit staff are available to answer questions and provide support. Please click on Health Connection at the bottom of this page to email your questions or call 705-721-7520 or 1-877-721-7520 and ask for Sexual Health at extension 8376.

Applicant Defined

The person wishing to apply to have another person’s blood tested is called the applicant.

To be eligible to apply, the applicant must have come into contact with the other person’s body fluids:

  • while providing emergency health care
  • giving emergency first aid
  • as a victim of a crime
  • in the course of his or her duty when the applicant belongs to a specified class or group of people.

These groups are:

    • persons who are employed in a correctional institution, place of open custody or place of secure custody
    • police officers, civilian employees of a police service, First Nations constables and auxiliary members of a police service
    • firefighters (including volunteer firefighters)
    • paramedics and emergency medical attendants and paramedic students on field placement
    • members of the College of Nurses of Ontario
    • members of the College of Physicians and Surgeons of Ontario
    • medical students engaged in training

To be eligible as a victim of a crime, a police report must have been filed and the applicant must consent to disclose this information if asked.

There are requirements that must be met in completing and submitting an application which are more fully described in the next section.
Note: Your completed application must be received by the health unit within 7 days of the exposure.

See submitting an application

Respondent Defined

The respondent is the person who has been identified by the applicant as the person whose body substances the applicant may have come into contact with. The respondent is the person who may be ordered to submit to a blood test.

There are many requirements and legal criteria which must be met to result in an order for mandatory testing of the respondent’s blood. An application does not always mean that mandatory testing will be ordered. There is also an opportunity within the process for the respondent to voluntarily provide this information.

If you have been named as the respondent and want to learn more, click on information for the respondent.

What is the Role of the Consent and Capacity Board?

The Consent and Capacity Board 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 general public.

The Consent and Capacity Board must begin and complete a hearing within seven days after receiving a referral of an application and must make its decision within one day of the hearing ending.

The board will provide the applicant, the respondent and the medical officer of health with a copy of their decision and a copy of any order made.

A decision of the board 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.

Submitting an Application

How do I apply?

Links to the forms needed for the application:

Instructions are provided on the form. It is important to follow all of the steps on the form and to answer all the questions and complete all fields. If the application is not complete, it may not be accepted by the medical officer of health.

How long do I have to submit an application?

Your application, which includes both the applicant report and the physician report, must be received at the health unit within 7 days from the time you have been exposed. If the application is not received within seven days, it will not be processed.

How do I count the days to make sure I meet the deadline?


The day the exposure occurred is day zero. Begin counting at 1 on the next day and include Saturdays, Sundays and holidays. The legislation states that if the deadline, or your 7th day, falls on a Saturday, Sunday or holiday, you may extend the deadline by one day.

Where do I send the application?


An application is processed by the health unit responsible for the area where the respondent lives. For help in identifying which health unit is the correct one, you may call the Simcoe Muskoka District Health Unit or The Ministry of Health’s INFOline at 1-866-532-3161.

However, you may drop off or fax your application to any Ontario health unit and it will be forwarded to the correct one. To meet the deadline, please drop off or fax both completed forms to any health unit no later than 4 pm on the 7th day.

What kind of information is asked for on the forms?

As the applicant you must:

  • provide a description of the circumstances of the occurrence and the details of the exposure and your injury
  • provide your immunization history
  • include the name and address of the person whose blood you are applying to have tested
  • agree to counselling about the exposure and treatment options
  • agree to have your blood tested for the three diseases, HIV, hepatitis B and hepatitis C
  • provide consent for the release of information about your blood test results, if asked, to the Consent and Capacity Board
  • give consent for the release of information on the police report if you were the victim of a crime.

Will my personal information on the application be shared?

Your application will be read by the medical officer of health and by members of the Consent and Capacity Board if your application is forwarded for an order.

Your blood test results will be shared with the doctor who completed the physician report, your family physician if named, and with the Consent and Capacity Board members if requested.

None of your personal information will be shared with the respondent.

Processing an Application

How long does the whole process take?

The regulations to the act require specific time lines be followed. Despite the shortened time frames intended by the legislation, the process itself has many steps and time will vary depending on many factors.

What are the steps in the process?

a) Voluntary Process

  • When an application is received by the correct health unit and all requirements are met, it proceeds to the voluntary stage. This means that the medical officer of health assigns a public health nurse to contact the respondent and ask that he or she voluntarily provide either a blood sample to test for the three diseases, or evidence of testing that was done within the past four weeks for hepatitis B and C, and HIV
  • Two days is allowed for this stage of the process.
  • If after two days the respondent cannot be reached, the application is forwarded to the Consent and Capacity Board who will hold a hearing within seven days.
  • The public health nurse continues to try to reach the respondent and if successful, will notify the Consent and Capacity Board and ask to have the application withdrawn (as long as the hearing hasn’t yet started).
  • When the respondent is contacted, the public health nurse will explain the request and keep information about the applicant confidential.
  • The nurse will help the respondent to arrange for blood testing for hepatitis B and C, and HIV. The respondent will be asked to sign a consent form giving permission for the test results to be shared with the medical officer of health, the respondent’s physician and the applicant’s physician.
  • The respondent must show identification when he or she has the testing done. The person taking the blood is required to carefully handle the specimens, send them to the Central Public Health Lab in Toronto and ask for immediate analysing.
  • When the test results are received by the medical officer of health, the results will be immediately forwarded to the applicant’s physician. The applicant is notified and asked to make an appointment with his or her doctor so that testing results can be interpreted to the applicant.

b) Order Process

  • When the respondent cannot be reached within two days or when the respondent refuses to voluntarily provide the information requested, the application is forwarded to the Consent and Capacity Board.
  • The Consent and Capacity Board now has seven days to start and conclude a hearing and one more day to make a decision about whether to issue an order compelling the respondent to provide a sample.
  • The hearing is public and any person involved with the application may be called as a witness.
  • The applicant, respondent and medical officer of health will be notified of the decision made by the board.
  • When a respondent is ordered to provide a blood sample he or she must do so within seven days of the order.
  • If the respondent does not comply with an order made by the board, 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 board.
  • A person who does not comply to the order could be fined up to $5,000 per day.
  • When an order is written and the respondent complies, the respondent is provided with a laboratory requisition and must go to a designated person to have the blood drawn. The respondent must bring identification.
  • The results of the blood tests will be sent to the applicant’s physician and the applicant is notified to make an appointment with his or her physician to have the results interpreted.

Can a respondent’s blood sample be used for any other purpose?

No. The blood sample is not used for any purpose other than for the testing specified in the order.

The sample is not released to anyone except those working in the Central Public Health Lab. The results of the testing cannot be disclosed to anyone except as is necessary for the purpose of analyzing the sample and providing the required reports and notices as stated in the order.

It is important for you to know that the results of blood testing under the Mandatory Blood Testing Act cannot be used in a criminal proceeding.

How can I protect myself before an exposure occurs?

The health unit advises everyone to protect their health by always applying routine practices when in contact with blood or body fluids of other people and to be sure that immunizations are up-to-date.

  • universal precaution information (LINK)
  • Hepatitis B vaccination information
  • vaccine schedule for adults

If you have more questions about blood or body fluid precautions or immunization, email Your Health Connection or call 705-721-7520 (1-877-721-7520).

Information for the Respondent

The respondent is the person who has been identified by the applicant as the person whose blood or body fluids the applicant may have come into contact with. The respondent is the person who may be ordered to submit to a blood test.

Under what circumstances might I be asked to provide a blood sample?

You may be asked to provide a blood sample in a situation where:

The person who was exposed to your bodily substance belongs to one of the classes, or groups of people who are eligible to apply, such as police officers, security guards, paramedics or nurses or when a person was exposed to your body fluids, in one of three circumstances:

  • while you were being provided with emergency health care
  • while you were being given emergency first aid, or
  • during an alleged crime against that person, for which there is a police report.

How would I be notified about this?

You may be approached by the individual (applicant) to ask for your relevant blood test information before that person submits an application. You may also be asked to volunteer to have testing done.

However, once the individual has submitted the application to the medical officer of health and it meets the requirements to proceed, you will be contacted by a public health nurse from the health unit. Initial contact may be by phone and a meeting may be arranged to discuss the process further with you.

What if I already know my hepatitis B, C or HIV status?


You will be asked to confirm the results of prior testing for these three communicable diseases, hepatitis B, hepatitis C and HIV. You will be asked to sign consent for the release of this information from your doctor to the medical officer of health. Only those results from tests done very recently (within the 4 weeks preceding the incident) will be accepted.

What happens if I agree to be tested?


You will be asked to agree to have a blood sample taken to test for hepatitis B, hepatitis C and HIV. A requisition will be given to you and arrangements made to have the testing done at a lab or in one of the Health Unit’s sexual health clinics. There is no cost to have your blood tested. You will also be asked for your consent to release test results to the medical officer of health and for your permission for these results to be share with applicant’s physician.

Can I refuse to submit to a blood test?

Yes, however, when you refuse, the application is sent immediately to the Consent and Capacity Board who will hold a hearing to decide whether to write an order which would force you to submit to a blood test.

You will have a chance to share with the board any information about your refusal or an explanation of your situation before the hearing. The public health nurse will give you with a form to write this information on. The form can then be faxed to the board. You could be called to be present at the hearing held by the Consent and Capacity Board.

At the hearing, the Consent and Capacity Board will carefully consider the application following the requirements in the regulations to the act. The application may be dismissed, or an order may be made which requires you to have the blood testing and/or release previous test results done for hepatitis B and C or HIV. The order will specify who will draw your blood and where it will be sent to be analysed. The order will also require the results of the tests to be released to the medical officer of health, your doctor (if one is named) and the applicant’s doctor.

Can I refuse an order?

There is no right of appeal of the board’s decision. It is important to know that a refusal may result in a fine of up to $5,000 per day.

What if I don’t have a family doctor?

If you volunteer to have the testing, a public health nurse from the health unit will help you to make arrangements to be tested in one of the Health Unit’s sexual health clinics.

If the testing is ordered by the Consent and Capacity Board, then the order will specify who will draw the blood.
In both situations, you must bring photo identification or two pieces of identification with your signature, to the appointment when blood is drawn.

Where does my blood sample go for testing?

Whether you volunteer for testing or it is the result of an order, the blood that is drawn for testing is sent by courier to the Central Public Health Lab in Toronto for analysis. Only two small tubes of blood are needed for the testing. The blood is carefully packaged and sealed for transport and is kept secure throughout the process.

What happens with the results?

If you volunteer for blood testing, the results are sent to your doctor (if you ask for this to be done) and to the medical officer of health. In this case, the medical officer of health shares the results of your tests with the applicant’s doctor. This doctor interprets the results to the applicant.

When the tests are ordered, the Central Public Health Lab must send the results to your doctor and to the applicant’s doctor.

Can my blood sample be used for any other purpose?


No. Your blood sample is not used for any purpose other than for the testing specified in the order. The sample is not released to anyone except those working in the Central Public Health Lab. The results of the testing cannot be shared with anyone except as is necessary for analyzing the sample and providing the required reports and notices as stated in the order.

It is important for you to know that the results of your blood testing cannot be used in a criminal proceeding.

Where can I get more information?

Here are some resources about this new legislation that may be helpful:

Mandatory Blood Testing Act – directs the process for blood testing.

Ontario Regulation 449/07 – sets the requirements and procedures which must be followed with respect to an order for compulsory blood testing.

Ministry of Community Safety and Correctional Services – provides additional information.

Health Unit staff are available to answer questions and provide support. Please email Your Health Connection or call 705-721-7520 (1-877-721-7520) and ask for Sexual Health at extension 8376.

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