Health Law, Access to Medications, HIV Testing, Public Health

Depending on our resources and the issue, HALCO may provide free summary advice and/or representation to people living with HIV in Ontario. If we cannot assist, we will do our best to provide information and referrals to other services.

We may be able to assist with the following matters:

  • Access to Medications
  • Access to Medical Care (for example, Ontario Health Insurance Plan (OHIP), Canadian Dental Care Plan (CDCP))
  • HIV Testing (with limited exceptions, only for people living with HIV)
  • Public Health Issues (for example, section 22 Orders, contact tracing)

The Steps to Justice Website offers step-by-step information about health law and other common legal problems: https://stepstojustice.ca/legal-topic/health-and-disability/

Access to Prescription Drugs

There are different ways that low-income people who do not have access to government or private plans can get HIV-related drugs, and maybe some other drugs. For more information, contact the Blue Door Clinic https://www.bluedoorclinic.org/, telephone: 437-235-7423.

Ontario Drug Benefit Program (ODB)

The Ontario Drug Benefit program (ODB) provides prescription drug coverage for eligible Ontario residents. For information about ODB, see here: https://www.ontario.ca/page/get-coverage-prescription-drugs#section-0  

Eligible people will qualify for ODB when they turn 65 years old. People will qualify before age 65 if they are:

Note that beginning on April 1, 2019, OHIP+ will no longer be universal:

  • OHIP+ will continue for people age 24 and under who do not have private insurance.
  • People age 24 and under who receive Ontario Works/Ontario Disability Support social assistance or home care, or who are resident in certain care homes will be eligible for ODB without any deductibles or co-payments, whether they have access to private insurance drug coverage or not.
  • People age 24 and under who are in any way captured by private insurance drug coverage will no longer have any drug coverage under OHIP+. It does not matter whether the private insurance actually covers the drug(s) prescribed, or if there are deductibles, co-payments or other limits. If they or their families are left with significant prescription drug costs that are not covered by the private insurance, they can access the Trillium Drug Program (the Trillium Drug Program requires the payment of an annual deductible based on household net income and a co-payment for each prescription).

For more information about prescription drugs, as well as dental and vision benefits for low-income Ontarians, please see the Income Security Advocacy Centre guide: https://incomesecurity.org/new-resource-guide-to-health-benefits-in-ontario/

ISAC has created two new public resources to ease the transition for clients turning 65 and leaving social assistance.

• Living on OW/ODSP and turning 65? Top 5 Tips on Protecting your Income When Turning 65: A resource for seniors to help them plan for these changes, including tips on filing taxes annually, understanding when and how to apply for seniors’ benefits, how to keep their social assistance health benefits, and how to avoid paying fees for prescription drugs.

• Is your patient turning 65 and receiving social assistance? Top 5 Things You Can Do to Help Seniors Maintain their Income and Health Benefits when Turning 65: Tips for healthcare and social service providers to help their patients/clients navigate changes to their income and health benefits. The resource highlights the referrals and actions needed before the patient/client turns 65.

Access to Medical Care

There are different ways that low-income people who do not have access to government or private plans will be able to get access to HIV-related medical care, and maybe other care. For more information, contact the Blue Door Clinic https://www.bluedoorclinic.org/, Telephone: 437-235-7423.

Ontario Health Insurance Plan (OHIP)

The Ontario Health Insurance Plan (OHIP) pays for many health services for residents of Ontario. For information about OHIP, see here: https://www.ontario.ca/page/apply-ohip-and-get-health-card

Canadian Dental Care Plan (CDCP)

The Canadian government has launched the Canadian Dental Care Plan (CDCP) to assist eligible individuals with dental costs. Various dental services are included, including cleanings, x-rays, fillings and root canals. Some services require pre-approval by CDCP.

Information about CDCP can be found here: https://www.canada.ca/en/services/benefits/dental/dental-care-plan.html 

Note about Health Information Privacy

The Ontario government provides some health professionals with access to people’s drug and pharmacy services information. More information, including how to block access, can be found here: https://www.ontario.ca/page/health-care-provider-access-drug-and-pharmacy-service-information

Health care professionals, including doctors and registered nurses, owe their patients a duty of confidentiality. However, there are situations where health care professionals are permitted to release a patient’s health care information without the patient’s consent. This webpage does not address privacy law issues. For privacy-related information, please see the Privacy Law page of our website: www.halco.org/areas-of-law/privacy-law.

HIV Testing and Reporting in Ontario

Self-Testing

In the past, HIV testing was only accessible through a healthcare provider or a designated testing site. Recently, some people have been able to get HIV self-testing kits that allow them to test on their own or with the help of others such as community organizations. If someone tests positive for HIV using a self-testing kit, they will have to get a confirmatory test (anonymous or nominal) before they can get medical care for HIV. For more information about self-testing, see here: https://www.halco.org/wp-content/uploads/2023/10/HALCO_HIV-self-testing_September-2023-2.pdf. For a statement from HALCO and others about the importance of a human rights-based approach to HIV self-testing, see here (English) and here (French).

Informed Consent

Other than in very unique circumstances, people have a choice whether to be tested for HIV or not. People must give their informed consent to a health professional before getting an HIV test. This means that before the test, a healthcare provider must tell the person:

  • about the different testing options (nominal and anonymous) and what can happen after the test
  • whether their name or other personal information will be shared with Public Health authorities in Ontario

The person being tested should also be offered pre- and post-test counselling.

Types of HIV Testing – Nominal and Anonymous

Other than self testing, there are two main ways in Ontario to get tested for HIV infection: nominal testing (using people’s name) and anonymous testing (not using people’s names). The key difference between getting a nominal or anonymous test is that the person’s HIV positive test result and other personal information, including their name and contact information, will automatically be reported to their local Public Health Unit if they test positive nominally. People may need OHIP coverage to get a nominal test for free. People do not need OHIP coverage to get a free anonymous test, and only a designated anonymous testing site can provide HIV testing without using a person’s name.

A map of designated anonymous HIV testing sites across Ontario can be found here: https://mappingsero.ca/anonymous-hiv-testing-sites/. The list of current designated anonymous testing sites can also be found here: https://www.ontario.ca/laws/regulation/900569 (scroll down to Schedule 1 at the bottom of the webpage).

People can also contact the free, confidential Ontario AIDS & Sexual Health Infoline: https://www.toronto.ca/community-people/health-wellness-care/sexual-health-infoline-ontario/, English and a number of other languages:  416-392-2437 or toll-free in Ontario 1-800-668-2437, French: toll-free in Ontario 1-800-267-7432

HALCO’s HIV Testing and Reporting to Public Health in Ontario guide includes the following:

  • differences between nominal and anonymous HIV testing
  • what gets reported to Public Health authorities when people test positive for HIV
  • reducing the possibility of a person’s name being reported to Public Health authorities after testing positive anonymously and accessing HIV-related medical care For more information about the reporting of HIV to Public Health, please see below.

The guide can be found here: https://www.cleo.on.ca/en/publications/hivtest

To track what happens to people’s blood and personal health information when they get an HIV test or other tests while getting treatment for HIV, see here: https://mappingsero.ca/