Nova Scotia’s Regulated Health Professions Act: What’s in store for 2025 and beyond?
By Tyana Caplan & Jennifer Taylor
As 2025 begins, the legal landscape for regulated health professions in Nova Scotia remains in transition.
Nova Scotia’s Regulated Health Professions Act (“RHPA” or “the Act”) was enacted on November 9, 2023; the Regulated Health Professions General Regulations became effective on June 3, 2024; and full implementation of the new legislation is expected to be complete in 2026.
With this significant shift underway, there is no time like the start of a new year to explore what’s on the horizon for regulated health professions in the province.
What is the RHPA, and what does it do?
The RHPA is an ambitious legislative undertaking intended to modernize the regulation of health professionals by establishing a shared regulatory framework that will eventually apply to all health professions in Nova Scotia. The full impact of the Act will take time to unfold, with further details to be developed through regulations and bylaws specific to each profession. However, for now, two main objectives of the Act appear to be (1) extending government oversight over self-regulated health professions, and (2) standardizing many of the rules and procedures applicable to regulated health professions.[1]
Note: The Act distinguishes between “existing regulators”, the term used for current entities like the College of Physicians and Surgeons of Nova Scotia, the Nova Scotia College of Nursing, etc., and “regulatory bodies”,[2] the term used to encompass the regulators continued or established under the RHPA.
(1) Increased Ministerial authority and oversight
The “governance” provisions in the Act give the Minister and Governor in Council (Cabinet) extensive authority and oversight over regulatory bodies.[3]
The relevant sections provide that:
- The Governor in Council can designate health professions; prescribe their scope of practice; continue and establish regulators; and name the regulatory bodies.[4]
- The Governor in Council can regulate multiple areas,[5] including standards of practice; investigation and hearing procedures; conditions and restrictions on practice; and more.[6]
- The board of each regulatory body will have to provide an Annual Report to the Minister.[7]
- The Minister can request information from regulators regarding whether they are fulfilling their obligations. Existing regulators and regulatory bodies have a duty to comply with any such requests.[8]
- The Minister can “establish a quality assurance program for regulatory performance”,[9] and a regulatory body “must participate.”[10]
- The Minister can designate an outside “person or organization to set requirements for mandatory standards of practice.”[11] The Minister can also order inquiries into a range of matters, including the administration and operation of a regulatory body, or the state of practice of a regulated health profession.[12]
- If “it is in the public interest to do so” or the directive relates to “health, safety or quality assurance” in a profession, the Minister can “direct a regulatory body with respect to exercising its mandate and objectives.”[13]
- The Governor in Council can appoint an administrator of a regulatory body, “for a specified term.”[14]
Sections 16 to 22 of the Act apply to existing regulators, so existing regulators must comply with these provisions even before they have fully migrated to the new Act.[15]
It’s important to note that, by December 3, 2024, both existing regulators and regulatory bodies were required to have adopted mandatory standards of practice regarding:
- “maintaining the information of a registrant without a licence” on the regulator’s website or another public digital platform;[16] and
- “addressing sexual misconduct and sexual abuse.”[17]
(2) Standardization of rules and procedures (with many details left to regulations)
When fully implemented, the Act will standardize many of the rules and procedures for regulated health professions in the province, with other profession-specific details left to regulations to be made by the Governor in Council following consultation with existing regulators, and bylaws to be made by the regulatory bodies themselves.
Every regulatory body will be governed by a board[18] that develops bylaws[19] and governance policies,[20] and appoints the registrar.[21] A regulator’s existing board will become the initial board of the new regulatory body upon migration to the RHPA, and may remain in place thereafter for up to a year.[22] The Act provides that “the number of public representatives on the board must be as close as possible to half of the board.”[23]
Regulatory bodies must establish the following statutory committees:
- registration and licensing;
- registration and licensing review;
- complaints;
- professional conduct;
- fitness-to-practice;
- reinstatement; and
- practice review.[24]
The Act’s processes for these committees are generally similar to those followed by existing regulators, although there is an increased focus on public representation.[25]
Employees of the regulatory body will not be permitted to serve on the board or any committee.[26]
What health professionals are covered by the RHPA?
The health professionals covered by the Act include:[27]
- audiologists and speech-language pathologists;
- chiropractors;
- counselling therapists;
- dentists;
- dental hygienists;
- dental technicians;
- denturists;
- dieticians;
- dispensing opticians;
- physicians and surgeons;
- medical laboratory technologists;
- medical imaging technologists and radiation therapy professionals;
- midwives;
- naturopathic doctors;
- nurses – including Licensed Practical Nurses (LPNs), Nurse Practitioners (NPs); and Registered Nurses (RNs);
- occupational therapists;
- optometrists;
- paramedics;
- pharmacists;
- physiotherapists;
- psychologists; and
- respiratory therapists.
The RHPA will eventually repeal the 21 existing statutes applicable to these professions. (The Paramedics Act has already been repealed.)
Where does the transition stand?
The Department of Health and Wellness is consulting with existing regulators before they migrate to the RHPA.
So far, paramedics are the only group to have been migrated to the RHPA. Effective June 3, 2024, the College of Paramedics of Nova Scotia became the Nova Scotia Regulator of Paramedicine, and the new Paramedicine Regulations came into force.
It appears that, between now and the end of 2026, other health professions will migrate to the new framework in three phases. Relevant updates include:
- Audiologists and speech-language pathologists: The Nova Scotia College of Audiologists and Speech Language Pathologists “will be migrated to the new legislative regime by June 2025”, according to their 2023 – 2024 Annual Report.
- Dentists and oral health professionals: The Department of Health and Wellness announced in September that the Dental Act is targeted for replacement in January 2025. This will impact dentistry and dental assisting. According to a September 2024 update from the Provincial Dental Board, dental hygiene, dental technology, and denturism are also expected to be migrated in “Phase I”, under an amalgamated regulator.
- Dispensing opticians: The Nova Scotia College of Dispensing Opticians expects to be migrated by Summer 2026, in the final phase.
- Medical imaging technologists and radiation therapists: The Nova Scotia College of Medical Imaging and Radiation Therapy Professionals “is in phase two, so is expected to come under the new legislation in 2025” (according to its Winter 2024 newsletter).
- Medical laboratory technologists: The Nova Scotia College of Medical Laboratory Technologists expects medical laboratory technologists to come under the new framework by Summer 2025.
- Naturopathic doctors: The Nova Scotia Association of Naturopathic Doctors has announced that naturopathic doctors will become a regulated health profession under the RHPA, which is expected to be finalized in 2025.
- Nurses and midwives: The Nova Scotia College of Nursing and the Midwifery Regulatory Council of Nova Scotia have both announced that they expect to be migrated to the RHPA by Summer 2026. The Government has also directed that these two regulators will amalgamate.
- Occupational therapists: Occupational therapists are expected to be migrated in Phase I, according to this update from the Provincial Dental Board (the College of Occupational Therapists of Nova Scotia had expected a transition in Fall 2024, according to their Summer newsletter).
- Optometrists: The Optometry Act is scheduled to be replaced by September 2026.
- Pharmacists: Pharmacists are expected to be migrated in 2025.
- Psychologists: The Nova Scotia Board of Examiners in Psychology expects to be migrated in Fall 2025, according to an August 2024 update.
What about existing professional conduct processes?
Many complaints investigations and/or disciplinary hearings will likely be in progress under existing legislation at the time of its repeal. The RHPA contains a transition provision for processes that have been initiated under prior legislation.[28]
As regulators transition to the new regime under the RHPA, health professionals will want to keep abreast of their ethical and statutory duties while staying tuned for announcements and direction from their regulators.
This update is provided for general information only and does not constitute legal advice. For specific guidance on how the Regulated Health Professions Act may affect you or your organization, please contact the authors, or a member of our Health Group.
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[1] A related statute, the Health Professional Associations Continuation Act, was enacted in September, to continue the Nova Scotia Dental Association and the Nova Scotia Optometrist Association.
[2] RHPA, section 2.
[3] RHPA, sections 4-22; see also sections 25-26.
[4] RHPA, section 4.
[5] RHPA, sections 13-14. Regulations are to be made based on recommendations of the Minister, after consultation with the regulator(s).
[6] RHPA, section 13.
[7] RHPA, section 15; Regulated Health Professions General Regulations, NS Reg 106/2024, s 8 [“General Regulations”].
[8] RHPA, section 16. See also section 167.
[9] RHPA, section 18.
[10] General Regulations, s 51.
[11] RHPA, section 19(2).
[12] RHPA, section 21(1).
[13] RHPA, section 20(1).
[14] RHPA, section 22.
[15] RHPA, section 167.
[16] General Regulations, section 9.
[17] General Regulations, section 10.
[18] RHPA, sections 7(1) and 10.
[19] RHPA, section 12. Under section 3 of the General Regulations, the registrar of a regulatory body must send proposed bylaws to the Nova Scotia Regulated Health Professions Network Administrator for feedback from the Network.
[20] RHPA, section 10(1)(g).
[21] RHPA, section 11.
[22] RHPA, section 9.
[23] RHPA, section 7(2).
[24] See also section 47 of the General Regulations regarding practice review committees.
[25] There is also the option for “joint panels”, where a member of one regulated health profession sits on a committee panel for another profession: RHPA, sections 23-26; General Regulations, section 18.
[26] RHPA, section 8(1).
[27] RHPA, sections 178-200.
[28] RHPA, section 169.