The MLT Act defines the scope of practice for a MLT as follows:

3. The practice of medical laboratory technology is the performance of laboratory investigations on the human body or on specimens taken from the human body and the evaluation of the technical sufficiency of the investigations and their results. 1991, c. 28, s. 3.

Health professionals may be authorized to perform one or more controlled act(s). Under the RHPA, no profession has a monopoly over any of the controlled acts. This regulatory structure allows for evolution in professional scopes of practice, and is emulated in other provinces in Canada and other jurisdictions around the world. In the Medical Laboratory Technology Act, 1991, the controlled act authorized to MLTs is:

4. In the course of engaging in the practice of medical laboratory technology, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to take blood samples from veins or by skin pricking. 1991, c. 28, s. 4. 

Also, its important to note that MLTs may only complete the controlled act in certain conditions. The MLT Act states:

5. (1) A member shall not perform a procedure under the authority of section 4 unless the procedure is ordered by a member of the College of Physicians and Surgeons of Ontario or the Royal College of Dental Surgeons of Ontario or by a prescribed person. 1991, c. 28, s. 5 (1); 1997, c. 9, s. 5.

Controlled acts may only be performed by health professionals in their practice if its authorized to them, if the controlled act is delegated to them by a health professional who is authorized to perform it, or if an exemption exists. Delegation of controlled acts and medical directives are often discussed together because they are both tools used to facilitate interprofessional care. MLTs could be asked to implement medical directives, such as for reflex testing, or be delegated the authority to perform a controlled act, such as releasing test results to a patient. MLTs could also potentially delegate the controlled act of phlebotomy, which is authorized to them. For more information about delegation consult CMLTO’s guidelines webpage here

The Medical Laboratory Technology Act, 1991 defines the restricted title of a MLT as follows:

9. (1) No person other than a member shall use the title “medical laboratory technologist”, a variation or abbreviation or an equivalent in another language. 1991, c. 28, s. 9 (1)

“As of Right” Applicants

In accordance with Ontario Regulation 198/23 of the Medical Laboratory Technology Act, 1991 (MLT Act), a person registered as a Medical Laboratory Technologist (MLT) with a regulatory authority in a Canadian jurisdiction other than Ontario is exempt from subsection 9 (1) and (2), Restricted titles, if they meet all the conditions outlined in the regulation.

For more information on the “As of Right” registration pathway, please refer to Registration Committee Policy 23: Applicants Registered in a Canadian-Regulated Jurisdiction available here

MLTs are expected to understand and comply with the professional, legal, and ethical requirements governing their practice. This includes all applicable Provincial statutes and regulations, such as:

• Laboratory & Specimen Collection Centre Licensing Act, RSO 1990 c.L.1 – sets out the requirements and expectations for licensed laboratories
• Personal Health Information Protection Act, 2004 (PHIPA) – Ontario’s provincial privacy legislation, applies to personal health information
  • As of June 1, 2016, new reporting obligations under PHIPA took effect for MLTs and for employers.
• Health Care Consent Act, 1996 – provides a framework for patient consent to treatment
• Ontario Labour Mobility Act – provides for the labour mobility of professionals across Canada

Federal statutes and agreements, such as:

Personal Information and Protection of Electronic Documents Act, 2000 – Canada’s federal privacy legislation, applies to personal information

Medical laboratory technologists (MLTs) share a common scope of practice and are individually accountable both to the employer and to the CMLTO for their conduct and for ensuring that they have the knowledge, skill and judgment to practice safely. Employers may provide an MLT with education and training to enable an MLT to practice in areas that fall outside the speciality(ies) included on the MLT certificate of registration. MLTs are accountable to their employer and the College for their conduct and professional practice. The employer is also accountable for an MLT practising outside the speciality(ies) listed on their certificate of registration.

An MLT may do this provided they have the necessary knowledge, skills, and judgement. 
Specific laboratory techniques, and as such, an individual MLT’s ability to perform them are independent from the speciality on their certificate of registration. Under the Medical Laboratory Technology Act, 1991, all MLTs have the same scope of practice. If an MLT has the knowledge, skills, and judgement to perform a new technique safely and competently, then there is nothing inhibiting them from doing so.  However, facility policies and training need to be considered and supervision of the individual would be a facility-specific management/staff decision based on the individual MLT’s knowledge, skills, and judgement in the area they are working in.

An MLT may do this provided they have the necessary knowledge, skills, and judgement.
The legislative and regulatory framework in Ontario enables MLTs to learn and perform new tasks if certain conditions are first met. For tasks involving legislative authority (such as ordering laboratory tests) or authorized acts (such as communicating a diagnosis), medical directives and delegation need to be used. Please refer to the medical directives and delegation (link to appropriate page) section of the CMLTO website for further information.

For tasks that do not involve legislative authority and do not pose a risk of serious bodily harm, such as taking vital signs, an MLT must ensure they have and maintain the necessary knowledge, skills, and judgement to perform the task safely and comply with relevant facility policies prior to undertaking the task. 

Communicating a diagnosis is an authorized act under the Regulated Health Professions Act, 1991 (RHPA). Releasing test results directly to a patient is a form of communicating a diagnosis, an act which is not authorized to MLTs. Under the RHPA, it is possible to delegate a controlled act. To delegate a controlled act, a whole series of activities need to be undertaken including, but not limited to:

1. Having a regulated health professional who does have access to the specific controlled act (as defined by their discipline specific act) agree to delegate this act, following their own Colleges guidelines and/or regulations related to delegation (if there are any), and most importantly to take responsibility for the delegation. 
2. Developing, usually through the local institutions (in the case of hospitals this is often done through the Medical Advisory Committee (MAC)), specific policies related to delegations and medical directives. An excellent resource to understand this process better has been developed by the Health Profession Regulators of Ontario (HPRO) can be accessed at Home | HPRO (regulatedhealthprofessions.on.ca)
3. Having an individual (regulated or not) who accepts the delegation, and through the process of training, education and assessment develops and maintains the knowledge, skills and judgement to perform the specific procedure safely. In the case of a regulated health professional, this must be done in accordance with any regulations and guidelines developed by their regulatory body. 

The CMLTO supports the underlying precepts of the RHPA, including the ability to safely delegate the performance of a controlled act so that patients receive the most appropriate care, from the most appropriate health professional.