Health and Care Professionals Regulation

131/2025 M219/2025 July 16, 2025 April 1, 2026 except section 1 (part), sections 2 (i) and 4 (c) and Part 10 effective November 29, 2027 Health Professions and Occupations Act Health and Care Professionals Regulation [Last amended April 1, 2026 by B.C. Reg. 41/2026 and includes amendments by B.C. Reg. 44/2026] 1 General Matters Definitions 1 In this regulation: audiologist means a licensee who is authorized to practise audiology; audiology means the health profession in which a person provides the types of health services referred to in section 7 [scope of practice for audiology] ; dietetics means the health profession in which a person provides the types of health services referred to in section 15 [scope of practice for dietetics] ; dietitian means a licensee who is authorized to practise dietetics; hearing instrument dispensing means the health profession in which a person provides the types of health services referred to in section 21 [scope of practice for hearing instrument dispensing] ; hearing instrument practitioner means a licensee who is authorized to practise hearing instrument dispensing; occupational therapist means a licensee who is authorized to practise occupational therapy; occupational therapy means the health profession in which a person provides the types of health services referred to in section 27 [scope of practice for occupational therapy] ; optician means a licensee who is authorized to practise opticianry; opticianry means the health profession in which a person provides the types of health services referred to in section 29 [scope of practice for opticianry] ; optometrist means a licensee who is authorized to practise optometry; optometry means the health profession in which a person provides the types of health services referred to in section 35 [scope of practice for optometry] ; physical therapist means a licensee who is authorized to practise physical therapy; physical therapy means the health profession in which a person provides the types of health services referred to in section 46 [scope of practice for physical therapy] ; psychologist means a licensee who is authorized to practise psychology; psychology means the health profession in which a person provides the types of health services referred to in section 54 [scope of practice for psychology] ; speech-language pathologist means a licensee who is authorized to practise speech-language pathology; speech-language pathology means the health profession in which a person provides the types of health services referred to in section 60 [scope of practice for speech-language pathology] . Designation of health professions 2 Each of the following continues to be designated as a designated health profession for the purposes of the Act: a audiology; b dietetics; c hearing instrument dispensing; d occupational therapy; e opticianry; f optometry; g physical therapy; h psychology; j speech-language pathology. Regulator 3 The College of Health and Care Professionals of British Columbia is the regulator responsible for governing the designated health professions referred to in section 2. Health profession corporations 4 A corporation that does not hold a health profession corporation permit must not carry on the business of providing health services to the public, if the health services are provided by licensees who practise any of the following designated health professions: a optometry; b physical therapy. Use of "doctor" 5 1 Despite anything to the contrary in this regulation, the title "doctor" may be used by a person who is entitled to use an academic or educational designation that consists of or includes that title. 2 If any of the following circumstances apply, a licensee who is authorized under this regulation to use the title "doctor" must, in using the title, indicate clearly that the licensee is not a medical practitioner or is not authorized to practise medicine: a the licensee is engaged in the practice of the licensee's designated health profession; b without limiting paragraph (a), the licensee is interacting with a person in carrying out business, professional or other activities related to the practice of a designated health profession; c the licensee is providing information to the public with respect to i the practice of a designated health profession, or ii a matter in relation to health. 3 For certainty, a person described in subsection (1) who is also a licensee is subject to subsection (2). 4 A board may make bylaws respecting the use of the title "doctor" for the purposes of subsection (2), including imposing prohibitions, requirements, limits and conditions that are additional to those set under that subsection. 2 Practice of Audiology 1 General Practice Matters Exclusive title 6 Except as permitted under the Act, only an audiologist may use the title "audiologist". Scope of practice for audiology 7 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for audiology: a assessing the physical health status of patients for the purpose of providing the health services referred to in paragraph (b); b preventing, treating and managing i auditory disorders and conditions in the central and peripheral auditory systems, ii communication and vestibular disorders and conditions in the central and peripheral auditory systems that arise from the disorders and conditions referred to in subparagraph (i), and iii without limiting subparagraph (ii), vestibular disorders and conditions in the inner ear; c advising on health and care as it relates to the disorders and conditions referred to in paragraph (b). 2 The primary purposes for providing health services in the practice of audiology are the following: a to promote, maintain and restore physical health as it relates to the disorders and conditions referred to in subsection (1) (b); b to rehabilitate auditory and vestibular function. 2 Full Restricted Activities List of full restricted activities 8 An audiologist may perform the restricted activities described in the following items of the Restricted Activities Table: a item 26 [inserting substances that solidify] ; b items 57 and 59 [wearable hearing instruments] . Fitting methods 9 The methods that an audiologist may use to fit a wearable hearing instrument include sound field testing and real ear measurements. 3 Limited Restricted Activities List of limited restricted activities 10 An audiologist may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division: a item 1 [diagnoses] ; b items 18 and 25 [insertions] . Diagnoses 11 An audiologist may diagnose a disorder or condition that the audiologist is authorized under section 7 (1) (b) [scope of practice for audiology] to prevent, treat and manage. Other limited restricted activities 12 An audiologist may insert the following into the external ear canal: a an instrument, device or finger, except for the purpose of cerumen management as defined in section 13 (1) [restricted activities if certified] ; b air that is under pressure for the purpose of tympanometry. Restricted activities if certified 13 1 In this section: cerumen means the wax-like substance that occurs naturally as a secretion of sebaceous and ceruminous glands in the cartilaginous portion of the ear canal; cerumen management means services related to the removal of cerumen. 2 A certified audiologist may insert the following into the external ear canal: a an instrument, device or finger, for the purpose of cerumen management; b air that is under pressure, for the purpose of cerumen management; c water that is under pressure, for the purpose of assessing the function of the vestibular system or cerumen management. 3 Practice of Dietetics 1 General Practice Matters Exclusive title 14 Except as permitted under the Act, only a dietitian may use the title "dietitian". Scope of practice for dietetics 15 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for dietetics: a assessing the health status of patients for the purpose of providing the health services referred to in paragraph (b); b preventing, treating and managing diseases, disorders or conditions, as they relate to diet and nutrition, by planning, implementing and evaluating dietary and nutritional interventions; c advising on health as it relates to diet and nutrition. 2 The primary purposes for providing health services in the practice of dietetics are to promote, maintain and restore physical and mental health as it relates to the diseases, disorders or conditions described in subsection (1) (b). 2 Full Restricted Activities Design therapeutic diets 16 A dietitian may perform the restricted activity described in item 50 [design therapeutic diets] of the Restricted Activities Table. 3 Limited Restricted Activities List of limited restricted activities 17 A dietitian may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division: a items 19, 20 and 24 [insertions] ; b items 51 to 53 [therapeutic diets] . Therapeutic diets 18 1 A dietitian may compound or administer a therapeutic diet if nutrition is to be administered by enteral instillation. 2 A dietitian may dispense a therapeutic diet if nutrition is to be administered orally or by enteral instillation. Restricted activities if certified 19 A certified dietitian may perform the restricted activities described in items 19, 20 and 24 [insertions] of the Restricted Activities Table for the purpose of administering a therapeutic diet by enteral instillation. 4 Practice of Hearing Instrument Dispensing 1 General Practice Matters Exclusive title 20 Except as permitted under the Act, only a hearing instrument practitioner may use the title "hearing instrument practitioner". Scope of practice for hearing instrument dispensing 21 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for hearing instrument dispensing: a assessing hearing to identify hearing loss; b performing the restricted activities of dispensing and fitting wearable hearing instruments; c advising on the use of hearing instruments. 2 The primary purposes for providing health services in the practice of hearing instrument dispensing are to promote and maintain auditory acuity. 2 Limited Restricted Activities List of limited restricted activities 22 A hearing instrument practitioner may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division: a items 18, 25 and 26 [insertions] ; b items 57 to 59 [wearable hearing instruments] . Limited restricted activities 23 1 A hearing instrument practitioner may insert the following into the external ear canal: a an instrument, device or finger, except for the purpose of cerumen management as defined in section 24 (1) [restricted activities if certified] ; b air that is under pressure for the purpose of tympanometry; c a substance that subsequently solidifies, for the purpose of making ear mold impressions. 2 A hearing instrument practitioner may prescribe, fit or dispense a wearable hearing instrument for patients aged 19 years or older. Restricted activities if certified 24 1 In this section: cerumen means the wax-like substance that occurs naturally as a secretion of sebaceous and ceruminous glands in the cartilaginous portion of the ear canal; cerumen management means services related to the removal of cerumen. 2 A certified hearing instrument practitioner may insert the following into the external ear canal for the purpose of cerumen management: a an instrument, device or finger; b air that is under pressure; c water that is under pressure. 3 A certified hearing instrument practitioner may prescribe, fit or dispense a wearable hearing instrument for patients aged less than 19 years. Fitting methods 25 The methods that a hearing instrument practitioner may use to fit a wearable hearing instrument include sound field testing and real ear measurements. 5 Practice of Occupational Therapy 1 General Practice Matters Exclusive title 26 Except as permitted under the Act, only an occupational therapist may use the title "occupational therapist". Scope of practice for occupational therapy 27 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for occupational therapy: a assessing the health status of patients for the purpose of providing the health services referred to in paragraph (b); b preventing, managing and treating diseases, disorders and conditions, with a focus on removing or mitigating impediments to a patient's performance of everyday activities, by i using physical, psychosocial and cognitive interventions, and ii adapting the patient's personal and environmental conditions to that patient's physical, sensory and cognitive abilities; c advising on the patient's performance of everyday activities in relation to the diseases, disorders and conditions referred to in paragraph (b). 2 The primary purposes for providing health services in the practice of occupational therapy are the following: a to promote, maintain and restore physical and mental health as it relates to the diseases, disorders and conditions referred to in subsection (1) (b); b to rehabilitate and improve a patient's safe and effective performance of the patient's everyday activities. 2 Limited Restricted Activities List of limited restricted activities 27.01 An occupational therapist may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division: a item 2 [procedures on tissue below dermis] ; b item 12 [substances] ; c items 19, 20 and 24 [insertions] . [en. B.C. Reg. 44/2026, Sch. 1, s. 1 (b).] Substances 27.02 An occupational therapist may administer oxygen by inhalation. [en. B.C. Reg. 44/2026, Sch. 1, s. 1 (b).] Restricted activities if certified 27.03 1 A certified occupational therapist may perform a procedure on tissue below the dermis for the purpose of wound care. 2 A certified occupational therapist may, for the purpose of airway suctioning, insert an instrument, device, hand or finger a beyond the point in the nasal passages where they normally narrow, b beyond the pharynx, or c into an artificial opening into the body. [en. B.C. Reg. 44/2026, Sch. 1, s. 1 (b).] 6 Practice of Opticianry 1 General Practice Matters Exclusive titles 28 Except as permitted under the Act, only an optician may use the titles "optician" and "dispensing optician". Scope of practice for opticianry 29 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for opticianry: a assessing refractive errors and visual acuity by conducting automated refractions; b performing the restricted activities of dispensing and fitting vision appliances; c advising on the use of vision appliances. 2 The primary purposes for providing health services in the practice of opticianry are to promote and maintain visual acuity. Practice standards 30 1 The board must make bylaws establishing or adopting practice standards respecting the performance, by opticians, of the restricted activities described in the following items of the Restricted Activities Table: a item 61 [dispensing authorities] ; b item 64 [fitting contact lenses] . 2 Bylaws made under subsection (1) (a) must include practice standards respecting the conditions, signs and symptoms referred to in section 33 (3) [referral to qualified practitioner] . 3 The board must make bylaws establishing or adopting practice standards respecting the provision of vision appliance records by opticians to patients. 1.1 Full Restricted Activities List of full restricted activities 30.01 An optician may perform the restricted activity described in item 64 [fitting contact lenses] of the Restricted Activities Table. [en. B.C. Reg. 44/2026, Sch. 1, s. 2.] 2 Limited Restricted Activities List of limited restricted activities 31 An optician may perform the restricted activities described in items 61 to 63 [vision appliances] of the Restricted Activities Table, but only as provided for in this Division. [am. B.C. Reg. 44/2026, Sch. 1, s. 3.] Dispensing vision appliances 32 1 An optician may dispense a corrective eyeglass lens a in accordance with a prescription for a corrective eyeglass lens or a dispensing authority, b in accordance with an altered prescription i with the express prior authorization of the prescriber, or ii with respect to the vertex alteration required for the proper fitting of eyeglasses using conversion charts or similar formulae, or c by duplicating corrective eyeglass lenses using a lensometer or similar device, if there is no change in refractive value. 2 An optician may dispense a contact lens in accordance with a contact lens record. Restricted activities if certified 33 1 In this section, qualified practitioner means the following: a an optometrist; b a medical practitioner; c an extrajurisdictional practitioner who is authorized to prescribe a corrective eyeglass lens. 2 Subject to subsection (3), a certified optician may prepare a dispensing authority. 3 If a patient has or may have a condition, or is exhibiting signs or expressing symptoms, that indicate a need for an assessment by a qualified practitioner, an optician a must not prepare a dispensing authority for the patient, and b must recommend to the patient that the patient be assessed by a qualified practitioner. 4 Repealed. [B.C. Reg. 44/2026, Sch. 1, s. 4.] [am. B.C. Reg. 44/2026, Sch. 1, s. 4.] 7 Practice of Optometry 1 General Practice Matters Exclusive titles 34 Except as permitted under the Act, only an optometrist may use the titles "optometrist" and "doctor". Scope of practice for optometry 35 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for optometry: a assessing the physical health status of patients for the purpose of providing the health services referred to in paragraph (b) and performing the restricted activities referred to in paragraph (c); b preventing, treating and managing i diseases, disorders and conditions of the eye and other anatomical structures directly related to the vision system, and ii ocular motor, refraction and sensory disorders; c performing the restricted activities of dispensing and fitting vision appliances; d advising on the health of the vision system and on the use of vision appliances. 2 The primary purposes for providing health services in the practice of optometry are to promote, maintain and restore physical health as it relates to the diseases, disorders and conditions referred to in subsection (1) (b). Practice standards 36 1 The board must make bylaws establishing or adopting practice standards respecting the performance, by optometrists, of the restricted activities described in the following items of the Restricted Activities Table: a item 60 [prescribing vision appliances] ; b item 64 [fitting contact lenses] . 2 The board must make bylaws establishing or adopting practice standards respecting the provision of vision appliance records by optometrists to patients. 2 Full Restricted Activities List of full restricted activities 37 An optometrist may perform the restricted activities described in items 60, 62, 63 and 64 [vision appliances] of the Restricted Activities Table. 3 Limited Restricted Activities Listed drugs defined 38 In this Division, listed drug means a Schedule I or II drug that is included within any of the following drug categories: a anti-allergy medications; b anti-bacterial and anti-viral medications; c anti-glaucoma medications; d anti-inflammatory medications that are non-steroidal; e corticosteroids; f cycloplegics; g miotics; h mydriatics; i topical anaesthetics. List of limited restricted activities 39 An optometrist may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division: a item 1 [diagnoses] ; b items 2 to 4 [procedures on tissue] ; c item 14 [substances] ; d item 28 [ultrasounds] ; e items 46, 48 and 49 [drugs] . Diagnoses 40 An optometrist may diagnose a disease, disorder or condition that the optometrist is authorized under section 35 (1) (b) [scope of practice for optometry] to prevent, treat and manage. Other limited restricted activities 41 1 An optometrist may perform a procedure on tissue below the dermis, below the surface of a mucous membrane or in or below the surface of the cornea for the purpose of removing a superficial foreign body from an eye. 2 An optometrist may administer a substance by irrigation for the purpose of treating a disorder of a tear duct. 3 An optometrist may apply ultrasound for the purpose of measuring the thickness of a cornea. Drugs 42 1 An optometrist may prescribe, dispense or administer a listed drug if both of the following conditions are met: a either i the drug is prescribed, dispensed or administered for the purpose of general therapeutic treatment or care, or ii the drug is dispensed or administered for the purpose of making a diagnosis; b the drug is prescribed or dispensed in a form to be administered topically, or is administered topically. 2 An optometrist who performs a restricted activity described in subsection (1) (a) (i) must notify the medical practitioner or nurse practitioner who is the patient's primary care provider, if known to the optometrist. [en. B.C. Reg. 44/2026, Sch. 1, s. 5.] Repealed 43 Repealed. [B.C. Reg. 44/2026, Sch. 1, s. 5.] If emergency 44 1 An optometrist may prescribe, dispense or administer a listed drug if all of the following conditions are met: a no suitable medical practitioner is readily available to assess the patient; b the drug is prescribed, dispensed or administered for the purpose of emergency treatment of angle closure glaucoma; c the drug is prescribed or dispensed in a form to be administered orally, or is administered orally. 2 An optometrist who performs a restricted activity described in subsection (1) a may perform the activity only to the extent reasonably required for emergency treatment until the patient can be assessed by a suitable medical practitioner, b must immediately refer the patient to a suitable medical practitioner, and c must notify the medical practitioner or nurse practitioner who is the patient's primary care provider, if known to the optometrist. [am. B.C. Reg. 44/2026, Sch. 1, s. 6.] 8 Practice of Physical Therapy 1 General Practice Matters Exclusive titles 45 Except as permitted under the Act, only a physical therapist may use the titles "physical therapist" and "physiotherapist". Scope of practice for physical therapy 46 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for physical therapy: a assessing the physical health status of patients for the purpose of providing the health services referred to in paragraph (b); b preventing, treating and managing diseases, disorders and conditions by physical and mechanical means; c advising on the physical health of patients. 2 The primary purposes for providing health services in the practice of physical therapy are the following: a to promote, maintain and restore physical health; b to rehabilitate and improve physical function; c to relieve pain. [am. B.C. Reg. 41/2026, Sch. 1.] 2 Full Restricted Activities Spinal joints 47 A physical therapist may perform the restricted activity described in item 10 [spinal joints] of the Restricted Activities Table. 3 Limited Restricted Activities List of limited restricted activities 48 A physical therapist may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division: a item 1 [diagnoses] ; b item 2 [procedures on tissue below dermis] ; c item 9 [joint dislocations] ; d item 12 [substances] ; e items 19, 20 and 22 to 24 [insertions] . Diagnoses 49 A physical therapist may diagnose a disease, disorder or condition that the physical therapist is authorized under section 46 (1) (b) [scope of practice for physical therapy] to prevent, treat and manage. Other limited restricted activities 50 1 A physical therapist may administer oxygen by inhalation. 2 A physical therapist may, for the purpose of airway suctioning, insert an instrument, device, hand or finger a beyond the point in the nasal passages where they normally narrow, b beyond the pharynx, or c into an artificial opening into the body. 3 A physical therapist may perform a procedure on tissue below the dermis for the purpose of wound care. [am. B.C. Reg. 44/2026, Sch. 1, s. 7.] Restricted activities if certified 51 1 A certified physical therapist may perform a procedure on tissue below the dermis by inserting solid filament needles for the purpose of reducing inflammation or managing pain. 2 A certified physical therapist may reduce a dislocation of a joint. 3 A certified physical therapist may insert an instrument, device, hand or finger beyond the labia majora or anal verge for the purpose of assessing or treating the pelvic floor. 9 Practice of Psychology 1 General Practice Matters Definition for Part 52 In this Part, school psychologist means a licensee who is authorized under the bylaws to use the title "school psychologist". Exclusive titles 53 1 Except as permitted under the Act, only a licensee who is authorized under the bylaws to do so may use the titles "psychologist" and "school psychologist". 2 Despite subsection (1), a person who is not a licensee may use the title "psychologist", and an organization whose members are not licensees may incorporate the words "psychology", "psychological" or "psychologist" in their title or designation, if a that person is, or the members of that organization are, teaching, lecturing or engaging in research as a psychologist, and b those activities are carried out by reason of, and in the course of, duties under an academic appointment or program in a university as defined in the University Act . Scope of practice for psychology 54 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for psychology: a assessing the mental health status of patients for the purpose of providing the health services referred to in paragraph (b); b preventing, managing and treating mental disorders and conditions by using psychosocial interventions; c advising on mental health. 2 The primary purposes for providing health services in the practice of psychology are to promote, maintain and restore mental health. Limits and conditions 55 1 A school psychologist may provide the health services described in section 54 (1) [scope of practice for psychology] only as they relate to a patient's ability to function and learn in a learning environment. 2 Without limiting the health services described in section 54 (1), a school psychologist may provide the health services of designing, implementing and enhancing learning environments that facilitate learning and intellectual functioning. 2 Limited Restricted Activities Diagnoses 56 1 A licensee who is authorized under the bylaws to use the title "psychologist" may diagnose a mental disorder or condition. 2 A school psychologist may diagnose a mental disorder or condition that affects learning and intellectual functioning within a learning environment. 10 Not in force 57-58 Not in force. 11 Practice of Speech-Language Pathology 1 General Practice Matters Exclusive titles 59 Except as permitted under the Act, only a speech-language pathologist may use the titles "speech-language pathologist" and "speech therapist". Scope of practice for speech-language pathology 60 1 The following types of health services, provided primarily for the purposes set out in subsection (2), constitute the scope of practice for speech-language pathology: a assessing the health status of patients for the purpose of providing the health services referred to in paragraph (b); b preventing, treating and managing i speech, language and related communication disorders and conditions, ii vocal tract disorders and conditions, and iii feeding and swallowing disorders; c advising on health and ability as they relate to the disorders and conditions referred to in paragraph (b). 2 The primary purposes for providing health services in the practice of speech-language pathology are the following: a to promote, maintain and restore physical and cognitive health and ability as they relate to the disorders and conditions referred to in subsection (1) (b); b to rehabilitate vocal tract and swallowing function. 2 Limited Restricted Activities List of limited restricted activities 61 A speech-language pathologist may perform the restricted activities described in the following items of the Restricted Activities Table, but only as provided for in this Division: a item 1 [diagnoses] ; b item 12 [substances] ; c items 18 to 20, 24 and 25 [insertions] ; d item 49 [drugs] . [en. B.C. Reg. 44/2026, Sch. 1, s. 8.] Diagnoses 62 A speech-language pathologist may diagnose a disorder or condition that the speech-language pathologist is authorized under section 60 (1) (b) [scope of practice for speech-language pathology] to prevent, treat and manage. Substances 62.01 A speech-language pathologist may administer oxygen by inhalation. [en. B.C. Reg. 44/2026, Sch. 1, s. 9.] Insertions 63 A speech-language pathologist may insert into the external ear canal an instrument, device or finger, or air that is under pressure, for the purpose of tympanometry. Restricted activities if certified 64 1 A certified speech-language pathologist may insert an instrument, device or finger beyond the pharynx for the purpose of a assessing or managing voice and swallowing disorders and conditions, or b voice restoration. 2 A certified speech-language pathologist may insert an instrument or device a beyond the point in the nasal passages where they normally narrow, for the purpose of assessing or managing voice and swallowing disorders; b into an artificial opening in the body for the purpose of i assessing or managing voice and swallowing disorders and conditions, or ii voice restoration. 3 A certified speech-language pathologist may, for the purpose of performing a restricted activity described in subsection (1) or (2), administer topically a Schedule I or II drug that is an anaesthetic. [Provisions relevant to the enactment of this regulation: Health Professions and Occupations Act , S.B.C. 2022, c. 43, ss. 25 & 27.]