HEAL 8171

Law and Health

Care
Administration
Week 5
 Agenda
• Unit Learning Outcomes
3.1 Review Provincial health care legislation
3.2 Describe how changes to federal legislation is reflected in
provincial legislation
4.3 Distinguish between the roles of Colleges, Professional
Associations and Unions
5.1 Explain how professional standards reflect the requirements
identified in provincial legislation
5.3 Discuss the financial implications to agencies when
legislation changes practice
Queen’s Park
 Ontario Parliament
House of Commons
Members of Provincial Parliament (MPP)
Lieutenant Governor – Edith Dumont
 Ministries
Ministry of Health
• Public Hospitals Act (1990)
• Regulated Health Professions Act (1991)
• Substitute Decisions Act 1992
• Home Care and Community Services Act (1994)
• Health Care Consent Act 1996
• Personal Health Information Protection Act (2004)
• Narcotics Safety and Awareness Act (2010)
 Ministries Continued
Ministry of Long Term Care
• Fixing the Long Term Care Homes Act (2022)
Ministry of Seniors and Accessibility
• Retirement Homes Act. (2010)
Regulated Health Professions Act (1991)
• Roles and Duties of the Colleges
• Standards of Practice
• Entry to Practice
• Quality Assurance
• Reports and Complaints
• A regulatory college is a corporation that governs each
regulated health profession responsible for regulating the
practice of the profession and governing according to the
RHPA
Regulated Health Professions Act (1991)
• Scope of Practice
• Controlled Acts
• Title Protection
 From the RHPA
• Nursing Act 1991
• Medicine Act 1991
• Pharmacy Act 1991
• Dentistry Act 1991
• Physiotherapy Act 1991
• Occupational Therapy Act 1991
The scope of practice model is set out in the Regulated Health
Professions Act, 1991 (RHPA) and consists of two elements:
a scope of practice statement and a series of authorized or
controlled acts.
Scope of Practice Statement Each regulated health profession
has a scope of practice statement that describes in a general
way what the profession does and the methods that it uses.
The scope of practice statement is not protected in the sense
that it does not prevent others from performing the same
activities. Rather, it acknowledges the overlapping scope of
practice of the health professions.
(CNO)
 Controlled Acts
From the RHPA: Controlled Acts are defined as:

An activity that can cause harm if it is performed by an

unqualified person
 Controlled Acts
1. Communicating a diagnosis
2, Performing a procedure on tissue below the dermis or mucous
membrane
3. Setting or casting a fracture of a bone or a dislocation of a
joint
4. Spinal manipulation
5. Administering a substance by injection or inhalation
6. Putting a hand, instrument or finger into a natural or artificial
body openings
7. Applying or ordering the application of a form of energy
 Controlled Acts
8. Prescribing, dispensing or compounding a drug
9. Prescribing or dispensing contact lenses or eye glasses
10. Prescribing a hearing aid for a hearing impaired person
11. Fitting or dispensing a dental prosthesis, orthodontic or
periodontal appliance
12. Managing labour or conducting the delivery or a baby
13. Allergy Challenge testing
14. Treating, by the means of psychotherapy technique
 Delegation
Delegation occurs when a regulated health professional
(delegator) who is legally authorized and competent to
perform a controlled act temporarily grants their authority to
perform that act to another individual (delegatee).
CNO
 Professional standards
• Updated when legislation changes
• Controlled act of psychotherapy
• NP authorized to prescribe controlled medications
• PHIPA
• New standards created when legislation passed
• Medical Assistance in Dying
 Group Work
• Working in groups from your profession go to your
Regulatory College and identify your Controlled Acts
• Identify the expectations of Delegation
• Identify your Scope of Practice
 Professional Associations
• Advocate for health policy
• Promote excellence in practice
• Contribute to the shaping of health care
• Influence decisions that effect the profession and the public
 Unions
• Salaries – competitive wages
• Safe work environments
• Hours of work
• Benefits
 Standards of Practice
• Best Practice Guidelines
• Clinical Standards
• Professional Standards
 Health Care Consent Act 1996
• Promotes individual Authority and Autonomy
• Facilitates communication between the health care provider
and client
• Consent can be oral, written or implied
• Consent can be withdrawn
• No minimum age for consent if the client is capable
 Substitute Decision Maker Act 1992
• When a client is not capable of making decision
• Must follow clients wishes
• Hierarchy of Substitute Decision Maker
• Guardian
• Individual named as attorney for personal care
• Individual appointed by Consent and Capacity Board
• Spouse, Partner, Relative in the following order: 1) Spouse or
Partner, 2) Child if 16 or older, custodial parent, Children’s Aid
Society, 3) Parent who only has a right of access, 4) Brother or
sister, 5) other relative
• A Public Guardian or Trustee
 Personal Health Protection Information
Act, 2004
• Regulates the collection, use and disclosure of personal
health information by health information custodians and their
agents.
• Circle of Care: Is this information necessary for me to provide
care?
• Yes – you are in the circle of care
• No – you are not in the circle of care
 Circle of Care
It is a term commonly used to describe the ability of certain
health information custodians to assume an individual’s
implied consent to collect, use or disclose personal health
information for the purpose of providing health care, in
circumstances defined in PHIPA.
(IPC)
 Penalties under PHIPA
• Fine up to $200,000 or 1 year in prison or both
• An organization of institution up to $1,000,000
• Professional Misconduct: giving information about a client to a
person other than the client or his or her authorized
representative, except with the consent of the client or his or
her representative, or as required or allowed by law.
 Funding the Health Care System
• Federal and Provincial jurisdiction
• Federal transfer based on Canada Health Act
• Provinces determine what they will cover
• Ontario Health Act defines what OHIP covers
• New initiatives, if Federal they will cover the cost
• Medications for MAID
• Vaccines for the Pandemic
 Health Insurance Act 1990
OHIP – Ontario Health Insurance Plan
• Medically necessary physician services
• Prescribed inpatient and outpatient services
• Eye exams for specified patients in specified age groups
• Dental surgical services that require hospitalization
• Limited podiatry services
 Case Study of MAID
• Nursing Act 1991
• Medicine Act 1991
• Pharmacy Act 1991
• Public Hospitals Act 2010
• Narcotics Safety and Awareness Act 2010
 Summary
• Provincial legislator
• Ministry of Health
• Ministry of Long Term Care
• Ministry of Senior Citizens
• Provinicial Legislation
• Regulated Health Professions Act,
• Role of Regulatory Colleges
 Questions and Summary
Unit Learning Outcome covered:
3.1 Review Provincial health care legislation
3.2 Describe how changes to federal legislation is reflected in
provincial legislation
4.3 Distinguish between the roles of Colleges, Professional
Associations and Unions
5.1 Explain how professional standards reflect the requirements
identified in provincial legislation