Proposed regulatory changes under the Excellent Care for All Act, 2010: Supporting the establishment of the Patient Ombudsman
O. Reg. 445/10; O. Reg. 188/15; and new Regulation
Bill or Act:
Excellent Care for All Act, 2010
Summary of Decision:
Amendments to Ontario Regulation 445/10 and Ontario Regulation 188/15, as well as new Ontario Regulation 236/16, were approved for the purpose of supporting the establishment of the Patient Ombudsman. The regulations were filed on June 24, 2016 and came into force on July 1, 2016.
January 29, 2016
Summary of Proposal:
On June 8, 2010 the Excellent Care for All Act, 2010 (ECFAA) came into force. The principles of ECFAA help put patients first by strengthening the healthcare system's organizational focus and accountability for delivering high quality patient care. In 2014, amendments were made to ECFAA under the Public Sector and MPP Accountability and Transparency Act, 2014 to establish a Patient Ombudsman (PO) in Ontario. Once these amendments come into force, the PO will be able to investigate, facilitate the resolution of, and report on complaints made by patients, former patients and their caregivers that relate to the care experience of the patient or former patient at a hospital, long-term care home, or community care access centre. This will help to strengthen complaints management processes across the health system and allow patient voices to be better heard.
The PO is a Lieutenant Governor in Council (LGIC) appointment and will be an employee of Health Quality Ontario (HQO). The PO will be supported by an Office of the PO, which will be a part of HQO. Situating the office within HQO will help to strengthen the linkages between the PO's work and HQO's ongoing efforts related to province-wide healthcare system quality improvement. In order to support the PO role, and to enhance the clarity of ECFAA, the following regulatory changes are being proposed:
1) Defining the term 'caregiver' in regulation
-The ministry is proposing to provide a meaning for the term 'caregiver' that would apply to all references in ECFAA and its regulations.
-The intent is to further define who is able to bring forward a complaint to the PO and to enhance the clarity and consistency of provisions under ECFAA.
-The proposed definition would apply to any provisions pertaining to caregivers under ECFAA. These include surveying caregivers concerning their satisfaction with services provided by a health care organization (2010, c. 14, s. 5); engaging caregivers in the development of Quality Improvement Plans for health care organizations (O. Reg. 187/15); and requirements related to the patient relations process in health care organizations (O. Reg. 188/15).
-In order to have one definition of caregiver that applies across all of ECFAA, the ministry is also proposing to amend O. Reg. 188/15 to remove an existing definition of caregiver that applies only to the patient relations process in hospitals.
2) Clarify references to personal health information (PHI)
-Regulation under ECFAA (O. Reg. 445/10) includes a provision which states that HQO "may only collect de-identified [PHI] for the purposes of carrying out its functions and making its reports" (s. 11).
-This provision would be made superfluous once the amendments to ECFAA that relate to the PO come into force. This is because the amendments state that, "Despite any other Act, the Council [HQO] may only collect [PHI] where the [PO] collects that information in exercising his or her powers under this Act."
-To ensure clarity regarding HQO's specific permissions with respect to collecting PHI, the ministry is proposing that the superfluous provision be removed (i.e. removal of s. 11 of O. Reg. 445/10).
The Ministry is seeking comments on the proposed regulatory changes. All comments received during the consultation period will be considered. Content of final regulations are at the discretion of the Minister of Health and Long-Term Care or the LGIC, who may make changes as appropriate.
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July 1, 2016