Bill 21 – An Act to Protect Patients

On November 19, 2018, the Government of Alberta has given Royal Assent to Bill 21 – An Act to Protect Patients.  This Bill introduces the most profound changes to the Health Professions Act (HPA) since its inception in 2001.  Parts of this legislation came into force on the day of assent with the balance coming into effect on April 1, 2019.

The enactment of this legislation has far reaching impact on health Colleges and their members. The bill is available at Bill 21. Please read on to understand the highlights of this new legislation.

Clear definitions

This HPA amendment addresses sexual abuse and sexual misconduct by healthcare professionals directed to patients.

  • Sexual abuse is defined in the HPA as the threatened, attempted or actual conduct of a regulated member towards a patient that is of a sexual nature and includes any of the following conduct: (i) sexual intercourse between a regulated member and a patient of that regulated member; (ii) genital to genital, genital to anal, oral to genital, or oral to anal contact between a regulated member and a patient of that regulated member; (iii) masturbation of a regulation member by, or in the presence of, a patient of that regulated member; (iv) masturbation of a regulated member’s patient by that regulated member; (v) encouraging a regulated member’s patient to masturbate in the presence of that regulated member; and (vi) touching of a sexual nature of a patient’s genitals, anus, breasts or buttocks by a regulated member.
  • Sexual misconduct is defined in the HPA as any incident or repeated incidents of objectionable or unwelcome conduct, behaviour or remarks of a sexual nature by a regulated member towards a patient that the regulated member knows or ought reasonably to know will or would cause offence or humiliation to the patient or adversely affect the patient’s health and well-being but does not include sexual abuse.
  • Sexual nature does not include any conduct, behaviour or remarks that are appropriate to the service provided.

Consistency of conduct related processes and sanctions

The implementation of these amendments has significant impact on the complaints and discipline processes carried out by all health regulatory Colleges.  Most notably, the introduction of mandatory sanctions imposed as a result of findings of unprofessional conduct on either of these accounts:

  • Cancellation of a practice permit for any health professional whose conduct is deemed to be sexual abuse of a patient with no ability to reapply or be reinstated
  • Suspension of a practice permit for any health professional whose conduct is deemed to be sexual misconduct toward a patient

Further, should a regulated member be required to sit before a Hearing Tribunal on allegations related to Bill 21, the College must ensure that there is at least one tribunal member with the same gender identity as the patient alleging the sexual abuse or misconduct.

Standards of Practice

With these changes, the government has specified new details that must be in a College’s Standards of Practice. These include:

  • Setting out who is considered a patient for the purposes of the College’s regulated members;
  • Determining when a sexual relationship may occur between a regulated member or former member and a patient; and
  • Determining when it is acceptable for a regulated member’s spouse/interdependent relationship partner to be a patient.

These amendments must follow the standard route for Council approval, member validation and Ministerial approval. The timeline to achieve this work is very condensed and must be submitted to the Minister of Health by December 30, 2018.  As a result of this timeline, you will receive an invitation to enact self-regulation and participate in the member validation survey.  Please watch your email as this will be distributed to you on December 7, 2018 and will be available for comment until December 16, 2018.

Upon approval by Alberta Health, the new Standards of Practice will come into force April 1, 2019.

Applications for registration

As of November 19, 2018, it became law for College’s to collect additional information from all new applicants.  This includes:

  • A valid criminal records check;
  • Whether an applicant is currently an investigated person under the HPA or the equivalent in another jurisdiction;
  • Whether any conduct of the applicant has previously constituted unprofessional conduct;
  • Evidence of whether the applicant has ever had conditions imposed on their practice permit or equivalent; and
  • Evidence of whether there has ever been a judgment in a civil action against the applicant with respect to their practice.

Patient relations program

As per the HPA, Each College is required to establish a patient relations program to, “include measures for preventing and addressing sexual abuse of and sexual misconduct towards patients by regulated members.” These measures must include, but are not limited to:

  • Educational requirements for regulated members;
  • Educational guidelines for the conduct of regulated members towards patients;
  • Training for trauma informed practices for College staff, councils and hearing tribunals;
  • Information for persons respecting the College’s complaints processes; and
  • Assistance in directing persons to appropriate resources, persons or organizations that may be able to assist them.

A College must also provide funding for patients who have alleged unprofessional conduct in the forms of sexual abuse and/or sexual misconduct against a regulated member.

Transparency through public-facing website

Colleges must post health professionals’ discipline history for sexual abuse or misconduct.

We are committed to successful implementation of all new obligations outlined in the legislation and are working diligently to comply with them. Stay tuned for updates and please feel welcome to contact us, at 780.487.6130 ext. 0, for discussion.