Government Bill

Third Session, Forty-second Parliament

* ******* ***, ****

Legislative Assembly of British Columbia

BILL 36

HEALTH PROFESSIONS AND

OCCUPATIONS ACT

Honourable Adrian Dix

Minister of Health

Explanatory Note

This Bill replaces the Health Professions Act. The primary objectives of the Bill are to prioritize protection of the public and to facilitate good governance by regulators. The Bill expands the regulation of health service providers. While the practice of health professions continues under this Bill to be fully regulated through self-regulating bodies, more flexible models of regulation are available under this Bill for the practice of health occupations that present a lower risk of harm to the public. The Bill streamlines the process for designating new health professions and occupations. It also clarifies processes for creating and combining regulatory bodies and transferring the governance of health professions and occupations between regulators. The Bill establishes the Office of the Superintendent of Health Profession and Occupation Oversight. The superintendent is responsible for preparing performance standards for regulators and guidelines with respect to regulatory best practices. The superintendent will review governance practices, including by responding to complaints and conducting audits, investigations and system-wide reviews. Finally, the Bill establishes, within the superintendent’s office, an independent discipline tribunal. This enables investigatory and disciplinary processes conducted with respect to licensees to be separated, ensuring that the determination of discipline matters is independent of regulatory colleges and licensees and focused on protecting the public. MINISTER OF HEALTH

BILL 36 – 2022

HEALTH PROFESSIONS AND OCCUPATIONS ACT

Contents

PART 1 – INTERPRETATION AND GUIDING PRINCIPLES

Division 1 – Interpretation

1 General definitions

2 If Administrative Tribunals Act applies

3 Application of powers and duties

4 Application if reference to health profession corporation 5 Application to former regulated health practitioners 6 Health professions and occupations

7 Types of standards

8 Sexual misconduct and sexual abuse

9 Discrimination

10 Definitions respecting misconduct and actionable conduct 11 Misconduct and actionable conduct

12 Risk under Criminal Records Review Act

13 Persons with interest in citation or discipline hearing Division 2 – Guiding Principles

14 Guiding principles for persons acting under this Act 15 Anti-discrimination measures

PART 2 – DESIGNATION AND MODEL OF REGULATION

Division 1 – Designation

16 Purposes of designation assessment

17 When designation assessment must or may be conducted 18 How to conduct designation assessment

19 Consultation

20 Obtaining additional information

21 Risk assessment

22 Matters to consider to assess risk

23 Report and recommendations

24 Decision respecting designation

25 Designation regulation for designated health profession 26 Designation regulation for designated health occupation 27 Designation regulations generally

28 Amending or repealing designation regulations

Division 2 – Effect of Designation

29 Unauthorized practice

30 Unauthorized use of titles

31 General exceptions

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32 Exception if meeting eligibility standards

33 Exception for persons from other jurisdictions

34 False or misleading information

35 Unauthorized acts of corporations

PART 3 – PRACTICE OF DESIGNATED HEALTH PROFESSIONS Division 1 – Authority to Practise

36 Definitions

37 Authority to practise designated health profession 38 Requirements for licence

39 Fit to practise

Division 2 – Making Licence or Permit Applications 40 Procedural matters

41 Making applications

42 Receiving applications

43 Administrative acceptance

44 Administrative refusal

45 Reconsideration

46 Information to licence or permit committee

47 Other matters

Division 3 – Licences

48 Definitions

49 General licensing bylaws

50 Extrajurisdictional applicants

51 Before making decision

52 Acceptance of application

53 Adverse application decision

54 Adverse application decision based on proceeding 55 Information in registry

Division 4 – Health Profession Corporation Permits 56 Definitions

57 Bylaws

58 Requirements for permit

59 Requirements respecting shares

60 Collaboration agreements

61 Before making decision

62 Acceptance of application

63 Adverse application decision

64 Notice of adverse application decision

65 No review or appeal

66 If permit issued

Division 5 – Duties of Licensees

67 Bylaws

68 General duty to comply

69 Duty to be fit to practise

70 Duty to practise ethically

71 Duty respecting misconduct

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72 Duties respecting practice

73 Misrepresentation of drugs and devices

74 Duty if delegating activities

75 Duty to cooperate

76 Duty to give notice

77 Continuing duties

78 Duty to provide information

79 Duties if practising in facility

80 Duties if practising through corporation

81 Duty if practice in another jurisdiction

82 Duties if not practising or restricted

Division 6 – Duties to Report Licensees

83 Making reports under this Division

84 Duty to report if health facility admission

85 Duty to report if suspected significant risk to public 86 Duty to report sexual misconduct, sexual abuse and discrimination 87 Other persons have duty to report

88 After receiving regulatory report

89 Immunity for persons required to report

Division 7 – Prohibition Against Adverse Actions

90 Definitions

91 Adverse actions prohibited

92 Adverse actions against patients

93 Adverse actions against employees

94 Adverse actions against regulated health practitioners 95 Other types of adverse actions

96 Discipline and enforcement are not adverse actions Division 8 – Quality Assurance Program

97 Bylaws

98 Purposes of quality assurance program

99 Conduct of quality assurance assessment

100 If individual performance matter identified

101 If general issue of professional performance identified 102 Protecting confidentiality

103 Failure to cooperate

104 Protecting the public

105 Notice of health hazard

Division 9 – Discipline for Administrative Matters 106 Bylaws

107 What are administrative matters

108 Assessment and action

109 Disposition

110 Information to respondents and review

111 Information to investigation committee

112 No further review or appeal

Division 10 – Discipline of Health Profession Corporations 113 Grounds for disciplinary action

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114 If reason for disciplinary action suspected

115 Disposition

116 If revocation or penalty

117 Enforcement of Act

Division 11 – Complaints and Initiating Investigations 118 Bylaws

119 Regulatory complaints by registrar

120 Regulatory complaints by others

121 Gathering information and records

122 Summary actions by registrar

123 Information to investigation committee and board 124 Initiating investigation without regulatory complaint Division 12 – Investigations of Fitness and Misconduct 125 Review of regulatory complaint

126 General directions to registrar

127 Control of investigation

128 If capacity in question

129 Duty to proceed in timely manner

130 Limits on investigation powers

131 General investigation powers

132 Competence assessments

133 Non-compliance with investigator’s orders

134 Investigation committee’s assessment

135 Matters affecting assessment

136 On completing assessment

137 Information to director of discipline

138 If new information

139 If proposal for disciplinary order

Division 13 – Capacity Evaluations

140 Initiating capacity evaluation

141 Assessments and reports

142 Failure to cooperate

143 Protecting the public

144 Capacity officer’s assessment

145 On completing assessment

146 Continuing practice order

147 Revocation order

148 Reconsideration

149 Variation or termination of continuing practice order 150 Copies of orders and notices

151 If registrar is capacity officer

Division 14 – Summary Action or Disposition During Investigation 152 Period for acting under this Division

153 Summary protection orders

154 Authority to dispose of regulatory complaint

155 If investigation is divided

156 Dismissal, suspension or termination

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157 Restorative processes

158 Disposition with respondent’s consent

159 Disposition without respondent’s consent

Division 15 – Citations for Discipline Hearings

160 Interpretation

161 Receiving request for citation

162 Whether to issue citation

163 Former or absent licensees

164 Issuing citation

165 Notice to interested person

166 Effect of citation

167 Cancelling citation

168 If citation refused or cancelled

Division 16 – Discipline Hearings

169 Appointing discipline panels

170 Choosing discipline panel members

171 If member absent or appointment ends

172 No jurisdiction over constitutional matters

173 Recommendation to cancel citation

174 Legal representation

175 Public may attend

176 Control of proceedings

177 Recording proceedings

178 Respondent must cooperate

179 Failure to comply with orders

180 Admissibility of evidence generally

181 Admissibility of settlement information

182 Witnesses

183 Protection of persons in vulnerable circumstances 184 Considerations for protection order

185 General protection orders

186 Protection orders respecting attendance

187 Protection orders respecting cross-examination 188 Orders respecting sensitive records

189 Relevance of sensitive records

Division 17 – Orders After Discipline Hearings

190 If decision of competence or no misconduct

191 If decision of lack of competence or misconduct 192 Orders for investigation expenses

193 Corrections and clarifications

194 Application for review

195 Conduct of review

196 After review

197 Enforcement of disciplinary orders

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PART 4 – PRACTICE OF DESIGNATED HEALTH OCCUPATIONS Division 1 – Authority to Practise

198 Definitions

199 Authority to practise designated health occupation 200 Eligibility to practise

201 Director’s discretion

202 Registration or authorization may be required

203 Rules

204 Procedural matters

205 Making applications

206 Receiving applications

207 Before making decision

208 If application accepted

209 Adverse application decision

210 Administrative refusal

211 Information in registry

212 Other matters

Division 2 – Duties of Regulated Health Service Providers 213 May set practice requirements

214 General duty to comply

215 Duty respecting actionable conduct

216 Duties respecting practice

217 Duty to cooperate

218 Duty to give notice

219 Continuing duties

220 Duty to provide information

Division 3 – Complaints

221 Rules

222 Regulatory complaints by health occupation director 223 Regulatory complaints by others

224 Gathering information and records

225 Summary actions

Division 4 – Investigations

226 General powers

227 Appointment of investigator

228 Duty to proceed in timely manner

229 Limits on investigation powers

230 Investigation powers

Division 5 – Decision After Investigation

231 What health occupation director must decide

232 Decision

233 Reconsideration

PART 5 – INVESTIGATIONS AND DISCIPLINE GENERALLY

Division 1 – Identity Protection

234 Definitions

235 Applications under this Division

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236 Who may apply for identity protection order

237 Considerations for identity protection order

238 Notice before decision is made

239 Identity protection orders

240 Termination orders and reconsideration

241 Notice of final decision

Division 2 – Disclosure of Information

242 Protected information

243 Disclosure of protected information

244 Disclosure may be refused

245 Investigation information to complainants

246 Investigation information to respondents

247 Information for purposes of hearing

248 Information respecting citations and orders

249 Update of registry

250 If identity protection order made

251 Personal health information

252 Notice of health hazard

253 Notice to employers

254 Content of notice to employers

255 Public notice of certain matters

256 Publication of certain matters

Division 3 – Orders During Investigation Stage

257 Information and production orders

258 Summary dismissal orders

259 Summary protection orders

260 Making summary protection orders

261 Reconsideration

262 Variation or termination of summary protection order 263 Suspension and termination orders

Division 4 – Disciplinary and Other Orders

264 Definition

265 Factors that must be considered

266 Factors that may be considered

267 Additional factors if respondent is licensee

268 Restorative processes

269 Orders not affecting practice authority

270 Orders affecting practice authority

271 Monetary penalties and refunds

272 Orders for hearing costs

273 Orders for investigation expenses

274 Making order for penalty, costs, expenses or refund 275 Recovery of penalty, costs, expenses or refund Division 5 – Support Programs

276 Definitions

277 Bylaws or rules

278 Administration

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279 Application for support

280 After receiving application

281 Decision respecting support

282 Eligibility for information services

283 Eligibility for support services and workers

284 Decision is not a finding

285 Determinations respecting information services 286 Determinations respecting support services

287 Determinations respecting support workers

288 List of support workers

289 Notice of decision and determination

290 Receiving support services

291 Service providers

292 Eligibility of service providers

293 Information to support worker

294 Assistance support workers must give

295 Assistance support workers may give

296 Recommendations to persons with powers and duties 297 Application to change determination

298 When support must be changed, suspended or terminated 299 When support may be changed, suspended or terminated 300 Recovering funding

301 Amounts that can be recovered

302 Orders for recovery

303 Recovery from respondents

304 If order made for other amounts

305 Responsibility for funding support programs

306 Shared funding agreements

PART 6 – HEALTH PROFESSIONS REVIEW BOARD

307 Definitions

308 Health Professions Review Board continued

309 Chair and members

310 Review powers

311 Making applications

312 Variations of application requirements

313 Serving applications

314 Identity protection

315 Conduct of review

316 Review does not operate as stay

317 Application of Administrative Tribunals Act to reviews 318 After licensing decision review

319 After complaint disposition review

320 After timeliness review

321 Giving copies of order

322 Recommendations to superintendent

323 Annual report

324 Other administrative matters

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PART 7 – PUBLIC HEALTH EMERGENCIES

Division 1 – Emergency Orders Generally

325 Definitions

326 Application of Part

327 Application of emergency orders

328 Duration of emergency orders

329 Notice and consultations

Division 2 – Administrative Orders

330 When administrative orders may be made

331 Suspending or extending periods

332 On making administrative order

Division 3 – Scope of Practice Orders

333 When scope of practice orders may be made

334 Scope of practice orders

335 Limits on authorizations, modifications and waivers 336 Taking regulated actions

337 Limits on acting as authorized person

338 Records and reports

339 On making scope of practice order

340 Minister retains discretion

PART 8 – REGULATORS

Division 1 – Regulatory Colleges

341 Definitions

342 Regulatory colleges

343 Corporate matters

344 Responsibilities of board

345 Recommendations of superintendent

346 Appointments to board

347 If board membership does not meet requirements 348 Board chair and vice chair

349 Oath of office

350 Remuneration and expenses

351 Bylaws respecting conflicts of interest

352 If board member has conflict of interest

353 If regulatory complaint against board member

354 Request to superintendent respecting conflict

355 Bylaws respecting appointments

356 Bylaws respecting general practice

357 Bylaws respecting meetings and committees

358 No interference or influence

359 Registrar and other persons

360 Deputy registrar and employees

361 Professional standards advisors

362 Advice of professional standards advisors

363 Officers

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Division 2 – Health Occupation Directors

364 Responsibilities of health occupation director 365 Appointment of health occupation director

366 Application of bylaws if appointed by board

367 Deputy health occupation director

368 Investigators and others

369 General powers and duties

370 No interference or influence

Division 3 – Unauthorized Practice

371 Duty to monitor

372 References under this Division

373 Suspected contravention by unauthorized person 374 Investigation of unauthorized person

375 Information about investigation

376 Dismissal of matter

377 Disposition of matter

Division 4 – Hearings, Reconsiderations and Reviews 378 Interpretation

379 Bylaws and rules

380 Conduct of hearings

381 Application for reconsideration or review

382 Conduct of reconsideration or review

383 After reconsideration or review

Division 5 – Administration

384 How bylaws and rules may be made

385 General bylaw- and rule-making powers

386 Administrative powers

387 Notices and consultations

388 Collaboration between jurisdictions

389 Oversight of agreements

390 Disciplinary and capacity records

391 Information and records generally

392 Fees for regulatory colleges

393 Fees for regulatory programs

394 Application of Financial Administration Act

395 Keeping a registry

396 Publishing information kept in registry

397 Publishing information generally

398 Annual report

399 Statutory immunity for protected persons

400 Statutory immunity for regulatory colleges

Division 6 – Restructuring Assessments

401 Restructuring assessments

402 When restructuring assessment must or may be conducted 403 How to conduct restructuring assessment

404 Minister’s decision

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Division 7 – Transferring Governance Responsibilities 405 Definitions

406 Transfer of governance responsibilities

407 Transfer agreements

408 Transfer under transfer agreement

409 Records and confidential information

410 Power or duty in progress

411 Practitioners

412 Applicants

413 Health profession corporations

414 Directions respecting transfer

Division 8 – Establishing New Regulatory College

415 Establishing new regulatory college

416 Additional establishment powers

Division 9 – Amalgamating Regulatory Colleges

417 Definitions

418 Amalgamation orders

419 First board

420 Transition of board

421 First bylaws and transition of bylaws

422 Officers and committees

423 If regulatory program included

424 Additional restructuring powers

425 Effect of amalgamation generally

426 Property and obligations

427 Information and records

428 Power or duty in progress

429 Bylaws to authorize continued actions

430 Quality assurance assessments

431 Investigation and discipline

432 Practitioners

433 Applicants

434 Health profession corporations

PART 9 – REGULATORY OVERSIGHT

Division 1 – Superintendent’s Office

435 Establishment of superintendent’s office

436 Members of superintendent’s office

437 Employees

438 Deputy superintendent

439 Retention of experts

440 Collection of fees

441 Minister’s directions

442 Administrative powers

Division 2 – Discipline Tribunal

443 Establishment of discipline tribunal

444 Director of discipline

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445 Deputy director of discipline

446 Retention of experts

447 Practice and procedure

448 Process for appointing discipline panel members 449 Appointment of discipline panel members

450 Application of Administrative Tribunals Act

451 Information and records

Division 3 – Appointment of Board Members

452 Appointment processes

453 Consultations and assistance

454 Recommendations for appointments and rescindments Division 4 – Types of Oversight Processes

455 Definitions

456 Performance standards

457 Types of oversight processes

458 When superintendent must act

459 When superintendent may act

460 Dismissal of oversight complaint

461 Transfer of oversight complaint

Division 5 – Conduct of Oversight Processes

462 Making oversight complaints

463 Notice of decision to dismiss

464 Notice to regulator

465 Notice to other persons

466 General powers

467 If Indigenous matters

468 Obtaining information and records

469 Oversight investigations and systemic reviews

470 Additional powers

471 Enforcement of orders

472 Remedial and other actions

473 Matters to consider

474 Preparing oversight report

475 Providing oversight report

476 Further information

477 Minister’s orders

478 If order made

479 Failure to comply with certain orders

Division 6 – Inquiries and Public Administrators

480 Inquiries

481 After inquiry

482 Public administrators

483 Board members if public administrator appointed 484 Costs and expenses

Division 7 – Reports

485 Director of discipline’s annual report

486 Superintendent’s annual report

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487 Making reports

488 Special reports and public comments

489 Receipt of annual report

PART 10 – ADMINISTRATION AND ENFORCEMENT

Division 1 – Information

490 Compellability of information

491 Health human resources information

492 Discrimination monitoring information

493 If information collection order made

494 Disclosure of potential fraud or misbilling

495 Notices, orders and other records

Division 2 – Recovering Debts Due

496 Definitions

497 Who may make certificates

498 Making certificates

499 Filing certificates

500 Effect of certificates

Division 3 – Court Orders and Judicial Review

501 Definitions

502 Applications for orders

503 Hearings and orders

504 Injunction or compliance order

505 Order to compel information

506 Search and seizure order

507 Content of search and seizure order

508 Seizure of things not described in order

509 Detention of seized things

510 Detention of seized records

511 Warrantless search

512 Judicial review

Division 4 – Offences and Penalties

513 Offence Act application

514 Offences

515 Limitation date

516 Offence by corporation

517 Single and continuing offences

518 Penalties

PART 11 – REGULATION-MAKING POWERS

Division 1 – Regulations of Lieutenant Governor in Council 519 General regulation-making powers

520 Designations

521 Hearings

522 Disposition of regulatory complaints

523 Monetary penalties, costs and expenses

524 Support programs

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525 General matters respecting regulators

526 Restructuring regulators

527 Superintendent’s office

528 Fees and expenses

529 Applications to court

530 Information

531 Other matters

532 Classes, exemptions and discretion

Division 2 – Incorporation by Reference

533 Incorporation by reference authorized

PART 12 – TRANSITIONAL PROVISIONS, REPEAL, CONSEQUENTIAL AMENDMENTS AND AMENDMENT TO THIS ACT

534 Definition

535 Transition – advisory panels

536 Transition – applications for designation

537 Transition – board members

538 Transition – bylaws

539 Transition – certified non-registrants

540 Transition – applications for registration or health profession corporation permit

541 Transition – committees

542 Transition – investigations

543 Transition – disciplinary proceedings

544 Transition – Labour Mobility Act and nurse practitioners 545 Transitional regulations

546 Repeal – Health Professions Act

547 – 643 Consequential Amendments

644 Amendment to this Act

645 Commencement

HIS MAJESTY, by and with the advice and consent of the Legislative Assembly of the Province of British Columbia, enacts as follows:

PART 1 – INTERPRETATION AND GUIDING PRINCIPLES

Division 1 – Interpretation

General definitions

1 In this Act:

“accreditation standards” means accreditation standards as defined in section 7 (2) [types of standards];

“actionable conduct” has the meaning given to it in section 11 (1) [misconduct and actionable conduct];

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“administrative matter” means a matter referred to in section 107 [what are administrative matters];

“anti-discrimination measures” means measures taken, including implementing processes, for the purposes of conducting regulatory processes or providing health services in a manner that is consistent with one or more of the objectives referred to in section 15 [anti-discrimination measures];

“aspect of practice” means an activity, other than a restricted activity, that

(a) is part of providing a health service that is within the scope of practice of a designated health profession, and

(b) requires professional knowledge, skills, ability and judgment;

“assessment”, in the context of an assessment by a regulated health practitioner of a patient or of a respondent undergoing a capacity evaluation, means to apply a clinical judgment for the purposes of evaluating the patient’s or respondent’s physical or mental condition to determine the following:

(a) in the case of a patient, whether the condition can be improved or resolved by the provision of health services that the regulated health practitioner is authorized to provide;

(b) in the case of a respondent, the matters referred to in section 141 (1) (b)

[assessments and reports];

“authorization”, in the context of a designated health occupation, means an authorization, in the form of a permit, letter or other type of written record, to practise the designated health occupation, issued or renewed by the health occupation director of the applicable regulatory program;

“board” means a board of a regulatory college;

“bylaw” means a bylaw of a regulatory college, made by the board;

“capacity”, except in section 343 (3) [corporate matters], means capacity to be fit to practise a designated health profession, as described in section 39 (3)

[fit to practise];

“capacity evaluation” means an evaluation of a respondent’s capacity, conducted as part of an investigation and further to an order made under section 140 [initiating capacity evaluation];

“capacity officer” means a person retained or employed under section 363

[officers] to exercise the powers and perform the duties of a capacity officer;

“capacity record” has the meaning given to it in section 390 [disciplinary and capacity records];

“capacity summary” means the summary described in section 390 (2) (b);

“citation” means a citation for a discipline hearing, issued by the director of discipline;

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“competence” means competence to be fit to practise a designated health profession, as described in section 39 (2);

“competence assessment” means an assessment of a respondent’s competence, conducted as part of an investigation and further to an order made under section 132 [competence assessments];

“conflict of interest” includes actual, potential and perceived conflicts of interest;

“continuing practice order” means an order made under section 146

[continuing practice order];

“continuing professional development” means an activity or program undertaken for the purpose of ensuring that professional knowledge, skills and abilities remain current;

“corporation” has the same meaning as in the Business Corporations Act;

“credential” means a certificate or other record that is evidence of the holder’s education, training, experience or other qualifications;

“criminal record check” has the same meaning as “criminal record check” or

“criminal record check verification”, as applicable in the context, in the Criminal Records Review Act;

“criminal record check authorization” has the same meaning as in the Criminal Records Review Act;

“designated health occupation” means a health occupation that is designated under Part 2 [Designation and Model of Regulation] as a designated health occupation;

“designated health profession” means a health profession that is designated under Part 2 as a designated health profession;

“designated profession or occupation” means a designated health profession or designated health occupation;

“designation assessment” means an assessment conducted under Division 1

[Designation] of Part 2;

“designation regulation” means a regulation of the minister that designates a health profession or health occupation as a designated profession or occupation;

“diagnose” means to identify a disease, disorder or condition as the cause of the signs expressed or symptoms exhibited by an individual;

“director of discipline” means the person appointed under section 444 [director of discipline] as the person responsible for the management of the discipline tribunal;

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“disciplinary order” means the following:

(a) an order that

(i) is or may be made against a respondent for the purpose of disposing of an administrative matter, regulatory complaint or citation, and

(ii) is described in section 268 [restorative processes], 269 [orders not affecting practice authority], 270 [orders affecting practice authority] or 271 [monetary penalties and refunds];

(b) an order made against a respondent by a discipline panel in the course of a discipline hearing;

“disciplinary record” has the meaning given to it in section 390;

“discipline hearing” means a hearing before a discipline panel of the discipline tribunal;

“discipline panel” means a discipline panel appointed under section 169

[appointing discipline panels] to conduct a discipline hearing;

“discipline panel member” means a person appointed under section 449

[appointment of discipline panel members];

“discipline tribunal” means the discipline tribunal established under section 443

[establishment of discipline tribunal];

“disclose” includes all of the following:

(a) to give, under this Act, information or a record to a person;

(b) to publish information, a record or a registry;

(c) to include information in a registry, if the

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