On May 1, 2018, new regulations under the Regulated Health Professions Act came into effect. These amendments are part of the Protecting Patients Act, which was passed on May 30, 2017, and which strengthens the prevention of, and response to, incidents of patient sexual abuse, increases supports for victims of sexual abuse by regulated health professionals and improves regulatory oversight and accountability of health regulatory colleges. Visit the Ministry of Health and Long-Term Care website for more information about the Protecting Patients Act 2017.
DEFINING WHO IS A PATIENT, AND WHEN, IN RELATION TO SEXUAL ABUSE ALLEGATIONS
Criteria that specifies under what conditions or circumstances someone will be considered to be a patient, for the purposes of subsection 1 (6) of the Health Professions Procedural Code, have now been established. The regulation states that an individual can be considered a patient where there is a direct interaction between the individual and the health professional and any of the following conditions are met:
- The professional has charged or received payment from the individual (or a third party on behalf of the individual) for a health care service provided by the professional;
- The professional has contributed to a health record or file for the individual;
- The individual has consented to the healthcare service recommended by the professional; and
- The professional prescribed a drug for which a prescription is needed to the individual.
In other words, if any of the above interactions takes place between an individual and a pharmacy professional, then that individual would be considered, in the context of sexual abuse allegations, to be a patient.
Pharmacy professionals must use their professional judgment to determine whether a specific interaction with a patient fits within the prescribed definition. Things to consider may be, but are not limited to, whether the patient took any action as a result of the interaction, whether the patient would identify as a patient of the professional, whether the professional is accountable for action taken to provide care to the patient, whether any payment was processed as result of the interaction, and/or what role the professional plays in the pharmacy.
The regulation also establishes a minimum time period of one year after the end of a patient-professional relationship during which a sexual relationship between professionals and former patients are prohibited. This means that any pharmacy professional who engages in a sexual relationship with a patient before waiting a full year since terminating the patient-professional relationship will be subject to mandatory revocation of his/her certificate of registration.
An exception to this definition applies only if all of the following conditions are satisfied:
- There is, at the time the professional provides the healthcare services, an existing sexual relationship between the individual and the professional;
- The individual received a healthcare service from the professional in an emergency situation or in circumstances where the service is minor in nature; and
- The professional has taken reasonable steps to transfer the care of the individual to another professional or there is no reasonable opportunity to transfer care to another member.
SPECIFIED OFFENCES TRIGGERING MANDATORY REVOCATION
Additional changes to regulations that are now in effect have also specified the sexual offences under the Criminal Code which will trigger mandatory revocation of a regulated health professional’s certificate of registration.
- 151 - Sexual interference
- 152 - Invitation to sexual touching
- 153 - Sexual exploitation
- 153.1 - Sexual exploitation of a person with disability
- 160 (3) - Bestiality in the presence of or by a child
- 162 - Voyeurism
- 162.1 - Publication, etc., of an intimate image without consent
- 163.1 - Child pornography
- 170 - Parent or guardian procuring sexual activity
- 171.1 - Making sexually explicit material available to a child
- 172.1 - Luring a child
- 172.2 - Agreement or arrangement - sexual offence against a child
- 271 - Sexual assault
- 272 - Sexual assault with a weapon, threats to a third party or causing bodily harm, and
- 273 - Aggravated sexual assault.
REQUIREMENTS TO POST ON THE PUBLIC REGISTER
Colleges are now required to report certain information about a regulated health professional on the public register, including:
- If there has been a finding of guilt against a professional under the Criminal Code or the Controlled Drugs and Substances Act and certain information related to it;
- Any currently existing conditions of release following a charge for an offence under the Criminal Code or Controlled Drugs and Substances Act;
- If a professional has been charged with an offence under the Criminal Code or the Controlled Drugs and Substances Act and the charge is outstanding;
- If a member has been the subject of a disciplinary finding by another regulatory or licensing authority in any jurisdiction; and
- If a member is currently licensed or registered to practice another profession in Ontario or a profession in another jurisdiction.
FUNDING FOR THERAPY SERVICES EXPANDED
The proclamation of Protecting Patients Act regulations on May 1, 2018 also has made it easier for patients who have been sexually abused by a regulated health professional to be able to access funding for therapy and counselling services. Instead of waiting for a finding by a panel of the Discipline Committee, a patient can now request funding through the College’s Patient Relations Program to help pay for therapy or counselling services immediately after the College has been made aware of a complaint or a report of sexual abuse by a pharmacist or pharmacy technician.
Should a patient wish to access this funding, there is little more required than to complete a simple form now available on our website along with information we need from the patient’s therapist or counsellor. The College then pays the therapist directly for services provided to the patient. The communication between patients and the College to help them access these funds is discreet, confidential and respectful of a patient’s right to choose whether to participate in the program.
This is an important part of our regulatory responsibility and commitment to protect the public. The College is fully supportive of the move to make access to funding for therapy services easier for victims of sexual abuse. For more information about the Patient Relations Program or about the funding available for patients through this program, please visit our website.
These important regulatory changes will further strengthen our collective commitment to zero tolerance for sexual abuse of patients by regulated health professionals and will also result in greater consistency between the Drug and Pharmacies Regulation Act and the Regulated Health Professions Act with respect to interim suspensions. The College remains committed to working closely with government as additional regulations – including those related to the composition of panels and committees and functions of the Patient Relations Committee – are developed.