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Directing Residential Care Concerns to Health Authorities

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The Challenges
Other issues that have been raised about the registry relate to: privacy considerations when it comes to sharing information for investigation, which affects investigators’ ability and authority to access health records, witnesses and licensing information; perceived partiality of investigator; multiple investigatory streams, and conflicting results; perceived loopholes in various processes; as well as questions about sustainable operating funding. There are also important philosophical differences around expectations between operators and the investigators whose background is in labour relations and mediation (“zero tolerance”, “just fire them” versus “graduated discipline”, without aides necessarily being dismissed and deregistered).
==References==
#Patient Care Quality Review Board Act, Bill, 41, 2008, s. 1
#(2013) Patient Care Quality Office Resource Guide. Ministry of Health, p. 5. Online : http://www.phsa.ca/NR/rdonlyres/CF2CFA45-A2FC-45C6-920C-F775C740CA03/64611/PCQOResourceGuideMoHS_PHSA2012.pdf (Last accessed May 1, 2014).
#See: Provincial Health Services Authority. Patient Care Quality Office. Online : http://www.phsa.ca/NR/rdonlyres/CF2CFA45-A2FC-45C6-920C-F775C740CA03/64611/PCQOResourceGuideMoHS_PHSA2012.pdf (Last accessed May 1, 2014). Also Note : Murtaugh, J. (2012). Patient Care Quality Program Final Evaluation Report. Prepared for BC Ministry of Health. Online: http://www.health.gov.bc.ca/library/publications/year/2012/patient-care-quality-program-evaluation-report.pdf [“Murtaugh”] Notes that staff find the PCQ timelines challenging and unreasonable.
#Murtaugh.
#See Murtaugh, pg. 17, Figure 1.
#Murtaugh, pg. 24.
#Murtaugh.
#Murtaugh, p. 21.
#Murtaugh, p. 41
#"care quality complaint" means a complaint
##(a) respecting one or more of the following:
###(i) the delivery of, or the failure to deliver, health care;
###(ii) the quality of health care delivered;
###(iii) the delivery of, or the failure to deliver, a service relating to health care;
###(iv) the quality of any service relating to health care, and
##(b) made by or on behalf of the individual to whom the health care or service was delivered or not delivered. "Health care" means anything that is provided to an individual for a therapeutic, preventive, palliative, diagnostic or other health related purpose, and includes (a) a course of health care, and (b) other prescribed services relating to individuals' health or well-being.
#HCCCFAA, s.1
#HCCCFAA, s.1
#Patient Quality Care Review Board Act. Bill 41 (2008). Patient Care Quality Review Board, “Legislation” . Online: http://www.patientcarequalityreviewboard.ca/legislation.html (Last accessed May 1, 2014)
#Patient Care Quality Review Board. “About us”. Online: http://www.patientcarequalityreviewboard.ca/aboutus.html (Last accessed May 1, 2014)
#For an example of appeal board issues potentially affecting the care of residents, See: SB, CB, SG & JN v. Vancouver Island Health Authority & Cowichan Lodge. 2008 BCCCALAB 6. (Application for Stay order pending appeal - Granted)
#Patient Care Quality Review Board. 2013 Annual Report. Online: http://www.health.gov.bc.ca/library/publications/year/2013/PCQRB-annualreport-1213.pdf (Last accessed May 1, 2014)
#Patient Care Quality Review Board. “Frequently asked questions”. Online : http://www.patientcarequalityreviewboard.ca/faqs.html#Q20 (Last accessed May 1, 2014)
#Patient Quality Care Review Board Annual Report, 2011-12, pg.33. Online : http://www.health.gov.bc.ca/library/publications/year/2012/PCQRB-annualreport-1112.pdf (Last accessed May 1, 2014)
#CCALA, s. 15.
#See Sivertson (Guardian ad litem of) v. Dutrisac [2011] B.C.J. No. 810, 2011 BCSC 558.
#Best of Care, Part 2, pg. 314.
#Ombuds, Best of Care, Recommendation 160: The Fraser, Interior, Northern and Vancouver Island health authorities inspect all residential care facilities governed under the Hospital Act in the same manner and with the same frequency as they inspect residential facilities licensed under the Community Care and Assisted Living Act commencing immediately.
#Office of the BC Ombudsperson. June 2013. Update on Status of Recommendations- The Best Of Care: Getting It Right For Seniors In British Columbia (Part 2) Public Report No. 47 Pg. 8.
##March 2013 - FH confirmed that it conducts and will continue to conduct annual inspections of residential care facilities governed under the Hospital Act in the same manner as CCALA facilities are inspected.
##October 2012- FHA has begun annual Hospital Act facility inspections. -January 2012
##FHA will collaborate with the Ministry of Health and other health authorities to develop and implement a standardized and consistent approach to the inspection of residential facilities governed under the Hospital Act.
#Ombuds, Best of Care Part 2, pg. 311
#Fraser Health. Inspection Category Definitions. Revised September 7, 2012.
#Ministry of Health. (February 2012). A guide to community care facility licensing in British Columbia, pg. 40. Online : http://www.health.gov.bc.ca/ccf/publications/a-guide-to-community-care-facility-licensing.pdf (Last accessed May 1, 2014) [ “Community care licensing guide”]
#Ombuds, Best of Care, p. 348.
#http://www.ccalab.gov.bc.ca/dec/2004_BCCCALAB_1.pdf (Last accessed May 1, 2014)
#Community care licensing guide, pg. 4.
#RCR, Schedule D, Bill of Rights, s 4 (d).
#Vancouver Coastal Health. Clinical Ethics Services. Online : http://alliedhealth.vch.ca/docs/Ethics_Brochure.pdf (Last accessed May 1, 2014)
#Interior Health. « Dispute of a Health care Decision made by a Temporary Substitute Decisionmaker » AL0100 Consent – Adults . Administrative Policy Manual. Date [Approved 2005, last reviewed June 2012].
#Rudnick, A., Pallaveshi, L. , Sibbald, R.W. , & Forchuk, C. (March 2014 ) Informal ethics consultations in academic health care settings: A quantitative description and a qualitative analysis with a focus on patient participation. Clinical Ethics , 9(1), 28-35.
#RCR, s. 38.
#RCR, s. 40 (1).
#Care Aide and Community Health Worker Registry. “About the Registry”. Online: http://www.cachwr.bc.ca/About-the-Registry.aspx (Last accessed May 1, 2014)
#The Registry’s enabling framework is the Letter of Understanding (LOU) that was signed by HEABC, the Facilities Bargaining Association (FBA) and the Community Bargaining Association (CBA) in 2010. Appendix A of the LOU outlines the Registry’s investigative and removal process. The Registry reports to the Executive Director at Health Match BC, the HEABC President /CEO, and the MOH.
#“Employers- Frequently Asked Questions” Online: http://www.cachwr.bc.ca/About-the-Registry/Employer-FAQ.aspx (Last accessed May 1, 2014)
#Foerster, V.& Murtagh, J. (February , 2013) British Columbia Care Aide & Community Health Worker Registry: A Review, Ministry of Health, pg. iv. Online: http://www.health.gov.bc.ca/library/publications/year/2013/bc-care-aide-registry-report.pdf (Last accessed May 1, 2014)
{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}}
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