1 / 31

The Long-Term Care Homes Act, 2007

Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario. Creation of Resident-Centred Legislation. Includes a Preamble which states that the people of Ontario and their Government believe i

yoshino
Télécharger la présentation

The Long-Term Care Homes Act, 2007

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario The Long-Term Care Homes Act, 2007 Presentation to Queens University Law School March 24, 2010 Bella Fox, Senior Counsel Priti Sachdeva, Counsel Legal Services Branch Ministry of Health and Long-Term Care

    2. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Creation of Resident-Centred Legislation Includes a Preamble which states that the people of Ontario and their Government believe in resident-centred care; Reflects the Governments expectations for the creation of a resident-centred system in which people receive the care and support they require; and Is based on the fundamental principle set out in the Act as follows: The fundamental principle to be applied in the interpretation of this Act and anything required or permitted under this Act is that a long-term care home is primarily the home of its residents and is to be operated so that it is a place where they may live with dignity and in security, safety and comfort and have their physical, psychological, social, cultural and spiritual needs met.

    3. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Key Program Areas Residents rights and safeguards; Service expectations and requirements; Funding and accountability; System Management (including a licensing scheme); and Compliance inspection and enforcement.

    4. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Preamble A new Preamble highlights key themes including: Belief in resident-centred care; Commitment to the health and well-being of Ontarians living in long-term care homes now and in the future; Access to long-term care homes that is based on assessed need; Accountability and transparency; Service planning that focuses on resident needs and the safety needs of all residents; Responsibility to take action where requirements under the Act are not met; Commitment to the promotion of the delivery of long-term care home services by not-for-profit organizations.

    5. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Residents Rights, Care and Services Residents Bill of Rights expanded and strengthened to enhance enforceability; Requirement for a mission statement for each home that is consistent with the fundamental principle and Residents Bill of Rights and that is put into practice in the day-to-day operation of the home; Requirement to ensure that the home is a safe and secure environment for its residents; Requirement for a written plan of care for each resident setting out all aspects of the residents care. Staff must collaborate with each other in its development and implementation. Staff who provide direct care must have immediate and convenient access to the plan of care;

    6. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Residents Rights, Care and Services Requirement to provide current key services, including nursing and personal support, restorative care, recreational and social activities, dietary services and hydration, medical services, information and referral assistance, religious and spiritual practices and accommodation services. Additional services and service requirements, including staffing and care standards, may be added through regulation; Requirement for at least one Registered Nurse to be on duty and on-site, 24/7, except as provided for in the regulations;

    7. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Residents Rights, Care and Services Requirement to ensure that there is an organized volunteer program that includes measures to support the participation of volunteers; Allows for the establishment of an Office of the Long-Term Care Homes Resident and Family Adviser to assist and provide information to residents, their families and others and also advise the Minister on issues concerning the interests of residents.

    8. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Strengthened Safeguards Protect residents from abuse and ensure that residents are not neglected; Development and implementation of a policy to promote zero tolerance of abuse and neglect of residents; Immediate investigation and taking of appropriate action by the licensee on each suspected, alleged or witnessed incident of abuse or neglect of a resident; Whistle-blowing protection for all persons including staff, residents and volunteers who disclose information to the Director or inspector or give evidence (or may give evidence) in a proceeding or inquest;

    9. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Strengthened Safeguards Ministry must immediately visit the home if there is information: Of serious harm or risk of serious harm to a resident that resulted from: Improper or incompetent treatment or care, Abuse or neglect, or Unlawful conduct. Of retaliation or threats to retaliate against a person who has made a report of abuse or neglect or because evidence has been given or may be given in a proceeding or in an inquest.

    10. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Strengthened Safeguards Staff members who believe they have been retaliated against by an employer may have the matter dealt with by final and binding settlement by arbitration under a collective agreement, if any, or file a complaint with the Ontario Labour Relations Board.

    11. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Minimizing Restraints To ensure restraints are only used where absolutely necessary, and with appropriate safeguards, the Act limits the use of restraints as well as personal assistance services devices (PASDs) (such as trays) that limit or inhibit a residents movement where used as a restraint or to assist a resident with a routine activity of living. Provisions dealing with restraining have the following key features: Licensee must have a policy to limit the use of restraints and to ensure that any restraining that is necessary is done in accordance with the Act and regulations; Common law duty to restrain or confine a person when immediate action is necessary to prevent serious bodily harm to the person or others is preserved; When set out in a plan of care as part of treatment, use of a drug as prescribed by a physician is not a restraint; regulations will be able to be made relating to the use of psychotropic drugs; Resident can be restrained by a drug only under common law duty and if ordered by a physician or other person provided for in the regulations;

    12. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Minimizing Restraints Resident cannot be restrained, in any way, for convenience of the licensee or staff, or as a disciplinary measure; Use of barriers, locks or other devices or controls at entrances and exits to the home or the grounds of the home is not a restraint unless the resident is prevented from leaving; Resident may be restrained by a physical restraint only if the restraint is set out in the residents plan of care; A physical restraint may be included in a residents plan of care only if specific requirements set out in the proposed Act are met; A resident, or, if incapable, the residents authorized substitute decision-maker, must consent to the application of a physical restraint or a PASD.

    13. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Personal Assistance Services Devices Use of a personal assistance services device (PASD) to assist a resident with a routine activity of daily living is not a restraining of the resident. A PASD that limits or inhibits a residents movement and from which a resident is unable to release himself or herself can only be used if the PASD is included in the residents plan of care. The PASD may be included in the plan of care only if specific requirements set out in the Act are met. The Act codifies the requirement to have the consent of the resident or, if incapable, the residents substitute decision-maker to use a PASD. Use of a PASD to restrain a resident is considered a physical restraint to which the physical restraints provisions apply.

    14. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Admission of Residents Requirements for more comprehensive and timely assessments related to the applicants physical and mental health, current behaviour and behaviour during the year preceding the assessment; Expanded requirements for the provision of information to applicants about the placement process, choices that applicants have related to the process, and the implications of these choices for applicants; Admission requirements also apply to residents being transferred within a home to a specialized unit; Director may direct the placement co-ordinator to cease admissions to a home at any time if there is risk of harm to residents.

    15. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Operation of Homes Mandatory requirement to establish a Residents Council in each home; Requirement to establish a Family Council if requested; Extensive requirements for orientation and training for staff at the home; staff who provide direct care to residents must receive training in a number of areas including palliative care, abuse recognition and prevention, mental health issues, including caring for people with dementia, behaviour management and other areas provided for in regulation; Orientation for volunteers that includes information on the Residents Bill of Rights, the LTC homes mission statement and abuse policy and other areas provided for in regulation; Requirement to ensure that all the staff in the home have the proper skills and qualifications to perform their duties and possess the qualifications provided for in the regulations; staff duties can be set out in regulation;

    16. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Operation of Homes Requirement to have Administrator and the Director of Nursing and Personal Care with regulation-making powers to require these persons to work full-time or a certain number of hours; Requirement to conduct screening measures before hiring new staff or accepting new volunteers, including criminal reference checks (except for persons under 18 years). Requirement to limit the use of agency, temporary or casual staff in accordance with the regulations in order to provide a stable and consistent workforce and improve continuity of care; Requirement to conduct an annual resident and family satisfaction survey and make every reasonable effort to act on the results to improve service;

    17. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Operation of Homes Requirement to develop and implement a continuous quality improvement review system; Requirement to have an infection prevention and control program and emergency plans.

    18. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Resident Information, Agreements and Trust Accounts Requirement to provide a package of information to residents that includes the Residents Bill of Rights, the homes policy to promote zero tolerance of abuse and neglect, the homes mission statements, complaint procedures, and residents charges. Information, including inspection reports and compliance orders, must be posted in the home. Regulated documents will need to meet certain requirements set out in the regulations. Certain agreements will be voidable for 10 days. Coercion relating to the signing of documents will be prohibited; Regulation-making authority to enable strengthened requirements for management of resident trust accounts.

    19. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Resident Charges and Ministry Funding Residents shall not be charged more than the amount provided for in the regulations for all classes of accommodation, including basic accommodation; For preferred accommodation, a written agreement with the resident is required otherwise only the basic accommodation rate can be charged. For anything other than accommodation, the resident can only be charged if there is a written agreement with the licensee (e.g. television, telephone); Resident cannot be charged for anything prohibited in the regulations; Broad funding powers for the Ministry to fund homes (operating and capital costs) and impose conditions on funding.

    20. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Accountability Provisions Duties of Directors and Officers Care, diligence and skill of reasonably prudent person in comparable circumstances while taking such measures as necessary to ensure corporation complies with the Act; Reporting Obligations General obligation of licensee to submit reports to the Director as required by regulations; Mandatory reporting requirements to the Ministry of complaints, improper or incompetent treatment or care, abuse or neglect of a resident and unlawful conduct any of which results in harm or risk of harm to residents, and misuse or misappropriation of a residents money or funding provided to a licensee; Persons having obligations to report; Whistle-blowing protection; Directors obligation to publish certain reports.

    21. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Accountability Provisions Account and Record Obligations Licensees to keep accounts and records of each long-term care home operated separate from every other long-term care home and/or business operated by the licensee; Non-Arms Length Transactions Residents information packages must disclose non-arms length transactions between licensees and other providers of care, services, programs or goods to residents; Licensees cannot enter into any non-arms length transaction prohibited by the regulations; Regulations may permit certain types of transactions provided Directors prior approval is obtained and any related reports are submitted to the Director.

    22. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario System Management (including Licences) Strengthened public interest tests and eligibility requirements relating to the issuance of licences; Public consultation still required prior to licensing decisions; Licences to be issued with fixed terms (up to 25 years) and subject to conditions; Transitional licence terms for existing homes (except municipal) will be based on each homes structural classification; After a fixed term licence expires, a home may be granted another fixed term licence. The Ministry must provide at least three years notice prior to the expiry of any fixed term licence as to whether a new licence will be issued or not and under what conditions; Director not required to provide reasons;

    23. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario System Management (including Licences) Restrictions on licence amendments; Requirement for approval of management contracts; Security interest may be exercised if a management contract is entered into; Temporary licences can be issued for a fixed term of no more than 5 years, Director can issue a temporary emergency licence for a period of not more than 60 days to respond to emergencies; Director can authorize temporary additional beds for a single period of not more than 30 consecutive days in circumstances to be set out in regulation;

    24. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario System Management (including Licences) Licence transfers of beds and any change in the controlling interest in the licensee will require prior Ministry approval and will be subject to all relevant public interest tests, eligibility requirements and conditions imposed by the Ministry; Restriction on the transfer of non-profit homes to the for-profit sector except in limited circumstances set out in the regulations; Decisions of the Minister and Director relating to licensing are within the sole discretion of the Minister and Director and not subject to appeal; Regulation-making authority to ensure adequate building maintenance.

    25. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Municipal and First Nations Homes Southern municipalities will continue to be required to establish and maintain a long-term care home or joint home or help maintain a home or joint home with Ministry approval; Northern municipalities will be allowed to establish and maintain a home or joint home or help maintain a home or joint home with Ministry approval; Municipal homes will be approved by Ministry; the approval cannot be transferred by the municipality nor can it be revoked by the Ministry;

    26. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Municipal and First Nations Homes The Director will be able to make orders regarding renovations or alterations to approved homes, subject to a right of appeal to the Health Services Appeal and Review Board; First Nations may continue to establish long-term care homes, as currently provided in the Homes for the Aged and Rest Homes Act. First Nations may also continue to apply for licences to operate a long-term care home; Ministry will apply the public interest test for need when determining if a municipality or the First Nations can operate a new home or increase beds in an existing home.

    27. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario

    28. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Compliance Inspection and Enforcement Homes to be inspected at least annually. These inspections must be unannounced; Director may, in accordance with the regulations, recognize long-term care homes with an excellent record of compliance with the requirements under the legislation; More tools for the Ministry to move in a quick, consistent, transparent and appropriate way, using a variety of sanctions, including written notification, request for written plan of correction, compliance order, work/activity order, order that funding be returned or withheld and mandatory management order;

    29. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Compliance Inspection and Enforcement Most serious sanction is revocation where the Director makes an order revoking the licence. The Director may also order the home to be operated by an interim manager until the revocation becomes effective and the residents of the home are relocated. Exclusion of Due Diligence and Mistake of Fact to Certain Enforcement Orders Compliance orders, work/activity orders, orders to return or withhold funding, mandatory management orders and revocation orders can all be issued regardless of a licensee raising due diligence or mistake of fact in a particular circumstance; Exclusion does not apply to prosecutions.

    30. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Compliance Inspection and Enforcement Reviews and Appeals of Orders and Decisions Sufficiency of funding provided to a licensee from any source shall not be considered in any review or appeal; No automatic stay of an order or decision by the commencement of a review or appeal unless the Director/Appeal Board/Divisional Court determines that a stay will not cause harm or risk of harm to a resident;

    31. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Compliance Inspection and Enforcement Penalties Individuals 1st Offence up to $25,000 and/or imprisonment up to 1 year; Subsequent Offences up to $50,000 and/or imprisonment up to 1 year; Exception: relating to duties of directors and officers to exercise care, diligence and skill (section 69) - members of committees of management or boards of management, directors and officers of licensees that are non-profit, then fine is not less than $50 and not greater than $1000. Individuals not captured here subject to basic fines above but no imprisonment;

    32. Not Intended As Legal Advice - These slides do not represent the views of the Ministry of Health and Long-Term Care or the Ministry of the Attorney General of Ontario Compliance Inspection and Enforcement Corporations 1st Offence up to $50,000; Subsequent offences up to $200,000.00; Exception for individuals convicted of offences related to reporting obligations.

More Related