Policy and Political Action

Policy & Political Action

RNAO submission on Bill 160: Strengthening Quality and Accountability for Patients Act, 2017

RNAO is pleased to offer its submission on Bill 160, Strengthening Quality and Accountability for Patients Act, 2017.

RNAO supports Bill 160's objectives of strengthening transparency, accountability and quality of care in a person-centred health system. However, we caution against the unintended consequences of a number of the measures in the bill, such as expanding the practice of paramedics to primary care, accelerating privatization of health services, and further compromising safety of residents in long-term care.

Schedule 1. Amending the Ambulance Act

  1. Support the amendment to enable ambulances to go to destinations other than hospitals.
  2. Do not permit paramedics to deliver primary care. Refer patients requiring primary care needs to primary care providers.
  3. Give the client a choice of where to be delivered by ambulance.
  4. Proceed with the ban on fees or co-payments for ambulance services, and extend it to all medically necessary ambulance services.

Schedule 2. Amending the Excellent Care for All Act, 2010

  1. The legislation must limit the disclosure of personal information to HQO, to non-identifying information required for research purposes only. Require patient consent for the release of any data containing identifying information.
  2. Make the Patient Ombudsman an independent officer of the Legislature.

Schedule 3. Amending the Health Protection and Promotion Act, 1990

  1. Proceed to extend the scope of oversight by public health bodies as written and ensure that public health bodies have the funding to deliver on the expanded responsibilities.

Schedule 4. Health Sector Payment Transparency Act, 2017

  1. Ban the practice by the medical industry of providing payments and transfers of other value to health-care professionals and to organizations.
  2. Until a ban is in place, proceed to require public disclosure of payments and transfers of other value from the medical industry to health-care professionals and to organizations. Ensure that the reporting threshold is very low and that there are few exemptions.

Schedule 5. Amending the Long-Term Care Homes Act, 2007

  1. Mandate in legislation a minimum of four hours per resident-day of nursing and personal care (nurses and personal support workers) in long-term care. That should be comprised of one attending NP per 120 residents and a staff mix of 20 per cent RNs, 25 per cent RPNs and 55 per cent PSWs.
  2. Mandate the following compliance procedure: At the written notice and voluntary plan of correction stages, the inspector should recommend that non-complaint homes use RNAO's Long-Term Care Best Practices Guidelines (LTC BPG) Program to help them achieve compliance. At a compliance order stage, and for homes that are repeatedly found to be non-compliant, use of the Ministry of Health-funded RNAO LTC BP program should be a mandatory corrective measure. Fines should only be imposed as a last measure.
  3. Mandate that LTC inspection reports cover areas of compliance and non-compliance.
  4. Proceed with measures to minimize the use of restraints and confinement; however we urge that the word "confinement" be replaced with the term "placement in a protected area" and "confine" with "place in a protected area."
  5. Amend Section 6 amending 30.1 (2) 4 of the Act and Section 13 (2.1) (c) to read: "a physician, registered nurse, registered nurse in the extended class or other person," so that both RNs and nurse practitioners are able to recommend placement in protected areas.

Schedule 6. Medical Radiation and Imaging Technology Act, 2017

  1. Proceed with updating the regulation of medical radiation and imaging technology, but take measures to ensure RNs and NPs who may perform diagnostic ultrasounds are not obliged to join two regulatory colleges.

Schedule 7. Amending the Ontario Drug Benefit Act, 1990

  1. Proceed with the amendment of the Ontario Drug Benefit Act, and ensure that NPs and RNs are added to the list of acceptable prescribers and that RNs have access to medications under the EAP, and NPs with palliative care expertise have access to medications under the PCFA program.

Schedule 8. Ontario Mental Health Foundation Act, 1990

  1. Ensure significant enhancements in funding for mental health research and services.

Schedule 9. Oversight of Health Facilities and Devices Act, 2017

  1. Withdraw Schedule 9. Continue using the names "independent health facilities" and "out of hospital premises." Do not use the name "community health facilities."
  2. Do not repeal the Private Hospitals Act or the Independent Health Facilities Act.
  3. Introduce separate legislation to cover health facilities that are not adequately covered under existing legislation.

Schedule 10. Amending the Retirement Homes Act, 2010

  1. Proceed with strengthened oversight of retirement homes and with regular audits of the RHRA by the Auditor General, as well as reviews of the RHRA by the Ministry of Seniors Affairs.
  2. Do not allow confinement or restraint of residents in retirement homes except under temporary and extraordinary circumstances, until those residents can be placed in more appropriate settings.
  3. Replace the word "confinement" with the term "placement in a protected area", and "confine" with the term "place in a protected area."

To read the speaking notes, click here, or see the attachment at the bottom of this page.

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