ECFAA provides hospital boards with a broad mandate for oversight of patient care

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Posted in Governance, Health System, Hospitals, Patient Safety, Risk Management

The Medical Advisory Committee (“MAC”) of a hospital has traditionally been the primary mechanism for a board of directors to ensure that a hospital is providing the appropriate quality of care to its patients. However, the Quality Committee of a hospital, as required by the Excellent Care for All Act, may be equally as important for a board. While the MAC is critically important for oversight and evaluation of the patient care provided by privileged health care providers, it has a relatively limited mandate as compared to the Quality Committee. The Quality Committee is tasked with responsibility for, and granted the tools necessary to oversee, all aspects of patient care within a hospital; not just care provided by privileged doctors, dentists, extended class nurses and midwives. Michael Gleeson was recently interviewed on the topic of board oversight of patient care. See:

http://www.advocatedaily.com/ecfaa-provides-broader-oversight-of-patient-care.html

The Risk of Remaining Silent on Jurisdiction in Contracts

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Posted in Procurement, Risk Management

How a contract is interpreted by a court is in large part based on the terms set out in the jurisdiction and governing law sections of the contract. In some situations, parties may be tempted to omit these sections of a contract. Before omitting these sections, a party should be aware of the risks. By omitting jurisdiction and governing law clauses a party could be exposing itself to the possibility of: (i) bearing costs related to engagement of legal counsel in a foreign jurisdiction; (ii) bearing costs related to travel to a foreign jurisdiction; and (iii) being subject to a legal regime with remedies and penalties that the party did not consider when negotiating the relevant contract. Michael Gleeson was recently interviewed on the topic. See:

http://www.advocatedaily.com/the-risk-of-remaining-silent-on-jurisdiction-in-contracts.html

BILL 78: An opposition bill pushing for accountability in the funding of Ontario’s health care services

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Posted in Facilities, Health Professions, Hospitals, Investigations

On March 11, 2015, France Gélinas, the NDP’s health critic, introduced Bill 78, the Transparent and Accountable Health Care Act, 2015. Bill 78 has since passed second reading in the Ontario legislature and was referred to the Standing Committee on Social Policy on March 26, 2015.

The Bill proposes to promote transparency and accountability in the funding of health care services in Ontario by:

  • ensuring that certain persons and entities that receive public funds directly or indirectly are covered by legislative requirements relating to accountabi¬lity and transparency; and
  • requiring annual reporting on payments made by the Ontario Health Insurance Plan (OHIP) to certain persons and entities.

Both physicians and major suppliers to Ontario’s public health sector would be particularly impacted by this proposed legislation.

Broadening the Reach of the BPSAA, PSSDA, Ombudsman and Auditor General

Bill 78 proposes to broaden the reach of Part II.1 of the Broader Public Sector Accountability Act, 2010 (BPSAA) and the Public Sector Salary Disclosure Act, 1996 (PSSDA) to major health sector organizations and publicly-funded suppliers – in other words, to all health-sector entities receiving more than $1 million in public funding annually, whether directly or indirectly.

Subject to limited exceptions, Part II.1 of the BPSAA prohibits compensation increases for designated executives and restricts performance pay for designated employers. Currently, the only health-sector entities subject to these prohibitions are public hospitals. The Bill expands the reach of the PSSDA, which established Ontario’s “Sunshine List”, to all major health sector organizations, requiring the publication of the salaries of all employees earning over $100,000 per year.

Additionally, the mandate of the Auditor General is broadened by authorizing its audits of major health organizations and publicly-funded suppliers. Such health-sector entities would also be subject to oversight by the Ontario Ombudsman.

OHIP Payments Publication

Bill 78 would also require the Ministry of Health and Long-Term Care to annually publish a disclosure statement of the total amount paid to a person or entity receiving at least $100,000 through OHIP billings. The disclosure statement would also include “cautionary language”, explaining that the figures do not represent a physician’s net income. The cautionary language proposed by the Bill is as follows: “Readers of this disclosure statement should understand that it provides only a record of gross payments. In some instances, the recorded figure is a payment for the services of a number of physicians. Physicians must pay the expenses of their practice out of this gross amount. No calculation of a physician’s net income can be made from such figures. Conclusions cannot be drawn from these figures about the relative net income of any physician since overhead varies greatly from physician to physician.”

Supreme Court of Canada strikes down prohibition on assisted suicide

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Posted in Consent and Capacity, End-of-Life, Facilities, Family Health Teams, Health Leaders, Health Professions, Hospitals, Patient Safety, Risk Management

Mary Jane Dykeman interviewed about the new Supreme Court of Canada decision released today in Carter v. Canada (Attorney General)

See article: http://www.advocatedaily.com/supreme-court-reverses-ban-on-doctor-assisted-death-unconstitutional.html

Ontario’s IPC launches new resources to guard against snooping and other unauthorized access to personal health information

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Posted in Community Care Access Centre, Facilities, Family Health Teams, Foundations, Health Leaders, Hospitals, Privacy

The Information and Privacy Commissioner of Ontario launched a new campaign yesterday called “Is snooping on patients worth It?” See video and other resources.

Also included in this campaign is a new resource document for health care organizations called “Detecting and Deterring Unauthorized Access to Personal Health Information”.  This is a must read for all health care Privacy Officers.

The IPC/O’s tips for preventing or reducing the risk of unauthorized access include:

  • Develop and implement comprehensive privacy policies and review those policies on an annual basis
  • Provide mandatory privacy training for all staff – which includes initial orientation as well as ongoing privacy training and maintain a log of attendance
  • Prominently display privacy notices reminding staff of their privacy obligations
  • Include privacy warning flags in electronic health records to remind staff of their privacy obligations
  • Require all staff and other agents to sign confidentiality agreements on a regular basis
  • Have end-user agreements for anyone using your electronic information systems
  • Develop and implement a policy to restrict access to health information on a need-to-know basis only
  • Log, audit and monitor all accesses to electronic health records
  • Follow the IPC’s guidelines on privacy breach management with respect to patient notification and maintain a log of privacy breaches
  • Impose consistent, appropriate and proportionate disciplinary action for privacy breaches

DDO provides privacy coaching, breach management advice and on-site privacy training for health care organizations. If you haven’t reviewed your privacy policies lately or engaged your staff in formal privacy training in a number of years, call us to assist you. Mary Jane Dykeman mjdykeman@ddohealthlaw.com  416-967-7100 x 225