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HEALTH POLICY REPORT

A summary of current health legislation and policy developments

by OMA Health Policy Department

 

December 2007

PHARMACY COUNCIL: FOLLOW-UP MEDSCHECK

Subsequent to the April 2007 implementation of MedsCheck, the Pharmacy Council has developed a secondary service called “Follow-up MedsCheck,” which was launched November 30.

While an annual MedsCheck involves a 30-minute face-to-face medication review between a pharmacist and patient, the Follow-Up MedsCheck is triggered by a significant change in medication regime, may be conducted over the phone, and does not have a frequency limitation. Criteria for a Follow-Up MedsCheck include: a hospital discharge, a request by a physician or registered nurse, extended class RN(EC), or a pharmacist’s documented decision. It is expected that this supplementary service will be conducted at the same pharmacy where the annual MedsCheck took place, and applies to Ontarians taking a minimum of three chronic medications.

As an active participant in two Pharmacy Council working groups, the OMA is cognizant of physician interest and concern around these emerging developments, and their potential impact on patient care and physician practice.

OMA staff contact: Kristen Gane (ext. 3131)

FLU SHOTS

The distribution of flu vaccine for Ontario’s Universal Influenza Immunization Program (UIIP) is almost complete. As the program changes slightly year to year, it may be helpful to note the following:

  • The 2007 UIIP information packages are only available on the Internet, through the Influenza Immunization link on the Ministry of Health and Long-Term Care website (http://www.health.gov.on.ca/).
  • As in past years, distribution in Toronto is being administered by the Government Pharmacy (416-327-0837), while distribution outside Toronto is being administered by the local public health unit.
  • The distribution policy is as follows: Physicians will initially receive one-quarter of the total doses that they used last year, and another one-quarter two weeks later. Additional vaccine must be ordered. The OMA has no knowledge of any shortage of vaccine this year, so total requested volumes should be available.
  • The UIIP information package contains a fact sheet entitled “Informed Consent.” Although consent for treatment is always required, a consent “form” is not required, and the patient does not have to sign anything in order to receive a flu shot. The background material provided by the Ministry of Health and Long-Term Care is not clear on this point.

OMA staff contact: John Wellner (ext. 2953)

PANDEMIC PREPAREDNESS

The OMA continues its work to ensure that the health-care system will be responsive to both the needs of patients and physicians in the case of a pandemic or other widespread health emergency.

The Ministry of Health and Long-Term Care has recognized the gap in pandemic planning specific to community-based physicians and has established a primary care working group in order to gain an understanding of concerns specific to physicians and other front-line health-care workers. This is one of several opportunities that the OMA is using to engage the government with respect to physician concerns.

The OMA remains focused on issues related to personal protective equipment, the availability and administration of antiviral medications and vaccines, physician roles, emergency compensation and insurance, and ensuring that physicians can keep their offices open and that resource deficiencies in public health capacity are solved quickly. Progress is being made in local, provincial and national pandemic preparedness planning, but much more has to be done.

OMA staff contact: John Wellner (ext. 2953)

 

November 2007

DRUGS AND PHARMACOTHERAPY / LONG-TERM CARE

The Ontario Pharmacy Council recently convened a Long-Term Care (LTC) Working Group to explore the expansion of professional pharmacy services in LTC facilities.

Working group members, including a long-term care physician, will focus their efforts on formalizing and enhancing the medication review process, with an emphasis on the need to optimize residents’ medication therapy and reduce adverse drug events.

Recognizing that this initiative could potentially enhance the quality of care for LTC residents, in addition to promoting productive collaborative care, the OMA will continue to actively participate in deliberations.

OMA staff contact: Kristen Gane (ext. 3131)

PHYSICIAN BEHAVIOUR IN THE PROFESSIONAL ENVIRONMENT

The College of Physicians and Surgeons of Ontario (CPSO) is in the final stages of drafting its “Disruptive Physician Behaviour Initiative Report,” and the accompanying policy statement, now renamed “Physician Behaviour in the Professional Environment Policy.” The CPSO will likely approve final versions of both the report and policy at its Council meeting in November 2007.

The OMA has been working with the CPSO through various drafts of the report and policy to ensure that they are fair, transparent, realistic and realizable. Once the report and policy are final, the OMA will provide a link to the document on the CPSO website.

OMA staff contact: Michael Paul (ext. 2883)

 

October 2007

PHYSICIAN ASSISTANTS

The Ministry of Health and Long-Term Care has formally advised the OMA that it supports a number of physician-employed physician assistant (PEPA) pilot projects as part of its physician assistant (PA) initiative between October 2007 and March 2010.

The OMA PEPA proposal involves three practice settings: orthopedics, diabetes care, and support for family physicians in long-term care. The Ministry has authorized immediate action on the latter two, but requires more information about how PEPA will integrate with the wait times strategy before approving the orthopedic pilots.

PAs are different than other types of allied health providers in that they work entirely under physician delegation and supervision.

OMA staff contact: Carol Jacobson (ext. 2984)

NURSE PRACTITIONERS

The Health System Improvements Act (Bill 171) amended the Nursing Act and now protects the title “nurse practitioner” (NP). The College of Nurses of Ontario recently communicated this fact to its members. It should be noted, however, that the RN (Extended Class) scope of practice remains unchanged at this point, which means that only RN(EC)s in primary care have an “independent” expanded scope beyond that of a traditional RN. Advanced care nurses in pediatrics, anesthesia and adult acute care continue to function under medical delegation for their expanded duties.

The Minister of Health and Long-Term Care has referred the College of Nurses of Ontario’s proposed expanded scope of practice for RN(EC)s to the Health Professions Regulatory Advisory Council (HPRAC). HPRAC will report to the Minister by March 31, 2008. The OMA submission to HPRAC is now available here:

OMA Submission to HPRAC on Scope of Practice for RN(EC)s

OMA staff contact: Carol Jacobson (ext. 2984)

 

September 2007

MEDICAL PROFESSIONALISM

The College of Physicians and Surgeons of Ontario (CPSO) recently approved a practice guide entitled “Medical Professionalism and College Policies,” which is intended to frame key college policies in a way that helps members to better understand the context in which specific policies arise. The guide addresses professionalism as it relates to physicians’ interactions with individual patients, to the profession’s duty to the public through effective self-regulation, and to physicians as individuals and colleagues.

No new policies or obligations are introduced through the practice guide, but members are encouraged to look at it as a practice aid. The guide can be found on the CPSO website (http://www.cpso.on.ca/policies/PracticeGuide.pdf).

OMA staff contact: Barb LeBlanc (ext. 2964)

DISRUPTIVE PHYSICIAN BEHAVIOUR

The CPSO recently deferred a decision on a new policy on disruptive physician behaviour to its September meeting in order to obtain input from stakeholders, such as the OMA. While it is agreed that disruptive behaviour is not acceptable in today’s health-care system, it is important that the definition is appropriate and the mechanisms to deal with it are fair. The OMA is convening a small working group to review this issue with a view to providing timely input to the College. OMA staff contact: Michael Paul (ext. 2883)

DRUGS AND PHARMACOTHERAPY

On July 17, Minister of Health and Long-Term Care George Smitherman announced an expanded target group for the MedsCheck initiative, which was originally introduced in April of this year. Under the revised program, all Ontarians who take three or more prescription medications for chronic conditions can receive an annual one-on-one review of their medications from participating pharmacists.

The Pharmacy Council plans to continue its examination of further enhancements to pharmacists’ professional services in the coming months. In addition, the newly formed tripartite committee, composed of the OMA, Ontario Pharmacists’ Association (OPA), and the Ministry, will be exploring in depth: the possible role of pharmacists, the impact upon physician practice, and a means to ensure that evolving roles result in improvements in care.

Members are encouraged to contact the OMA as physician experience and feedback with the MedsCheck initiative will assist the Association in monitoring the effectiveness of the program and its impact upon physician practice.

OMA staff contact: Kristen Gane (ext. 3131)

REGULATED HEALTH PROFESSIONS ACT

The Minister of Health and Long-Term Care has referred several issues to the Health Professions Regulatory Advisory Council (HPRAC). The development of standards of practice and practice guidelines that would facilitate interprofessional collaboration between colleges, as well as the College of Nurses of Ontario proposed expanded scope of practice for RN(EC)s, will be reported on by March 31, 2008. Timing for the other items, including prescribing by non-physician health providers, and the regulation of dental assistants, paramedics and emergency medical attendants, has not yet been determined.

OMA staff contact: Carol Jacobson (ext. 2984)

MATERNAL AND NEWBORN CARE

At its September meeting, the OMA Board of Directors adopted a policy on maternal and newborn care. The policy paper describes models of maternal and newborn care, outlines current issues, and elucidates the OMA principles for maternal and newborn care. It suggests that neither physicians nor midwives need be restricted to working in one model of care.

OMA staff contact: Carol Jacobson (ext. 2984)

 

July 2007

PHYSICIAN ASSISTANTS

The OMA Board of Directors approved the proposed OMA physician-employed physician assistant (PEPA) demonstration project, which will be part of the Ministry of Health and Long-Term Care’s health human resource strategy to introduce physician assistants (PAs). The proposal has now been submitted to government for approval.

The OMA PEPA demonstration pilots will be in orthopedics, diabetic care management, and primary care in long- term care homes. The OMA may also explore a PEPA demonstration project in a primary care fee-for-service setting. The demonstration pilots will report to the bilateral OMA/MOHLTC Physician Assistant Implementation Steering Committee, which reports to the bilateral Physician Human Resources Committee.

OMA staff contact: Carol Jacobson (ext. 2984)

REPORTING ON PATIENT SAFETY INDICATORS

On May 5, 2007, Minister of Health and Long-Term Care George Smitherman announced the government’s intent to make legislative changes to increase transparency in an effort to enhance safety and accountability in health care. Subsequently, OMA staff, along with several key stakeholders, met with Ministry staff to discuss implementation planning.

Initial discussions explored issues such as purpose of reporting, what should be reported and to whom, and how hospital-level reporting of critical incidents might lead to system improvements.

The OMA will continue to actively participate in deliberations on this issue.

OMA staff contact: Kristen Gane (ext. 3131)

INTERPROFESSIONAL CARE

Ontario is moving toward interprofessional care models as one way to address the system problems and as a way to provide better patient care. The OMA Board of Directors adopted a policy on interprofessional care at its July meeting. This policy outlines the principles that will form the basis for further OMA work.

OMA Policy Paper: Interprofessional Care

OMA staff contact: Carol Jacobson (ext. 2984)

 

June 2007

PHYSICIAN ASSISTANTS

The OMA, in partnership with the Ministry of Health and Long-Term Care (MOHLTC), co-chairs the Physician Assistant Implementation Steering Committee. Currently, there are six emergency department demonstration pilots across the province led by Med Emerg. Twenty-five hospital sites have recently been selected for physician assistant inpatient demonstration pilots led by the Ontario Hospital Association. The sites include academic, community, large, and small hospitals. OMA representatives participated in the site selection process. Exploration is under way for an OMA-led pilot of physician-employed physician assistants.

OMA Staff Contact: Carol Jacobson (ext. 2984)

HEALTH SYSTEM IMPROVEMENTS ACT (BILL 171)

Bill 171, the Health System Improvements Act, passed third reading on May 31. Schedule G of the bill creates a new fair medical audit system. A Physician Audit Board, independent of both the MOHLTC and the College of Physicians and Surgeons of Ontario, will be established. New record-keeping standards will be put in place, and the authority to publish audit cases in the media has been eliminated. Details of the new audit system are online (https://www.oma.org/member/Legal/reports/mas.asp).

There are many more elements to Bill 171 that are of interest to physicians. The bill introduces a number of new professions and provides for the expansion of some scopes of practice. The bill will increase the utilization of allied health providers, and bring about a number of changes as to how professional Colleges conduct their business. Also, lessons learned from SARS and Walkerton will be implemented via new public health measures.

A President’s Update summarizing key aspects of the bill was communicated to members in early May (https://www.oma.org/members/communications/ update/may/vol12n12.asp#3).

The OMA’s written and oral presentations in response to the bill are posted in the Recent Issues area on the WebLink homepage (www.oma.org). Additional reports will be forthcoming via the OMA fax and e-mail network and the OMR.

OMA staff Contact: Carol Jacobson (ext. 2984)

LHIN PRIORITY AREAS IDENTIFIED

The OMA has recently posted two Ontario Hospital Association (OHA) documents to the OMA website, under the Local Health Integration Network (LHIN) section (www.oma.org/health/lhin).

As the preamble states: “These documents, compiled by the OHA, are a synthesis of the 14 LHIN Integrated Health Service Plans (IHSPs) created to help gain a high level understanding of the priorities across and within each LHIN. It is based on the final versions of LHIN IHSPs made available in November-December 2006.”

The first document provides an overview of LHIN priorities by area (for example, primary health, mental health and addiction, etc.) across all LHINs. The second document lists priority areas within each LHIN.

OMA Staff Contact: Michael Paul (ext. 2883)

DISCLOSURE OF CRITICAL INCIDENTS

The government has advised that it intends to make an amendment to the regulations under the Public Hospitals Act to mandate the disclosure of a critical incident to a patient. Further information will be communicated once it becomes available.

OMA Staff Contact: Kristen Gane (ext. 3131)

 

May 2007

PHYSICIAN ASSISTANTS

An OMA “President’s Update” published on February 23, 2007,  outlined the work the Association is carrying out with government and other partners regarding physician assistants (PAs). The Update encouraged members interested in physician-led PA projects to contact the OMA.

any e-mails and telephone calls related to both hospital-based and community-based PA projects have been received to date. Interest spans both general and family practice and specialists. General and family practice physicians working in long-term care homes have noted that PAs would enable them to increase their capacity in caring for their long-term care patients. Both hospital-based and community-based specialists see a role for PAs to enable them to increase the services they are able to provide. For example, cardiologists have noted that working with PAs in cardiac rehabilitation clinics/settings would be of value. A follow-up e-mail was sent by the OMA to all physicians who expressed an interest in physician-led PA projects, apprising them that the OMA-Ministry of Health and Long-Term Care PA Implementation Committee will first implement hospital-based PA projects. The Committee will then determine the next steps in initiating community-based, physician-led PA projects.

OMA staff contact: Carol Jacobson (ext. 2984)

DRUGS AND PHARMACOTHERAPY

On February 17, 2007, the Ontario Pharmacists’ Association (OPA) presented the OMA Section on General and Family Practice Executive with an overview of the Pharmacy Council’s planned spring initiative. The Pharmacy Council was launched in December 2006 as a result of Bill 102, the Transparent Drug System for Patients Act. The Council’s mandate is to advise the government on aspects of pharmaceutical services such as education, conduct, compensation and policy, and is co-chaired by the Ministry of Health and Long-Term Care and the OPA.

he first initiative, to be launched this spring, gives Ontario pharmacists the opportunity to offer a medication review service to their senior customers, with a focus on those who take several medications. The goal is to maximize adherence to drug therapy through individual education and counselling sessions. The OMA Health Policy Department is closely monitoring emerging developments to determine how this new initiative may impact Ontario physicians.

OMA staff contact: Kristen Gane (ext. 3131)

PERSONAL HEALTH INFORMATION

Ontario’s Information and Privacy Commissioner (IPC) recently issued an order to the Hospital for Sick Children following the occurrence of a stolen laptop computer from a vehicle. The IPC has ordered the hospital to change its policies and practices with respect to the protection of personal health information that is held off-site. The hospital has been ordered to ensure that all personal health information that leaves the premises is either encrypted or de-identified. Although this order applies only to the Hospital for Sick Children at this time, physicians should be mindful that it may be more broadly applied by hospitals and other facilities.

OMA staff contact: Barb LeBlanc (ext. 2965)

 

March 2007

SMOKING IN CARS

The OMA recently called on the provincial government to ban smoking in vehicles when children are present. This recommendation was first put forth in the 2004 OMA paper entitled “Exposure to Second-Hand Smoke: Are We Protecting Our Kids?” (https://www.oma.org/Health/tobacco/smoke2004.pdf).

Such a ban was recently introduced in the city of Bangor, Maine, and poll results indicate very strong public support for a similar measure across Ontario. However, both Minister of Health Promotion Jim Watson, and Premier Dalton McGuinty, have stated that they do not plan to act on the OMA’s recommendation.

OMA staff contact: John Wellner (ext. 2953)

OMA WORKING GROUP ON LONG-TERM CARE

The OMA continues to monitor developments concerning the Long-Term Care Homes Act (Bill 140), which consolidates the Nursing Homes Act, the Charitable Institutions Act, and the Homes for the Aged and Rest Homes Act. OMA concerns were communicated to the Legislative Standing Committee on Social Policy by OMA President Dr. David Bach, and Chair of the OMA Long-Term Care Working Group Dr. Stephen Chris, in a presentation and formal submission in January. The bill is expected to proceed to third reading in early spring. Lead OMA Committee: Long-Term Care Working Group

OMA staff contact: Kristen Gane (ext. 3131)

DRUGS AND PHARMACOTHERAPY

The Ministry of Health and Long-Term Care Drug System Secretariat is currently transitioning from Limited Use (LU) and Individual Clinical Review (Section 8) categories to a more efficient system of Conditional Listing and Exceptional Access Drugs, which is expected to streamline the process considerably. LU drugs are being considered for either Conditional Listing placement or general benefits. In addition, numerous drugs have been moved from the Section 8 category to Conditional Listing and are now included in the formulary. Very specialized drugs (which involve less than 200 requests per year) will be categorized as Exceptional Access drugs. The Ministry is exploring customized access options for these drugs, which may include online and/or phone requests. Expeditious drug access and reduced paperwork should lead to enhanced patient care, while easing the frustrations physicians experienced with the prior system.

In collaboration with the OMA Section on Palliative Care, the Ministry of Health and Long-Term Care has developed an expedited Section 8 form, which has received positive reviews from palliative care physicians. In addition, frequent users of the expedited form may be permitted to bypass this procedure and have all prescriptions accepted under certain conditions. This new system is currently under development by the Ministry, and is expected to be implemented early this year.

OMA staff contact: Kristen Gane (ext. 3131)

PHYSICIAN ASSISTANTS

As part of its HealthForceOntario strategy, the government is pursuing the introduction of physician assistants (PAs) in Ontario. A steering committee and a number of subcommittees have begun to meet, and the government plans to pilot a number of PA demonstration projects by late spring of this year. Hospitals have already been notified of this plan, and the OMA urges physician groups who may have an interest in participating in a pilot to contact their chief of staff. The timelines for initial expressions of interest are very tight, and those who are interested will have to move quickly.

In addition to hospital-based physician assistant projects, the government has indicated a willingness to consider physician-sponsored models. Physicians who are interested in this model should contact the OMA.

OMA staff contact: Carol Jacobson (ext. 2984)

February 2007

PRIMARY CARE POLICY FORUM

On January 13, 2007, the OMA hosted a primary care policy forum with members from across the organization and from the Professional Association of Internes and Residents of Ontario, the Ontario College of Family Physicians and the Coalition of Family Physicians. The group of 20 physicians contributed to an informative discussion on the future of primary care in Ontario. The member input from this discussion and from future outreach activities will form the basis of a primary care position paper to be discussed by the OMA Board of Directors at its June meeting.

Lead OMA Committee: Health Policy
OMA staff contact: David Ford (ext. 2989)

HEALTH System IMPROVEMENTS ACT (BILL 171)

As reported in the January edition of Health Policy Report, the Health System Improvements Act (Bill 171), introduced in December 2006, is an omnibus bill that, if passed, will amend numerous statutes. Of interest to physicians are amendments related to the Health Insurance Act (Justice Cory’s recommendations), the Regulated Health Professions Act (new professions and expanded scopes of practice, as well as changes to objects and functioning of colleges), and public health amendments.

The OMA is in the process of reviewing the legislation, which is composed of schedules A though Q, and will provide more detailed information to members in the coming weeks.

OMA staff contacts: Carol Jacobson (RHPA, ext. 2984); Jim Simpson (MRC, ext. 2940); or John Wellner (Public Health, ext. 2953)

SARS COMMISSION FINDINGS

Justice Archie Campbell’s SARS Commission Final Report was released in early January. The report describes a public health system that “lacked adequate resources, was professionally impoverished and was generally incapable of fulfilling its mandate.” Justice Campbell notes the significant sacrifices of the health professionals who worked through the SARS outbreak, those who became ill, and those who died from the disease: Dr. Nestor Yanga and nurses Nelia Laroza and Tecla Lin. The report states that although government and hospitals have “taken significant steps to improve our level of protection from infectious outbreaks such as SARS, serious problems persist.” The OMA played a significant role during the SARS crisis and is praised in the report for its ability to communicate important health notices, both immediately and effectively, to members. Many OMA concerns, presented to the Commission on the part of the profession, have been addressed in the report. OMA staff continue to champion these concerns in discussions with the government about infectious disease control and flu pandemic preparedness. The job is not yet complete though and we cannot rest, as Justice Campbell puts it, “until Ontario has a health system with robust and collaborative infection control, worker safety and public health functions.”

OMA staff contact: John Wellner (ext. 2953)

LONG-TERM CARE LEGISLATION (BILL 140)

The Long-Term Care Homes Act (Bill 140) represents government’s efforts to consolidate the Nursing Homes Act, the Charitable Institutions Act, and the Homes for the Aged and Rest Homes Act. The OMA Long-Term Care (LTC) Working Group is concerned that the highly prescriptive and bureaucratic focus of this legislation will result in the compromised health and safety of LTC residents, in addition to negatively impacting the working environment for LTC physicians. These concerns were communicated to the Legislative Standing Committee on Social Policy by Dr. David Bach, OMA President, and Dr. Stephen Chris, Chair of the Long-Term Care Working Group, in a presentation and formal submission on January 16, 2007 (https://www.oma.org/Legislation/index.asp). The OMA will continue to monitor government’s policy position as Bill 140 moves forward.

Lead OMA Committee: Long-Term Care Working Group
OMA staff contact: Kristen Gane (ext. 3131).

January 2007

LONG-TERM CARE LEGISLATION (BILL 140)

The “Long-Term Care Homes Act” (Bill 140) represents government’s efforts to replace the Nursing Homes Act, the Charitable Institutions Act, and the Homes for the Aged and Rest Homes Act, with one cohesive system of governance. Bill 140 passed second reading on Decem­ber 5, 2006, and will be referred to the Standing Committee on Social Policy in the new year.

The OMA Long-Term Care (LTC) Working Group is concerned that this bill will have a negative impact both on the work environment and the living environment in long-term care homes, as the focus is clearly bureaucratic in nature. The LTC Working Group is preparing a draft submission for the legislative committee, and member input is invited. Please contact Kristen Gane, OMA Health Policy Department, at (416) 599-2580 or 1-800-268-7215, ext. 3131, or via e-mail (kristen_gane@oma.org).

Lead OMA Committee: Long-Term Care working Group
OMA staff contact: Kristen Gane (ext. 3131)

TIMELY RETURN TO WORK PROGRAMS AND THE ROLE OF THE PRIMARY CARE PHYSICIAN

The OMA Section on Occupational and Environmental Medicine has updated the OMA’s 1994 position paper, “In Support of Timely Return to Work Programs and the Role of the Primary Care Physician.” The paper outlines a role for family physicians and the medical community in support of early return-to-work programs. The Health Policy Committee is collecting feedback on the updated paper and will be advising the OMA Board and the Section on Occupational and Environmental Medicine on how to proceed.

The document has been circulated to the following Sections for comment/feedback: Chronic Pain Physicians, Community Health Centre Physicians, General and Family Practice, GP Psychotherapy, Group Practice, HSO Physicians, Internal Medicine, Physical Medicine and Rehabilitation, Psychiatry, Respiratory Disease, Rheumatology, Rural Practice and Sports Medicine. Any member who wishes to review/comment on this policy may contact David Ford by e-mail (david_ford@oma.org) or phone (416) 340-2989, or 1-800-268-7215, ext. 2989.

Lead OMA Section: Occupational Medicine
OMA staff contact: David Ford (ext. 2989)

LHIN INTEGRATED HEALTH SERVICE PLANS (IHSPs)

All Local Health Integration Networks (LHINs) have now made public their multi-year Integrated Health Service Plans. These IHSPs provide a health-focused environmental scan of the LHIN, and set out the LHIN’s health program and service priorities for the next several years. The majority of the LHINs now have websites and these IHSPs, along with other useful LHIN information, are now available on each LHIN website. For ease of reference, the OMA will be placing a link between the OMA website (www.oma.org) and each LHIN website, as they become available.

Lead OMA Committee: Committee on Integration
OMA staff contact: Michael Paul (ext. 2883)

ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT, 2005

Under the Accessibility for Ontarians with Disabilities Act, 2005, the Ministry of Community and Social Services has established an Accessibility Standards Advisory Council, which is developing a series of provincial accessibility standards. The first two standards — transportation and customer service — are in draft form and may be adopted as regulation, as early as 2007. The customer service standard will have significant impact on anyone (including physicians) providing goods or services to the Ontario public — as persons with a disability will be entitled to receive “equivalent” customer service — this means that all current barriers to equal, accessible service must be removed or ameliorated within five years of the adoption of this regulation (possibly as early as 2012).

The OMA Health Policy Department is monitoring the development of these standards and will keep members apprised of developments as they occur.

OMA staff contact: Michael Paul (ext. 2883)

HEALTH SYSTEM IMPROVEMENTS ACT, 2006

The Ontario government tabled its omnibus legislation entitled the “Health System Improvements Act.” There are many components to this bill, including the new physician billing audit process, public health initiatives under the Health Protection and Promotion Act (HPPA), and amendments to the Regulated Health Professions Act (RHPA).

The RHPA amendments include the regulation of new professions, including naturopathy and homeopathy, kinesiology, pharmacy technicians and psychotherapy. Optometry will now be authorized to prescribe drugs as outlined in regulation.

As well, there have been changes to objects/mandate of colleges, including the promotion of interprofessional care and the collection of relevant information for the purposes of health human resources planning. The College of Physicians and Surgeons of Ontario Quality Assurance Program will now have the authority to impose licence restrictions and to order mediation. Facilities that employ health-care providers will be obligated to report issues of incapacity and incompetency in addition to the current sexual abuse reporting.

Changes are proposed to the HPPA which would allow the Chief Medical Officer of Health to issue directives to health-care providers if he or she believes that there is a public health risk.

The OMA is analyzing the implications of the bill and will provide input to the government legislative process.

OMA staff contacts: Carol Jacobson on RHPA (ext. 2984)
John Wellner on HPPA (ext. 2953)

ONTARIO CLEAN WATER ACT

Following the Walkerton water crisis in May 2000, the OMA has worked to ensure that safeguards are in place to prevent another such tragedy. The OMA played an important public health role at the Walkerton Enquiry, and participated in two special advisory committees to the Minister of the Environment.

OMA advocacy was focused on the health elements of two key pieces of legislation. The first was the “Safe Drinking Water Act,” which dealt with drinking water systems, treatment and testing protocols. The second, which was passed this fall, was the “Ontario Clean Water Act,” the aim of which is to protect drinking water sources. All the key legislation is now in place, but the protection of Ontario’s drinking water will require continued effort on the part of three tiers of government, the health community and others.

OMA staff contact: John Wellner (ext. 2953)

MANDATORY BLOOD TESTING ACT

As a result of amendments to the Health Promotion and Protection Act introduced in 2003, Medical Officers of Health (MOHs) have been put in the untenable position of having to adjudicate upon whether a mandatory blood test of an unwilling person should be taken, and to arrange such testing. The OMA has successfully advocated amendments that remove MOHs from these responsibilities.

OMA staff contact: John Wellner (ext. 2953)

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