Significant changes to the regulation of health professionals make for a busy 2021

Keeping up to speed with changes in the world of health professional regulation in Alberta will keep almost anyone working in healthcare busy in 2021. Colleges have significant work ahead of them to review and revise professional regulations, bylaws and standards of practice. Associations and colleges that currently operate as one entity will need to plan for their separation from one another, and will need to address the numerous transitional issues that will come with separation.

Healthcare organizations and professionals also need to be aware of recent and upcoming changes to health professional regulation in Alberta and their impact on their operations. They will need to prepare to address these changes by amending governance documents, policies or procedures as needed.

In 2020, we advised and wrote on changes made to Alberta’s Health Professions Act (“HPA”) through Bills 30 and 46. In this Communiqué, we comment briefly on those changes, outline additional coming changes to the regulations under the HPA (known and anticipated), and provide some insight into anticipated further legislative amendments to the HPA.

The New and Evolving Landscape of the Regulation of Health Professionals in Alberta

2020 HPA Amendments and Alberta Health Consultation Document

Changes made in Bill 30 were minor in volume but signalled a shift in the Alberta landscape, moving it further away from a pure self-regulating model to a shared-regulating model. The upcoming requirement to balance professional and public representation on college councils, hearing tribunals, complaint review committees and college appeal panels has signalled greater reliance on public input as opposed to professional expertise in key college decisions.

Changes in Bill 46, as outlined in a previous Communique, were substantial in volume and impact. Some of these amendments, yet to be proclaimed, were included as proposals in an Alberta Health consultation document (“AH Consultation Document”) published by the Alberta Medical Association (“AMA”) on August 6, 2020. The AH Consultation Document was a clear indication of the enormous volume and potentially ground-shifting changes being considered. While some of the Alberta Health proposals appeared in Bill 46 in the fall legislative session, many did not. However, we anticipate that more changes will be forthcoming.

2020 HPA Regulations

In addition to the changes to the HPA, last year also saw the making of new regulations or amendments to existing regulations that altered the health profession regulatory landscape, including:

• The new Physicians, Surgeons, Osteopaths and Physician Assistants Profession Regulation. Not yet in force, this will replace the current regulation for physicians and include the regulation of physician assistants by the existing College of Physicians and Surgeons of Alberta (“CPSA”). The regulation also contains other changes, including specifying the requisite information regulated members or applicants must provide to the Registrar for renewal or initial application for registration, and providing requirements respecting sponsorship agreements for registrants on a provisional register of the CPSA.
• The new Funding for Treatment and Counselling Regulation. 2018 amendments to the HPA created a new funding requirement for colleges for counselling of individuals alleging sexual abuse or misconduct by regulated health professionals. This new regulation, not yet in force, provides details about such funding requirements.
• The new Acupuncturists Profession Regulation. Not yet in force, this new regulation, in combination with the repeal of the Health Disciplines Act (Alberta), signals that the new College of Acupuncturists, which has been contemplated for some time, will be operational in the foreseeable future.

HPA Regulations Anticipated in 2021 and Beyond

2021 and beyond will see numerous additional changes to the HPA regulations including:

• Changes to the Licensed Practical Nurses Profession Regulation to support the future regulation of health care aides by this college.
• The possible making of a Restricted Activity Regulation given the Bill 46 amendments, which moved the regulation of restricted activities from Schedule 7.1 of the Government Organization Act (Alberta) (“GOA”) to the HPA. It is possible, for example, that a regulation will be made to transition the Restricted Activity Authorization Regulation, which is currently under the GOA. This regulation authorizes specified service providers to perform psychosocial interventions for addiction counselling purposes. New or amended standards of practice will be required for every college with members potentially authorized to perform restricted activities.
• Changes to every health profession regulation as a result of other Bill 46 amendments.

HPA Amendments Anticipated in 2021 and Beyond

2021 and beyond may see further amendments to the HPA, such as:

• Additional changes proposed in the AH Consultation Document, including: amendments to allow for changes to, creation of, or suspension of, standards of practice during an emergency; revision of the complaints and discipline process; amendments to the Health Information Act (Alberta) to designate all regulated health professionals and/or all colleges as custodians for the purpose of taking responsibility for abandoned patient records; and more.
• Provisions to regulate counselling therapists, whether through an existing college or through the proclamation of section 29 of the Alberta Mental Health Services Protection Act. If section 29 is proclaimed, this will see a new Schedule 3.1 respecting a new college to regulate counselling therapists, and an amendment to section 128 of the HPA to regulate the use of the word “psychotherapist.”