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Difference between revisions of "Directing Residential Care Concerns to Health Authorities"
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Directing Residential Care Concerns to Health Authorities (view source)
Revision as of 17:34, 26 June 2014
, 17:34, 26 June 2014no edit summary
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====Remedies==== | ====Remedies==== | ||
Basically the Mental Health Review Board’s authority is limited to whether or not the person should continue to be an involuntary patient .The Review Board (review panel) does not make decisions about treatment. The review panel also does not inquire into whether a person's initial certification was justified. | |||
=====Special Note on Treatment===== | |||
The Mental Health Review Board and review panels do not deal with treatment issues. The Mental Health Act permits a request for a second medical opinion on appropriateness of the treatment, within one month, three month and six month time frames under the Act. | |||
Also if a patient, relative or other person has a complaint about the treatment provided to an involuntary patient, the complaints may be brought to the attention of several different parties. This includes the patient's physician, the director of a designated facility, the hospital administration, the patient care quality officer (a service available at all hospitals in BC to deal with patient complaints), the health authority, the College of Physicians and Surgeons of B.C., the College of Registered Nurses of B.C., the College of Licensed Practical Nurses of B.C., the College of Registered Psychiatric Nurses of B.C., or the provincial Ombudsperson. | |||
===Professional Colleges & the Health Professions Review Board=== | |||
If the concern in a care facility relates to the actions of a specific person who is a member of a professional college (e.g., doctor, nurse or social worker), a complaint can be brought to their professional College for investigation. | |||
One of the major issues with relying on these regulatory bodies for residential care concerns is how long the complaint and investigation process takes. The College of Physicians and Surgeons notes for example, that the College tries to resolve complaints within six to eight months, but matters can take much longer. Decisions of the various professional colleges can be reviewed by the Health Professions Review Board. However, these reviews will be limited to the adequacy of the investigation and reasonableness of the decision (“disposition”) by the college. Even if a matter is found in favour of the person who made the complaint, the review board can only redirect the matter back to the professional college. | |||
Legal advocates working in institutional environments also note that regulatory colleges and review boards may not promote compliance or enforce the existing law (such as health care consent law) with their members, especially if the person’s actions are simply considered a “standard practice“. | |||
For example in one British Columbia case the Health Professions Review Board appeared to implicitly condone a physician’s use of a consent to treatment given at admission when he prescribed a psychoactive medication to a cognitively impaired resident without consulting the family (a common occurrence in residential care). The Review Board accepted that the physician felt he had implied consent for “what was termed ‘minor‘ forms of treatment such as painkillers and anti-diarrheal medications”. As noted throughout this manual, legally operators cannot request blanket consent to treatment at admission or any other time. The substitute decisionmaker cannot legally give it either because it violates the underlying premise of giving “informed consent” based on the condition and information at hand The Health Review Board referred to the physician’s actions simply as a “failure to communicate”, not as a breach of the resident’s legal rights around consent. | |||
===Community Care and Assisted Living Appeal Board=== | |||
Licensed residential care facilities can seek an exemption from certain sections of the Community Care and Assisted Living Act. Among other things this administrative tribunal (Board) is responsible for appeals dealing with the certification for care facilities and exemptions from the Act of certain standards or requirements. An operator is expected to show how the current regulations or standards cannot be met and how exemption will not increase the risk to the residents’ health and safety. | |||
People other than the operator or licensee can appeal these exemptions. The appeal can be brought within 30 days by a resident or the resident’s agent or personal representative of a person in care, or resident’s spouse, relative or friend. It has been used by residents’ families to appeal an operator’s efforts to close the facility without adequate notice. The Appeal Board is authorized by Community Care and Assisted Living Act. | |||
==Addressing Systemic Concerns: BC Seniors Advocate== | |||
The BC Seniors Advocate was appointed in March 2014 and is the first position of its kind in Canada. The Advocate has a broad mandate to identify and examine systemic issues affecting the well-being of seniors, raise awareness about resources available to seniors, and make recommendations to government and others who deliver seniors’ services related to health care, personal care, housing, transportation and income support. The Seniors Advocate does not investigate individual complaints. The position is governed by the Seniors Advocate Act. | |||
The Seniors Advocate will be responsible for: | |||
:(a) monitoring the provision of seniors' services, | |||
:(b) analyzing issues believed to be important to the welfare of seniors generally, and | |||
:(c) advocating in the interests of seniors. | |||
The Advocate has authority to: | |||
:(a) identify and analyze systemic challenges faced by seniors; | |||
:(b) collaborate with persons who deliver seniors' services for the purpose of improving the efficiency and effectiveness of service delivery; | |||
:(c) promote awareness, by seniors, their caregivers and their families, of systemic challenges faced by seniors, and of the resources available to seniors; | |||
:(d) make recommendations to government and to persons who deliver seniors' services respecting changes to improve the welfare of seniors. | |||
Because it is a new office, the specifics of the role of the Advocate will gradually unfold. At this point, the Seniors Advocate’s power to gather information is largely in relation to developing an advisory council, conducting research and consulting with persons who deliver seniors' services and with the public. The Senior’s Advocate may request information from public and private sector service providers, other than personal information. | |||
The Seniors Advocate Act provides a notable safeguard for residents in care facilities, their families and advocates; the law specifically offers a protection from retaliation for people who give information to the Seniors Advocate. However the Seniors Advocate Act does not identify penalties or repercussions if a person or organization contravened the protections from retaliation. | |||
====A Final Note on Rights, Remedies and Problem Resolution==== | |||
On its face, residential care has a myriad of mechanisms available to address problems in this area. At the same time, there can be legislative gaps and systems may not function in ways that allow residents or families access to those problem resolution processes. Where there are apparently appropriate laws, public and private bodies always have a choice - to interpret and apply these narrowly and technically (which often leads to inaction), or more hopefully, to interpret them in ways that are supportive of good care for people living in British Columbia’s residential care facilities. | |||
{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}} | {{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}} | ||
{{Legal Issues in Residential Care: An Advocate's Manual Navbox}} | {{Legal Issues in Residential Care: An Advocate's Manual Navbox}} | ||