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May 1, 2018 Legislative Changes Affecting Occupational Therapists and their Practice

May 03, 2018

On May 1, 2018, the Regulated Health Professions Act, 1991 (RHPA) was amended to give force to certain provisions introduced under the Protecting Patients Act, 2017. The Ministry of Health and Long-Term Care (MOHLTC) also introduced three new regulations that affect occupational therapists (OTs) and their practice.

Patient Definition and Criteria

The RHPA uses the terms patient and member. In keeping with the principles of occupational therapy, the terms client and registrant that are used by the College will have the same meaning as patient and member respectively.

The RHPA now includes a specific definition of patient as it relates to sexual abuse. The definition establishes a time period for how long a patient will remain a patient following the discontinuation of occupational therapy services and criteria for determining when a person will be considered a patient in relation to any allegation of sexual abuse.

According to the RHPA, the definition of patient includes an individual who was a member’s patient within one year from the date on which the individual ceased to be a member’s patient.

In other words, a client will be considered a client for a minimum of one year following the date occupational therapy services were discontinued. Any OT who engages in a sexual relationship with a client within one year of discontinuing service will be subject to mandatory revocation of their licence and will no longer be entitled to practice. Notwithstanding this definition, the Standards for the Prevention of Sexual Abuse and the Standards for Professional Boundaries describe certain situations where it may never be appropriate for an OT to enter into a personal or sexual relationship with a former client regardless of the time that has passed since OT service was discontinued.

In determining whether an individual is considered a patient, the RHPA sets out specific criteria:

The following criteria are prescribed criteria for the purposes of determining whether an individual is a patient of a member for the purposes of subsection 1 (6) of the Health Professions Procedural Code in Schedule 2 to the Act:

1. An individual is a patient of a member if there is direct interaction between the member and the individual and ANY of the following conditions are satisfied:

i. The member has, in respect of a health care service provided by the member to the individual, charged or received payment from the individual or a third party on behalf of the individual.
ii. The member has contributed to a health record or file for the individual.
iii. The individual has consented to the health care service recommended by the member.
iv. The member prescribed a drug for which a prescription is needed to the individual.

2. Despite paragraph 1, an individual is not a patient of a member if ALL of the following conditions are satisfied:

i. There is, at the time the member provides the health care services, a sexual relationship between the individual and the member.
ii. The member provided the health care service to the individual in emergency circumstances or in circumstances where the service is minor in nature.
iii. The member has taken reasonable steps to transfer the care of the individual to another member or there is no reasonable opportunity to transfer care to another member.

Funding for Counselling and Therapy For those Alleging Sexual Abuse

In addition to the new definition of patient, the amendments to the RHPA also change criteria for when an individual is eligible for funding for therapy and counselling related to sexual abuse by a regulated health professional. An individual is now eligible for funding once a complaint or report is made to the College alleging sexual abuse by an occupational therapist.

Mandatory Revocation

One of the regulations introduced expands the circumstances upon which an occupational therapist’s certificate of registration must be revoked by a panel of the Discipline Committee. This regulation lists 15 criminal offences, including sexual interference, possession of child pornography, luring a child, sexual assault, aggravated sexual assault, which if an occupational therapist is convicted of, require registration (license) revocation. Revocation would take place following a Discipline hearing and a finding of professional misconduct being made.

Additional Information to be Published on the Public Register (Find an Occupational Therapist)

Last summer in preparation for these legislative amendments and new regulations, the College introduced a number of bylaw amendments to address the new laws, including the requirement to publish information on the public register (Find an Occupational Therapist) about any OT charged with or convicted of a criminal offence or an offence under the Controlled Drugs and Substances Act. Another amendment to the RHPA which the College already required of OTs is that OTs self-report any memberships they may have with other professional regulators inside or outside of Ontario, and self-report any findings of professional misconduct, incompetence or incapacity made against them by any such regulator.

Consultation on Revised Standards for the Prevention of Sexual Abuse

In response to the changes in the RHPA, the Standards for the Prevention of Sexual Abuse have been revised and are now open for consultation. Please review the Standards and take a few minutes to provide your feedback here: https://www.surveymonkey.com/r/6TTQXC5      

The consultation closes on June 4 , 2018. Revisions to the Standards will be presented to Council for approval at their June 26, 2018 meeting.