August 6, 2020
Author: Fiona Balaton
On July 6, 2020, the Legislature of Alberta introduced Bill 30: Health Statutes Amendment Act, 2020. Bill 30 proposed amendments to a number of statutes across the health sector.
On July 28, 2020 Bill 30 was passed in the final hours of the summer sitting after the government invoked closure to limit the debate on Bill 30 to one hour at third reading. Bill 30 has been under heavy criticism from the Opposition, the Alberta Medical Association (AMA), and the Health Quality Council of Alberta (HQCA). Bill 30 will amend or repeal nine pieces of health legislation in Alberta:
- Alberta Health Care Insurance Act
- Health Quality Council of Alberta Act
- Health Professions Act
- Health Care Protection Act
- Regional Health Authorities Act
- Hospitals Act
- Public Health Act
- Health Governance Act
- Provincial Health Authorities of Alberta Act
This blog post explains some of the key changes and discusses how these changes may affect Albertans.
Alberta Health Care Insurance Act
Bill 30 broadens the scope of persons that can receive payment for insured services under the AHCIA. It allows physicians to enter into service agreements in favour of the current fee-for-service billing model, and allows the government to contract with a range of organizations to operate medical clinics.
This is one of the more contentious amendments. Section 13 is amended by striking out “physician or dentist” and substituting “physician, dentist or person referred to in section 20.1”. What constitutes a “person” referred to in section 20.1 is not entirely clear, except that it does not include an individual or a professional corporation. This language elicits concern from some groups as it appears to allow for billing by either a corporation, a partnership, a society or another recognized legal corporate entity. This particular amendment has been noted to effectively clear the way for privatization of health care in Alberta by some commentators.
Health Quality Council of Alberta Act
The Health Quality Counsel of Alberta is the provincial body mandated to improve patient safety and the quality of health care in Alberta. Bill 30 amends the Health Quality Council of Alberta Act by expanding the mandate of the Health Quality Council of Alberta to include “person-centred care”. This amendment is intended to support and strengthen the work of the Health Quality Council of Alberta to focus on person-centred care, in addition to patient safety and health service quality.
The changes under Bill 30 to the HQCA also give sweeping powers to the Minister. These new provisions allow the Minister to appoint the board of directors, and enables the Minister to make regulations under the Health Quality Council of Alberta Act, rather than the Lieutenant Governor in Council.
Bill 30 also creates a new requirement that HQCA submit to the Minister for approval each year a plan setting out its anticipated activities, expenditures and funding. These changes have been criticized as effectively eliminating the key role of the HQCA in Alberta’s health care system.
Health Professions Act
Bill 30 amendments to the Health Professions Act increase the required percentage of public members within a council, a hearing tribunal, a complaint review committee, or a panel of any one of them from 25% to 50%.
This amendment is intended to give Albertans a stronger voice and greater role in professional oversight. While this amendment does promote transparency and public participation, Health Professions, by definition, are self-governing professions. Increasing public membership by 50% on each Health Profession Council essentially means that health professions will no longer be self-regulated.
Health Care Protection Act
Bill 30 renames the Health Care Protection Act to the Health Facilities Act to reflect the Act’s role in regulating independently operated health-care facilities that provide services within the publicly funded health system.
Bill 30 also makes a number of changes to the requirements for obtaining approval for surgical facilities, by “reducing red tape and administrative burden so current and new chartered surgical facilities can provide more publicly funded surgeries and help reduce surgical wait times as part of the Alberta Surgical Wait-Times Initiative”.
The changes (or streamlining) under Bill 30 limits the number of factors that the Minister or a person designated by the Minister must assess in response to a request to provide surgical services. It also removes the requirement that approval for such facilities be by way of Ministerial Order. The effect of these changes mean that it will be easier to get approval for new private clinics and private surgical facilities. While the concept of chartered surgical facilities is not new, the push for significant expansion, along with the potential to contract medical services outside of the physician realm, has raised legitimate concern amongst health care professions. Specifically that the expansion of surgeries conducted by private corporations under the guise of shortening wait times will have the opposite effect and introduce a dangerous profit motive into the health care system leading to longer wait times.
Public Health Act
Bill 30 amendments clarify that COVID-19 quarantine requirements require all international travellers to quarantine for 14 days, while the related orders from the Chief Medical Officer of Health are in effect. Previously, the language stated that only those “returning to” Alberta must follow the quarantine requirements. The amendment substitutes “returning to” for “entering” Alberta.
Regional Health Authorities Act
Bill 30 clarifies the role and responsibilities of Alberta Health Services as the single health authority in Alberta and Covenant Health as a strategic partner and the largest provider of faith-based health-care services. The amendments to the Regional Health Authorities Act also clarify obligations for Alberta Health Services when it contracts out services, and allow the Minister to make regulations respecting such contracts.
Bill 30 changes who can be appointed to the Hospital Privileges Appeal Board. It eliminates the requirement that one member be a member of a board of an approved hospital. It also allows members to be appointed for a second three-year term. The intent behind this amendment is to make it easier to appoint and keep qualified members to review grievances brought forward by medical staff against hospital boards.
In addition, Bill 30 repeals the Health Governance Act and the Provincial Health Authorities Act.
Most amendments will come into force upon receiving Royal Assent. Others will come into force upon proclamation and one other will come into force April 1, 2021.
For any questions about Bill 30 amendments, please contact any of our Health Law lawyers.