Bill 21 of the Health Professions Act (HPA) arrives in full force on April 1, 2019. With it comes multiple changes to the HPA, how complaints are registered and adjudicated.

Key Aspects of Bill 21

The new provisions in Bill 21 are consistent with the two Government policy objectives: to enhance transparency, and to create additional measures to protect patients from sexual abuse by regulated members of the health professions. The changes include:

  • All applicants seeking registration as a regulated member must provide a criminal records check, and must provide additional information if they have been registered as a regulated member in another jurisdiction (e.g. previous findings of unprofessional conduct).
  • When any complaint is investigated, the investigator (or Complaints Director) must interview the complainant (subject to limited exceptions).
  • There are separate definitions for “sexual abuse” and “sexual misconduct”. Sexual abuse relates to physical acts, and sexual misconduct consists of objectionable conduct, behavior or remarks.
    • Sexual abuse is defined as the threatened, attempted or actual conduct of a regulated member towards a patient that is of a sexual nature and includes any of the following conduct:
      • sexual intercourse between a regulated member and a patient of that regulated member
      • genital to genital, genital to anal, oral to genital, or oral to anal contact between a regulated member and a patient of that regulated member
      • masturbation of a regulated member by, or in the presence of, a patient of that regulated member
      • masturbation of a regulated member’s patient by that regulated member
      • encouraging a regulated member’s patient to masturbate in the presence of that regulated member
      • touching of a sexual nature of a patient’s genitals, anus, breasts or buttocks by a regulated member
    • Sexual misconduct is defined as any incident or repeated incidents of objectionable or unwelcome conduct, behaviour or remarks of a sexual nature by a regulated member towards a patient, that a regulated member knows, or should know, would cause offence, humiliation, or adversely affect the patient’s health and wellbeing.
  • There are mandatory penalties for regulated health professionals, including:
    • cancellation of a practice permit for any health professional whose conduct is deemed to be sexual abuse of a patient
    • suspension of a practice permit for any health professional whose conduct is deemed to be sexual misconduct toward a patient
    • Increased information must be included in the college’s register, and published on the college’s website, in a manner that is easily accessible.

Each College in Alberta has developed standards of practice regarding (1) who is considered to be a “patient”, (2) when there can be a sexual relationship between a regulated member and a former patient; and (3) when a spouse may also be a patient. These standards of practice were approved by the Minister for each College. For example, a Registered Psychologist may not have a sexual relationship with a former patient under any circumstance. Other Colleges have different requirements.

Colleges must develop a patient relations program to prevent sexual misconduct and educate their members, and must make funding available to complainants for counselling, if they allege that they have been the victim of sexual abuse or sexual misconduct.

All these changes affect investigations. There is an expectation that investigators will be able to work effectively in a trauma-informed manner in conducting investigations in this complex area.