3rd Session, 43rd Legislature

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Bill 50

THE PHARMACEUTICAL AMENDMENT, REGULATED HEALTH PROFESSIONS AMENDMENT AND PUBLIC HEALTH AMENDMENT ACT

(Assented to                                         )

HIS MAJESTY, by and with the advice and consent of the Legislative Assembly of Manitoba, enacts as follows:

PART 1
THE PHARMACEUTICAL ACT

C.C.S.M. c. P60 amended

1   The Pharmaceutical Act is amended by this Part.

2   Subsection 2(2) is amended by adding the following after clause (a):

(a.1) prescribe drugs in accordance with Part 8.1 (Therapeutic Substitutions);

3   Subsection 73(1) is amended

(a) by replacing subclause (k)(i) of the French version with the following:

(i) la détermination des exigences auxquelles le membre doit satisfaire, y compris les compétences qu'il doit posséder,

(b) by adding the following after clause (k):

(k.1) respecting therapeutic substitutions under Part 8.1;

(c) by replacing subclause (m)(i) of the French version with the following:

(i) la détermination des exigences auxquelles le membre doit satisfaire, y compris les compétences qu'il doit posséder,

4   The following is added as Part 8.1:

PART 8.1
THERAPEUTIC SUBSTITUTIONS

Therapeutic substitution

76.1(1)   A member may, in accordance with the regulations, prescribe a drug that contains different active ingredients as a substitute for a drug originally prescribed by a practitioner if the member determines that the substitute drug and the originally prescribed drug have the same or a similar therapeutic effect.

Exception if instruction not to make substitution

76.1(2)   Despite subsection (1), the member must not make the therapeutic substitution if the member is instructed by the practitioner issuing the original prescription or the patient

(a) not to make a therapeutic substitution; or

(b) to dispense the originally prescribed drug.

Method of giving instruction

76.1(3)   For the purpose of subsection (2),

(a) the practitioner must give the instruction

(i) by documenting "no substitution" on the original prescription,

(ii) by documenting "no therapeutic substitution" on the original prescription, in the event that the practitioner authorizes a substitution under Part 9 but not under this Part, or

(iii) to the member orally; or

(b) the patient must give the instruction to the member in writing or orally.

Documentation required

76.1(4)   The member must ensure that

(a) the instruction is documented on the original prescription; and

(b) the documentation indicates whether the instruction was received from the practitioner or the patient.

Instruction continues

76.1(5)   If the drug is prescribed for a person on a continuing basis and the original prescription is subject to an instruction not to make the substitution under subsection (2), any subsequent oral authorization for the continuation of the prescription must be dispensed according to the instruction unless, at the time of issuing the subsequent authorization, the practitioner or the patient rescinds the instruction.

Section 78 does not apply

76.2   Section 78 does not apply to a member making a therapeutic substitution under this Part.

PART 2
THE REGULATED HEALTH PROFESSIONS ACT

C.C.S.M. c. R117 amended

5   The Regulated Health Professions Act is amended by this Part.

6   Subsection 1(1) is amended

(a) by replacing the definition "college" with the following:

"college" means the college of a regulated health profession that is established or continued by regulation. (« ordre » ou « ordre professionnel »)

(b) in the definition "regulated health profession", by striking out "a regulation under clause 8(a)" and substituting "regulation".

7   Subsections 9(1) and 12(1) are amended by striking out "clause 8(b)" and substituting "this Act".

8   Subsection 13(1) is amended by striking out "Unless the Lieutenant Governor in Council authorizes a college established" and substituting "Unless the Lieutenant Governor in Council, by regulation, authorizes a college established or continued".

9   Subsection 56(7) is amended in clause (a) of the definition "college" by striking out "a regulation under clause 8(b)" and substituting "regulation".

10   Section 163.1 is amended

(a) in clause (a) of the definition "college", by striking out "a regulation under clause 8(b)" and substituting "regulation";

(b) in clause (a) of the definition "regulated health profession", by striking out "a regulation under clause 8(a)" and substituting "regulation"; and

(c) by adding the following definitions:

"amalgamated college" means a college that is continued on the amalgamation of two or more colleges or associations by an amalgamation regulation. (« ordre fusionné »)

"amalgamation date" means the date on which an amalgamation regulation comes into force. (« date de la fusion »)

"amalgamation order" means an order made by the minister under section 166.1. (« arrêté de fusion »)

"amalgamation regulation" means a regulation made by the Lieutenant Governor in Council under section 166.5. (« règlement de fusion »)

"first council" means a first council provided for in an amalgamation order. (« premier conseil »)

"pre-amalgamation college or association" means a college or association named in an amalgamation order that is to be amalgamated with one or more other colleges or associations named in the order into an amalgamated college. (« entité pré-fusion »)

11   The following is added after section 166 as part of Part 12:

AMALGAMATION

Amalgamation order

166.1(1)   If the minister considers it to be in the public interest, the minister may, by order, commence the process of amalgamating two or more colleges or associations into an amalgamated college.

Order requested or required

166.1(2)   The minister may make the order

(a) if one or more colleges or associations request that the minister make the order; or

(b) on the minister's own initiative.

Content of amalgamation order

166.1(3)   The order must

(a) name two or more colleges and associations to be amalgamated; and

(b) provide for the first council, including

(i) appointing the members of the first council, and

(ii) stating the date on which the first council may begin to carry out one or more powers under subsection 166.4(1).

Section 13 does not apply to first council composition

166.1(4)   Section 13 (composition of council) does not apply to the first council appointed under clause (3)(b).

Composition of first council

166.1(5)   The first council may consist of

(a) newly appointed members;

(b) members of the boards and councils of one or more of the pre-amalgamation colleges or associations; or

(c) a combination of members referred to in clauses (a) and (b).

Remuneration of first council

166.1(6)   The minister may require that the remuneration and expenses of the first council be paid out of the funds of one or more pre-amalgamation colleges or associations.

Additional content related to first council

166.1(7)   If the minister considers it to be in the public interest, the minister may, in an amalgamation order,

(a) require the first council to consult with one or more persons about any matter specified in the order; and

(b) set a date before which or a schedule according to which the first council must carry out a power referred to in subsection 166.4(1).

Amalgamation administrator

166.2(1)   If the minister considers it to be in the public interest, the minister may, in an amalgamation order,

(a) appoint one or more persons as amalgamation administrators of one or more of the pre-amalgamation colleges or associations to assist in the amalgamation process;

(b) authorize the payment of remuneration and expenses out of the funds of one or more pre-amalgamation colleges or associations to any person appointed as an amalgamation administrator of the colleges or associations; and

(c) authorize the amalgamation administrator to carry out, as specified in the amalgamation order, any of the powers and duties of one or more of the pre-amalgamation colleges or associations, and their councils or boards, officers or committees, under this Act or the regulations and by-laws or under a profession-specific Act or the regulations and by-laws made under that Act, to the extent the administrator considers it appropriate to carry out such powers and duties for the purpose of facilitating the amalgamation.

Amalgamation administrator deemed to be carrying out power or duty

166.2(2)   The carrying out of a power or duty by a person appointed as an amalgamation administrator is deemed to be the carrying out of a power or duty by the pre-amalgamation college or association, or its council or board, officers or committees.

Termination of appointment

166.2(3)   The amalgamation administrator's term expires on the amalgamation date unless the minister terminates the appointment before that date.

Minister may vary or revoke order

166.3   The minister may vary or revoke an amalgamation order.

Powers of first council before amalgamation

166.4(1)   To enable an amalgamated college to begin regulating health professions under this Act on the amalgamation date, the first council may, before the amalgamation date,

(a) make the regulations, by-laws, standards of practice, code of ethics and practice directions that a college is authorized to make under this Act and that take effect under clause 166.6(1)(c);

(b) designate individuals to be appointed to one or more committees of the amalgamated college on the amalgamation date; and

(c) designate individuals to be appointed to the office of the registrar and to the other offices of the amalgamated college on the amalgamation date.

Consultation before amalgamation

166.4(2)   Before making a regulation, by-law, standard of practice or code of ethics under this section, the first council must consult with the members of each pre-amalgamation college or association and review and consider the comments received.

Minister may review first council's activities

166.4(3)   The minister may review the first council's activities under subsection (1) and require the first council to provide reports and information.

Minister may direct first council to exercise powers

166.4(4)   If the minister considers it to be in the public interest, the minister may direct the first council to carry out one or more powers referred to in subsection (1).

LG in C may make regulations

166.4(5)   If the first council does not comply with a direction under subsection (4) to make a regulation within a period of time specified by the minister, the Lieutenant Governor in Council may make the regulation.

Minister may exercise other powers

166.4(6)   If the first council does not comply with any other direction under subsection (4) within a period of time specified by the minister, the minister may carry out the power.

Amalgamation regulation

166.5   To give effect to an amalgamation, the Lieutenant Governor in Council may make regulations

(a) designating a health profession as a regulated health profession for the purposes of this Act, and prescribing its scope of practice;

(b) specifying the regulated health professions that are to be regulated by the amalgamated college;

(c) continuing all the pre-amalgamation colleges or associations as the amalgamated college, and prescribing the name of the amalgamated college;

(d) specifying the amalgamation date;

(e) dealing with anything required to transition the regulation of a health profession from a pre-amalgamation college or association to the amalgamated college, including

(i) the continuance or transition of registration from a pre-amalgamation college or association to the amalgamated college,

(ii) the continuance or transition of licences, certificates and permits issued by a pre-amalgamation college or association to the amalgamated college,

(iii) the continuance or transition of applications for licences, certificates and permits that are in progress on the amalgamation date from a pre-amalgamation college or association to the amalgamated college,

(iv) the continuance of complaints, investigations or proceedings of a pre-amalgamation college or association and, if applicable, the application of this Act, with necessary changes, to those complaints, investigations or proceedings,

(v) the continuance of a committee of a pre-amalgamation college or association as a committee of the amalgamated college,

(vi) the transition of officers and employees from one or more of the pre-amalgamation colleges or associations to the amalgamated college, and

(vii) any matter necessary to remedy a difficulty, inconsistency or impossibility resulting from the transition to the amalgamated college.

Effect of amalgamation

166.6(1)   On the amalgamation date set out in an amalgamation regulation,

(a) all the pre-amalgamation colleges or associations are continued under this Act as one corporation under the name of the amalgamated college, that is governed by the first council;

(b) the board and council members of the pre-amalgamation colleges or associations who are not appointed to the first council cease to hold office;

(c) the regulations, by-laws, standards of practice, code of ethics and practice directions of the amalgamated college that are made under section 166.4 are approved and take effect;

(d) the regulations, by-laws, standards of practice, codes of ethics and practice directions of the pre-amalgamation colleges or associations are deemed to be repealed;

(e) the individuals designated for appointment to the committees and offices of the amalgamated college under section 166.4 are so appointed;

(f) the committee members and officers of the pre-amalgamation colleges or associations who are not appointed committee members and officers of the amalgamated college cease to hold office; and

(g) the committees of the pre-amalgamation colleges or associations that are not continued as committees of the amalgamated college are disestablished.

Effect of amalgamation on rights and obligations

166.6(2)   Subject to subsection (1), on the amalgamation date

(a) the rights and property of each pre-amalgamation college or association become the rights and property of the amalgamated college;

(b) the debts, obligations and liabilities of each pre-amalgamation college or association become the debts, obligations and liabilities of the amalgamated college;

(c) an existing cause of action, claim or liability to prosecution is unaffected;

(d) a legal proceeding or action commenced by or against a pre-amalgamation college or association may be continued by or against the amalgamated college;

(e) a conviction against, or ruling, order or judgment in favour of or against, a pre-amalgamation college or association may be enforced by or against the amalgamated college; and

(f) a reference to a pre-amalgamation college or association in an enactment, by-law, contract, agreement, instrument or other document or record is deemed to be a reference to the amalgamated college.

Amalgamation not an assignment

166.6(3)   The amalgamation does not constitute an assignment by operation of law or a transfer or any other disposition of the rights or property of a pre-amalgamation college or association to the amalgamated college.

Transition from first council

166.7(1)   A first council continues to hold office until a council is constituted in accordance with section 13.

Additional requirements — council composition

166.7(2)   The Lieutenant Governor in Council may, by regulation, require that the council constituted in accordance with section 13 consist of a prescribed number of representatives of each of the health professions regulated by the amalgamated college.

12   Subsection 219(1) is amended by adding the following before clause (i) and after the centred heading "Governance":

(h.1) for the purpose of subsection 13(1) (composition of council), authorizing a college to have more than 11 council members;

Consequential amendment, S.M. 2009, c. 15

13   The Regulated Health Professions Act, as enacted by S.M. 2009, c. 15, is amended by adding the following after section 214 and before the centred heading "INTERCHANGEABLE PHARMACEUTICAL PRODUCTS":

THERAPEUTIC SUBSTITUTIONS

Therapeutic substitution

214.1(1)   A member may, in accordance with the regulations, prescribe a drug that contains different active ingredients as a substitute for a drug originally prescribed by a practitioner if the member determines that the substitute drug and the originally prescribed drug have the same or a similar therapeutic effect.

Exception if instruction not to make substitution

214.1(2)   Despite subsection (1), the member must not make the therapeutic substitution if the member is instructed by the practitioner issuing the original prescription or the patient

(a) not to make a therapeutic substitution; or

(b) to dispense the originally prescribed drug.

Method of giving instruction

214.1(3)   For the purpose of subsection (2),

(a) the practitioner must give the instruction

(i) by documenting "no substitution" on the original prescription,

(ii) by documenting "no therapeutic substitution" on the original prescription, in the event that the practitioner authorizes a substitution under section 216 but not under this section, or

(iii) to the member orally; or

(b) the patient must give the instruction to the member in writing or orally.

Documentation required

214.1(4)   The member must ensure that

(a) the instruction is documented on the original prescription; and

(b) the documentation indicates whether the instruction was received from the practitioner or the patient.

Instruction continues

214.1(5)   If the drug is prescribed for a person on a continuing basis and the original prescription is subject to an instruction not to make the substitution under subsection (2), any subsequent oral authorization for the continuation of the prescription must be dispensed according to the instruction unless, at the time of issuing the subsequent authorization, the practitioner or the patient rescinds the instruction.

Subsection 215(2) does not apply

214.1(6)   Subsection 215(2) does not apply to a member making a therapeutic substitution under this section.

PART 3
THE PUBLIC HEALTH ACT

C.C.S.M. c. P210 amended

14   The Public Health Act is amended by this Part.

15   The heading for Part 2 is amended by striking out "REGIONAL".

16   The centred heading before section 4 is amended by striking out "REGIONAL".

17   The centred heading before section 47 is amended by striking out "COURT".

18(1)   Subsection 49(1) of the English version is amended, in the part before clause (a), by striking out "they are" and substituting "the provincial judge is".

18(2)   The following is added after subsection 49(2):

Application to vary order

49(2.1)   On application by a medical officer or a person who is subject to an order made under subsection (1), any provincial judge may vary a requirement imposed in the order.

19(1)   Subsection 50(1) is amended

(a) by replacing the section heading with "Application to extend detention order";

(b) by striking out "the court" and substituting "a provincial judge"; and

(c) in the English version, by striking out "no more" and substituting "not more".

19(2)   Subsection 50(2) is amended by striking out "The court may make an order extending the period of detention if it" and substituting "The provincial judge may make an order extending the period of detention if the provincial judge".

19(3)   Subsection 50(3) is amended

(a) by striking out "court" and substituting "provincial judge"; and

(b) in the English version, by striking out "no more" and substituting "not more".

20   Section 52 is amended by striking out "must, in the opinion of the person making the order, be no longer" and substituting "must not, in the opinion of the provincial judge, be longer".

21   Subsection 61(5) of the English version is amended, in the part before clause (a), by striking out "they are" and substituting "the provincial judge is".

22(1)   Subsection 64(7) of the English version is amended, in the part before clause (a), by striking out "they are" and substituting "the provincial judge is".

22(2)   The following is added after subsection 64(8):

Application to vary order

64(8.1)   On application by a medical officer or a person who is subject to an order made under subsection (7), any provincial judge may vary a requirement imposed on the person in the order.

22(3)   Subsection 64(10) is amended

(a) by replacing the section heading with "Application to extend detention order"; and

(b) in the English version, by striking out "(court order to extend detention) apply" and substituting "(extension of detention order) apply,".

PART 4
COMING INTO FORCE

Coming into force — royal assent

23(1)   Subject to subsection (2), this Act comes into force on the day it receives royal assent.

Coming into force — proclamation

23(2)   Parts 1 and 2 come into force on a day to be fixed by proclamation.