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This is an unofficial archived version.

This version was current from October 19, 2008 to June 15, 2011.

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Latest version


C.C.S.M. c. R34

The Regional Health Authorities Act

Table of contents

(Assented to November 19, 1996)

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

PART 1

INTERPRETATION

Definitions

1

In this Act,

"board" means the board of directors of a regional health authority; (« conseil d'administration »)

"district health advisory council" means a district health advisory council established by a regional health authority under section 32; (« conseil de district de santé »)

"facility" means premises, and equipment in or associated with the premises, used to provide health services, social services or both and includes hospitals, personal care homes, laboratories and clinics; (« établissement »)

"health care organization" means a person or group of persons other than a health corporation or a health care provider who provides health services; (« organisme de soins de santé »)

"health care provider" means

(a) a duly qualified medical practitioner who receives funding or payment, including payment by way of fee for services rendered or salary, from a regional health authority or the government for the provision of health services, and

(b) any other individual who

(i) is employed by a regional health authority, or by a health care organization or health corporation in a health region, to provide health services,

(ii) is under contract to a regional health authority, or a health care organization or health corporation, to provide health services, or

(iii) receives funding or payment from the government for the provision of health services; (« fournisseur de soins de santé »)

"health corporation" means

(a) the board of a health and social services district established under The District Health and Social Services Act,

(b) the board of a hospital district, the board of a medical nursing unit district and the board of a medical service unit district established under The Health Services Act,

(c) a corporation which owns, operates or maintains a hospital or personal care home and which

(i) is a municipality,

(ii) is incorporated or registered under The Corporations Act, or

(iii) is established or continued under an Act of the Legislature, including a private Act, and

(d) a prescribed body corporate; (« personne morale dispensant des soins de santé »)

"health region" means a health region established or continued under this Act; (« région sanitaire »)

"health services" means

(a) community health services,

(b) emergency medical response services,

(c) home care services,

(d) hospital services,

(e) medical services,

(f) medical laboratory services,

(g) mental health services,

(h) nursing services,

(i) personal care services,

(j) provision of drugs, medical supplies and surgical supplies,

(k) public health services,

(l) diagnostic imaging services, and

(m) other goods and services respecting health promotion and protection or respecting the care, treatment or transportation of sick, infirm or injured individuals as may be prescribed in the regulations; (« services de santé »)

"hospital" has the same meaning as in The Hospitals Act; (« hôpital »)

"Indian Band" means a band as defined in the Indian Act (Canada); (« bande indienne »)

"minister" means the member of the Executive Council charged by the Lieutenant Governor in Council with the administration of this Act; (« ministre »)

"municipality" includes a local government district; (« municipalité »)

"personal care home" means premises in which personal care services are provided to residents in the premises, but does not include a private residence in which care is provided by an individual to his or her family member; (« foyer de soins personnels »)

"prescribed" means prescribed in the regulations;

"prescribed health services" means the health services or categories of health services, including the level and extent of health services, which a regional health authority must provide or make available, as prescribed by the minister; (« services de santé obligatoires »)

"provincial objectives and priorities" means the objectives and priorities for the provision of health services in the province, or in areas of the province, established by the minister under subsection 3(1); (« objectifs et priorités d'application provinciale »)

"regional health authority" means a regional health authority established or continued under this Act; (« office régional de la santé »)

"regional health plan" means a plan approved or amended under section 24; (« plan sanitaire régional »)

"securities" has the same meaning as in The Hospital Capital Financing Authority Act. (« valeurs mobilières »)

Purpose of Act

2(1)

The purpose of this Act is to create regional authorities with responsibility for providing for the delivery of and administering health services in specified geographic areas.

Canada Health Act criteria

2(2)

This Act shall be administered in a manner that complies with section 7 of the Canada Health Act, which sets out the criteria of comprehensiveness, universality, portability, accessibility and public administration in relation to the operation of the Manitoba Health Services Insurance Plan.

Conflict with other legislation

2(3)

Where there is a conflict between this Act or the regulations and any of the following, the provisions of this Act and the regulations prevail:

(a) The District Health and Social Services Act or the regulations under that Act;

(b) The Health Services Act or the regulations under that Act;

(c) an Act, including a private Act, establishing or respecting a facility or health corporation;

(d) the articles of incorporation or by-laws of a facility or health corporation.

PART 2

POWERS OF THE MINISTER

Provincial objectives and priorities

3(1)

The minister may establish provincial objectives and priorities for the provision of health services in the province or in areas of the province.

Prescribed health services and standards

3(2)

The minister may prescribe

(a) health services which must be provided or made available by a regional health authority; and

(b) standards for the provision of health services.

Directions to regional health authorities

3(3)

The minister may give directions to a regional health authority to achieve the purposes of this Act and the regulations, including but not limited to directions for the purpose of

(a) achieving provincial objectives and priorities;

(b) providing guidelines for the regional health authority to follow in carrying out and exercising its responsibilities, duties and powers; and

(c) coordinating the work of the regional health authority with the programs, policies and work of the government, the agencies of the government and other persons in the provision of health services.

Provision of health services by minister

4

Notwithstanding the provisions of this or any other Act or regulation, if the minister considers it is in the public interest to do so, the minister may

(a) provide or arrange for the provision of health services in any area of the province, whether or not health services are being provided in that area by a municipality, regional health authority, health care organization, health corporation or any other person; and

(b) do any other thing that the minister considers necessary to promote and ensure the provision of health services in the province.

Agreements

5(1)

The minister may enter into agreements for the purposes of this Act and the regulations with

(a) the Government of Canada, or an agency of the Government of Canada, with the approval of the Lieutenant Governor in Council;

(b) the government of another province, territory or jurisdiction, or an agency of one of those governments, with the approval of the Lieutenant Governor in Council;

(c) an Indian Band, with the approval of the Lieutenant Governor in Council;

(d) a municipality;

(e) a regional health authority; or

(f) any other person or group of persons.

Agreements with health corporations

5(2)

Without limiting the generality of subsection (1), the minister may enter into agreements with a health corporation, or an organization representing health corporations, respecting the preservation of corporate ownership, autonomy, governance and mission of the health corporation or health corporations.

Expropriation by minister

6

The minister may

(a) acquire, for and on behalf of a regional health authority, by purchase, lease, expropriation or otherwise, lands, buildings or both for the purposes of acquiring, constructing, expanding, converting or relocating a facility or providing health services under this Act; and

(b) upon acquisition, dispose of the lands, buildings or both to the regional health authority on such terms and conditions as the minister considers appropriate.

Delegation by minister

7

The minister may, in writing, delegate to any person any of the powers, duties and functions conferred or imposed on the minister under this Act.

PART 3

ESTABLISHMENT OF HEALTH REGIONS AND REGIONAL HEALTH AUTHORITIES

Establishment of health regions and regional health authorities

8(1)

The Lieutenant Governor in Council, by regulation,

(a) may establish one or more health regions in the province; and

(b) shall establish a regional health authority for each health region, to provide for the delivery of and administer health services in the health region.

Two regional health authorities for The City of Winnipeg

8(1.1)

Notwithstanding clause (1)(b), the Lieutenant Governor in Council may, by regulation, establish two regional health authorities for a health region established for The City of Winnipeg, in which case the regulation must also specify the health services for which each regional health authority is responsible.

Proposal and consultations

8(2)

Prior to the establishment of a health region and a regional health authority or authorities by the Lieutenant Governor in Council under subsection (1) or (1.1), the minister may, if he or she considers it advisable,

(a) cause a proposal to be prepared; and

(b) carry out consultations in the manner and to the extent that the minister considers appropriate;

respecting the proposed establishment of the health region and of the regional health authority or authorities for the health region.

Contents of regulation

8(3)

A regulation under subsection (1)

(a) shall name the health region and describe its boundaries;

(b) shall name the regional health authority or authorities for the health region;

(c) shall specify the organization and composition of the regional health authority or authorities, including but not limited to the composition of the board and the number of directors on it; and

(d) may be made effective retroactively to a date specified in the regulation.

S.M. 1997, c. 41, s. 2.

Corporations continued as regional health authorities

9(1)

The Lieutenant Governor in Council may, by regulation,

(a) continue an area of the province, described in the regulation, as a health region under this Act with the boundaries described and under the name set out in the regulation;

(b) continue a corporation, described in the regulation, as a regional health authority under this Act; and

(c) provide for the organization and composition of a corporation continued as a regional health authority under clause (b), including but not limited to the composition of the board and the number of directors on it.

Effect of continuation

9(2)

A health region and a regional health authority continued by regulation under subsection (1) are deemed to have been established under this Act.

Directors continued as first directors

9(3)

A director or chairperson of a regional health authority continued by regulation under subsection (1) who holds office on the coming into force of this Act is deemed to be a first director or chairperson of the regional health authority appointed under section 15 and continues to hold office until his or her successor is appointed or elected in accordance with section 14.

S.M. 1997, c. 41, s. 3.

Variation of health region or regional health authority

10(1)

The Lieutenant Governor in Council may, by regulation,

(a) vary the size or boundaries of a health region established or continued under this Act;

(b) vary any aspect of the organization or composition of a regional health authority established or continued under this Act, including but not limited to the composition of the board and the number of directors on it;

(c) change the name of a health region, a regional health authority, or both; and

(d) provide for such matters as the Lieutenant Governor in Council considers necessary to facilitate the variation or to protect the interests of creditors and other affected persons.

Proposal and consultations

10(2)

Prior to the making of a regulation by the Lieutenant Governor in Council under subsection (1), the minister may, if he or she considers it advisable,

(a) cause a proposal to be prepared; and

(b) carry out consultations in the manner and to the extent that the minister considers appropriate;

respecting the proposed variation or name change.

Retroactive effect

10(3)

A regulation made under subsection (1) may be made effective retroactively to a date specified in the regulation.

PART 4

REGIONAL HEALTH AUTHORITIES

DIVISION 1

STRUCTURE AND ADMINISTRATION

Corporate status

11

A regional health authority is a corporation, and, subject to this Act and the regulations, has all the rights, powers and privileges of a natural person of full capacity for the purposes of carrying out and exercising its responsibilities, duties and powers under this Act and the regulations.

Corporation without share capital

12

A regional health authority is established to operate exclusively as a corporation without share capital, and no part of the income or property of a regional health authority shall be paid to, or otherwise made available for, the personal benefit of any director of the regional health authority except as permitted by section 16.

Applicability of The Corporations Act

13

The Corporations Act shall not apply to a regional health authority except to the extent prescribed by the Lieutenant Governor in Council.

Board of regional health authority

14(1)

The management and affairs of a regional health authority established or continued under this Act shall be directed by a board of directors consisting of the prescribed number of directors who are appointed or elected in accordance with this Act and the regulations.

Terms of office

14(2)

The terms of office of the directors are as determined by the Lieutenant Governor in Council.

Vacancy

14(3)

A board may act despite a vacancy in its membership.

Chairperson

14(4)

The minister shall appoint a chairperson from among the directors of a regional health authority.

Vice-chairperson

14(5)

The minister may appoint one or more vice-chairpersons from among the directors of a regional health authority.  If the minister chooses not do so, a vice-chairperson shall be elected from among the directors in accordance with the by-laws of the board.

S.M. 1997, c. 41, s. 4.

First directors

15(1)

Notwithstanding section 14, the minister may

(a) appoint the number of persons the minister considers appropriate as the first directors of a regional health authority;

(b) appoint one of the first directors as the first chairperson of the board of the regional health authority; and

(c) make subsequent appointments to fill vacancies on the board until directors are appointed or elected under subsection 14(1), and a person appointed under this clause is deemed to be a first director.

Terms of office of first directors

15(2)

The terms of office of a first director and the first chairperson of a regional health authority continue until their successors are appointed or elected under section 14.

Remuneration and expenses of directors

16

A regional health authority shall pay its directors the remuneration and expenses that the Lieutenant Governor in Council determines.

Duties of directors

17

A director on a board of a regional health authority shall

(a) repealed, S.M. 1997, c. 41, s. 5;

(b) act honestly and in good faith with a view to the best interests of the regional health authority and the health region; and

(c) exercise the care, diligence and skill that a reasonable and prudent person would exercise in comparable circumstances, and carry out his or her functions in accordance with this Act and the regulations.

S.M. 1997, c. 41, s. 5.

By-laws and policies

18(1)

A board shall make by-laws and policies not inconsistent with this Act and the regulations regarding its internal organization and proceedings and for the general conduct and management of the affairs of the regional health authority.

Approval of by-laws by minister

18(2)

The by-laws made by a board, and all amendments to them, shall

(a) comply with any model by-laws, guidelines or directions provided or approved by the minister; and

(b) be submitted to the minister for approval in accordance with the procedures established by the minister.

By-laws not effective until approved

18(3)

A by-law of a board has no force or effect until approved by the minister.

By-laws and policies open to public

18(4)

All by-laws and policies made by a board shall be open for inspection by the public during the normal office hours of the regional health authority.

Meetings

19

A board shall hold

(a) an annual meeting, which shall be open to the public, at the time and in accordance with the requirements prescribed in the regulations; and

(b) other meetings in accordance with the by-laws of the board.

Quorum

20

Unless otherwise prescribed, a majority of the directors appointed and elected to a board constitutes a quorum for the transaction of business.

Appointment of chief executive officer

21(1)

A board shall appoint, and determine the terms and conditions of employment of, a chief executive officer for the regional health authority.

Responsibilities of chief executive officer

21(2)

The chief executive officer is responsible for the general management and conduct of the affairs of the regional health authority in accordance with the by-laws, rules, policies and directions of the board, which includes responsibility for

(a) carrying out the policies and programs of the regional health authority;

(b) managing the business affairs of the regional health authority; and

(c) such other matters as may be delegated by the board to the chief executive officer.

Officers and employees

22

Subject to this Act and the regulations, a board may appoint any officers and engage any employees and other persons it considers necessary to carry out and exercise the responsibilities, duties and powers of the regional health authority.

DIVISION 2

RESPONSIBILITIES, DUTIES AND POWERS OF REGIONAL HEALTH AUTHORITIES

Responsibilities of regional health authority

23(1)

A regional health authority is responsible for providing for the delivery of and administering health services to meet the health needs in its health region in accordance with this Act and the regulations.

Duties of regional health authority

23(2)

In carrying out its responsibilities, a regional health authority shall

(a) promote and protect the health of the population of the health region and develop and implement measures for the prevention of disease and injury;

(b) assess health needs in the health region on an ongoing basis;

(c) develop objectives and priorities for the provision of health services which meet the health needs in the health region and which are consistent with provincial objectives and priorities;

(d) prepare and implement a regional health plan in accordance with section 24;

(e) review and revise the regional health plan at least once a year, and more frequently if required by the minister;

(f) manage and allocate resources, including, but not limited to, funds provided by the government for health services, in accordance with this Act, the regulations, and the regional health plan;

(g) in providing for the delivery of health services,

(i) ensure that the prescribed health services are provided or made available,

(ii) comply with, and ensure compliance with, prescribed standards, and

(iii) ensure that there is reasonable access to health services;

(h) ensure that health services are provided in a manner which is responsive to the needs of individuals and communities in the health region and which coordinates and integrates health services and facilities;

(i) cooperate with other persons, including but not limited to government departments and agencies, to coordinate health services and facilities in the province and to achieve provincial objectives and priorities;

(j) comply with any directions given by the minister; and

(k) monitor and evaluate the delivery of health services and compliance with prescribed standards and provincial objectives and priorities, in accordance with guidelines provided or prescribed by the minister.

S.M. 1997, c. 41, s. 6.

Proposed regional health plan

24(1)

A regional health authority shall, within the time and in the form specified by the minister, prepare and submit to the minister a proposed regional health plan for the health region.

If more than one regional health authority

24(1.1)

If two regional health authorities are established in The City of Winnipeg, the proposed regional health plan shall relate to the health services for which that regional health authority is responsible under subsection 8(1.1).

Consultations

24(2)

In the course of preparing a proposed regional health plan, the regional health authority shall consult with such persons, including municipalities, Indian Bands, and government departments and agencies, as the regional health authority considers appropriate.

Content of proposed regional health plan

24(3)

A proposed regional health plan shall

(a) state the objectives and priorities developed by the regional health authority for the provision of health services to meet the health needs in the health region, which shall incorporate provincial objectives and priorities;

(b) state how the regional health authority proposes to carry out and exercise its responsibilities, duties and powers under this Act and the regulations and to measure its performance in carrying out and exercising those responsibilities, duties and powers;

(c) include a comprehensive financial plan which shall include a statement of how resources, including but not limited to financial resources, will be allocated to meet the objectives and priorities developed by the regional health authority and provincial objectives and priorities; and

(d) deal with such other matters and contain such other information as the minister may require.

Approval of proposed regional health plan

24(4)

The minister may

(a) approve, for the upcoming fiscal year, a proposed regional health plan as submitted; or

(b) refer a proposed regional health plan back to the regional health authority for further action, with any directions the minister considers appropriate.

Action where plan is referred back

24(5)

A proposed regional health plan that is referred back to a regional health authority under clause (4)(b) must be resubmitted as directed by the minister, and when it is resubmitted, subsection (4) applies.

Revisions and amendments

24(6)

A regional health authority shall submit to the minister, for approval,

(a) any revisions or amendments to an approved regional health plan proposed by the regional health authority from time to time; and

(b) proposed revisions or amendments to an approved regional health plan respecting matters specified by the minister, within the time specified by the minister;

and subsections (4) and (5) apply to any proposed revisions or amendments submitted to the minister under this subsection.

S.M. 1997, c. 41, s. 7.

General powers of regional health authority

25

Subject to this Act and the regulations, a regional health authority may

(a) provide for the delivery of social services, with the approval of the minister;

(b) purchase, lease or otherwise acquire personal property;

(c) sell, lease or otherwise dispose of personal property;

(d) accept grants, gifts, donations and bequests of real or personal property, including money, or of any interest in real or personal property, from any source, and, where the grant, gift, donation or bequest is made subject to directions or conditions, the regional health authority shall comply with and give effect to the directions or conditions;

(e) where authorized by regulation, charge fees for health services, or categories of health services, directly to the person who received the services, at the rates fixed in, or calculated in accordance with, the regulations;

(f) establish and apply to register charitable foundations, as that term is defined in the Income Tax Act (Canada), to benefit, directly or indirectly, the residents of the health region; and

(g) exercise any other powers that are necessary to carry out and exercise its responsibilities and duties under this Act and the regulations, unless otherwise directed by the minister.

Power to provide additional health services

26

Subject to this Act and the regulations, a regional health authority may provide for the delivery of health services in addition to the prescribed health services if

(a) there is a need for the additional health services;

(b) the additional health services are included in an approved regional health plan;

(c) provision of the additional health services is consistent with provincial objectives and priorities and the objectives and priorities set by the regional health authority for the health region;

(d) provision of the additional health services will not impair or interfere with the delivery or availability of prescribed health services; and

(e) sufficient resources are available to the regional health authority and can be allocated in a manner which will ensure that all health services provided in the health region meet the health needs in the health region, prescribed standards and applicable standards and requirements under any other Act or regulation.

Powers respecting real property

27

Subject to the approval of the minister, a regional health authority may

(a) purchase, lease or otherwise acquire for consideration real property, including a facility, or an interest in real property, that it considers necessary for its purposes, provided that, where the real property is in another health region, the regional health authority for that other health region consents to the purchase, lease or acquisition;

(b) construct, renovate, expand, convert or relocate buildings or structures, including facilities; and

(c) sell, lease or otherwise dispose of real property, including a facility, or an interest in real property, when the real property is no longer required for its purposes or when the regional health authority considers that it is in the interests of the health region to do so.

Regional health authority to approve certain facilities

28(1)

No person may construct, establish, operate, renovate, expand, convert or relocate a hospital or personal care home in a health region without the approval of the regional health authority for that health region or, if two regional health authorities are established in The City of Winnipeg, without the approval of the regional health authority that is responsible for the health services provided or proposed to be provided in the hospital or personal care home.

Restrictions respecting sale of facilities

28(2)

If the government or a regional health authority has provided funds for the acquisition, construction, expansion, conversion or relocation of, or major renovations to a facility, no person may sell, lease or otherwise dispose of the facility, or real property associated with it, without the approval of

(a) the regional health authority for the health region in which the facility is located; or

(b) if two regional health authorities are established in The City of Winnipeg, the regional health authority that is responsible for the health services provided in the facility.

Approval of minister

28(3)

A regional health authority shall not provide an approval under subsection (1) or (2) without the prior approval of the minister.

Approval additional to other requirements

28(4)

The requirements for approvals under subsections (1), (2) and (3) are in addition to the requirements under any other Act or regulation.

S.M. 1997, c. 41, s. 8.

Regional health authority may require reports

29(1)

A regional health authority may require that a health care organization, health care provider, health corporation or other person in receipt of payments or funding from the regional health authority provide to the regional health authority any reports, returns, financial statements, including audited financial statements, and statistical information that the regional health authority may require from time to time for the purposes of carrying out and exercising its responsibilities, duties and powers under this Act and the regulations.

Form of reports

29(2)

Reports, returns, statements and statistical information required to be provided under subsection (1) shall be provided within the time and in the form specified by the regional health authority.

Regional health authority may give directions

29.1(1)

A regional health authority may give a direction to a health corporation that provides health services within its health region.

Directions re services provided and use of funds

29.1(2)

A direction given to a health corporation may relate only to matters that have a region-wide impact on the regional health authority's responsibility to coordinate and integrate health services and facilities in its health region, including planning, standards, and the allocation of financial and other resources.

Limitation on direction

29.1(3)

A direction given to a health corporation may not

(a) relate to aspects of the health corporation's activities for which the regional health authority does not provide funds;

(b) require the health corporation to sell, transfer pursuant to section 46, encumber or otherwise dispose of the property or operation of the health corporation;

(c) require closure of a facility operated by the health corporation; or

(d) require a change in the composition of the board of directors of the health corporation.

Direction to be in writing, with reasons and filed

29.1(4)

The regional health authority must give the direction in writing and include reasons for giving it.  The direction must be signed by the chief executive officer of the regional health authority, and a copy of it must be filed with the minister.

Consultation required before direction may be given

29.1(5)

A direction under this section may be given only if

(a) the normal processes contemplated by any agreement under Division 3.1, including consultation and cooperation, fail to resolve the issue that is the subject matter of the potential direction; and

(b) the regional health authority has made reasonable efforts to consider and accommodate the position of the health corporation on the matter.

S.M. 2001, c. 44, s. 2.

Directions to be complied with

29.2

Subject to section 29.3, a health corporation shall comply with a direction given under section 29.1, notwithstanding any other Act, including a private Act, or any regulation, articles of incorporation or by-law.

S.M. 2001, c. 44, s. 2.

Limitation on direction: religious organizations

29.3(1)

A direction given under section 29.1 to a health corporation that is owned and operated by a religious organization must

(a) not be inconsistent with any agreement that the health corporation has entered into under subsection 5(2); and

(b) be consistent with the following principles:

1.

The health corporation may continue to respond to the spiritual and religious needs of its residents or patients, and to provide care and services in a manner that is consistent with the fundamental principles of the religion or faith to which it adheres.

2.

The health corporation may continue

(i) to own and operate its facilities,

(ii) to retain the identity of the facilities as faith-sponsored facilities, and

(iii) to be governed by a board of directors appointed or elected by the religious organization.

Request to refer matter to arbitration

29.3(2)

If a health corporation owned or operated by a religious organization believes a direction is not in keeping with subsection (1), it may request that the matter be referred to arbitration.  Such a request must be given to the regional health authority and the minister, within seven days after the health corporation receives the direction.

Appointment of arbitrator

29.3(3)

The parties may appoint an arbitrator selected by them jointly to conduct an arbitration under this section, but if they fail to do so within 10 days after the minister receives a request to refer a matter to arbitration, the minister shall select and appoint an arbitrator to determine the matter.

Arbitrator to hold hearing and file report

29.3(4)

Within 45 days after the appointment, or such longer period as the parties may agree to, the arbitrator shall

(a) hold a hearing on the matter of whether the direction is in keeping with subsection (1); and

(b) determine the matter and file a report with the parties.

Report binding

29.3(5)

The arbitrator's report is final and binding.

S.M. 2001, c. 44, s. 2.

Reports to minister by regional health authority

30(1)

A regional health authority shall provide to the minister any reports, returns and statistical information that the minister may require from time to time for the purposes of this Act and the regulations.

Form of reports

30(2)

Reports, returns and statistical information required to be provided under subsection (1) shall be provided within the time and in the form specified by the minister.

Agreements

31

Subject to this Act and the regulations, a regional health authority may enter into agreements for the purposes of this Act and the regulations with

(a) the government or an agency of the government;

(b) the government of Canada or of another province or territory, or an agency of one of those governments, with the consent of the minister;

(c) an Indian Band, with the consent of the minister;

(d) a municipality;

(e) another regional health authority; or

(f) any other person or group of persons.

District health advisory councils

32(1)

Unless the minister approves otherwise, a regional health authority shall establish at least one and no more than four district health advisory councils to advise and assist the board of the regional health authority.

Composition of council

32(2)

A district health advisory council shall be composed of the number of members prescribed by the minister, who shall be selected, by appointment, election or otherwise, in accordance with the regulations.

DIVISION 3

FINANCIAL MATTERS

Minister may provide funding to regional health authority

33

The minister may provide funding to a regional health authority for the purposes of this Act out of money appropriated by the Legislature for those purposes.

Grants or payments under other enactments

34

Notwithstanding any other Act or regulation, where another Act or regulation provides that the minister shall or may provide grants or payments respecting health services or facilities to any person, including a health care organization, health care provider or health corporation, the minister may instead provide those grants or payments to a regional health authority and, subject to any terms and conditions the minister considers appropriate, the minister may delegate to the regional health authority the minister's powers in respect of the provision of the grants or payments.

Minister may withhold payments to regional health authority

35

Notwithstanding this or any other Act or regulation, the minister may withhold any payment, or any part of a payment, to a regional health authority under this or any other Act or regulation until the regional health authority has complied with this Act and the regulations.

Regional health authority may withhold payments

36

Notwithstanding this or any other Act or regulation, or any agreement entered into by the regional health authority, a regional health authority may withhold any payment, or any part of a payment, to a health care organization or health corporation under this or any other Act or regulation until the health care organization or health corporation has complied with this Act and the regulations.

Fiscal year of regional health authority

37

The fiscal year of a regional health authority is April 1 to the following March 31.

Annual report

38(1)

A regional health authority shall, within six months after the end of each fiscal year, submit to the minister an annual report respecting that fiscal year in the form and at the time specified by the minister.

Content of annual report

38(2)

An annual report submitted under subsection (1) shall contain

(a) a report respecting the activities of the regional health authority, including but not limited to the health services provided or funded by the regional health authority, and the costs of these activities;

(b) a report respecting the health status of the population of the health region and the effectiveness of the health services provided or funded by the regional health authority;

(c) the audited financial statement of the regional health authority respecting the fiscal year covered by the annual report, in the form specified by the minister; and

(d) such other information as may be required by the minister.

Auditor

39(1)

A regional health authority shall appoint an external auditor who shall audit the records, accounts and financial transactions of the regional health authority annually.

Restrictions respecting appointment of auditor

39(2)

A regional health authority shall not appoint a person as auditor, and no person shall act as auditor of a regional health authority, if in the fiscal year in which the appointment is made, or in the preceding fiscal year, the person

(a) is or was a director on the board of the regional health authority or a director or member of the board of a health corporation providing services in the health region;

(b) has or had a direct or indirect interest in an agreement or contract entered into by the regional health authority, other than a contract respecting the audit; or

(c) is or was employed by the regional health authority in a capacity other than as auditor.

Financial information

40

A regional health authority shall, within the time specified by the minister, provide to the minister any financial information that is requested by the minister.

Limit on financial commitments

41

Except with the approval of the minister, a regional health authority shall not make any expenditures or expenditure commitments that are not within the financial limits set in the regional health plan for the regional health authority approved under section 24.

Financial responsibility for unfunded services

42

If a regional health authority provides or funds health services or social services that are not provided under a program supported by financial assistance from the government, the regional health authority shall be responsible for all costs of the health services and social services that are not funded by the government.

Borrowing

43(1)

Subject to the approval of the minister and the regulations, a regional health authority may borrow money for the purposes of the regional health authority, and may pledge its assets as security for money borrowed.

Securities

43(2)

Subject to the regulations and to The Hospital Capital Financing Authority Act, a regional health authority may issue securities.

Assignment of funds by regional health authority

44(1)

A regional health authority may enter into an agreement with the minister

(a) by which the regional health authority assigns to the minister, out of funds payable by the government for health services to the regional health authority in each fiscal year, an amount that is equal to the total of the principal and interest payable by the regional health authority in that fiscal year on securities issued by it or by a health corporation providing health services in the health region, or for sinking funds created in respect thereof; and

(b) in which the minister undertakes to hold the money so assigned in trust, for the payment of the principal and interest on the securities, as these amounts become payable from that money, or for sinking funds created in respect thereof.

Assignment of funds by health corporation

44(2)

Notwithstanding the provisions of this or any other Act or regulation, the minister may, in each fiscal year, withhold from any funds payable to a regional health authority for a health region the amounts assigned by a health corporation in the health region to the minister in an agreement entered into prior to the coming into force of this Act under section 69 of The Health Services Insurance Act or subsection 55(1) of The Health Services Act (as those provisions existed prior to the coming into force of this Act), for the payment of principal and interest on securities issued by the health corporation in accordance with the agreement, or for sinking funds created in respect thereof.

DIVISION 3.1

AGREEMENTS BETWEEN REGIONAL HEALTH AUTHORITIES AND HEALTH CORPORATIONS

Requirement for operating agreement

44.1(1)

A regional health authority may provide funding for operational purposes to a health corporation only if the authority and the health corporation have entered into a written agreement that provides for the following:

(a) the health services to be provided by or through the health corporation;

(b) the funding to be provided by the regional health authority for the health services;

(c) the term of the agreement;

(d) a process for resolving disputes under the agreement, and remedies for breaches of the agreement;

(e) any other prescribed matter.

Funding during negotiations

44.1(2)

Despite subsection (1), a regional health authority may, with the minister's approval, provide funding to a health corporation even though an agreement has not been entered into if the parties are in the process of negotiating such an agreement.

S.M. 1998, c. 57, s. 2.

Request for mediation

44.2(1)

If a regional health authority and a health corporation are unable to conclude an agreement under subsection 44.1(1), either of them may, on one or more occasions during the negotiation of the agreement, request the minister, in writing, to appoint a mediator to assist them in resolving any matter or matters in dispute.

Content of request

44.2(2)

The request for mediation must contain a description of the matter or matters in dispute as well as any matters on which the parties have reached agreement.

Notice to other party

44.2(3)

The party requesting mediation shall provide a copy of the request to the other party.

Appointment of mediator

44.2(4)

On receiving a request for mediation, the minister may appoint a mediator to assist the parties to conclude an agreement.  The minister shall provide the mediator with a statement of the matter or matters referred for mediation and set the time period within which mediation is to be conducted.

Minister may extend mediation period

44.2(5)

The minister may extend the period of mediation set under subsection (4).

Remuneration of mediator

44.2(6)

The minister may determine the remuneration and reimbursement for expenses payable to a mediator, and the regional health authority and the health corporation shall pay an equal share of those amounts unless the minister determines otherwise.

S.M. 1998, c. 57, s. 2.

Mediator's report

44.3

On the expiry of the period of mediation, the mediator shall give the minister a written report advising the minister about any matter or matters remaining in dispute and any recommendation the mediator wishes to make to assist the minister in resolving that matter or matters.

S.M. 1998, c. 57, s. 2.

Resolution if mediation unsuccessful

44.4(1)

If mediation is unsuccessful in resolving all or any of the matters in dispute within the time period set or extended under section 44.2, the minister may, if he or she believes it to be in the public interest, resolve the matter or matters remaining in dispute.

Resolution binding

44.4(2)

A resolution of the minister is to be interpreted, applied and enforced as though it had been arrived at by agreement between the parties under subsection 44.1(1).

Limitation

44.4(3)

A resolution of the minister relating to health services to be provided by or through a health corporation that is owned or operated by a religious organization must not be inconsistent with the fundamental religious principles of the religion or faith to which that health corporation adheres.

S.M. 1998, c. 57, s. 2.

Extension of existing agreement

44.5(1)

When an agreement under section 44.1 is about to expire and a new agreement has not been entered into, the regional health authority or the health corporation may request the minister to extend the term of the existing agreement for not more than 90 days.

Term of agreement extended

44.5(2)

If the minister grants an extension, the term of the agreement is deemed to be extended for the period specified.

S.M. 1998, c. 57, s. 2.

Division applies notwithstanding other Acts

44.6

An agreement may be entered into or a resolution made by the minister under this Division notwithstanding any other Act, including a private Act, or any regulation, articles of incorporation or by-law.

S.M. 1998, c. 57, s. 2.

DIVISION 4

AGREEMENT TO WIND UP CERTAIN HEALTH CORPORATIONS

Definition of "health corporation"

45

For the purposes of this Division, "health corporation" does not include a corporation with share capital or a municipality.

Agreement to transfer operations

46(1)

Notwithstanding the provisions of The Corporations Act or of any other Act, including a private Act, establishing or respecting a health corporation, a health corporation may enter into an agreement with a regional health authority under which the operations, property, liabilities and obligations of the health corporation will be transferred to and assumed by the regional health authority and the health corporation will be wound up.

Content of agreement

46(2)

An agreement under subsection (1) shall

(a) be in the form required by the minister;

(b) address all matters that are necessary to accomplish the purposes set out in subsection (1);

(c) include any apportionment under subsection (3);

(d) address all matters required by the minister;

(e) specify the proposed effective date of the transfer; and

(f) be approved by the board of the regional health authority and by the board or, where applicable, by the board and by the membership of, the health corporation, by a resolution passed by a majority of not less than 2/3 of the votes cast.

Apportionment of debt

46(3)

Where a health corporation and a regional health authority propose to enter into an agreement under this section,

(a) if the health corporation is established under The District Health and Social Services Act, it shall, in accordance with section 35.1 of that Act, apportion among, and charge to, the affected municipalities (as defined in that Act) the unfunded outstanding debts of the health corporation; and

(b) if the health corporation is established under The Health Services Act, it shall, in accordance with subsection

54(2) of that Act, apportion among, and charge to, the included municipalities (as defined in that Act) the unfunded outstanding debts of the health corporation.

Approval of minister

46(4)

An agreement under this section has no force or effect until it is approved in writing by the minister.

S.M. 1997, c. 41, s. 9.

Restrictions on activities of health corporation

47

Where a health corporation and a regional health authority propose to enter into an agreement under section 46, the health corporation shall

(a) not make any commitment or incur any liability, obligation or debt without the consent of the regional health authority; and

(b) take steps to facilitate the transfer of its operations, property, liabilities and obligations to the regional health authority and to wind up its affairs.

Effect of agreement

48

Notwithstanding the provisions of The Corporations Act or of any other Act, including a private Act, establishing or respecting a health corporation, unless the agreement provides otherwise, on the effective date of an agreement under section 46

(a) subject to this Act and the regulations, the regional health authority assumes the operations, activities and affairs of the health corporation;

(b) subject to this Act and the regulations, all the rights and property of the health corporation become the rights and property of the regional health authority;

(c) without limiting clause (b), any amount apportioned and charged to a municipality as a result of an apportionment by the health corporation under subsection 46(3) shall be paid by the municipality to the regional health authority within such time as the regional health authority and the municipality may agree, which shall be no later than one year from the date a request for payment is received by the municipality;

(d) all the debts, obligations and liabilities of the health corporation become the debts, obligations and liabilities of the regional health authority;

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

(f) a civil, criminal or administrative action or proceeding pending by or against the health corporation may be continued by or against the regional health authority; and

(g) a conviction against, or ruling, order or judgment in favour of or against, the health corporation may be enforced by or against the regional health authority.

Dissolution and disestablishment of health corporations

49(1)

On the effective date of an agreement under section 46,

(a) where the health corporation is established under The District Health and Social Services Act or The Health Services Act, notwithstanding either of those Acts, the minister may dissolve and disestablish the health corporation, its board and its corresponding district, and the Lieutenant Governor in Council or the minister, as the case may be, may repeal or amend any regulations under those Acts to achieve this purpose;

(b) where the health corporation is established under The Corporations Act, the health corporation shall take steps to dissolve under that Act; and

(c) where clauses (a) and (b) do not apply, the health corporation shall take reasonable steps to dissolve or disestablish.

Exception

49(2)

Subject to the approval of the minister, a health corporation is not required to dissolve or disestablish under clause (1)(b) or (c) if it does not transfer all of its operations and property to the regional health authority.

S.M. 1997, c. 41, s. 10.

Use of grants, gifts, etc.

50

Where any grant, gift, donation or bequest of real or personal property, including money, or of any interest in real or personal property, made to a health corporation for the purposes of a specified facility or for other specified purposes becomes, as a result of an agreement under section 46, the property of a regional health authority, the regional health authority shall use the grant, gift, donation or bequest for the purposes of that specified facility or for the specified purposes.

DIVISION 5

AMALGAMATION OF REGIONAL HEALTH AUTHORITIES

Proposal to amalgamate regional health authorities

51(1)

Two or more regional health authorities may submit to the minister a proposal to amalgamate to form a new regional health authority and, if the regional health authorities were established for different health regions, a new health region.

Content of proposal

51(2)

A proposal to amalgamate submitted under subsection (1) shall

(a) be in the form and shall contain the information required by the minister;

(b) be approved by the board of each regional health authority affected, by a resolution passed by a majority of not less than 2/3 of the votes cast by the directors on the boards; and

(c) specify the proposed effective date of the amalgamation.

Consultations

51(3)

On receipt of a proposal to amalgamate, the minister may carry out, and may require the regional health authorities proposing to amalgamate to carry out, consultations in the manner and to the extent the minister considers appropriate.

Expiration of proposal

51(4)

If a new regional health authority is not established under subsection (5) within two years after a proposal to amalgamate under subsection (1) is submitted to the minister, the proposal expires.

Establishment of new regional health authority

51(5)

The Lieutenant Governor in Council, on the recommendation of the minister, may, by regulation,

(a) amalgamate regional health authorities that have submitted a proposal under subsection (1) to establish a new regional health authority; and

(b) if the regional health authorities were established for different health regions, amalgamate their health regions to establish a new health region in their place.

Content of regulation

51(6)

A regulation under subsection (5) shall

(a) disestablish the regional health authorities that are amalgamated and, if the regional health authorities were established for different health regions, their corresponding health regions;

(b) dissolve the boards of the regional health authorities that are amalgamated;

(c) name the new health region and describe its boundaries;

(d) name the new regional health authority for the new health region;

(e) specify the effective date of the establishment of the new regional health authority and the new health region;

(f) specify the organization and composition of the new regional health authority, including but not limited to the composition of its board and the number of directors on it; and

(g) deal with such other matters as may be necessary to facilitate the amalgamation.

Board

51(7)

The directors of the board of a new regional health authority established under subsection (5) shall be appointed or elected in accordance with this Act and the regulations.

Interim board

51(8)

Notwithstanding subsection (7), where such action is necessary to ensure that the administration and provision of health services in the health region will not be interrupted, the minister may appoint an interim board for the new regional health authority to carry out and exercise the responsibilities, duties and powers of the new regional health authority until directors are appointed or elected in accordance with subsection (7).

Effect of amalgamation

51(9)

On the effective date of the establishment of a new regional health authority under subsection (5),

(a) all the rights and property of the regional health authorities that are amalgamated become the rights and property of the new regional health authority established in their place;

(b) all the debts, obligations and liabilities of the regional health authorities that are amalgamated become the debts, obligations and liabilities of the new regional health authority established in their place;

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

(d) a civil, criminal or administrative action or proceeding pending by or against the regional health authorities which are amalgamated may be continued by or against the new regional health authority established in their place; and

(e) a conviction against, or ruling, order or judgment in favour of or against, the regional health authorities which are amalgamated may be enforced by or against the new regional health authority established in their place.

S.M. 1997, c. 41, s. 11.

DIVISION 6

APPOINTMENT OF OFFICIAL ADMINISTRATOR AND DISESTABLISHMENT OF REGIONAL HEALTH AUTHORITIES

Appointment of official administrator

52(1)

The minister may at any time, by order, appoint a person as official administrator to act in the place of a regional health authority and its board, if the minister is of the opinion that

(a) the regional health authority or its board is not properly carrying out or exercising its responsibilities, duties or powers under this Act or the regulations, or any other Act; or

(b) the health and safety of patients or residents is threatened; or

(c) it is in the public interest to do so.

Powers of official administrator

52(2)

Unless the order under subsection (1) provides otherwise, and subject to the direction of the minister, an official administrator appointed under subsection (1)

(a) has the exclusive right to exercise all the powers and authority of the regional health authority and its board, including but not limited to the power to deal with and dispose of the property of the regional health authority;

(b) shall carry out all the responsibilities and duties of the regional health authority and its board; and

(c) shall be paid, out of the funds of the regional health authority, the remuneration and expenses determined by the minister.

Directors cease to hold office

52(3)

Unless the order under subsection (1) provides otherwise, on the appointment of an official administrator, the directors on the board of the regional health authority cease to hold office and shall cease to perform any duties or exercise any powers assigned to them under this or any other Act or regulation.

Directors may continue to act

52(4)

If, under the order under subsection (1), some or all of the directors continue to have the right to act with respect to any matter, any such act of the directors is valid only if approved by the official administrator.

Directors to assist official administrator

52(5)

Where an official administrator is appointed, the directors or former directors on the board of the regional health authority shall

(a) immediately deliver to the official administrator all funds, and all books, records and documents respecting the management and activities, of the regional health authority; and

(b) give the official administrator all information and assistance required to enable the official administrator to carry out and exercise his or her responsibilities, duties and powers.

Termination of appointment

52(6)

If, in the opinion of the minister, an official administrator is no longer required, the minister may do one or both of the following:

(a) terminate the appointment of the official administrator on such terms and conditions as the minister considers advisable;

(b) order the appointment or election of a new board for the regional health authority in accordance with the regulations.

S.M. 1997, c. 41, s. 12; S.M. 2006, c. 14, s. 116.

Disestablishment of regional health authority

53(1)

The Lieutenant Governor in Council may, if it considers that it is in the public interest,

(a) order that a regional health authority be disestablished and wound up; and

(b) appoint a person to wind up the regional health authority's affairs;

on any terms and conditions that the Lieutenant Governor in Council considers appropriate.

Disestablishment of health region

53(1.1)

If a regional health authority that is ordered disestablished and wound up under subsection (1) is the only regional health authority for the health region, the Lieutenant Governor in Council shall order the corresponding health region to be disestablished and wound up.

Powers of person appointed to wind up affairs

53(2)

A person appointed by the Lieutenant Governor in Council to wind up the affairs of a regional health authority under subsection (1) has all the power and authority of the regional health authority and its board for this purpose.

Effect of disestablishment

53(3)

On the disestablishment and winding up of a regional health authority and its corresponding health region,

(a) the regional health authority and its corresponding health region are disestablished and its board is dissolved;

(b) all the rights and property of the regional health authority become the rights and property of the government; and

(c) all the debts, obligations and liabilities of the regional health authority become the debts, obligations and liabilities of the government.

S.M. 1997, c. 41, s. 13.

PART 4.1

PATIENT SAFETY

Definitions

53.1

The following definitions apply in this Part.

"critical incident" means an unintended event that occurs when health services are provided to an individual and results in a consequence to him or her that

(a) is serious and undesired, such as death, disability, injury or harm, unplanned admission to hospital or unusual extension of a hospital stay, and

(b) does not result from the individual's underlying health condition or from a risk inherent in providing the health services. (« incident critique »)

"critical incident review committee" means a committee of one or more individuals established under subsection 53.3(1) or 53.4(1). (« comité d'examen des incidents critiques »)

"personal health information" means personal health information as defined in The Personal Health Information Act. (« renseignements médicaux personnels »)

"personal information" means personal information as defined in The Freedom of Information and Protection of Privacy Act. (« renseignements personnels »)

S.M. 2005, c. 24, s. 2.

Critical incident: disclosure and recording

53.2(1)

Regional health authorities, health corporations and prescribed health care organizations must establish written procedures respecting providing information about and recording critical incidents as required in subsection (2), in accordance with guidelines approved by the minister.

Duty to inform individual re critical incident

53.2(2)

If a critical incident occurs when a regional health authority, health corporation or prescribed health care organization is providing health services to an individual, the authority, corporation or organization must ensure that

(a) appropriate steps are taken to fully inform the individual, as soon as possible, about

(i) the facts of what actually occurred with respect to the critical incident,

(ii) its consequences for the individual as they become known, and

(iii) the actions taken and to be taken to address the consequences of the critical incident, including any health services, care or treatment that are advisable;

(b) a complete record is promptly made about the critical incident, which includes

(i) the facts of what actually occurred with respect to the critical incident,

(ii) its consequences for the individual as they become known, and

(iii) the actions taken and to be taken to address the consequences of the critical incident, including any health services, care or treatment that are advisable; and

(c) the record described in clause (b) is available to be examined and copied by the individual at no cost.

If individual lacks capacity or is deceased

53.2(3)

If an individual lacks the capacity to understand the nature and consequences of a critical incident, or is deceased, the information required to be provided and the record to be made available under subsection (2) must be provided or made available to a person authorized by the regulations to receive information and records on the individual's behalf.

S.M. 2005, c. 24, s. 2.

Critical incident: health corporation or organization

53.3(1)

Except as provided in subsection (6), if a critical incident occurs when health services are provided to an individual by a health corporation or a prescribed health care organization, the corporation or organization must promptly

(a) notify the regional health authority for the health region in which the critical incident took place about the critical incident, in accordance with guidelines established by the regional health authority; and

(b) in consultation with the regional health authority, establish a critical incident review committee, consisting of one or more individuals satisfactory to the regional health authority, to investigate and report respecting the critical incident.

Regional health authority to notify minister

53.3(2)

Promptly upon being notified about a critical incident under subsection (1), the regional health authority must notify the minister about the critical incident.

Investigation and reports of review committee

53.3(3)

A critical incident review committee established under subsection (1) must, in accordance with the health corporation's or prescribed health care organization's directions,

(a) investigate the critical incident and, during the investigation, provide information and reports to the corporation or organization as requested; and

(b) upon completing the investigation, report its findings and recommendations to the corporation or organization in writing.

Reports to regional health authority

53.3(4)

In accordance with guidelines established by the regional health authority, the health corporation or prescribed health care organization must provide information and reports to the authority about the critical incident and the critical incident review committee's investigation, including a written report upon completion of the investigation.

Reports by regional health authority to minister

53.3(5)

The regional health authority must provide information and reports to the minister about the critical incident and the critical incident review committee's investigation, including a written report upon completion of the investigation.

Exception: designated organizations

53.3(6)

Subsections (1) to (5) do not apply to a prescribed health care organization that is designated by regulation.  Instead, an organization that is designated must

(a) notify and report to the minister, rather than the regional health authority, if a critical incident occurs; and

(b) comply with the duties imposed on a regional health authority in section 53.4, with the necessary changes.

S.M. 2005, c. 24, s. 2.

Critical incident: regional health authority

53.4(1)

If a critical incident occurs when health services are provided to an individual by a regional health authority, the authority must promptly

(a) notify the minister about the critical incident; and

(b) establish a critical incident review committee to investigate and report respecting the critical incident.

Investigation and reports of review committee

53.4(2)

A critical incident review committee established under subsection (1) must, in accordance with the regional health authority's directions,

(a) investigate the critical incident and, during the investigation, provide information and reports to the regional health authority as requested; and

(b) upon completing the investigation, report its findings and recommendations to the regional health authority in writing.

Reports to minister

53.4(3)

The regional health authority must provide information and reports to the minister about the critical incident and the critical incident review committee's investigation, including a written report upon completion of the investigation.

S.M. 2005, c. 24, s. 2.

Critical incident: notification by others

53.4.1(1)

Any of the following who believes that a critical incident has occurred in respect of health services provided to an individual may notify the health corporation, prescribed health care organization or regional health authority which provided the health services:

(a) the individual himself or herself;

(b) a relative of the individual;

(c) an individual working at or for the regional health authority, the health corporation or the prescribed health care organization.

Action where notification received

53.4.1(2)

Promptly upon being notified under subsection (1), the health corporation, prescribed health care organization or regional health authority must determine if a critical incident occurred.

Review committee provisions apply

53.4.1(3)

If the health corporation, prescribed health care organization or regional health authority determines that a critical incident has occurred, it must ensure that the incident is investigated and reported on, and sections 53.3 and 53.4 apply, with necessary changes.

Retaliation prohibition applies

53.4.1(4)

Section 53.9 applies, with necessary changes, to an individual described in clause (1)(c) who gives a notification under this section.

S.M. 2005, c. 24, s. 2; S.M. 2008, c. 42, s. 83.

Minister's guidelines

53.5

The minister may establish guidelines respecting investigations to be carried out, and notices and reports to be provided, under this Part.

S.M. 2005, c. 24, s. 2.

Review committee may require information

53.6(1)

For the purpose of carrying out its duties under this Part, a critical incident review committee may require a health corporation, prescribed health care organization, regional health authority, health care provider or other person providing health services that has information or custody or control of a document or record — including a record containing personal health information or personal information — relating to the critical incident being investigated to provide the information, document or record to the review committee.

Limit re personal health information and personal information

53.6(2)

A critical incident review committee must limit personal health information and personal information to be provided under subsection (1) to the minimum amount necessary to properly carry out its duties under this Part.

Sharing of information between review committees

53.6(3)

If a critical incident involves more than one health corporation, prescribed health care organization or regional health authority, the members of the critical incident review committees established to investigate it may share information, documents and records — including records containing personal health information or personal information — with each other to the extent necessary to properly carry out their duties under this Part.

S.M. 2005, c. 24, s. 2.

Limit re personal health information and personal information in notices and reports

53.7

A notice, report or information provided under this Part may include personal health information and personal information.  But personal health information and personal information must be limited to the minimum amount necessary to accomplish the purposes of this Part.

S.M. 2005, c. 24, s. 2.

Discovery of information to be provided to individual

53.8

If, in the course of investigating a critical incident, a critical incident review committee becomes aware of information that should be, or should have been, provided to an individual or included in a record under subsection 53.2(2),

(a) the review committee must notify the health corporation, prescribed health care organization or regional health authority responsible for providing or recording the information; and

(b) the corporation, organization or authority must ensure that the information is promptly provided or recorded as required under subsection 53.2(2).

S.M. 2005, c. 24, s. 2.

Retaliation prohibited

53.9

No person shall dismiss, suspend, demote, discipline, harass or otherwise disadvantage another person because that other person has complied with a requirement to provide information, documents or records under this Part.

S.M. 2005, c. 24, s. 2.

Limit on access to records re critical incident

53.10(1)

No person, including an individual information is about, has a right of access under any Act or regulation — including under Part 2 of The Freedom of Information and Protection of Privacy Act or Part 2 of The Personal Health Information Act — to any of the following:

(a) a notice provided under section 53.3 or 53.4;

(b) a record or information — including an opinion or advice — prepared solely for the use of a critical incident review committee, or collected, compiled or prepared by a critical incident review committee for the sole purpose of carrying out its duties under this Part;

(c) a report, record or information that is required to be prepared or provided by a health corporation, prescribed health care organization or regional health authority under section 53.3 or 53.4.

Exception

53.10(2)

The limit on the right of access in subsection (1) does not apply to

(a) the information in a record referred to in clause 53.2(2)(b), or to an individual's right to examine and copy a record under clause 53.2(2)(c);

(b) information in a record created or maintained for the purpose of providing health services, including health care or treatment, to an individual; or

(c) information in a record required by law to be created or maintained by the owner, operator or person in charge of a facility or by a health care provider.

S.M. 2005, c. 24, s. 2.

PART 5

GENERAL PROVISIONS

Duties and powers of health corporations, etc.

54

Notwithstanding any other Act, including a private Act, or any regulation, articles of incorporation or by-law, a health care organization, health care provider, health corporation or other person in receipt of payments or funding from a regional health authority

(a) shall comply with this Act and the regulations;

(b) shall comply with prescribed standards;

(c) shall submit reports, returns, financial statements, including audited financial statements, and statistical information as required by a regional health authority under section 29 or by the regulations;

(d) shall, where the person is a health corporation, comply with any requirements or restrictions respecting borrowing or investments set out in the regulations;

(e) subject to the regulations, may enter into agreements or other arrangements with a regional health authority respecting the delivery of health services; and

(f) where authorized by regulation, may charge fees at the rates fixed in, or calculated in accordance with, the regulations for health services, or categories of health services, provided in a health region directly to the person who received the health services.

Approvals may be subject to conditions

55

An approval or consent given by the minister or a regional health authority under this Act or the regulations may be subject to terms and conditions.

Appointment of inspectors by minister

56(1)

The minister may appoint any person as an inspector for the purposes of this Act and the regulations.

Power to enter, inspect and require production

56(2)

An inspector appointed under subsection (1) may, at any reasonable time and upon presentation of identification,

(a) enter and inspect a facility in a health region;

(b) subject to Part 5 of The Mental Health Act, require a regional health authority, or a health care organization, health care provider, health corporation or other person providing health services in a health region, to produce for examination, audit or copying, any records, documents and things relating to its business and activities, including the provision of health services, which are in the possession or under the control of the regional health authority, health care organization, health care provider, health corporation or person.

Use of data processing system and copying equipment

56(3)

In carrying out an inspection, examination or audit under this Act, an inspector may

(a) use a data processing system at the facility or the place where the records, documents or things are kept to examine any data contained in or available to the system;

(b) reproduce, in the form of a print-out or other intelligible output, any record from the data contained in or available to a data processing system at the facility or in the place; and

(c) use any copying equipment at the facility or place to make copies of any record or document.

Assistance to inspectors

56(4)

Any person who owns, operates or is in charge of a facility or who has custody or control of a record, document or thing referred to in subsection (2) shall give an inspector appointed under this Act all reasonable assistance to enable the inspector to carry out his or her duties and shall furnish to the inspector any information the inspector may reasonably require.

Warrant by justice

56(5)

A justice, who is satisfied by information on oath that an inspector appointed under this Act has been prevented from exercising his or her powers under this Act, may at any time issue a warrant authorizing the inspector and any other person named in the warrant to exercise the powers granted.

S.M. 1998, c. 36, s. 135.

Minister to appoint interim manager

56.1(1)

The minister may at any time by order, appoint any person or other entity as the minister sees fit as an interim manager to take control of, operate and manage a facility operated by a health corporation, where

(a) the minister believes on reasonable grounds that

(i) the health and safety of patients or residents is threatened,

(ii) the health corporation has failed to meet its financial obligations for that facility,

(iii) the health corporation has failed to show financial responsibility for that facility,

(iv) the health corporation has failed to meet any standards of operation prescribed in this or any other Act or in any regulations prescribed under this or any other Act for that facility, or

(v) the health corporation has failed to perform a duty under this Act or the regulations, or any other Act; or

(b) in the minister's opinion, it is in the public interest to do so.

Powers of the interim manager

56.1(2)

Unless the order under subsection (1) provides otherwise, subject to subsection (4) and subject to the direction of the minister, a manager appointed under subsection (1)

(a) has the exclusive right to exercise all the powers and authority of the health corporation and its board or the board of the facility;

(b) shall carry out all the responsibilities and duties of the health corporation and its board or the board of the facility; and

(c) shall be paid out of the funds of the health corporation, the remuneration and expenses determined by the minister.

Minister may require reports

56.1(3)

Upon the appointment of a manager under subsection (1), the minister may from time to time require that the manager provide to the minister any or all of the information referred to in subsection 29(1).

Limitation on powers

56.1(4)

The powers of the manager appointed under subsection (1) do not include the power of the health corporation and its board or the board of the facility to sell, transfer pursuant to section 46, encumber or otherwise dispose of the property or operation of the health corporation or the facility.

Powers of directors suspended

56.1(5)

Subject to subsections (4) and (6) and unless the order under subsection (1) provides otherwise, on the appointment of an interim manager, the powers of the directors on the board of the health corporation are suspended and the directors shall cease to perform any duties or exercise any powers assigned to them under this or any other Act or regulation.

Directors may continue to act

56.1(6)

If, pursuant to the order under subsection (1), some or all of the directors continue to have the right to act with respect to any matter, any such act of the directors is valid only if approved by the minister.

Directors to assist manager

56.1(7)

Where a manager is appointed under subsection (1), the directors or former directors on the board of the health corporation shall

(a) immediately deliver to the manager all funds, and all books, records and documents respecting the management and activities of the health corporation; and

(b) provide the manager with all information and assistance required to enable the manager to carry out and exercise the manager's responsibilities, duties and powers.

Termination of appointment of interim manager

56.1(8)

If in the opinion of the minister, an interim manager is no longer required for a facility, the minister may terminate the appointment of the manager on such terms and conditions as the minister considers advisable including the provision of assurances from the health corporation

(a) as to the funding of existing and future liabilities of the health corporation; and

(b) that the conditions which necessitated the appointment of an interim manager could and would be avoided in the future.

S.M. 1997, c. 41, s. 14; S.M. 2001, c. 44, s. 3; S.M. 2006, c. 14, s. 116.

Confidentiality of information

57

Except for the purpose of the administration or enforcement of this Act and the regulations, information obtained by or provided to the minister, an inspector appointed under this Act, a regional health authority or any other person engaged in the administration or enforcement of, or in the provision of health services under, this Act or the regulations and relating to

(a) the relationship between a health care provider and his or her patient; or

(b) health services provided to, or the medical condition of, an individual;

is confidential and shall not be communicated to any person not entitled by law to that information without the consent of the patient or individual.

Protection from liability

58

No action for damages or other proceedings lie or may be brought personally against

(a) a director of a regional health authority or a person acting on the instructions of a director;

(b) an official administrator appointed under section 52, a person appointed to wind up a regional health authority under section 53, or any person acting on their instructions;

(c) a commissioner appointed under Part 6; or

(d) any other person acting under the authority of, or engaged in the administration or enforcement of, this Act or the regulations;

for anything done or omitted in good faith in the performance or exercise, or intended performance or exercise, of any duty or power under this Act or the regulations, or for any neglect or default in the performance or exercise, or intended performance or exercise, in good faith of a duty or power under this Act or the regulations.

Regulations by Lieutenant Governor in Council

59

The Lieutenant Governor in Council may make regulations

(a) defining words and phrases that are used in this Act but are not defined in this Act;

(b) prescribing bodies corporate for the purposes of the definition "health corporation";

(c) prescribing other goods and services for the purposes of the definition "health services";

(d) prescribing provisions of The Corporations Act which apply to regional health authorities;

(e) prescribing the number of directors to be appointed or elected to the board of a regional health authority;

(f) respecting the appointment of directors to the board of a regional health authority, including but not limited to nomination procedures;

(g) respecting the election of directors to the board of a regional health authority, including but not limited to

(i) establishing electoral areas within a health region and, where this is done, specifying the number of directors to be elected from each electoral area,

(ii) specifying when elections are to be held,

(iii) specifying the qualifications of electors and candidates,

(iv) respecting the nomination of candidates and the conduct of elections, and

(v) respecting the filling of vacancies, by by-election, appointment or otherwise;

(h) prescribing a quorum for a board of a regional health authority under section 20;

(i) authorizing the charging of fees for health services, or categories of health services, directly to the person who received the health services, including but not limited to

(i) specifying who may charge and collect such fees, and

(ii) fixing, or setting the method of calculating, the fees which may be charged;

(j) respecting the establishment of charitable foundations by regional health authorities, including but not limited to the functions, powers and duties of foundations;

(k) respecting the funding of regional health authorities, including but not limited to

(i) the manner of determining funding to regional health authorities,

(ii) the allocation of funds,

(iii) advances and the recovery of overpayments;

(l) respecting the borrowing and investment powers of regional health authorities and health corporations, including but not limited to restrictions on borrowing and investment;

(m) respecting the issuing of securities by regional health authorities and health corporations;

(n) respecting capital projects undertaken or approved by a regional health authority;

(o) respecting capital expenditures by or approved by regional health authorities;

(p) respecting any transitional or other problems resulting from

(i) the establishment, continuation or variation of a health region or a regional health authority under this Act,

(ii) the amalgamation of regional health authorities under Division 5 of Part 4 of this Act, or

(iii) the winding-up of the affairs of a regional health authority which is disestablished under section 53;

(p.1) respecting the obligations of regional health authorities in relation to the provision of health services in the French language, including without limitation, the designation of those regional health authorities which must fulfill the obligations;

(p.2) respecting critical incidents for the purpose of Part 4.1, including

(i) prescribing health care organizations for the purpose of the Part,

(ii) respecting the persons who are to receive information and records under subsection 53.2(3) on behalf of an individual who lacks capacity or is deceased, and

(iii) designating prescribed health care organizations for the purpose of subsection 53.3(6);

(q) prescribing any matter or thing that may be or is to be prescribed under this Act;

(r) respecting any other matter that the Lieutenant Governor in Council considers necessary or advisable.

S.M. 1997, c. 41, s. 15; S.M. 2005, c. 24, s. 3.

Regulations by minister

60

The minister may make regulations

(a) prescribing health services or categories of health services, including the level and extent of health services, which must be provided or made available by a regional health authority;

(b) prescribing standards for the provision of health services and the operation of facilities;

(c) respecting the monitoring and enforcement of standards and of compliance with this Act and the regulations;

(d) respecting the annual public meeting of a regional health authority, including but not limited to specifying when the meeting is to be held, notice requirements, matters to be dealt with and procedures to be followed;

(e) respecting the acquisition and disposal of personal property by a regional health authority;

(f) respecting the health services which may be provided by a regional health authority in addition to prescribed health services;

(g) respecting agreements between regional health authorities and health care organizations, health care providers, health corporations and other persons;

(h) requiring books, registers, accounts, files and records to be kept by regional health authorities;

(i) respecting reporting requirements by a regional health authority to the minister;

(j) respecting district health advisory councils, including

(i) prescribing the number of members on a district health advisory council,

(ii) the method of selection, by appointment, election or otherwise, of members of a district health advisory council, and

(iii) the duties and functions of district health advisory councils;

(k) respecting advisory committees, including but not limited to service provider advisory committees;

(l) respecting conflicts of interest for directors, officers and employees of regional health authorities and for members of district health advisory councils, including but not limited to

(i) prescribing those things which constitute a conflict of interest, and

(ii) requiring regional health authorities to make by-laws respecting conflicts of interest and respecting the contents of those by-laws;

(m) respecting reporting requirements by a health care organization, health corporation or other person in receipt of payments or funding from a regional health authority to the regional health authority;

(n) establishing a procedure to mediate and resolve disputes between a regional health authority and a health care organization, health care provider, health corporation or other person;

(o) respecting confidentiality requirements to be observed by a person with respect to information obtained in the administration of this Act or the regulations or in providing health services under this Act or the regulations;

(p) respecting information management, including but not limited to

(i) information technology and systems to be used by a regional health authority and the standards that such technology and systems must meet, and

(ii) the retention, storage, transmission and destruction of all clinical, administrative and other records, in whatever form, by a regional health authority or any other person;

(q) respecting the sharing of personal health information and other information between a trustee, as defined in The Personal Health Information Act, and the minister, or between trustees, to resolve complaints.

S.M. 2001, c. 44, s. 4.

Regulations may create categories

61(1)

The power to make regulations under this Act in relation to any person, matter or thing includes the power to create categories of those persons, matters or things and to make different regulations for each of those categories.

Regulations may incorporate by reference

61(2)

A regulation made under this Act may incorporate, by reference or otherwise, the provisions of any other Act or regulation.

PART 6

TRANSITIONAL PROVISIONS RESPECTING LABOUR RELATIONS AND EMPLOYEES

62 to 77

Repealed on April 1, 2002, by section 79.

Transfer of employees in civil service

78(1)

The Lieutenant Governor in Council may transfer employees in the civil service to a regional health authority and cause them to become employees of the regional health authority.

Application of Civil Service Superannuation Act

78(2)

The Lieutenant Governor in Council may, by regulation, designate employees transferred to the employ of a regional health authority under subsection (1) as employees within the meaning of The Civil Service Superannuation Act.

Status of transferred employees

78(3)

For the purposes of The Civil Service Superannuation Act, a regional health authority is an agency of the government and that Act may be made to apply to all or some of the employees of the regional health authority as though the regional health authority was an agency of the government.

Application of Labour Relations Act

78(4)

For the purposes of this section, section 59 of The Labour Relations Act relating to common control or direction of associated or related activities or businesses does not apply to a regional health authority or to the Crown in right of Manitoba.

S.M. 1997, c. 41, s. 16.

79

Repealed.

S.M. 1997, c. 41, s. 17.

PART 7

CONSEQUENTIAL AMENDMENTS AND COMING INTO FORCE

80 to 86

NOTE: These sections contained consequential amendments to other Acts that are now included in those Acts.

C.C.S.M. reference

87

This Act may be cited as The Regional Health Authorities Act and referred to as chapter R34 of the Continuing Consolidation of the Statutes of Manitoba.

Coming into force

88(1)

This Act, except for Part 6, comes into force on April 1, 1997.

Coming into force: Part 6

88(2)

Part 6 of this Act comes into force on the day this Act receives royal assent.