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The District Health and Social Services Act
This is an unofficial archived version of The District Health and Social Services Act
as enacted by SM 1987-88, c. 9 on July 17, 1987.

R.S.M. 1987, c. H26

The District Health and Social Services Act

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

Definitions.

1(1)

In this Act

"affected municipality" where used in connection with a district or a board means a municipality all or part of which is within the district or within the district of the board; ("municipalité touchée")

"board" means a health and social services board established under this Act, and where used to refer to the board of a district means the board established under this Act for that district; ("Conseil")

"commission" means Manitoba Health Services Commission; ("Commission")

"district" means a health and social services district established under this Act; ("district" )

"facilities" means premises in which health services or social services, or both, are provided including the equipment in the premises used to provide the services and without limiting the generality of the foregoing includes hospitals, personal care homes, clinics and laboratories; ("installations")

"health services" means

(a) services usually provided by or through a hospital including in-patient care and treatment and out-patient care and treatment,

(b) personal care usually provided in personal care homes,

(c) medical services,

(d) dental services,

(e) chiropractic services,

(f) optometric services,

(g) nursing care, whether at facilities or at the home of the patient,

(h) medical laboratory services,

(i) x-ray services,

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

(k) public health services, including, without limiting the generality of public health services, public health nursing and public health inspection, environmental health, school health, maternal and child health, family planning, health education, occupational and industrial health, accident prevention, poison control, rehabilitation, continuing care services, communicable diseases control and epidemiology,

(l) ambulance services,

(m) mental retardation services,

(n) mental health services,

(o) physiotherapy,

(p) provision of orthotic and prosthetic devices,

(q) enforcement of The Public Health Act and the regulations made thereunder,

(r) services and programs related to alcoholism and chemical abuse, and

(s) such other services related to health or to the care or treatment of sick, infirm or injured persons as may be prescribed in the regulations; ("services de santé")

"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")

"proposal" means a proposal prepared under this Act; ("projet")

"regulation" means a regulation made under this Act, and where used to refer to regulations respecting a board of a district means the regulations made under section 6 that apply to that board or that district, as the case may be; ("règlement")

"social services" means

(a) the provision and administration of social allowances,

(b) child welfare services,

(c) the provision of child day care centres,

(d) probation services,

(e) family services,

(f) employment and rehabilitation services,

(g) marriage counselling, and

(h) such other services related to social development and to the counselling of people in respect of their participation in community life as may be prescribed in the regulations. ("services sociaux" )

Local government district.

1(2)

Where under this Act, any act or proceeding is required or permitted to be done or taken by a local government district, the act or proceeding shall or may be done or taken by the resident administrator of the local government district, and where there is reference in this Act to the council of a municipality that reference shall include the resident administrator of a local government district where the context so requires.

Inclusion of lands outside municipalities.

1(3)

A proposal or a regulation made under section 6 may provide for the inclusion within a district of lands not within a municipality, and where lands not within a municipality are included within a district the regulations respecting the district shall provide that the government

(a) through the member of the Executive Council charged with the administration of The Municipal Act; or

(b) where the lands are within Northern Manitoba as that expression is defined in The Northern Affairs Act, through the member of the Executive Council charged with the administration of that Act;

is responsible for paying some apportioned share of the costs and expenditures of the board of the district that are not approved by the commission in its reviews of the budgets of the board in the same manner as an affected municipality.

Preparation of proposals.

2(1)

The minister may cause to be prepared a proposal for the establishment, organization, administration and financial support of a proposed health and social services board in respect of a proposed district.

Contents of proposal.

2(2)

A proposal prepared under subsection (1) shall include proposals

(a) respecting the area to be included in the proposed district;

(b) respecting the organization and composition of the proposed board and the manner of appointment or election of members of the proposed board;

(c) respecting the health services and social services that shall or may be provided or administered by or through the proposed board;

(d) respecting the facilities that may be required by the proposed board for its purposes and objects and the manner by which the proposed board may acquire those facilities;

(e) respecting the manner of providing financial support for the proposed board, including the levying and apportionment of amounts among the affected municipalities;

and shall refer to any undertakings obtained by the minister under section 4 in respect of any matter referred to in the proposal.

Proposal for variation.

3(1)

The minister may cause to be prepared a proposal to vary the size and boundaries of a district or to vary any aspect of the organization, administration or financial support of a board or to vary the health services and social services that a board is required or authorized to provide within its district, or dealing with two or more of those matters.

Contents of proposal.

3(2)

A proposal prepared under subsection (1) shall clearly indicate the variations to the district or to the organization, administration or financial support of the board or to the health services or social services that the board is required or authorized to provide within its district and shall refer to any undertakings obtained by the minister under section 4 in respect of any matter referred to in the proposal.

Obtaining undertakings,

4(1)

For the purposes of preparing a proposal, the minister may enter into negotiations with the owners and operators of hospitals, personal care homes, clinics, laboratories and other premises in which health services or social services are provided, and with persons providing health services or social services within a district or proposed district, with a view to obtaining undertakings, and he may obtain undertakings in writing from any such owner, operator or person in respect of any matter referred to in the proposal conditional on the proposal being adopted in whole or in part, as the undertaking may specify.

Effect of undertakings.

4(2)

Subject to subsection .(3), where a written undertaking has been obtained under subsection (1) in respect of any matter referred to in a proposal, if the proposal is adopted in whole or in part, or adopted with changes that are not material to the undertaking or to a condition specified in the undertaking, the person giving the undertaking is bound by the undertaking and, notwithstanding that he has not received or will not receive adequate or any consideration for or in respect of any matter dealt with in the undertaking, and notwithstanding that the board is not a party to the undertaking, the undertaking may be enforced by the board to which the proposal relates.

Expiry of an undertaking.

4(3)

Where a written undertaking is obtained under subsection (1) if the proposal to which it relates is not adopted in whole or in part within two years after the date the undertaking is given, or renewed, the undertaking ceases to have effect and is not enforceable.

Submission of proposal.

5

Where a proposal has been prepared, the minister shall submit the proposal to each municipality all or part of which is within the district or proposed district, to the governing board of each hospital district all or part of which is within the district or proposed district, and to any other person who the minister thinks should consider the proposal, and invite their comments in respect of the proposal.

Establishment of district and board.

6(1)

Subject as hereinafter provided, the Lieutenant Governor in Council may, by regulation, establish a health and social services district, define its boundaries or describe its area and give it a name by which it may be known, and establish a health and social services board to provide health services and social services within the district and give the board a name by which it shall be known.

Variation in districts and boards.

6(2)

Subject as hereinafter provided, the Lieutenant Governor in Council may, by regulation, vary the size and boundaries of a district or vary any aspect of the organization, administration or financial support of a board or vary the health services or social services that a board is required or authorized to provide in its district or vary two or more of those matters.

Boundaries co-terminus.

7

The boundaries of a district shall be defined or the area described in such a way that the boundaries of the district follow, as much as possible, boundaries of municipalities, school divisions, hospital districts or other areas previously determined under or in accordance with an Act of the Legislature for the purposes of such Act.

Details of regulation.

8

A regulation under subsection 6(1) shall

(a) provide for the organization and composition of the board;

(b) specify the health services and social services that the board is required to provide within a district;

(c) specify the health services and social services that the board is authorized to provide within its district;

(d) specify the method of apportioning among the affected municipalities the amount of costs or expenditures of the board that are not approved by the commission in its reviews of the budgets of the board;

and shall set out such other details and deal with such other matters as the Lieutenant Governor in Council deems advisable.

Effect of regulation.

9

A regulation made under section 6 has the force of law but it is not a regulation within the meaning of The Regulations Act and that Act does not apply thereto.

Restriction on establishment of boards.

10

The Lieutenant Governor in Council shall not establish a district or a board for the district or amend, vary or repeal a regulation made under section 6 unless not less than one-half of the affected municipalities within the district or proposed district have by resolution of the council thereof, approved the proposal respecting the establishment or the amendment, variation or repeal.

Effect of establishment of board on hospital district.

11

Where a district established under this Act includes all or part of a hospital district and the board of the district is required under the regulations respecting the board to provide hospital care and treatment within the district, notwithstanding The Health Services Act the Lieutenant Governor in Council shall

(a) dissolve the hospital district and the governing board of the hospital district; or

(b) change the boundaries of the hospital district so that the hospital district does not include any land within the district established under this Act;

and may repeal or amend any regulation made under that Act to achieve that purpose and any amendment to regulations under that Act made under this section are not invalid by reason of non-compliance with any provision of that Act.

Effect of dissolution on hospital district

12

Where a hospital district is dissolved under section 11 because of the establishment of a board and district under this Act, the board of the district shall assume, and is responsible for, all the debts and obligations of the governing board of the hospital district, and all property, assets and rights of the governing board of the hospital district, vest in the board of the district.

Effect of change of boundaries of hospital district.

13

Where the Lieutenant Governor in Council changes the boundaries of a hospital district under section 11 the Lieutenant Governor in Council shall amend the regulations under The Health Services Act respecting the hospital district and the governing board thereof and adjusting the scheme and supplementary schemes of the hospital district in accordance with the change in the boundaries of the district and any amendment to regulations under The Health Services Act made under this section are not invalid by reason of non-compliance with any requirement of that Act.

Reference to Municipal Board.

14

Where, by reason of a dissolution or variation of a hospital district, the obligations of municipalities, all or part of which are within the hospital district are affected, the minister may refer the matter to The Municipal Board to make an order respecting the apportionment of the obligations of the municipalities concerned and, notwithstanding The Health Services Act, the order of The Municipal Board in respect thereof is final and binding. Application of secs. 11 to 14 in other situations. 15 Sections 11 to 14 apply with such modifications as the circumstances require to and in respect of a local health unit and the advisory board of the local health unit where a district is required under the regulations respecting the board to provide health services similar to those provided by a local health unit.

Properties and liabilities of existing owners.

16(1)

Where a board of a district is required or authorized under the regulations respecting the board to provide any health service or social service that is being provided in the district

(a) through a hospital within the district that is not a hospital owned and operated by a governing board of a hospital district established under The Health Services Act; or

(b) through a personal care home;

the Lieutenant Governor in Council, with the consent of the owner of the hospital or personal care home, may order

(c) that the hospital or personal care home, as the case may be, and all property and assets of the owner thereof used in connection therewith vest in the board of the district subject to any charge or encumbrance against the property or assets; and

(d) that the board of the district is liable for all debts and liabilities of the owner of the hospital, or personal care home, as the case may be, that were incurred for the purposes of the acquisition, construction, repair, maintenance or operation of the hospital or personal care home.

Consent of certain owners.

16(2)

Where the owner of a hospital or personal care home mentioned in subsection (1) is a corporation with share capital, the consent of the owner required under subsection (1), shall not be given unless it is approved by a special resolution as that expression is defined in The Corporations Act.

Consent by owners of certain personal care homes.

16(3)

Where the owner of a personal care home is a corporation incorporated in accordance with The Elderly and Infirm Persons' Housing Act, the consent mentioned in subsection (1) shall not be given unless it is approved by resolution of the council of each municipality concerned in the establishment of the corporation.

Where subsecs. (2) and (3) do not apply.

16(4)

Where the owner of a hospital or personal care home is a corporation and subsections (2) and (3) do not apply, any consent required under subsection (1) may be given by resolution of the board of directors or other governing board of the corporation.

Corporate status.

17(1)

Upon being elected or appointed, the persons who are from time to time members of a board are a body corporate under the name given to the board by the Lieutenant Governor in Council, but The Corporations Act does not apply to the board.

Non-profit board.

17(2)

A board is a non-profit corporation, and no member of the board shall by reason of his membership on the board receive any pecuniary gain from the revenues of the board, but a member of the board may be reimbursed for his reasonable expenses incurred in connection with the performance of his duties and functions as a member of the board.

Municipal representation on board.

18

The council of each affected municipality in a district shall in accordance with the regulation respecting the board elect or appoint or have the right to nominate at least one person resident within the district as a member of the board of the district.

Programs.

19(1)

Subject to the approval of the minister, a board may take such steps as it deems necessary to establish and operate programs for providing health services and social services that it is required or authorized to provide.

Powers, etc. for required services.

19(2)

Where the board of a district is required under the regulations respecting the board to provide in the district a health service or a social service that, under an Act of the Legislature, a member of the Executive Council is authorized or required to provide, the board has, for the purposes of providing that health service or social service, all the powers, authority, duties and functions granted to or imposed on that member of the Executive Council that are necessary to enable the board to provide the health service or social service.

Delegation of powers, etc., for authorized services.

19(3)

Where the board of a district is authorized under the regulations respecting the board to provide in the district a health service or a social service that, under an Act of the Legislature, a member of the Executive Council is authorized or required to provide, the member of the Executive Council may, in writing, delegate to the board such powers, authority, functions and duties granted or imposed on the member of the Executive Council for the purposes of providing the health services or social services as the member of the Executive Council thinks will be necessary to enable the board to provide the health service or social service.

Boards subject to law.

20

In providing health services or social services, or both, a board is subject to and shall comply with the law relating to those health services or social services except as may be otherwise provided by this Act.

Contracting for professional services.

21

Notwithstanding any other Act of the Legislature, where a board of a district is required or authorized to provide a health service, it may with the approval of the commission employ or contract with medical practitioners, dentists, chiropractors, optometrists, and other professional personnel, duly qualified in their respective disciplines, to provide the service for and on behalf of the board and the board may collect fees and charges for or in respect of those services from the persons to whom the services are provided.

Acquisition of facilities.

22(1)

Subject to the consent of the commission, the board of a district may acquire by purchase, lease, gift or otherwise, facilities, lands or premises within the district for its purposes and construct facilities on any land so acquired or convert any buildings and structure on the land for its purposes.

Disposal of real property.

22(2)

A board that has received payments from the government under this Act towards the payment of capital expenditures for the acquisition, construction or major renovation of facilities shall not, without the consent of the minister, sell or dispose of any real property that has been used for those facilities; and the minister may impose conditions on the granting of any consent given for the purpose of this subsection.

Expropriation.

23

The minister may, for and on behalf of a board of a district, acquire by purchase or expropriation lands or premises or both for the purposes of acquiring or constructing facilities, and may, upon acquiring the lands or premises or both dispose of them to the board on such terms as he may specify.

Borrowing.

24

With the consent of the commission and subject to such terms and conditions as the commission may specify, a board may borrow money for the purposes of the board.

Assigning employees.

25

Any member of the Executive Council may, with the agreement of the board, assign a person employed by the government under the member of the Executive Council to a board to perform duties and functions specified by the board and the assignment does not affect the status of the person under The Civil Service Act or The Civil Service Superannuation Act, and the member of Executive Council may terminate the assignment at any time.

Status of employees.

26

For the purposes of The Civil Service Act and The Civil Service Superannuation Act, a board is an agency of the government and either or both of those Acts may be made to apply to all or some of the employees of the board as though the board was an agency of the government.

Provision of services.

27

A board shall provide within its district all health services and social services that under the regulations respecting the board it is required to provide and may provide within its community any health service or social service that under the regulations respecting the board it is authorized to provide.

Cost of services not supported by government.

28

Where the board provides health services or social services that are not provided under a program supported by government financing the board shall apportion the costs thereof among the affected municipalities in accordance with the regulations respecting the board.

Joint provision of services.

29

With the consent of the commission a board may enter into an agreement with another board or another person which

(a) the parties agree to provide jointly certain health services or social services or both; or

(b) one party undertakes to provide certain services for and on behalf of the other party;

and for the purposes of carrying out an agreement under this section a board may, with the consent of the commission, acquire lands and premises or an interest therein, outside its district.

Special facilities.

30

Notwithstanding that a board is neither required nor authorized to provide a particular health service or social service, it may, with the consent of the minister, acquire facilities in which that service may be provided by a person who is authorized to provide the service and may enter into agreements with such a person respecting the use of the premises for that purpose.

Budget.

31

Each board shall, before a date in each year fixed under the regulations, prepare and submit to the commission a budget for the next ensuing year showing

(a) the anticipated costs and expenditures to be incurred made by the board in providing health services and social services in its district in the next ensuing year; and

(b) the anticipated revenue of the board in the next ensuing year.

Form of accounts and budgets.

32(1)

Each board shall prepare its budget, keep its accounts and records and account for its funds in accordance with the regulations and any directions with respect thereto that the commission may give.

Separate accounting.

32(2)

In preparing budgets, keeping accounts and records, and in accounting each board shall in accordance with the regulations, show its revenues and expenditures in respect of each separate health service or social service, provided by the board, or in respect of other aspects of the business and affairs of the board, in such a manner as the commission may direct.

Budget review.

33

Sections 55, 56, 57, 58 and 60 of The Health Services Insurance Act apply with such modifications as the circumstances require to boards and to the review of budgets of boards by the commission and upon approving a budget for a board, the commission shall notify the board of which items in the budget submitted by the board are approved and which are not approved.

Health Insurance benefits.

34(1)

Where a board provides health services that are benefits or the cost of which are benefits, under The Health Services Insurance Act, the commission shall pay to the board the moneys payable under that Act with respect thereto.

Funding from government

34(2)

In addition to any moneys that the commission is authorized to pay to a board in accordance with The Health Services Insurance Act, or any other Act of the Legislature, the minister may direct the commission to provide funds to a board for and in respect of any health services and social services provided by the board and which under an Act of the Legislature the minister or the government is authorized to provide or pay for; and in that event the Minister of Finance shall on the requisition of the minister pay to the commission moneys authorized under an Act of the Legislature to be so paid and applied.

Funding by commission.

34(3)

In addition to any moneys that the commission is authorized to pay to a board in accordance with The Health Services Insurance Act or subsection (2), the commission may pay to boards any moneys that have been made available to the commission by the Legislature for the purposes of supporting programs of providing health services or social services through boards.

Apportionment of excess liabilities.

35

Where a board does not have sufficient moneys in any year to meet its obligations that come due in that year, it shall, as soon as possible after the end of the year, apportion the deficiency among the affected municipalities in respect of the board in accordance with its regulations and charge to each of the affected municipalities its proportionate share, and each of the affected municipalities shall pay to the board the amount apportioned to it within 90 days of the date it receives notice of the amount charged to it.

Inspection for minister.

36(1)

Any person authorized by the minister for the purpose, may, at any reasonable time

(a) enter and inspect any facilities of a board;

(b) examine, make copies of and take extracts from, any books, records, files, registers, accounts or documents of a board; and

(c) require a board or an official thereof to provide or verify information concerning the business and affairs of the board.

Confidentiality of certain information.

36(2)

Information obtained by or furnished to the minister or a person authorized under this section, and relating to or respecting

(a) the relationship of a medical practitioner to his patient; or

(b) the medical services rendered by a medical practitioner to a patient;

shall not be communicated to any person not legally entitled thereto.

Suspension of board.

37(1)

Where the minister is satisfied that a board

(a) has failed to meet standards prescribed in the regulations or in any regulation made under any other Act of the Legislature in respect of any program or facility operated by the board or in respect of any health service or social service provided by the board; or

(b) has failed to show financial responsibility; or

(c) has failed to meet its financial obligations;

he may suspend the powers of a board for such period as he may determine and in that event the commission is, during the period of the suspension, seized with all the powers, and assets of the board, and shall for all purposes stand in the place of, exercise powers and perform functions for and in the name of, the board, and administer the business and affairs of the board.

Liabilities.

37(2)

Where the minister suspends the powers of a board under subsection (1) the commission is, during the period of the suspension, responsible for the liabilities and obligations of the board to the extent only of the value of the assets and properties of the board, and the commission may employ persons to administer on behalf of the commission the business and affairs of the board during the suspension.

Regulations of Lieutenant Governor in Council.

38

For the purpose of carrying out the provisions of this Act according to their intent, the Lieutenant Governor in Council may make regulations ancillary thereto and not inconsistent therewith, and every regulation made under, and in accordance with the authority granted by, this section has the force of law, and without restricting the generality of the foregoing the Lieutenant Governor in Council may make regulations

(a) prescribing services related to health or to the care and treatment of sick, infirm or injured persons as health services under this Act;

(b) prescribing services related to social development or to counselling of people in respect of their participation in community life as social services under this Act;

(c) prescribing qualifications for members of boards and grounds for disqualification of members of boards;

(d) limiting the terms of office of members of boards and limiting the re-appointment or reelection of members of boards for successive terms;

(e) prescribing procedures for filling vacancies on boards;

(f) requiring boards to hold public meetings and prescribing the manner of calling, the matters to be dealt with, and the procedure for such meetings;

(g) respecting elections of members of boards to be elected;

(h) prescribing forms of consent to be given by persons before they receive certain health services or social services and respecting the effect of such consents.

Regulations of minister.

39(1)

For the purpose of carrying out the provisions of the Act the minister may make regulations not inconsistent with any other provision of this Act

(a) specifying the manner of and other details relating to the provision of health services and social services by a board;

(b) prescribing standards to be observed by boards in the provision of health services and social services and in the construction, maintenance and operation of facilities;

(c) prescribing the form of reports and returns to be made by boards to the commission;

(d) respecting the preparation of budgets by boards, and the review, approval and rejection by the commission of budgets of boards, and prescribing the date before which boards must submit their budgets to the commission;

(e) prescribing forms to be used by boards or by persons receiving health services or social services from boards;

(f) respecting the manner of, and other details relating to, the making of payments by the commission to boards;

(g) respecting the location and standards of facilities and equipment in facilities;

(h) respecting model by-laws and rules for boards and requiring certain by-laws and rules to be made by boards;

(i) prescribing books, registers, accounts, files and records to be kept by boards for various purposes;

(j) prescribing rules respecting confidentiality of information received or collected by boards;

(k) prescribing rights of persons to whom a board provides or is required to provide health services or social services;

(l) prescribing maximum charges that may be made by a board for health services and social services provided by the board.

Application of Regulations Act.

39(2)

The Regulations Act does not apply to regulations made under subsection (1), but the minister shall send a copy of each regulation made under subsection (1) to each board.

Retroactive effect.

39(3)

A regulation made under subsection (1) may be retroactive and effective during a period beginning before the regulation was made on a date fixed in the regulation.

By-laws of boards.

40

Subject to the approval of the minister, each board shall make by-laws

(a) respecting the time, place and manner of holding annual and other meetings of the board;

(b) respecting procedures of the board at their meetings;

(c) determining the place of the head office of the board within the community of the board;

(d) creating, and delegating duties to, executive and other committees of the board;

(e) respecting the officers of the board and their powers and duties;

(f) respecting rules of conduct of persons admitted to receiving services in, using or visiting facilities of the board;

(g) respecting standards and conditions of employment of employees of the board;

(h) respecting the appointment, rights, duties and conduct of professional staff of the board.