Health Care Consent Act Quiz

Environmental Health Law - EHN 121, Unit 10 - HPPA II

• Course: Environmental Health Law (EHN 121)
• Unit: 10 - HPPA II
• Author: Daniel Huynh
• Institution: Toronto Metropolitan University
• Year: 2024

Health Protection and Promotion Act

• Act: R.S.O. 1990, Chapter H.7 (Parts 4-5)
• Revision Date: September 2023

Unit 10 - Contents

• Part IV: Communicable Diseases
  • Section 22 Orders
  • Section 24 Direction
  • Duties to Report Diseases
  • Communicable Disease Outbreak Order
  • More duties to report
  • Court Orders
  • Persons under detention
  • Immunization/Confidentiality
• Part V: Rights of Entry and Appeals
  • Rights of Entry
  • Appeals to HSARB or to the Court
• Part IX: Enforcement

Part IV - Communicable Diseases

• Duties to report diseases
• Medical Officer of Health's powers to issue Communicable Diseases Orders
• Medical Officer of Health's powers to issue Communicable Diseases Directions
• Cooperation between health units
• Court Orders

"Institution"

• Definition: Various types of facilities where people share common living spaces and/or meals; excluding schools
• Includes: Homes, facilities, institutions (almost all non-private residential types)

Definitions, Part IV

• Repealed definitions
• Premise details
• Children's residences
• Child Care and Early Years Act, 2014 (formerly Day Nurseries Act)
• Supported group living residence
• Intensive support residence
• Home for special care
• Long-term care home
• Psychiatric facility
• Correctional institution (amended 2018 to Correctional Services and Reintegration Act, 2018)
• Detention facility (repealed 2018)
• Private Hospital
• Prescribed Place

Section 22 Order

• Medical officer of health may require person to take or refrain from action in respect of communicable disease under specific circumstances (subsection 2).
• Condition precedent: a communicable disease exists; there's immediate risk of outbreak; the disease poses risk to health in that unit, and order requirements decrease/eliminate that risk.
• Time: medical officer of health may specify time/period person must comply
• Content of order details: closure of premises, placarding, isolation, cleaning/disinfecting, destruction of objects; submission to medical exam; submission to care if virulent, don't expose others

Addresses of Section 22 Order

• Resident of health unit
• Present in health unit
• Owner/occupier of premises in health unit
• Owns/in charge of thing in health unit
• Engaged in an activity in the health unit
• Overrides Health Care Consent Act
• Reasons must be in Order
• If under 16, addressed to "parent"

Communicable Diseases Order (Class Orders)

• Directed to a class of people residing or present in health unit.
• Notice to class is required for members of class.
• If delivery would result in delay that increases risks to health, general notice may be delivered through suitable communication methods and/or by posting at suitable location
• Notice must contain sufficient info to recognize who is directed, order details, and where to direct inquiries.

Health Care Consent Act, 1996

• This act does not apply to situations where a person is being examined or treated to ascertain if they're infected with a virulent disease and/or treatment for this same condition.

Additional contents of order

• Report details
• Time restrictions on when the report must be given to officer of health

Reasons for order

• Order details set out in order are required for effectiveness

Order by M.O.H. - re person under sixteen

• Responsibility for compliance falls on parent or other legally responsible party
• Law applies to orders directed to persons under 16

Section 24 Direction

• If person not likely to comply, health officer can direct health unit employees or contractors to do work; billed to person receiving order.

Directions by M.O.H.

• Medical officer of health can give directions regarding eliminating/reducing risk of communicable disease to affected persons
• Conditions under which health officer may issues directions: person refuses, not likely to comply promptly, cannot be easily identified/located.
• Includes contents of directions: placarding of premises, cleaning/disinfecting, and destruction of materials.
• Cost recovery: board of health can recover expenses from the party directed by court

Duties to Report Diseases/Duty to Report Reportable Diseases

• Reporting to medical officer of health for reportable diseases is necessary from physicians, chiropractors, dental surgeons, nurses, pharmacists, optometrists, naturopaths, and “prescribed persons”.
• Reporting duty includes disease knowledge, or suspicion, in non-hospital patients. This duty extends to those who provide services to persons not considered patients or outpatients of a hospital

Definition of "practitioner"

• Includes specific professions: members of Colleges of Chiropractors, Dental Surgeons, Nurses, Pharmacists, Optometrists, Naturopaths of Ontario.

Duty to Report Communicable Disease (Carrier - Physician/Nurse)

• Physicians and registered nurses in extended classes have the duty to notify the medical officer of health if there is reasonable belief that patient is infected with a communicable disease.

Duty to Report Disease (Hospital Administrator)

• Hospital administrators are obligated to report diseases of public health significance for in-patients or outpatients if documented in hospital records.

Duty of Superintendent of Institution to Report Re Disease

• Superintendents must report instances where residents may have diseases of public health significance.

When report to be given (Hospital/Institution)

• Reporting must occur as soon as the entry is made into the hospital or institution records.

R.R.O. 1990, Reg. 569 - Reports

• Details what a report under section 25, 26, 27 or 28 (or subsection 29(2) or section 30 including info on name, address, birth date, sex and onset of symptoms or date of death) under the Act needs to contain for the person in question.
• Additional information from the person who reported that may be requested by a medical officer -Report needed within 24 hours

Duty of School Principal to Report Communicable Disease

• School principals have to report any suspicions related to a communicable disease in a student.
• Specific information needed for reports on students

Duty to report disease (Laboratory)

• Laboratories are responsible for reporting instances where a disease of public health significance specimen is identified
• Time limits for the reporting are detailed.

Definition of "Laboratory"

• Definition of the term related to laboratory work.

R.R.O. 1990, Reg. 569 - Reports (Laboratory) and specifics

• Additional details on content of reports for specimens collected for disease and public health issues

Duty to Report Communicable Disease Acquired at Facility

• Medical officer of health needs to report acquired communicable disease at health facilities
• Details of "health facility". This term includes hospitals, long-term care facilities, psychiatric facilities and any other facility prescribed by law .

Communicable Disease Outbreak Order (Facilities)

• Orders for dealing with outbreaks in public hospitals and institutions
• Conditions for issuing orders: outbreak in the facility/existence of an outbreak/risk to health in the facility, etc. Order specifies details needed to address the outbreak.

Time (Communicable Disease Outbreak Orders)

• Orders must specify the time frame within which actions need to be completed.

Reasons for Communicable Disease Outbreak Order

• Order details must be included with an order specifying its reasons.

Definitions (Communicable Disease Outbreak Order)

• Definitions of “institution” and “public hospital” for the sake of reference in orders.

Duty to Report Death (Physician/Nurse)

• Physicians and nurses in extended classes have to report deaths relating to public-health significance diseases.

R.R.O. 1990, Reg. 569 - Reports (Death)

• Specific information required in report of death related to disease of public health significance

Duty of Medical Officer of Health to Report to MOHLT

• Medical officers of health report to the Ministry and the Ontario Agency for Health Protection and Promotion regarding public health diseases and deaths

Reports by M.O.H. - re events

• Medical officer of health must report reportable events within 7 days of receiving a report
• Details of these reports

R.R.O. 1990, Reg. 569 - Reports

• Copy of a report made to a medical officer of health regarding communicable diseases needs to be made available to the Ministry and the Ontario Agency for protection and health promotion

OAHPP - New

• Definition of Ontario Agency for Health Protection

Communication Between Health Units

• Medical officers of health can exchange information in respect of a person concerning a communicable disease

Communicable diseases of the eyes

• Health-care professionals attending a childbirth must comply with regulations in respect of communicable diseases of the newborn's eyes

Physician or Nurse to Report Refusal or Neglect of Treatment , and procedures

• Any physician or registered nurse in extended class have to report any refusal or neglect regarding treatment of communicable disease

Report Refusal to Co-operate

• Details for reporting refusal to cooperate with treatment

Court Orders

Court Order (Requirements)

• Application required, diseases like virulent may be present, if person has not complied with health officer's order
• Specific actions to take (isolate, submit to an examination by medical officer, placement under care and treatment of a physician) are determined
• Additional rules and policies

Court Order (By Ontario Court of Justice)

• Additional procedures related to the court and application

Capability of Hospital or Facility

• To perform detention, treatment, and care.

Delivery to hospital / other facility

• Details on locating and apprehending those under orders
• Delivering to named facilities

Order by Ontario Court of Justice (Police Assistance, Amended 2018)

• Law enforcement support for carrying out the court

Care and treatment

• Details regarding lawful detention, care and treatment of an infected individual
• Time limits for this are given.

Health Care Consent Act, 1996 (Regarding Court Orders)

• Details on how the Act does or does not apply to specific procedures during court orders

Physician responsibilities (Court Order)

• Physician designation procedures for care and treatment

Designation of physician (Court Order)

• Specific requirements related to designating a physician for care and treatment in special circumstances

Reports (Court Order)

• Reports, processes, and procedures
• Information relating to reports are required for court procedures.

Order to continue detention and treatment

• Judge may extend periods of detention and treatment, based on specific conditions
• Details on extending time
• The maximum limit of time is not more than six months

Release and discharge from hospital or other facility

• Procedures related to release from detention and discharge from facilities

Certificate of M.O.H.

Hearing of application or motion

• Procedures related to hearings to appeal

Effect on proceeding before the Board

• A proceeding relating to a similar case cannot be performed until court order is addressed

Appeal

• Details on how parties may appeal

Appeal to Court of Appeal

• Details on grounds for appeal

Where Person Withdraws from Care and Treatment

• Procedures related to withdrawing from ordered care or treatment of virulent communicable disease

Court Order - Communicable Disease

• Procedures which address the case where person with an infectious disease has failed to comply with medical officer's order and their methods to remain isolated

Persons Under Detention

• Specific Procedures for examination

Examination of Person under Detention (Amended 2018) and specific definitions of terms

• Procedures related to examination of individuals in detention
• Specifics on the terms used for correctional facilities

Definitions (Examination of Person under Detention - Amended 2018)

• Clarifications/details for various terms for special cases

Immunization

• Details related to Immunization: general information, immunizing agents, etc.

Duty to Inform (Immunization)

• Duty for health officials to inform people who consent for immunization

Duty to report reactions (Immunization)

• Procedures and reporting terms

Idem (Immunization)

• Procedures for forwarding of reports to different MOH units

R.R.O. 1990, Reg. 569 - Reports(Immunization)

• Specific procedures needed for adverse events for immunization

Confidentiality

• Procedures related to maintaining confidentiality
• Specific exemptions

Drugs for STIs

• Regulations / guidelines regarding the provision of drugs to treat sexually transmitted infections (STIs)

Supply of drugs (Unqualified persons) Prohibited

• Guidelines and restrictions on supplying drugs in relation to the treatment of those with sexually transmitted infections (STIs)
• Exemptions for Pharmacists

Part V - Rights of Entry and Appeals

Rights of Entry

• Details on who can enter a premises
• Reasons for entry procedures
• Power of entry on premises
• Procedures regarding reasonable times and certain conditions

Interpretation, Persons (Rights of Entry)

• Definitions and procedures related to persons involved with entry procedures

Interpretation, Purpose (Rights of Entry, Persons)

• Details regarding purpose(s) for this act

Entry (Rights of Entry)

• Details related to the entry process

Examinations (Rights of Entry), Procedures regarding an examination of premises/person

Samples or Extracts

Reasonable times (Rights of Entry)

• Guidelines for exercising these rights

Private Residence

• Restriction regarding entering private residence for specific procedures

Operator to cease operation

• Procedures related to having to cease operation of premises/systems for the purposes of examination and investigation

Copies

• Requirements regarding copies for documentation of evidence

Charter Override (Rights of Entry)

• Procedures for warrant applications for inspectors regarding an alleged offense

Application for warrant

Obstruction

• Procedures relating to obstructing
• Specific case of a refusal that does not count towards an obstruction of a procedure

Warrant by justice of the peace

• Specific details related to a warrant issue from justice of the peace
• Requirements for a warrant
• Procedures regarding execution

Appeals to Health Services and Appeals Review Board (HSARB)

• Details about appealing orders

Right to hearing (Appeals)

• Procedures regarding a right of a person to have a hearing

Effect of Order (Appeals)

• Procedures related to when an order takes effect

Powers of the Board (Appeals)

• Powers of the board for hearing and order processes

Time for hearing (Appeals)

• Details related to the time frame for hearings

Extension of time for hearing

Parties and evidence (Appeals)

Examination of documentary evidence (Appeals)

Members holding hearing not to have taken part (appeals)

• Restrictions on members involved in an investigation to take part in hearing and communicating about subject matter

Recording of evidence (Appeals)

• Procedures and requirements

Release of documentary evidence (Appeals)

-Release of evidence procedures

Appeal to Court

• Appeal procedures to the court for decisions related to proceedings before the Board

Powers of court on appeal

• Details related to the appeal procedure and exercising powers from courts

Part IX - Enforcement

Offence, Orders

• Legal implications for failing to follow an order
• List of sections that are subject to offenses

Offence, specified provisions

• List of specified provisions that can lead to a legal penalty

Offence, Regulations

• Offenses related to regulation non-compliance
• List of regulations that may result in an offense

Penalty

• Details related to penalties for offenses, specifying maximum limits.

Corporation (Enforcement)

• Specific penalties applicable to organizations

Directors, officers, employees and agents (Enforcement)

• Legal liabilities for those in a position of responsibility within an organization for failure to comply with the law

Court Orders (Prohibit continuation/repetition)

• Procedures related to preventing continuation or repetition of violations
• Order procedures

Test your knowledge on the Health Care Consent Act, 1996 and related orders issued by medical officers of health. This quiz includes questions on definitions, responsibilities, and requirements under the Act. Perfect for students or professionals in the health care field.