1 / 42

Ontario Caregiver Recognition Act

Ontario Caregiver Recognition Act. The Right of Caregivers to Access Health Information of Relatives with Mental Health and Addiction Issues. Billy Chan, Ph.D., R.S.W. Law and Mental Health Program Centre for Addiction and Mental Health Toronto, Ontario Canada. Outline.

colm
Download Presentation

Ontario Caregiver Recognition Act

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Ontario Caregiver Recognition Act The Right of Caregivers to Access Health Information of Relatives with Mental Health and Addiction Issues Billy Chan, Ph.D., R.S.W. Law and Mental Health Program Centre for Addiction and Mental Health Toronto, Ontario Canada

  2. Outline • Objectives and key provisions of the proposed OCRA • Definition of key terms • Allied caregiver • Informal Health Information Custodian • Overview of proposed OCRA • Rationale and justifications • Best practice approach • Federal and provincial mental health strategies • The Vision Family Council 2013 Annual General Meeting

  3. Objectives and Key Provisions Family Council 2013 Annual General Meeting

  4. Objectives of the proposed Ontario Caregiver Recognition Act (OCRA) • Establish a legislative framework to recognize • The roles and contributions of caregivers • The right of allied caregivers to access health information of the Person they care for, while respecting the right to confidentiality of the Person • Broader aspects of recognition and supports to caregivers Family Council 2013 Annual General Meeting

  5. Key Provisions of (proposed) OCRA • Designate allied caregivers as informal health information custodians • Develop procedures to safeguard right of allied caregivers to access health information of the Person and right of the Person to maintain confidentiality • Establish OCRA Council to oversee implementation and monitoring of the Act • Periodic review and consultation to expand recognition and support to caregiver Family Council 2013 Annual General Meeting

  6. Definition of key Terms Family Council 2013 Annual General Meeting

  7. Key definitions • The Person: An individual living with mental health and addictions issues • Caregiver: An individual within the Person’s social network who provides care and support without financial compensation • Allied caregiver: A designated caregiver who provides support to, and often live with the Person Family Council 2013 Annual General Meeting

  8. Key definitions • Health Information Custodian (HIC) • a person or organization who has custody or control of personal health information as a result of their formal (usually paid) duties stipulated in PHIPA (2004) • Informal HIC • A designated caregiver in the social network who has knowledge of health information of the Person as a result of providing unpaid care and support to the Person Family Council 2013 Annual General Meeting

  9. Allied caregiver as informal Health Information Custodian (HIC) • “…access to their family member’s care plan • to be included respectfully by physicians and others in discussions of how and by whom that plan will be implemented” (Senate Committee Report, 2006, p. 29) • The “need to know” principle (Szmukler & Bloch, 1997) to assist them in their caring and supportive role. Family Council 2013 Annual General Meeting

  10. Overview of proposed OCRA Family Council 2013 Annual General Meeting

  11. Person living with mental health and addiction issues One-way input in partnership Two-way input in partnership Barrier to partnership due to confidentiality Recovery Mental health professionals Family Caregiver Confidentiality: A major barrier to partnership in Recovery Family Council 2013 Annual General Meeting

  12. Allied family caregivers as informal Health Information Custodians Ontario Caregiver Recognition Act Allied family caregiver as informal HICs Access to health information of the Person Family Council 2013 Annual General Meeting

  13. Mandatory interview with Person to identify allied caregiver Yes Regular review of allied caregiver designation No Revocation of allied caregiver status Mandatory procedure to designate allied caregivers Family Council 2013 Annual General Meeting

  14. Establish an OCRA Council to monitor progress Family Council 2013 Annual General Meeting

  15. Safeguards to balance the rights of allied caregivers and the person Mandatory interview with Person Mandatory interview with family Explicit and informed consent required Victim of abuse by family Yes No Consent not required Duty to warn/protect Yes No Share health information with family Family as allied caregiver Person provides consent No Yes Yes No Access to health information on a “need to know” basis Mandatory periodic review of Person’s consent Yes Family Council 2013 Annual General Meeting

  16. Two-way input in partnership enabled through OCRA Goal: Partnership through (proposed) OCRA to promote recovery Person living with mental health problems and illnesses Recovery Mental health professionals Allied family caregiver Family Council 2013 Annual General Meeting

  17. Bill ??? Caregiver Recognition Day, Ontario: First (weekday) of (Month), 201? OCRA The Vision Family Council 2013 Annual General Meeting

  18. Rationale Family Council 2013 Annual General Meeting

  19. More responsibilities, less rights • Compared to mental health professionals, caregivers have • Less support from the system • Less rights to health information • More burden in the care of their ill relatives (Canadian Mental Health Association, undated) Family Council 2013 Annual General Meeting

  20. Between a rock… • “First, they (caregivers) must suffer with their loved ones through their daily hardships and use their limited personal resources to try to alleviate them • Second, they must contend with a mental health system that often excludes them from involvement in the information-gathering and decision-making processes… Family Council 2013 Annual General Meeting

  21. And a hard place • while simultaneously leaving them to serve as the fail-safe mechanism to provide unlimited, unpaid care, filling in the cracks that open when any part of the so-called system fails” (The Standing Senate Committee, 2006, p. 34) Family Council 2013 Annual General Meeting

  22. Justifications Family Council 2013 Annual General Meeting

  23. Best practice approach • Carer Recognition Act (Government of Western Australia, 2004) • Carer Recognition Policy (Queensland Government, 2007) • Caring for Carers (UK Department of Health, 2008) • Manitoba Caregiver Recognition Act (2011) Family Council 2013 Annual General Meeting

  24. Manitoba Caregiver Recognition Act (2011) • “These caregivers provide a valuable service to their families and to their communities, and in many cases, it comes at a physical, emotional and sometimes financial cost to individuals and families • Our legislation recognizes both the value of their contribution and the need to work with caregivers to provide a network of supports” Family Council 2013 Annual General Meeting

  25. the federal government Family Council 2013 Annual General Meeting

  26. The Standing Senate Committee Report (2006) • Recommendation #2 • That health care professionals take an active role in promoting communication between persons living with mental illness and their families Family Council 2013 Annual General Meeting

  27. The Standing Senate Committee Report (2006) • Recommendation #3 • That health care professionals have discretion to release personal health information, without consent, in circumstances of clear, serious and imminent danger for the purposes of warning third parties and protecting the safety of the patient Family Council 2013 Annual General Meeting

  28. The Standing Senate Committee Report (2006) • That this discretion be governed by a clearly defined legal standard set out in legislation, and subject to review by privacy commissioners and the courts (The Standing Senate Committee Report, 2006, p. 69) Family Council 2013 Annual General Meeting

  29. Mental Health Strategy for Canada (2012) • Priority 2.1 • It is critical that they (families) have access to the information and resources they need to sustain themselves, and that their voices be heardin the mental health system (Mental Health Commission of Canada, 2012, p. 29) Family Council 2013 Annual General Meeting

  30. Mental Health Strategy for Canada (2012) • Priority 3.5 • Caregivers need increased access to financial supports like tax credits, caregiver allowances, and respite care, as well as to workplace policies—such as allowing caregiver leaves and flexible hours—that would ease their burden (Mental Health Commission of Canada, 2012, p. 55) Family Council 2013 Annual General Meeting

  31. The Ontario government Family Council 2013 Annual General Meeting

  32. Selection Committee Final Report to Ontario Legislature (2010) • Recommendation # 21 • A task force to incorporating adequate representation from caregivers to propose changes in involuntary admission and treatment Family Council 2013 Annual General Meeting

  33. Selection Committee Final Report to Ontario Legislature (2010) • Recommendation # 22 • A task force to investigate and propose changes to PHIPA to ensure caregivers have access to personal health information of their ill relatives Family Council 2013 Annual General Meeting

  34. Selection Committee Final Report to Ontario Legislature (2010) • Recommendation #16 • Increased availability of respite care to allow family members the time and freedom to pursue personal, social and recreational endeavours in order to maintain their own mental health Family Council 2013 Annual General Meeting

  35. Accountability: A two-way street • MOHLTC: • All mental health and addiction programs and services are based on the best available evidence from lived experience, practice and research (The Minister’s advisory group on the 10-year mental health and addictions strategy, 2010, p. 17) • Ontario will build on effective mental health and addictions programs and services with the best available evidence from lived experience, practice and research. Services must improve quality of life in a sustainable way (Ministry of Health and Long-term Service, 2011. p. 9) Family Council 2013 Annual General Meeting

  36. The vision Family Council 2013 Annual General Meeting

  37. Safeguards to balance the rights of allied caregivers and the person Mandatory interview with Person Mandatory interview with family Explicit and informed consent required Victim of abuse by family Yes No Consent not required Duty to warn/protect Yes No Share health information with family Family as allied caregiver Person provides consent No Yes Yes No Access to health information on a “need to know” basis Mandatory periodic review of Person’s consent Yes Family Council 2013 Annual General Meeting

  38. Establish an OCRA Council to monitor progress Family Council 2013 Annual General Meeting

  39. The next step… • Minister of Health to introduce a Government Bill • Family Council • CAMH • Other Family Councils and mental health organizations within Ontario • OCSWSSW • Contact MPP to introduce a private member’s public bill • Caregivers (Legislative Research Service, 2011) Family Council 2013 Annual General Meeting

  40. Bill ??? Caregiver Recognition Day, Ontario: First (weekday) of (Month), 201? OCRA The Vision Family Council 2013 Annual General Meeting

  41. References • Canadian Mental Health Association (undated). Families of People with Mental Illness: Current Dilemmas and Strategies for Change, as quoted in Family Mental Health Alliance (2006). Caring together: Families as partners in the mental health and addiction system. • Health Canada (2004). Informal/Family Caregivers in Canada Caring for Someone with a Mental Illness: Final report. • Legislative Research Service (2011). How an Ontario Bill Becomes Law: A guide for legislators and the public. Legislative Assembly ofOntario. • Mental Health Commission of Canada. (2012). Changing directions, changing lives: The mental health strategy for Canada. Calgary, AB: Author. • The Minister’s advisory group on the 10-year mental health and addictions strategy (2010). Respect, recovery, resilience: Recommendations for Ontario's mental health and addictions strategy. Family Council 2013 Annual General Meeting

  42. References • Ministry of Health and Long-term Service (2011). Open minds, healthy minds: Ontario's comprehensive mental health and addictions strategy. • Select committee on mental health and addictions (2010). Navigating the journey to wellness: The comprehensive mental health and addictions action plan for Ontarians. Canada: Legislative Assembly of Ontario. • The Standing Senate Committee on Social Affairs, Science and Technology, (2006). Out of the shadows at last: transforming mental health, mental illness and addiction services in Canada. • Szmukler, G. I., & Bloch, S. (1997). Family involvement in the care of people with psychoses. An ethical argument. British Journal of Psychiatry, 17(11), 401-405. Family Council 2013 Annual General Meeting

More Related