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Regulating, De-Regulating and Changing Scopes of Practice Is it a Question of Why or Why Not ?

Regulating, De-Regulating and Changing Scopes of Practice Is it a Question of Why or Why Not ?. Presentation by: Robert Morton, Vice-Chair, HPRAC Health Professions Regulatory Advisory Council to the 2003 CLEAR Conference in Toronto, ON September 12, 2003. Disclaimer.

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Regulating, De-Regulating and Changing Scopes of Practice Is it a Question of Why or Why Not ?

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  1. Regulating, De-Regulating and Changing Scopes of PracticeIs it a Question of Why or Why Not? Presentation by: Robert Morton, Vice-Chair, HPRAC Health Professions Regulatory Advisory Council to the 2003 CLEAR Conference in Toronto, ON September 12, 2003

  2. Disclaimer • The enclosed material represents the views of HPRAC and is not endorsed by the Ministry of Health and Long-Term Care • The Criteria Review is an internal project developed by HPRAC to update its policy documents • There have been no referrals made to HPRAC on any of these issues

  3. RHPA Organization 21 Regulatory Health Professional Colleges

  4. Ontario’s RHPA System • RHPA - umbrella legislation for all health professions • HPPC - Health Professions Procedural Code - applies equally to all regulated health professions • 21 Profession-specific Acts - describe the scope of practice and any controlled acts authorized to a profession • 23 health professions are regulated by 21 regulatory bodies • 13 hazardous “controlled” acts in the RHPA • Performance of these acts is restricted to members of profession(s) authorized to use these acts

  5. Statutory Functions of HPRAC • Advise the Minister on, • regulation/deregulation of health professions • amendments to the Acts and regulations • any matter referred by the Minister • quality assurance programs • the effectiveness of patient relations programs • effectiveness of complaints/discipline related to sexual misconduct • Review the effectiveness of the RHPA

  6. HPRAC’s Criteria Review • What is it? • Internal HPRAC-driven project to review and potentially update the criteria for regulation, de-regulation and changing scopes of practice in the health professions • What is the purpose? • The review will guide HPRAC’s review of its two key policy documents: • Request for Regulation under the RHPA • Request for Change in Scope of Practice under the RHPA

  7. HPRAC’s Criteria Review • Why now? • 10+ years since the RHPA was proclaimed • 15+ years since the Health Professions Legislative Review (HPLR) • Changes have occurred in the regulatory sphere due to: • technology • demographics • economics • professional education and development • Section 11 of the RHPA: The Advisory Council has the duty to provide advice to the Minister on: “whether regulated professions should no longer be regulated.”

  8. Criteria Review Process • Step 1 - Jurisdictional review • Conducted from Feb - Apr 2003 • Reviewed criteria and process in other Canadian provinces, the U.S. and the UK • Determined that the criteria for regulation and changing scopes of practice used in Ontario are similar to most other jurisdictions (with a few exceptions) • Identified trends and emerging issues

  9. Criteria Review Process • Step 2 - Discussion Paper • Developed by HPRAC in June 2003 • Identifies key issues • Stimulates discussion of key issues with respect to criteria for regulation (sunrise), de-regulation (sunset) and changing scopes of practice • Seeks stakeholder input until Nov 28, 2003 • Paper is available for download from HPRAC’s website (www.hprac.org)

  10. Criteria Review Process • Step 3 - Revised policy documents • HPRAC will review and potentially revise its internal policy documents based on a review and analysis of all relevant information

  11. Trends and Emerging Issues • Based on research conducted during the jurisdictional review: • Emergence of telemedicine and Internet-based medicine • Collaborative scopes of practice • “Sunset” reviews of regulated professions • Economic issues (cost/benefit analysis of regulation - to public, professions and regulators) • Evolutions in education and accreditation standards

  12. Trends and Emerging Issues • Efficacy of a profession’s treatment modalities and its relationship to harm • Least regulation possible • Importance of public interest principles and continuing problems defining the public interest

  13. Panelists • Criteria for Regulation: • Jo-Ann Willson, Registrar, College of Chiropractors • Criteria for De-Regulation: • Rob Alder, Chair, HPRAC • Criteria for Changing a Profession’s Scope of Practice: • Sharon Saberton, Registrar, College of Medical Radiation Technologists

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