New Regulations amend Regulated Health Professions Act, 1991 and Impact Regulation of Occupational Therapists

When Ontario’s Protecting Patients Act, 2017 was passed into law on May 30, 2017, it made amendments to the Regulated Health Professions Act, 1991 (RHPA). Several other amendments, however, were yet to be proclaimed and further changes were likely to come given the Minister’s new regulation-making authority. On May 1, 2018, certain amendments came into force and the Minister introduced new regulations that were added to the RHPA.

What do the new changes mean for occupational therapists?

Definition of Patient for Sexual Abuse Provisions

The word “patient,” as it relates to the Health Professions Procedural Code’s sexual abuse provisions, has been expanded.  Now a former patient will remain a “patient” for one year from when the person would otherwise cease to be considered a patient (i.e., when an OT last provided care to the patient). The Minister of Health and Long-Term Care has also established other criteria for defining a patient for such purposes. Without restricting the ordinary meaning of the word “patient,” an individual is a patient if there is a direct relationship/interaction between the individual and the occupational therapist and the occupational therapist has;

  • issued billings or received health payments for a health care service, or
  • contributed to a patient record/file for that individual, or
  • received consent from the individual for health care services recommended by the OT, or
  • prescribed a drug for which a prescription is needed, to that individual (not applicable to OTs)

If any of the above interactions occur between an individual and an occupational therapist, then that individual is considered the OT's patient, for the purposes of the sexual abuse provisions. That individual will also continue to be considered a patient for one year after the termination of the OT–patient relationship. Any sexual act that occurs during that time between the OT and the individual would result in the OT being subject to mandatory revocation.

It should be noted that these provisions do not apply when;

  • emergency care is provided to a pre-existing sexual partner, and
  • there is no reasonable opportunity to transfer care to another health care professional and it is clear that effort has been made.
Patient Funding for Therapy and Counselling

All colleges are required to have a patient relations program that provides funding for therapy for patients who are victims of sexual abuse by a regulated health care professional.  A patient is now eligible for funding from the time a complaint/report of allegations of sexual abuse by a health professional is filed with the College. At this time, funding is limited to cover the costs of therapy and counselling. However, the Minister does have the power to make regulations that would include other types of expenses that could qualify for funding.  Occupational therapists should ensure that their professional liability insurance policies provide for this coverage of sexual abuse therapy and counselling as per the College of Occupational Therapists of Ontario's requirements.  OSOT's professional liability insurance policy meets these requirements.

Mandatory Revocation Expanded

The Minister has set out a list of criminal offences that would result in mandatory revocation of an occupational therapist's certificate of registration by the College of Occupational Therapists of Ontario.  

Expanded Duty to Report

Colleges are now required to report certain information about a regulated health professional on the public register, including: 

  • If there has been a finding of guilt against a professional under the Criminal Code or the Controlled Drugs and Substances Act and certain information related to it
  • Any currently existing conditions of release following a charge for an offence under the Criminal Code or Controlled Drugs and Substances Act
  • If a professional has been charged with an offence under the Criminal Code or the Controlled Drugs and Substances Act and the charge is outstanding
  • If a member has been the subject of a disciplinary finding by another regulatory or licensing authority in any jurisdiction
  • If a member is currently licensed or registered to practice another profession in Ontario or a profession in another jurisdiction.

Occupational therapists will recognize that the College of Occupational Therapists of Ontario is already compliant with these requirements further to by-law amendments approved in the past year.​

Implications for Occupational Therapists

These new regulations apply to the regulation of occupational therapists in the province and will direct practices and policies of the College of Occupational Therapists of Ontario.  Registered occupational therapists should be familiar with the regulatory framework and regulations, standards and guidelines that impact their practice at all times.  Members are encouraged to be diligent in their review of communications from the College of Occupational Therapists of Ontario (COTO) to be currently apprised of expectations and requirements of regulated occupational therapists and the processes required to ensure OTs meet their accountability obligations to public protection.  OSOT continues to monitor and respond to member input regarding Ontario's regulatory requirements for occupational therapists in the spirit of assuring an appropriate balance of public protection, regulatory rigour and impact on the professional.