In November 2018, the Alberta government passed Bill 21: An Act to Protect Patients which amends the Health Professions Act (HPA) and introduced a number of new requirements that apply to all regulated health professionals in Alberta.
Concerning sexual misconduct
The purpose of Bill 21 is to better protect patients from sexual abuse and sexual misconduct by regulated health professionals. Each regulatory college, including the College of Licensed Practical Nurses of Alberta (CLPNA), will define who constitutes a ‘patient’ in their Standards of Practice, but generally speaking, a patient can be anyone being provided professional services.
The amendments to the HPA define ‘sexual abuse’ and ‘sexual misconduct’ and establish obligations on health professionals and regulatory colleges. The new rules aim to ensure consistent penalties are applied to all regulated health professionals for findings of sexual abuse or sexual misconduct. If complaints involve conduct that falls under these definitions, then specific obligations are triggered, including:
- restrictions on the use of informal resolution procedures,
- requirements for the composition of Hearing Tribunals and training, and
- mandatory sanctions.
Legislation in effect
Although most changes go into effect on April 1, 2019, some of the changes are already in effect, such as the additional information required from applicants at registration and the ability of the Complaints Director to appeal a Council decision to the Court of Appeal.
The amendments also give regulatory colleges new tools to increase public access to members’ disciplinary history and help maintain public confidence in the profession. Information available on the CLPNA’s website will be changing to provide more transparency around disciplinary decisions.
There are mandatory sanctions for health professionals found to have committed sexual abuse or sexual misconduct towards a patient that go into effect on April 1:
- upon a finding of sexual abuse, the health professional’s practice permit must be permanently cancelled;
- upon a finding of sexual misconduct, the health professional’s practice permit must be suspended, although the length of the suspension or the imposition of more severe sanctions (including cancellation) are within the discretion of the hearing tribunal; and
- any health professional whose practice permit is cancelled for sexual misconduct towards a patient has a five-year prohibition on applying for reinstatement.
Due to the position of power and trust that health providers have over their patients, a consensual sexual relationship with a patient is not possible. The Standards of Practice specific to Boundary Violations (coming into effect on April 1) define when someone is considered a patient for the purposes of these sanctions.
Patient Relations Program
Under the new amendments, each regulatory college is required to establish a patient relations program. This program will include measures for preventing and addressing sexual abuse and sexual misconduct towards patients by regulated members. Although the Alberta government has not yet released the final details about the Patient Relations Program, we know that it must:
- establish educational requirements for regulated members,
- establish educational guidelines for the conduct of health professionals towards patients,
- provide training for the CLPNA’s staff, Council and Hearing Tribunals on trauma-informed practices, and
- provide information to assist the public in understanding the CLPNA’s complaints process.
At the CLPNA, we know that the vast majority of LPNs maintain professional boundaries and treat their patients with respect and professionalism. These new amendments to the Health Professions Act serve as an important reminder for all LPNs to have a heightened awareness and professional respect for the power imbalance between health professionals and patients.