Third Session, 45th General Assembly
55 Elizabeth II, 2006
AN ACT RESPECTING THE
DELIVERY OF HEALTH
Received and Read the First Time...................................................................................................
Minister of Health and Community Services
Ordered to be printed by the Honourable House of Assembly
This Bill would provide for the delivery of health and community services in the province through regional health authorities whose powers and duties are set out in the Bill.
AN ACT RESPECTING THE DELIVERY OF HEALTH
1. Short title
3. Objectives and priorities
4. Powers of the minister
5. Ministerial directions
6. Creation of regions and health authorities
7. Regional health authorities are corporations
8. Board of directors
9. Remuneration and expenses of trustees
12. Quorum of a board
14. CEO of a board
15. Officers and employees
16. Responsibility of authority
17. Authority's powers
18. Funding for authorities
19. Withholding of funding
20. Fiscal year
23. Review or audit by minister
24. Request for reports etc.
25. Protection from liability
26. Appointment of administrator
28. Authorities continued
29. Consequential Amdt.
Be it enacted by the Lieutenant-Governor and House of Assembly in Legislative Session convened, as follows:
1. This Act may be cited as the Regional Health Authorities Act.
2. In this Act
(a) "authority" means a regional health authority established under paragraph 6(1)(b);
(b) "board" means the board of trustees of an authority;
(c) "health and community services" means health and community services as defined by the regulations made under section 27; and
(d) "minister" means the minister appointed under the Executive Council Act to administer this Act.
Objectives and priorities
3. The minister may establish objectives and priorities for the provision of health and community services in the province or in areas of the province.
Powers of the minister
4. (1) The minister may determine
(a) health and community services which shall be provided by an authority; and
(b) standards for the provision of health and community services by an authority.
(2) Where the minister determines a health and community service or a standard under subsection (1) the authority to which it is applicable shall comply with the minister's determination.
5. (1) The minister may give directions to an authority including directions for the purpose of
(a) achieving objectives and priorities as established under section 3;
(b) providing guidelines for the authority to follow in carrying out its duties and responsibilities and the exercise of its powers under this Act; and
(c) coordinating the work of the authority with the programs, policies and work of the government of the province, the agencies of the government, other regional health authorities and other persons in the provision of health and community services in the province.
(2) An authority to which the minister gives directions under subsection (1) shall comply with the directions.
Creation of regions and health authorities
6. (1) The Lieutenant-Governor in Council, by regulation,
(a) may establish one or more health regions in the province; and
(b) shall establish a regional health authority for each health region to provide for the delivery and administration of health and community services in the health region.
(2) A regulation made under subsection (1) shall
(a) name the health region and describe its boundaries;
(b) name the authority for the health region; and
(c) specify the organization and composition of the authority, including the composition of the board and the number of trustees on it.
(3) A regulation made under this section may be made with retroactive effect.
(4) An authority is an agent of the Crown.
Regional health authorities are corporations
7. An authority is a corporation without share capital for the purpose of Part XXI of the Corporations Act.
Board of directors
8. (1) The management and affairs of an authority shall be directed by a board of trustees appointed by the minister in accordance with the regulations.
(2) The minister shall appoint a chairperson of the board of trustees of an authority from among the trustees of the authority.
(3) The trustees of the authority may, in accordance with the by-laws of the authority, elect from among their number one or more vice-chairpersons.
(4) The trustees of an authority shall be appointed for a term of 3 years and may be re-appointed to one further term of 3 years.
(5) Where a trustee resigns from a board or becomes unable to carry out his or her duties and responsibilities, the minister may appoint a person to replace him or her and that person shall serve for the remainder of the term of the trustee being replaced.
(6) The board of an authority may act despite a vacancy in its membership.
(7) A trustee whose term of office has expired continues to be a trustee until he or she is reappointed or replaced.
Remuneration and expenses of trustees
9. An authority shall pay its trustees the remuneration and expenses that the Lieutenant-Governor in Council may determine.
10. (1) A board may make by-laws not inconsistent with this Act or the regulations relating to its internal organization and proceedings and for the general conduct and management of its affairs.
(2) A board may make by-laws respecting medical staff of the authority, including by-laws respecting
(a) the granting, variation, suspension and revocation of medical staff privileges;
(b) categories of medical staff privileges;
(c) the membership of a medical advisory committee;
(d) the duties and functions of senior medical officers of the authority; and
(e) rules and regulations governing medical staff.
11. (1) A board shall hold
(a) an annual meeting, which shall be open to the public, at the time and place set out in the by-laws of the board, but the meeting shall be held not later than 6 months after the end of the fiscal year; and
(b) other meetings in accordance with the by-laws of the board.
(2) A trustee may, in accordance with the by-laws of the board, participate in a meeting of the board by means of the telephone or other communication device that permits all persons participating in the meeting to hear one another simultaneously.
Quorum of a board
12. (1) A majority of the trustees constitute a quorum for the transaction of business of the board.
(2) A trustee who participates in a meeting of the board by a means permitted by subsection 11(2) is, for the purpose of establishing a quorum, present at the meeting.
13. A board may establish those committees composed of its members that it considers necessary to assist it in carrying out its duties and responsibilities and exercising its powers under this Act.
CEO of a board
14. (1) Subject to the approval of the minister, a board shall appoint, and determine the terms and conditions of employment of, a chief executive officer for the authority.
(2) The chief executive officer of an authority, under the direction of the board, is responsible for the day to day management and conduct of the affairs of the authority.
Officers and employees
15. An authority may appoint the officers and engage the employees and other persons it considers necessary to carry out the duties and responsibilities and to exercise the powers of the authority.
Responsibility of authority
16. (1) An authority is responsible for the delivery and administration of health and community services in its health region in accordance with this Act and the regulations.
(2) Notwithstanding subsection (1), an authority may provide health and community services designated by the minister on an inter-regional or province-wide basis where authorized to do so by the minister under section 4.
(3) In carrying out its responsibilities, an authority shall
(a) promote and protect the health and well-being of its region and develop and implement measures for the prevention of disease and injury and the advancement of health and well-being;
(b) assess health and community services needs in its region on an ongoing basis;
(c) develop objectives and priorities for the provision of health and community services which meet the needs of its region and which are consistent with provincial objectives and priorities;
(d) manage and allocate resources, including funds provided by the government for health and community services, in accordance with this Act;
(e) ensure that services are provided in a manner that coordinates and integrates health and community services;
(f) collaborate with other persons and organizations, including federal, provincial and municipal governments and agencies and other regional health authorities, to coordinate health and community services in the province and to achieve provincial objectives and priorities;
(g) collect and analyze health and community services information for use in the development and implementation of health and community services policies and programs for its region;
(h) provide information to the residents of the region respecting
(i) the services provided by the authority,
(ii) how they may gain access to those services, and
(iii) how they may communicate with the authority respecting the provision of those services by the authority;
(i) monitor and evaluate the delivery of health and community services and compliance with prescribed standards and provincial objectives and in accordance with guidelines that the minister may establish for the authority under paragraph 5(1)(b); and
(j) comply with directions the minister may give.
17. (1) An authority may
(a) purchase, lease or otherwise acquire personal property;
(b) sell, lease or otherwise dispose of personal property;
(c) accept grants, gifts, bequests and donations of real and personal property and, where the grant, gift, bequest or donation is made subject to directions or conditions, the authority shall, unless the person from whom it is received consents otherwise, comply with and give effect to the directions or conditions;
(d) unless prohibited by the regulations, charge fees for health and community services directly to the person who received the services;
(e) conduct research, provide education and training, and engage or collaborate with persons or other organizations in the conduct of research or the provision of education and training, in the field of health and community services;
(f) establish, and apply
to register, charitable foundations, as that term is defined in the Income Tax Act (
(g) exercise the other powers that are necessary to carry out its duties and responsibilities and exercise its powers under this Act.
(2) Subject to the approval of the minister, an authority may
(a) purchase, lease or otherwise acquire real property, or an interest in real property, that it considers necessary for its purposes;
(b) construct, renovate, expand, convert or relocate buildings or structures; and
(c) sell, lease or otherwise dispose of real property or an interest in real property where the real property is no longer required for its purposes.
(3) An authority may borrow money
(a) for the purpose of carrying out its day to day operations; and
(b) for the purpose of acquiring real property for the use of the authority, or for the purpose of erecting, repairing, adding to, furnishing or equipping a building for the use of the authority.
(4) An authority may enter into agreements with other organizations respecting the provision of health and community services by or through or in cooperation with those organizations.
Funding for authorities
18. (1) The minister may provide funding to an authority for the purpose of this Act out of money appropriated by the legislature for that purpose.
(2) Money provided to an authority for a particular purpose shall not be expended by the authority for another purpose without the prior approval of the minister.
Withholding of funding
19. The minister may withhold a payment, or part of a payment, to an authority until the authority has complied with this Act or a direction of the minister given under section 5.
20. The fiscal year of a regional health authority is April 1 to the following March 31.
21. (1) An authority shall, annually, prepare and submit to the minister, at the time and in the manner required by the minister, a budget containing estimates of amounts necessary to enable the authority to carry out its duties and responsibilities and exercise its powers in the coming financial year.
(2) The minister may approve or disapprove a budget submitted under subsection (1) or may approve a budget subject to the changes to it required by the minister.
(3) Except with the prior approval of the minister, an authority shall not make, or contract to become liable for, an expenditure or indebtedness beyond or in excess of the estimated amount of expenditure set out in its budget and approved by the minister under this section.
(4) Where an authority becomes liable for an indebtedness contrary to subsection (3), the minister may dismiss some or all of the members of the board of the authority.
(5) Where the minister dismisses a member of a board under subsection (4), the member does not have a cause of action against the Crown nor a right to compensation as a result of the dismissal.
22. An authority shall appoint an independent auditor who shall, annually, audit the records, accounts and financial transactions of the authority.
Review or audit by minister
23. (1) An authority shall keep accounts, and other financial records and information as required by the regulations.
(2) An authority shall provide information to the minister respecting its accounts and other financial records in the manner and at the time required by the minister.
(3) An authority shall permit the minister to review the books of account and other financial records of the authority.
(4) The minister may audit the accounts of an authority either generally or with respect to a specific transaction or expenditure and, where the minister decides to conduct the audit, the authority shall provide the minister with the information and other assistance required by the minister within the time required by the minister.
Request for reports etc.
24. Where requested to do so by the minister, an authority shall provide the minister with the records, reports and other documents he or she specifies in the request.
Protection from liability
25. An action for damages does not lie against a trustee, an officer or an employee of an authority personally for anything done or omitted in good faith in the performance or intended performance of a duty or the exercise or intended exercise of a power under this Act, or for a neglect or default in the performance, or intended performance, of a duty, or the exercise or intended exercise, of a power, in good faith, under this Act.
Appointment of administrator
26. (1) Where an authority is, in the opinion of the minister, in serious financial difficulty, the minister, subject to the approval of the Lieutenant-Governor in Council, may appoint an administrator who shall have the power to carry out the duties and exercise the responsibilities of the authority.
(2) Upon the appointment of an administrator, the board of the authority for which the administrator was appointed shall cease to hold office and may no longer direct the affairs of the authority or exercise the functions, powers or carry out the duties conferred on the board by this Act.
27. The Lieutenant-Governor in Council may make regulations
(a) prescribing what constitutes "health and community services" for the purpose of this Act;
(b) conferring on an authority the authority to provide specified health and community services;
(c) respecting the manner in which health and community services are provided by an authority and different provisions may be made applicable to all authorities or to some authorities only;
(d) delegating to an authority a duty or power conferred on a minister by an Act necessary or incidental to the provision by the authority of a health or community service;
(e) respecting the appointment of trustees to the board of an authority;
(f) prohibiting or authorizing the charging of fees for health and community services, or categories of services, by an authority directly to the persons who received those services;
(g) respecting the keeping, preparing and reporting of financial, administrative, statistical and clinical information, including the keeping confidential of that information;
(h) respecting the provision of information by an authority to the minister including the content, form and timing of the information;
(i) respecting accounting categories an authority may establish and the form and content of those categories;
(j) respecting client records including
(i) ownership of those records,
(ii) access to those records,
(iii) use of those records, and
(iv) disposal of those records;
(k) respecting the establishment of charitable foundations by authorities;
(l) respecting the funding of authorities including
(i) the manner of determining funding to authorities,
(ii) the allocation of funds,
(iii) the expenditure of funds, and
(iv) advances and the recovery of overpayments;
(m) respecting the borrowing and investment powers of authorities;
(n) respecting transitional matters resulting from
(i) the establishment, continuation or variation of a health region or an authority under this Act,
(ii) the amalgamation of authorities, and
(iii) the winding up of the affairs of a regional health authority;
(o) respecting the appointment of an administrator under section 26 and the powers and duties of an administrator; and
(p) generally, to give effect to the purpose of this Act.
28. The authorities created by the Regional Integrated Health Authorities Order, Newfoundland and Labrador Regulation 18/05, are continued and this Act applies to them for all purposes as if they had been created by regulations made under section 6.
29. (1) Section 2 of the Adoption Act is amended by adding immediately after paragraph (d) the following:
(d.1) "authority" means a regional health authority established under the Regional Health Authorities Act;
(2) Paragraph 2(h) of the Adoption Act is repealed.
(3) Section 55 of the Adoption Act is repealed and the following substituted:
Provincial director's right to information
55. (1) The provincial director has the right to information that is in the custody or control of
(a) a department of the government of the province;
(b) a board, commission or other body listed in the Schedule to the Access to Information and Protection of Privacy Act; or
(c) a regional health authority established under the Regional Health Authorities Act,
that is necessary to enable him or her to locate a person for the purpose of this Act or is necessary for the health or safety of an adopted person.
(2) A department, authority, board, commission or other body referred to in subsection (1) that has custody or control of information to which the provincial director is entitled under subsection (1) shall, upon request, disclose that information to the provincial director.
(3) This section applies notwithstanding another Act of the province.
(4) A director under the Child, Youth and Family Services Act shall, upon request, disclose to the provincial director information obtained under the Child, Youth and Family Services Act that is necessary to enable the provincial director to exercise the powers or perform the duties or functions given to him or her under this Act.
(4) The Adoption Act is amended generally by striking out the word "board" wherever it occurs and substituting the word "authority".
(5) Section 2 of the Child Care Services Act is amended by adding immediately after paragraph (a) the following:
(a.1) "authority" means a regional health authority established under the Regional Health Authorities Act;
(6) Paragraph 2(b) of the Child Care Services Act is repealed.
(7) The Child Care Services Act is amended generally by striking out the word "board" wherever it occurs and substituting the word "authority".
(8) Paragraph 2(1)(a) of the Child Youth and Family Services Act is repealed and the following substituted:
(a) "authority" means a regional health authority established under the Regional Health Authorities Act;
(9) The Child, Youth and Family Services Act is amended generally, except subsections 23(2) and (3), by striking out the word "board" wherever it occurs and substituting the word "authority".
(10) Section 4 of the Health and Community Services Act is repealed.
(11) Paragraph 11(1)(c) of the Health and Community Services Act is amended by striking out the words and comma "regional health and community service boards,".
(12) Subparagraph 2(1)(i)(vii) of the Public Service Collective Bargaining Act is repealed and the following substituted:
(vii) a regional health authority established under the Regional Health Authorities Act,
30. (1) The Hospitals Act is repealed.
(2) The Regional
Integrated Health Authorities Order,
(3) The Cancer Treatment and Research Foundation Act is repealed.
(4) The assets and liability of the Cancer Treatment Research Foundation are vested in the Eastern Regional Health Authority continued under this Act.
(5) Sections 3.2 and 5 of the Consolidated Orders under the Public
Service Collective Bargaining Act, Consolidated
31. This Act comes into force on a day to be proclaimed by the Lieutenant-Governor in Council.
ŠEarl G. Tucker, Queen's Printer