Third

Session, 45th General Assembly

Elizabeth II, 2006

BILL 11

AN ACT RESPECTING THE

DELIVERY OF HEALTH AND COMMUNITY SERVICES AND THE ESTABLISHMENT OF

REGIONAL HEALTH AUTHORITIES

Received and Read the First Time ...................................................................................................

Second Reading .................................................................................................................................

Committee ............................................................................................................................................

Third Reading .....................................................................................................................................

Royal Assent ......................................................................................................................................

HONOURABLE

TOM

OSBORNE

Minister

of Health and Community Services

Ordered

to be printed by the Honourable House of Assembly

EXPLANATORY NOTE

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.

A BILL

AN ACT RESPECTING THE DELIVERY OF HEALTH AND COMMUNITY SERVICES AND THE ESTABLISHMENT OF

REGIONAL HEALTH AUTHORITIES

Analysis

Short title

Definitions

Objectives and priorities

Powers of the minister

Ministerial directions

Creation of regions and health

authorities

Regional health authorities are

corporations

Board of directors

Remuneration and expenses of trustees

By-laws

Meetings

Quorum of a board

Committees

CEO of a board

Officers and employees

Responsibility of authority

Authority's powers

Funding for authorities

Withholding of funding

Fiscal year

Budget

Auditor

Review or audit by minister

Request for reports etc.

Protection from liability

Appointment of administrator

Regulations

Authorities continued

Consequential Amdt.

Repeal

Commencement

Be it enacted by the Lieutenant-Governor and

House of Assembly in Legislative Session convened, as follows:

Short title

1. This

Act may be cited as the Regional Health

Authorities Act .

Definitions

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

(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.

Ministerial

directions

(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

(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

(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.

By-laws

(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.

Meetings

(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

(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.

Committees

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

(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

(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.

Authority's

powers

(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 ( Canada );

and

(

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

(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 .

Fiscal year

20. The

fiscal year of a regional health authority is April 1 to the following March

Budget

(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.

Auditor

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

(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

(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.

Regulations

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.

Authorities

continued

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 .

Consequential

Amdt.

(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

(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 ,

Repeal

(1) The Hospitals Act is repealed.

(2) The Regional

Integrated Health Authorities Order , Newfoundland and Labrador Regulation 18/05, is

repealed.

(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 Newfoundland and Labrador Regulation 969/96, are

repealed.

Commencement

31. This Act comes into force on a day to be

proclaimed by the Lieutenant-Governor in Council.

Earl G. Tucker, Queen's Printer