1974 Bill 202 I , ' .' at Third Session, 17th Legislature, 23 Elizabeth II THE LEGISLATIVE ASSEMBLY OF ALBERTA BILL 202 The Community Health and Social Services Centres Act DR. PAPROSKI First Rea,ding .............................. . Second Re,ading ..................... , ....... . Third Reading ............. ,." .... , ....... . Printed by L. S. WALL, Queen's Printer for the Province of Alberta, EDMONTON

Bill 202 Dr. Paproski BILL 202 1974 THE COMMUNITY HEALTH AND SOCIAL SERVICES CENTRES ACT (Assented to , 1974) HER MAJESTY, by and with theadvke and consent of the Legislative Assembly of Alberta, ena'cts as foHows: 1.

(1) In this Act (a) "authorizing Act" means an .Act under or pursuant to which a local authority is authorized to provide any s'ervices, money, supplies or things in the fields of health and social development and, without lim­ itation, includes the following enactments, namely: (

i) The Health Unit Act~· (ii) The. Homes for the Aged Act; (iii) The A~berta Hospitals Act; (iv)

section 20 of The Improvement Districts Act; (

v) sections 199 to 206 of The. Municipal Govern­ ment Act; (vi) The Nursing Homes Act; (vii) The Preventive Social Services Act; (viii) The Public Health Act; (ix)

section 147 of The School Act; (

x) The Social De.velopment Act; (xi)

section 8, clause 14 of The Special Areas Act; (xii) The Treatment Services Act; (xiii) The Venereal Dise,ases Prevention Act; (xiv)

section 12 of The Welfare Homes Act; (xv) The Nursing Services Act; (xvi) The Tuberculosis Act; (b) "Community Health and Social 8ervices Centre Area" or "Area" means the Community Health and Social Services Centre Area established by a Plan; (c) "Community Health and Social Services Centre Board" or "Community Board" means a Community Health and Social Services Centre Board incorpor­ ated by a Plan;

Explanatory Notes Genera1. This Bill is part of a broad legislative plan to bring about co­ ordinated community health and social services. It will define broadly Community Health and Social Services Centres with regard to administrative structure, health and social facilities and services, and areas to be served by such centres. This Bill will make provision for the administrative structure, type of facility and health and social services that may be provided and will authorize the implementation of plans that may be used by the communities to co-ordinate public health and social services.

The purpose and objectives of this Bill are: 1. To elevate total health of individuals and families to optimal level in Alberta. 2. To provide an alternative to institutional care in communities with local autonomy with emphasis on outpatient care or non­ institutional care. 3. To promote health rather than sickness by emphasizing total health with special reference to preventive and rehabilitativ,e health and social service in addition to diagnosis, treatment, and teaching of health. 4. To provide through community health and social services pro­ grams emphasis on quality of life which is a community concern. 5.

To allow the community (consumers) of health and social services to express their needs and set their priorities with guidelines set down by communities and the Department of Health and Social Development. 6. To furnish a key-link mechanism via such centres to provide total health delivery systems. 7. To provide ongoing evaluation of needs (health and social accounting) in order that response can be quicker (with less lag time between need and service). 8. To minimize bureaucracy with regards to health and social services. 9. To help avoid fragmentation and overlapping of health and social services.

(d) "Community Health and Social S'ervices Centre Plan" or "Plan" means an order of the Lieutenant Governor in Council under

section 2, subse'cNon (5) ; (e) "Department" means the Department of Health and Social Development; (f) "health and social services" means services, money, supplies or things provided pursuant to an author­ izing Act; (g) "hospital district" means a general hospital dis­ trict, an auxiliary hospital district, a general and auxiliary hoslpital district, a general hosp'ital and nursing home district or a general and auxiliary hospital and nursing home district under The Al­ berta Hospitals Act; (h) "local health and social services authority" or "local authorityH means (

i) the Minister, with reference to health and social services provided under programs administer­ ed by the Department, or Oi) a health unit incorporated under The Health Unit Act, or (iii) a foundation under The Homes for the Aged Act, or (iv) a hospital d.istrict, or (

v) the owner of a non-district hospital, or (vi) a nursing home district or an auxiliary hospi­ tal and nursing home distri'ct under The Nursing Homes Act, or (vii) a city, town, new town, village, municipal dis­ trict or county, or (viii) the Minister of Municipal Affa-irs, in the case of an improvement distri'ct or special area, or Ox) a local board of health under The Public H e.alth Act, or (

x) the board of trustees of a school district or school division; (i) "Minister" means the Minister of Health and Social Development; (j) "non-district hospital" means a hospital owned by a person other than a hospital district; (k) "participating local authority" means a local health and soc-ial services authority that is specified in a Plan as a partidpating local authority.

(2) Where a local health and social services authority is empowered under this Act or a Plan to approve any d?cu­ ment, action or proposed action, the approval shall be gIven by way of 2

10. To provide optimal health and social services per dollar cost. 11. To encourage a team approach for community health and social services, recognizing voluntary aid and professionals as both important in provision of health and social services. 12. To provide a point of entry and referral for community health and social services. This Bill will repeal and replace the provisions of The Depart­ ment of Health and Social Development Act dealing with "com­ posite health and social services plans." The Bill is a substantially different approach from that Act, however, on these counts.

Firstly, a community Plan under this Bill must include at least com­ munity health services provided by health units and municipally­ administered social services, although the Plan may include other services in addition. Secondly, an active or auxiliary hospital or a nursing home cannot be initially included in an initial Com­ munty Plan although it may at a later stage be included if the Community Health and Social Services Centre Board consents to its inclusion into the Plan.

Thirdly, a privately owned or "non­ district" hospital may be included in a Plan where The Department of Health and Social Development Act contemplates only the in­ clusion of district hospitals. I.

Definitions and manner of giving approvals. 2

(

a) an order, in the caS'e 'Of the Minister 'Of Health and SDcial DevelDpment Dr the Minister 'Of Muni­ cipal Affairs, 'Or (

b) a by-law 'Of its cDuncil, in the case of a city, tDwn, village, municipal district or county, or (

c) a resDlution, in any other case, and any apprDval, 'Once given, may nDt be revDked. 2.

(1) Subject tD subsectiDns (2) tD (4), the Minister and 'Other local health and sDcial serviees authDrities may prepare a ,propDsal for a CDmmunity HeaUh and Social Services Centre Plan under this section.

(2) A prDpDsal for a Plan under this sectiDn may not be prepared unless at least the follDwing are parties to its preparation, namely, (

a) the Minister, (

b) any city, town, new town, village, municipal distriot or county that is wholly or partly included in the proposed Community Health and Social Services Centre Area, (

c) the Minister 'Of IV[unicipal Affairs, if any improve­ ment district Dr special area is WhDlly Dr partly included in the prDposed Area, and (

d) any health unit that is whDlly Dr partly included in the prDposed Area.

(3) Where any IDcal authDrity, other than one referred tD in subsectiDn (2) or (4), is intended tD be included as a participating local authority in a prDpDsal for a Plan, (

a) the Minister shall affDrd that IDcal authDrity the 'Opportunity 'Of participating in a preparatiDn of the proposal, and (

b) that IDcal authDrity may apprDve the propDsal for the Plan, nDtwithstanding that its approval is not necessary for the purpDse 'Of making an 'Order under subsection (5).

(4) The following kinds of IDcal authorities, nam'ely, (

a) a hDspital district, Dr (

b) the 'Owner 'Of a nDn-district hDspital, Dr (

c) a nursing home district Dr an auxiliary hospi.tal and nursing home district under The Nurs~ng Homes Act, shall not participate in the preparation 'Of a propD~a~ un~'er this sectiDn and shall nDt be included as a partlclpatmg local authDrity under the prDpDsal fDr the Plan but may be 3

2. Preparation of proposal and establishment of a Community Health and Social Services Plan. 3

included as participating local authorities under the Plan subs'equent to its effective date in accordance with

section 7, subsection (5).

(5) Subject to subsection (6), the Lieutenant Governor in Council may make an order for the establishment of a Community Health and Social Services Oentre Plan in accordance with the proposal prepared under subsection (1) and providing for the matters referred to in

section 3.

(6) The Lieutenant Governor in Council shall not make an order under subsection (5) unless the participating local authorities referred to in subs'ection (2) have approved the proposal prepared pursuant to subsection (1). 3.

(1) A Community Health and Social Services Centre Plan shall (

a) specify the name of the Plan, (

b) establish a part of Alberta as a Community Health and Social Services Centre Area and specify the name of the Area, (

c) subject to subsection (2), incorporate as a body corpo~ate a Community Health and Social Services Centre Board for the Area and ,specify the name of the Community Board, (d) (e) (f) (g) (

h) provide for the composition of the Community Board, the manner of electing or appointing its members and its chairman and the terms of office of its members, prescribe the rates of the remuneration payable to members of the Community Board and by whom it is payable, specify the participating local authorities which shall include those local authorities referred to in

section 2, subsection (2), specify the effective date of the Plan, specify a period of not less than four years, com­ mencing on the effective date of the Plan, as the initial term of the Plan, (

i) specify the health and social services that are to be provided by the Corom unity Board which shall include at least the following, namely, (

i) public health serv'iees normally provided by a health unit, and (ii) social services required to be provided by mu­ nicipalities, 4

3. Mandatory provisions to be contained in a Plan. 4

(

j) provide for the designation of, or manner ot the appointm'ent of the Communi,ty Board's auditor, and (

k) prescribe the Community Board's fiscal year.

(2) Where the Area is wholly within one municipality, the Plan may provide that the municipal corporation con­ cerned shall be the Community Board under the Plan and in that case a reference to the Community Board in this Act or the Plan shall be deemed to be a reference to the municipal corporation with respect to that Plan.

(3) Where the Plan provides f.or the election of som'e or all of the members of the Community Board, the Plan may make any of the provisions 'Of The Municipal ElectiOi1L Act apply f.or that purpose or may vary any of the provisions of that Act for the purposes of the election. 4.

(1) A Community Health and Social Services Centre Plan may (

a) provide for the circumstances under which the Plan may be amended by the Lieutenant Governor in Council only with the prior a-pproval of (

i) the Community Health and Social Services Centre Board, or (ii) all or any specifi'ed number or percentage of the participating local authorities, or (iii) the Community Board and all or any specified number or percentage of the participating local authorities; (

b) specify the powers and duties of the participating local health unit and social services authority 'Or local authorities that are to be exercised and per­ formed by the COlnmunity Board in the Area; (

c) specify any provisions of the authorizing Acts that apply to the Community Health and Social Servic'es Centre Area or to the Community Board, or both; (

d) specify any provisions of an authorizing Act that do not apply to the Area or the Community Board, or both; (

e) restrict or qualify the application 'Of any provisions of an authorizing Act to the Area or to the Com­ muni,ty Board or both; (

f) specify the health and social services, in addition to those referred to in secti'On 3, subsection (1) ,clause (i), that are to be provided by the Community Board, which, without limitation, may include (

i) child abus'e action programs, (ii) community mental health programs, 5

4. Additional matters that may be included in a Plan. 5

(iii) progran1s for handicapped persons, (iv) senior citizen programs, and (

v) voluntary help programs to provide any health and social services; (

g) provide for the manner of financing the Plan from sources other than funds appropriated by the Legis­ lature; (

h) confer any powers on the Provincial Auditor in relation to the inspection or audit of the books, records and accounts of the Community Board; (

i) transfer to the Community Board the property in all or any specified assets of a participating local authority; (

j) authorize the transfer, sale, or lease to the Com­ munity Board of any land or any equipment, supplies or other personal property owned by a participating local authority; (

k) provide for the assumption by the Community Board of all or any specified liabilities, obligations or responsibilities of a participating local authority; (1) provide for the transfer of all or any of the em­ ployees of a participating local authority to the employment of the Community Board and any other matters related to the salary rates, conditions of employment and pension plans or arrangements applicable to those employees upon their transfer; (

m) prescribe any conditions with respect to any mat­ ters enumerated in

section 3 or this section; (

n) adjust or authorize the adjustment of any grants or other payments by the Government to partici­ pating local authorities in respect of health and social services; (0) restrict, qualify or prescribe exceptions to the ap­ plication of any of the provisions of

section 5; (

p) confer or impose on the Community Board any powers or duties in relation to the provision of health and social services by it in the Area or any other powers or duties in connection with or in­ cidental to the carrying out of the Plan; (

q) confer or impose on a participating local authority any rights or duties in connection with or incidental to the carrying out of the Plan; (

r) provide for any other matter necessary for or in connection with or incidental to the Plan.

(2) Except as otherwise provided in the Plan, the ex­ penses incurred by a Community H'ealth and Social Services Centre Board in the operation of a Plan shall be provided 6

from funds appr'Opriated by the Legislature for the pur­ poses of this Act and for that purpose, the Provincial Treasurer shall, in consultation with the Minister, pay any moneys S'O appropr:iated to ,the Community Board in instal­ ments or otherwise as he may direct. 5.

(1) Subject to the Community H'ealth and Social Services Centre Plan and except as otherwise provided in the Plan, upon the effective date of the Plan (

a) the C'Ommunity Health and Social Services Centre Board has with respect to the Area the powers, duties, responsibilities, liabilities and obligations of each of the local authorities under their respective authorizing Acts, (

b) the participating local authorities 'cease to have, with respect to the Area, the powers, duties, respon­ s:ibilities, liabilities and oibligations of the Commun­ ity Board referred to in clause (a), (

c) a reference in a provision of any authorizing Act to a participating local authority shall, with respect to the Area, be read as a reference to the Commun­ ity Board, (

d) a reference in an authorizing Act to the territorial limits or corporate area 'Of a participating local authority shall be deemed ,to be, with respect to the Community Board, a reference to the Com­ munity Health and Social Services Oentre Area, and (

e) a reference in any enactment, other than an author­ izing Act, to a participating local authority or its territory 'Or corporate area shall, to the 'extent that it avplies to a Community Health and Social Ser­ vices Centre Area and relates to the provision of health and social services, be deemd to be a reference to the Community Board and the area respectively.

(2) The Plan operates according to its provisi'Ons and this Act, notwithstanding the authorizing Acts or any other Acts. o.

(1) In addition to the powers conferred on it by

section 14 of The

Interpretation Act and by the Plan, the Community Health and Social Services Centre Board may, subj ect to the Plan and except as otherwise provided :in the Plan, (

a) make rules respecting the calling of its meetings and the conduct of business thereat, and generally as to the conduct of its business and affairs; 7

5. Effect of a Plan. 6. Powers of a Community Health and Social Services Centre Board. 7

(

b) appoint such employees as it considers necessary and prescribe their duties and their salaries or remuneration and conditions of 'employment; (

c) obtain the services of any agents or of any advisers or persons providing technical or professional services of a kind required by the Community Board in connection with its business and affairs ; (

d) purchaS'e, h'Old, sell or otherwise dispose of any estate or interest in land; (

e) a'cquire by gift or devise any estate or interest in land and hold and alienate it, subject to the terms of any trust upon which it may be held; (

f) make such banking arrangements as are necessary for the carrying out of its duties and functions; (

g) draw, make, accept, endorse, execute and issue promissory notes, bills of 'exchange and 'Other nego­ tiable or transferable instruments; (

h) subject to the terms of any trust upon which it may be held, invest in such manner as the C'Ommunity Board considers proper, all moneys that come into the hands of the C'Ommunity Board and that are not then required to be expended; (

i) act as trustee 'Of any moneys or property given or bequeathed to the Community Board 'Or a partici­ pating local authority for or in connecti'On with the provision of health and social services; (

j) may fr'Om time to time borr'Ow money from any pers'On 'Or enter into overdraft arrangements with a chartered bank or treasury branch for the purpos'e of meeting its obligations as they become due, and may give security for the repayment of such moneys; (

k) enter into any agreement with any other local authority necessary or incidental to the 'Operation of the Plan; (1) exercise or perform any power or duty conferred or imposed 'On it by the Plan.

(2) A Community Board may ex'ercise and perform the powers and duties 'Of a participating I'Ocal authority in ac­ cordance with a Plan notwithstanding that the participa­ ting local authority ceases to exist on or after the effective date of the Plan 'Or of an amendment to the Plan pursuant to

section 7, as the case may be. 7.

(1) Subject to subsectiDns (2) and (3), the Lieu­ tenant Governor in Council may from time to time by order amend a Community H'ealth and Social Services Centre Plan. a

7. Amendments to Plans. 8

(2) An order shall not be made under subsectiiQn (1) to amend a Plan unless any prior approvals required under the Plan for that amendment and referred to in

section 4, subs'ection (1), clause (

a) have been obtained.

(3) A Plan shall not be amended during the initial term of the Plan where the effect of the amendment would be to remove a then existing participating local authority from the operation of the Plan, (

a) unless a vote 'Of the electors in the Community H'ealth and Social Services Centre Area is conducted by the Community Board on the question of whether the amendment should be made or not and the 'eleetiQrs vote in favor of the amendment, or (

b) unless an amendment is appriQved by an unanimous vote of the CiQmmunity Board.

(4) The Municipal ElectioYn Act applies with the neces­ sary modifications to a vote conducted by a Community HeaLth and Social Services Centre Board under subsection (3).

(5) The Lieutenant Governor in CiQuncil may not amend a Plan to include as a participating local authority (

a) a hospital district, 'Or (

b) the owner of a non-district hospital, or (

c) a nurs.ing home district Dr an auxiliary hospital and nursing home district under The Nursing Homes Act, unless the amendment is approved by the ]V[inister and the Community Board in addition tiQ any other approvals that may be required pursuant to the Plan. ( 6 ) Nothing in this

section shall be construed as pre­ cluding the amendment of a Plan during or after its initial term in order to include additional participating local authorities other than those mentioned in subsection (5).

(7) Notwithstanding subsections (1) to (4), the Lieu­ tenant Governor in Council may make an order (

a) estabHshing a new Community Health and Social Services Centre Plan for the purpose of consoli­ dating an existing Plan and subs'equent amend~ ments to it, or (

b) amending a Plan to correct a typographical errQr or drafting error. 8.

(1) Subject to subs8'ctions (2) and (3), the Li~u­ tenant Governor in CiQuncil may terminate a CommunIty Health and Social Services Oentre Plan.

(2) An order shall not be made under this

section for the termination of a Plan as of a date during the initial 9

8. Termination of a Plan. 9

term of the Plan unless the then existing participating local authorities unanimously approve of the termination.

(3) An order shall not be made under this

section for the termination of a Plan as of a date subsequent to the initial term 'Of the Plan unless the Community Board conducts a v'Ote of the electors in the Community Health and Social Services Centre Area on the question of whether the Plan should be terminated or not, and the electors vote in favour of terminating the Plan.

(4) The Municipal Election Act applies with the neces­ sary modifications to a vote conducted by a Community Board under subsection (3).

(5) Where the Lieutenant Governor in Council makes an order tern1inating a Plan, the order may provide for (

a) any matter in connection with the dissolution of the Community Board and the winding up of its affairs, (

b) the transfer, sale or other disposition of the assets of the Community Board and the assumption of its liabilities and responsibili.ties, (

c) the transfer 'Of all or any of the Community Board's employees to any of the participating local author­ ities, (

d) any matter pertaining to the pension plan or ar­ rangements for the Community Board's employees, and (

e) any other matter in connection with or incidental to the terminati'On of the Plan. 9. The Lieutenant Governor in Council may make r'eg­ ulations (

a) prescribing limits, on the basis of population or size, or any comhination thereof, of a Community Health and S'Ocial Services Centre Area; (

b) pres'cribing terms and conditions that shall be contained in any Plan established under this Act; (

c) respecting any other matter necessary to carry out this Act in accordance with its intent. 10. The Department of Health and Social De.velopment Act is amended by striking out sections 12 to 17 and the heading preceding them. 11. This Act comes into force on the day upon which it is assented to. 10

9. Regulations. 10. This will amend

chapter 25 of the Statutes of Alberta, 1971 to remove the provisions under the heading "Composite Health and Social Services Plans". 10 Title: 1974 (17th, 3rd) Bill 202, The Community Health and Social Services Centres Act