Bill 40 - Health Facilities Act

BILL 40

Health Facilities Act

His Majesty, by and with the advice and consent of the Legislative Assembly of New Brunswick, enacts as follows:

DEFINITIONS AND INTERPRETATION

Definitions

1 The following definitions apply in this Act.

“additional medical goods or services” means medical goods or services that (biens ou services médicaux additionnels)

(a) are prescribed by a medical practitioner or an oral and maxillofacial surgeon,

(b) may be provided in addition to funded surgical services, and

“facility services” means services related to the provision of a funded surgical service that are provided in a funded surgical facility and set out in an agreement approved by the Minister under section 3. (services de l’établissement)

“funded surgical facility” means a surgical facility at which a funded surgical service is provided with the approval of the Minister under section 4. (établissement chirurgical financé)

“funded surgical services” means surgical services that are entitled services as defined in the Medical Services Payment Act, excluding minor surgical services prescribed by regulation. (services chirurgicaux financés)

“Minister” means the Minister of Health and includes any person designated by the Minister to act on the Minister’s behalf. (ministre)

“non-medical goods or services” means non-medical goods or services that (biens ou services non médicaux)

(a) are not prescribed by a medical practitioner or an oral and maxillofacial surgeon,

(b) may be provided in addition to funded surgical services, and

“operator” means an individual, corporation, unincorporated association, partnership or limited partnership that operates a surgical facility. (exploitant)

“oral and maxillofacial surgeon” means a dental practitioner whose name is entered in the specialists register and who is the holder of a specialist’s licence in oral and maxillofacial surgery issued pursuant to the New Brunswick Dental Act, 1985. (chirurgien buccal et maxillo-facial)

“regional health authority” means a regional health authority as defined in the Regional Health Authorities Act. (régie régionale de la santé)

“surgical facility” means a funded surgical facility and an unfunded surgical facility. (établissement chirurgical)

“surgical services” means funded surgical services and unfunded surgical services. (services chirurgicaux)

“unfunded surgical facility” means a surgical facility at which an unfunded surgical service is provided with the approval of the Minister under section 12. (établissement chirurgical non financé)

“unfunded surgical services” means surgical services prescribed by regulation that are not entitled services as defined in the Medical Services Payment Act. (services chirurgicaux non financés)

Types of facilities

2 A facility at which both a funded surgical service and an unfunded surgical service are provided shall be treated as

(a) a funded surgical facility for the purpose of providing a funded surgical service, and

(b) an unfunded surgical facility for the purpose of providing an unfunded surgical service.

FUNDED SURGICAL FACILITIES

Approval of proposed agreement

3( 1) A regional health authority may enter into an agreement with a person to operate a funded surgical facility if the regional health authority provides the Minister with a copy of the proposed agreement and the Minister approves the proposed agreement.

3( 2) When considering the proposed agreement referred to in subsection (1), the Minister shall take into account the following factors:

(a) the need for the type of surgical service in the Province;

(b) the quality of care that will be provided at the funded surgical facility;

(c) the cost effectiveness of the provision of the funded surgical service at the funded surgical facility and other economic considerations; and

(d) any other factors the Minister considers appropriate.

3( 3) The Minister shall approve a proposed agreement only if the Minister is satisfied that

(a) the provision of the funded surgical service would be consistent with the principles of the Canada Health Act (Canada),

(b) the proposed agreement sets out the facility services to be provided,

(c) the proposed agreement outlines performance expectations and performance measures with respect to the provision of the funded surgical service and facility services, and

(d) the proposed agreement provides for the monitoring of compliance with the applicable by-laws, codes and standards of practice of the College of Physicians and Surgeons of New Brunswick.

3( 4) If the Minister approves a proposed agreement, the parties to the agreement shall not amend the proposed agreement without the approval of the Minister.

3( 5) The Minister may impose terms and conditions on the approval of a proposed agreement under this section.

Approval of funded surgical facility

4( 1) A person may operate a funded surgical facility if the person makes an application to the Minister to operate the facility and the Minister approves the facility.

4( 2) An application under subsection (1) shall include

(a) a copy of an agreement referred to in section 3, and

(b) proof that

( i) the facility is registered with an accreditation organization approved by the Minister, and

( ii) the accreditation organization has undertaken to complete an accreditation process with respect to the surgical services to be provided within two years after an approval of the Minister under this section.

4( 3) If the Minister approves a funded surgical facility, the approval shall set out the funded surgical services that are authorized to be provided at the facility and the period during which the approval is valid.

4( 4) The Minister may impose terms and conditions on an approval of a funded surgical facility under this section.

4( 5) The Minister shall publish or otherwise make public an approval of the Minister, with reasons, of a funded surgical facility under this section.

4( 6) No person shall assign or transfer an approval of the Minister to another person.

Selection of patients

5( 1) An operator of a funded surgical facility shall select patients to receive funded surgical services in accordance with the New Brunswick Surgical Access Registry.

5( 2) For the purpose of giving priority to a person on a wait list of a regional health authority, no person shall

(a) give or accept money or other valuable consideration,

(b) pay or accept payment for additional medical goods or services or non-medical goods or services, or

Facility services

6( 1) An operator of a funded surgical facility shall provide facility services to a patient receiving a funded surgical service.

6( 2) No person shall charge and collect from a patient who receives a funded surgical service at a funded surgical facility an amount for the provision of facility services.

6( 3) If a patient receives any services at a funded surgical facility in substitution for facility services due to a lack of available resources at the funded surgical facility, the patient is not required to pay for the substituted services.

Provision of additional and non-medical goods or services

7( 1) Subject to subsections (2) and (4), no person shall charge and collect from a patient who receives a funded surgical service at a funded surgical facility an amount for the provision of additional medical goods or services or non-medical goods or services.

7( 2) An operator may charge and collect from a patient an amount for the provision of additional medical goods or services if, before the patient is provided with the goods or services, the following conditions are met:

(a) the patient receives an explanation of the nature of the goods or services and the cost to the patient of the goods or services;

(b) the patient receives a written statement signed by the person providing the funded surgical service that sets out

( i) the nature of the goods or services,

( ii) the rationale for prescribing the goods or services,

( iii) that the goods or services are not entitled services as defined in the Medical Services Payment Act or facility services, and

( iv) the cost to the patient of the goods or services; and

7( 3) If an operator charges and collects from a patient an amount for the provision of additional medical goods or services, the amount shall not be more than the cost of providing the additional medical goods or services, including administration costs.

7( 4) An operator may charge and collect from a patient an amount for the provision of non-medical goods or services if, before the patient is provided with the goods or services, the following conditions are met:

(a) the patient receives an explanation of the nature of the goods or services and the cost to the patient of the goods or services; and

(b) the patient consents in writing to receive the goods or services and to pay for the goods or services.

7( 5) A patient who consents in writing to receive goods or services and to pay for goods or services under paragraph (2)(c) or (4)(b) may revoke consent at any time before the goods or services are provided.

Termination of approval

8( 1) An approval of the Minister under section 4 terminates on the expiry of the agreement referred to in section 3, on the cancellation of the agreement by either party to the agreement or if the operator ceases operation of the funded surgical facility.

8( 2) The operator of a funded surgical facility shall notify the Minister and the applicable regional health authority without delay if the operator cancels the agreement referred to in section 3 or ceases operation of the facility.

Contravention of this Act, the regulations or an agreement

9( 1) The Minister may terminate the approval of a funded surgical facility or amend the approval to remove a surgical service if the Minister is satisfied that there has been a contravention of this Act, the regulations or an agreement referred to in section 3 with respect to the facility or the operator of the facility.

9( 2) If the Minister terminates or amends an approval under subsection (1), the Minister shall notify the operator of the funded surgical facility in writing.

Accreditation terminated

10( 1) The Minister shall terminate the approval of a funded surgical facility or amend the approval to remove a surgical service if the Minister is satisfied that the facility is no longer accredited to provide the surgical service.

10( 2) If the Minister terminates or amends an approval under subsection (1), the Minister shall notify the operator of the funded surgical facility in writing.

Change in circumstances

11( 1) The Minister shall notify the operator of a funded surgical facility in writing of the Minister’s intent to terminate the approval of the facility or to amend the approval of the facility to remove a surgical service if the Minister is of the opinion that the circumstances with respect to the approval have changed in a material and substantial way.

11( 2) The notice under subsection (1) shall include information with respect to

(a) the change in circumstances,

(b) the Minister’s intent to terminate or amend the approval, and

(c) the ability of the operator to satisfy the Minister’s concerns with respect to the change in circumstances as referred to in subsection (3).

11( 3) The Minister shall not terminate or amend an approval if, within 60 days after the operator receives a notice under subsection (1), the operator establishes to the satisfaction of the Minister that

(a) the concerns have been addressed or will be addressed, or

(b) the concerns are not founded or do not warrant terminating or amending the approval.

11( 4) If the Minister terminates or amends an approval under this section, the Minister shall notify the operator of the funded surgical facility in writing.

UNFUNDED SURGICAL FACILITIES

Approval of unfunded surgical facility

12( 1) A person may operate an unfunded surgical facility if the person makes an application to the Minister to operate the facility and the Minister approves the facility.

12( 2) An application under subsection (1) shall include

(a) a proposal with respect to the provision of the unfunded surgical service and other services, and

(b) proof that the facility is accredited to provide the surgical service by an accreditation organization approved by the Minister.

12( 3) When considering the application referred to in subsection (1), the Minister shall take into account the following factors:

(a) whether the provision of the unfunded surgical service contemplated in the proposal would have an adverse impact on the publicly funded and publicly administered health care system in the Province or interfere with the Province’s ability to apply the principles of the Canada Health Act (Canada);

(b) whether the public interest would be served by the approval of the unfunded surgical facility; and

12( 4) If the Minister approves an unfunded surgical facility, the approval shall set out the unfunded surgical services that are authorized to be provided at the facility and the period during which the approval is valid.

12( 5) The Minister may impose terms and conditions on an approval of an unfunded surgical facility under this section.

12( 6) No person shall assign or transfer an approval of the Minister to another person.

Unfunded surgical services

13( 1) An operator of an unfunded surgical facility may charge and collect from a patient an amount for the provision of an unfunded surgical service and other services if, before the patient is provided with the services, the following conditions are met:

(a) the patient receives an explanation of the nature of the services and the cost to the patient of the services; and

(b) the patient consents in writing to receive the services and to pay for the services.

13( 2) A patient who consents to receive services and to pay for services under paragraph (1)(b) may revoke consent at any time before the services are provided.

Termination of approval

14( 1) An approval by the Minister under section 12 terminates if the operator ceases operation of the unfunded surgical facility.

14( 2) The operator of an unfunded surgical facility shall notify the Minister without delay if the operator ceases operation of the facility.

Contravention of this Act or the regulations

15( 1) The Minister may terminate the approval of an unfunded surgical facility or amend the approval to remove a surgical service if the Minister is satisfied that there has been a contravention of this Act or the regulations with respect to the facility or the operator of the facility.

15( 2) If the Minister terminates or amends an approval under subsection (1), the Minister shall notify the operator of the unfunded surgical facility in writing.

Accreditation terminated

16( 1) The Minister shall terminate the approval of an unfunded surgical facility or amend the approval to remove a surgical service if the Minister is satisfied that the facility is no longer accredited to provide the surgical service.

16( 2) If the Minister terminates or amends an approval under subsection (1), the Minister shall notify the operator of the unfunded surgical facility in writing.

Change in circumstances

17( 1) The Minister shall notify the operator of an unfunded surgical facility in writing of the Minister’s intent to terminate the approval of the facility or to amend the approval of the facility to remove a surgical service if the Minister is of the opinion that the circumstances with respect to the approval have changed in a material and substantial way.

17( 2) The notice under subsection (1) shall include information with respect to

(a) the change in circumstances,

(b) the Minister’s intent to terminate or amend the approval, and

(c) the ability of the operator to satisfy the Minister’s concerns with respect to the change in circumstances as referred to in subsection (3).

17( 3) The Minister shall not terminate or amend an approval if, within 60 days after the operator receives a notice under subsection (1), the operator establishes to the satisfaction of the Minister that

(a) the concerns have been addressed or will be addressed, or

(b) the concerns are not founded or do not warrant terminating or amending the approval.

17( 4) If the Minister terminates or amends an approval under this section, the Minister shall notify the operator of the unfunded surgical facility in writing.

GENERAL PROVISIONS

Provision of information

18( 1) At the request of the Minister, a regional health authority shall provide information to the Minister with respect to surgical facilities, including

(a) a list of the surgical facilities that have been accredited to provide a surgical service,

(b) a description of the accreditations of the surgical facilities and any terminations or amendments to the accreditations, and

18( 2) At the request of the Minister or a regional health authority, a funded surgical facility shall provide information to the Minister or the regional health authority with respect to the facility for the purpose of ensuring compliance with this Act and the regulations, an agreement referred to in section 3 and any other terms and conditions imposed by the Minister.

18( 3) At the request of the Minister, an unfunded surgical facility shall provide information to the Minister with respect to the facility for the purpose of ensuring compliance with this Act and the regulations and any other terms and conditions imposed by the Minister.

Inspections

19( 1) The Minister or a regional health authority may appoint in writing a person as an inspector for the purpose of ensuring compliance with this Act and the regulations, an agreement referred to in section 3 and any other terms and conditions imposed by the Minister.

19( 2) The Minister or a regional health authority shall issue to every inspector a certificate of appointment.

19( 3) An inspector shall produce their certificate of appointment on request in the execution of their duties under this Act.

19( 4) An inspector may enter and inspect a surgical facility at any reasonable time.

19( 5) An inspector may apply for an entry warrant under the Entry Warrants Act before or after attempting to enter a surgical facility.

19( 6) During an inspection, an inspector may

(a) require to be produced for inspection, or for the purpose of obtaining copies or extracts, any record or document relevant to the inspection, and

(b) make those examinations and inquiries of any person that the inspector considers necessary for the purpose of ensuring compliance with this Act and the regulations, an agreement referred to in section 3 and any other terms and conditions imposed by the Minister.

19( 7) Immediately on demand by an inspector, a person shall produce a record or document required by the inspector under subsection (6).

19( 8) Every person shall give an inspector all reasonable assistance to enable the inspector to carry out an inspection under this section, including providing the inspector with the information that the inspector reasonably requires.

19( 9) No person shall obstruct or interfere with an inspector who is carrying out or attempting to carry out an inspection under this section.

Orders

20 If the Minister is of the opinion that a person has not complied with or is not complying with this Act or the regulations, the Minister may apply to a judge of The Court of King’s Bench for an order directing the person to comply with this Act or the regulations or restraining the person from contravening this Act or the regulations.

Decisions of the Minister

21( 1) A decision of the Minister under this Act is final and shall not be appealed but is subject to judicial review.

21( 2) A person aggrieved by a decision of the Minister may make an application for judicial review of the decision to The Court of Appeal of New Brunswick within 30 days after the making of the decision.

21( 3) An application for judicial review does not stay the operation of the decision of the Minister, unless a judge of The Court of Appeal of New Brunswick orders otherwise, but the Minister may suspend the operation of the decision until the Court has rendered its decision.

Debt to the Crown

22( 1) If a person charges and collects from a patient an amount that is not authorized by this Act or the regulations, the amount is a debt due to the Crown in right of the Province and may be recovered by action in the name of the Crown in right of the Province in a court of competent jurisdiction.

22( 2) If an amount is recovered under subsection (1), the patient shall be reimbursed.

Offences

23( 1) No person shall provide a surgical service at a location other than at a regional health authority or a surgical facility.

23( 2) No person shall operate a surgical facility without the approval of the Minister.

23( 3) No person shall provide a surgical service that is not authorized to be provided at the surgical facility as set out in the approval of the Minister.

23( 4) A person who violates or fails to comply with subsection (1), (2) or (3) commits an offence punishable under Part 2 of the Provincial Offences Procedure Act as a category I offence.

23( 5) No person shall charge and collect from a patient an amount that is not authorized by this Act.

23( 6) A person who violates or fails to comply with subsection (5) commits an offence punishable under Part 2 of the Provincial Offences Procedure Act as a category F offence.

23( 7) A person who violates or fails to comply with subsection 4(6), 5(1) or (2), subsection 8(2) or 12(6), section 18 or subsection 19(8) or (9) commits an offence punishable under Part 2 of the Provincial Offences Procedure Act as a category E offence.

Regulations

24 The Lieutenant-Governor in Council may make regulations

(a) respecting facility services, including prescribing services that are facility services if certain funded surgical services are provided and in other circumstances;

(b) prescribing surgical services for the purposes of the definition “unfunded surgical services” in section 1;

(d) providing for clauses to be included in the agreement referred to in section 3;

(e) respecting the statement referred to in paragraph 7(2)(b), including

( i) the form of the statement,

( ii) matters to be contained in the statement,

( iii) the timing of the provision of the statement, and

( iv) the period during which the operator of the funded surgical facility shall retain the statement;

(f) prescribing conditions for the purposes of subsection 7(2);

(g) respecting the revocation of consent under subsections 7(5) and 13(2) and the reimbursement of an amount to the patient;

(h) respecting the provision of information under section 18, including

( i) the content of the information,

( ii) the form of the information, and

( iii) the timing of the provision of the information;

(i) respecting the publication of information to be provided under section 18;

(j) prescribing exceptions in an emergency to the provisions respecting additional goods and services and defining “emergency” for the purposes of the exceptions;

(k) prescribing the maximum amounts that may be charged and collected under this Act;

(l) respecting the retention of records by operators of surgical facilities;

(m) prescribing provisions of the regulations, the violation of which or failure to comply with constitute an offence;

(n) in relation to offences under the regulations, prescribing categories of offences for the purposes of Part 2 of the Provincial Offences Procedure Act;

(o) defining words or expressions used but not defined in this Act;

(p) respecting any other matter that may be necessary for the proper administration of this Act.

CONSEQUENTIAL AMENDMENTS AND COMMENCEMENT

Medical Services Payment Act

25 Section 1 of the of the Medical Services Payment Act, chapter M-7 of the Revised Statutes, 1973, is amended by repealing the definition “private facility” and substituting the following:

“private facility” means a private clinic established, operated or maintained by a person other than a regional health authority as defined in the Regional Health Authorities Act but does not include a surgical facility as defined in the Health Facilities Act; (établissement privé)

Prescription and Catastrophic Drug Insurance Act

26( 1) Paragraph 27(4)(b) of the Prescription and Catastrophic Drug Insurance Act, chapter 4 of the Acts of New Brunswick, 2014, is amended by striking out “private hospital facility” wherever it appears and substituting “private facility”.

26( 2) Paragraph 32(b) of the Act is amended by striking out “private hospital facility” wherever it appears and substituting “private facility”.

Regional Health Authorities Act

27 Section 1 of the Regional Health Authorities Act, chapter 217 of the Revised Statutes, 2011, is amended by repealing the definition “surgical services” and substituting the following:

“surgical services” means funded surgical services provided at a funded surgical facility as those terms are defined in the Health Facilities Act. (services chirurgicaux)

28 This Act or any provision of it comes into force on a day or days to be fixed by proclamation.