Presented to: BC Care Providers Association 30 th Annual Conference, Whistler, BC May 6, 2013

1. Presented to: BC Care Providers Association 30th Annual Conference, Whistler, BC May 6, 2013 Presented by: Bruce Bell, Director, BC CACHWR E-mail: bruceb@healthmatchbc.org Phone: 604-714-2268 1

2. Role and Mandate of the Registry • To protect vulnerable patients, residents and clients. • To establish and improve standards of care in the care aide and community health worker occupations, now called Health Care Assistants (HCAs). • To promote professional development for care aides and community health workers (HCAs) and to assist these workers in identifying career opportunities. 2

3. The Care Aide Registry took effect on Jan.29, 2010. As of May 2013, the Care Aide Registry has registered 46,000 Care Aide Workers. This number includes the following: • Health Care Assistants currently working full time, part time or casual. • LPN/PNs who work as HCAs as well as RN/PN students who have completed the first two semesters of their training. 3

4. Process for Removal from the Registry • Employers report alleged abuse HCA cases to the Registry • Registry removes HCA from active registry list • Suspended or terminated • Back to active registration • Investigation • Remain de-registered 4

5. Employers Abuse Reporting FormAvailable at www.cachwr.bc.ca.Click on: Employer Information Reporting a Violation 5

6. Reported Alleged Abuse Cases To date the Registry has been notified regarding 185 alleged abuse discipline cases. The Registry has five investigators. • Lisa Hansen • Paula Butler • Jean Greatbatch • Kate Young • Elaine Doyle Of the 185 alleged abuse cases 54 have gone to an investigator appointed by the Registry. 6

7. Alleged Abuse Reports • 185 alleged abuse cases reported • 84 suspensions for abuse • 101 terminations for abuse • 54 registry investigations • 8 HCAs permanently remove from the Registry after an investigation • 30 HCAs returned to the Registry after remedial conditions fulfilled • 37 HCAs removed from the Registry and not disputed by the union or individual • 10 employer/union resolved the issue in the grievance procedure 7

8. The Registry: A Review • The Review was announced in June 2012. Final report released on March 21, 2013. • It is a model to support Health Care Assistant (HCA) professions, oversee unregulated health workers, and ensure patient safety and quality care. • Health Care Assistants (HCAs) were formerly known as Care Aides & Community Health Workers. • The first registry in Canada designed to track and address cases of alleged abuse. • The Registry has been developed and implemented through a phased approach. 8

9. On-going Commitment • Developing and implementing the Registry model would not have been possible without the support of all the stakeholders – Educators, Employers, Unions and Senior Advisory Groups. • The Ministry of Health remains committed to the Registry model and looks forward to working with its partners to continue strengthening the Registry. • Expanding to the private sector. • Strengthening the Registry Advisory Committee by adding a Ministry of Health representative. • Enhance the protection mandate to the vulnerable. • Potential alternative funding options. 9

10. Report Findings The recommendations in the review report cover four broad areas for improvement: • The enabling framework • Governance • Gaps in the protection mandate • The funding model 10

11. Action Plan • High level response to recommendations focused on short, medium and long term actions • Sets the direction • Stakeholder involvement will be critical 11

12. 1 – The Enabling Framework • Assess implications of expanding Registry mandate to include private sector • Possibility has existed since the onset, and raised by both BC Ombudsperson and in the review • Better protection of vulnerable individuals • Some private Employers are already requesting to participate • Educators are encouraging all students to register • Will be pursuing discussions with all stakeholders regarding challenges with existing model re: disentangling LR/Registry issues to inform discussions with the Unions 12

13. 2 – Governance • Review how to strengthen the Registry Advisory Committee’s role in governance • Ensure there is a clear process to raise and address issues/concerns within the Committee • Bring Ministry of Health representative to the table to ensure alignment with government priorities and progress with items in the Action Plan (role TBD – i.e. Member or ex-officio) • Support communication strategies flowing from the Registry Advisory Committee 13

14. 3 – Protection Mandate • Protection of vulnerable individuals should be the key goal/interest of all parties • Assess privacy issues raised in light of need to protect public • Need to balance interests of others 14

15. 4 – Funding Model • No significant changes to the funding model are planned in the short-term. • Assess funding options for additional costs to those located outside of the lower mainland • Assess protocols for investigator costs and the possibility of more standardized processes • Before considering any changes, it is necessary to understand the implications of expanding the Registry mandate to include the private sector. 15

16. Ongoing Development As part of the phased approach, the Registry will be moving forward with the development of Educational processes, including: • Finalizing and implementing the Education Recognition process for BC HCA programs • Developing a pilot of the proposed PLAR process for those without certification from a recognized BC HCA program • Hiring a full-time Education Assessment Officer • Implementing any necessary changes resulting from the review of the provincial HCA competencies and curriculum 16

17. Looking Ahead • Actions outlined in the Registry Action Plan are dependent on meaningful participation on the part of key players • Implementation will depend on feasibility and collaboration with Unions, Employers, Educators, and other stakeholder groups • Roll-out will look at short, medium and long term strategies 17

18. Frequently Asked Questions • What is the role of the appointed investigator? • The primary role of the investigator is to make a recommendation to the Registry regarding the HCA status with the Registry. • Is the investigator’s decision binding with respect to placement/removal on/from Registry? • The investigator’s decision is binding with respect to placement/removal from the Registry. Unionized employees have the right to pursue the matter in arbitration under the applicable CBA. 18

19. Frequently Asked Questions • At an investigation is the employer expected to advocate for removal from the Registry? • No, the employer’s responsibility is to assist the investigator and provide the facts that led them to the decision to terminate the employee. The decisions on membership with the Registry rests exclusively with the investigator. • Does the investigator have any other role? • The investigator can with the parties concurrence mediate the employee’s termination of employment. In doing so, the investigator may be required to look at the broader employment relationship to make a recommendation in the resolution of the dispute to the satisfaction of the parties. 19

20. Frequently Asked Questions • As an employer, should I check with the Registry before offering employment to a HCA? • By registering with the Care Aide Registry as an employer, you can look online to verify whether a HCA is registered or not. 20

21. More information is available at www.cachwr.bc.ca BC Care Aide & Community Health Worker Registry 200 –1333 West Broadway, Vancouver, BC V6H 4C6 Toll free phone: 1-877-867-3222 Toll free fax: 1-877-494-3222 Website: www.cachwr.bc.ca Email: register@cachwr.bc.ca • Bruce Bell, Project Director Email: bruceb@healthmatchbc.org Phone: (604) 714-2268 • Elizabeth Thow, Administrative Assistant Email: elizabetht@healthmatchbc.org Phone: (604) 742-5505 21