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Co-ordinated Home Care Program Regulation


Published: 2014

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AR 296/2003 CO-ORDINATED HOME CARE PROGRAM REGULATION (Consolidated up to 153/2014)
ALBERTA REGULATION 296/2003
Public Health Act
CO‑ORDINATED HOME CARE PROGRAM REGULATION
Table of Contents
                1      Definitions
                2      Program
                3      Requirements for admission
                4      Appointment and duties of a manager
                5      Provision of services
                6      Records and reports to Minister
                7      Reimbursement
                8      Fees
                9      Repeal
              10      Expiry Definitions
1   In this Regulation,
                               (a)    “Act” means the Public Health Act;
                              (b)    “health care service” means any one or more of the following:
                                        (i)    nursing service;
                                      (ii)    rehabilitation therapy service;
                                     (iii)    health care procedures authorized and supervised by a nurse or a rehabilitation therapist;
                               (c)    “homemaking service” means any one or more of the following:
                                        (i)    adult sitting and child care;
                                      (ii)    routine housecleaning, laundry, ironing or mending;
                                     (iii)    budgeting, banking, paying bills or shopping for essentials;
                                     (iv)    menu planning or meal preparation;
                                       (v)    any other home management service;
                              (d)    “manager” means a program manager appointed under section 4;
                               (e)    “palliative care client” means a client for whom treatment aimed at cure is no longer appropriate, but for whom treatment and care aimed at maintaining and improving the quality of the remaining life are primary objectives;
                               (f)    “personal care service” means either or both of the following:
                                        (i)    personal hygiene care;
                                      (ii)    assistance with the personal activities of daily living;
                               (g)    “program” means a co‑ordinated home care program provided under this Regulation;
                              (h)    “rehabilitation therapy service” means service provided by a physiotherapist, an occupational therapist, a speech pathologist or a respiratory technologist;
                               (i)    “support service” means any one or more of the following:
                                        (i)    personal care service;
                                      (ii)    homemaking service;
                                     (iii)    heavy housework service;
                                     (iv)    handyman service;
                                       (v)    the services commonly known as “Meals on Wheels” and “Wheels to Meals”;
                                     (vi)    transportation service.
Program
2(1)  Where a program is approved by the Minister, a regional health authority shall provide the program in accordance with this Regulation.
(2)  A regional health authority shall ensure that its program is co‑ordinated with other agencies providing similar health care and support services.
(3)  A program shall provide
                               (a)    nursing service,
                              (b)    personal care service, and
                               (c)    homemaking service.
(4)  A program may provide the following services:
                               (a)    rehabilitation therapy service;
                              (b)    dressings, medications and other related preparations;
                               (c)    the temporary use of a health aid not provided under the Alberta Aids to Daily Living and Extended Health Benefits Regulation under the Act;
                              (d)    heavy housework service;
                               (e)    handyman service;
                               (f)    the services commonly known as “Meals on Wheels” and “Wheels to Meals”;
                               (g)    transportation service;
                              (h)    nutrition service.
(5)  Where a program provides health care services and support services, the regional health authority shall ensure that those services are made available to all palliative care clients admitted to the program.
(6)  A regional health authority shall use volunteers to the fullest extent possible in its program.
Requirements for admission
3(1)  Subject to this section, a person may be admitted to a program when
                               (a)    the manager is satisfied that
                                        (i)    the person has been assessed as requiring a health care service or a support service,
                                      (ii)    the person’s home is suitable for the provision of a health care service or a support service,
                                     (iii)    the program is the most suitable method of providing the amount, level and type of any health care service or support service required by the person,
                                     (iv)    the resources and the budget of the program are sufficient to meet the assessed needs of the person, and
                                       (v)    the person does not require the services of a health care professional 24 hours a day on a continuing basis,
                                     (vi)    repealed AR 102/2007 s2,
                                  and
                              (b)    the person is a resident of Alberta as defined in the Alberta Health Care Insurance Act.
(2)  Notwithstanding subsection (1)(b), if a person otherwise meets the requirements of subsection (1), the person may be admitted to the program if the person agrees to pay for the cost of any health care service or support service provided, including related administrative costs, as assessed by the regional health authority.
(3)  Notwithstanding subsection (1)(a)(v), if a person otherwise meets the requirements of this section, the person may be admitted to the program
                               (a)    if awaiting placement in a health care facility,
                              (b)    if the person is, in the opinion of the manager, a palliative care client, or
                               (c)    if, in the opinion of the manager, the provision of additional health care services and support services may avoid institutional placement and the period for which the additional services are required does not exceed 3 months in a calendar year.
(4)  A person who is refused admission to a program by a manager under subsection (1)(a) may apply to the regional health authority for a review of that decision.
AR 296/2003 s3;102/2007
Appointment and duties of a manager
4(1)  A regional health authority shall appoint, as a member of the regional health authority staff, a manager who shall do the following:
                               (a)    determine, in accordance with the requirements of section 3, the eligibility of a person for admission to the program;
                              (b)    case co‑ordinate with respect to each client in relation to the following matters:
                                        (i)    general assessment of client needs;
                                      (ii)    development of a care plan that designates any health care services and support services required by the client;
                                     (iii)    monitoring and re‑assessing the client’s progress with respect to the care plan;
                                     (iv)    co‑ordinating with other agencies providing services to the client;
                                       (v)    determining the time of discharge of a client from the program and carrying out a discharge plan;
                               (c)    determine, in accordance with this Regulation, the amount of any fee to be paid for any support service provided to the client under the program.
(2)  A manager shall keep a record, in a manner acceptable to the Minister, for each client admitted to the program respecting
                               (a)    the general assessment carried out pursuant to subsection (1)(b)(i), and
                              (b)    the development of the care plan pursuant to subsection (1)(b)(ii).
(3)  A manager shall keep a record, in a manner acceptable to the Minister, respecting each person referred to the program but not admitted, and that record shall describe the reasons for non‑admission to the program for each such person.
Provision of services
5(1)  When a client is admitted to a program under section 3, the regional health authority may provide the health care services and support services that are authorized under this Regulation to that client.
(2)  A regional health authority or other person who under a contract with a regional health authority provides some or all of the health care services and support services under subsection (1) shall provide those services in accordance with the Continuing Care Health Service Standards, approved by the Minister of Health and published by the Department of Health in March 2007, as amended from time to time.
AR 296/2003 s5;102/2007;170/2012
Records and reports to Minister
6   A regional health authority shall submit to the Minister, in the form and manner and at the time prescribed by the Minister, records and reports respecting the operation of the program.
Reimbursement
7   Where a person receives a benefit under
                               (a)    the Department of Veterans’ Affairs Act (Canada),
                              (b)    the Blue Cross Plan,
                               (c)    the Group Surgical Medical Insurance Plan operated pursuant to Treasury Board Minute No. 758836 of the Government of Canada dated July 7, 1978,
                              (d)    the Workers’ Compensation Act,
                               (e)    the Motor Vehicle Accident Claims Act,
                               (f)    the Victims of Crime Act, or
                               (g)    any private insurance program
in respect of a condition for which the person is also receiving a service under this Regulation, the person shall reimburse the regional health authority for the cost of the service provided under this Regulation in an amount equal to the lesser of
                              (h)    the cost of providing the service under this Regulation, and
                               (i)    the amount the person receives under clauses (a) to (g),
as assessed by the regional health authority.
Fees
8(1)  Subject to this section, a client who receives support services, other than personal care service, shall pay the fee prescribed in this section.
(2)  A client who receives a support service other than a personal care service shall pay the fee set by the Minister and shall pay the fee monthly.
(3)  When a client receives the support service commonly known as “Meals on Wheels” or “Wheels to Meals”, the fees set by the Minister are applicable on a per meal basis.
(4)  When a client receives a support service other than “Meals on Wheels” or “Wheels to Meals”, the fees set by the Minister are applicable on an hourly basis.
(5)  No fee is chargeable for any support services provided to the client, the client’s spouse or adult independent partner or the client’s dependants under this Regulation where the client is in receipt of
                               (a)    a social allowance provided under Part 2 of the Social Development Act,
                              (b)    a widow’s pension under the Widows’ Pension Act,
                               (c)    a Guaranteed Income Supplement provided under the Old Age Security Act (Canada), or
                              (d)    a benefit under the Assured Income for the Severely Handicapped Act.
(6)  On application by a client, the regional health authority may waive the payment of the whole or any part of the fees payable by the client under this section where the regional health authority is of the opinion that to require payment of the fees would cause undue financial hardship.
Repeal
9   The Co‑ordinated Home Care Program Regulation (AR 239/85) is repealed.
Expiry
10   For the purpose of ensuring that this Regulation is reviewed for ongoing relevancy and necessity, with the option that it may be repassed in its present or an amended form following a review, this Regulation expires on October 31, 2017.
AR 296/2003 s10;173/2012;153/2014