A Little Context:
I am the Clinical Leader for Calgary Zone, Integrated Home Care, Alberta Health Services (AHS) is a Health Care System. While funded through the Alberta Government, it is not a “government-run” organization. Policy and practice guidance is provided by Alberta Health, which is the Alberta government department responsible for ensuring the Province of Alberta is fulfilling its obligation to meet the stipulations within the Canada Health Act. Alberta Health is the portfolio for the Alberta Minister of Health, Minister Sarah Hoffman. This meets the requirement that the Canada Health Act be publicly administered and responsible to the provincial government.
Home Care and the Canada Health Act
The Canada Health Act stipulates that a province “must insure all insured health services provided by hospitals, medical practitioners or dentists, and where the law of the province so permits, similar or additional services rendered by other health care practitioners”. This allows broad interpretation on the part of each provincial government as to what is included and what is not. (Canada Health Act, 1985, p. 6).
While hospitals are specifically included under the Program Criteria of the Canada Health Act, inclusion of “extended health care services” are not specifically stated as a Program Criteria. They are nonetheless mentioned and specifically defined under the Interpretation section. “Extended health care services are defined as:
- nursing home intermediate care service,
- adult residential care service,
- home care service, and
- ambulatory health care service; (Canada Health Act, 1985, p. 2).
This allows for the cash contributions provided from the federal government to the provincial government to be used in the funding of home care services, however the scope of such services are left for each of the provinces to determine.
Alberta Law and Home Care
Home care support is provided to clients in every province, however the amount and type of support service does vary from province to province. Within Alberta, Home Care is governed by the Co-Ordinated Home Care Program Regulation, a piece of provincial legislation that defines Home Care and the services to be provided. Similarly to the Canada Health Act, the Co-ordinated Home Care Program Regulation provides a directive that a home care program shall provide nursing service, personal care service and homemaking service. It further goes on to say that a home care program may provide rehabilitation therapy service.
So while the Canada Health Act suggests rather than demands the inclusion of Home Care, and the Co-Ordinated Home Care Program Regulation suggests rather than demands the inclusion of Occupational Therapy within the provision of home care, program administrators have clearly seen the value in the provision of both. Therefore Home Care, and Occupational Therapy services within Home Care are covered under insured health services.
So while the Canada Health Act suggests rather than demands the inclusion of Home Care, and the Co-Ordinated Home Care Program Regulation suggests rather than demands the inclusion of Occupational Therapy within the provision of home care, program administrators have clearly seen the value in the provision of both.
Alberta Law and Occupational Therapy
The Health Professions Act is a broad, over-arching piece of legislation that defines the scope of practice, restricted activities, and regulation expectations for 36 named professions. It is no surprise it is 296 pages long! Key principles include self-regulation within each profession and that the included professionals have over-lapping and non-exclusive scopes of practice. There are restricted activities that are defined as requiring specific competencies and skills, but are not linked to any specific profession. The expectations defined in the Act for Occupational Therapists in the province of Alberta are overseen by the Alberta College of Occupational Therapists (ACOT). In compliance with the Act, ACOT sets entry requirements, defines services provided by members, sets standards of professional practice, sets competency requirements, investigates complaints about regulated members and imposes disciplinary actions if required.
This legislation helps to ensure that the health providers within the system of health care provision are competent and qualified to serve the users of the system.
Conclusion
For many years I was both a front-line Occupational Therapist and Case Manager within Home Care. Occupational Therapy training provides an excellent platform for Case Management, and this role is pivotal for helping the client to be well-supported in a complex health care system. Now, in my role as a Clinical Lead for a specific method of support service provision, I find myself drawing on and expanding on my Occupational Therapy skills. I am in a position to interact with and support all Home Care professionals. Within Alberta, Home Care has nurses, occupational therapists, physical therapists, licensed practical nurses, social workers, wound care specialists, speech language pathologists, dietitians, palliative care specialists, pediatric and geriatric specialists and health care aides. Outside of Home Care, we are often in contact with health professionals of all backgrounds across the service spectrum. The Health Professions Act helps to ensure we can count on our fellow professionals to have the base level of competency to provide the service as intended. In Home Care, we provide care to every age, and we meet the client where they are, both literally and figuratively. There is no situation quite so client-centered and client-driven as when that client can bar the door or expel you from their home!
Community Care is my passion and the environment where I am inspired by our clients going into the world and doing the best they can with what they have every day. For some people and for some days, that is just getting from their bed to their wheelchair and into the living room. I am so proud to be a part of that process. Home Care may have to limit their services based on the resources provided, but it is amazing what is done with the services that are available. It is a very effective use of health care dollars and I commend the decision makers that wisely included this in insured health benefits as allowed for within the Canada Health Act and defined in the Co-Ordinated Home Care Program Regulation.
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References
Health Canada. (2005, May 16). Canada Health Act. Retrieved September 25, 2018, from http://laws-lois.justice.gc.ca/eng/acts/c-6/
Alberta Health. (n.d.) Health Services in Alberta. Retrieved September 25, 2018, from http://www.health.alberta.ca/health-services.html
Alberta Queens Printer. (Alberta Regulation 296/2003) Co-Ordinated Home Care Program Regulation. Retrieved September 25, 2018, from http://www.qp.alberta.ca/documents/Regs/2003_296.pdf
Alberta Queens Printer. (July 1, 2018) Health Professions Act. Retrieved September 25, 2018, from http://www.qp.alberta.ca/1266.cfm?page=H07.cfm&leg_type=Acts&isbncln=9780779740772