FOR IMMEDIATE RELEASE
May 5, 2025
Ms. Kathy Wilkie, BHA (Hons.), MLT, C. Dir.,
CEO, Health and Supportive Care Providers Oversight Authority
Via Email: kathy.wilkie@hscpoa.com
Dear Ms. Kathy Wilkie,
Thank you for the meeting of April 24, 2025, and the opportunity to engage in this important conversation. We value the dialogue; however, we want to be clear that our position remains firm. CUPE/OCHU will continue to challenge the Health and Supportive Care Oversight Authority Act, and the regulations made under it.
We are deeply concerned that the current model is not self-regulating and excludes PSWs from meaningful participation in decision-making, including representation on the Board, committees, and other key roles. As discussed, this was a policy decision, and one that disproportionately impacts some of the most vulnerable workers in the healthcare sector: predominantly racialized, female, and among the lowest paid.
Transparency and procedural fairness must be at the core of this legislation. In our view, PSWs deserve the same procedural fairness and rights afforded to other regulated professionals. Fairness demands peer evaluation. When HSCPOA has the authority to make decisions that may affect a person’s ability to earn a living, those decisions must not only be fair; they must be made with the input of a PSW, as they have the specialized knowledge of their scope of practice, daily challenges and the nuanced realities of providing health care. Without this insight, a decision maker may misinterpret behaviour, overestimate risks, or apply irrelevant standards. Moreover, where workers have no meaningful ability to influence the decisions that govern their professional practice, there may be serious implications for their rights under the Charter. CUPE/OCHU is prepared to pursue this matter as far as necessary to protect the rights and interests of the more than 30,000 PSWs we represent.
We cannot commit to ending our campaign. That said, if you believe any of our communications are factually inaccurate, we welcome clarification.
We have serious concerns about the Health and Supportive Care Oversight Authority Act and the Regulations under the Act. We understand that you have limits on your ability to deal with some of these issues given the government’s control of HSCPOA, but we do want to hear from you about your ability to address these issues within the powers you do have.
As you know, we have sent multiple communications outlining our concerns but will review our main points again.
Due process
We have concerns about due process for our members with the Oversight Authority being put in place. We want to ensure our members are treated fairly and that they are regulated in the same manner and provided with the same due process and procedural fairness as other regulated health professionals (i.e. nurses). Our members should be accorded the same rights in terms of process as other regulated professionals, and we are concerned that the processes set out in the legislation are unfair and fall short in several respects.
- Committees appointed by the Board (i.e., the Discipline Committee and Appeals Committee) exclude PSWs
- Reg. 212/24 Discipline and Appeals specifically excludes registrants and former registrants from being members of the Discipline and Appeals Committees. This is outlined in s. 2(2)(a) of the Regulation:
2 (1) The discipline committee shall be composed of at least seven members appointed by the board.
(2) A person is eligible to be appointed or re-appointed to the discipline committee if, on the date of the appointment or re-appointment, they,
(a) are not a current or former registrant;
The exclusion of PSWs from these committees is wrong and offensive and is not in line with the standards for other regulated professions. For example, the Discipline Committee of the College of Nurses includes RNs.
The Discipline and Appeals Committees should include PSW representation so that the voices of our members are heard and taken into consideration when decisions are being made about disciplining PSWs. It is important to have members on these committees that understand the perspective of PSWs from first-hand experience. It is further completely unclear what justification there is for excluding PSWs from these committees.
- There is no right to full written reasons from decisions of the Discipline and Appeals Committees
- Reg. 212/24 Discipline and Appeals outlines provisions regarding the processes of the Discipline and Appeals Committees. Some of these provisions mirror the Health Professions Procedural Code, which we view as an appropriate standard to follow. However, there are still gaps in terms of due process with the procedures set out in the Regulation.
Most glaringly, the Regulation does not outline a right to a written decision with detailed reasons. Under the Orders section, reasons are contemplated but don’t appear to be required as they are in the Health Professions Procedural Code. The only place they are mentioned is in saying that the Panel must make sure any order and its reasons are made available to the public in s. 14(7). However, later in s. 24 of the Regulation it states:
- If a proceeding before a panel of the discipline committee arises from a complaint by a person who is not a party to the proceeding, the committee shall send the person a copy of its determination or order, including the reasons if any that it has given, at the same time that it sends a copy of its determination or order, as the case may be, to each party who participated in the proceeding or the party’s representative.
The Complainant is not a party to the proceeding per s. 7 of this Regulation, and so s. 24 is meant to ensure they receive a copy of the decision. We are deeply concerned that the provision provides that reasons may not be given – that is what the words “if any” necessarily imply. Registrants have the right to know how and why a committee reached its decision, and there needs to be a provision similar to that right which is specifically outlined in the Health Professions Procedural Code.
For example, regarding the discipline committee, s. 54 of the Health Professions Procedural Code includes a provision that states:
- “A panel shall give its decision and reasons in writing to the parties and, if the matter had been referred to the Discipline Committee by the Inquiries, Complaints and Reports Committee, to the complainant in the matter.”
So many of the other procedural provisions have been included, with respect to evidence and disclosure and public hearings – why not this?
- The CEO’s unilateral decisions about registration should be subject to a full right to appeal to the Health Professions Appeal and Review Board (HPARB)
In O. Reg. 217/24 Registration, the Regulation sets out in s. 9 the procedure for a Registration Review under s. 28(6) of the Act. This section provides for reviews of the CEO’s decisions regarding registration refusals, revocations, etc. There is nothing in the Regulation to suggest that the “review” by the HPARB is more than a written review.
The CEO’s unilateral decisions about registration should be subject to a full right to appeal to the HPARB, either by way of a review or a full hearing. This should be at the member’s election.
The CEO’s decisions on these matters will have serious consequences for members and they should have the right to have a full hearing at HPARB if they choose to do so. A written hearing is not sufficient and is procedurally unfair given what is at stake for member concerning their registration status with the Authority. Other professionals regulated under the Regulated Health Professionals Act have the right to appeal through the hearing process at HPARB. PSWs should have access to this process as well.
- Interim urgent action – CEO’s unilateral powers should be revoked and there should be a right to appeal complaints decisions made by the CEO
The Act bestows powers upon the CEO to take “interim urgent action” in the following circumstances, without giving notice to the registrant:
Urgent interim action
45 (1) The Chief Executive Officer may, at any time following the receipt of a complaint or following the appointment of an investigator, suspend or impose conditions on a registrant’s registration on an interim basis if the Chief Executive Officer believes on reasonable and probable grounds that the conduct of the registrant exposes or is likely to expose members of the public who receive health services or supportive care services from the registrant to harm or injury and that urgent intervention by the Chief Executive Officer is needed.
No notice or review required
(2) The requirements in section 28 do not apply to an interim action taken under subsection (1).
In O. Reg. 219/24 Complaints, the CEO’s powers of taking “interim urgent action” are entrenched. The Regulation allows the CEO to take urgent interim action prior to notifying a registrant of a complaint. The Regulation also allows the CEO to undertake “urgent interim action” pursuant to s. 45 (1) of the Act (i.e. imposing conditions on a registrant) in response to a complaint before the expiry of the 30-day period (a registrant has 30 days to provide written submissions to the CEO regarding the complaint).
Registrants cannot appeal complaints decisions made by the Chief Executive Officer to HPARB, like professionals regulated under the RHPA can about decisions made by a college’s Inquiries, Complaints and Reports Committee. This is a denial of due process.
We understand that HSCPOA’s position is that due process and principles of fundamental justice are followed before the CEO makes a decision about a complaint and that this involves an investigation of the complaint and an opportunity for the registrant to provide a response to the complaint. Yet this right is curbed by the provisions that allow for interim urgent action to be taken without notice to the registrant and before the 30 day period in which a registrant is supposed to have the opportunity to provide their response.
This is an unfair process and does not provide registrants with the same procedural fairness as other regulated health professions.
The CEO’s unilateral powers to take interim urgent action should be revoked and there should be a right to appeal complaints decisions made by the CEO to HPARB.
- There is no provision providing a right to appeal decisions of the Discipline and Appeals Committee
In O. Reg. 212/24 Discipline and Appeals, there are provisions regarding a hearing before the Discipline Committee and the Appeals Committee. There is no provision providing for a right to appeal any decision of either Committee to the Divisional Court for judicial review.
This is in contrast to s. 70 of the Health Professions Procedural Code under the Regulated Health Professions Act, which provides the following:
Appeals from decisions
70 (1) A party to proceedings before the Board concerning a registration hearing or review or to proceedings before a panel of the Discipline or Fitness to Practise Committee, other than a hearing of an application under subsection 72 (1), may appeal from the decision of the Board or panel to the Divisional Court.
PSWs should have the same right to appeal these decisions to the Divisional Court and such a provision should be included in the legislation.
Fees
In addition to our serious concerns about Due Process as just outlined, we are extremely concerned about fees being imposed for PSWs. PWSs cannot be expected to take on extra costs.
We understand that fees have not yet been set but the legislation clearly contemplates fees being imposed.
For example, in O. Reg. 217/24 Registration, there are provisions that deal with fees being payable with registration applications, suspension for non-payment of fees, etc. Examples from O. Reg. 217/24:
- Application for registration
- An applicant may apply for registration by submitting an application to the Chief Executive Officer together with any applicable fees set by the Authority pursuant to section 50 of the Act.
- Requirements for certificate of registration, any class
- (1) The following are the standards and qualifications for registration:…
- The applicant must pay the required registration fee, if any.
- Suspension for non-payment of fees
- (1) If a registrant fails to pay a fee that they are required to pay, the Chief Executive Officer shall give the registrant notice of intention to suspend the registrant and may suspend the registrant’s registration for failure to pay the fee 30 days after notice is given.
(2) If the Chief Executive Officer suspends a registrant’s registration pursuant to subsection (1), the Chief Executive Officer shall lift the suspension on the payment of,
- (a) the fee the registrant failed to pay; and
- (b) any other required fees.
Despite the fact that the legislation clearly contemplates fees for registrants, there has been no information provided about what fees may be imposed and when this may happen. The lack of transparency is astonishing.
You have suggested to us that we would no doubt be consulted. CUPE and its members have not been consulted about the impact fees may have on PSWs and have no reason to believe we would be given our questions and concerns about fees have gone unanswered for several years at this point. The threat of the fees alone is a burden on our members, and we demand that clarity be provided in this regard.
Privacy and Safety Concerns with the Public Register
CUPE has serious concerns around the potential for abuse of a registry being made available that lists PSW’s legal and used names, gender, and the current facility where they work.
This reduced level of privacy is a clear and present danger to those registrants who are experiencing intimate partner violence, abusive relationships, stalking or other situations where privacy is essential for personal safety.
It is not clear in the rules around the register (O. Reg. 218/24: REGISTER) that exemptions will be made to shield registrants’ personal information when their health and safety is compromised, threatened, or in danger. What limited sections are written into the rules are poorly drafted and unclear.
As we mentioned during our meeting, we welcome the dialogue and look forward to meeting again when you have had an opportunity to review our concerns. We also hope to hear from the government decision makers directly, in response to our requests to meet with them.
Yours sincerely,
Michael Hurley,
President,
Ontario Council of Hospital Unions-CUPE
Debra Maxfield,
Chair,
Health Care Workers Coordinating Cttee.
