Sunset Criteria Review

1
Sunset Criteria Review

• Presentation by
• Rob Alder, Chair of HPRAC
• Health Professions Regulatory Advisory Council
• to the 2003 CLEAR Conference in Toronto, ON
• September 12, 2003

2
Disclaimer

• The enclosed material represents the views of
  HPRAC and is not endorsed by the Ministry of
  Health and Long-Term Care
• The Criteria Review is an internal project
  developed by HPRAC to update its policy documents
• There have been no referrals made to HPRAC on
  this issue

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What does the RHPA say about de-regulation?

• The RHPA offers the potential to consider
  de-regulation
• HPRACs mandate is clear under Section 11(1)(b)
  of the RHPA
• The Advisory Councils duties are to advise the
  Minister on whether regulated professions should
  no longer be regulated.
• Section 15 (2) of the RHPA
• The Advisory Council shall conduct its
  proceedings in the manner it considers
  appropriate.

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Sunset Criteria

• There are no criteria established under the RHPA
  for considering the de-regulation of a health
  profession
• Which factors should be considered in a sunset
  review?
• Are de-regulation criteria simply the reverse of
  the criteria for regulation?

5
Sunset Criteria

• HPRAC reviewed the process and criteria used in
  other jurisdictions when conducting sunset
  reviews
• Sunset reviews are important evaluations in
  providing indicators for system efficiencies
• Most sunset reviews have led to administrative
  changes to regulatory agencies
• De-regulation does not necessarily mean no
  regulation

6
Pew Health Professions Commission

• Recommended comprehensive sunset provisions be
  adopted by each state to ensure that regulatory
  bodies were operating in an effective and
  efficient manner
• The Taskforce recommended the following criteria
  be considered in sunset reviews

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Pew Commission Recommendations

• The regulatory program provides accurate, timely
  and comprehensive information to the public about
  the qualifications and practice history of the
  licensed professional
• The regulatory program encourages public
  participation in its policy development
• The regulatory body performs its operations,
  programs and statutory duties efficiently,
  effectively and expeditiously

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Pew Commission Recommendations

• The regulatory body protects consumers against
  incompetent, negligent, fraudulent or other
  illegal acts by licensed professional or
  unlicensed persons posing as professionals
• Continued regulation by the regulatory body is
  necessary and, if so, whether it should be
  changed
• The education, experience and testing
  requirements to ensure minimum competence, or
  whether they place undue burdens on those who
  want to enter the profession from within or
  outside the state

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Pew Commission Recommendations

• The practice authority of the regulated
  profession helps or hinders access to care
• The regulations have any deleterious economic
  impacts on practitioners, the public and the
  states business

10
Sunset Criteria Review - Key Questions from the
HPRAC Discussion Paper

• Are sunset reviews merely considerations of
  whether a profession is regulated or not? If
  sunset reviews are more, then what types of
  alternatives should be considered (eg.
  regulatory effectiveness improvements, College
  mergers, etc.)?
• What criteria ought to be considered during a
  sunset review?
• Should a sunset review consider evidence of a
  professions effectiveness? If so, should
  effectiveness of treatment modalities outweigh
  other factors relating to a professions
  effectiveness?

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Key Questions

• Given the economic costs associated with
  regulation, what economic factors should be
  considered during a sunset review?
• What criteria and/or process would ensure that a
  sunset review is transparent, consistent with,
  and protective of, the public interest?

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Next Steps

• Submissions in response to HPRACs Discussion
  Paper will be received until November 28, 2003
• HPRAC will review and analyze the submissions and
  revise its internal policy documents based on the
  input received from stakeholders