Employer Responsibilities under the RHPA
Controlled Acts & Delegation
- 27. (1) No person shall perform a controlled act set out in subsection (2) in the course of providing health care services to an individual unless,
- the person is a member authorized by a health profession Act to perform the controlled act; or
- the performance of the controlled act has been delegated to the person by a member described in clause (a). 1991, c. 18, s. 27 (1); 1998, c. 18, Sched. G, s. 6.
The authority to perform most of the controlled acts can be delegated to another person including a regulated health professional as long as the delegation is made "in accordance with any applicable regulations under the health profession Act governing the member's profession" (RHPA S28. (1))
Registered Dietitians can be given the authority to order diagnostic procedures and treatments. This authority is transferred through a medical directive. The most common controlled acts delegated to Registered Dietitians are:
- skin pricking to collect a blood sample; and
- adjusting the dose of insulin (prescribing a drug).
A guide on the use of orders, directives and delegations is available online to address questions regarding the use of orders and delegation.
The Controlled Acts
The Regulated Health Professions Act defines the controlled acts and exemptions as follows:
- Controlled acts
- 27. (2) A "controlled act" is any one of the following done with respect to an individual:
- Communicating to the individual or his or her personal representative a diagnosis identifying a disease or disorder as the cause of symptoms of the individual in circumstances in which it is reasonably foreseeable that the individual or his or her personal representative will rely on the diagnosis.
- Performing a procedure on tissue below the dermis, below the surface of a mucous membrane, in or below the surface of the cornea, or in or below the surfaces of the teeth, including the scaling of teeth.
- Setting or casting a fracture of a bone or a dislocation of a joint.
- Moving the joints of the spine beyond the individual's usual physiological range of motion using a fast, low amplitude thrust.
- Administering a substance by injection or inhalation.
- Putting an instrument, hand or finger,
- beyond the external ear canal,
- beyond the point in the nasal passages where they normally narrow,
- beyond the larynx,
- beyond the opening of the urethra,
- beyond the labia majora,
- beyond the anal verge, or
- into an artificial opening into the body.
- Applying or ordering the application of a form of energy prescribed by the regulations under this Act.
- Prescribing, dispensing, selling or compounding a drug as defined in the Drug and Pharmacies Regulation Act, or supervising the part of a pharmacy where such drugs are kept.
- Prescribing or dispensing, for vision or eye problems, subnormal vision devices, contact lenses or eye glasses other than simple magnifiers.
- Prescribing a hearing aid for a hearing impaired person.
- Fitting or dispensing a dental prosthesis, orthodontic or periodontal appliance or a device used inside the mouth to protect teeth from abnormal functioning.
- Managing labour or conducting the delivery of a baby.
- Allergy challenge testing of a kind in which a positive result of the test is a significant allergic response. 1991, c. 18, s. 27 (2); 2007, c. 10, Sched. L, s. 32.
As of June 2009 the following controlled act will be added: - Treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual's serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual's judgement, insight, behaviour, communication or social functioning.
Exemptions to the Controlled Acts
- 27. (3) An act by a person is not a contravention of subsection (1) if the person is exempted by the regulations under this Act or if the act is done in the course of an activity exempted by the regulations under this Act. 1991, c. 18, s. 27 (3).
- rendering first aid or temporary assistance in an emergency;
- fulfilling the requirements to become a member of a health profession and the act is within the scope of practice of the profession and is done under the supervision or direction of a member of the profession;
- treating a person by prayer or spiritual means in accordance with the tenets of the religion of the person giving the treatment;
- treating a member of the person's household and the act is a controlled act set out in paragraph 1, 5 or 6 of subsection 27 (2); or
- assisting a person with his or her routine activities of living and the act is a controlled act set out in paragraph 5 or 6 of subsection 27 (2).
29. (1) An act by a person is not a contravention of subsection 27 (1) if it is done in the course of,
