Saturday, October 21, 2017

Self-Regulation...

Frequently Asked Questions

1. Are Paramedics in Manitoba regulated at this time?

Paramedics are currently government regulated in Manitoba. The Emergency Medical Services branch of Manitoba Health is responsible for regulating all EMS providers in accordance with the Emergency Medical Response and Stretcher Transportation Act. The EMS branch is also mandated to regulate EMS service providers and operators in the delivery of ambulance and emergency medical services.

2. Why should Manitoba paramedics be self-regulating if they are currently regulated by Government?

The purpose of regulation is to ensure that professionals practice in a safe, competent and ethical manner. One of the most persuasive arguments in favour of self-regulation is that a profession has evolved over time and developed a specialized body of knowledge which makes it increasingly difficult and expensive for the government to determine and monitor standards of practice for the profession. In such cases it is therefore thought that members of that profession are in the best position to set standards and to evaluate whether they have been met. Paramedics understand the profession and practice of paramedicine better than anyone else so it simply makes good sense for the public to have paramedics regulate themselves, as long as they do so in the public interest.

3. In the application for self-regulation, PAM suggests that annual College registration fees would be between $300 and $400. Elsewhere I have read that annual registration fees would likely be in the range of $500 - $550. What will registration in a Manitoba paramedic College cost?

While it's difficult to estimate the annual operating costs at this time, the Paramedic Association of Manitoba used other Canadian paramedic College fees as a benchmark to approximate the fees in our application. Paramedics are self-regulated in three other province...Alberta, Saskatchewan and New Brunswick. The 2012 registration fees in these jurisdictions range from $395 (NB.) to $425 (SK. and AB.) Taking into consideration that Manitoba has a higher number of practitioners to share the cost of operating a regulatory College than does New Brunswick, and the fact that Saskatchewan is recovering from two years of artificially low registration fees set by Government when their College was established, we are confident that our registration fees will fall into the suggested $300 - $400 range.

4. As a Paramedic in Manitoba today, there is no requirement for me to pay a licensing fee. Why should I have to pay a fee to register in a self-regulating College?

While it's true that Manitoba paramedics do not pay for licensing at this time, the current Government regulator could institute a fee at any time. The Emergency Medical Response and Stretcher Transportation Act allows for "prescribing the fee payable for the issuance of any license", including your EMS Provider License. Paramedic students will soon be paying a fee to write a national certification exam in order to license in Manitoba, and the current regulator has suggested they are actively considering an annual license fee for all paramedics in our province.

5. Many of the Technicians working in small towns and villages across the province don't make $400 as volunteer responders or EMS providers. What can be done to ensure College registration fees are not excessive for these individuals?

Registration fees are required to offset the cost of operating a regulatory College. Although licensing fees are not currently charged, Government does have the authority to prescribe a fee to issue or renew a license at any time. While PAM has suggested that the annual College registration fee would be between $300 and $400, we recognize that there will be need to consider a tiered fee structure based in part on license classifications.

6. I am employed in EMS Dispatch, and wonder how self-regulation would impact me. Under a self-regulatory College, would dispatchers have the opportunity to participate in continuing education that is pertinent to our position in the communications center?

The licensing of EMS Dispatch personnel is relatively new to the EMS profession in Manitoba (2006). It is anticipated that all EMS personnel currently licensed by Government would fall under the authority of a paramedic self-regulatory College, and that the various license levels could be subject to review as the transition to self-regulation is undertaken.

The Regulated Health Professions Act, which prescribes the duties and responsibilities of all health regulatory bodies, directs Colleges to establish a "continuing competency program to maintain the competence of the members and to enhance the practice of the regulated health profession ". That said we would expect that future continuing education programs be directed toward the needs of the license holder to ensure competency in his or her area of practice.

7. Would a paramedic College in Manitoba require members to carry liability insurance? Who would pay for the insurance?

In the application for self-regulation, PAM recommends that all licensed College members be required to carry liability insurance. One scenario would have the liability insurance included in the annual College registration fee, which is the way other paramedic Colleges in Canada handle this requirement (NB., SK., and AB.). Another scenario could have members purchase their liability insurance from a selected "third party", which is the method used by Manitoba Dental Hygienists. Regardless of the way that a Manitoba College chose to offer liability insurance to it's members, PAM is confident the cost for annual registration INCLUDING liability insurance would fall within the estimated $300 - $400.

8. Would members of a self-regulating College be subject to discipline by the College?

As a recognized profession under the Regulated Health Professions Act, a paramedic College would be required to receive and investigate complaints against registered members and initiate appropriate action to ensure the public is protected. Complaints would be considered by an Investigations Committee as defined within the legislation, composed of registered members of the College and one or more public representatives. All investigations would follow a well-defined and transparent process designed to ensure fairness and accountability.

Paramedics are currently government regulated in Manitoba. The Emergency Medical Services branch of Manitoba Health is responsible for regulating all EMS providers in accordance with the Emergency Medical Response and Stretcher Transportation Act. As the regulator they are responsible to receive complaints and conduct investigations. Typically, complaints are forwarded to employers for consideration, and as such do not follow a process well understood by the public or the practitioner.

Regardless of the regulatory model, paramedics are subject to investigation and discipline. In a self-regulatory environment, these processes are much more clearly defined, ensuring fairness and accountability for both the public and the practitioner.

9. Would a paramedic College define Scope of Practice for all paramedics? What impact would this have on EMS service delivery?

Self-regulation should be viewed as a partnership with Government under the Regulated Health Professions Act (RHPA) to regulate paramedics in order to protect the public from harm. Scope of practice for new self-regulated health professions is set by Government as outlined in the RHPA, and would require consultation and Ministerial approval to amend.

Scope of practice for Manitoba paramedics under the current regulatory model is extremely limited and relies heavily on medical delegation of authority (TOF). It is anticipated that scope of practice for paramedics regulated by a College would be more inclusive of competencies outlined in the NOCP. This would have no detrimental impact on EMS service delivery.

10. Would a College of Paramedics prevent cities such as Winnipeg, Brandon and Thompson from providing the same level of EMS service as they do today?

No. Self-regulation means that the government has granted a professional group, such as paramedics, the privilege and responsibility to regulate themselves. In essence, the paramedic profession would regulate their own members in order to protect the public from harm that could be caused by paramedics in the course of their practice. A College of paramedics would not regulate EMS service operators.

11. Would education be controlled by a self-regulating paramedic College?

A self-regulating paramedic College is NOT an educational institution. A regulatory College is responsible to set standards for education, registration and practice, and to assist members in meeting those standards.

A self-regulated profession may, in accordance with the Regulated Health Professions Act, approve education programs and competency requirements that must be met by graduates applying for registration in the profession. However, before approving or removing approval from any educational program, the regulated health profession must consult with Government.

The Regulated Health Professions Act does require health professions to establish a continuing competency program to maintain the competence of their members and to enhance the practice of the profession.

All matters related to standards of practice and competency are subject to consultation with College members, Government and affected stakeholders.


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