The discipline process

When a complaint is made about a regulated health professional, there are several steps to investigate and resolve the case. The health professional regulatory colleges are responsible for some steps in the process, and the Discipline Tribunal is responsible for others. 

Overview of the discipline process

The discipline process may include these steps. 

Investigation

Under the Health Professions and Occupations Act (HPOA), the regulatory colleges are responsible for investigating complaints against health professionals. Once an investigation is complete, a regulatory college’s investigation committee decides whether there are reasonable grounds to believe the regulated health professional lacks competence or has committed misconduct.  

Sexual abuse cases

Sexual abuse complaints are handled differently from other cases. All resolutions of sexual abuse cases require written approval from the director of discipline. 

Sexual abuse, as defined in section 8 of the HPOA, generally means any actual or attempted sexual activity, touching or conduct that happens without consent, or when consent is obtained through exploitation or manipulation.  

Resolving sexual abuse cases

To resolve a sexual abuse case, the registrar of a regulatory college must request written approval from the director of discipline.  

Timeline: The Discipline Tribunal aims to decide on requests to resolve sexual abuse matters within 30 business days. 

Resolution by a registrar

A registrar may make an order which would resolve the case. There are limits on what disciplinary orders a registrar can make. 

Resolving matters with disciplinary orders

The director of discipline must provide approval for a registrar to issue certain disciplinary orders. The director must approve an order that:

• Requires a health professional take anti-discrimination measures
• Requires a health professional to undergo a competency assessment 
• Revokes a health professional’s practice authority 
• Imposes limits or conditions on a health professional’s eligibility to apply for reinstatement 
• Imposes limits or conditions on a health professional’s practice authority following a suspension 
• Imposes a monetary penalty or a requires the health profession to provide a refund 

Resolution by the Discipline Tribunal

The case is passed to the Discipline Tribunal if:  

• The college can’t resolve the case  
• A citation is requested 

Request for a citation

When a college’s investigation committee directs the registrar to request a citation, the registrar must: 

• Send the request to the director of discipline 
• Submit materials including the entire investigative record and the respondent’s disciplinary record  

The HPOA says that the director must issue the citation unless:  

• There is insufficient evidence to proceed  
• There are procedural fairness issues that cannot be addressed  
• The matter has been or will be addressed by another proceeding  
• The matter is better resolved by the college  
• It is not in the public interest to proceed  

Timeline: The director of discipline aims to complete all requests for a citation within 30 days.  

After a citation is issued

If the director of discipline issues a citation, the Discipline Tribunal must provide the regulatory college with a copy of the citation and then serve it on the health professional.  

Setting consent resolution deadlines

After a citation is requested, the parties can propose to cancel the citation and to resolve the matter with a disciplinary order. They can only do this before the consent resolution deadline.  When the director of discipline issues a citation, they must set a consent resolution deadline. Normally, this will be six months after the date the citation is issued.  

Case management process

After the citation is issued and before the consent resolution deadline, the complaint enters the Discipline Tribunal’s case management process.  

What to expect

The parties involved in the case must attend a case management meeting within 45 days of the citation being served on the health professional. During this meeting, and any other case management meetings, the Discipline Tribunal works with the parties to: 

• Identify a possible resolution of the case 
• Confirm or change the hearing date 
• Address any outstanding issues 
• Narrow the issues in dispute 
• Ensure the case is proceeding efficiently  

Request for mediation

As part of the case management process, parties involved in the case may request formal mediation with a mediator provided by the Discipline Tribunal. There is no charge for the mediator’s services but the rest of the costs of mediation must be paid for by the parties. 

If the case is resolved before the consent resolution deadline

If the parties agree on a resolution any time before the consent resolution deadline, they may make a proposal to cancel the citation and make a disciplinary order. If the director approves the proposal, the citation is cancelled and the colleges make the proposed order. 

Hearing management process

If a case has not been resolved after the consent resolution deadline, it enters the Discipline Tribunal’s hearing management process.  

What to expect

The parties are required to attend a hearing management meeting within 30 days of the consent resolution deadline.  

During this meeting, and any other hearing management meetings, the Discipline Tribunal works with the parties to:  

• Address any outstanding issues 
• Oversee the exchange of hearing information 
• Schedule and hear applications 
• Narrow the issues in dispute  
• Ensure the case is proceeding efficiently 

If the case proceeds to a hearing

In a hearing, the case is heard by a panel of three people. The discipline panel must include a member of the same regulated health profession as the health professional defending themselves against the allegations.  

Discipline Tribunal hearings are virtual and conducted on video unless the hearing panel decides that all or part of the hearing should be in person.  

Members of the public may attend a hearing unless a hearing panel decides that part of the hearing should be confidential. Similarly, all documents and exhibits used in the hearing are public except for some sensitive personal information or other material that a hearing panel decides should not be public. 

If the case is resolved before the end of a hearing

If the parties agree on a resolution of the case before the end of a hearing, they must submit an agreed statement of facts to the hearing panel.  The hearing panel will make the order that they decide is appropriate. 

Application for review

After a hearing where a panel has found that misconduct has occurred and made a disciplinary order, the parties to a hearing (the College and the health professional) and the complainant may apply to the director of discipline to review the decision of the panel.  

The director of discipline may hold a review hearing and may:  

• Confirm or change the hearing panel’s order 
• Issue a new order  
• Refer the matter back to the hearing panel 

Publishing orders and requests for citations

Regulatory colleges must publish all disciplinary orders and requests for citations issued against regulated health professionals at any stage of the discipline process. The director of discipline must review what the regulatory colleges have published and may require them to include more information.