ISBN 978-1-4601-4246-2 - Alberta

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This publication is issued under the Open Government Licence – Alberta (http://open.alberta.ca/licence).Alberta HealthISBN 978-1-4601-4246-2 2018 Government of AlbertaReport Back: Addiction and Mental Health Stakeholder MeetingsContact: albertavaluingmentalhealth@gov.ab.ca2Government of Alberta Report Back: Addiction and Mental Health Stakeholder Meetings

ooSummaryoThe Government of Alberta met with stakeholders in Edmonton on August 8 and in Calgary on August 13, 2018 to collect feedback onproposals to improve care safety and quality, and consumer protections in addiction and mental health facilities and services. An onlinepublic survey was also available from August 16 to September 14, 2018.84 attendees – 53 in Edmonton and 31 in Calgary – represented persons with lived experience, families and advocates, operators,Indigenous communities, experts, Alberta Health Services and cross-ministry representatives.Overall, stakeholders were supportive of developing core standards and quality assurance mechanisms as an important step towardsimproving addiction and mental health services for Albertans.Continuous quality improvemento It was widely recognized that successful regulation of addiction and mental health services and facilities requires standards to bedeveloped and implemented in a culture of continuous quality improvement and learning. We must clearly develop and implementstandards. Government should look to best practice and current research in core standards and quality assurance when developingtools, and engage operators in improving quality and safety of addiction and mental health services and facilities for Albertans.KeyThemes forCoreStandardsand QualityAssuranceA flexible and client-centered approach is requiredo The addiction and mental health sector is diverse and requires standards that enable operators to tailor their services to unique clientneeds. Differing needs of rural and urban populations, different types of service models (e.g. residential facilities versus dayprogramming) and the unique needs of Indigenous people means that there is no ‘one size fits all’ approach.Operator burdeno It is important that measures do not result in a loss of addiction treatment beds, decrease in programming, or increased costs beingpassed on to clients.Coordination and reducing duplication of efforto Operators reported that standards already exist in many facilities; it is important that new standards or quality assurance measures alignwith or complement existing requirements. For example, accredited facilities already have inspection and reporting requirements, somemunicipalities currently require licensing, and some organizations are developing public information repositories of addiction and mentalhealth services.Balancing information-sharing with privacyo Stakeholders supported the need for public access to more information about addiction and mental health services in Alberta to informdecision-making about their care. However, participants stressed that this must be carefully balanced with maintaining the privacy ofservice users. Reporting information to Alberta Health and publishing information about operators or facilities could identify vulnerableservice users, especially in small communities.Government of Alberta Report Back: Addiction and Mental Health Stakeholder Meetings3

ThemesCoreStandards4Proposed ApproachesComments ReceivedInformed Consent Approaches:o General informed consent regarding services and terms andconditions.Oro Written service contracts (services, terms and conditions, feesand refund policies, complaint processes, etc.).Informed Consent:o A client-centered and flexible process can reduce barriers andprotect the client and operator, but there may be issues withclient engagement or operator burden if the consent is tooonerous.Incident Reporting Approaches:o Government notified of all incidents (i.e. incidents that disruptservices or have potential to cause physical or mental harm toclients).Oro Government notified of critical incidents (e.g. deaths or seriousphysical or mental harms.Incident Reporting:o Well-defined standards can provide assurance and helpprevent harmful incidents, but may increase operator burden.Stakeholders identified that critical incidents (i.e. deaths andserious physical and mental harms) are most important toreportRecord Keeping and Reporting Approaches:o Operators must keep maintain a prescribed set of records (e.g.client’s clinical information (medication received, treatmentplan), client’s next of kin, staff files (qualifications, training),written service contract, incidents). Operators would need toreport certain information to Government (e.g. incidents) andthe Government could request further information, if needed.Oro Operators must keep records but the list of records is notprescribed. Operators share information/records with theGovernment only on request.Record Keeping and Reporting:o Well-defined standards can improve care, prevent harmfulincidents and protect operators; however, stakeholdersexpressed concerns regarding potential duplication of workand maintaining privacy of records.Impacted Operators Approaches:o Initially core standards apply to: All public and private AMH facilitiesOr‒ Only public and private residential addiction facilitiesImpacted Operators:o Core standards should apply to all public and private addictionand mental health services and facilities, through a phased-inapproach starting with public residential addiction services.Government of Alberta Report Back: Addiction and Mental Health Stakeholder Meetings

QualityAssuranceCompliance Scheme Approaches:o Contribute to improvements in safety and quality of carethrough: Registration; Licensing; or AccreditationCompliance Scheme:o Though a compliance scheme would help protect clients andproviders, stakeholders cautioned against a ‘one size fits all’approach.Quality Assurance Approaches:o Inspections as a result of incidents or complaintsOro Regular inspections AMH facilities and in response to incidentsor complaintsQuality Assurance:o Stakeholders supported regular and incident-triggeredinspection of facilities, but stressed the need for clear andrelevant definitions of incidents that would trigger aninspection.Provision of Information to the Public Approaches:o Government to publish information about: Operators, such as phone number, location(s), servicesoffered When operators are not in compliance with minimumstandards When there are incidents at AMH facilitiesOro Government does not publish information about operators orfacilitiesProvision of Information to the Public:o Publishing information about facilities would benefit Albertansmaking decisions about their or a loved one’s care; however,public reporting of incident and complaint information requiresa cautious approach and careful consideration.Government of Alberta Report Back: Addiction and Mental Health Stakeholder Meetings5

Appendix – List of AttendeesEdmonton (August 8, 2018) – 53 attendees in totalAlberta Community Council on HIVRecovery AcresAlberta Education – IndigenousMental HealthHealth CanadaBrain Care CentreOffice of Alberta HealthAdvocates (2 attendees)Parkinson AlbertaAlberta Community and SocialServices (3 attendees)United Way – Alberta Capital RegionAlberta College of Social Workers(2 attendees)Enoch Cree Nation #440Physician and Clinical PsychologistGeorge Spady SocietyCanadian Mental Health Association –Edmonton RegionCanadian Mental Health Association –Alberta DivisionLG’s Circle on Mental Health and AddictionPoliceWise for Children &FamiliesMember of VMH StakeholderGroupMNA (2 attendees)Society of Alberta OccupationalTherapistUniversity of Alberta – School of PublicHealthAlberta’s Chief Medical Officer ofHealthAlberta Health Services (3 attendees)Little WarriorsCommunity Mental Health Action PlanTreaty 8Eating Disorder Support Network of AlbertaSociety (2 attendees)Edmonton Mennonite Centre ofNewcomers/ Multicultural Health BrokersFamilies Supporting Adults with MentalIllness (2 attendees)Homeward TrustEagle Healing Lodge, SaddleLake (2 attendees)Alberta School BoardsAssociationAlberta School Councils’AssociationCanadian AccreditationCouncilAlberta Indigenous RelationsMetis Indian Town Alcohol AssociationPsychologists' Association of AlbertaTreaty 8 First Nations of Alberta –Treaty OfficeTreaty 8 Health Protocol tableCoordinatorAlberta College of PharmacistsCollege of Alberta PsychologistsStreetworks (2 attendees)Calgary (August 13, 2018) – 31 attendees in totalAlcove Addiction Recovery for women, Eden Valley Health CentreCalgary (2 attendees)Aventa (2 attendees)Kainai Wellness CentreAlberta Network for Mental HealthAssociation of Alberta Sexual AssaultServices (2 attendees)Person with lived experienceCity of CalgaryAlberta College of Social WorkersStony Trail Wellness CentreKerby Centre, CalgaryAlberta Health Services (4 attendees)Stoney Nakoda Tsuut'ina TribalCouncil (2 attendees)Tsuut’ina Health CentreHealth Sciences Association of AlbertaAlberta Pharmacists' AssociationSagesse6Calgary Homeless FoundationSchizophrenia Society ofAlbertaSheldon Kennedy ChildAdvocacy CentreCalgary Dream CentreAlberta Adolescent RecoveryCentre (2 attendees)The AlexGovernment of Alberta Report Back: Addiction and Mental Health Stakeholder Meetings

6 Government of Alberta Report Back: Addiction and Mental Health Stakeholder Meetings Appendix - List of Attendees Edmonton (August 8, 2018) - 53 attendees in total Metis Indian Town Alcohol Association Alberta Education - Indigenous Mental Health Alberta Community Council on HIV Office of Alberta Health Advocates (2 attendees)

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