Mandatory Reporting Obligations Sexual Abuse of Patients
The Regulated Health Professions Act (RHPA) requires certain people (regulated health care providers including physiotherapists and facility operators (employers)) to file a mandatory report with a
regulatory College if they have “reasonable grounds” to believe that a physiotherapist or member of another regulated health care profession has sexually abused a patient. The legislative requirement can be found in section 85 of the Health Professions Procedural Code which is Schedule 2 of the Regulated Health Professions Act.
This fact sheet is intended to provide information for potential reporters of sexual abuse to assist them in understanding their professional reporting obligations. Additional information can be obtained by referring to the Professional Reporting Obligations Briefing Note or by contacting the Director, Professional Conduct at 416-591-3833/1-800-583-5885 ext. 233 or at investigations@collegept.org.
What is Sexual Abuse?
The legislation defines sexual abuse of a patient as:
(a) sexual intercourse or other forms of physical sexual relations between the regulated health care provider and the patient,
(b) touching, of a sexual nature, of the patient by the regulated health care provider, or
(c) behaviour or remarks of a sexual nature by the regulated health care provider towards the patient.
It does not include touching, behaviour or remarks of a clinical nature appropriate to the service provided.
When and how soon do I have to report?
A registrant must make a mandatory report to the College within 30 days of learning of the incident if he or she has “reasonable grounds”, obtained while practising physiotherapy to believe that a registrant has sexually abused a patient
A person who operates a facility shall file a mandatory report within 30 days if the person has reasonable grounds to believe that a regulated health care provider who practises at the facility has sexually abused a patient.
If the reporter has reasonable grounds to believe that the regulated health care provider will continue to sexually abuse the patient or will sexually abuse other patients, the report must be filed immediately.
What are reasonable grounds?
This question sometimes involves a judgment call. Rumour or innuendo does not constitute reasonable grounds however concrete information from a credible source such as a patient, the parent of a patient, a guardian or custodian, or other third party could all be sources of credible information. A registrant may have reasonable grounds to suspect that a patient has been sexually abused even if he or she has not spoken to the patient.
What information should the report include?
The report should include:
- the name of the person filing the report
- the name of the regulated health care provider who is the subject of the report
- an explanation of the alleged sexual abuse
- the name of the patient (with written consent of the patient having been obtained)
If written consent from the patient or a substitute decision maker cannot be obtained, should I still send the mandatory report to the College?
If written consent from the patient or a substitute decision maker cannot be obtained, should I still send the mandatory report to the College?
Yes. It would be appropriate to discuss the reporting
obligation with the patient, the patient’s representative or their substitute decision maker. Where it could be helpful, these individuals should be encouraged to contact the Director, Professional Conduct at the College for further information. If the patient or their representative remains uncomfortable with the patient’s name appearing in a report to the College, you must still submit a report to the College without the name of the patient.
Do I still have to submit a mandatory report if I do not know the name of the person who is allegedly committing the abuse?
No. A registrant is not required to file a mandatory report if he or she does not know the name of the registrant / member who would be the subject of the report.
Where should I send the Mandatory Report?
The report should be addressed to the Registrar of the appropriate College. If the report is concerning a physiotherapist, the mandatory report can be submitted online using the online form.
File a Mandatory Report
What happens if an individual fails to make a mandatory report required by the RHPA?
Failure by a person to make such a report where required may result in prosecution and upon conviction a fine up to $25,000 for a first offence and up to $50, 000 for a subsequent office. If the reporter is a regulated healthcare provider, their respective College may also take action.
Where a facility fails to file a mandatory report where required to do so, failure to make such a report may result in prosecution and upon conviction a fine up to $50,000 for a first offence and up to $200, 000 for a subsequent office.
What happens once the College receives the report?
The Office of the Registrar will determine if additional investigation is required. The results of the investigation would be considered by a panel of the Inquiries, Complaints and Reports Committee of the College which is comprised of representatives of the public and the profession.
How does a physiotherapist respond to the report?
The ICRC will not make a final decision on a matter without the physiotherapist having the opportunity to respond to the report in writing and possibly by way of meeting with an investigator. The physiotherapist will also be provided with a summary of the investigation for their review. In the event that he or she chooses to make submissions, these submissions will also be considered by the panel.
What information will the College share with me after I submit the mandatory report?
The physiotherapist and the College are the only parties involved in the process. As such the outcome of the process is not shared with the individual who submitted the mandatory report to the College. In the event that the matter is referred to the Discipline Committee for a hearing, the College may ask the reporter to participate in the hearings process as a witness. Decisions of the Discipline Committee are available to the public.
Can the ICRC revoke a physiotherapist’s Certificate of Registration?
No. A physiotherapist’s certificate of registration may only be revoked as a result of a finding made by either the Discipline Committee or the Fitness to Practice Committee.
In rare circumstances the ICRC may direct the Registrar to suspend or impose terms, conditions or limitations on a member’ s certificate of registration through an Interim Order. This will only be considered in cases where the matter has been referred to the Discipline Committee or the Fitness to Practice Committee for a hearing and it is the opinion of the ICRC that immediate action is required to protect the public interest.
What decisions can the ICRC make?
The panel may where appropriate:
- Refer the matter to the Discipline Committee for a hearing
- Refer the matter to a Health Inquiry Panel for health related inquiries, which could result in a result in a referral to the Fitness to Practise Committee for a hearing
- Issue a verbal caution
- Require the physiotherapist to take part in a specified continuing education and remediation plan
In addition, the panel could:
- Take no further action
- Issue guidance, advice and/or recommendations to the physiotherapist
- Issue a written caution
- Invite the physiotherapist to participate in a remediation plan as defined in an Acknowledgement & Undertaking
How long does the process take?
There are no timelines associated with these types of investigations as some investigations are quite detailed and extensive while others are relatively short. Given the sensitive nature of sexual abuse cases, these matters are processed as quickly as possible. Case status updtes can be obtained by contacting the Director, Professional Conduct at 1-800-583-5585 or 416-591-3833 ext. 233 or at investigations@collegept.org.