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Location: Consent and Capacity Board > Publications > Annual Reports > Annual Report 2003 - 2004 (HTML)

Coat of Arms

CONSENT AND CAPACITY
BOARD

Office of the Chair and CEO
Theodore Nemetz



June 30, 2004



The Honourable George Smitherman
Minister of Health and Long-Term Care
80 Grosvenor Street
10th Floor, Hepburn Block
Toronto, ON M7A 2C4

Dear Minister:

Re: Consent and Capacity Board

On behalf of the Consent and Capacity Board, it is my pleasure to submit our 2003/2004 Annual Report pursuant to the MBS Agency Establishment and Accountability Directive.

Yours sincerely,






Theodore Nemetz
Chair and CEO
Consent and Capacity Board




Consent and Capacity Board
2003/2004 Annual Report



Coat of Arms

TABLE OF CONTENTS


OVERVIEW OF THE BOARD

JURISDICTION OF THE BOARD

ORGANIZATIONAL CHALLENGES

CONTINUING IMPACT OF LEGISLATIVE CHANGE

BOARD MEMBERSHIP

BOARD PERSONNEL

FINANCIAL ANALYSIS


OVERVIEW OF THE BOARD

The Consent and Capacity Board is an independent body created under the Health Care Consent Act by the provincial government. The Board conducts hearings under the Mental Health Act, the Health Care Consent Act, the Substitute Decisions Act and the Long-Term Care Act. The Board functions under statutory requirements and a memorandum of understanding between the Chair, the Minister of Health and Long-Term Care, and the Deputy Minister of Health and Long-Term Care.

Board members are psychiatrists, lawyers or members of the general public. For the vast majority of its cases, the Board is required, by law, to sit in panels of three (lawyer, psychiatrist and community member) or in panels of five. A small number of cases may be heard by a Senior Lawyer Member (who meets certain legislated criteria) sitting alone. The Board is divided into six districts and while members are appointed province wide, for the most part, members adjudicate within their own district and travel to other districts as required.

The district structure has just been completed. There had previously been nine geographical regions corresponding to the locations of the former Provincial Psychiatric Hospitals. The Board has completed transition incorporating the creation of six districts that can be rationalized having regard to a number of criteria, including costs, resources and community if interest. The Board has now divided the province into the same regions/districts used by the Ministry of Health and Long-Term Care.

The reconfigured regional structure will provide for a district director to be responsible for each of the districts in accordance with authority that may be delegated by the chair of the Board from time to time. Primarily, the district directors will be responsible for liaison with the stakeholders within the district and to act as a resource for the Board members within their district.


JURISDICTION OF THE BOARD

The Board has authority to hold hearings to deal with the following matters:

Health Care Consent Act

Mental Health Act

Substitute Decisions Act

Long Term-Care Act


ORGANIZATIONAL CHALLENGES

During the fiscal year 2003-2004 the Consent and Capacity Board focused on organizational challenges in two key areas: membership renewal and administrative restructuring. Membership renewal is an ongoing challenge for the Board, but particularly so over the past two years. The high rate of renewal and growth among members has had a significant impact on Board resources. The administrative restructuring is essentially complete. All case co-ordination is now centralized in Toronto with the stakeholders being able to contact the Board office through a local telephone and fax number.

The Board is continuing to assess its needs to ensure that the very best candidates are put forward for membership. Over the years, the Board has developed a rigorous screening program for candidates in an effort to ensure that the qualities and expectations of both the candidate and the Board are a good match. The Board also tries to have each member sit regularly to ensure they remain up-to-date with the adjudicative process.

In 2003-2004, Board membership continues to change as new members are appointed to replace those members whose terms have expired. To more efficiently deal with the volume of training required, the Board created and implemented an intense central, formalized training program.

The centralization of the case coordination has resulted in the ability to begin to develop much needed technology systems that allow for case management, tracking and control of the ever increasing numbers of matters that are coming before the Board. It also allows for the ability to collect and analyse data in order to identify and meet the needs of the Board and its stakeholders.

The Board engaged in-house Counsel who is responsible for publishing the Board’s decisions on-line at www.Canlii.org. The availability of the Board’s decisions on-line at no charge allows all of our stakeholders to view the case law as it is evolving and allows them to be better prepared for hearings. The Counsel also acts as a resource to the members finding precedents. This will bring about a more consistent approach by all members in their decision making.

In the upcoming year the Board intends to embark on strategic review of its service delivery to achieve optimum performance.


CONTINUING IMPACT OF LEGISLATIVE CHANGE

Mental Health Legislative Reform, 2000 (Bill 68) made several changes to the Mental Health Act and the Health Care Consent Act, including the following:

The amendments, which came into effect December 1, 2000, expanded the role and function of the Consent and Capacity Board to include optional review of Community Treatment Orders and a mandatory review of the second consecutive order and every second order thereafter. Reviews of involuntary committal are substantially longer than before because the changes to the legislation essentially tripled the number of potential factors to be considered. Furthermore, as a result of the amendments, the Board is now required to conduct a hearing into the patient's relevant decision-making capacity virtually every time a hearing is convened for any purpose under the Health Care Consent Act. Overall, the Board is doing more hearings and those hearings are greater in length, more complex in nature, and significantly higher in sensitivity. In the result more panels are required to deal with the ongoing hearings.

The number of CTO applications has increased (62 in this fiscal year) and are very time consuming. In addition the required mandatory review of CTO’s has added additional hearings. As the use of CTOs grows there will be more mandatory reviews which come with each second renewal. The expanded involuntary committal criteria continues to have significant implications for the Board's resources because of the length of the hearings. Hearings also take longer because lawyers and physicians are still familiarizing themselves with the nuances of the amendments to the legislation. There have been 5 appeals taken from decisions of the Board concerning Community Treatment Orders but only 3 have been dealt with by the Court up to this time. There is still much needed judicial direction needed.

Ontario has always been seen as a leader in the area of mental health and consent law. Because of the aging population, and increased interest and changing views with respect to mental health law and services, the Ontario experience in this area is subject to an ever-increasing level of legal, academic and public interest. Not surprisingly, the amendments to the legislation in 2000 significantly increased the level of legal scrutiny, as well as, public and academic interest – both in Ontario and internationally. Consequently, the decisions and work of the Board are undergoing closer scrutiny than ever before. For the first time, the Supreme Court of Canada heard and ruled on a case on appeal from the Consent and Capacity Board. As more appeals are heard by the Superior Court of Justice and Court of Appeal conflicting jurisprudence will be resolved.


BOARD MEMBERSHIP

Member Date First Appointed Date Current Term Expires

Chair
   
Mr. R. John Harper

September 3, 1997

March 31, 2004

Lawyer Members

   
Mr. K. Atkinson April 25, 2001 April 24, 2004
Mr. C. Bondy February 21, 2001 February 20, 2004
Ms. F. Boody-Hunter July 31, 2001 July 30, 2004
Ms. M. Campbell July 10, 2003 July 9, 2006
Mr. P. Capelle May 17, 1999 May 16, 2005
Mr. R. A. R. Carleton November 21, 2001 November 20, 2004
Mr. T. Charuk November 22, 2000 March 31, 2007
Mr. P. Clay October 16, 2002 October 15, 2005
Ms. M. Field-Marsham October 2, 2002 October 1, 2005
Mr. A. Fish October 22, 1997 October 21, 2003
Mr. N. Forest December 12, 2001 December 11, 2004
Mr. W. Gay January 13, 1999 January 12, 2005
Mr. J. Goldenberg November 1, 2000 October 31, 2003
Mr. G. Goulard June 30, 2000 June 29, 2006
Mr. M. Handelman May 13, 1998 May 12, 2004
Mr. D. A. Harris November 21, 2001 November 20, 2004
Mr. M. Hennessy August 21, 2003 August 20, 2006
Mr. H. A. Hubbard July 4, 2001 July 3, 2004
Mr. G. A. Hurtubise June 1, 1986 April 2, 2003
Ms. J. Jacob April 3, 1995 April 2, 2007
Ms. C. Jones June 1, 1986 April 2, 2003
Ms. S. Kert March 24, 2004 March 23, 2007
Ms. C. Lafrenière December 12, 2001 December 11, 2004
Mr. D. Lewis October 9, 2002 October 8, 2005
Ms. K. Lindsay-Skynner April 3, 2002 April 2, 2005
Mr. F. McArdle April 15, 2003 April 14, 2006
Mr. M. McCue July 8, 1998 July 7, 2004
Mr. J. McNair August 24, 1998 August 23, 2004
Mr. I. McTavish June 1, 1986 April 2, 2007
Ms. S. Meyrick March 26, 2003 March 25, 2006
Mr. G. Michener October 2, 2002 October 1, 2005
Mr. T. Nemetz December 4, 1996 December 3, 2004
Mr. M. Newman October 21, 1998 October 20, 2004
Mr. A. Nicol October 27, 1999 October 26, 2005
Ms. C. Noble February 21, 2003 February 20, 2006
Mr. P. O'Neil May 16, 2001 May 15, 2004
Ms. S. Opler November 21, 2001 November 20, 2004
Ms. M. Phillips September 5, 2000 September 4, 2006
Mr. D. Ramsbottom May 17, 1999 May 16, 2005
Mr. J. D. Shanks March 20, 2002 March 19, 2005
Mr. R. Sharda February 27, 2002 February 26, 2005
Mr. S. Srivastava June 1, 1989 April 2, 2003
Mr. B. Starkman February 27, 2002 February 26, 2005
Mr. L. Steacy March 24, 2004 March 23, 2007
Mr. K. Walker November 7, 2001 November 6, 2004
Mr. J. Wilson November 9, 2000 March 31, 2004
Ms. J Zamprogna-Ballès January 13, 1999 January 12, 2005
Psychiatrist Members

   
Dr. N. Alam January 13, 1999 January 12, 2005
Dr. S. Allain April 3, 1995 April 2, 2004
Dr. F. Allodi February 21, 2001 February 20, 2005
Dr. J. Atcheson June 5, 1987 April 2, 2003
Dr. L. Bassarath July 4, 2001 July 3, 2004
Dr. R. Bhatla November 22, 2000 March 31, 2004
Dr. R. Billings January 24, 1985 April 2, 2005
Dr. D. Braden October 6, 1999 October 5, 2005
Dr. M. Brennagh June 5, 1996 June 4, 2003
Dr. D. Byers June 1, 1983 April 2, 2003
Dr. S. Calleia December 15, 1988 April 2, 2004
Dr. G. A. Chaimowitz July 4, 2001 July 3, 2004
Dr. R. Chandrasena June 1, 1986 April 2, 2006
Dr. P. Chang January 13, 1999 January 12, 2005
Dr. Y. Charbonneau August 23, 1993 April 2, 2004
Dr. P. E. Cook July 4, 2001 July 3, 2004
Dr. A. Côté October 23, 1986 April 2, 2004
Dr. I. Côté June 30, 2000 June 29, 2006
Dr. G. daCosta June 2, 1989 April 2, 2003
Dr. R. Denson January 3, 2003 January 2, 2005
Dr. D. Deshauer November 22, 2000 November 21, 2003
Dr. J. Dougan October 23, 1986 April 2, 2003
Dr. L. Fernando June 13, 2001 June 12, 2004
Dr. R. Fleming June 5, 1996 June 4, 2006
Dr. F. W. Furlong February 16, 2000 February 15, 2006
Dr. J.G. Gagnon June 30, 2000 June 29, 2003
Dr. D. A. Galbraith January 13, 1994 April 2, 2006
Dr. J. T. Glaister May 17, 1999 May 16, 2005
Dr. J. Handforth June 2, 1989 April 2, 2006
Dr. P. Hoaken January 22, 1987 April 2, 2007
Dr. D. Hopkins September 8, 1994 April 2, 2003
Dr. C. Hudson June 5, 1996 June 4, 2006
Dr. G. M. Irvine January 24, 1985 April 2, 2004
Dr. J. Jackson February 6, 2002 February 5, 2005
Dr. F. Jarrett August 24, 1994 April 2, 2007
Dr. J. Johnson July 23, 1993 April 2, 2007
Dr. A. Jones June 30, 2000 June 29, 2006
Dr. P. Kelly February 16, 2000 February 15, 2006
Dr. W. Komer December 18, 2001 December 17, 2004
Dr. D. Krstich December 15, 1988 April 2, 2003
Dr. E. MacLeod June 6, 1968 April 2, 2007
Dr. W. Maley February 6, 2002 February 5, 2005
Dr. R. Manchanda June 17, 1993 April 2, 2006
Dr. K. Martin February 6, 2002 February 5, 2005
Dr. P. Max June 30, 2000 June 29, 2006
Dr. H. M. Meier June 1, 1986 April 2, 2006
Dr. A. Miller January 1, 1979 April 2, 2004
Dr. J. Nkansah October 23, 1986 April 2, 2005
Dr. J. Pellettier October 2, 2002 October 1, 2005
Dr. E. Perez January 24, 1985 April 2, 2004
Dr. E. Persad March 24, 2004 March 23, 2007
Dr. E. R. Pohlman June 30, 2000 June 29, 2006
Dr. Q. Rae-Grant June 5, 1996 June 4, 2006
Dr. E. Ralyea June 5, 1996 June 4, 2006
Dr. G. Shugar April 7, 2001 July 3, 2004
Dr. M. Silverman July 11, 1990 April 2, 2004
Dr. C. Stevenson June 5, 1996 June 4, 2006
Dr. W. Surphlis July 4, 2001 July 3, 2004
Dr. R. Swinson June 5, 1996 June 4, 2003
Dr. M. Tremblay November 20, 1992 April 2, 2004
Dr. J. Wilkes July 4, 2001 July 3, 2004
Dr. L. Wright July 4, 2001 July 3, 2004
Community Members

   
Mr. R. Aaronson August 1, 2003 July 31, 2006
Mr. K. Abell June 21, 2000 June 20, 2006
Mr. R. Adams June 30, 2000 June 29, 2006
Mr. J. Anderson July 8, 1998 July 7, 2004
Ms. V. Ariemma November 21, 2001 November 20, 2004
Ms. B. D. Atlin February 16, 2000 February 15, 2006
Mr. J. Balfe December 12, 2001 December 11, 2004
Mr. M. Berger July 4, 2001 July 3, 2004
Ms. L. Carpenter March 24, 2004 March 23, 2007
Ms. S. Carson February 16, 2000 February 15, 2006
Ms. H. Cutaia-Mahler July 10, 2003 July 9, 2006
Ms. V. Donovan May 17, 1999 May 16, 2005
Ms. L. D. Eccles December 16, 1998 December 15, 2004
Ms. L. J. Ferguson July 8, 1998 July 7, 2004
Ms. S. Green February 27, 2002 February 26, 2005
Ms. C. Guilbault July 10, 2003 July 9, 2006
Mr. D. Hoff February 27, 2002 February 26, 2005
Ms. B. Hodgson August 21, 2003 August 20, 2006
Ms. J. James October 6, 1999 October 5, 2005
Ms. F. Kapasi December 16, 1998 December 15, 2004
Ms. J. Laking July 11, 2001 July 10, 2004
Mr. R. Lanthier May 6, 1999 May 5, 2005
Ms. I. Larin December 16, 1998 December 15, 2004
Ms. S. LeBlanc June 1, 1986 April 2, 2003
Mr. P. Lessard May 28, 2003 May 27, 2006
Mr. B. Levey June 30, 2000 June 29, 2006
Ms. J. Limina August 24, 1998 August 23, 2004
Ms. F. Lissaman September 11, 1998 September 10, 2004
Ms. M. Lundstrom February 8, 1996 February 7, 2005
Ms. S. Machel May 28, 2003 May 27, 2006
Ms. J. Mackenzie October 6, 1999 October 5, 2005
Ms. H. McCartney-Oostrom June 30, 2000 June 29, 2006
Ms. S. Meagher July 8, 1998 July 7, 2004
Mr. A. Mete July 10, 2003 July 9, 2006
Ms. P. Muldowney-Brooks May 17, 1999 May 16, 2005
Mr. M. Omilon May 6, 1999 May 5, 2005
Mr. F. Ouellette July 8, 1998 July 7, 2004
Mr. T. Pappas October 2, 2002 October 1, 2005
Mr. P. Petrides August 21, 2001 August 20, 2004
Mr. P. Philion December 18, 2001 December 17, 2004
Ms. D. Pitts October 6, 1999 October 5, 2005
Mr. P. E. Ralph February 6, 2002 February 5, 2005
Ms. E. Rankin Nash October 21, 1998 October 20, 2004
Ms. D. Reiche May 17, 1999 May 16, 2005
Ms. J. E. Robins-Holm July 4, 2001 July 3, 2004
Mr. G. Strang September 24, 2003 September 23, 2006
Ms. L. Watson February 16, 2000 February 15, 2006
Mr. A. Wotherspoon June 24, 1998 June 23, 2004


BOARD PERSONNEL

As of March 31, 2004

R. John Harper Chair
Jim Curren Chief Operating Officer and Registrar
Stephanie Miller Executive Assistant
Joaquin Zuckerberg Legal Counsel
Lori Coleman Deputy Registrar
Janet Martell Coordinator, Business Operations
Margaret James Administrative Officer
Queenie Wan Financial Assistant
Jitka Christof Secretary
Angie Grande Senior Case Coordinator
Paula Cabral Case Coordinator
Rosa Cirillo Case Coordinator
Kareen Afarian Case Coordinator
Amy Viveiros Case Coordinator
Michael Blakely Case Coordinator
Lorissa Sciarra Case Coordinator
Erin Sullivan Case Coordinator
Florence Douglas Intake Officer
Shaun Subica/Andrea Ramdeo Inquiry Officer


FINANCIAL ANALYSIS

Financial Expenditure Report (April 1, 2003 to March 31, 2004)

  Internal
Allocation

Actual
Expenditures

Surplus
(Deficit)

DIRECT OPERATING EXPENSE      
Salaries and Wages 553,300 618,638 ($65,338)
Benefits

66,100

80,979

($14,879)

Subtotal $619,400 $699,617 ($80,217)


OTHER DIRECT OPERATING EXPENSES
     
Transportation and Communications
334,300
482,754
($148,454)
Services
2,031,300
3,535,222
($1,503,922)
Supplies and Equipment

58,600

51,876

$6,724

Subtotal $2,424,200 $4,069,852 ($1,645,652)


TOTAL OPERATING EXPENSES


$3,043,600


$4,769,469


($1,725,869)


The major cost driver for the Board is the conduct of hearings. The Board has no discretion regarding the holding of hearings. Board decisions impact on the life and individual liberty of people in Ontario and are usually urgent in nature. The Board has a statutory obligation to commence a hearing on an application within seven calendar days.

Additional costs for scheduling and Board members' travel are attributed to the growth in the number of hearings under the Health Care Consent Act and the Substitute Decisions Act which require the Board to hold hearings in residences, local hospitals, etc. A shortage of psychiatrists in some regions requires that some of the members incur considerable travel costs to attend hearings in other regions.

Board caseload has been increasing annually. For example, applications have increased from 3,678 in 2002/2003 to 4,152 in 2003/2004. Board caseload has also been increasing in intensity. Hearings that are more complex have resulted in increased requests for written reasons, increased need for the services of court reporters and in appeals to the courts.

In November 2003 the Board moved to using court reporters for all hearings in response to concerns raised by the Ombudsman about transcripts. A significant portion of our deficit was a result of this change.