1. Information Sharing Strategy Regional Collaborative Service Delivery 2015

2. Areas to be Covered: Overview Information Sharing Strategy How to Share Information Legislation and Practices Moving Forward Further Learning and Resources Reality and Desired State

3. Information Sharing Strategy Vision Information sharing will improve service delivery to Albertans through increased collaboration across the Government of Alberta and service delivery partners. Goals (of this presentation) Culture of continuous improvement exists regarding information sharing practices

4. What is Information Sharing Improved information sharing means that the right information is available to the right people at the right time as they work collaboratively, resulting in better decisions and improved outcomes for Albertans. Ministry of Education School Authorities, Community Agencies, Partners, etc. Health, and Human Services Ministries Shared Information Shared Information Shared Information

5. Information Sharing Strategy Consulted social-based service staff and leaders across Alberta Shared responsibilities, clear expectations, and collaborative approaches Staff to feel safe, supported, and knowledgeable about sharing information Aligned to Alberta’s Social Policy Framework create a person-centered system of high-quality services; and enable collaboration and partnerships. Aligned to Inspiring Education “It’ll take every one of us to make a difference. To collaborate and move forward.” Government Direction Supported through two Minister Mandate Letters (from Premiers to Ministers) J

6. Definitions for the Presentation Child – under 18 (see Children First Act) Custodian – provides a health service (see Health Information Act) and for presentation includes Affiliates Parent – for presentation includes Guardians Disclosure Authority – able to use professional judgment and discretion to release information as described by legislation (“Collection” and “Use” also described in legislation) Consent for Information Sharing – is not the same as consent for treatment or assessment J

7. RCSD – Participants and Legislation Children First Act -personal and health information related to a child (under 18) Health Information Act (Custodian) –Alberta Health, Alberta Health Services, and regulated members of health professions designated as custodians under the HIA (Physicians, Pharmacists, Registered Nurses) Either HIA or FOIP – depends on type of service provided – depends on type of information, and – depends who is employer/contractor FOIP Act (personal information) – public bodies ( someone employed by Human Services or a school jurisdiction) Personal Information Protection Act – private sector - private schools (and ECS operators) OrganizationsEmployeesAssociations S

8. Best Practices 1 to Disclose Critical Thinking Knowledgeable of legislation Authority within organization to disclose Apply professional judgment Relationship Building and Communication Dialogue between sharing partners Inform parents / clients (even when consent not needed) Use and Disclosure Disclose only the minimum information necessary to carry out the purpose in a reasonable manner Record the disclosure (or decision not to disclose) S 1 May also be legal requirement.

9. Consent Confusion Referral Consent for Treatment Record with Personal / Health Information Declaration Notification Direct Collection of Information Disclosure Authorized by Legislation Treatment, Assessment, or Service Rules for disclosure Authority to collect Treatment, Assessment, or Service Consent for Information Disclosure Rules for disclosure Minimum Written Rules for disclosure Minimum Written

10. Current Policy Encourages Appropriate Disclosure Current Provincial Privacy legislation (FOIP, HIA, PIPA, & CFA) allow for information sharing within defined parameters Personal and health information will be shared between government and human services delivery partners where necessary for collaborative service delivery or where required for health and safety. - Cabinet approved November 2012

11. How to Share Information Asked to share an individual’s personal or health information Who is the request from? (role and verify) Why do they need the information? (determination and amount) Parent Police Public School Private School Nurse Case Worker

12. Who are you? Who are you employed by or providing services for? (which legislation may provide authority) What information is requested? (personal or health)

13. Enabling: Health Information Act (HIA) To a person responsible for providing continuing treatment and care to the individual [35(1)(b)] or To any person to avert or minimize: the risk of harm to the health or safety of a minor [35(1)(m)(i)]; or an imminent danger to the health or safety of any person [35(1)(m)(ii)] or With consent [34(1-2)] Health Information Custodian Least amount of information

14. Enabling: Children First Act Supports Disclosure through a two part test: Part 1 For the purposes of enabling or planning for the provision of services or benefits to a child; and Part 2 If, in the opinion of the custodian making the disclosure, the disclosure is in the best interests of the child. Health Information Custodian

15. Enabling: Children First Act (CFA) To a guardian Supports Disclosure through a two part test: Part 1 Disclosure is in best interests of child; and Part 2 Child does not expressly request no disclosure Health Information Custodian

16. Enabling: FOIP Act To avert or minimize: the risk of harm to the health or safety of a minor [40(1)(ee)(i)]; or an imminent danger to the health or safety of any person [40(1)(ee)(ii)], or For the purpose it was collected or for a use consistent with that purpose [40(1)(c)], or To an employee of a public body if necessary for the delivery of a common or integrated program or service [40(1)(i)], or With consent [40(1)(d)] Personal Information Public Body

17. Common or Integrated Program or Service Some Attributes (FOIP Act) Legislative authority for the bodies to work together. Common goals expressed in the program description or business plan. A formal agreement between public bodies, with proper authorization, explaining their roles and how the components fit together. Evidence of joint planning. A formal agreement or legislative authority for working together. Terms of reference authorized or approved by heads of the public bodies. Joint planning between the public bodies, Collaboration or coordination in delivery in order to achieve common objectives or goals. Clear delineation of services being jointly delivered from those that are not. S

18. Enabling: Children First Act Supports Disclosure through a two part test: Part 1 For the purposes of enabling or planning for the provision of services or benefits to a child; and Part 2 If, in the opinion of the service provider making the disclosure, the disclosure is in the best interests of the child. Personal Information Service Providers Child Parent S

19. Enabling: Children First Act To a guardian Supports Disclosure through a two part test: Part 1 Disclosure is in best interests of child; and Part 2 Child does not expressly request no disclosure Personal Information Service Providers S

20. Enabling: Personal Information Protection Act (PIPA) Consent required except where this Act provides otherwise… Disclosure without consent: 20(a) a reasonable person would consider that the disclosure of the information is clearly in the interests of the individual and consent of the individual cannot be obtained in a timely way or the individual would not reasonably be expected to withhold consent; 20(c) the disclosure of the information is to a public body and that public body is authorized or required by an enactment of Alberta or Canada to collect the information from the organization; Personal Information Private Schools

21. Law Enforcement Provisions FOIP to assist with an investigation [40(1)(q)] if the information is in respect of a minor or a parent or guardian of a minor and the head of the public body believes, on reasonable grounds, that the disclosure is in the best interests of that minor [40(1)(gg)] CFA Service providers, personal information about the child or about the child’s parent Custodians health information about the child only HIA that the information relates to the possible commission of an offence under a statute or regulation of Alberta or Canada [37(1)(a)]

22. Other Legislation: Student Record Regulation Student transfer - 8(1) If a student transfers to another school in Alberta, the board from which the student transfers shall, on receipt of a written request from that school, send the original student record containing the information to that school. Disclosure of information - 10 authorizations (including with consent) (g) in accordance with the Freedom of Information and Protection of Privacy Act. Children, Youth, and Family Enhancement Act (CYFEA) Any person who has reasonable and probable grounds to believe that a child is in need of intervention shall forthwith report the matter to the Human Services Minister’s designated person (director). (must disclose)

23. How Information Changes Health Custodian Health Custodian HIA School Public Body HIA CFA FOIP CFA Human Services Per. Info Same information held by different people Health Custodian FOIP CFA

24. Decisions Professional Judgment Conversation Discretion Authority Resources

25. When no consent form: If currently using unnecessary consent: May need new communication tool to create dialogue with parents May need revised business process / record keeping to document disclosure (not consent form) May be different requirements within legislations: Disclosure under the HIA for the purposes of continuing treatment and care, the recipient of the information must be informed in writing of the purpose of the disclosure and the authority under which the disclosure is made. S

26. If Consent is required – Streamline Consent Process Request consent as few times as possible Request consent at appropriate times Include robust notification about how information may be shared at time of direct collection Explain to client Respond to questions Collect appropriately (verbal, written)  No delay services  Uncomplicated process  Valid process S

27. Requirements for Consent (for information sharing) FOIP ActHealth Information Act Consent Requirements: Must specify to whom the personal information may be disclosed and How it may be used; and Must be signed, or meet requirements to be accepted if by electronic or verbal means. Consent Requirements: The identity of the person to whom it may be disclosed; The purpose for which it may be disclosed; An acknowledgement that the person consenting has been made aware of reasons for, and risk and benefits of consenting and not consenting; The effective date, and the date (if any) that it expires; and A statement that the person may revoke the consent at any time. When the information is being used for an inconsistent purpose When no authority to disclose is described in legislation S

28. Moving Forward

29. On-line Resources Available now: Children First Act Information Sharing (learning legislations) Information Sharing in Action (applying legislation)

30. Common supporting resources Information Sharing Strategy Information Sharing under the Children First Act Decision Tree Sharing Information to Avert or Minimize Risk of Harm Understanding Common Notification Parent (Client) Guide Best Interest of the Child Managing Risks Consent Notification Information Sharing Agreement Information Management Researching

32. “Help Desks” Health Education Human Services Staff Member District* (FOIP Coordinator) District* (FOIP Coordinator) ISS Office Organization* Information Privacy Office GOA employee GOA Staff Member HIA Help Desk AHS Privacy Intake Line AHS Staff Member Organization* *role of “organization” varies Service Alberta

33. Achieving Balance Individual’s Right to Privacy Improved Outcomes / Access to Services Limiting information (authorized and necessary) Public Safety & Security Information Sharing Promote culture shift away from the current risk-averse to the desired state of risk-managed

34. Barriers to information sharing Multiple consent forms and different procedures and policies Lack of clarity using ‘sensitive information’ Rules not widely shared or not easy to understand Inconsistent application of relevant legislation Lack of consistent training for all levels Fear of reprisal when making decisions to share information

35. Desired State Application Staff apply knowledge and skill in sharing personal and health information for decision making that supports students Continuous Improvement Researched and evidenced-based practices sustain and advance a culture of appropriate information sharing Leadership Leaders support innovation and build capacity for appropriate information sharing through policy and governance Infrastructure Personal and Health information shared is safeguarded by the organization disclosing and organization receiving the information

36. Information Sharing Strategy Office HS.infosharing@gov.ab.ca 780.638.1372 Education Contact Stephen.M.Wright@gov.ab.ca 780-644-4496