Investigative Reports

Own Motion Investigation – Programs Adrift

In Kevin Brezinski’s latest public report, systemic issues were uncovered within the Alberta Adult Health Benefit program and Alberta Child Health Benefit program, operated jointly by Alberta Health and Seniors, Community and Social Services (SCSS).

The Albertans accessing the programs are those with lower income who may be pregnant or have high ongoing prescription drug needs. The Ombudsman’s office received a number of complaints related to the programs which led to this investigation. Notably, one complaint of unfair treatment came from a father who applied for family benefits on multiple occasions due to serious health issues. However, he did not receive a decision on any of his applications.

“It’s always particularly concerning when the complaints come from Albertans who are vulnerable or rely on social programs for assistance,” said Brezinski.

The Ombudsman concluded his investigation with 28 recommendations and five observations. The improvements emphasize the urgent need for modernization and increased oversight within the programs to ensure equitable access to healthcare benefits for all eligible Albertans.

Programs Adrift- Investigation into Benefit Programs

Ombudsman Investigation – PDD Program

The Alberta Ombudsman has released a public report on his investigation into the Persons with Developmental Disabilities (PDD) program which found systemic issues in how the program assesses intellectual capacity. The investigation, initiated by a complaint from a mother advocating for her son, sheds light on legislative flaws in the program’s eligibility criteria and decision-making process.

Over 10 years ago, the Court of Queen’s Bench identified the same legislative issue and determined that the Developmental Disabilities Regulation (the Regulation) unfairly limits PDD applicants’ assessment if they lack a reliable IQ score. Justice Ouellette’s 2013 decision emphasized the flawed nature of the legislation, as it was never intended for an IQ score to be the sole determinant of eligibility.

The Ombudsman’s investigation found that Seniors, Community and Social Services (the Department) had reviewed the Regulation three times, yet no amendments were made. As a result, the Ombudsman found section 3 of the Regulation to be unreasonable and improperly discriminatory. Within the report, the Ombudsman highlighted the importance of a fair process when it comes to the individuals applying for the PDD program benefits.

To address the systemic issues, the Ombudsman concluded his investigation with two recommendations aimed at improving procedures for future PDD program applicants.

Denied by Design – Investigation in PDD

Criminal Code Review Board – Own Motion Investigation

In November 2021, the Alberta Ombudsman office received a complaint from an individual who had been found not criminally responsible on account of mental disorder, with concerns about the CCRB. The concerns he highlighted were the following: he was unable to fully participate in the hearing, the CCRB did not consider his evidence, he believed the decision makers showed a bias against him and he was unaware of the process and available appeals.  

Following this complaint, the Alberta Ombudsman launched an own motion investigation to look deeper into whether the CCRB had sufficient rules, policies and procedures in place to ensure administratively fair hearings and decisions. 

While there was strong evidence of compassion and a well-functioning system, the CCRB agreed with the Alberta Ombudsman that there are areas for improvement. The Ombudsman’s investigation identified two key findings, a lack of publicly available information and an absence of formal internal policies.  

Criminal Code Review Board – Own Motion Report

Emergency Isolation Support Program – Own Motion Investigation

On March 17, 2020, the Government of Alberta declared a state of public health emergency across the province as concerns over the novel coronavirus (COVID-19) pandemic grew.

Alberta’s Emergency Isolation Support (EIS) Program offered temporary aid—a one-time payment benefit for Albertans who were unable to work due to a requirement to isolate or to care for a dependent who was isolating as a result of COVID-19.  The program, administered by the Ministry of Labour and Immigration with the assistance of the Ministry of Service Alberta, responded to the immediate nature of the circumstances and was developed quickly to meet the rising need. The cost of this program was significant and the government reported the benefit to Albertans was in excess of $108 million dollars.

This own motion investigation looked deeper into whether the application of the EIS program was administratively fair. We investigated the application of the program policy, eligibility requirements, applicant assessment criteria, and how decisions were made and documented.

The Ombudsman’s investigation identified five key findings which resulted in two observations and seven recommendations provided to Labour and Immigration for improvements.

Emergency Isolation Support Program – Own Motion Report

Youth in Segregation – Own Motion Investigation

Incarcerated individuals in Alberta have a right to get in contact with the Alberta Ombudsman when they believe they are the subject of unfair treatment. Following a complaint from an incarcerated individual, we launched an own motion investigation into the use of segregation in Alberta’s two young offender centres.

This own motion investigation focused on the centres’ adherence to legislation and policy in the enforcement of a young person’s placement in segregation. We investigated the adequacy of the appeal and review process related to that enforcement and the young person’s access to representation during an appeal and review process of their placement in segregation.

We concluded the investigation with four key findings and eight recommendations for improvements to ensure correctional authorities address systemic issues arising from the use of segregation.

“Young people incarcerated in Alberta’s young offender centres are at risk without strict boundaries that guide decisions about when and how to segregate an individual. We know prolonged periods of isolation or the use of segregation as a disciplinary measure is contrary to best known practices for an individual’s rehabilitation.”

“I believe it is in Alberta’s best interest to put to paper laws defining and governing the use of segregation in our young offender centres. In our investigation, we noted several examples of effective legislation here in Canada from which to learn.”

Marianne Ryan, Alberta Ombudsman

Youth in Segregation – Own Motion Report

Building Relationships with Albertans – Municipality Report

In April 2018, the role of the Alberta Ombudsman expanded to include municipalities. In Canada, municipalities serve as local government and are responsible for providing services, facilities, safety and infrastructure for their communities. In Alberta, the Municipal Government Act (MGA) guides how municipalities function, how they provide services that in the opinion of council are necessary or desirable for all or a part of the municipality.

“The stories we hear from Albertans having trouble while accessing municipal government programs can offer valuable insights into how frontline services are delivered. In sharing these observations, we aim to give voice to those affected and provide the opportunity for improvements across the greater public service.”

Marianne Ryan, Alberta Ombudsman

Building Relationships with Albertans – Municipality Report

Treating people with mental illness fairly – a report on Mental Health Review Panels

In 2013 and 2014, the previous Alberta Ombudsman found broad areas of unfairness with Mental Health Review Panels (review panels) processes and made several recommendations to improve the situation.

We launched this investigation because the 2014 recommendations had not been fully implemented.

In Alberta, the review panels act as a safeguard to ensure patients affected by a mental illness receive fair treatment. More specifically, in accordance with the Mental Health Act (the Act), the review panels are responsible for holding hearings and making decisions related to patient admission, detention and treatment. This important process protects patients and their rights, including instances where people unable to provide informed consent may be detained and treated.

The outcome of this investigation resulted in 9 recommendations to solve problems and ensure that people with mental illness are treated fairly. A number of the recommendations focused specifically on the steps to ensure patients understand their rights under the Act.

“People with mental illness are some of the most vulnerable members of our society. When decisions affecting a patient’s healthcare come at great personal cost, it is imperative the principles of procedural fairness are consistently followed.”

Marianne Ryan, Alberta Ombudsman

 

Our office is committed to working with authorities to advance procedural fairness, and in the case of formal investigations, make strong recommendations that ultimately improve public services for all Albertans.

We will monitor how the review panels (and Alberta Health) implement our recommendations.

Treating people with mental illness fairly

An investigation into the levy of a fee to request a review by the Complaint Review Committee of the Alberta Dental Association and College

An Alberta Ombudsman own motion investigation has led to changes by the Alberta Dental Association and College (ADAC) that will improve access to the organization’s complaint review process.

The Ombudsman’s investigation, launched in December 2015, was triggered after receiving complaints from Albertans asked to pay a $500 fee to request a review of the regulatory college’s decisions by its internal Complaint Review Committee (CRC).

Peter Hourihan, the Alberta Ombudsman of the day, acknowledged the ADAC council met recently and passed a motion to reduce the fee to $200 and implement a process to allow complainants to request the fee be waived. However, Hourihan noted the college could have gone farther.

“While regulatory colleges have the legal right to levy these fees, I would be much more satisfied had the ADAC removed the fee altogether,” he said. “It would be one thing to levy fees on members of the college – in this case dentists – as they can provide input into those decisions through their membership. It’s another thing when it involves the public. When a public body imposes a fee to request reviews of its decisions, the public interest is not served if those fees become a barrier to the review processes enshrined in law, particularly for low income individuals. Just because a public entity can level a fee doesn’t mean it always should.”

Own motion investigation helps reduce financial barriers to review process

A review of the Gamma Knife Neurosurgery Program administered by Alberta Health

A complaint made to the Ombudsman by an individual, whose application for funding for Gamma Knife Neurosurgery was not approved, resulted in an own motion investigation into the administrative fairness of the funding approval process used by Alberta Health’s Health Insurance Programs Branch.

While there are no specific recommendations arising from this investigation, the Ombudsman noted it is important for administrators of special funding programs to periodically review governing legislation to ensure public information about the program reflects the legislated funding criteria. If the program criteria are clear and concise, the funding criteria should flow from the legislative authority, and be clearly communicated to applicants.

Gamma Knife Neurosurgery Program administration review

Student Aid Alberta review

An Alberta Ombudsman review of the Student Aid Alberta program has led to changes by the province to improve information and transparency regarding the student loan review process.

The Ombudsman’s review, finalized in July 2015, was triggered by a student inquiry about the review process.

After advising the department of the Ombudsman review, we learned the department had already begun work to revise the entire review process and make it transparent and understandable for students. The willingness of Student Aid Alberta to work with the Ombudsman allowed for our input and resulted in a number of changes being made to policy, communication materials such as the website, forms and correspondence, and procedures.

The Alberta Ombudsman will continue to provide oversight on this matter, and monitor the department’s implementation of these changes.

Student Aid Review

Prescription for Fairness

A public report entitled Prescription for Fairness – Special Report: Out-of-Country Health Services, was issued pursuant to Section 28(2) of the Ombudsman Act.

The Alberta Ombudsman, of the time conducted an investigation, under his own motion, pursuant to Section 12(2) of the Ombudsman Act in response to a number of complaints brought to his attention. His investigation focused on whether the provincial department of Alberta Health and Wellness (now known as Alberta Health) met the needs of Albertans in accessing out-of-country health services that are either not available in Canada or are not available in a reasonable timeframe.

This report remains relevant today, as we continue to hold the Committee and Appeal Panel to the standard established by the report.

Special Report: Out-of-Country Health Services