Act to combat maltreatment of seniors and other persons of full age in vulnerable situations

In this text, "the Act" refers to the Act to combat maltreatment of seniors and other persons of full age in vulnerable situations .

On April 6, 2022, this Act was enhanced in an effort to strengthen the fight against the maltreatment of seniors and other persons of full age in vulnerable situations ^{Read the content of the note 1} and to monitor the quality of health and social services. A summary  (in French only) is available to facilitate understanding of the changes and additions made by the Act.

The Act provides for the following measures to combat maltreatment of seniors and other persons of full age in vulnerable situations:

• Mandatory adoption of an anti-maltreatment policy
• Expansion of the local service quality and complaints commissioner’s role
• Possibility of waiving confidentiality or professional secrecy when there is a significant risk of death or serious injury, protection against reprisals and immunity from prosecution
• Regulation of the use of cameras or other monitoring mechanisms
• Implementation of a Québec-wide framework agreement and collaborative intervention processes to combat maltreatment of seniors and other persons of full age in vulnerable situations
• Obligation to report certain cases of maltreatment
• Voluntary reporting
• Addition of criminal offences particularly concerning the perpetrators of abuse, with a view to ensuring the health and safety of our most vulnerable loved ones
• Establishment of an assistance, assessment and referral centre on elder abuse

Under the Act, all institutions in the health and social services system, whether public or private, are required to adopt and implement an anti-maltreatment policy.

Policy objectives

The main objectives of the policy are to:

• Establish measures to prevent maltreatment of persons in vulnerable situations
• Combat maltreatment
• Support people in any steps taken to end maltreatment, whether at the hands of a person working for the institution or of any other person

Communication of the policy

The institution must display its policy in full view of the public and publish it on its website. This obligation also applies to private seniors’ residences (PSR), intermediate resources (IR), and family-type resources (FTR).

Furthermore, means must be implemented to make its policy known to:

• People who work in the institution
• Clients and residents, including those who receive home care services
• Close family members of users and residents
• Health professionals employed in the health and social services system
• Social economy enterprises
• Community organizations
• Private resources offering health and social services

The local service quality and complaints commissioner (CLPQS) is responsible for upholding users’ rights and diligently addresses the complaints that are filed regarding the care and services received in health and social services institutions.

Under the Act, the Commissioner must also address all reports regarding situations of potential maltreatment, including reports by people other than the user, for example, by a member of their family or an employee. The Commissioner must also inform the institution’s executive director and the Ministère de la Santé et des Services sociaux if there are reasonable grounds to believe in the existence of a situation that is likely to undermine the health or well-being of a person or group of persons, including such a situation arising from the application of practices or procedures.

In order to obtain a more detailed picture of the situations of abuse experienced in different residential settings, more effective use of the reports is required of local service quality and complaints commissioners.

See the list of local service quality and complaints commissioners to find out the contact information for the local service quality and complaints commissioner for your sector.

The Act facilitates the reporting of situations of maltreatment by witnesses of acts against persons of full age in vulnerable situations by means of the following provisions:

• the waiving of confidentiality or professional secrecy:
  • A person who witnesses maltreatment and who is bound by professional secrecy may report or participate in the examination of a report in some cases. Professional secrecy or confidentiality may be lifted if there is a significant risk of death or serious injury. A serious injury is defined as a “physical or psychological injury that has a significant adverse effect on an identifiable person’s or group of persons’ physical integrity, health or well-being”.
• protection against reprisals:
  • Reprisals are prohibited against a person who, in good faith, reports maltreatment or cooperates in the examination of a report or complaint of maltreatment. These include demotion, dismissal, disciplinary measure, unwarranted transfer of a user or early termination of a lease.
• immunity from prosecution:
  • Legal proceedings may not be brought against a person who, in good faith, has reported maltreatment or cooperated in the examination of a report.

The regulation allows the use, for user monitoring purposes, of any mechanism, device or technological means, whether concealed or not, to capture images or sound, for example:

• A monitoring camera
• A tablet
• A smart phone

The Regulation respecting the terms governing the use of monitoring mechanisms by a user sheltered in a facility maintained by an institution operating a residential and long-term care centre sets out the terms of use of monitoring mechanisms by a user or their representative.

In particular, the Regulation determines:

• The user’s and their representative’s obligations with respect to the installation of monitoring mechanisms
• The terms governing the use of monitoring mechanisms that the user and their representative must comply with
• The rules applicable to the images or sounds recorded by monitoring mechanisms
• The obligations of health and social services institutions with respect to the use of monitoring mechanisms

These obligations, terms or rules with respect to monitoring mechanisms apply to users, their family members and friends, institutions and to anyone who works in a facility operated by a residential and long-term care centre.

The framework agreement aims to establish a partnership and promote collaboration between the different actors involved in combatting maltreatment of seniors.

Québec-wide framework agreement to combat maltreatment of seniors and other persons of full age in vulnerable situations

The objectives of the Québec-wide framework agreement are to:

• Ensure better protection for seniors in vulnerable situations
• Provide necessary assistance to seniors in vulnerable situations
• Ensure the best intervention is carried out to put an end to situations of maltreatment of seniors in vulnerable situations

Collaborative intervention processes

The Act provides for collaborative intervention processes between the various stakeholders in cases of maltreatment, such as the police, social workers, prosecutors, etc.

Collaborative intervention processes promote:

• A rapid and accurate assessment of the abusive situation
• An appropriate and timely response
• An intervention that is complementary to the legal system in order to put an end to the abusive situation or to effectively protect seniors or other persons of full age in vulnerable situations
• A decrease in the negative impact of stakeholders’ actions and procedures on the victim of maltreatment while ensuring they are effective.

These collaborative intervention processes were launched in March 2018 and are expected to be implemented throughout Québec.

Under the Act, any health services and social services provider or any professional within the meaning of the Professional Code who, in the normal course of performing their duties or profession, has reasonable grounds to believe that a person is a victim of maltreatment must report it immediately if it concerns the following people:

• Clients of residential and long-term care centres (CHSLD)
• Persons in vulnerable situations residing in private seniors' residences (PSR)
• Persons of full age housed in an intermediate resource (IR) or a family-type resource (FTR)
• Persons deemed incompetent following a medical assessment
• Incapacitated, protected persons, irrespective of their place of residence, namely:
  • A person under tutorship
  • A person under curatorship
  • A person for whom a protection mandate has been registered

The obligation to report applies even to people bound by professional secrecy, except for lawyers and notaries.

The report must be filed with the local service quality and complaints commissioner of the institution where the mistreated person receives services. To find out the contact information for the commissioners in your region, see the list of local service quality and complaints commissioners.

With regard to vulnerable situations outside the health and social services system, reports must be filed with one of the partners of the Québec-wide framework agreement, that is:

• The police;
• The Public Curator
• The Commission des droits de la personne et des droits de la jeunesse (CDPDJ);
• The Autorité des marchés financiers (AMF).

While the Act makes reporting of maltreatment mandatory in some circumstances, it encourages voluntary reporting of situations of maltreatment at any time.

Anyone who witnesses maltreatment of an older adult or a person of full age in a vulnerable situation may make a voluntary report. If the victim of the abuse receives services from the health and social services system, they must report it to the institution’s local service quality and complaints commissioner. To find out the contact information for the commissioners in your region, see the list of local service quality and complaints commissioners.

With regard to vulnerable situations outside the health and social services system, reports must be filed with one of the partners of the Québec-wide framework agreement, that is:

• The police;
• The Public Curator
• The Commission des droits de la personne et des droits de la jeunesse (CDPDJ);
• The Autorité des marchés financiers (AMF).

To find out the best place to report maltreatment, contact the Mistreatment Helpline  (1-888-489-2287). You will be referred to the appropriate resources.

Specific provisions of the Act include criminal offences in an effort to ensure the health and well-being of the most vulnerable people. These criminal offences apply, in particular, to the perpetrators of abuse, but also in the following situations:

• failing to report abuse
• threatening, bullying or attempting to take any reprisal against a person
• obstructing or attempting to obstruct in any way whatsoever an inspector or investigator performing their duties.

For more information about a request for the imposition of criminal sanctions associated with the Act to combat maltreatment of seniors and other persons of full age in vulnerable situations, see the section Request for the imposition of criminal sanctions associated with the Act to combat maltreatment of seniors and other persons of full age in vulnerable situations in the page Additional contact information for the Ministère de la Santé et des Services sociaux.

The assistance, assessment and referral centre on abuse serves as a single gateway for anyone concerned about an abuse situation. The establishment of this center was entrusted to the Mistreatment Helpline.

The Mistreatment Helpline is designed to:

• accept calls for information or support
• provide moral support through active listening
• assess the situation described and its level of risk
• provide information on the available resources and possible recourses
• refer the person to the stakeholders in the best position to assist them, including the CLPQS or a designated advocate
• follow up on the situation, with the person’s consent, in order to assist them with the path they choose or with the steps they take.