General definitions

1   In this regulation and a designation regulation:

"Act" means the Health Professions and Occupations Act;

"authorization", with respect to the performance of restricted activities by persons who are not licensees, means an authorization that meets the requirements of section 8 (2) [requirements for authorizations];

"certified", with respect to the performance of restricted activities by licensees, means certified in accordance with bylaws made under section 7 [requirements to be certified];

"order", with respect to the performance of restricted activities by licensees, means an order that meets the requirements of section 6 (2) [requirements for orders].

Definitions relevant to health services

2   In this regulation and a designation regulation:

"medical assistance in dying" means the following health services:

(a) the administration of drugs that are intended to cause the death of a person who requests this service;

(b) the prescribing or dispensing of drugs that may be self-administered by a person who requests this service for the purpose of causing the person's own death;

(c) the administration, prescribing or dispensing of drugs or substances that are intended to be used in relation to a health service referred to in paragraph (a) or (b);

"mental health" includes developmental, behavioural, cognitive, emotional, intellectual and interpersonal functioning.

Definitions relevant to restricted activities

3   Definitions in the Schedule of Restricted Activities apply to this regulation and a designation regulation.

Restricted activities prescribed

4   The activities described under the Schedule of Restricted Activities are prescribed as restricted activities for the purposes of the Act and the regulations made under it.

Authority to perform restricted activities

5   (1) Subject to section 31 [general exceptions] of the Act, a licensee may perform a restricted activity only if all of the following conditions are met:

(a) the licensee is within a class of licensees that is authorized under a designation regulation to perform the restricted activity;

(b) the licensee performs the restricted activity only in the course of providing the types of health services that constitute the scope of practice for the licensee's designated health profession;

(c) the licensee performs the restricted activity in accordance with the limits and conditions that apply to the licensee under the Act.

(2) For certainty, restricted activities that licensees are authorized to perform if acting under an order or if certified

(a) are in addition to any other restricted activities that the licensees are authorized to perform under a designation regulation, and

(b) are not limited by limits, if any, that apply to the performance of those other restricted activities.

Requirements for orders

6   (1) A licensee may issue to another licensee an order to perform a restricted activity if both of the following conditions are met:

(a) the licensee who issues the order is authorized under a designation regulation to perform the restricted activity without an order from any other person;

(b) the licensee to whom the order is issued is authorized under a designation regulation to perform the restricted activity if acting under an order.

(2) A licensee who is authorized under a designation regulation to perform a restricted activity if acting under an order may perform the restricted activity on receiving an order that meets all of the following requirements:

(a) the order is issued by a person who is authorized, under an enactment of British Columbia, Alberta, Yukon or the Northwest Territories,

(i) to perform the restricted activity without an order, authorization or equivalent form of permission from any other person, or

(ii) to issue an order, authorization or equivalent form of permission to another person to perform the restricted activity;

(b) the order is issued by a person who

(i) has assessed, or is in the course of assessing, the patient with respect to whom the order is issued, and

(ii) continues to have the authority referred to in paragraph (a) as of the time that the restricted activity is performed;

(c) the order names the patient;

(d) any additional requirements set out in the designation regulation.

(3) For certainty, an order

(a) may be issued by any means,

(b) may be issued to one or more individuals or classes of licensees, and

(c) may, but is not required to, do one or both of the following:

(i) provide for the time or times at which a health service that includes the performance of the restricted activity is to be initiated;

(ii) incorporate by reference a protocol or guideline in whole or in part and with any changes the issuer of the order considers necessary or appropriate.

(4) In subsection (3), "protocol or guideline" means a recorded description of a course of action or decision-making process to be used in providing, to or for a specified class of patients, a health service that includes the performance of a restricted activity.

Requirements to be certified

7   (1) If a designation regulation limits the performance of a restricted activity to certified licensees,

(a) the board of the regulatory college that is responsible for governing the licensees' designated health profession must make bylaws in accordance with subsection (2) to establish a certification program, and

(b) a licensee may perform the restricted activity only if certified in accordance with the bylaws.

(2) For the purposes of subsection (1), the board must make bylaws respecting all of the following:

(a) the name of the certification program;

(b) the education, training, experience or other qualifications that licensees must have to perform the restricted activity;

(c) the manner of assessing whether licensees are competent to perform the restricted activity in the practice settings in which the activity will be performed.

(3) In addition to the bylaws referred to under subsection (1) (a), a board may make bylaws respecting the process to be used to ensure that licensees continue to be competent to perform the restricted activity.

Requirements for authorizations

8   (1) A licensee may issue to a person who is not a licensee an authorization to perform a restricted activity if the licensee is authorized under a designation regulation to issue the authorization.

(2) A person who is not a licensee may perform a restricted activity on receiving an authorization that meets all of the following requirements:

(a) the authorization is issued by a licensee who is authorized under a designation regulation to issue an authorization to perform the restricted activity;

(b) the authorization names the patient;

(c) any additional requirements set out in the designation regulation.

(3) For certainty, an authorization may, but is not required to, include instructions with respect to the performance of the restricted activity.

Insertions into external ear canal

9   (1) A licensee who is authorized under a designation regulation to insert an instrument, device, hand, finger or substance into the external ear canal may insert the thing up to, but not past, the eardrum.

(2) Subsection (1) does not apply to a licensee who is a medical practitioner.

Prescribing and dispensing drugs

10   (1) If a licensee is authorized under a designation regulation to both prescribe and dispense a drug, the board of the regulatory college that is responsible for governing the licensee's designated health profession

(a) may make bylaws establishing or adopting practice standards respecting the performance of those restricted activities, and

(b) must, if bylaws are made under paragraph (a), include practice standards respecting drug storage, drug diversion and conflicts of interest.

(2) A licensee who is authorized under a designation regulation to both prescribe and dispense a drug must not do so unless one of the following conditions is met:

(a) a practice standard applies to the prescribing and dispensing of the drug;

(b) the licensee has written authorization to prescribe and dispense the drug from the registrar of the regulatory college that is responsible for governing the designated health profession practised by the licensee.

(3) Subsection (2) does not apply to a licensee who is a nurse or midwife.

(4) A licensee who is authorized under a designation regulation to dispense or administer a drug, but not to sell the drug, may receive payment for the drug if

(a) the payment is received on behalf of the licensee's employer, and

(b) the employer lawfully requires payment for that drug with respect to the patient for or to whom the drug is dispensed or administered.

Application

11   This Division applies despite any prohibition, limit or condition imposed

(a) under the Act, or

(b) under an enactment with respect to the practice of a profession, occupation or trade by a person or class of persons.

Exemption if suspected overdose

12   A person who is not otherwise authorized under the Act to administer oxygen or naloxone may, if the person suspects that another person is suffering from an overdose, treat the other person by the emergency administration of one or both of the following:

(a) oxygen by inhalation;

(b) naloxone, by intramuscular injection or intranasally.

Exemption if suspected heart stoppage

13   A person who is not otherwise authorized under the Act to apply electricity for the purpose of affecting activity of the heart may, if the person suspects that the heart of another person has stopped, treat the other person by the emergency use of an automatic or semi-automatic defibrillator.

Exemption for dental appliances

14   A person who is not otherwise authorized under the Act to dispense a dental appliance may make or sell dental appliances while engaged in the business of making or selling, on a wholesale basis, articles for use by licensees who practise any of the following designated health professions:

(a) medicine;

(b) dentistry, dental technology or denturism.

Exemption for wearable hearing instruments

15   A person who is not otherwise authorized under the Act to dispense a wearable hearing instrument may make or sell wearable hearing instruments while engaged in the business of making or selling, on a wholesale basis, wearable hearing instruments.

General exemption for vision appliances

16   (1) A person who is not otherwise authorized under the Act to dispense a vision appliance may make or sell vision appliances while engaged in the business of making or selling, on a wholesale basis, vision appliances.

(2) A person who is not otherwise authorized under the Act to dispense a vision appliance may sell corrective eyeglass lenses if all of the following conditions are met:

(a) the lenses are not intended for use by any particular individual;

(b) the lenses are inserted into frames and sold as parts of a complete, ready-to-wear device;

(c) the device is sold as merchandise from a permanent place of business.

Exemption for personalized vision appliances

17   (1) In this section, "customer" means a person for whose use a contact lens or corrective eyeglass lens is to be dispensed.

(2) A person who is not otherwise authorized under the Act to dispense a vision appliance may dispense a corrective eyeglass lens or contact lens if both of the following conditions are met:

(a) the person has

(i) a copy of the customer's vision appliance record, or

(ii) the information contained in the customer's vision appliance record and a statement from the customer certifying the existence and validity of that record and the accuracy of the information provided;

(b) the person dispenses the corrective eyeglass lens or contact lens in accordance with the customer's vision appliance record.

(3) A person who is not otherwise authorized under the Act to dispense a vision appliance may dispense a duplicate of a corrective eyeglass lens if both of the following conditions are met:

(a) the duplicate is made using measurements taken by a lensometer or similar device;

(b) there is no change in the refractive value of the lens.

Bylaws respecting licensee classes

18   A board may make bylaws establishing restricted and provisional classes of licensees.

Bylaws respecting health services

19   A board may make bylaws imposing prohibitions, requirements, limits and conditions on the provision, by licensees or a class of licensees, of health services that the licensees are authorized under a designation regulation to provide.

General

1   In this regulation and a designation regulation:

"Restricted Activities Table" means the table to section 4 [restricted activities] of this Schedule;

"sale" or "sell" includes barter, distribute, supply, offer, expose, advertise or possess for the purpose of selling, whether or not for consideration.

Substances and drugs

2   In this regulation and a designation regulation:

"compound" means,

(a) with respect to a drug, to mix the drug with at least one other ingredient, and

(b) in any other case, to mix 2 or more appropriate ingredients;

"design", with respect to a therapeutic diet, includes determining

(a) the appropriate ingredients of a therapeutic diet and the volume and proportion of those ingredients, and

(b) the method and frequency of delivering the ingredients of a therapeutic diet;

"dispense", with respect to a drug, includes

(a) to prepare and sell a drug referred to in a prescription,

(b) to provide a drug to a person for the purpose of self-administration or administration to or by another person,

(c) to take steps to ensure the pharmaceutical and therapeutic suitability of a drug for its intended use, and

(d) to take steps to ensure a drug's proper use;

"drug" means a drug that is included or incorporated by reference under a Schedule;

"enteral instillation"

(a) means the administration of a substance directly into the gastrointestinal tract, and

(b) does not include the oral administration of a therapeutic diet;

"parenteral instillation" means the administration of a substance directly into the blood stream;

"prescribe", with respect to a drug, means to issue a prescription;

"prescription", with respect to a drug, has the same meaning as in the Pharmacy Operations and Drug Scheduling Act;

"Schedule", with respect to a drug, means Schedule I, IA, II or III of the Drug Schedules Regulation, as applicable;

"substance" includes air and water, but does not include a drug;

"therapeutic diet" means a diet

(a) that includes drugs, substances or both, and

(b) is designed for the purpose of preventing, managing or treating a disease, disorder or condition, in relation to physical or mental health, for which nutrition plays a significant role in treatment and management.

Wearable devices

3   (1) In this regulation and a designation regulation:

"automated refraction" means a refraction conducted

(a) for the purpose of assessing refractive errors and visual acuity, and

(b) using an automated refraction system that has one or more computerized components;

"contact lens" means a lens or mold designed or offered for the purpose of being placed on the cornea or other anterior surface of an eye to correct the refractive error of, or induce physiological change in, the eye;

"contact lens record" means a record that

(a) is prepared by one of the following:

(i) an optometrist or medical practitioner;

(ii) an optician or extrajurisdictional practitioner, if authorized to fit a contact lens, and

(b) sets out the contact lens specifications that have been derived from fitting a contact lens using information contained in

(i) a prescription for a corrective eyeglass lens, or

(ii) a dispensing authority;

"dental appliance"

(a) means an appliance or a device designed or offered for a dental condition or other condition of the orofacial complex, and

(b) does not include an athletic mouthguard designed or offered for temporary protection against injury during sporting activities;

"dispense", with respect to a wearable device, includes the following, as applicable:

(a) to design, make, alter or prepare a wearable device, other than to fit the wearable device;

(b) to select or make recommendations with respect to the selection of a wearable device;

(c) to inspect a wearable device and to confirm that the specifications set out in an applicable prescription or other applicable record are met;

(d) to take steps to ensure

(i) the therapeutic suitability of a wearable device for its intended use, and

(ii) the proper use of the wearable device;

(e) to sell a wearable device;

"dispensing authority" means a record of an assessment of a patient's refractive errors and visual acuity, prepared on conducting an automated refraction;

"fit" includes the following, as applicable:

(a) to adapt a wearable device for a named patient, including conducting activities related to ensuring physiological safety or suitability;

(b) to perform tests or conduct other activities related to assessing the physiological safety or suitability of a wearable device for a named patient;

(c) to conduct an activity described in a designation regulation for a purpose described in paragraph (a) or (b);

"prescribe", with respect to a wearable device, means to issue a prescription;

"prescription", with respect to a wearable device, means an authorization to dispense a wearable device to a named patient;

"prescription for a corrective eyeglass lens" means a prescription for a corrective lens that

(a) is prepared, based on an assessment of the patient's eye health, by any of the following:

(i) an optometrist or a medical practitioner;

(ii) an extrajurisdictional practitioner, if authorized to prescribe a corrective eyeglass lens, and

(b) sets out

(i) the lens power required to correct the refractive error of an eye, and

(ii) reading addition, prisms, back vertex distance and contraindications;

"vision appliance" means a corrective eyeglass lens, contact lens, low vision aid or other type of appliance or device designed or offered for a vision condition;

"vision appliance record" means a contact lens record, a dispensing authority or a record of a prescription for a corrective eyeglass lens;

"wearable device" means a dental appliance, vision appliance or wearable hearing instrument, as applicable;

"wearable hearing instrument"

(a) means an instrument that is wearable on the head or body and designed or offered for a hearing condition, and any

(i) ear molds, boots or other acoustic couplers for the instrument, and

(ii) parts or accessories for the instrument, if intended to affect the sound pressure level at the eardrum, and

(b) does not include the following with respect to an instrument referred to in paragraph (a):

(i) direct audio input accessories or batteries for the instrument;

(ii) accessories that are attachable to the instrument by the wearer and are not intended to affect the sound pressure level at the eardrum.

(2) For certainty, a contact lens record and a dispensing authority are not prescriptions for a vision appliance.

Restricted activities

4   An activity described in Column 1 of the following table is prescribed as a restricted activity for the purposes of the Act and the regulations made under it.