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CQB Decision Elder Advocates and James Darwish V Government of Alberta Et Al August 2008

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CQB Decision Elder Advocates and James Darwish V Government of Alberta Et Al August 2008 Court of Queen’s Bench of Alberta Citation: Elder Advocates of Alberta Society v. Alberta, ABQB 490 Date: 20080814 Docket: 0503 13196 Registry: Edmonton Between: Elder Advocates of Alberta Society and James O. Darwish, Personal Representative of the Estate of Johanna H. Darwish, Deceased Plaintiffs - and - Her Majesty the Queen In Right of Alberta, Aspen Regional Health Authority, Calgary Health Region, Capital Health, Chinook Regional Health Authority, East Central Health, Northern Lights Health Region, Palliser Health Region, Peace Country Health Defendants _______________________________________________________ Reasons for Judgment of the Honourable Madam Justice S.J. Greckol _______________________________________________________ I. Introduction........................................................Page: 3 II. Legislation.........................................................Page: 5 A. Class Proceedings Legislation....................................Page: 5 B. Legislative Scheme for the Provision of Health Care Services. Page: 8 1. Federal Health Legislation.................................Page: 9 2. Alberta Legislation - Alberta Health Care Insurance Act and Subordinate Regulations. ...........................................Page: 9 3. Alberta Legislation - Nursing Homes Act and Subordinate Regulations .....................................................Page: 12 Page: 2 4. Alberta Legislation - Hospitals Act and Subordinate Regulations .....................................................Page: 17 5. Alberta Legislation - Regional Health Authorities Act and Subordinate Regulations. ..........................................Page: 26 6 . Directive D-317........................................Page: 28 III. Facts.............................................................Page: 28 A. Affidavits of Plaintiffs.........................................Page: 28 1. Elder Advocates of Alberta Society.. Page: 28 (a) Ruth Maria Adria.................................Page: 28 (i)Affidavit Filed February 28, 2006 .........................................Page: 28 (ii)Affidavit Filed June 5, 2006 .........................................Page: 30 (b) James Darwish...................................Page: 30 (i)Affidavit Filed February 27, 2006..............Page: 30 (ii)Affidavit Filed June 5, 2006...................Page: 33 (iii) Affidavit Filed November 30, 2006.............Page: 35 (iv)Affidavit Filed September 17, 2007.............Page: 36 (v)Affidavit Filed January 22, 2008...............Page: 37 (vi)Cross-examination on Affidavits...............Page: 37 B. Affidavits on behalf of the Defendants. Page: 38 1. Alberta Heath and Wellness...............................Page: 38 (a) Tom Mills. .....................................Page: 38 (i)Affidavit Filed September 11, 2006.............Page: 38 (ii)Information on Alberta Seniors Benefit..........Page: 42 (iii) Information on Assured income for the Severely Handicapped..............................Page: 43 (iv)Information on Supports for Independence /Alberta Works .........................................Page: 43 (v)Cross-Examination on Affidavit................Page: 43 2. Regional Health Authorities. .............................Page: 45 (a) Brenda Huband - Calgary Health Region. Page: 46 (b) Norm Petherbridge - East Central Health. Page: 49 (c) Robert Stratychuk - Chinook Health Region. Page: 52 (d) Linda Metz - Northern Lights Health Region. Page: 55 (e) Seamas O’Fuarthain - Palliser Health Region. Page: 57 (f) Lynne Mansell - Capital Health. Page: 58 (g) Shelly Pusch - Aspen Regional Health. Page: 60 (h) Sean Chilton - Peace County Health. Page: 62 (i) Denise McBain - David Thompson Regional Health Authority ...............................................Page: 64 IV. Issues............................................................Page: 67 Page: 3 V. Analysis..........................................................Page: 68 A. Do the Pleadings Disclose a Cause of Action?. Page: 68 1. Breach of Fiduciary Duty.................................Page: 70 2. Breach of Duty of Care. .................................Page: 77 3. Breach of Contract......................................Page: 84 4. Unjust Enrichment with Remedy of Restitution .....................................................Page: 85 (a) The Enrichment of the Defendants. Page: 86 (b) Corresponding Deprivation of the Plaintiffs. Page: 88 (c) Absence of Juristic Reason for Enrichment.. Page: 88 5 . Ultra Vires Action......................................Page: 89 6 . Ultra Vires Tax. .......................................Page: 94 7. Section 15(1) of the Charter..............................Page: 95 (a) Discrimination...................................Page: 96 (b) Human Dignity...................................Page: 96 (c) Disadvantage....................................Page: 97 (d) Proposed Comparator Groups. Page: 98 (e) Conclusion on Charter claim........................Page: 99 B. Is there an Identifiable Class of Two or More Persons?. Page: 99 C. Do the Claims of the Prospective Class Members Raise a Common Issue? ..........................................................Page: 102 D. Is a Class Proceeding the Preferable Procedure for the Fair and Efficient Resolution of the Common Issues?..............................Page: 111 E. Are Either Mr. Darwish or the EAAS Appropriate Representative Plaintiffs? ..........................................................Page: 114 VI. Summary of Findings...............................................Page: 115 VII. Disposition.......................................................Page: 117 I. Introduction [1] The Plaintiffs, the Elder Advocates of Alberta Society (the EAAS) and James O. Darwish in his capacity as the personal representative of the estate of Johanna H. Darwish (Darwish), bring this application for certification pursuant to the Class Proceedings Act, R.S.A. 2000 c. C- 16.5 (CPA). The EAAS is a non-profit society. Darwish is the son of Johanna H. Darwish, who was a resident in the Lynwood Nursing Home from March 1994 until her death on February 22, 2006. Darwish was his mother’s guardian and trustee and is now the executor of her estate. The Lynwood Nursing Home is operated by the Defendant, Capital Health, through its agent, the Capital Care Group, which is a wholly-owned subsidiary health corporation of Capital Health. [2] The Defendants, Her Majesty the Queen in Right of Alberta (the Government) and the nine Regional Health Authorities (RHAs), including Aspen Regional Health Authority, Calgary Health Authority, Capital Health, Chinook Regional Health Authority, David Thompson Page: 4 Regional Health Authority, East Central Health, Northern Lights Health Region, Palliser Health Region, and Peace Country Health, administer and operate a regime for the provision of health care services to Alberta residents pursuant to the Alberta Health Care Insurance Act, R.S.A. 2000, c. A-20 (AHCIA), the Nursing Homes Act, R.S.A. 2000, c. N-7 and the Hospitals Act, R.S.A. 2000, c. H-12. [3] The Government funds health care services by providing global, population-based funding to the RHAs, all of which are bodies corporate and have been established pursuant to the Regional Health Authorities Act, R.S.A. 2000, c. R-10 (RHAA). In turn, the RHAs are responsible for the planning and delivery of health care services in hospitals, long-term care facilities (LTCFs), community health services and public health programs to the residents of each respective region. The RHAs deliver health care services directly or indirectly through either wholly-owned subsidiary health corporations or private operators who have entered into nursing home contracts with the RHAs pursuant to s. 2 of the Nursing Homes Act. [4] One of the core services delivered by the RHAs to each region is residential long-term care, in nursing homes and auxiliary hospitals. The RHAs determine how much health care funding is to be directed to these LTCFs. The LTCFs are required to provide nursing home care to eligible residents and to operate their facilities in accordance with the applicable legislation and regulations: see the Nursing Homes General Regulation, Alta. Reg. 232/85, ss. 2, 4. [5] The Plaintiffs led evidence establishing that the RHAs fund nursing homes and auxiliary hospitals in the same way, and that this funding essentially comes from two different streams of income: one is the global health care funding provided from the Government, the other is money paid by residents as an accommodation charge (Accommodation Charge). For the fiscal year ending March 1, 2005, approximately $577.7 million in funding for LTCFs came from the global health care funding stream and approximately $206.5 million from the Accommodation Charge stream. [6] The Plaintiffs bring this action on behalf of a proposed class of “all Residents of Long- Term Care Facilities and patients in general hospitals in Alberta who have been assessed as requiring auxiliary hospital or nursing home level care, and the estates of such persons who, since August 1, 2003, have been charged the Accommodation Charge, save and except for all such persons, who at any time since August 1, 2003, have received: (a) Assured Income for the Severely Handicapped (AISH); (b) Supports for Independence (SFI); (c) the full Supplementary Accommodation Benefit; (d) benefits to pay the Accommodation Charge from the Worker’s Compensation Board, the Department of Veteran Affairs (Canada), the Department of National Defence (Canada), the First Nations and Inuit Branch of Health
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