3 - Interpretive Guide for Info Sharing · !An!interpretive!Guide!to!Information!Sharing!Practices!in!Ontario!–!Page!3! New!Directions!for!Community!Safety!–!Hugh!C.!Russell!and!Norman!E.!Taylor!2014!

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Ontario(Working(Group(on(Collaborative,(Risk7driven(Com

munity(Safety(

Ontario(Association(of(Chiefs(of(Police(

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Hugh!C.!Russell!and!Norman!E.!Taylor!April,!2014!

New(Directions(in(Community(Safety(Consolidating!Lessons!Learned!about!Risk!and!Collaboration!

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An!Interpretive!Guide!to!Information!Sharing!Practices!in!Ontario!…within!the!Context!of!Collaborative,!RiskMdriven!!

Community!Safety!and!WellMbeing!!

!An!interpretive!Guide!to!Information!Sharing!Practices!in!Ontario!–!Page!1!

New!Directions!for!Community!Safety!–!Hugh!C.!Russell!and!Norman!E.!Taylor!2014!

!Table!of!Contents!!

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!!! ! ! ! ! ! ! ! ! ! !!!!!Page!!Setting!the!Stage!for!OWG1related!Information!Sharing!in!Ontario! !!!!!! !!!!!!!!!!!!!!2!! ! !Scope!of!the!Examination!and!Resulting!Guidelines!!! ! ! !!!!!!!!!!!!!!4!!Level!One:!! ! ! ! ! ! ! ! ! ! !!!!!!!!!8113!Sharing!Information!in!the!Interests!of!Community!Safety!and!!Well1being:!Eight!Framing!Principles!!! ! ! ! ! ! !!!!!!!!!!!

! ! ! ! ! ! ! ! !Level!Two:!! ! ! ! ! ! ! ! ! !!!!!!!14116!Guidance!for!Policy!Makers!and!Data!Managers!on!System1wide!!Information!and!Data!Sharing! ! ! ! ! ! !!!!!!!!!!!!!Level!Three:! ! ! ! ! ! ! ! ! !!!!!!!17123!Guidance!for!Practitioners!at!Collaborative,!Risk1driven!Situation!Tables! !!!!!!!!!!!!!!!Conclusion!! ! ! ! ! ! ! ! ! !!!!!!!!!!!!23!!

Appendix!A!–!An!Inventory!of!Relevant!Legislation!and!Regulations!!!Appendix!B!–!A!Preliminary!Review!of!Relevant!Legislation!and!Regulations!

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!An!Interpretive!Guide!to!Information!Sharing!Practices!in!Ontario!

…within!the!Context!of!Collaborative,!RiskMdriven!Community!Safety!and!WellMbeing!!

“Much!of!this!attention!has!been!drawn!because![of]!a!paradigm!shift!in!meeting!the!needs!of!marginalized!individuals!experiencing!high!levels!of!risk.!!While!different!government!agencies!have!worked!to!meet!the!needs!of!these!individuals!long!before!…!much!of!that!work!was!done!in!silos.!![New!methods!provide]!an!opportunity!to!bring!down!traditional!barriers!between!human!service!professionals!and!allow!for!a!type!of!collaborative!intervention!that!more!efficiently!and!effectively!responds!to!the!needs!of!individuals!who!are!in!situations!of!acutelySelevated!risk.1!“!

Dr.!Chad!Nilson!(2014)!!Inaugural!Research!Fellow!

!!The!Ontario!Working!Group!on!Collaborative,!Risk1driven!Community!Safety!(OWG)!is!a!co1operative!effort!comprised!of!police!services,!provincial!and!municipal!government!agencies,!community!agencies!and!other!partners.!The!OWG!is!a!sub1

committee!of!the!Ontario!Association!of!Chiefs!of!Police!(OACP)!Community!Safety!and!Crime!Prevention!Committee,!and!its!activities!are!supported!by!the!Ministry!of!Community!Safety!and!Correctional!Services.!!The!OWG!is!designing!a!prototype!Community!Safety!Planning!Framework!and!also!supporting!the!development!and!implementation!of!risk1driven,!collaborative!intervention!models.!These!emerging,!evidence1based!strategies!will!help!improve!community!safety!and!well1being!in!Ontario.!!As!these!risk1driven,!community1based!collaborations!continue!to!develop!so!too!will!the!range!of!multi1sector!partnerships!grow!and!engage!many!others!(e.g.!non1governmental!organizations,!local!leaders,!community!groups).!!These!comprehensive,!integrated!approaches!can!have!a!significant!positive!impact!on!a!person’s!life,!a!family’s!well1being,!and!the!safety!of!neighbourhoods.!!They!are!cost1efficient!and!effective.!!They!also!challenge!us!to!put!aside!many!of!our!conventional!assumptions!about!roles,!about!the!ownership!and!sharing!of!vital!information,!and!about!the!nature!of!supports,!interventions!and!services!that!can!be!most!effective!in!building!and!sustaining!healthy!lives!and!healthy!communities.!

1 Nilson,!C.!(2014).!!Risk1driven!collaborative!intervention:!A!preliminary!impact!assessment!of!Community!Mobilization!Prince!Albert’s!hub!model.!p!23.!Saskatoon.!University!of!Saskatchewan.!

Setting!the!Stage!for!!OWG0related!Information!

Sharing!in!Ontario!



!Changing!conventional!practices!and!workplace!assumptions!of!one!organization!can!be!difficult.!!To!change!and!refocus!those!of!an!entire!system!is!more!complex!and!involves!many!elements.!!It!also!requires!bold!leadership!as!those!at!the!front!lines!seek!to!employ!promising!practices.!!OWG!partners!have!already!discovered!some!of!the!hurdles!that!emerge!when!implementing!a!collaborative,!risk1driven!strategy!for!reducing!the!incidence!of!crime!and!victimization.!!One!of!the!earliest!they!encountered!is!that!of!sharing!among!agencies!confidential!information!about!people!or!places!at!risk.!!Such!sharing!is!not!expressly!forbidden,!and!in!fact!is!recognized!in!law!as!essential!under!certain!circumstances.!!But,!conventions!adopted!across!the!sectors!over!many!years!have!unintentionally!conspired!to!discourage!this!practice!in!the!extreme.!!Ways!to!do!this!successfully!while!still!protecting!the!fundamental!rights!and!privileges!on!which!a!healthy!democracy!is!founded,!have!been!applied,!tested!and!proved!in!places!around!the!world.!!This!interpretive!guide!on!information!sharing!practices!is!built!in!part!on!such!emerging!practices!and!experiences!outside!of!Ontario.!!Some!of!the!most!recent,!exemplary!and!strongest!evidence1based!initiatives!are!in!the!province!of!Saskatchewan,!arising!from!the!City!of!Prince!Albert!in!particular.!!The!OWG!has!benefited!from!their!experiences!and!especially!the!generous!consultation!and!advice!provided!by!those!Canadian!pioneers!in!collaborative,!risk1driven!community!safety!practices.!!!!This!guide!has!been!developed!strictly!in!an!Ontario!context!for!practitioners!and!policy!experts!within!Ontario’s!human!services.!!It!is!just!one!of!many!tools!that!the!OWG!is!developing!to!support!everyone!involved,!from!front!line!professionals!to!executive!policy!makers,!as!this!process!of!change!gains!momentum!in!Ontario.!!This!guide!focuses!exclusively!on!some!of!the!challenges!inherent!in!the!need!to!exchange!personal!and!confidential!information!when!two!or!more!agencies!consider!collaborating!in!order!to!more!effectively!address!the!immediate!service!needs!of!people!or!places!at!risk!of!harm!or!victimization.!!Research!to!inform!these!guidelines!was!completed!by!an!inter1agency!working!group,!comprised!of!policy!and!practice!experts!from!six!provincial!ministries,!and!from!police!and!community!agencies!representing!six!Ontario!municipalities.!!!!!



In!looking!at!the!information!sharing!challenge,!the!working!group!considered!the!following!questions!in!the!context!of!the!broader!movement!and!change!dynamics!currently!underway!in!Ontario:!!

!• What!do!we!think!is!going!to!come!out!of!this!analysis?!• What!will!the!professional!community!value!most!in!our!deliverable!package?!!• What!are!the!relative!benefits!of!inventories,!interpretations,!conclusions,!

and/or!recommendations?!!They!also!recognized!a!need!for!this!work!to!communicate!to!the!most!influential!drivers!of!change.!!From!these!early!deliberations,!and!recognizing!the!rapid!evolution!underway!around!emerging!models!of!community!safety!and!well1being!in!the!province,!the!group!determined!that!an!interpretive!approach!would!yield!the!most!immediate!and!practical!benefit!to!the!broad!community!of!interest.!!The!working!group!members!framed!their!guidance!as!follows:!!

What!are!we!collectively!learning!about!the!existence!and!range!of!relevant!legislation,!regulation,!policy!and!protocols!in!use?!!What!more!do!we!think!the!professionals!in!all!sectors!involved,!and!their!respective!executive!policy!makers,!need!to!know!right!now?!!And!what!principles!must!govern!our!approach!to!this!issue!in!Ontario?!!

This!in!turn!led!to!the!recognition!that!this!guidance!needs!to!be!offered!on!three!distinct!levels:!!

Level!One!–!Sharing!Information!in!the!Interests!of!Community!Safety!and!Well1being:!Eight!Framing!Principles!

!One!of!the!constructs!of!our!modern!bureaucracy,!and!its!acculturated!tendency!to!organize!human!services!into!‘silos’,!is!the!pressure!put!on!executives!to!grow!and!manage!those!services!in!an!environment!of!fierce!competition!for!diminishing!public!resources,!and!thus!to!protect!them!from!outside!criticism!and!potential!liability!for!their!actions!and!decisions!as!much!as!possible.!!Both!of!those!pressures!join!the!higher!order!social!expectations!and!legal!obligations!concerning!protection!of!privacy!and!confidentiality!to!create!very!secure!vaults!of!service!information,!and!to!condition!workers!at!all!levels!of!the!organization!with!a!first!instinct!to!withhold!information.!!That!is!the!context!in!which!this!working!group!was!asked!by!the!OWG!to!provide!guidelines!for!information!sharing!between!agencies.!!!!!!

Scope!of!the!Examination!and!Resulting!Guidelines!



As!a!first!step!in!developing!interpretive!answers!to!all!of!these!questions,!the!multi1sector!working!group!explored!the!issues!in!depth,!and!offers!in!Level!One!a!number!of!resulting!principles!that!are!vital!to!providing!a!solid!and!re1established!foundation!on!which!to!make!essential!decisions!about!sharing!or!withholding!personal!and!confidential!information!at!every!level!of!collaboration.!!The!principles!emerged!from!an!informed!dialogue!among!professionals!representing!a!wide!range!of!perspectives!on!the!challenges!and!complexities!in!keeping!individuals,!families!and!communities!safe,!healthy,!and!free!from!harm.!!A!theme!analysis!was!conducted!against!the!notes!arising!from!these!multiple!conversations,!from!some!preliminary!interpretive!work!conducted!by!the!group!on!several!samples!of!legislation,!regulation!and!protocols,!and!from!the!available!evidence!base!on!the!role!played!by!risk!in!community!safety!and!well1being,!including!the!social!determinants!of!health,!well1documented!criminogenic!risk!factors,!and!other!sources.!!It!is!our!belief!that!adherence!to!these!principles!will!help!both!the!policy!maker!and!the!practitioner!make!the!best!decisions!about!sharing!personal!and!confidential!information,!and!in!so!doing,!will!strengthen!emerging!practices!that!are!contemplated!throughout!this!series!of!papers.!!Discovery!of!these!eight!principles!was!driven!in!part!by!the!experiences!of!front!line!human!services!workers!who!are!struggling!to!find!effective!ways!they!may!legally,!ethically!and!effectively!collaborate!in!order!to!reduce!the!chances!that!people!at!risk!of!harm!will!actually!become!victims.!!But,!in!the!process!of!isolating!these!principles,!what!we!have!discovered!encourages!us!to!recognize!that!they!are!just!as!appropriate!for!consideration!by!agency!executives!and!lawmakers!as!well.!!Collaboration!on!the!front!lines!of!service!delivery!works;!we!have!seen!it!succeed!in!reducing!victimization!and!crime!in!other!jurisdictions.!!But!if!collaborative,!community1wide!safety!planning!is!going!to!work,!then!information!also!needs!to!be!shared!across!all!relevant!sectors!at!the!municipal!level,!between!and!among!those!agency!executives.!We!are!already!beginning!to!see!spontaneous!information!sharing!occur!in!some!Ontario!municipalities!11!driven!in!some!cases!by!the!need!for!effective!health!planning.!!At!the!provincial!level,!the!same!applies.!How!can!we!encourage!municipal!level!agencies!to!share!information!and!collaborate!to!produce!more!holistic!solutions!to!local!problems!if!we!continue!to!have!provincial!agencies!impose!policies!and!standards!that!may!inhibit!effective!collaboration?!!!So,!while!these!guidelines!emerged!from!the!need!for!systems!change!at!the!local!level,!we!would!assert!



that!to!be!sustainable,!local!innovations!require!systemic!reform!up!stream!as!well.!

!Level!Two!–!Guidance!for!Policy!Makers!and!Data!Managers!on!System1wide!

Information!and!Data!Sharing!!Several!broader!questions!flow!from!the!application!of!these!principles!to!decisions!about!information!and!data!sharing!across!the!system,!and!beyond!the!frame!of!front1line!interactions!among!professionals.!!In!Level!Two,!we!trace!some!of!these!considerations!with!a!view!to!encouraging!promising!programming!already!underway!in!Ontario,!and!to!stimulate!continuing!actions!and!investments!in!this!direction.!!!For!example:!!

• What!has!the!OWG!exercise!told!us!to!date!about!the!broad!systemic!challenges!associated!with!collaborative,!risk1driven!models!of!community!safety!and!well1being?!!

!• What!opportunities!might!exist!to!advance!information!and!data!sharing!

more!generally!across!multiple!sectors,!in!support!of!all!components!and!phases!of!the!frameworks!of!community!safety!planning!being!considered?!(Note:!For!additional!background,!see!also!the!discussion!on!Information!Sharing!in!the!Framework!for!Planning…Community!Safety!and!WellSbeing)!!

!• Under!what!circumstances!and!in!what!forms!could!data!currently!being!

collected!for!isolated!purposes!be!effectively!combined,!connected!and!utilized!to!inform!other,!more!general!purposes,!if!tied!to!consistent!goals!of!the!system?!(see!also!Collaborative!Analysis!for!Systemic!Improvements)!

!• What!more!do!we!think!policy!makers!need!to!know!right!now!to!assist!

them!in!guiding,!encouraging!and!supporting!the!adoption!of!these!new!models!from!the!highest!responsibility!levels!of!every!sector!that!contributes!to!an!effective!human!services!system!in!Ontario?!!

!Level!Three!–!Guidance!for!Practitioners!at!Collaborative,!Risk1driven!Situation!

Tables!!To!provide!immediate!assistance!to!those!professionals!who!have!become!or!may!soon!become!engaged!in!collaborative,!risk1driven!rapid!intervention!models!(i.e.!the!Situation!Table,!described!more!fully!below!and!also!in!



Mitigating!Acutely!Elevated!Risk!of!Harm),!the!immediate!questions!that!have!shaped!Level!3!of!this!interpretive!guide!are:!!

• What!has!our!analysis!revealed!about!possibilities!and!challenges!for!moving!forward!with!collaborative,!risk!driven!approaches!to!community!safety!and!well1being?!!

!• What!more!do!we!think!the!professional!community!needs!to!know!right!

now!in!order!to!advance!confidently!and!responsibly!with!Situation!Tables!in!the!province?!

!• What!degree!of!interpretation!(of!law!or!policy)!is!currently!required!by!

the!professionals!and!front!line!agency!representatives?!!• How!equipped!are!these!individuals!to!make!those!interpretations,!and!

how!can!they!be!better!supported!in!making!these!determinations!in!practice?!

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Level!One!!Sharing!Information!in!the!Interests!of!Community!Safety!and!Well0being:!!Eight!Framing!Principles!

!The!classic!phrase!“First,!do!no!harm”!is!more!familiar!in!the!context!of!health!care!and!bioethics,!where!it!serves!to!remind!professionals!that!those!sometimes1difficult!interventions!must!

always!be!undertaken!within!a!strictly!ethical!framework!and!with!the!balance!tilted!in!favour!of!a!patient’s!overall!wellness.!!Similarly,!it!serves!well!as!the!first!consideration!in!choosing,!designing,!adapting!and!implementing!any!new!methods!of!multi1sector!intervention!for!the!purposes!of!community!and!individual!safety!and!well1being.!!This!is!particularly!true!when!applied!to!the!question!of!whether!private!and!confidential!information!should!be!shared,!even!in!the!best!of!interests.!!!!This!principle!requires!that!practitioners!first!and!continually!operate!to!the!best!of!their!ability!in!ways!that!will!more!positively!than!negatively!impact!those!whose!privacy!may!be!affected.!!It!reminds!practitioners!that!privacy!legislation!and!related!guidelines!have!evolved!in!Canada!for!very!good!reasons,!and!nothing!in!the!new!approaches!being!contemplated!in!Ontario!should!ever!seek!to!undermine!those!protections.!!It!provides!our!service!managers,!governing!authorities,!policy!makers!and!legislators!with!one!super1ordinate!criterion!for!every!decision!they!must!make!as!this!province!seeks!to!enable!more!effective!strategies,!tactics!and!practices!for!achieving!safety!and!well!being!at!the!community!level.!!And!finally,!it!communicates!clearly!to!those!who!may!question!these!emerging!practices!that!the!interests!of!the!individual!or!family!will!remain!at!all!times!a!priority!consideration!for!all!involved.!!

Public!officials!across!the!spectrum!of!human!services!assume!within!their!roles!a!high!degree!of!professional!responsibility!to!protect!individuals!and!communities!from!harm.!!Part!of!this!

involves!the!first!principle!above.!!!But!additionally,!this!same!responsibility!entails!a!Duty!of!Care.!!For!example,!the!first!principle!behind!legislated!child!protection!provisions!across!Canada!is!the!duty!to!report,!collaborate,!and!share!information!as!necessary!to!ensure!the!protection!of!children.!!Similar!obligations!apply!with!regard!to!young!persons!in!conflict,!or!potentially!in!conflict!with!the!law,!with!students!in!classrooms,!with!persons!with!special!needs,!and!with!persons!experiencing!mental!health!issues!and!addictions.!!And,!taking!action!to!protect!all!our!citizens!from!violence!is!also!an!obligation!of!the!state,!as!contemplated!within!the!Charter2!and!elsewhere!in!Canadian!law,!and!as!expressed!under!the!principles!of!several!international!agreements3.! 2!Canadian!Charter!of!Rights!and!Freedoms.!s!7.!3!Kjaerulf!F,!Barahona!R.!(2010).!Preventing!violence!and!reinforcing!human!security:!a!rights1based!framework!for!top1down!and!bottom1up!action.!Rev!Panam!Salud!Publica.!2010:27!(5)!382–95.!

1. Do!No!Harm!!

2. A!Duty!of!Care!!



!As!a!result,!in!deciding!whether!to!withhold!personal!and!confidential!information!from!another!professional,!human!service!practitioners!are!required!to!use!the!same!watchfulness,!attention,!caution!and!diligence!that!would!be!expected!of!any!other!person!in!similar!circumstances!to!ensure!that!no!harm!accompanies!that!decision.!!!!Anything!short!of!that!would!not!meet!the!standard!of!care!or!service!for!which!they!are!responsible.!!In!short,!many!human!service!professionals!are!obligated!to!share!information!when!high1risk!circumstances!demand!it.!!

As!in!all!aspects!of!professional!work,!any!decision!to!share!information!must!be!executed!under!appropriate!professional!discipline.!!Nothing!in!the!provisions!and!guidance!which!follows!

contemplates!a!careless!exchange!of!personal!and!confidential!information!at!any!time,!but!rather!reflects!the!need!for!a!conscientious!methodology!for!meeting!and!balancing!the!obligations!outlined!in!the!previous!two!principles.!!The!Professional!Discipline!principle!presumes!the!highest!standards!of!professional!practice!(e.g.!adherence!to!the!policies!and!procedures!upheld!by!the!profession),!care!for!those!for!whom!service!and!supports!are!contemplated,!and!ethical!behaviour.!A!practitioner!deciding!whether!to!share!personal!and!confidential!information!must!also!consider!the!professional,!ethical!and!moral!integrity!of!the!individuals!and!organizations!that!will!or!that!might!receive!that!information.!!!Under!this!principle!the!decision!to!share!information!must!only!be!made!if!the!practitioner!is!first!satisfied!that!those!individuals!and!organizations!will!also!receive,!protect,!and!act!upon!that!information!in!accordance!with!established!professional!and!community!standards.!!As!this!relates!to!collaborative!community!safety!and!well1being!practices,!this!principle!reinforces!the!need!to!establish!solid!planning!frameworks!and!carefully!structured!processes!as!contemplated!throughout!these!guidelines.!

!This!principle!is!well!established!in!many!privacy!provisions!in!place!in!Ontario,!and!it!is!a!particularly!useful!guide!to!professionals!seeking!to!achieve!the!correct!balance.!!It!dictates!that!information!must!only!ever!be!shared!for!purposes!that!can!

be!reasonably!deemed!to!be!consistent!with!the!role!of!the!information!holder,!and!consistent!with!the!professional!responsibilities!for!which!the!information!came!into!the!possession!of!the!professional!and/or!agency!involved!in!the!first!place.!!For!example,!if!the!original!reason!for!the!information!was!to!provide!care,!sharing!it!must!enhance!or!further!that!care;!if!to!provide!protection!from!harm!or!prevention!of!a!crime,!it!must!enhance!or!further!that!protection!or!prevention;!if!to!keep!someone!safe,!it!must!enhance!or!further!that!individual’s!safety.!

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3. Professional!Discipline!!

4. Consistent!Purpose!



Beyond!the!simple!decision!to!share!or!not!to!share,!this!principle!also!serves!to!inform!three!additional!dimensions:!the!nature!of!the!information!to!be!shared;!the!scope!of!that!information;!and,!the!range!of!recipients!with!whom!it!is!shared.!!These!dimensions!have!application!at!both!the!front!lines!and!at!the!broader!systemic!level.!!For!example,!in!a!given!situation!it!may!fall!outside!of!Consistent!Purpose!for!one!practitioner!to!share!a!piece!of!identified,!personal!and!confidential!information,!with!other!professionals!working!in!other!human!service!sectors.!!But,!provided!the!subjects!in!the!situation!involved!can!be!carefully!kept!anonymous,!greater!latitude!would!apply.!!And,!the!scope!of!the!information!might!also!come!into!play!in!such!a!decision,!such!that!it!may!fall!within!Consistent!Purpose!to!only!share!details!selectively,!carefully!limiting!disclosure!to!directly!relevant!information!that!could!better!inform!a!multi1sector!perspective!on!the!risk!factors!facing!that!individual.!!And!finally,!while!it!might!be!acceptable!to!share!very!limited!information!among!a!diverse!group!of!concerned!professionals!to!better!understand!a!situation,!more!specific!details!may!only!meet!the!Consistent!Purpose!test!among!a!very!narrow!few,!those!who!have!the!most!direct!roles!to!play!in!any!intervention.!!Similarly,!designing!a!multi1sector!risk!analysis!system!that!might!cross1tabulate!identifiable!personal!and!confidential!information!for!research!purposes!would!require!a!significantly!high!standard!of!security,!with!adequate!firewalls!to!guard!against!inconsistent!uses!of!the!information.!!On!the!other!hand,!it!may!be!much!more!acceptable!to!develop!robust!analytics!that!rely!solely!on!anonymous!data,!at!least!up!to!the!point!that!certain!risk!factor!thresholds!are!reached,!at!which!time!Consistent!Purpose!might!indeed!be!invoked!to!activate!legitimate!sharing!of!more!identifiable!details!for!intervention!purposes.!!

The!privacy!provisions!that!govern!any!multi1sector!approaches!to!community!safety!and!well1being!consistently!recognize!and!establish!that!the!best!and!most!reliable!course!to!follow!before!sharing!personal!and!

confidential!information!is!to!gain!the!consent!of!the!subject!or!subjects!involved.!!The!professionals!involved!in!collaborative!models!of!community!safety!must!always!respect!these!provisions!wherever!possible.!!To!the!degree!that!conventional!provisions!may!apply!to!the!situations!they!encounter,!they!must!continue!to!follow!their!established!protocols.!!At!the!same!time,!many!of!these!same!privacy!provisions!also!consistently!recognize,!albeit!in!varied!language,!that!a!probability!of!harm!or!a!potential!deficiency!in!care!may!constitute!a!valid!reason!for!qualified!professionals!to!act!in!the!best!interests!of!the!individual,!family,!or!even!the!community!involved,!under!a!principle!of!Implied!Consent4.!!

4!For!one!example!explanation!of!this!concept,!see!IPC!(2004).!Frequently!asked!questions:!Personal!Health!Information!and!Privacy!Act.!pp.!22124.!Toronto.!!Information!and!Privacy!Commissioner!of!Ontario.!

5. Consent!or!Implied!Consent!



!Consent!becomes!“implied”!when!it!is!not!expressly!granted!by!a!person,!but!rather!inferred!by!the!practitioner!from!a!person's!actions!and/or!the!facts!and!circumstances!of!a!particular!situation!about!which!the!practitioner!is!considering!sharing!personal!and!confidential!information.!!When!Implied!Consent!is!invoked!in!making!a!decision!to!share!information,!a!practitioner!is!always!encouraged!to!follow1up!the!assumption!by!gaining!expressed!consent!as!early!as!possible.!!Appendix!B!highlights!that!some!legislative!acts!and/or!regulations!dictate!that!when!Implied!Consent!is!to!be!relied!upon,!specific!requirements!may!apply!regarding!immediate,!written!notification!to!the!subject(s)!involved.!!As!well,!some!legislative!acts!and/or!regulations!dictate!that!under!certain!circumstances,!consent!must!always!be!expressed!and!not!implied,!but,!it!is!also!possible!that!under!some!circumstances,!other!provisions!related!to!probable!harm!may!have!the!effect!of!overriding!this!requirement.!!Professionals!should!always!consult!their!relevant!policy!frameworks!with!regard!to!this!principle.!!

The!members!of!the!multi1sector!working!group!examined!a!wide!range!of!provisions!in!law,!in!regulation!and!in!existing!protocols,!and!ultimately!determined!that!as!desirable!as!it!may!seem,!it!is!not!

possible!to!assert!any!definitive!rules!for!making!hard!and!fast!determinations!about!sharing!or!withholding!information,!as!highlighted!in!the!preceding!principle.!!Furthermore,!it!is!unlikely!that!the!spirit!of!any!of!these!foregoing!principles!would!be!well!served!by!such!a!rigid!framework,!in!that!this!would!remove!professional!judgment!and!situational!responses!from!the!equation.!!!!Lawmakers!often!keep!legislation!broad!with!the!expectation!that!qualified!and!responsible!practitioners!will!further!define!and!realize!upon!its!full!potential!in!practice.!!Thus,!it!may!be!incumbent!on!all!professionals!and!executives!across!the!human!services!system!to!reframe!this!discussion!as!often!as!possible.!!There!would!certainly!be!unacceptable!levels!of!organizational!risk!in!ever!offering!free!license!to!practitioners!on!the!basis!of!one!set!of!interpretations!or!another.!!But,!balancing!that,!there!is!as!much!to!lose!in!adopting!an!excessively!rigid!and!restrictive!stance!out!of!a!simple!deference!to!caution.!!!

!To!guard!against!both!extremes!requires!us!to!avoid!simple!answers.!With!professional!diligence!and!well1informed!practices,!successful!navigation!of!this!complex!issue!is!possible.!!More!examples!of!this!are!shown!in!Appendix!B!of!this!document,!with!commentary!to!highlight!this!principle!in!application.!

6. Precise!Rules!are!Neither!Possible!Nor!Appropriate!



!Guidance!can!and!must!be!provided!to!assist!professionals!and!agencies!in!making!these!often1difficult!determinations!while!acting!in!good!faith!and!with!the!correct!balance!of!their!responsibilities!in!mind.!!But!as!there!are!no!hard!and!fast!rules!to!be!

relied!upon,!in!the!end!the!decision!will!require!a!call!made!by!the!practitioner,!together!with!his!or!her!would1be!collaborators,!on!the!basis!of!myriad!considerations!about!the!situation.!!Thus,!it!must!remain!the!duty!of!all!professionals!involved!to!seek!the!clarifications!they!may!require!from!within!their!respective!sectors!and!to!document,!evaluate!and!share!their!resulting!decisions!as!much!as!possible,!with!a!view!to!building!a!stronger!and!broader!base!of!experience!and!evidence.!!Further,!this!must!be!done!on!an!ongoing!basis!as!practices!evolve,!so!that!this!experience!ultimately!serves!to!advance!our!collective!understanding!and!our!abilities!to!apply!these!practices!with!growing!confidence.!!!!Furthermore,!all!professionals!who!may!become!involved!in!sharing!information!for!purposes!of!community!safety!and!well1being,!as!contemplated!elsewhere!in!this!paper,!must!remain!mindful!of!their!legal!commitments!under!confidentiality!and!non1disclosure!agreements.!!To!the!extent!that!personal!and!confidential!information!about!individuals!or!families!may!be!encountered!during!the!good!faith!execution!of!their!duties,!including!information!to!which!it!turns!out!later!they!may!have!no!direct!entitlement!or!Consistent!Purpose!within!their!own!roles,!they!must!act!as!professionals!and!take!measures!to!prevent!any!further!disclosure,!discussion,!or!record!keeping!of!such!information.!!!It!is!similarly!incumbent!upon!the!organizers!of!such!forums!as!the!Situation!Table,!described!later!in!this!paper,!to!adopt!appropriate!memoranda!of!understanding!and!effective!non1disclosure!agreements!as!part!of!their!practice.!!

Much!of!the!privacy1related!legislative,!regulatory!and!policy!framework!that!currently!exists!across!Ontario’s!human!services!has!been!crafted!over!several!years!in!

the!absence!of!the!emerging!insights!and!trends!in!community!safety!and!well1being!now!being!considered.!!Through!the!analysis!involved!in!developing!this!interpretive!guide,!certain!gaps!in!language!and!clarity!have!already!been!identified,!and!others!will!undoubtedly!emerge!as!these!new!practices!evolve!over!the!months!ahead.!!

7. Due!Diligence!and!Evolving!Responsible!Practice!

8. Opportunities!for!Reform!do!Exist!!



Other!jurisdictions!across!Canada!are!engaged!in!similar!examinations!of!their!policies,!as!they!also!give!consideration!to!emerging!models!of!collaborative!risk1driven!community!safety.!!There!is!a!good!proportion!of!federal!legislation!that!shapes!information!sharing!practices!in!Ontario!and!other!provinces.!!Looking!ahead,!Ontario!is!well!positioned!to!bring!leadership!and!experience!to!any!Federal1Provincial1Territorial!forums!that!might!emerge!with!a!view!to!bringing!greater!clarity!to!these!issues!at!home.!!

In!addition!to!informing!the!Level!Two!and!Level!Three!discussions,!which!follow!below,!these!eight!principles!also!provided!a!useful!focus!and!structure!to!the!analysis!that!is!reflected!in!the!sub1appendices!to!this!guide.!!!!

Appendix!A!provides!a!comprehensive!inventory!of!the!relevant!pieces!of!legislation!and!regulation!currently!in!place!in!Ontario!that!in!one!way!or!another!‘cut!across’!the!issues!of!information!sharing!for!the!purposes!under!discussion.!!Considering!the!breadth!and!volume!of!material,!the!working!group!elected!to!follow!a!sampling!approach!with!a!view!to!determining!trends!and!general!insights!that!could!best!inform!our!collective!understanding!of!the!challenges!and!permissions!represented!within!current!law.!!Appendix!B!highlights!a!number!of!these!items!selected!for!closer!review!from!this!full!list.!!As!each!piece!was!examined,!relevant!sections!and!clauses!related!to!barriers!and/or!permissions!for!sharing!private!information,!with!consent,!Implied!Consent,!or!no!consent,!were!isolated!and!discussed,!and!this!is!reflected!in!the!commentary!in!that!section.!

A!Framework!for!Analysis!Emerges!from!these!Principles!

!



Level!Two:!Guidance!for!Policy!Makers!and!Data!Managers!!on!System0wide!Information!and!Data!Sharing!!While!much!of!the!direct!motivation!behind!this!paper!arises!from!the!pending!adoption!of!multi1sector!rapid!intervention!models!in!Ontario,!or!the!so1called!Situation!Tables!described!in!greater!detail!below,!it!is!also!important!to!address!the!broader!questions!of!information!sharing!as!well,!in!response!to!general!trends!emerging!from!the!OWG,!and!from!policing!and!health!initiatives!in!Ontario,!and!from!those!arising!under!the!current!Shared!Forward!Agenda!on!the!Economics!of!Policing!at!the!Federal1Provincial1Territorial!level!as!well.!!We!are!on!the!verge!of!a!sea!change!in!our!collective!thinking!about!information!related!to!safe!and!healthy!communities,!families!and!individuals.!!After!more!than!a!generation!of!systems!evolution!that!has!resulted!in!extreme!siloing!of!data,!professionals!in!all!sectors!are!recognizing!that!while!adopting!increasingly!rigorous!and!well1intentioned!measures!to!protect!the!privacy!of!all!citizens,!we!may!have!inadvertently!diminished!our!ability!to!act!collectively!and!responsibly!in!serving!those!with!the!most!critical!needs!for!our!services.!!The!current!Health!Links!strategy,!Ontario’s!Open!Government!initiatives,!and!new!cross1sector!analytics!on!justice!system!recontact!being!pursued!by!the!Canadian!Centre!for!Justice!Statistics!(CCJS)!are!just!a!few!examples!of!attempts!to!swing!this!pendulum!back.!!For!Ontario!policy!makers!and!data!managers!alike,!this!trend!of!reversal!challenges!current!workplace!cultures!and!requires!confident!leadership!in!every!part!of!our!human!services!system.!!Potential!benefits!are!encouraging!and!essential.!!Isolated!service!models!are!expensive,!unresponsive,!and!insufficient.!!Conversely,!collaborative!approaches!bring!efficiency,!effectiveness,!timeliness,!and!greater!accuracy!to!our!efforts,!leading!to!better!outcomes!for!our!communities.!Collaboration,!by!definition,!demands!sharing!information!and!data!sets!to!the!extent!required!for!timely,!appropriate!and!supportive!programming,!while!still!respecting!the!privacy!protection!responsibilities!that!apply!to!the!respective!data!owners!across!the!system.!!By!adhering!to!the!spirit!of!the!principles!outlined!above,!new!opportunities!will!exist!for!better!understanding!the!sources!and!nature!of!the!demands!on!all!of!our!public!services.!!Here!are!just!some!examples,!some!already!underway,!and!some!that!might!lie!ahead!for!human!service!agencies!and!professionals!in!Ontario:!!

• Collaborative!analytics!based!upon!de1identified!risk!pattern!data!arising!from!Situation!Tables!

• Integrated!multi1sector!heat!mapping,!a!process!for!geographically!representing!concentrations!of!at1risk!and!under1serviced!people!and!locations!across!a!spectrum!of!social!determinants!of!health,!well1being,!prosperity!and!criminogenic!factors!



• Using!CCJS!recontact!data!to!track!the!greatest!demands!on!police,!corrections!and!courts,!as!well!as!on!the!health,!mental!health!and!addictions!sectors!

• Conducting!recontact!informed!analysis!to!reveal!composite!risk!patterns!among!those!presenting!the!highest!risk!and!frequency!of!contact!with!the!criminal!justice!system!

• Integrated!health,!social!services,!education!and!criminal!justice!data!analysis!to!identify!and!plan!for!predictive!risk!patterns!at!local,!regional!and!provincial!levels!

• Integrated!analysis!of!health,!courts,!policing!and!corrections!datasets!to!reveal,!better!plan!for,!and!meet!the!needs!of!individuals!for!non1criminalizing!treatment!and!supports!for!persons!living!with!mental!health!issues!

!Many!of!these!initiatives!may!be!able!to!proceed!to!some!degree!using!anonymous!data,!but!nonetheless,!all!of!them!will!challenge!our!current!tendencies!towards!data!ownership.!!As!appreciation!for!the!new!service!potentials!that!arise!from!collaborative!analysis!continues!to!grow,!we!can!anticipate!continuing!pressure!to!confront!any!and!all!barriers!to!the!most!effective!and!efficient!utilization!of!data!sets.!!To!that!end,!the!OWG!is!confident!that!the!practices!outlined!in!this!guide,!and!those!more!broadly!described!in!the!Framework!for!Planning…Community!Safety!and!WellSbeing!will!accelerate!the!advancement!of!a!renewed!culture!of!collaboration!across!Ontario’s!human!services,!and!thus!help!to!drive!continued!innovations!such!as!these!at!the!systemic!level.!!The!eight!framing!principles!in!Level!One!can!also!inform!those!who!will!be!charged!with!conceiving,!planning!and!executing!any!of!these!larger!scale!efforts!at!data1based!collaboration,!as!illustrated!in!part!by!the!following!sample!discussion!points:!!

• Dramatic!lessons!from!the!United!States!with!respect!to!public!outcry!over!massive!data!collection,!and!both!real!and!perceived!privacy!violations,!serve!to!underscore!how!essential!the!Do!No!Harm!principle!will!be!to!the!conception!and!execution!of!any!so1called!big!data!models!for!collaboration!in!Ontario.!!!

!• Both!in!practice!and!in!messaging,!it!will!be!vital!that!considerations!for!security,!

data!segregation,!and!Consistent!Purpose!remain!front!and!centre!at!all!times.!!

• The!Duty!of!Care!principle!should!serve!as!a!powerful!motivator!as!we!seek!to!restore!and!find!new!linkages!in!the!care!path!and!in!the!service!path!of!persons!facing!cumulative!risk!factors,!with!a!view!to!developing!more!comprehensive!and!collaborative!ways!of!meeting!their!needs!before!they!reach!crisis!levels.!

!!!!



• Once!available,!collaborative!data!should!also!empower!the!province’s!academic!community!to!conduct!new!forms!of!research.!!Consistent!with!the!principle!of!Evolving!Responsible!Practice,!it!is!necessary!that!any!such!research!go!beyond!the!theoretical,!and!be!greeted!by!policy!makers!and!practitioners!as!valuable!new!insights!to!better!inform!practice,!and!lead!to!better!and!more!efficient!alignment!of!our!investments!in!community!safety!and!well1being.!!

!• Under!the!principle!that!Opportunities!for!Regulatory!Reform!Do!Exist,!it!should!

be!anticipated!that!moving!forward!on!larger!scale!collaborations!will!serve!to!illuminate!new!ways!to!build!a!more!enabling!and!economically!sound!legislative!and!regulatory!framework!around!our!human!services!in!Ontario.!

!



Level!Three!Guidance!for!Practitioners!at!Collaborative,!Risk0driven!Situation!Tables!!

The!concept!of!multi1agency!risk!driven!intervention!refers!to!special!forums!wherein!professionals!from!a!variety!of!human!service!sectors!convene!to!identify!the!need!and!develop!immediate!plans!for!multi1agency!

interventions.!These!forums!and!their!resulting!interventions!are!intended!to!reduce!elevated!risk!situations!that,!if!left!unattended,!are!highly!likely!to!create!harm!to!individuals,!families!or!the!community.!!Current!examples!of!this!type!of!forum!include!the!Hub,!currently!operating!as!part!of!Community!Mobilization!Prince!Albert!and!elsewhere!in!Saskatchewan,!the!youth1focused!Hybrid!Hubs!operating!in!and!around!Halifax,!NS,!the!active!intervention!table!operating!at!FOCUS!Rexdale!in!Toronto,!and!the!Gateway!Hub!operating!within!the!North!Bay!Community!Mobilization!project.!!Several!other!examples!are!currently!under!consideration!and/or!development!in!other!Ontario!jurisdictions.!!While!variations!in!the!precise!structure!and!composition!of!these!and!other,!similarly1inspired!models!can!be!expected,!for!simplicity!and!consistency!with!OWG1adopted!language!in!Ontario,!we!will!refer!to!these!various!risk!intervention!forums!as!“Situation!Tables.”!!!A!Situation!Table!is!a!discussion!between!multiple!agencies!that!may!include!government!institutions,!local!authorities,!health!trustees,!police!services,!First!Nations!or!other!culturally!representative!groups,!and!community1based!organizations!in!the!human!services!delivery!sector!taking!place!on!a!regular,!frequent!basis.!!It!is!typically!a!discussion!and!does!not!take!on!any!actual!case!management!role!or!authority.!!The!case!management!and!the!actual!service!delivery!roles!fully!remain!with!the!agencies.!!The!discussion!focuses!on!providing!immediate!coordinated!and!integrated!responses!through!mobilization!of!resources!to!address!situations!facing!individuals,!families!or!environments!with!risk!factors,!as!recognized!across!a!range!of!service!providers.!!!The!purpose!of!these!regularly!scheduled!integrated!meetings!is!to!discuss!situations!brought!forward!by!one!or!more!agencies!that!have!recognized!cumulating!circumstances!of!acutely!elevated!risk!(defined!further!below)!to!an!individual!or!the!community,!circumstances!that!appear!to!extend!beyond!their!own!scope!of!expertise!and/or!responsibility.!!By!cautiously!and!progressively!sharing!limited!information!about!the!situation,!participants!seek!recognition!from!their!colleagues!in!other!sectors!who!may!have!a!role!to!play!in!mitigating!the!circumstances!that!could!lead!to!harm.!!These!agencies!work!together!to!mobilize!existing!resources!with!the!expectation!that!early!intervention!can!help!the!individuals!and/or!community!in!question!and,!by!connecting!them!swiftly!to!multiple!services,!can!reduce!the!possibility!of!the!situation!worsening!to!the!point!where!more!significant!problems!emerge!and!result!in!more!formal!and!much!more!limited!response!options!from!police,!child!protection!services,!or!other!enforcement!agencies.!!

What!is!Multi0agency!Risk0driven!Intervention!“or!a!Situation!Table”?!



Each!agency!only!brings!to!the!discussion!table!those!situations!that!it!has!determined!may!involve!risk!factors!beyond!its!own!scope!or!usual!practice,!and!thus!represent!situations!that!could!be!much!more!effectively!addressed!in!a!multi1agency!manner.!!The!agency!must!therefore!examine!each!situation!carefully!and!come!to!the!conclusion!that!the!risks!posed!by!situation!are!serious!enough!to!take!to!the!table!for!discussion!there.!!These!situations!are!relatively!exceptional,!with!significantly!more!being!handled!in!the!normal!course!of!business!than!taken!to!the!Situation!Table.!!!Criteria!that!can!be!taken!into!account!at!this!stage!include5:!!

!• The!intensity!of!the!presenting!risk!factors,!as!in:!Is!the!presenting!risk!of!such!

concern!that!sharing!of!personal!and!confidential!information!may!be!justified!by!bringing!the!situation!to!the!table!for!discussion?!!

• Is!there!a!reasonable!expectation!of!probable!harm!if!nothing!is!done?!!!

• Would!that!harm!constitute!damage!or!detriment!and!not!mere!inconvenience!to!the!individual!or!to!the!service!providers?!!

!• Did!the!agency!do!all!it!could!to!mitigate!the!risks!before!bringing!forward!the!

situation?!!

• !Are!the!risks!applicable!across!multiple!agencies?!!!

• Is!it!reasonable!to!assume!that!disclosure!to!the!table!will!help!minimize!or!prevent!the!anticipated!harm?!!!

The!first!half!of!each!Situation!Table!meeting!is!devoted!to!follow1up!discussions,!where!prior!intervention!plans,!carried!out!since!the!last!meeting,!are!assessed!for!their!effectiveness!in!connecting!services!and!reducing!risks!to!manageable!levels.!!If!an!initial!intervention!did!not!reduce!the!risk!to!an!acceptable!level,!the!agencies!review!the!tasks!and!their!progress!to!determine!if!more!tasks!need!to!be!undertaken,!and!if!so,!by!whom.!!Once!the!existing!situations!are!discussed,!new!situations!are!introduced.!This!is!done!in!a!rounds!format!–!the!discussion!moves!around!the!room!allowing!any!person!at!the!table!to!propose!a!new!situation.!Situations!are!introduced!and!discussed!in!a!staged!approach!that!minimizes!disclosure!of!personal!and!confidential!information.!!Introduction!of!a!new!situation!begins!using!non1identifiable!information!only.!!Limited!identifiable!information!is!introduced!into!the!discussion!only!as!necessary!to!determine!actions.!This!process!is!described!more!fully!below.!!!

5!Justice!(2013).!!Guidelines!on!information!Sharing!at!Hubs.!!Regina.!!Saskatchewan!Ministry!of!Justice.!



It!is!important!to!stress!that!the!Situation!Table!must!at!all!times!be!a!highly!disciplined!conversation.!!It!must!never!be!regarded!as!a!place!of!convenience!for!

discussing!and!executing!case1work!that!should!otherwise!follow!normal!channels!and!operate!within!existing!provisions.!Thus,!in!service!of!this!principle,!participants!adopt!a!threshold!test!for!determining!the!substance!of!their!conversations,!and!that!threshold!combines!both!the!degree!of!probable!harm!involved!in!any!given!situation,!and!the!degree!to!which!the!operating!risk!factors!involved!cross!multiple!human!service!disciplines.!Taken!together,!these!combined!factors!represent!acutely!elevated!risk.!!!!This!term!was!initially!framed!and!adopted!under!the!Community!Mobilization!Prince!Albert!Hub!model!with!a!view!to!distinguishing!this!threshold!for!its!unique!purpose!of!supporting!the!validity!of!collaborative!intervention!planning6.!!It!is!deliberately!distinct!from!other!operating!thresholds!that!might!trigger!a!much!more!limited!range!of!unilateral!response!and!enforcement!options!by!one!or!more!of!the!agencies!involved,!often!characterized!by!common!terms!such!as!crisis,!imminent!danger,!violent!threat,!or!criminal!activity!in!progress.!

!Key!to!sharing!information!at!the!Situation!Table!is!the!need!to!strike!a!balance!between!an!individual’s!right!to!privacy!with!the!benefits!of!the!reduction!of!acutely!elevated!risk.!!The!Situation!Table!offers!a!new!way!for!these!service!providers!to!achieve!more!effective!integration!in!their!services,!leading!to!more!rapid!and!effectively!targeted!interventions!for!those!specific!and!critical!situations!where!these!are!most!essential!to!achieve.!!Perhaps!most!importantly,!the!Situation!Table!provides!for!risk1driven!and!preemptive!responses,!rather!than!the!more!typical!incident1driven!and!reactive!measures,!addressing!in!real!time!the!recognized!conditions!that!have!placed!individuals,!families!and/or!neighbourhoods!at!imminent!risk!of!harm,!disorder!or!conflict!with!the!law.!!!One!important!effect!of!adhering!to!this!threshold!is!that!it!quickly!prohibits!open!discussions!at!the!Situation!Table!of!routine!situations!brought!forward!for!consideration!that!would!be!better!and!more!appropriately!addressed!by!one!or!more!service!providers!in!the!normal!course!of!business.!!Situations!meeting!this!threshold!are!those!most!likely!to!benefit!greatly!from!collective!problem!solving!at!the!Situation!Table,!and!from!the!immediate!cooperative!action!taken!forward!from!the!meetings!by!the!most!appropriate!agencies.!!!

6!McFee,!D.R.!&!Taylor,!N.E.!(2014).!!The!Prince!Albert!hub!and!the!emergence!of!collaborative!risk1driven!community!safety.!Canadian!Police!College!Discussion!Paper!Series:!Change!and!Innovation!in!Canadian!Policing.!!C.!Murphy,!Ed.!Ottawa.!!Canadian!Police!College.!

Acutely!Elevated!Risk!



Note!that!the!dynamic!nature!of!these!types!of!situations!precludes!any!hard!and!fast!rules!for!defining!such!a!threshold.!Rather,!it!is!the!active!participation!and!wide1ranging!qualifications!of!the!multiple!professionals!involved!that!establishes!its!validity,!and!it!is!this!reliance!on!a!consensus!of!experts!that!ensures!the!necessary!discipline!in!the!conversation.!!!

Along!with!the!type!of!information!that!is!shared,!with!whom!that!information!is!shared!is!just!as!important!a!consideration.!!It!is!strongly!recommended!that!Situation!

Tables!adopt!a!four1filter!approach!to!the!sharing!of!information!in!order!to!operate!carefully!within!the!circumstantial!provisions!so!common!to!existing!privacy!policy,!as!discussed!in!Level!One!above!and!as!outlined!in!Appendix!B!below.!The!four!filters!will:!!!

• Only!allow!situations!of!acutely!elevated!risk!to!be!discussed;!!• Minimize!the!identifiable!personal!information!and!personal!health!information!

that!is!disclosed!to!the!discussion;!!• Limit!the!agencies!to!which!the!information!is!disclosed;!and!!• Limit!the!recording!of!identifiable!information!–!i.e.!only!agencies!with!a!role!to!

play!record!identifiable!information!and!no!identifiable!information!is!recorded!in!the!central!records!of!the!Situation!Table.!!

!This!is!the!approach!that!has!evolved!out!of!three!years!of!experience!and!extensive!consultations!among!privacy!experts!examining!Community!Mobilization!Prince!Albert,!where!it!has!been!applied!with!considerable!success7.!!It!has!since!become!the!standard!for!all!Hubs!operating!in!that!province.!!It!is!also!the!approach!that!is!shaping!new!learning!programs!to!support!the!adoption!of!this!model!as!outlined!in!Mitigating!Acutely!Elevated!Risk!of!Harm.!!One!such!learning!program!showcases!and!explains!the!four1filter!process!as!follows:!!

• Filter!One:!Agency!Screening!prior!to!introduction!to!the!Hub!!!!The!first!filter!is!the!screening!process!within!the!agency!that!brings!forward!a!situation!for!discussion.!The!agency!determines!that!the!risk!factors!are!beyond!its!scope/mandate!to!mitigate!the!elevated!risk!and!all!traditional!inter1agency!approaches!have!been!excluded!from!consideration!or!exhausted.!It!is!the!responsibility!of!each!agency!to!organize!its!own!screening!process.!!!!

7!Nilson,!C.,!Winterberger,!M.,!and!Boechler,!T.!(2013).!Hub!Database!Methodological!Summary:!An!Overview!of!the!Ongoing!Development!and!Implementation!of!a!Database!Tracking!General!Information,!Risk!Factors!and!Activities!of!Hub!Discussions!Held!At!Community!Mobilization!Prince!Albert.!Prince!Albert,!SK:!Community!Mobilization!Prince!Albert.!!

The!Four0Filter!!Approach!



• Filter!Two:!De1identified!discussion!at!the!Situation!Table!!!!The!agency!then!presents!the!situation!to!the!discussion!in!a!de1identified!format.!This!allows!the!Situation!Table!to!collectively!decide!if!the!situation!meets!the!standard!of!acutely!elevated!risk!factors!across!a!range!of!service!providers,!before!any!personal!and!confidential!information!is!disclosed.!!The!wide!range!of!sector!specialists!at!the!discussion!is!the!ideal!setting!for!making!a!decision!as!to!whether!such!risk!factors!are!indeed!present.!If!the!circumstances!do!not!meet!this!threshold,!no!personal!and!confidential!information!is!disclosed!and!no!further!discussion!of!the!situation!occurs!at!the!Situation!Table.!!But,!if!at!this!point!the!consensus!is!that!sharing!information!with!the!Situation!Table!is!necessary!to!help!prevent!harm!or!inadequate!care!to!an!individual!or!the!public,!limited!disclosure!will!be!permitted!as!contemplated!within!the!circumstantial!provisions!found!in!relevant!privacy!protection!acts!and!regulations.!!!

• Filter!Three:!Limited!identifiable!information!shared!!!!If!the!agencies!conclude!that!the!above!threshold!is!met,!limited!identifying!information!will!be!shared,!only!to!the!extent!necessary!to!help!determine!who!should!continue!to!be!part!of!the!discussion.!!At!this!point,!the!Situation!Table!is!able!to!determine!which!agencies!will!be!required!to!participate!in!a!full!intervention!planning!discussion,!outside!of!the!full!table.!!It!is!also!at!this!threshold!that!the!Situation!Table!will!decide!to!begin!a!numbered!discussion!for!purposes!of!tracking!the!intervention.!!This!refers!to!the!creation!of!a!new,!strictly!de1identified!record!in!the!Situation!Table!database.!!Agencies!that!may!become!involved!in!the!intervention!and!follow1through!on!a!situation!will!use!this!anonymous!entry!number!as!a!point!of!reference!for!their!own!record!keeping!(as!in,!“this!case!was!discussed!at!a!Situation!Table”),!and!for!purposes!of!recognition!should!the!situation!return!to!the!table!at!some!future!point.!!All!responsibility!for!record!keeping!related!to!actual!case!management!will!remain!with!each!agency!that!has!a!role!to!play.!!The!Situation!Table!will!not!generate!nor!maintain!any!individualized!or!identifiable!records.!It!is!also!from!these!anonymous!entries!that!a!broad!range!of!analysis!into!community!risk!factors!and!agency!and!inter1agency!roles!can!later!be!conducted.!!(Note:!More!information!on!the!Situation!Table!database!options!can!be!found!in!Mitigating!Acutely!Elevated!Risk!of!Harm.)!



!• Filter!Four:!Full!in1camera!discussion!among!intervening!agencies!only!

!At!this!final!threshold,!only!those!identified!agencies!that!have!a!direct!role!to!play!in!an!intervention!will!meet!separately!to!discuss!limited!personal!and!confidential!information!that!needs!to!be!disclosed!in!order!to!inform!the!plan!for!addressing!the!acutely!elevated!risk!factors.!!Discussion!is!still!limited!to!only!the!information!that!is!deemed!necessary!to!assess!the!situation!and!to!determine!appropriate!actions.!!Sharing!of!information!at!this!level!proceeds!within!the!allowances!for!care,!and!for!individual!and!community!safety!that!apply!to!each!profession.!!In!all!cases,!obtaining!consent!to!provide!multi1sector!services,!and!to!permit!any!further!sharing!of!personal!and!confidential!information!in!support!of!such!services,!will!be!the!first!priority!of!the!combined!agencies!responding!to!the!situation.!

!!If!at!any!point!in!the!above!sequence!it!becomes!evident!that!resources!are!currently!being!provided!within!existing!agencies,!and!the!Situation!Table!is!confident!elevated!risk!is!already!being!mitigated,!there!is!no!further!discussion.!!!!!!Actions!arising!from!a!Situation!Table!discussion!are!taken!almost!immediately!by!one!or!more!agencies,!and!these!can!include!a!door1knock,!a!multi1agency!visit!to!an!individual!or!family!deemed!to!be!in!need!of!services.!!At!that!time!an!invitation!for!services!is!offered!and,!if!accepted,!the!services!are!then!provided!by!the!individual!agencies!as!part!of!their!normal!business,!with!much!more!continuing!inter1agency!cooperation!than!what!might!otherwise!have!been!provided.!!!!

Most!privacy!provisions!recognize!and!establish!that!the!best!and!most!reliable!course!to!follow!before!sharing!private!and!confidential!information!is!to!gain!the!consent!of!the!subject!or!subjects!involved.!!

!As!shown!in!Appendix!B!below,!many!of!these!same!privacy!provisions!also!consistently!recognize!that!the!risk!of!harm!or!inadequate!care!may!constitute!a!valid!reason!for!qualified!professionals!to!act!in!the!best!interests!of!the!individual,!family,!or!even!the!community!involved.!!Following!on!the!established!thresholds!described!above,!any!individuals!and!families!that!actually!become!subject!to!in1depth!discussion!at!the!Situation!Table!will!have!been!recognized!by!a!panel!of!human!service!professionals!as!facing!an!acutely!elevated!level!of!risk.!!Thus,!to!be!timely!and!effective,!taking!action!may!require!the!disclosure!of!information!to!other!professionals,!without!the!prior!explicit!consent!of!those!experiencing!the!risk,!for!the!purposes!of!fully!examining!options!and!collectively!constructing!solutions.!!Even!in!these!situations,!however,!if!there!is!a!possibility!that!consent!to!share!information!can!be!obtained,!it!should!always!be!sought!as!soon!as!practicable.!!!

Operating!with!Consent!and!Implied!Consent!



!What!is!important!to!recognize!here!is!that!in!many!such!situations,!these!same!risk!levels!can!prevent!the!individual!or!family!from!being!able!to!recognize!that!they!are!indeed!in!a!vulnerable!and!high1risk!situation.!!The!presence!of!multiple!and!compounding!risk!factors!in!their!lives!can!also!limit!their!capacity!to!see!the!benefits!of!help!when!it!is!offered,!and!very!often!precludes!the!individuals!involved!from!either!seeking!or!accepting!help!from!professionals!and!agencies.!!!An!analysis!of!Hub!situations!in!Prince!Albert!that!were!addressed!over!a!one!year!period!shows!that!among!the!most!common!and!severe!risk!factors!–!those!that!led!to!the!threshold!determination!in!each!situation!–!were,!in!order!of!frequency:!substance!abuse!and!addiction;!criminality;!and,!a!history!of!victimization8.!It!is!unfortunate,!but!natural!to!assume!that!many!individuals!and!families!who!have!fallen!into!an!acutely!elevated!risk!situation!based!upon!these!types!of!risk!factors!are!highly!likely!to!deny!offers!of!help.!!In!too!many!cases,!it!is!precisely!these!same!conditions!that!have!motivated!their!reluctance!to!share!or!disclose!vital!information!to!the!human!service!providers,!officials,!family!members!and!neighbours!that!might!otherwise!be!of!much!needed!assistance!in!their!lives.!!!Conclusion! !!

The!OWG!has!developed!the!preceding!guidance!after!extensive!research,!discussion!and!consultation!specific!to!these!issues!of!information!sharing,!and!it!is!our!hope!that!they!will!provide!a!common!point!of!

reference!for!Situation!Table!practitioners,!data!managers,!and!their!governing!agency!executives!alike.!!While!researching!and!deliberating!on!these!issues,!however,!the!working!group!also!learned!much!from!the!early!experience!to!date!within!Ontario!and!elsewhere.!!!This!experience!would!argue!strongly!that!the!greatest!risk!to!careful!and!responsible!navigation!through!these!privacy!issues!is!most!likely!to!arise!from!unprepared!practitioners!and/or!inadequately!managed!practices!at!Situation!Tables!and/or!elsewhere!within!emerging!models!of!collaboration!anticipated!to!take!shape!in!Ontario.!!This!must!be!avoided.!!Any!unwarranted!and!careless!breach!of!privacy!could!bring!discredit!to!the!process,!with!the!potential!to!affect!all!Situation!Tables!and!other!related!initiatives!in!the!province!and!elsewhere.!!As!a!result,!to!support!this!guide,!we!also!stress!that!in!our!collective!view!there!can!be!no!substitute!for!effective!training!and!qualified!operational!guidance!to!support!the!rigorous!application!of!these!disciplines!in!Ontario.!!The!resource!paper,!Mitigating!Acutely!Elevated!Risk!of!Harm,!examines!this!need!among!other!important!considerations!that!should!guide!the!adoption!of!any!collaborative,!risk1driven!intervention!models!at!the!local,!regional!or!provincial!level.!

8!Hub!(2012).!!Report!on!the!Prince!Albert!Hub!201112012.!!Community!Mobilization!Prince!Albert.!

Operational!Guidance!and!Learning!Support!!

is!Strongly!Recommended!



!!!

The!guidance!offered!in!this!paper!is!intended!as!a!place!to!start,!and!not!as!the!definitive!position!on!information!sharing,!if!such!a!thing!could!ever!exist.!!The!issues!related!to!balancing!protection!of!privacy!with!individual!and!community!safety!are!complex!and!fluid.!!At!the!

same!time,!with!proper!training,!rigorous!disciplines,!and!good!faith!adherence!to!key!principles,!opportunities!do!exist!within!the!existing!legal!framework!in!Ontario!for!multi1sector!professionals!to!work!together!to!achieve!better!and!more!timely!service!connections!to!meet!the!acute!needs!of!people!and!families!at!risk!in!Ontario!communities.!!It!may!only!be!through!the!experience!gained!through!these!new!approaches,!and!continuing!discussion!of!the!issues,!that!we!will!learn!our!way!collectively!toward!that!ideal!balance.!!The!February!2014!OWG!Symposium!provided!one!such!opportunity,!and!feedback!from!that!event!indicated!a!strong!desire!and!willingness!to!move!forward!with!collaborative!models!in!many!communities.!!We!would!advocate!strongly!for!continued!study!and!the!active!engagement!of!other!professionals!and!academics!as!these!models!progress!in!Ontario,!with!a!view!to!evolving,!testing!and!further!documenting!the!most!responsible!and!responsive!practices.!!We!would!also!urge!policy!makers!in!every!sector!to!remain!open!to!regulatory!and/or!legislative!adjustments!that!might!be!necessary!to!bring!greater!clarity!to!these!practices.!!What!is!most!important!at!this!early!stage!of!adoption!is!that!community!and!agency!leaders!apply!the!necessary!due!diligence!to!ensure!that!such!practices!proceed!with!care!and!only!after!careful!consideration!for!their!appropriateness!to!their!community,!and!that!they!operate!within!a!fully!informed!and!well!managed!framework,!as!explained!in!detail!in!Framework!for!Planning…Community!Safety!and!WellSbeing.!!!!!

Recommendations!for!Continued!Study!and!

Discussion!

New$Directions$for$Community$Safety$–$Hugh$C.$Russell$and$Norman$E.$Taylor$2014$

Appendix(A(…an$Inventory$of$Relevant$Legislation$and$Regulations$in$Ontario$$$

$

(listed$alphabetically)$

$

Federal Legislation $

Access$to$Information$Act$

Controlled$Drugs$and$Substances$Act$

Criminal$Code$of$Canada$

Criminal$Records$Act$

Personal$Information$Protection$and$Electronic$Documents$Act$

Privacy$Act$

Youth$Criminal$Justice$Act$*$$

$

Provincial Legislation and Regulations $

Age$of$Majority$and$Accountability$Act$

Child$and$Family$Services$Act$*"Christopher’s$Law$(Sex$Offender$Registry),$2000$

Courts$of$Justice$Act$re:$Office$of$the$Children's$Lawyer$

Education$Act"Freedom$of$Information$and$Protection$of$Privacy$Act$*"Health$Care$Consent$Act,$1996$

Human$Rights$Code$

Mental$Health$Act$

Ministry$of$Correctional$Services$Act$and$Regulation$778$

Municipal$Freedom$of$Information$and$Protection$of$Privacy$Act$*"Ombudsman$Act$

Parental$Responsibility$Act,$2000$

Personal$Health$Information$Protection$Act$*"Police$Services$Act$and$Regulation$265/98$*"Provincial$Advocate$for$Children$and$Youth$Act,$2007$Safe$Schools$Act$

Provincial$Offences$Act$

Public$Guardian$and$Trustee$Act$

Public$Hospital$Act$

Substitute$Decisions$Act$

*$Denotes$items$selected$for$review$under$the$working$group’s$sampling$approach.$See$Appendix$B.""

.

New$Directions$in$Community$Safety$–555$Hugh$C.$Russell$and$Norman$E.$Taylor$2014!

!Contents…!Appendix!B!!A!Preliminary!Review!of!Relevant!Legislation!and!Regulations!!!

!

!!! ! ! ! ! ! ! ! ! ! !!!!!Page!!

Overview! ! ! ! ! ! ! ! !!!!!! !!!!!!!!!!!!!!2!

! ! !

The!Sampling!Process!! ! ! ! !!!!!!!!!!!!!!! ! ! !3!

!The!Child!and!Family!Services!Act!(CFSA)! ! ! ! ! !!!!!!!!!!!3?5!

!

The!Freedom!of!Information!and!Protection!of!Privacy!Act!(FIPPA);!and!!!!!!!!!!!!!!!!!5?7!

The!Municipal!Freedom!of!Information!and!Protection!of!Privacy!Act!!

(MFIPPA)!

! ! ! ! ! ! ! !!!!!!!!!! ! ! ! !

The!Personal!Health!Information!Protection!Act!(PHIPA)! ! ! !!!!!!!!!!!7?8!

!

The!Police!Services!Act!and!Regulations!(PSA)!! ! ! ! !!!!!!!!!9?10!

!

The!Youth!Criminal!Justice!Act!(YCJA)!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!10?11!

!

Summary! ! ! ! ! ! ! ! ! ! 11!

! ! ! ! ! ! ! ! ! !!!!!!!!

! ! ! ! ! ! ! ! !

Appendix$B:$A$Preliminary$Review$of$Relevant$Legislation$and$Regulations$in$Ontario$–$Page$2$


Appendix!B!…a!Preliminary!Review!of!Relevant!Legislation!and!Regulations!in!Ontario!!

!

As!described!in!the!body!of!An$Interpretive$Guide$to$Information$Sharing$Practices$in$Ontario,!several!members!of!a!multi?sector!

working!group!met!to!give!consideration!to!the!applications!and!interpretations!of!

current!legislation,!regulations!and!protocols!within!the!context!of!collaborative,!risk?

driven!models!of!community!safety.!!It!is!important!to!stress!that!these!sessions!were!

not!intended!to!constitute!a!legal!review,!and!no!attempt!to!offer!a!legal!opinion!should!

be!implied!from!this!analysis.!

!

Rather,!the!aim!as!outlined!on!pages!2?5!in!the!guidelines!document!was!to!provide!

assistance!on!several!levels!and!to!answer!several!questions!for!practitioners!and!policy!

makers!alike.!!!

!

This!Appendix!B!provides!a!summary!of!just!some!of!the!outcomes!from!a!sampling!

process!that!was!applied!to!several!selections!from!among!the!full!range!of!relevant!acts!

and!regulations!listed!in!Appendix!A.!!!This!process!was!intended!to!address!the!

following!questions!in!particular:!

!

• What!degree!of!interpretation!(of!law!or!policy)!is!currently!required!by!the!

professionals!and!front!line!agency!representatives?!

• How!equipped!are!these!individuals!to!make!those!interpretations,!and!how!

can!they!be!better!supported!in!making!these!determinations!in!practice?!

!

Several!illustrative!selections!are!featured!and!discussed!in!the!sections!below.!!It!is!

important!to!note!that!while!this!sampling!is!in!no!way!intended!to!represent!or!speak!

for!a!complete!study!of!all!of!the!relevant!acts!and!regulations,!certain!patterns!and!

issues!become!readily!apparent!in!any!such!review.!!These!selections!were!chosen!for!

their!ability!to!highlight!those!and!to!provide!a!basis!for!the!principles!and!general!

guidance!offered!in!An$Interpretive$Guide$to$Information$Sharing$Practices$in$Ontario.!!The!samples!selected!for!discussion!here!include:!

!

1. The!Child!and!Family!Services!Act!(CFSA)!

2. The!Freedom!of!Information!and!Protection!of!Privacy!Act!(FIPPA)!

3. The!Municipal!Freedom!of!Information!and!Protection!of!Privacy!Act!

(MFIPPA)!

4. The!Personal!Health!Information!Protection!Act!(PHIPA)!

5. The!Police!Services!Act!and!Regulations!(PSA)!

6. The!Youth!Criminal!Justice!Act!(YCJA)!

Overview



!

!Members!of!the!working!group!volunteered!to!make!

selections!from!the!overall!list!of!identified!

legislation!in!Appendix!A,!to!complete!some!analysis!based!on!the!following!framework,!

and!to!prepare!a!summary!presentation!for!discussion!by!the!full!group.!!Outcomes!

from!those!discussions!form!the!basis!for!the!sections!below.!

!

1. Identify$the$legislation/regulation.$$

2. Identify$specific$clauses$that$are$relevant$to$information$sharing$under$certain$conditions.$

$3. Briefly$summarize$the$above$clauses$in$plain$language.$

$4. Provide$an$interpretative$explanation$of$the$“exception”$clauses$and$the$degree$

to$which$they$are$currently$being$applied$or$not$applied$in$practice$for$the$sharing$of$information$under$acute$risk$circumstances.$

$5. Are$you$currently$using$the$clauses,$identified$in$question$2,$or$“exception”$

clauses,$identified$in$question$4,$operationally$to$share$information?$$If$yes,$how?$$If$not,$why?$

$6. Identify$gaps$and$areas$within$the$above$clauses$that$may$require$further$

clarification$and/or$legal$or$policy$interpretation$by$experts$in$order$to$provide$useful$guidance$to$information$sharing$under$the$anticipated$conditions.$

!

!

!

The!analysis!revealed!that!Section!72!of!this!provincial!Act!clearly!requires!any!person,!and!more!specifically!any!

professional!or!official,!to!report!suspected!child!abuse!or!

a!child!at!risk,!includes!an!ongoing!duty!to!report,!and!

allows!information!sharing!to!occur!in!all!such!

circumstances.!

!

S.$72$–$Despite$the$provisions$of$any$other$Act,$if$a$person,$including$a$person$who$performs$professional$or$official$duties$with$respect$to$children,$has$reasonable$grounds$to$suspect$one$of$the$following,$the$person$shall$forthwith$report$the$suspicion$and$the$information$on$which$it$is$based$to$a$society.$

!

!

!

The Sampling Process

1. The Child and Family Services Act (CFSA)



The!Act!also!delineates!clearly!which!to!professionals!and!officials!these!obligations!may!

apply:!

!

Subsection$(4)$applies$to$every$person$who$performs$professional$or$official$duties$with$respect$to$children$including:$$

(a)$a$health$care$professional,$including$a$physician,$nurse,$dentist,$pharmacist$and$psychologist;$(b)$a$teacher,$person$appointed$to$a$position$designated$by$a$board$of$education$as$requiring$an$early$childhood$educator,$school$principal,$social$worker,$family$counsellor,$operator$or$employee$of$a$day$nursery$and$youth$and$recreation$worker;$

(b.1)$a$religious$official,$including$a$priest,$a$rabbi$and$a$member$of$the$clergy;$(b.2)$a$mediator$and$an$arbitrator;$

(c)$a$peace$officer$and$a$coroner;$(d)$a$solicitor;$and$(e)$a$service$provider$and$an$employee$of$a$service$provider.$

!

The!responsibilities!outlined!explicitly!override!any!other!provincial!statute,!placing!the!

highest!priority!on!taking!action!in!the!interests!of!any!child!in!need!of!protection.!

!

Discussion!!

The!duty!to!report!provisions!in!this!Act!may!potentially!cause!some!confusion!among!

professionals!engaged!in!risk!intervention.!!Specifically,!when!this!duty!is!invoked!by!a!

professional’s!knowledge!of!any!of!the!risk!circumstances!set!out!in!sub?section!(1),!the!

Act!contemplates!immediate!and!direct!reporting!by!that!professional!to!the!

appropriate!Children’s!Aid!Society!or!its!equivalent.!!Thus,!in!those!situations!where!

such!information!is!known,!to!one!or!more!agencies!or!professionals,!this!must!be!the!

first!and!immediate!course!of!action.!

!

What!is!important!to!note,!however,!is!that!in!many!risk?based!interventions!such!as!

those!outlined!in!the!guidelines!and!in!Mitigating$Acutely$Elevated$Risk$of$Harm,!specific!

risks!to!children!may!not!be!the!initial!point!of!entry!for!the!discussion.!!In!other!words,!

a!Situation!Table!could!be!hearing!a!situation!involving!a!parent,!a!household,!or!even!a!

particular!location,!and!it!may!only!become!clear!through!the!sharing!of!information!

that!the!situation!involves!acute!risks!and!potential!harms!to!children.!

!

Ultimately,!the!spirit!and!language!of!this!Act!appears!to!make!a!strong!case!for!the!

participation!of!child!protection!professionals!at!any!Situation!Table.!!Further,!it!appears!

to!provide!a!solid!framework!for!the!exchange!of!relevant!information!in!such!

circumstances,!in!order!to!expedite!collaborative!action!by!those!professionals!and!

others!in!the!interest!of!children’s!safety!and!well?being.!



!

!

Potential!for!Legislative!or!Regulatory!Update!!

The!duty!to!report!is!very!strong!and!clear!within!this!legislation.!!However,!there!is!

currently!nothing!expressed!with!regard!to!any!corresponding!duty!for!service!providers!

to!collaborate!in!order!to!more!fully!investigate,!understand,!and!develop!

comprehensive,!multi?agency!plans!to!assist!children!and!their!families!in!reducing!the!

risk!factors!that!may!be!operating!in!their!lives.!

!

!

!

These!two!acts!are!very!similar!in!many!ways,!and!

specifically!as!they!relate!to!the!issues!of!risk!

intervention!and!relevant!exemptions!for!sharing!

information.!

!

For!example,!FIPPA!includes!the!following!clause!shown!below.!MFIPPA!includes!similar!language!in!its!Clause!32!

and!more!specifically,!it!features!almost!identical!

language!in!sub?section!32(h).!

!

42.!!(1)!An!institution!shall!not!disclose!personal!information!in!its!custody!or!

under!its!control!except,!

!

(b)!where!the!person!to!whom!the!information!relates!has!identified!that!

information!in!particular!and!consented!to!its!disclosure;!

!

(c)!for!the!purpose!for!which!it!was!obtained!or!compiled!or!for!a!

consistent!purpose;!

!

(h)!in!compelling!circumstances!affecting!the!health!or!safety!of!an!

individual!if!upon!disclosure!notification!thereof!is!mailed!to!the!last!

known!address!of!the!individual!to!whom!the!information!relates;!

!

Similarly!mirrored!in!both,!and!perhaps!most!central!to!the!purposes!of!this!current!

analysis,!is!the!following!clause,!shown!here!as!5(1)!from!MFIPPA:!!

5.!!(1)!!Despite!any!other!provision!of!this!Act,!a!head!shall,!as!soon!as!practicable,!disclose!any!record!to!the!public!or!persons!affected!if!the!head!has!

reasonable!and!probable!grounds!to!believe!that!it!is!in!the!public!interest!to!do!

so!and!that!the!record!reveals!a!grave!environmental,!health!or!safety!hazard!to!

the!public.!

!

2. The!Freedom!of!Information!and!Protection!of!Privacy!Act!(FIPPA);!and!

3. The!Municipal!Freedom!of!Information!and!Protection!of!Privacy!Act!(MFIPPA)!!



Consistent!with!several!of!the!principles!in!the!interpretive!guide,!professionals!at!a!

Situation!Table!will!be!left!to!interpret!the!applicability!of!the!conditions!described!in!

the!final!words!of!that!clause!to!the!best!of!their!ability.!

!

Both!acts!also!make!clear!the!principle!of!Consistent!Purpose,!including!(in!43!and!33!

respectively)!the!following!direction!in!essentially!the!same!terms:!

!

The!purpose!of!a!use!or!disclosure!of!personal!information!that!has!been!

collected!directly!from!the!individual!to!whom!the!information!relates!is!a!

consistent!purpose!under!clauses!31!(b)!and!32!(c)!only!if!the!individual!might!

reasonably!have!expected!such!a!use!or!disclosure.!!

!

Finally,!with!respect!to!consent!to!disclose!information,!both!acts!are!essentially!silent!

on!the!principle!of!Implied!Consent,!except!as!follows.!!First,!as!shown!in!the!sample!

clause!42(h)!above,!consent!appears!to!be!overridden!by!the!terms!‘in!compelling!

circumstances’.!!Further,!clause!2!of!MFIPPA!(and!correspondingly!in!FIPPA),!stipulates:!!

(2)!!Before!disclosing!a!record!under!subsection!(1),!the!head!shall!cause!notice!

to!be!given!to!any!person!to!whom!the!information!in!the!record!relates,!if!it!is!

practicable!to!do!so!(emphasis$added).!!

!Discussion!!

It!would!appear!from!the!above!highlighted!clauses!and!from!other!elements!within!

these!two!acts!that!officials!can!share!information!with!appropriate!persons!if!there!is!

reason!to!suspect!reasonable!public!safety!hazards!and!harms,!and!if!the!sharing!is!done!

for!consistent!purposes!to!which!the!information!was!obtained.!!Moreover,!such!sharing!

appears!to!make!this!an!obligation!where!the!public!interest!is!served.!!!!

!


As!it!stands,!professionals!will!be!left!to!determine!to!the!best!of!their!ability!precisely!

what!is!included!for!consideration!within!“reasonable$and$probable$grounds$to$believe$that$it$is$in$the$public$interest$to$do$so”!and!“a$grave$environmental,$health$or$safety$hazard$to$the$public”.!!It!would!undoubtedly!bring!greater!comfort!to!those!seeking!to!

collaborate!in!the!public!interest!to!reduce!acute!levels!of!risk!…!risks!that!could!indeed!

lead!to!grave!outcomes!for!individuals,!families,!and!neighbourhoods,!for!example!…!if!

more!complete!language!was!available,!either!in!the!acts!themselves!or!in!

accompanying!regulations!and/or!policy!statements.!!In!the!meantime,!it!is!likely!that!

conventions!surrounding!‘good$faith’!principles!may!afford!some!degree!of!confidence!

to!those!facing!the!decision!of!when!grounds!are!reasonable!and!probable,!and!with!

whom!to!share!vital!information.!

!



In!addition,!it!is!worth!noting!that!the!current!wording!of!both!42(h)!(FIPPA)!and!32(h)!MFIPPA$specifies!the!mailing!of!a!disclosure!notification!to!the!last!known!mailing!

address!of!a!subject,!if!and!when!an!election!has!been!made!to!disclose!information!on!

the!basis!of!implied!consent,!or!for!the!other!purposes!described!above.!!Immediate!

notification!and!obtaining!ongoing!consent!of!the!subject!are!among!the!practices!

provided!for!in!the!Four!Filter!process!of!the!Situation!Table,!as!described!in!An$Interpretive$Guide$to$Information$Sharing$Practices$in$Ontario.!!Thus,!clarification!may!

be!in!order!to!better!align!these!provisions.!!In!many!high!risk!situations,!face?to?face!

notification!may!be!in!fact!much!more!practicable!than!notification!by!mail.!!Good!note!

keeping!by!involved!intervention!professionals,!together!with!the!implementation!of!an!

on?scene!consent!form!to!be!used!at!first!opportunity,!may!also!help!to!alleviate!agency!

concerns!in!this!regard.!

!

!

!

This!particular!piece!of!legislation!may!be!among!the!

most!problematic,!depending!on!the!interpretations!

applied!by!professionals!and!their!managers.!!

Confusion!arises!first!from!the!specificity!with!which!

this!Act!defines!exemptions!to!support!the!principle!of!

implied!consent.!!The!Act!clearly!states:!!

(2)!!Subject!to!subsection!(3),!a!consent!to!the!collection,!use!or!disclosure!of!

personal!health!information!about!an!individual!may!be!express!or!implied.!!

!

However,!in!the!following!subsection!(3),!limits!to!this!allowance!are!spelled!out!as!

follows:!

!

(3)!!A!consent!to!the!disclosure!of!personal!health!information!about!an!

individual!must!be!express,!and!not!implied,!if,!

!

(a)!a!health!information!custodian!makes!the!disclosure!to!a!person!that!

is!not!a!health!information!custodian;!or!

!

(b)!a!health!information!custodian!makes!the!disclosure!to!another!

health!information!custodian!and!the!disclosure!is!not!for!the!purposes!of!

providing!health!care!or!assisting!in!providing!health!care.!!

!

As!it!stands,!this!language!appears!to!erect!a!very!firm!silo!around!the!health!sector,!and!

appears!to!prohibit!the!necessary!collaboration!of!professionals!for!high!risk!

circumstances!where!health!issues!may!only!form!part!of!an!individual!or!family’s!

complex!picture,!and!where!information!sharing!with!non?health!professional!may!be!

vital!to!developing!appropriate!interventions!and!supports,!even!when!for!the!benefit!of!

the!desired!health![and!safety]!outcomes.!

!

4. The Personal Health Information Protection Act (PHIPA)



!

Additional!confusion!enters!these!deliberations!by!professionals!in!the!form!of!the!

following!clause,!appearing!much!later!in!the!language!of!the!Act:!!

40.!!(1)!!A!health!information!custodian!may!disclose!personal!health!information!

about!an!individual!if!the!custodian!believes!on!reasonable!grounds!that!the!

disclosure!is!necessary!for!the!purpose!of!eliminating!or!reducing!a!significant!

risk!of!serious!bodily!harm!to!a!person!or!group!of!persons.!!

!

What!is!unclear!here!is!the!degree!to!which!this!clause!is!intended!to!override!the!

earlier!silo!established!within!and!among!health!practitioners,!and!if!indeed!the!

intention!is!to!open!more!possibilities!for!collaboration!with!other!professionals!in!the!

interests!of!individual,!family!or!community!safety.!!If!so,!then!this!clause!would!have!

the!effect!of!making!multi?sector!collaborations!an!option!for!health!practitioners.!

!

Discussion!!

Professionals!in!health!care!will!want!to!consult!their!own!management!in!order!to!seek!

local!clarifications!on!how!these!clauses!may!specifically!apply!to!their!roles!and!to!their!

own!efforts!to!participate!fully!in!risk?driven!collaborations.!

!


The!need!for!clarification!in!this!legislation,!and/or!its!surrounding!policy!frameworks,!

arises!in!three!forms.!!First,!if!Sections!(2)!and!(3)!above!are!to!be!taken!at!face!value!by!

local!managers,!then!clearly!the!health!sector!is!at!risk!of!continually!isolating!its!

professionals!from!participation!in!collaborative!activities!where!they!have!much!to!

contribute!and!much!to!gain!when!it!comes!to!delivering!the!necessary!care!and!

ensuring!the!safety!of!their!patients!and/or!their!families.!!Secondly,!this!becomes!even!

more!troubling!and!potentially!confounding!to!those!same!professionals!if!the!risks!of!

harm!extend!directly!or!indirectly!to!children,!either!as!patients!themselves,!or!if!

potentially!placed!at!risk!by!conditions!affecting!their!parents!or!caregivers,!and!where!

other!legislation!may!serve!to!override!the!health!care!silo.!!Finally,!it!appears!clear,!

from!Section!40,!that!active!participation!by!health!professionals!in!the!reduction!and!

mitigation!of!acute!risk!situations!was!indeed!contemplated!within!this!legislation.!!

However,!as!it!stands,!this!clause!alone!may!be!inadequate!to!give!the!necessary!levels!

of!comfort!to!front!line!practitioners!facing!such!situations.!

!

!



Much!like!the!Personal$Health$Information$Protection$Act,!this!legislation!delivers!a!fair!potential!for!confusion!in!its!own!way.!!Principally!at!

issue!is!the!limiting!nature!of!the!following!clause:!

!

5. (1)!!A!chief!of!police!or!his!or!her!designate!may!disclose!any!personal!

information!about!an!individual!if!the!individual!is#under#investigation#of,#is#charged#with#or#is#convicted#or#found#guilty#of#an#offence!(emphasis$added)!under!the!Criminal$Code!(Canada),!the!Controlled$Drugs$and$Substances$Act!(Canada)!or!any!other!federal!or!provincial!act.!

!

In!our!modern!reality,!police!devote!upwards!of!75!percent!of!their!time!to!non?criminal!

social!disorder,!complete!with!its!own!forms!of!harm!and!victimization!despite!falling!

outside!of!the!provisions!outlined!in!the!above!clause.!!As!it!stands,!this!language!could!

easily!have!the!effect!of!shutting!down!any!collaboration!by!police!in!matters!that!do!

not!readily!present!with!a!likelihood!of!conviction.!!This!is!clearly!not!how!any!modern!

police!service!would!restrict!its!responsibilities!for!community!safety.!

!

In!truth,!most!police!service!have!sought!to!overcome!such!restrictive!language!through!

the!formation!of!a!variety!of!protocols,!partnerships,!and!memoranda!of!understanding!

(MOU’s),!as!contemplated!elsewhere!in!the!same!Act:!!

(3)!!The!procedures!to!be!followed!in!disclosing!personal!information!under!this!

section!to!an!agency!that!is!not!engaged!in!the!protection!of!the!public!or!the!

administration!of!justice!shall!be!in!accordance!with!a!memorandum!of!

understanding!entered!into!between!the!chief!of!police!and!the!agency.!

!

But!even!in!so!doing,!the!implication!of!criminal!justification!may!still!hover!over!such!

arrangements,!and!many!police!officers!are!left!to!rely!on!‘good!faith’!interpretations!to!

ensure!that!their!necessary!efforts!at!collaboration!do!not!fall!too!far!outside!of!such!an!

assumption.!

!

It!would!appear!that!the!best!enabling!language,!that!which!permits!the!collaboration!

that!police!leaders!and!front!line!members!alike!have!come!to!recognize!as!necessary!to!

the!successful!execution!of!their!responsibilities,!is!provided!by!a!wide!interpretation!of!

the!following!clause:!!

!

6.!!In!deciding!whether!or!not!to!disclose!personal!information!under!this!

Regulation,!the!chief!of!police!or!his!or!her!designate!shall!consider!the!

availability!of!resources!and!information,!what!is!reasonable!in!the!

circumstances!of!the!case,!what!is!consistent!with!the!law!and!the!public!interest!

and!what!is!necessary!to!ensure!that!the!resolution!of!criminal!proceedings!is!

not!delayed.!

!

!

5. The Police Services Act and Regulations (PSA)




The!opportunity!may!soon!exist!to!modify!the!language!in!this!act!to!better!reflect!the!

nature!of!modern!policing!in!Ontario.!!Specifically,!the!language!should!be!broadened!to!

allow!for!sharing!of!information!in!situations!where!an!individual!can!be!identified!with!

acutely!elevated!risk!factors,!and!not!solely!when!those!risk!factors!have!already!

manifest!in!crime.!!In!short,!it!is!essential!to!achieving!the!full!spectrum!of!policing!

functions!that!the!potential!exists!for!the!Chief!and/or!his!or!her!designated!officers!to!

share!information!for!crime!prevention!and!risk?intervention!purposes.!

!

!

!

In!many!ways,!this!Act’s!language!represents!the!complete!inverse!of!the!Police$Services$Act!discussed!above.!!It!is!clear!that!the!drafters!of!this!legislation!

were!seeking!to!distance!the!discussion!as!much!as!possible!away!from!criminalization,!

and!more!towards!prevention,!intervention,!and!pro?social!development!of!young!

persons,!while!still!ensuring!accountability!and!consequences!for!those!in!conflict!or!

potentially!in!conflict!with!the!law.!!As!a!result,!the!concepts!of!collaboration!and!risk?

reduction!are!evident!throughout.!

!

Many!of!the!references!to!privacy!or!information!sharing!in!this!context!pertain!to!the!

protection!from!disclosure!to!the!public,!or!to!anyone!whose!knowledge!of!the!youth’s!

issues!and!challenges!might!adversely!affect!positive!outcomes!over!the!long!term.!!As!

stated!in!a!General!Rule:!

!

The!privacy!provisions!of!the!YCJA$should!be!viewed!in!context!of!rehabilitative!focus!of!the!Act.!This!includes!protecting!youth!from!stigma!of!having!a!criminal!

record!that!could!hinder!rehabilitation.!

!

But,!within!the!framework!of!virtually!all!agencies!and!professionals!that!might!have!a!

role!to!play!in!achieving!such!outcomes,!the!primary!concern!is!for!confidentiality!and!

diligent!isolation!of!records,!and!not!for!limiting!the!conversation.!!Section!125(6)!spells!

this!out!quite!plainly!as!follows:!

!

s.!125!(6)!The!provincial!director,!a!youth!worker,!the!Attorney!General,!a!peace!

officer!or!any!other!person!engaged!in!the!provision!of!services!to!young!persons!

may!disclose!to!any!professional!or!other!person!engaged!in!the!supervision!or!

care!of!a!young!person!—!including!a!representative!of!any!school!board!or!

school!or!any!other!educational!or!training!institution!—!any!information!

contained!in!a!record!kept!under!sections!114!to!116!if!the!disclosure!is!

necessary:!

!

!

6. The Youth Criminal Justice Act (YCJA)



(a)!to!ensure!compliance!by!the!young!person!with!an!authorization!

under!section!91!or!an!order!of!the!youth!justice!court;!

!

(b)!to!ensure!the!safety!of!staff,!students!or!other!persons;!or!

!

(c)!to!facilitate!the!rehabilitation!of!the!young!person.!

!

Discussion!!

It!is!important!to!stress!that!the!YCJA!will!only!govern!those!situations!at!a!risk!intervention!table!where!the!subject!has!in!fact!already!come!into!contact!with!the!

criminal!justice!system,!either!in!the!context!of!the!current!risk!intervention,!or!in!the!

past.!!In!such!cases,!it!may!be!advisable!for!the!professionals!involved!to!declare!the!

discussion!a!conference!as!contemplated!under!the!YCJA,!and!to!thus!give!adequate!recognition!(at!Filter!Three)!to!the!specific!provisions!in!this!act!with!respect!to!

confidentiality!and!the!need?to?know!principle.!

!

!

!Summary!!

Managers!in!all!sectors!planning!to!participate!at!Ontario!Situation!Tables!need!to!know!

their!own!applicable!legislation!and!in?house!policies!and!procedures!in!order!to!

facilitate!increased!confidence!among!their!representatives,!and!to!enable!and!

encourage!them!to!share!limited!information,!whenever!appropriate,!about!individuals!

at!acutely!elevated!risk.!

!

This!partial!analysis!should!serve!to!provide!acute!care!service!providers!with!a!degree!

of!confidence!to!be!at!the!Situation!Table!and,!at!a!minimum,!to!partake!in!any!

collaborative!intervention!where!appropriate!thresholds!of!risk!align!with!prevailing!

legislative!clauses,!and!where!they!are!clearly!the!appropriate!experts!for!delivering!a!

particular!and!much!needed!human!service.!

!

As!described!in!the!body!of!An$Interpretive$Guide$to$Information$Sharing$Practices$in$Ontario!and!again!reinforced!here,!it!must!remain!the!duty!of!all!professionals!involved!

to!seek!the!clarifications!they!may!require!from!within!their!respective!sectors!and!to!

document,!evaluate!and!share!their!resulting!decisions!as!much!as!possible,!with!a!view!

to!building!a!stronger!and!broader!base!of!experience!and!evidence.!!Further,!this!must!

be!done!on!an!ongoing!basis!as!practices!evolve,!so!that!this!experience!ultimately!

serves!to!advance!our!collective!understanding!and!our!abilities!to!apply!these!practices!

with!growing!confidence.!

!