(2012-2013 Annual Report) PDF

1
MISSION
STATEMENT
Annual
report
TABLE of
contents
03 Mission Statement
04 Declaration on the Reliability of the Data
05 report from the President and the Director General
08
Report from the Director of Professional and Rehabilitation Services
14 Report from the Head of Research
18 Highlights from the Reports of the Board Committees and other information
24 Summary of Relevant Statistics
27 Declaration on the Reliability of the Financial statements
28 Report from the External Auditor
29 Financial Report
34 Members of the Board of Directors
36 Organizational Chart
38
Employees of the Foster Addiction
Rehabilitation Centre
39
Code of Ethics of the
Board of Directors
3
MISSION STATEMENT
The mission of the Foster Addiction Rehabilitation Centre (CRD Foster) is to offer adaptation, rehabilitation
and social integration services to persons who, because of an alcohol, gambling or drug addiction or any
other addiction, require such services, as well as support services for their families and friends. The centre
offers these services to the English-speaking population of Quebec.
The Foster Addiction Rehabilitation Centre remains committed to:
— Providing accessible, quality services that respect the cultural diversity of the individuals we serve;
— Developing and maintaining the professional competencies of our multidisciplinary team;
— Establishing a continuum of care in the field of addictions by sharing our expertise and promoting
partnerships with our institutional and community partners;
— Continuously improving our services by applying evidence-based interventions wherever feasible;
— Participating and contributing to the development of applied research in the field of addictions and
transferring the knowledge gained from this research to the community.
The Foster Addiction Rehabilitation Centre has initiated during the year a strategic planning process.
This process will also enable us to revise the fundamental values of the institution.
The Foster Addiction Rehabilitation Centre has forwarded a request to renew its linguistic mandates in order
to maintain its status as a “recognized” institution (établissement reconnu) under article 29.1 of the Charte
de la langue française, thus permitting the use of French and English in its communications.
We will also be requesting to be a “designated” institution (établissement désigné) under article 508 of the
Act Respecting Health Services and Social Services to provide its services in English.
4
STATEMENT ON THE
RELIABILITY OF THE DATA
As Director General, it is my responsibility to ensure the reliability of the data contained in this annual
management report and of the related controls.
The results and information contained in the Foster Addiction Rehabilitation Centre 2012-2013 management
report:
— reliably describe the mission, mandates, responsibilities, activities and strategic orientations of the institution;
— present the objectives, indicators, identified targets and results;
— present precise and reliable data.
I declare that the information presented in this annual management report, and the controls relating thereto
are reliable and correspond to the situation as it existed on March 31, 2013.
The Director General
John Topp
5
REPORT FROM THE PRESIDENT
AND THE DIRECTOR GENERAL
This was our first complete year of functioning as a public institution. Numerous changes associated
with the governance of a public institution happened during the year. We reviewed the major regulations
governing the board and its committees. We thus adopted revised regulations for the Board, the Audit
Committee and the newly created Governance and Ethics Committee.
The Board also elected a new executive committee. Mr. Peter Ohlin, long-time member of the board
and president for more than twenty years decided to step down and remain a regular member. We wish
to thank Mr. Ohlin for his commitment to the institution and his support during all of these years. He
was replaced by Mr. Jim Wyant. Ms. Janet Soutter was elected as vice-president and Ms. Robin Hale as
treasurer. The Director General automatically becomes the secretary of a public board. The board still
has two vacancies. These can only be filled by requesting new letters patent. This situation will continue
until the 2015 province-wide board elections. The new board functions very well and no complaints were
made pertaining to the Code of Ethics of the Board of Directors.
One of the highlights of the year was the attribution by the Ministry and the Montreal Agency of two
hospital liaison teams in the St-Mary’s and Montreal General Hospital emergency rooms. This new
program recognizes our mandate to provide services to the English-speaking population of Montreal.
It also provides much needed funding at the Montreal outpatient clinic and provides additional staffing
and two new beds at the inpatient clinic. This is the first funding in addiction services since we opened
the Montreal point of service. We had received a new permit in May for 22 beds to reflect the reality of
our operations. We have since sent a second request to increase to 24 beds following this new funding.
The Agency has already recommended the increase.
Two new managers were added to the team this year. In May, Alyssa Mew was nominated as interim
Program Advisor in replacement of Phuong-Anh Urga, currently on leave. In September, Stephanie
LeBlanc became the new Coordinator of Inpatient and Montérégie Outpatient Services. Both bring
experience, expertise and commitment to the institution.
6
We continue to invest in the maintenance of our building. The replacement of the residence windows,
originally planned for October, is behind schedule and was delayed until spring. We did not wish to have
this work done during the winter months. We are also planning renovations to the residence in order to
build a new double room and increase nursing office space. The lease of the Montreal office was renewed.
The building was sold again this year and we continued our discussions with the new owners to renovate
extra space which had been added to the lease.
The financial situation of Foster is good despite the continued cuts resulting from Law 100 and the
optimization process. We finished the year with a surplus attributable to staff turnover and vacant
positions. We had also been fortunate in receiving $200,000 non-recurrent fund from the Montérégie
Agency at the end of last year, which was carried over to this financial year.
Jim Wyant
President
John Topp
Director General
7
”One of the highlights of the year
was the attribution by the Ministry
and the Montreal Agency of two
hospital liaison teams in the
St-Mary’s and Montreal General
Hospital emergency rooms. This new
program recognizes our mandate
to provide services to the Englishspeaking population of Montreal.”
8
Report from the Director
of Professional and
Rehabilitation Services
Ms. Stephanie LeBlanc joined the management team being nominated as Coordinator of Inpatient and
Montérégie Outpatient Services in 2012-2013. Ms. Leblanc began at CRD Foster in 2007 and has been a
valued member of the Montreal outpatient team for over 4 years. Since her nomination, she has shown
leadership skills and vision in working with the Montérégie and inpatient teams. Ms. LeBlanc holds
a Bachelor’s degree in Social Work from the University of Victoria.
The focus over the last year was to consolidate our detoxification program at the inpatient centre. We revized
the program, updated our withdrawal assessment kit and increased the nursing team to accommodate more
clients in the detoxification program. The updating of the detoxification program was simultaneous with
the implementation of the liaison teams in Montreal and the implementation of the corridor of service
with Charles Lemoyne Hospital.
In striving to complete the goals of our improvement plan, we have been working closely with our network
partners putting in place formalized service agreements, creating corridors of service and implementing
standardized procedures to facilitate formal referrals. We also began formalizing our treatment programs,
including the Entourage program.
Addiction Rehabilitation Programs
Hospital Liaison Teams in Addiction
In 2012-2013, CRD Foster, in collaboration with Centre Dollard-Cormier–Institut universitaire sur les
dépendances (CDC–IUD), was given the mandate by the Ministry of Health and Social Services to deploy
liaison teams in addiction at St. Mary’s Hospital and the Montreal General Hospital. The service is primarily
for those identified in the emergency rooms having a substance abuse problem. The objectives of the liaison
teams are to improve the accessibility, continuity and quality of care provided to clients, improve screening
and detection of those at risk for substance abuse problems and improve the continuum of care between
the hospital and rehabilitation centers. The funding provided was used to hire two full time nurses to work
in each of the identified hospitals and to increase the nursing staff available at the inpatient to support the
increase in admissions. Resources were added to the clinical team, an ARH and an educator were added to
the Montreal outpatient team and an ARH was added to the inpatient team. The capacity at the inpatient
center was also increased to accommodate the referrals from the liaison team, resulting in 24 available
beds. The program implementation has been successful, resulting in an improved collaboration with each
of the hospitals.
9
Social Reintegration Program
This was year two of the federal social reintegration program of young adults (18-30 years old) at risk
of social disaffiliation in addiction treatment. Over the year a social reintegration assessment tool was
created to support the development of treatment plans with clients seeking services. The assessment tool
was inspired by the L’Outil d’évaluation des besoins en reinsertion social RÉSO and the items from the Global
Assessment of Individual Needs (GAIN). The treatment plan form was also modified to reduce redundancy and
improve continuity of care.
The Association des centres de réadaptation en dépendance du Québec (ACRDQ) published « Les Services de
réinsertion sociale-guide de pratique et offre de services de base », a review of best practices in social
reintegration and recommendations regarding implementation of the program in addiction rehabilitation. The
guide has inspired a deliberate focus on increasing collaboration with network partners (including Carrefour
jeunesse emploi, Batshaw Youth and Family Services, etc.) and a plan to incorporate workshops into our
regular programming.
Entourage Services
The Entourage Program Task Force, Ms. Kathy Sisak and Ms. Alice Li, under the supervision of Ms. Alyssa
Mew, Interim Program Advisor, have begun to formalize the Entourage program. The task force has developed
an adult entourage instrument which has been piloted and will be circulated to the teams in the next year.
This tool was inspired by instruments described by evidence-based approaches such as ABCT (Epstein and
McCrady) and CRAFT. Other structured approaches that were consulted include the CAMH’s Brief Couple’s
Therapy (BCT). Additional versions of the interview tool (for use in the youth entourage and gambling
program) will be finalized in the upcoming year.
The task force also successfully implemented CAMH’s Families CARE program. Families CARE is a group
based program that helps family members Cope And Relate Effectively with the person in their entourage
who has an addiction. The program offers support, education and skills development. It is currently offered
at the NDG and Pointe Claire points of service. The team has also increased involvement of family members
in all levels of care, for example CARE groups have been schedule at the same time as treatment groups to
encourage families to come to treatment together.
10
”The focus over the last year was
to consolidate our detoxification
program at the inpatient centre.
We revized the program, updated
our withdrawal assessment kit
and increased the nursing team
to accommodate more clients
in the detoxification program.”
11
The task force has also increased access to services by implementing regular Family Nights at the NDG
point of service. Family Nights consist of a presentation on substance use disorders, gambling and
cyberdependence and a discussion on the impact of addiction on family members. The information session
is open to the general public. Efforts were made to inform partners by creating pamphlets and posters. We
have had six Family Nights and a total of 22 participants have attended.
Inpatient Rehabilitation
With the implementation of the addiction liaison teams, there has been an increase in the number of
detoxification cases admitted to the inpatient. Therefore we have reviewed the detoxification program and
have begun to implement formal evaluation forms to support the nursing team in referring the clients to
the appropriate level of detoxification. The detoxification program is based on SAMHSA’s (Substance Abuse
and Mental Health Service Administration) TIP 45 and levels of care as defined by and in accordance with the
American Society of Addiction Medicine (ASAM) criteria. We have also finalized the standing prescriptions for
the nursing department and are defining the detoxification program protocols.
Collaborations and Partnerships
There was a significant improvement in collaboration with network partners supported by the introduction
of the formal referral form. The form was created for front line workers and network partners to facilitate
access for clients in need of specialized services in addiction, to build on gains that the client has already
made and to facilitate communication between our organization and the referring agent.
Over the last year, agreements with CSSS Cavendish, CSSS Ouest-de-l’Île and Batshaw Youth and Family
Centers were initiated and an agreement with CSSS Saint-Léonard et Saint-Michel was finalized. There
was also a considerable increase in collaboration with the CSSS Sud-Ouest-Verdun where CRD Foster was
a contributor to the mental health table and participated in the Salon de la santé mentale du Sud-OuestVerdun. We noted that services were not as utilized in the area, therefore we increased our presence in two
Anglophone high schools; that was well received.
We participated in Our Family My Community, a project organized by Batshaw Youth and Family Centers for
families of the youth protection cases in the Sud-Ouest region that involve children between the ages of one
and five and their older siblings. The objective of the program is to maintain children within their community
while their parents seek treatment.
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The addition of nurses in the outpatient program enabled us to consolidate nursing services and provide
additional support to clinicians referring clients to the inpatient detoxification program. It also facilitated
access to detoxification and rehabilitation services to clients accessing services from hospitals. In the
Montérégie, it enabled us to create a successful corridor of services with the Charles LeMoyne Hospital and
CRD Le Virage.
Professional Services
Training
The majority of the training provided focused on the integration of new employees. Seventeen new employees
joined CRD Foster over the year and as a result we provided two cycles of all the core competency modules.
New trainings were also added to the core competency modules such as OMEGA, which teaches a safe
approach to preventing and managing violent behaviour, and Risk Management designed to present the
objectives of risk management and declaration of incidents and accidents.
CRD Foster participated in two cross training initiatives. The first project was with the Douglas Mental Health
Institute, we were invited to a presentation on Eating Disorders. Dr. Howard Steiger, Psychologist and Shiri
Freiwald, Clinical Activities Specialist for the Eating Disorder Program provided training on Eating Disorders
for the clinical staff at CRD Foster. In turn, Ms. Arpita Gupta and Ms. Julie Champagne from CRD Foster were
invited to the Douglas to present on addictions and mental health.
The second cross training event was in collaboration with the Philippe-Pinel Institute to train their staff on
screening and brief interventions and CRD Foster was able to send clinical team members to a training given
by Dr. Marsha Linehan. Employees from each organization also had the opportunity to shadow for a day. The
cross training initiatives were well received and have encouraged continued collaboration and partnership
for the upcoming year.
Group viewings of webinars were implemented this year. Topics included Youth Gambling: Genetic and
Environmental Factors, Shifting from Cognitive to Behavioral Approaches in CBT, and Post-Traumatic Stress
Disorder and Problem Gambling. Clinical staff from all points of service had the opportunity to log into the
webinars. This was an innovative and cost effective initiative that gave all clinical staff the opportunity to
remain current in the field of addiction.
The Regional Training Program, a program created by CRD Foster, CRD Le Virage and the Montérégie Health
and Social Service Agency, trained front line workers from 7 different CSSS and provided 37 trainings. There
was a significant focus over the last year on improving the training material and adapting the material to
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the needs of the participants. As a result of the regional training initiative, service agreements were signed
with CSSS La Pommeraie and CSSS Vaudreuil-Soulanges and an agreement with CSSS Haut-Saint-Laurent
was initiated.
As we continue to be a site for internships, we have hosted students from a number of disciplines and
universities including from the School of Social Work (Graduate program McGill University), Nursing program
(Undergraduate program from University of Victoria), Criminology (Undergraduate program from Université
de Montréal), Psychology (Undergraduate program McGill University), and Counseling Psychology (Graduate
Program Yorkville University). Mr. John Furuli, Ms. Jo-Anne Théoret, Ms. Alyssa Mew, Ms. Kathy Sisak and
Ms. Robyn Yanofsky all dedicated their time to integrating and supervising the interns as well as numerous
other members of the clinical team who support the integration of interns at CRD Foster.
Research
Despite the suspension of the research committee for the majority of the year, three major research projects
were completed. The first study was on the Mécanismes d’accès jeunesse en toxicomaine (MAJT). The objectives
of the study were to describe the access mechanisms in different regions, review the efficiency of the access
mechanism and provide specific data in five targeted regions. We also worked in collaboration with the
Douglas Mental Health Institute on the Memory Reconsolidation Blockade for Treating Drug Addiction study. This
was a feasibility study based on the premise that the drug Propranolol may mitigate the effects of substance
dependence by targeting craving memory, effects of drug related cues on the patient and stress enhanced
drug memory retrieval.
We also participated in the “Estimation de la taille et caractérisation de la population utilisatrice de drogues par
injection à Montréal” study to estimate the number of injection drug users on the island of Montreal. The
results of the study will be presented in the upcoming year.
Jennifer Mascitto
Director of Professional and Rehabilitation Services
14
Report from the
Head of Research
Along with the continuing work on existing research initiatives, the last year’s notable activities including
two new grant awards totalling in excess of a half million dollars, and the publication of three invited
book chapters and one scholarly review of clinical practices. Beyond these objective indicators of research
productivity, however, developments that reflect significant evolution in Foster’s research agenda are also
noteworthy. First, the grants won in the past year involve studies where the impact of acute but low levels
of alcohol consumption coupled with sleep deprivation in young people is evaluated. Sleep deprivation in
young adults, many who drive, is ubiquitous, as is low level, “legal” blood alcohol concentrations from
social drinking. Sleep deprivation is understood to impair driving performance, and the combination of
alcohol and sleep deprivation are thought to further exacerbate driving capacities. This study looks at both
age and sex factors in how alcohol + sleep deprivation may impair driving, as well as what aspects of
brain function are involved. The results of this study should provide needed data to assist policy makers
and law enforcement personnel and licensing authorities in their prevention efforts. In order to conduct
these studies, sophisticated virtual reality technology (i.e., driving simulation), alcohol administration, and
technology-monitored sleep deprivation induction in healthy normal drivers represent new experimental
procedures for us. We have therefore recruited a sleep expert, Dr. Reut Gruber from McGill University and a
noted neuroscientist, Dr. Antoine Bechara of the University of Southern California to assist us.
Second on the output side, we are excited by one study result in particular (Ouimet et al., in press) with
respect to our randomized controlled trial of motivational interviewing with hard-core impaired drivers.
Currently in press in a high impact scholarly journal in the addiction field, this report describes how we
succeeded in reducing relapse to dangerous driving behaviour in these high-risk drivers over a five-year
period by exposing them to only one 30-minute motivational interviewing session. Such long-term followups are rare in the addiction intervention literature, and we believe that this study and its finding that good
things can come in very small packages will have significant implications in the field of DWI prevention.
15
Finally, we have completed initiatives that brought our research team together in partnership with Quebec’s
licensing authorities as well as the Association of Quebec’s Public Addiction Treatment Centres (ACRDQ) to
accomplish two pragmatic objectives: i) the reformulation of the provincial DWI re-licensing program; and ii)
the translation and cultural validation of the Global Assessment of Individual Needs (i.e., GAIN) instrument
for use in Quebec’s public addiction treatment network as the standard assessment protocol in the province.
These knowledge translation projects reflect our commitment to convert public investments in research into
tangible benefits for Canadians, an increasingly pressing concern for provincial and federal governments
facing a dire cost containment economic environment. More than that, however, they are very satisfying for
us as researchers as these efforts are likely to contribute tangibly to improving public health and safety.
New Grants
20122015
Principal Investigator, “Effects of sleep deprivation with low blood alcohol
levels on executive functions in young drivers”.
Funding Agency: Canadian Institutes of Health Research (CIHR).
$ 430,000
20122015
Principal Investigator. « Les effets cumulatifs du manque de sommeil et d’un
taux légal d’alcoolémie (0.05 %) sur la conduite des jeunes conducteurs :
l’influence de l’âge, du sexe et des facteurs cognitifs. »
Funding Agency: Fonds québécois de la recherche sur la société et culture
(FQRSC)–Fonds de la recherche en santé du Québec (FRSQ)–Société
d’assurance automobile du Québec (SAAQ).
$ 150,000
16
On-going initiatives
20082013
Principal Investigator, “Gender differences in the multidimensional assessment of DWI recidivism risk”.
Funding Agency: Canadian Institutes of Health Research (CIHR).
$ 432,000
20092014
Co-Investigator, A Randomized Controlled Evaluation of “Extended
Specialized Early Intervention Service” vs. “Regular care” for Management
of Early Psychosis over the Five year Critical Period (PI: Malla).
Funding Agency: Canadian Institutes of Health Research (CIHR).
$ 2.4 million
20092015
Principal Investigator, “CIHR team in transdisciplinary studies in DWI onset,
persistence, prevention and treatment”.
$ 1.6 million
Funding Agency: Canadian Institutes of Health Research (CIHR).
20102015
Co-Principal Investigator, “Réseau stratégique de recherche et d’innovation
en sécurité routière”. Appui aux réseaux d’innovation (PI: Bellavance).
Funding Agency: Fonds de recherche sur la nature et les technologies (FQRNT).
$ 500,000 20112014
Co-Principal Investigator, “Influence of alcohol and peer passengers on
risky driving behavior in young adults” (PI: Ouimet).
Funding Agency: Canadian Institutes of Health Research (CIHR).
$ 285,000
20112014
Principal Investigator, “Multidimensional mechanisms of high risk driving”.
Funding Agency: Fonds québécois de la recherche sur la société et culture
(FQRSC)-Fonds de la recherche en santé du Québec (FRSQ)–Société de
l’assurance automobile du Québec (SAAQ).
$ 149,000
20112014
Co-Principal Investigator, “The effectiveness of in-vehicule alcohol detection technology to in reducing impaired driving in young drivers”.
Funding Agency: Fonds québécois de la recherche sur la société et culture
(FQRSC)–Fonds de la recherche en santé du Québec (FRSQ)–Société de
l’assurance automobile du Québec (SAAQ)
$ 149,000
20112013
Principal Investigator, “Improving administrative assessment of risk and
decision making for driving while impaired recidivism”.
Funding Agency: Canadian Institutes of Health Research (CIHR).
$ 165,000
17
20112016
Co-Investigator, “L’Équipe des IRSC en épidémiologie sociale et psychiatrique
et le développement de la zone circonscrite d’épidémiologie du sud-ouest
de Montréal: la poursuite de l’étude longitudinale sur la santé mentale et $1.7 million
l’étude de ses comorbidités avec la santé physique”. (PI: Caron).
Funding Agency: Canadian Institutes of Health Research (CIHR)
New In Print
Brown, T.G. & Ouimet, M.C. (2012). Treatments for Alcohol-Related Impaired Driving. In: M. McMurran (Ed).
Alcohol-Related Violence: Prevention and Treatment. Chichester: Wiley-Blackwell.
Brown, T.G. et al. (2012). The neurobiology of driving while impaired with alcohol. In: J.P Assailly (Ed.) The
Psychology of Risk Taking. New York: Nova Psychology Research Progress.
Brown, T.G., Bhatti, J., Di Leo, I. (2013). Driving While Impaired (Treatments). In: Interventions for Addiction:
Comprehensive Addictive Behaviors and Disorders. Elsevier Inc., San Diego: Academic Press, pp. 207–217.
Well, S. & Brown, T.G. (2012). Patient attitudes towards change in Adapted Motivational Interviewing for
substance abuse: a systematic review. Substance Abuse and Rehabilitation, 3(1), 61-72.
In press
Ouimet, M.C., Dongier, M., Di Leo, I., Legault, L., Tremblay, J., Chanut, F., Brown, T.G. A randomized controlled trial
of brief Motivational Interviewing in impaired driving recidivists: a 5-year follow-up of traffic offenses and crashes.
Alcoholism: Clinical and Experimental Research.
Thomas G. Brown, Ph.D.
Head of Research
Foster Addiction Rehabilitation Centre
Director, Addiction Research Program
Douglas Mental Health University Institute Research Centre
Assistant Professor, Dept. of Psychiatry, Faculty of Medicine, McGill University
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HIGHLIGHTS FROM THE
BOARD COMMITTEES
AND OTHER INFORMATION
Local Commissioner for Complaints and Quality of Services
There has been no request to the Commissioner (complaint, intervention or assistance) during the 20122013 financial year. There has always been a low volume of complaints due to the active involvement of the
professionals and managers in the management of dissatisfactions and also the presence and involvement
of the members of the Clients’ Committee.
During the year, the Commissioner participated in the Watchdog Committee. The Commissioner also
participates in the provincial table of Commissioners of Rehabilitation Centres of Quebec. For the next year,
the Commissioner has already planned a meeting of all professional teams in order to promote the complaint
review system.
Watchdog Committee
The watchdog Committee met to review the activities of the year. There were no complaints filed during
the year. This can be explained by the continuous monitoring of dissatisfactions by Clients’ Committee and
management team. There were 23 registered dissatisfactions this year. Of these, 22 originated from the
inpatient center and one was from Montreal outpatient services. Nineteen of the reported dissatisfactions
came to our attention through the Clients’ Committee, which continues to be highly active in meeting
clients seeking services on an outpatient and inpatient basis. Three of the dissatisfactions were brought by
the clients themselves and one dissatisfaction was reported by a family member. As for the nature of the
dissatisfactions, three concerned staff conduct and interpersonal relations, nine were related to treatment
services, four were related to the environment, five about specific rights and two about auxiliary services.
Management resolved each of these issues to the client’s satisfaction. There were no trends identified in
the issues reported.
The Risk Management Committee reported a total of 76 declarations of incidents and accidents, almost
double the number of declarations from the previous year indicating an increased awareness among staff
of the risk management procedures. Of these 76 declarations, 69 originated from the inpatient center, four
from the Montérégie and three from the Montreal outpatient services. There were five were incidents and
71 accidents. No sentinel events were identified.
The Clients’ Committee is doing very well. The committee continues its monthly meetings with the clients.
The follow-up with management functions smoothly. The committee would like to recruit more female
members. There are currently only two women on the committee.
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The executive committee of the Multidisciplinary Council held three regular meetings during the year
in October, January and March. The meetings centered on presentations of ongoing clinical projects,
discussions of proposed policies and topics presented by the clinical representatives.
There is no specific report to present from the Working Conditions Committee. The committee did not meet
this year. New members were recruited and we now have a full membership. Foster did continue being active
on the Prevention Mutual.
The Watchdog Committee also reviewed the implementation of the 2011-2014 Improvement Plan. The only
objective that has a direct impact on this committee is the binding recommendation to secure the inpatient
windows, install exterior door alarms and ensure dual coverage at all times. All of these requirements have
been met. With the current renovations of the nursing office, we will also meet all nursing and safety norms.
The Watchdog Committee’s membership will change in the coming year. After seven years, the Local
Commissioner, Ms. Danièle Gagnon, informed us that she will be leaving the institution. She added that
she appreciated the experience, had learned considerably about addiction, especially from Morris Kokin in
the beginning and the others who have followed. She also wished to thank the board for its support. Her
replacement, Ms. Sylvie Côté, was introduced and participated in the committee meeting.
Risk Management Committee
In 2012-2013, the Risk Management Committee participants included Paul Raymer, Réjeanne Simard, John
Topp and Jennifer Mascitto. The committee met once for an official meeting midyear and the committee
members were trained on updated risk management procedures at the end of the year. In 2012-2013, there
were a total of 76 declarations of incidents and accidents, almost double the number of declarations from
the previous year indicating an increased awareness among staff of the risk management procedures.
Of the 76 declarations, 69 originated from the inpatient center, four from Montérégie outpatient services
and three from Montreal outpatient services. Of the 76 declarations, five were categorized as incidents and
71 as accidents.
Of the accidents and incidents reported, the 37 events categorized as “other” were accidents related to
injuries that resulted from daily activities, sports accidents, and errors related to charting. There were no
trends identified in the incidents/accidents declared.
Over the last year there were improvements in training related to risk management. Trainings in incident
and accident reporting and OMEGA have become part of the core competency modules provided to new staff
20
integrating at CRD Foster. Other improvements over the last year included the implementation of double
coverage for the night shift following a recommendation by the accreditation committee and revision of our
policy regarding confidentiality within and across our programs.
Lastly, as part of regular chart maintenance, selected files were reviewed and destroyed at the NDG and
Brossard point of service. There were 1260 files treated and there were no identifiable errors in the files
related to charts and charting procedures.
Multidisciplinary Council
The executive committee held three regular meetings during the year in October, January and March.
During the executive committee meetings, various topics were discussed such as: Law 21, specifically
the determination of reserved activities and the recognition of therapy experience, Champlain College
internships and the renewal of service agreements. The executive committee also spent time discussing the
implementation of the hospital liaison teams and their impact on programming.
As specified in our internal regulation, the mandates of two of the elected members ended this year and
were eligible for re-election. An election was called and having received the same two candidates, Carol-Ann
Milch and Marilyn Payne were re-elected to a two-year mandate.
Another topic of interest was the social reintegration program. Two clinical members participated in the
ACRDQ discussion day on the social reintegration program guide. This led to a discussion at the executive
committee and to a formal recommendation to management on the importance of the social integration
program at Foster.
The executive committee adopted a work plan for the year consisting of two main objectives: The use of the
GAIN in the context of high volume hospital liaison referrals and the formulation of a position on abstinence
and its impact on our interventions. Discussions on the use of the GAIN will continue as the program is still
in implementation. As for the position on abstinence, a mandate was given to Tom Brown to document our
treatment philosophy, therapeutic approaches and intervention methods. The resulting document will be
presented to the multidisciplinary council for discussion and presented to the board of directors for approval.
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Strategic Plan
CRD Foster became a public institution in February 2012. The institution had initiated the conversion
process long before and was waiting for ministerial confirmation. Because of the pending change in
status, we had not initiated a strategic planning process. In fact, our main strategic objective was to
become a public institution.
We initiated our strategic planning process during the year. While this planning cycle will only be for
two years, we will position ourselves for the next cycle and start the 2015-2020 cycle with a clear
mandate. With the help of two external consultants, we aim to achieve two objectives. Firstly, we wish to
position Foster as a public institution offering addiction rehabilitation services to the English-speaking
population of Quebec. Considering the specificity of this mandate, we have initiated discussions with our
multiple network partners.
We will also use this opportunity to revisit our mission statement and our organizational values. We have held
a series of meetings with our staff and will present during the coming year the result of these discussions
and work on defining a revised set of values.
2012-2013 Management and Accountability Agreement with the
« Agence de la santé et des services sociaux de la Montérégie »
The Foster Addiction Rehabilitation Centre has signed a management and accountability agreement with the
Montérégie Agency containing specific objectives which must be met during the year. The following tables
describe and explain the results obtained.
Indicator: Addictions
1.07.04 PS: Percentage of individuals evaluated in an addiction
treatment centre within a delay of 15 working days
2011-2012
Results
2012-2013
target
2012-2013
Results
69%
80%
63,8%
Comments
We are below the target. The main reasons for the delay is the insufficient staffing at our major Montreal points
of service and staff absences at the Brossard point of service.
22
Indicator: Human Resources
2011-2012
results
2012-2013
target
2012-2013
results
3.01 PS: Ratio between the number of hours paid in sick leave
and the number of hours worked
3,26%
3,47%
3,71%
3.09 PS: The institution will have concluded a revision process
of its services and work methods.
no
yes
no
3.13 PS: The institution has been granted accreditation by
a recognized workplace improvement program
no
yes
no
3.14 PS: The institution has been granted accreditation including
a section on organizational climate
yes
yes
yes
Comments
3.01 PS: Our ratio is near the target. We closely manage sick leaves.
3.09 PS: We have begun a revision process of the nursing services.
3.13 PS: We haven’t initiated this process. The institution became public at the beginning of the year.
3.14 PS: We have completed the second year of the 2011-2014 accreditation cycle.
Follow-up on the recommendations of the Conseil québécois d’agrément (CQA)
CRD Foster completed this year the second year of the 2011-2014 accreditation cycle. Several tasks were
conducted to address the recommendations of CQA and achieve the objectives outlined in our improvement
plan. The most important of these recommendations focused on the safety of facilities and staff at the
residence. We had already installed alarms connecting external doors. During the year, we increased
the maintenance staff and clinical staff to ensure a minimum of two people at all times. Finally, we awarded
a contract for the replacement of windows in the building. In addition to being more efficient in terms of
energy, the new windows will be safer especially at the bedroom floor. The installation of the windows is
scheduled for early April.
All objectives of Year 1 and Year 2 of the Improvement Plan are either completed or well underway.
23
Follow-up on the application of Law 100 (2010, chapter 20)
CRD Foster is subject to the provisions of Law 100. Our target is $50,103 at the end of the 2013-2014. As of
March 31, 2013, we have reduced our administrative expenses by a recurrent amount of $50,502. We have
thus met the requirement set forth by the MSSS. The specific measures are as follows:
— Abolition of an administrative support position: $29,070
— End of a service contract:
— Reduction of recruitment costs:
Total
$8,979
$12,453
$ 50,502
24
SUMMARY OF RELEVANT
STATISTICS
The Foster Addiction Rehabilitation Centre had a lower volume of activity this year in both its inpatient and
outpatient programs. The decrease in outpatient services can be attributed to unfilled positions. As for the
inpatient, there was a reduction of demand during the first periods of 2013, followed by an infestation which
required extensive decontamination and the reduction of capacity for a few periods.
Outpatient Services
During the course of the year, 2324 episodes of services were provided in our various programs. The same
individual can be counted more than once if that person received more than one episode of service. An
episode is defined as an individual registered in a program and receiving services at a specific time.
An individual registered in two programs, i.e. gambling and substance abuse will be counted twice. An
individual who registers to services at two specific periods during the year will be counted twice. Hence,
these episodes represent the total volume of activity in the outpatient program. The number of distinct
individuals served is slightly lower.
Number of Outpatient Episodes by Year
Program
2012-2013
2011-2012
2010-2011
2009-2010
Substance Abuse
New episodes
1 599
1 590
1 685
1 740
Total
2 050
2 113
2 212
2 246
New episodes
200
203
274
243
Total
274
294
356
313
New episodes
1 799
1 793
1 959
1 983
Total
2 324
2 407
2 568
2 559
Problem Gambling
Total
25
Inpatient Services
During the year, 268 individuals were admitted to the St-Philippe residence for a total of 269 individuals
served. The twenty substance abuse rehabilitation beds were occupied at a rate of 79%, and the two problem
gambling beds were occupied at a rate of 68% for an overall occupation rate of 78% for our twenty-two beds.
2012-2013
2011-2012
2010-2011
2009-2010
Substance abuse
237
247
246
265
Problem Gambling
31
22
24
19
268
269
270
284
Substance abuse
76%
79%
80%
84%
Problem Gambling
96%
68%
82%
69%
Total
78%
78%
81%
83%
Total Clients Served
Total
Occupation Rate
26
27
DECLARATION ON
THE RELIABILITY OF THE
FINANCIAL STATEMENTS
The Foster Addiction Rehabilitation Centre’s financial statements were completed by management who is
responsible for their preparation and valid presentation including estimates and important conclusions.
This responsibility includes selecting the appropriate accounting practices that comply with the Canadian
Accounting Standards for the public sector and specifics provided in the Financial Management Manual
made under section 477 of the Act Respecting Health Services and Social Services. The financial information
contained elsewhere in the annual report is consistent with that given in the financial statements.
To fulfill its responsibilities, management maintains a system of internal controls it considers necessary.
This provides reasonable assurance that assets are safeguarded, that transactions are properly recorded
and in a timely manner, that they are duly approved and that they can produce reliable financial statements.
Management at the Foster Addiction Rehabilitation Centre recognizes that it is responsible for managing its
affairs in accordance with laws and regulations which govern it.
The Board oversees how management fulfills its responsibilities in financial reporting and has approved the
financial statements. The Board is assisted in their responsibilities by the Audit Committee. This committee
meets with management and the auditor, examines the financial statements, and recommends their approval
to the Board.
The financial statements were audited by the firm Demers Beaulne duly mandated to do so, in accordance
with the auditing standards generally accepted in Canada. Their report states the nature and extent of
the audit and offers their opinion. The firm Demers Beaulne may, without restriction, meet with the Audit
Committee to discuss any matter that relates to the audit.
John Topp
Director General
Maryse Couturier
Director of Administrative Services
28
29
FINANCIal
Report
STATEMENT OF OPERATIONS
Year ending March 31, 2013
main
activities
secondary
activities
capital
activities
Total
2013
Total
2012
$
$
$
$
$
3 893 510
602 388
683 688
5 179 586
3 552 755
35 445
-
-
35 445
30 774
7 741
4 050
4 919
16 710
6 724
Revenues
Agency & MSSS
Sales of services
and recoveries
Investment revenues
-
-
-
-
626 588
Other
Gain on disposal
99 849
152 623
-
252 472
186 349
Total
4 036 545
759 061
688 607
5 484 213
4 403 190
3 107 115
509 101
-
3 616 216
3 507 878
10 684
-
-
10 684
7 909
164
-
-
164
183
48 668
Expenses
Salaries and
fringe benefits
Medication
Medical supplies
Foodstuffs
54 213
-
-
54 213
-
-
219
219
67 585
-
-
67 585
50 157
-
-
56 536
56 536
58 276
Other
655 175
210 809
45
866 029
592 645
Total
3 894 936
719 910
56 800
4 671 646
4 265 716
141 609
39 151
631 807
812 567
137 474
Bank charges
Maintenance and repairs
Depreciation
of fixed assets
Revenue Surplus
30
STATEMENT OF ACCUMULATED SURPLUS
Year ending March 31, 2013
Funds
Total
operating
capital
2013
2012
$
$
$
$
Accumulated surplus, beginning
of year already established
677 454
275 761
953 215
869 620
Previous years accounting
modifications without reprocessing
-
-
-
(53 879)
Accumulated surplus beginning
of year restated
677 454
275 761
953 215
815 741
Revenue surplus
180 760
631 807
812 567
137 474
Accumulated surplus, end of year
858 214
907 568
1 765 782
953 215
-
-
1 765 782
953 215
Consisting of:
— Unallocated balance
31
STATEMENT OF FINANCIAL SITUATION
Year ending March 31, 2013
Funds
Total
operating
capital
2013
2012
$
$
$
$
Cash
214 334
117 045
331 379$
726 553
Temporary investments
600 000
500 000
1 100 000
884 068
Agency & MSSS accounts receivable
550 958
-
550 958
195 845
Other accounts receivable
194 652
2 665
197 317
114 485
4 471
(4 471)
-
-
433 772
107 132
540 904
(129 068)
49 266
1 467
50 733
6 688
Financial assets
Amount due from Operating fund
Receivable grant–accounting reform
Other
Total of financial assets
2 047 453
723 838 2 771 291 1 798 571
Liabilities
Temporary loans
Other accounts payable
Advance from the Agency–
decentralized funds
Deferred incomes
Liabilities related to future social benefits
Total of liabilities
Net financial assets
-
10 597
10 597
8 152
504 027
-
504 027
270 548
-
4 088
4 088
-
270 563
-
270 56
366 970
-
426 287
411 694
426 287
1 200 877
14 685 1 215 562 1 057 364
846 576
709 153
1 555 729
741 207
207 058
Non financial assets
Fixed assets
-
198 415
198 415
Prepaid expenses
11 638
11 638
4 950
Total of non financial assets
11 638
198 415
210 053
212 008
907 568 1 765 782
953 215
Accumulated surplus
858 214
32
STATEMENT OF CHANGES IN NET FINANCIAL ASSETS
Year ending March 31, 2013
Funds
Total
operating
capital
2013
2012
$
$
$
$
Net financial assets at the beginning
of the year already established
672 504
68 703
741 207
553 816
Previous years accounting modifications
without reprocessing
-
-
-
(17 559)
Net financial assets at the beginning
of the year restated
672 504
68 703
741 207
536 257
Surplus of the year
180 760
631 807
812 567
137 474
-
(47 893)
(47 893)
-
Variations due to fixed assets
Purchases
Depreciation
-
56 536
56 536
58 276
(Gain)/loss on disposal
-
-
-
(626 588)
Proceeds of disposition
-
-
-
630 621
Total of variations due to fixed assets
-
8 643
8 643
62 309
(11 638)
-
(11 638)
-
4 950
-
4 950
5 167
Total of variations
due to prepaid expenses
(6 688)
-
(6 688)
5 167
Increase of net financial assets
174 072
640 450
814 522
204 950
Net financial assets
at the end of the year
846 576
709 153
1 555 729
741 207
Variations due to prepaid expenses
Acquisition of prepaid expenses
Use of prepaid expenses
33
34
MEMBERS OF THE
BOARD OF DIRECTORS
AND EMPLOYEES *
* as of March 31, 2013
Board of Directors
Officers
Administrators
Jim Wyant, President
Daniel Babin
Carol-Ann Milch
Janet Soutter, Vice-President
Dara Charney
Peter Ohlin
Robin Hale, Treasurer
Mark Hayter
Gordon Pinkerton
John Topp, Secretary and Director general
Julie Leblanc
Tanya Schultz
Howard Magonet
Committees of the Board of Directors
Governance
and Ethics Committee
Watchdog Committee
Jim Wyant, President
Danièle Gagnon, Local
Commissioner for Complaints
and Quality of Services
Robin Hale
Peter Ohlin
Janet Soutter
John Topp
Audit Committee
Peter Ohlin, President
Peter Ohlin, President
Mark Hayter, President
of the Clients’ Committee
Howard Magonet, representative
of the Board of Directors
John Topp, Director General
Executive Committee of the
Multidisciplinary Council
Carol-Ann Milch, President
Marilyn Payne, Vice-President
Julie Leblanc, Secretary
Jennifer Mascitto
John Topp
Risk Management Committee
John Topp, President
Robin Hale, Vice-President
Jennifer Mascitto, Risk Manager
Jim Wyant, Secretary
Paul Raymer
Réjeanne Simard
35
HUMAN RESOURCES
As of March 31, 2013, CRD Foster employed 68 individuals occupying 55.7 permanent positions
and 4 temporary, including four professionals from Centre Dollard-Cormier. Housekeeping,
maintenance, laundry and information systems are provided by external contractors.
Human Resources as of March 31
Description
2013
2012
6
6
Full time positions
39
23
Part time positions
18
6
16 195
16 968
9
9
Management
Full time positions
Regular employees
Temporary positions
Number of paid hours
Equivalent full time
Note: The year 2011-2012 only included the employees of the main activities, thus the problem gambling
and the Centre Dollard-Cormier staff were not included.
36
Board of directors
risk management
committee
audit committee
director general
John Topp
multidisciplinary Council
1 administrative assistant
coordinator
DIRECTor of administrative
services
Stéphanie Leblanc
Maryse Couturier
kitchen SERVICES
2 Cooks
ADMINISTRATIve support
1 Accountant
1 Administrative Technician
contracted SERVICES
Laundry
Maintenance
Housekeeping
IT Services
montérégie Outpatient
services
Inpatient Services
reception / secretarial support
clinical personnel
adult program
5,2 Nurses
1 Secretary
2,9 Clinicians
youth program
3,4 Clinicians
Problem gambling
program
1,5 Clinicians
Social reintegration
Program
0,5 Clinician
regional training
1 Clinicians
8,6 Clinicians
nursing
37
clients’ Committee
Watchdog Committee
Governance and Ethics
Committee
consulting Physician
director of professional
and rehabilitation Services
Interim clinical
Program Advisor
Jennifer Mascitto
Alyssa Mew
coordinator
Ximena Rodriguez-Solis
Montreal Outpatient
Services
saaq Driver
Evaluation program
reception / secretarial support
contractual evaluators
1 Administrative Secretary
1,6 Secretaries
researcher
Thomas G. Brown
research
head
CRD Foster Research Program
director
adult program
9,3 Clinicians
nursing
2 Nurses
youth program
6,1 Clinicians
Problem gambling
program
3,1 Clinicians
social reintegration
program
0,5 Clinician
Addiction Research Program
Douglas Institute Research Centre
38
Employees of the
Foster Addiction
Rehabilitation Centre
Ryan Aronson
Lindsay Faul
Malorie Moore
Marie Louise Ayer
Sarah Freeman
Sophie Noreau
David Bailey
John Furuli
Nathalie Ordona
Daniel Balenzano
Edwina Gallant
Colleen O’Shea
Jacques Beaudin
Debra Gartenberg
Marilyn Payne
Michelle Bisares
Mario Giguère
Alison Pollock
Johanne Boulé
Arpita Gupta
Ximena Rodriguez Solis
Sylvie Bourgon
Yael Gutner
Tanya Schultz
Chantal Boyer
Rachael Herbert
Jody Sell
Thomas Brown
William Jones (médecin)
Wendy Shepherd
Holly Burley
Zophie Kocsis
Réjeanne Simard
Julie Champagne
Annie Lafontaine
Kathy Sisak
Andrea Chen
Julie Leblanc
Catherine Smyth-Laporte
Sheila Clark
Stéphanie LeBlanc
Colleen Soutter
Marcelin Cloutier
Richard Lestage
Suzanne St-Pierre
Maryse Couturier
Victoria Levine
Jo-Anne Théoret
Kimberley Creton
Alice Li
John Topp
Lucy Cumyn
Yvonne Lo
Nadia Turgeon
Julie Dahmé
Sandra Malenfant
Phuong-Anh Urga
Sylvie D’Amour
Jennifer Mascitto
Eric Widdicombe
Derek De Braga
Marlene McIntyre
Robyn Yanofsky
Graciela De Dona
Alyssa Mew
Jousalin Zawahreh
Joseph Douek
Carol-Ann Milch
Fady Zigby
39
CODE OF ETHICS
OF THE BOARD
OF DIRECTORS
ADOPTED BY THE BOARD OF DIRECTORS
ON JUNE 12, 2012
40
INTRODUCTION
The administration of a publicly funded institution presents characteristics and obeys imperatives,
which distinguish it from private sector administration. Such a social contract imposes a particular
trust between the institution and the citizens it serves. Ethical behavior remains, consequently, a
constant concern of the institution to guarantee to the general population an honest and responsible
management of public funds.
In order to respect these fundamental values, we have collected in this Code of Ethics of the Board
of Directors the major ethical guidelines to which the administrators of Centre de réadaptation Foster
adhere. Each administrator of CR Foster is expected to respect the principles of ethics stated in the
law and the Code of Ethics of the Board of Directors. At all times, the most demanding principles and
rules apply.
Administrators must act not only according to the letter but also to the spirit of these principles and
of these rules.
41
DUTIES AND OBLIGATIONS
OF THE ADMINISTRATORS
1 — To act in good faith, in the best interests of the institution and the population served without
taking into account the interests of any other person, group or entity.
2 — To take a position on propositions by exercising their right to vote in the most objective manner.
To this end, they can make no commitment towards third parties nor grant them guarantees with
regard to their vote or to whatever decision.
3 — To demonstrate discretion concerning information acquired while exercis­ing their duties. Furthermore, they should give evidence of caution and restraint towards confidential information, which,
if communicated, could damage the interests of the institution, infringe on the private life of
individuals or confer an advantage to a physical or legal person.
4 — To maintain strict confidentiality in all matters where such confidentiality is prescribed by law
or specific decision of the Board.
5 — To reveal any information or fact to the other members of the Board when they know or suspect
that the communication of this information or this fact could have a significant impact on the
decision.
6 — To refrain from intervening in the process of hiring of staff, with the exception of the director
general or a director.
7 — To refrain from favouring friends or close relations. They should also refrain from acting as
intermediates, even for free, between a corporation, profit or non-profit, and the institution
42
CONFLICT OF INTERESTS
8 — Administrators should avoid conflicts of interest situations; they should conduct themselves in
a manner that avoids procurement of unwarranted advantages or benefits resulting from their
functions as administrators, either for themselves or for others.
9 — Administrators, under pain of forfeiture of office, should announce in writing their interests to
the Board of Directors when they have a direct or indirect interest in a company, which may
create a conflict of interest. In such a case, administrators should refrain from sitting and from
participating in any discussion or decision when a question concerning the company in which
they have this interest is discussed.
However, being minority shareholders of a legal person who runs such a company does not in
itself constitute a conflict of interests if the shares of this legal person are traded in a recognized
stock exchange and if the administrators are not insiders of this moral person in the sense of the
article 89 of the Loi sur les valeurs mobilières. (L.R.Q., chapter V-1.1).
43
10 — Administrators should use the property, the resources or the services of the institution in
ways recognized and applicable to all. They cannot confuse the possessions of the institution
with their own.
11 — Administrators cannot accept nor seek any advantage or profit, directly or indirectly, from a third
party conducting business with the institution, or acting in the name or for the profit of such a party,
if this advantage or profit could influence them in exercising their duties or create expectations
of favouritism or gain.
In particular, it is considered unacceptable to receive any present, sum of money, loan at a
preferential rate, remission of a debt, job offer, favour or any other consideration having an
appreciable monetary value which compromises or seems to compromise the capacity of the
administrators to make just and objective decisions.
12 — Administrators should receive no compensation or other pecuniary or material advantages with
the exception of the reimbursement of their expenses incurred while exercising their duties as
defined in the travel expense policies determined by the government.
44
CONDUCT OF ADMINISTRATORS
AFTER THE END OF THEIR MANDATE
13 — Administrators should conduct themselves in such a manner as to avoid benefiting from
unjustified advantages, in their personal name or for others, resulting from their previous
functions as administrators.
14 — In the year following the end of their mandate, administrators should avoid acting, in their
personal name or for others, in any procedure, negotiation or other operation in which the
institution is a party and about which they hold information unavailable to the public.
15 — Administrators should, in the year following the end of their mandate, refrain from seeking
employment with the institution, if they are not already employed by the institution.
16 — Administrators should not make use, at any time, of the confidential information, which they
obtained in the execution of their duties, or during their tenure.
17 — Administrators should avoid tarnishing, by inappropriate comments, the reputation of the
institution and its employees and administrators.
45
MECHANISMS OF APPLICATION
OF THE CODE
18 — Any allegation of misbehavior or neglect regarding the law or the Code of Ethics of the Board
of Directors aimed at administrators must necessary be forwarded to the president of the Committee on the Code of Ethics of the Board of Directors or, if the allegation is aimed at the latter
person, to another member of the committee. The person to whom this allegation is forwarded
informs the committee, which then has to meet, at the latest, in the next thirty (30) days.
19 — T he committee can also examine, on its own initiative, any situation of irregular behavior
by administrators.
20 — W
hen an allegation is passed on to him or her by virtue of the preceding article, the president
of the committee can reject, on summary examination, any allegation as frivolous, persecutory
or made in bad faith. However, the president must inform the other members of the committee
of this decision, during their next meeting. The committee may decide to investigate this allegation despite this negative recommendation.
21 — T he committee decides on the necessary procedures to conduct any inquiry within its competence. The inquiry must, however, be conducted in confidence and protect, as much as possible,
the anonymity of the person at the origin of the allegation.
22 — A t a moment deemed appropriate, the committee has to inform an administrator under investigation of the nature of the complaint by stating the relevant articles of the law or the Code
of Ethics. At his or her request and within a reasonable delay, the administrator has the right
to be heard, to have person(s) of his or her choice testify and to deposit any document which
the administrator may consider relevant.
46
23 — W
hen the committee comes to the conclusion that an administrator has broken the law or the
Code of Ethics of the Board of Directors or gave evidence of misbehavior of a similar nature,
the committee presents to the Board of Directors a report containing the contents of the inquiry
and the recommendation of a penalty. This report is confidential.
24 — T he Board of Directors meets in camera to decide on the penalty to be imposed on the said
administrator. The latter cannot participate in the considerations or in the decision but can, on
demand, be heard before the decision is taken.
25 — A ccording to the nature and the seriousness of the neglect or the misbehavior, the penalties,
which can be taken, are a call to order, a reprimand, suspension or forfeiture of office. The
administrator in question is informed, in writing, of the penalty imposed.