MAID Reporting for Alberta Practitioners Step by Step Guide

Medical Assistance in Dying

Accessing Forms

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Where a practitioner receives an oral or a written request for MAID, the practitioner (MD or NP) should engage the patient in a full discussion about MAID, seeking to understand their circumstances and perspective and to ensure all options for care have been considered (e.g. palliative care).

This guide outlines reporting requirements for Alberta physicians (MDs), nurse practitioners (NPs) and pharmacists with a role in medical assistance in dying (MAID). It applies to both AHS and non-AHS practitioners.

MAID reporting is required under federal regulation, professional standards of practice, AHS policy and the Office of the Chief Medical Examiner (OCME), as noted below. Reports are received by the AHS Care Coordination Service on behalf of the MAID Regulatory Review Committee, Alberta Minister of Health and Health Canada as applicable. Please fax all reports to MAID Reporting 403-592-4266 or 1-888-220-2729 unless indicated otherwise (i.e., OCME).

NOTE: Where the AHS Care Coordination Service is involved, they will assist practitioners in understanding what reporting will be required.

See webinar, your College website or FAQs for further resources. All forms are available for download from the Forms tab.

Step 1 - Patient Written Request

MD or NP receives a written request for MAID in any format, including by email or text but is not further participating:

Within 7 days1, the MD or NP must report the request and indicate if they will be:

  • Making a formal referral for the patient (including consulting another practitioner or directly contacting the Care Coordination Service); or
  • Transferring their care as a result of the request

Use the Physician/Nurse Practitioner Form (sections 1a, 1b, 1c, 2)2.

You are not required to report if you are following the College Standard of Practice and you provide the CCS information to the patient but take no further action such as a referral or transfer of care.

MD or NP receives a written request for MAID in any format, including by email or text and is willing to participate further:

  1. Upon receiving the patient’s written, witnessed request, the MD or NP must ensure a Goals of Care Designation order is completed to ensure EMS is aware of the patient’s wish not to be resuscitated or transported during the assessment phase and after receiving MAID.
  2. Unless you are fully comfortable with all of the required steps in the MAID process, you are strongly encouraged to contact the Care Coordination Service for assistance through the process.
  3. Proceed to Step 2.

Step 2 - Patient Eligibility Assessment

AHS Care Coordination Service arranges unless already performed.

Initial/Second assessment

  • Assessing practitioner performs assessment and may or may not refer patient for additional specialist assessment as appropriate (e.g., capacity; medical specialist)

The assessing practitioner must report the patient is ELIGIBLE or INELIGIBLE for MAID as soon as feasible to avoid delay for the patient, but no later than 30 days2 after the assessment.

Where the Required Information and Part A of the Combined Assessment/Providing Practitioner Record is used and submitted through MAID Reporting, no additional reporting form will be required.

Should the Combined Assessor/Provider form not be used, additional reporting will be required using the Physician/Nurse Practitioner Form (sections 1a, 1b, 1c, 3)2.

Step 3 - Referral to Providing Practitioner

Patient and providing practitioner develop a plan for MAID together, usually with assistance of the AHS Care Coordination Service.

If the AHS Care Coordination Service connects the patient with a MAID provider

No practitioner reporting required (reporting done by Care Coordination Service)

If the MD or NP refers the patient to a providing practitioner

Notify Care Coordination Service (no formal reporting required)

Step 4 - Mandatory Period of Reflection

  • The mandatory period of reflection is 10 full days between the date the patient signs the request and the date of provision. This does not include either the date the request was signed or the date of the provision.
  • Under exceptional circumstances, this period of reflection may be shortened if both assessing practitioners agree the patient may lose capacity or die within that timeframe. Reporting is required where the timeframe is shortened using either the combined form or the Physician/Nurse Practitioner Form (sections 1a, 1b, 1c, 4)

Step 5 - Provision of MAID

Providing practitioner collaborates with a pharmacist to obtain medication and administer to the patient

Providing practitioner must complete the Providing Practitioner Record or Required Information and Part B of the Combined Assessment/Providing Practitioner Record. Within 24 hours of the patient’s death, the providing practitioner must fax to the OCME (780-422-4063 (Edmonton) or 403-297-8134 (Calgary)) and Maid Reporting (403-592-4266 or 1-888-220-2729): the completed Record of Request3, Consent to Treatment4, Providing Practitioner Record form and Record of Medication Administration (to be provided by Care Coordination Service). Within 30 days of dispensing the medication for MAID, the pharmacist must report. Use the Pharmacist Form2.

OR: Self-Administration of MAID Medication

Providing practitioner collaborates with a pharmacist to obtain medication and deliver to the patient for self-administration

Within 30 days of dispensing the medication, the pharmacist must report. Use the Pharmacist Form.

The providing practitioner must complete the Providing Practitioner Record or Required Information and Part B of the Combined Assessment/Providing Practitioner Record. Within 24 hours of the patient’s death, the providing practitioner must fax to the OCME (780-422-4063 (Edmonton) or 403-297-8134 (Calgary)) and MAID Reporting (403-592-4266 or 1-888-220-2729): the completed Record of Request3, Consent to Treatment4, Providing Practitioner Record form OR combined form and Record of Medication Administration (to be provided by Care Coordination Service).

If the Care Coordination Service is not involved and, at any time, the primary, assessing or providing practitioner becomes aware the:

patient has WITHDRAWN their request:

As soon as feasible but no later than 30 days after becoming aware, the practitioner must report the patient has withdrawn their request2,5 Use the Physician/Nurse Practitioner Form (sections 1a, 1b, 7).

patient has DIED of a cause other than MAID:

As soon as feasible but no later than 30 days after becoming aware, the practitioner must report the patient died of another cause2,3. Use the Physician/Nurse Practitioner Form (sections 1a, 1b, 8).

patient has become INELIGIBLE for MAID due to loss of capacity or the practitioner has learned the request was not voluntary:

As soon as feasible but no later than 30 days after becoming aware, the practitioner must report the patient is no longer eligible for MAID2,3. Use the Physician/Nurse Practitioner Form (sections 1a, 1b, 3b).

If the Care Coordination Service is involved, and any of the above 3 situations arise, reporting will be done through the Care Coordination Service and no action is required from the assessing or providing practitioner.

1 7-day timeframe is AHS procedure and meets CPSA expectations outlined in the Medical Assistance in Dying standard of practice, clauses 3 and 4.
2 30-day timeframe is within the Criminal Code Regulation for the Monitoring the Medical Assistance in Dying: SOR/2018-166.
3 AHS Care Coordination Service forwards to the providing practitioner for review and submission to the OCME.
4 To be completed by the patient immediately before MAID is provided.
5 No report necessary if practitioner does not become aware until >90 days.

Contact Information for Reporting

(printable version)

Care Coordination Service
Phone: 811
Email: maid.careteam@ahs.ca

Alberta Reporting
Record of Request:

  • Edmonton and North: 780-641-9123
  • Calgary and Central: 403-592-4264
  • South: 403-592-4265

Physician / Nurse Practitioner Reporting: 403-592-4266
Pharmacist Reporting: 403-592-4266

Fax Numbers and cover sheet for Office of the Chief Medical Examiner (OCME) and AHS:

Provincial Medical Assistance in Dying Office
6th Floor, 10101 Southport Rd SW
Calgary, AB T2W 3N2