Under section 54(10) of the Personal Health Information
Protection Act (PHIPA), a health sector provider may charge a fee
for responding to a person's access request if it first gives
the person an estimate. Section 54(11) provides that the amount of
the fee shall not exceed the prescribed amount or "the amount
of reasonable cost recovery", if no amount is prescribed.
However the government has never prescribed an amount so that,
until recently, there was little guidance as to what a health
service provider could charge for a copy of a patient's
THE IPC'S INTERPRETATION OF WHAT AMOUNTS TO
"REASONABLE COST RECOVERY"
The IPC's Order HO-009 provides some guidance in this
regard. In this case, the patient made a complaint regarding the
$125 fee charged by her physician for providing access to 34 pages
of psychological therapy notes. The IPC found that this fee
exceeded the amount of reasonable cost recovery and reduced it to
$33.50. To avoid creating a financial barrier or impediment to
access, the IPC interpreted the words "reasonable cost
recovery" as entitling health sector providers to recover
something less than the actual or full costs associated with
responding to access requests.
The IPC reduced the fee to $33.50 on a basis that permits a
health sector provider to charge $30 for photocopying or printing
the first 20 pages, and 25 cents per page for every additional
page. The set fee of $30 not only covered the cost of photocopying
and printing the first 20 pages but also covered the following
receipt and clarification, if necessary, of a request for a
providing a fee estimate
locating and retrieving the record
reviewing the contents of the records for 15 minutes to
determine if the record contains information to which access may be
preparing a response letter to the individual
the cost of faxing a copy of the record to a fax number in
Ontario or mailing a copy of the record by ordinary mail to an
address in Canada.
Order HO-009 provides health sector providers with welcome
guidance in determining what fee to charge where the requests
involve a limited number of records of personal health
At the same time, it may not allow for a "reasonable cost
of recovery" where the record is voluminous, in multiple forms
and where portions are offsite and located in a records management
facility. Therefore, health sector providers may want to develop
frameworks allowing them to both determine and reduce the costs of
responding to access requests.
Health service providers will need to continue improving
processes for responding to access requests by:
Developing frameworks for estimating and determining
Exploring means of reducing costs for searching for and within
records, including the implementation of records management
techniques and software.
Making appropriate changes to record-keeping of the time and
resources involved in processing an access request.
Changes made to better determine and to reduce the costs of
responding to requests for access made under PHIPA may also be
applied to requests under the Freedom of Information and Protection
of Privacy Act (FIPPA), which applies to hospitals since January 1,
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