CRTO Council Meeting Minutes Held on March 1, 2019 from 9:00 am to 4:00 pm 19th floor Conference Rm., 180 Dundas St. W., Toronto, ON

Attendance:

Council Members: Christina Sperling, RRT – President Jeff Earnshaw, RRT Patricia Latimer, Public Member – Vice President Monique Forster, Public Member Kelly Arndt, RRT James Lexovsky, Public Member Michelle Causton, Public Member Kelly Munoz, RRT Allison Chadwick, RRT Andrea Winters, RRT

Jacqueline Conant, Public Member Rhonda Contant, RRT

Staff: Kevin Taylor, RRT, Registrar & CEO Amelia Ma, Manager Finance & Office Carole Hamp, RRT, Manager of Quality Practice Lori Peppler-Beechey, RRT, Manager Governance & Quality Temeka Tadesse, IT & Database Specialist Shaf Rahman, Manager of Professional Conduct

Student Representatives: Regrets: Kelly Andrea Cifuentes, La Cité Jody Saarvala, RRT Namitha Robin, Michener Lindsay Martinek, RRT Hannah Do, St. Clair

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1.0: INTRODUCTION AND GUESTS

Christina Sperling, President, welcomed Council Members, Student Representatives and staff to the meeting.

2.0: APPROVAL OF COUNCIL AGENDA

Council reviewed the agenda for March 1, 2019. Motion # 1 MOVED BY Andrea Winters, RRT and SECONDED BY Michelle Causton, to

recommend that Council approve the Council Meeting Agenda for March 1, 2019.

MOTION # 1 CARRIED.

3.0: STRATEGIC ISSUES

3.1 GOVERNANCE AND PROFESSIONAL DEVELOPMENT PROGRAM UPDATE Lori Peppler-Beechey, Manager of Governance, provided the Council an update on Onboarding

Orientation of new council and committee members. The following was discussed:

Lori stated that phase 1 of onboarding was completed.

Phase 2 will be done via webinar. Shaf Rahman, Manager of Professional Conduct

will be joining the webinar to do the ICRC orientation as well. The reason being, all 4

new members to council/committees are also on the ICRC committee, therefore,

combining the orientation will streamline orientation.

Lori Peppler-Beechey also reminded the council about the ongoing discussion regarding the

competencies/attributes to consider in selecting members of council, chair, vice-chair, etc.

Carole Hamp, Manager of Quality Practice, provided a data review of Relevant, LaunchRT,

PortFolio, and Workshops.

LaunchRT:

Total of 523 members have completed it.

Of that, 429 passed on the initial attempt

94 members required a rewrite

4 members will have to complete a SCERP.

If a Member was to fail Launch after completing the SCERP, the process would then

repeat itself.

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RelevanT:

2672 Members completed it this year

There were suggestions made by the Membership, one of which was to include

legislation as a topic for future RelevanT reviews.

PortFolio:

Peer assessors about to begin reviewing portfolios in April.

Each assessor will review approximately 16/17 portfolios

The results will be provided to the Membership by June at the latest.

Andrea Winters, RRT commented that she had received positive feedback on the

new portfolios, with membership stating that it was easier to understand and there

was much less confusion around how to complete it.

Workshops:

21 workshops were completed in person, 6 via webinars.

Attendance was around 382 members.

The workshops were a good opportunity to engage the Membership and answer

their questions, as some members are hesitant to contact the CRTO directly when

they have questions.

4.0: OPERATIONAL & ADMINISTRATIVE ISSUES

4.1 REGISTRAR + STAFF ACTIVITY REPORT

The professional development program is well on its way to being completed.

Renewal period ended on February 28, 2019 with about 800 members renewing on the final two days of renewal.

A late fee will be charged for any members who renew on or after March 01, 2019.

On April 11, 2019 Suspensions for members who have not renewed will take place on April 11, 2019.

If a suspended Member does not renew their certificate of registration by February 29, 2020, the Member’s certificate will be revoked. This revocation will be considered an administrative revocation.

Are You Practicing Factsheet:

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The roll out of the Factsheet has been met with positive feedback. There have been some questions regarding the content, but overall it

appears the membership has a good understanding of the document. The purpose of the document was to assist members in determining if

they should renew their certificate, and if so, under which class.

Staff and Council took a moment to acknowledge the departure of Patricia Latimer from Council as her term has ended and wished her the best in her future endeavours.

Public Member Appointments to Council and Committees: CRTO is still waiting on new public member appointments from the

government. Ideally, the CRTO would prefer to have 8 public members, however, until

that time, the current public members will be asked to carry a larger workload.

British Columbia Respiratory Therapist Regulator: The organization is still waiting to have their regulations passed by the

provincial government. Currently in in the process of drafting policies and getting set to go live

once the regulations are passed.

Prince Edward Island: The province is rumoured to be moving forward with umbrella legislation

to regulate all health care professionals. There will be one regulator to regulate all health care professionals. A lot of administration items will be done in combination.

National Accreditation: All provinces have now approved the new accreditation requirements. Presentations will be done at all schools in order to educate them and

ensure understanding of the new national process.

4.2 FINANCIAL STATEMENTS

A review of all Financials Statements occurred.

4.3 INVESTMENT PORTFOLIO

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A review of all investments and related documents occurred.

There were no specific items highlighted for discussion.

4.4 PRIORITIES, BUDGET 2019-2020 + WORK PLAN Historical Priorities Recap:

In 2015, the main focus was to increase membership engagement and leverage technology to better meet CRTO mandates.

Outreach and PDP programs have been very successful. However, the CRTO continues to focus on improving these processes.

Strategic Priorities:

Governance and Accountability are both current hot topics in the world of regulation; therefore there will be a focus on improving both aspects by the CRTO.

The province is currently undergoing a shift in the health care model, with a focus on quicker hospital turn around and getting people out of hospitals as soon as possible. In turn, there will now be a greater focus on community care. The CRTO will monitor and implement strategies accordingly.

Current Priorities:

Enhancing Engagement: Communications review will occur. Website update will be done in an attempt to refresh the website. Considerations of using additional social media (eg. Facebook, Twitter,

Instagram). However, prior to doing this, CRTO needs to consider what the messaging should be (eg. awareness of the profession, information for the membership and public, etc).

Operational Excellence: More investment in Information Technology. Recruitment of new staff Streamlining Professional Conduct processes.

Governance and Accountability: Audit procedures to highlight areas for improvement. Council appointments: Establishing the competencies for appointments.

Enhancing Professionalism: Focus on helping RTs to better understand and view on-going learning.

The CRTO wants to help RTs to better target their learning goals, and for the process to be more efficient.

2019-2020 Budget:

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Review of all line items in the budget was done.

Budget discussion items included: Need to recruit additional staff Professional Conduct budget increase of 10% to account for a projected

increase of 3 to 4 cases. Discussion was held regarding fee increases (small yearly increase vs.

large increase once every 5 to 7 years).

Motion # 2 MOVED BY Michelle Causton and SECONDED BY Kelly Munoz, RRT to recommend that Council approve the 2019-2020 Budget.

MOTION # 2 CARRIED.

4.5 MEMBERSHIP STATISTICS

Review of membership statics occurred.

Discussion around accountability of the regulator to ensure appropriate amount of RTs in the province to meet provincial needs. However, difficulty in addressing this concern is that the regulator does not control enrolment and funding for education programs. Therefore, the CRTO approach at this time will be to monitor the situation.

5.0: CONSENT AGENDA ITEMS

5.1 MINUTES FROM NOVEMBER 30, 2018

Council reviewed the Minutes from November 30, 2018.

5.2 EXECUTIVE COMMITTEE

Christina Sperling, RRT, Chair of Council reviewed executive committee report.

5.3 REGISTRATION COMMITTEE

Patricia Latimer, Chair of Registration Committee reviewed committee report.

5.4 QUALITY ASSURANCE COMMITTEE

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Rhonda Contant, RRT, Chair of Quality Assurance Committee reviewed committee report.

5.5 PATIENT RELATIONS COMMITTEE

Jacqueline Conant, Chair of Patient Relations Committee reviewed committee report.

5.6 INQUIRES, COMPLAINTS AND REPORTS COMMITTEE (ICRC)

Allison Chadwick, RRT, Chair of ICRC reviewed committee report.

5.7 DISCIPLINE COMMITTEE

Christina Sperling, RRT, Chair of Discipline Committee reviewed committee report.

5.8 FITNESS TO PRACTISE COMMITTEE

Christina Sperling, RRT, Chair of Fitness to Practise Committee reviewed committee report.

Motion # 3 MOVED BY Patricia Latimer and SECONDED BY Allison Chadwick, RRT to

recommend that Council approve all consent agenda items. MOTION # 3 CARRIED.

6.0 COMMITTEE ITEMS ARISING

6.1 EXECUTIVE COMMITTEE ITEMS

No items for this meeting

6.2 REGISTRATION COMMITTEE ITEMS

Item 6.2.1: Approval of Recognized RT Programs Council reviewed memo from Registration Committee to Council,

approve the Respiratory Therapy Programs recommending that council for 2019 based on the programs’ accreditation status with the Council on Accreditation for Respiratory Therapy Education (CoARTE).

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Motion # 4 MOVED BY Rhonda Contant, RRT and SECONDED BY Jacqueline Conant to recommend that Council approve the 2019 Respiratory Therapy Programs.

MOTION # 4 CARRIED.

6.3 QUALITY ASSURANCE COMMITTEE ITEMS

No items for this meeting

6.4 PATIENT RELATIONS COMMITTEE ITEMS

No items for this meeting

6.5 INQUIRES COMPLAINTS AND REPORTS COMMITTEE ITEMS

No items for this meeting

6.6 DISCIPLINE & FITNESS TO PRACTISE COMMITTEES ITEMS

No items for this meeting

7.0 LEGISLATIVE AND POLICY ISSUES:

7.1 AUDITOR OBJECTIVITY

Audit review will be done by the Executive Committee. This will allow the Executive Committee to directly communicate with the auditor.

Auditing guide will be created to assist the Executive Committee.

The main reason for Executive Committee to directly review and communicate with auditor is to assist in maintaining audit objectivity.

7.2 SIGNING OFFICERS POLICY REVISIONS

Rationale: As Deputy Registrar position is vacant, the CRTO will need to name two individuals who can sign cheques.

The new revised policy will grant the Registrar & CEO the authority to pick two individuals (internal staff) to sign the cheques.

Any cheque that exceeds $10 000 will require internal staff signature and external signature. The external party will be Christina Sperling, President.

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Motion # 5 MOVED BY Michelle Causton and SECONDED BY Monique Forster to recommend that Council approve the revised signing officer policy.

MOTION # 5 CARRIED.

7.3 COLLEGE GOVERANCE REFORM Discussion on multiple topics occurred regarding which aspects of CNO Vision 2020 report the Council would support. Discussion topics included:

Change of Terminology in regards to the title of Council to Board of Directors, Directors, etc:

Changing Council to “Board of Directors” would make it easier for the public to understand its function.

Equal naming of professional and public members of council as “Directors” aligns with the purpose of the council, which is to regulate for the public interests, and does not give an impression of bias.

However, it’s important to ensure that we make it clear that the public is represented; therefore, a possibility that initially the CRTO would delineate between the public and professional “Directors”, or possibly include RRT at the end of the names of the “Professional Directors”.

CRTO website should have a brief biography of each “Director” so that the public and membership can understand the background of each “Director”.

If all individuals are named “Director”, we must consider the language in the by-laws to properly explain that all Panels must have a public member or “Public Director”.

If we change all Council Members to “Directors”, we may not be transparent as to the selection process difference between a public director (who is appointed) vs a professional director (who is elected). However, if Council is agreeable to the other CNO Vision 2020 proposal, which is to appoint professional members as well, then this would not be an issue.

Decreasing the Size of Council: CNO Vision 2020 recommends that smaller Council size is more efficient

to accomplish Council functions. A positive would be that Council would be much easier to manage, and

more agile and flexible to respond to issues at a quicker pace. A negative would be that Council would be too small, and may become

fragmented into different camps of thinking, or one Council member could easily influence others within the smaller Council.

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A smaller Council may not get the same cross-section of representation from all over Ontario. We may risk only certain areas being represented.

o A possible solution to this would be to decrease Council size, but not drastically. Therefore, geographical representation would still be there for the most part (possibly 10 members).

Elected vs. Appointment Professional Members of Council & Competency Based Selection Process:

Members may view the appointment of professional members as their specific geographical region no longer being represented.

o To combat this perception, geographical location can be an attribute considered in the appointment process. This can then be communicated to the membership.

If appointing professional members, then it must be based on competency, including different areas of practice.

Competency based selection would allow for more efficient functioning of Council.

The process could be to send out a communique explaining the new process, rationale for it, and then ask for submissions of members interested in being on Council.

You may get more qualified people interested in being on Council, as some people are discouraged in running in an election (the current process).

Generally, the Council was in favor of competency based selection process to appoint professional members to Council.

Equal number of professional and public members on Council: The Council was in favor of equal number of public and professional

members.

Having a small Council (or Board of Directors) and having no Executive Committee: The smaller Council would do the same job as Executive Committee. It

would allow the Council to be more responsive and agile in responding to CRTO matters.

It would take away redundancies between the Council and Executive Committee. For example, someone on Executive Committee may have to attend two different meetings (Executive meeting and Council meeting) which covers the same topics.

A consideration would be that Council meetings are public. A negative to not having an Executive Committee and having a small

Council is that it may not allow for the Council members to be on committees. Therefore it would take away from the “frontline view of the regulator” that Council members benefit from now, as some are both

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on Council and on a committee. This could be a hindrance to the Council’s mandate.

The Council was divided on this point. o Recommendations were made to obtain more information

on the pros and cons of having a small Council and no Executive Committee.

o Possibly see if other smaller regulators are planning on doing this, and what are their opinions/considerations.

Having a smaller maximum term for Council Members: The current 9 year limit allows for a council member to get a solid

understanding and level of comfort for the role (the longer you serve, the more you understand).

This consideration could take on a needs based approach. If there is a lot of interest to be on Council by the membership, then we can cap the maximum term to 6 years. If not a lot of interest to be on Council by membership, we continue to proceed with 9 year maximum terms.

Another approach could be to have a 9 year maximum term limit, but

every three 3 years, revisit the specific council member’s qualifications

and see if more qualified candidates are available.

A shorter term would allow for fresh new perspectives on current CRTO

issues.

Council was undecided on this recommendation.

Council would appoint public members as well, no longer have government

appointments. By doing so, the CRTO would have to cover the costs for public

members:

By being paid by the government, there is a perception currently that the public members are independent and not influenced by the CRTO. By paying for public members, the perception could switch, that the public members are no longer independent.

A benefit would be that the CRTO would no longer need to wait for public appointments, address the need for public members on Council/Committees quicker.

The CRTO would have better control over the selection process, and some sort of competence based selection process could be developed.

Membership may not be willing to pay for public members. “Why should I have increased fees, if the government is paying them already?”

Council was undecided on this recommendation.

A motion did not occur on this agenda item.

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7.4 REVISED ORDERS FOR MEDICAL CARE PPG Carole Hamp, Manager of Quality Practice did a brief presentation on the revised PPG.

The purpose of the revised PPG was to provide clarity between delegations vs. orders/medical directives.

Considerations on the validity of electronic orders were included in the PPG.

There is a FAQ section in the PPG to address common questions about delegations vs. orders/medical directives.

For the future, there is contemplation of creating a teaching video highlighting the differences between delegations vs. orders/medical directives.

Motion # 6 MOVED BY Michelle Causton and SECONDED BY Jacqueline Conant to

recommend that Council approve the circulation of the PPG to the membership.

MOTION # 6 CARRIED.

9.0: NEXT MEETING

Next Council Meeting: Friday, May 31, 2019 - 09:00 to 16:00 Location: 180 Dundas Street West, Toronto, ON – 19th Floor conference room.

10: ADJOURNMENT

MOTION # 7 MOVED BY Monique Forster and SECONDED BY Rhonda Contant, RRT to adjourn the Council Meeting.

MOTION # 7 CARRIED.

The March 1, 2019 Council Meeting adjourned at 3:00 pm.