Fair Registration Practices Report

Midwives (2017)

The answers seen below were submitted to the OFC by the regulated professions.

This Fair Registration Practices Report was produced as required by:

  • the Fair Access to Regulated Professions and Compulsory Trades Act (FARPACTA) s. 20 and 23(1), for regulated professions named in Schedule 1 of FARPACTA
  • the Health Professions Procedural Code set out in Schedule 2 of the Regulated Health Professions Act (RHPA) s. 22.7 (1) and 22.9(1), for health colleges.

Index

  1. Qualitative Information
  2. Quantitative Information
  3. Submission

1. Qualitative Information

a) Requirements for registration, including acceptable alternatives
i. Describe any improvements / changes implemented in the last year.

Successsful completion of a Jurisprudence Course set and approved by the Registration Committee is a non-exemptible registration requirement for issuance of a General or Supervised Practice certificate of registration, as outlined in the College’s Registration Regulation. This is not a new requirement, however, as of July 1, 2017 the College implemented a Jurisprudence Course to enable new applicants to meet this requirement. The College’s Jurisprudence Course is offered online and consists of a handbook to be reviewed, and an e-Learning module with exam questions, which are open book. There are no limits on the number of attempts an applicant can take to successfully complete the exam, however, applicants must correctly answer all questions to be successful. The course takes about four hours to complete and applicants can log in and out to complete it at their own pace. The course may be completed up to 12 months before registration.

 

ii. Describe the impact of the improvements / changes on applicants.

Introduction of the Jurisprudence Course improves applicant understanding of what it means to be a regulated health professional in Ontario. Applicants should therefore have an improved understanding of their professional obligations.

iii. Describe the impact of the improvements / changes on your organization.

The Jurisprudence Course should enhance applicant education and understanding of the regulatory framework which governs the practice of midwifery in Ontario, and the obligations of being a regulated health professional. This improves the College’s ability to effectively regulate the profession and serve the public interest.

b) Assessment of qualifications
i. Describe any improvements / changes implemented in the last year.

The College’s internal registration application checklist was reviewed and updated for improved processing of applications and requirements. This update included a verification of completion of the Jurisprudence Course.

The qualification and registration requirements remain the same. However, a decision making tool was created in 2017 to help in the fair and consistent assessment of applicant qualifications where the application requires referral to the Registration Committee. The tool focuses on the provisions and requirements of the Registration Regulation to ensure applicants are meeting all of the legislative requirements, while also being given fair opportunity to address any gaps in their application, regardless of route of entry. This helps to ensure appropriate grounds for referral, provision of better submissions and focused review by the Registration Committee panel.

ii. Describe the impact of the improvements / changes on applicants.

Usage of the checklist and tool improves the ways applicant qualifications are assessed by College staff and ensure qualifications are considered in ways that are fair, objective and impartial for all applicants.

 

iii. Describe the impact of the improvements / changes on your organization.

Usage of the updated checklist and new tool have improved administrative processes by providing staff with a workable means to maintain consistency while ensuring consideration of all legislative requirements and routes of entry for fair and objective assessment of applications. These tools are helpful for all members of the Registration Department.

c) Provision of timely decisions, responses, and reasons
i. Describe any improvements / changes implemented in the last year.

Implementation of an updated registerable checklist and decision making tool for application processing.

A risk assessment tool has been developed and is being used by the Registration Committee to aid Panels in making decisions grounded within their legislative powers and to help expand on the reasons for their decisions. This tool continues to be refined to support a rigourous and thorough decision making and drafting process.

The panel referral process and materials were reviewed and improved.

The College continues to operate in accordance with our current registration policies, procedures and timelines for application and registration processes.

ii. Describe the impact of the improvements / changes on applicants.

Usage of the updated checklist and the decision making tool noted above, has improved the ability to identify grounds for referral to the Registration Committee when an application does not meet the legislative requirements for automatic registration. Prioritization of file review for these applicants allows for timely communication with applicants to discuss alternative options, submissions to the Registration Committee Panel and overall management of applicant expectations of the application and registration processes. 

Improved standardization of panel processes and materials has served to maintain consistency, fairness, objectivity and impartiality to how applications referred are considered.

iii. Describe the impact of the improvements / changes on your organization.

The risk assessment tool and improved standardization of the panel materials helps with the efficiency of Registration Committee Panels. Written decisions and reasons continue to be issued to all applicants who are referred to the Registration Committee, generally within 30 days of the Panel’s meeting.

 

d) Fees
i. Describe any improvements / changes implemented in the last year.

There were no changes to fees (application, administration and membership) in 2017 in accordance with the College’s Fees and Renumeration By-laws.

ii. Describe the impact of the improvements / changes on applicants.

No changes and therefore no impact on applicants.

iii. Describe the impact of the improvements / changes on your organization.

No changes and therefore no impact on the organization.

e) Timelines
i. Describe any improvements / changes implemented in the last year.

Registration timelines have remained the same in 2017 as in 2016. However, with regard to the aforementioned Jurisprudence Course requirement applicable as of July 1, 2017, applicants must have completed the course up to 12 months prior to registration.

ii. Describe the impact of the improvements / changes on applicants.

Implementation of the College’s Jurisprudence Course did not appear to have an impact on the registration timeline for applicants. The requirement was communicated to stakeholders and potential applicants well in advance. In addition, detailed information is available on the College’s website including the Jurisprudence Handbook, and direct access to the Course registration form.

Based on the regulatory impact assessment approach being undertaken by the College, we will consider any potential impacts that may result from future regulatory requirements/changes, this includes consideration of operational and stakeholder impacts and timelines. Applicants and members can therefore be assured that regulatory measures are proportionate to the risk being addressed and have been well considered prior to implementation.

 

iii. Describe the impact of the improvements / changes on your organization.

A detailed system and implementation process was developed for the launch of the Jurisprudence Course and has been monitored for effectiveness. Staff were trained and timelines were developed to ensure effective and efficient operationalization of the process to enable applicants’ access to the Jurisprudence e-learning module and exam in a timely manner.

The College intends to improve our data collection and analysis in the coming years to assist with development of enhanced monitoring systems for tracking and ensuring timelines. The goal is to enhance the organizational capability to deliver risk-based regulation effectively and efficiently.

f) Policies, procedures and/or processes, including by-laws
i. Describe any improvements / changes implemented in the last year.

Policies and Procedures

Any changes in practice, policies or procedures related to registration at the College are guided by the principles of fairness, objectivity, impartiality and transparency. The College is adopting a risk-based approach to regulation and this work is guided by the College’s strategic plan for 2017-2020, please see the College's website (www.cmo.on.ca). As outlined in the College’s strategic framework, our key priorities, guiding principles and expected outomes are as follows:

2017-2020 Strategic Priorities

  • Modernization of legislation and regulation
  • Implementation of risk-based regulation
  • Public participation and engagement

Guiding Principles

  • Accountability
  • Transparency
  • Integrity
  • Proportionality
  • Innovation

Expected Outcomes

  1. Clients and the public can be confident that midwives possess and maintain knowledge, skills and behaviours relevant to their professional practice, and exercise clinical and professional judgment to provide safe and effective care.
  2. Clients and the public can be confident that midwives practise the profession with honesty and integrity, and regard their responsibility to the client as paramount.
  3. Clients and the public can be confident that midwives maintain boundaries between professional and non-professional relationships.
  4. Clients are safeguarded from sexual abuse from midwives.
  5. Clients can expect midwives to facilitate their choice and autonomy in decision-making.
  6. Clients and the public can be confident that midwives demonstrate accountability by complying with legislative and regulatory requirements.
  7. Clients and the public can expect midwives to practise free of a condition that prevents them from providing safe care.
  8. Clients and the public trust that the College of Midwives of Ontario regulates in the public interest.

The College has adopted a new tool for policy development, the Regulatory Impact Assessment statement. For more information on the purpose of the regulatory impact assessment tool and how it is being used by the College, please see the College’s website.

In 2017 the College undertook a review of all registration policies and procedures as part of a process to move the registration program towards risk-based regulation. Guided by the College’s new policy development process and with the intention of streamlining the registration policies and procedures to enable:

  1. the delivery of effective operation of systems to balance necessary levels of public protection with reasonable levels of risk;
  2. enhanced organizational capability to deliver risk-based regulation effectively and efficiently;
  3. responsiveness and transparency of our new regulatory approach.

The outcome of this review resulted in a streamlining plan which was approved by Council in December 2017. The plan outlines how the College will rescind policies which no longer serve the regulatory framework and do not meet the critieria for a policy. In addition, the streamlining plan identifies registration policies which require updating and revision. Where policies are to be rescinded, the policies will be archived on the College’s website and any relevant information will be published via alternative means, such as in tips sheets or registration handbooks/guides available on the website. This work will be implemented over the next two years.

The College also participated in the Risk Assessment Checklist Program developed by the Healthcare Insurance Reciprical of Canada (HIROC). This included a College-wide voluntary self-assessment of practices. The registration checklist focused on registration practices related to registering and licensing in a fair and consistent manner. Completing the self-assessment is very much in line with the goals of the College’s streamlining process and the College has committed to completing the risk assessment program over the next two years.

In 2017 the College continued to work on proposed revisions to the Registration Regulation. The proposed changes are currently in the draft form and will potentially impact the requirements for entry-to-practice, class change and maintenance of registration. Further work is being done to ensure alignment with any changes in the practice of the profession and other regulatory changes. Once this work is completed and approved by the Council, the College will conduct consultation on the proposed changes.  

Processes

As discussed above, the registration application checklist was updated for improved processing of requirements. This update also included verification for completion of the Jurisprudence Course.

A decision making tool was created in 2017 to help in the assessment of applicant qualifications and referral to the Registration Committee.  

In coordination with other Canadian midwifery regulators through the Canadian Midwifery Regulators Council, the College began using an updated, standardized Letter of Standing and Professional Conduct form.  

By-laws

There were no changes to the by-laws.

 

 

ii. Describe the impact of the improvements / changes on applicants.

Policies and Procedures

The objective of the streamlining plan is to ensure that College’s registration policies, procedures and information are current, effective and efficient.  Implementation of the streamlining plan will encompass legislative duties as a regulator while aligning with our approach to risk-based regulation. As a result, applicants will be able to more readily access relevant information via our website, better understand the requirements of registration, including the application process and timelines and provide enhanced transparency for applicants, members and the public. It is anticipated that streamlining the registration policies and procedures will facilitate improved registration operations and efficiency, positively impacting applicants.

Participation in the HIROC checklist self-assesment will help ensure that we continue to register applicants in a fair and consistent manner. 

The purpose of making future changes to the Registration Regulation is to remove confusing regulatory language, to simplify the registration processes and requirements to align with current best practice, risk-based regulation and ongoing changes in the regulatory and professional practice environment.

Processes

The development of tools to assist staff and the Registration Committee to more effectively process applications, leads to better communication with applicants and more efficiency overall.

iii. Describe the impact of the improvements / changes on your organization.

Policies, Procedures and Processes

The changes included with the streamlining plan are intended to facilitate improved regulatory operations and enhanced transparency to applicants, current registrants, and members of the public.  In practice this will allow the College to develop clear benchmarks and service standards that can be used to evaluate effectiveness.

Usage of the checklist and tool improves administrative processes by maintaining consistency and ensuring qualifications are considered in ways that are fair, objective and impartial for all applicants.

 

g) Resources for applicants
i. Describe any improvements / changes implemented in the last year.

The Jurisprudence Handbook and the e-learning module is available to applicants and members. The purpose of this handbook is to provide information on the ethical and legal framework within which midwives practise in Ontario.

Due to extenuating circumstances related to limitations of our current database, online applications were not launched in 2017. Current application forms are under review and information, digital application forms, a guide and website updates are planned for 2018.

Updates to College website to ensure information is current and more accessible, including the creation of a resource section for all policies (current and archived), guides, standards, decision making tools, and strategic documents are planned.

ii. Describe the impact of the improvements / changes on applicants.

Applicants have easy access to detailed website information describing the Jurisprudence Course and direct access to the Jurisprudence Handbook and the registration form for the e-learning module, making it possible to quickly learn about the course, the time required to complete it, cost and how to access it.  

It is anticipated that enhanced application forms, website layout and information will facilitate better access to information for applicants looking to understand other aspects of the application and registration process, the legislative framework, and the assessment of qualifications.

 

iii. Describe the impact of the improvements / changes on your organization.

Improved resources and information enables College staff to process registration applications more efficiently.

h) Review or appeal processes
i. Describe any improvements / changes implemented in the last year.

No changes in 2017.

ii. Describe the impact of the improvements / changes on applicants.

No changes, no impact on applicants in 2017.

iii. Describe the impact of the improvements / changes on your organization.

No changes, no impact on the organization in 2017.

i) Access to applicant records
i. Describe any improvements / changes implemented in the last year.

No changes in 2017.

ii. Describe the impact of the improvements / changes on applicants.

No changes, no impact on applicants in 2017.

iii. Describe the impact of the improvements / changes on your organization.

No changes, no impact on organization in 2017.

j) Training and resources for registration staff, Council, and committee members
i. Describe any improvements / changes implemented in the last year.

The College continued to offer regular training for members of Council and staff. In 2017 Council participated in training related but not limited to risk-governance, risk-based regulation, risk management, decision writing, facilitation, competency, sexual abuse prevention training. The College also completed the first stage of the voluntary HIROC risk assessment checklist program. The College  has commited to completing the risk assessment program over the next two years.

The College continues to be a member of the Ontario Regulators for Access Consortium (ORAC) and staff attended all ORAC meetings and trainings throughout 2017.

Staff attended the 2017 Touchstone Symposium - Perspectives on Successful Transitions for Internationally Educated Health Professionals (IEHPs).

 

ii. Describe the impact of the improvements / changes on applicants.

Participation in the HIROC risk assessment program will help ensure that we are registering applicants in a way that is consistent, impartial and fair. 

Moving towards risk-based regulation and governance and undertaking reviews of all registration policies and procedures enables the College to identify areas for improvement and better alignment with the fair access principles, with the intention of implementing regulatory tools, requirements and processes which facilitate fair, objective, impartial, transparent and timely registration practices and public protection. It is anticipated that this will positively affect applicants.

iii. Describe the impact of the improvements / changes on your organization.

Expanding Council, Committee and staff knowledge of risk-based regulation, risk management, professional competence and decision writing, amongst other things, has enhanced the College’s capacity to critically assess our programs, policies, Regulations and tools and lends itself to consistent decision making.

k) Mutual recognition agreements
i. Describe any improvements / changes implemented in the last year.

No changes in 2017.

ii. Describe the impact of the improvements / changes on applicants.

No changes in 2017.

iii. Describe the impact of the improvements / changes on your organization.

No changes in 2017.

l) Other (include as many items as applicable)
i. Describe any improvements / changes implemented in the last year.

No other items that have not been identified in previous questions.

ii. Describe the impact of the improvements / changes on applicants.

No other items that have not been identified in previous questions.

iii. Describe the impact of the improvements / changes on your organization.

No other items that have not been identified in previous questions.

Describe any registration-related improvements/changes to your enabling legislation and/or regulations in the last year

There have been no registration-related amendments to our enabling legislation nor our regulations in the last year.

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2. Quantitative Information

a) Languages
Indicate the languages in which application information materials were available in the reporting year.
Language Yes/No
English Yes
French No
Other (please specify) 0
Additional comments:
 
b) Gender of applicants
Indicate the number of applicants in each category as applicable.
Gender Number of Applicants
Male 0
Female 82
None of the above 0
Additional comments:
 
c) Gender of members
Indicate the number of members in each category as applicable. Select the option that best corresponds to the terminology used by your organization.
Gender Number of Members
Male 1
Female 906
None of the above 0
Additional comments:
 
d) Jurisdiction where applicants obtained their initial education
Indicate the number of applicants by the jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
65 4 8
Malta
1
Peru
1
Poland
1
U.K.
2
Total
5
0
82

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
e) Jurisdiction where applicants who became registered members obtained their initial education
Indicate the number of applicants who became registered members in the reporting year by the jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
63 4 6
Malta
1
Peru
1
Poland
1
U.K.
2
Total
5
0
78

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
f) Jurisdiction where members were initially trained
Indicate the total number of registered members by jurisdiction where they obtained their initial education1 in the profession or trade.
Ontario Other Canadian Provinces USA Other International Unknown Total
762 13 28
Argentina
1
Belgium
1
China
7
France
1
Ghana
1
Guatemala
1
Hungary
2
India
1
Iran
26
Lebanon
1
Malta
1
Morocco
1
Netherlands
3
New Zealand
1
Peru
2
Philippines
2
Poland
3
Russia
1
S. Africa
1
Sweden
1
Switzerland
1
U.K.
44
Venezuela
1
Total
104
0
907

1 Recognizing that applicants may receive their education in multiple jurisdictions, for the purpose of this question, include only the jurisdiction in which an entry-level degree, diploma or other certification required to practice the profession or trade was obtained.

Additional comments:
 
g) Applications processed
Indicate the number of applications your organization processed in the reporting year:
Jurisdiction where applicants were initially trained in the profession (before they were granted use of the protected title or professional designation in Ontario)
from January 1st to December 31st of the reporting year Ontario Other Canadian Provinces USA Other International Unknown Total
New applications received 64 4 7 5 0
80
Applicants actively pursuing licensing (applicants who had some contact with your organization in the reporting year) 65 4 8 5 0
82
Inactive applicants (applicants who had no contact with your organization in the reporting year) 0 0 0 0 0
0
Applicants who met all requirements and were authorized to become members but did not become members 0 0 0 0 0
0
Applicants who became FULLY registered members 63 4 0 0 0
67
Applicants who were authorized to receive an alternative class of licence3 but were not issued a licence 0 0 2 0 0
2
Applicants who were issued an alternative class of licence3 0 0 6 5 0
11

1 An alternative class of licence enables its holder to practice with limitations, but additional requirements must be met in order for the member to be fully licensed.

Additional comments:
 
h) Classes of certificate/license
Inidcate and provide a description of the classes of certificate/license offered by your organization.

You must specify and describe at least one class of certificate/license (on line a) in order for this step to be complete.

# Certification Description
a) General Description (a)

Practice with no restrictions.

b) Supervised Practice Description (b)

Practice under supervision.

c) Transitional Description (c)

Practice with restrictions and under supervision.

d) Inactive Description (d)

Not practising.

Additional comments:
 
i) Reviews and appeals processed
State the number of reviews and appeals your organization processed in the reporting year (use only whole numbers; do not enter commas or decimals).
Jurisdiction where applicants were initially trained in the profession (before they were granted use of the protected title or professional designation in Ontario)
from January 1st to December 31st of the reporting year Ontario Other Canadian Provinces USA Other International Unknown Total
Applications that were subject to an internal review or that were referred to a statutory committee of your governing council, such as a Registration Committee 3 0 2 0 0
5
Applicants who initiated an appeal of a registration decision 0 0 1 0 0
1
Appeals heard 0 0 0 0 0
0
Registration decisions changed following an appeal 0 0 0 0 0
0
Additional comments:

Appeal was subsequently withdrawn by applicant.

j) Paid staff
In the table below, enter the number of paid staff employed by your organization in the categories shown, on December 31 of the reporting year.

When providing information for each of the categories in this section, you may want to use decimals if you count your staff using half units. For example, one full-time employee and one part-time employee might be equivalent to 1.5 employees.

You can enter decimals to the tenths position only. For example, you can enter 1.5 or 7.5 but not 1.55 or 7.52.

Category Staff
Total staff employed by the regulatory body 14
Staff involved in appeals process 2
Staff involved in registration process 5
Additional comments:
 

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3. Submission

Submission
I hereby certify that:
Name of individual with authority to sign on behalf of the organization:
Kelly Dobbin
Title:
Registrar & CEO, College of Midwives of Ontario
Date:
2018/03/01

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