Fair Registration Practices Report

Respiratory Therapists (2016)

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.

No changes this year

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

No changes this year

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

No changes this year

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

The CRTO’s assessment of internationally educated applicants includes a clinical skills assessment (CSA) stage. In 2016, the CRTO changed the format of the CSA to allow for the assessment of individuals on an as needed and timely basis (one applicant at a time). The content, structure and evaluation tools used in the assessment did not change.

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

The new (one applicant at a time) format of the Clinical Skills Assessment allows applicants to be assessed in a more timely manner, completing this stage of the assessment three to four months after they register for the CSA. Previously, the CRTO required a minimum of three applicants for each CSA session; and with relatively low numbers of applicants going through the assessment, this resulted in delays for some applicants. Applicants no longer have to wait for the minimum number of applicants before proceeding with the CSA. This also provides for more continuity between the three stages of assessment; program review, behavioural descriptive interview and clinical skills assessment (CSA).

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

The new format allows the CRTO to schedule clinical skills assessments on an as needed basis. Previously, the CRTO required a minimum of three applicants for each CSA session. With relatively low numbers of applicants going through the assessment, this created delays in the assessment process. This change improves the CRTO’s assessment processing and decision timelines; and makes scheduling of the assessments more responsive to individual applicants.

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

As mentioned above, the CRTO changed the format of the Clinical Skills Assessment to allow for individual (one applicant at a time) assessments. Previously, the CRTO required a minimum of three applicants for each CSA session. With relatively low numbers of applicants going through the assessment, this created delays in the assessment process. The new (individual) assessment format has improved the CRTO’s assessment processing timelines.

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

The new (individual) format of the CSA allows applicants to complete this stage of their assessment three to four months after they register for the CSA. Previously, the CRTO required a minimum of three applicants for each CSA session, and with relatively low numbers of applicants going through the assessment, this created delays for some applicants. Under the new format, applicants are now able to proceed through all three stages of the assessment and receive decisions in a more timely manner.

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

The new CSA format allows the CRTO to schedule assessments on an as needed basis. Previously, the CRTO required a minimum of three applicants for each CSA session. With relatively low numbers of applicants going through the assessment, this created delays in the assessment process. This change improves the CRTO’s assessment processing timelines, and makes scheduling of the assessments more responsive to individual applicants. Processing one applicant at a time also results in fewer assessors required at any one time. This improves scheduling and contributes to a more timely efficient assessment process.

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

In December 2016, the CRTO Council approved a number of changes to the CRTO By-laws, including the fee By-law. Under the new By-law the annual registration fee is scheduled to increase from $500.00 to $560 for 2018/19 registration year, and then to $620 effective March 1, 2019. The registration fee for inactive members will increase from $50.00 to $100.00 effective March 1, 2018.

In addition, the new Fee By-law clarifies that "where consideration of an application for a certificate of registration involves an evaluation by the CRTO of the applicant’s educational program, additional training, or experience, the applicant shall pay an evaluation fee that shall not exceed $5,000.00, as set in Policies and Procedures". The assessment fees remain the same as in previous years, that is:

·         $500.00 -  Program Review and Interview stage; and

·         $2,750.00 – Clinical Skills Assessment (CSA) stage.

Assessment Results Appeal Fee – applicants who believe that the assessment results for any portion of the process are inaccurate may request an appeal. The request for appeal must include $250.00 appeal fee. The fee is refundable if the appeal is resolved in the applicant’s favour.

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

The registration fee increase will affect applicants once they are registered with the CRTO.  All CRTO Members are required to pay the registration fees as set in the CRTO By-law.

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

The CRTO’s registration fees have been stable for the last 22 years; however, the gap between costs and our revenue has been closing year over year. The approved increase in registration fees is expected to sustain the CRTO’s operations for the next 5 to 7 years if operating costs remain steady. 

$250.00 appeal fee covers some of the administrative cost of the appeal. Most of the appeal costs are covered directly by the CRTO.

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

Clinical Skills Assessment (SCA) Schedule – The CSA is now offered on an as needed basis. In 2016, the CRTO changed the CSA format to allow for individual (one applicant at a time) assessments. This new format allows applicants to complete this stage of their assessment three to four months after they register for the CSA. Applicants no longer have to wait for the minimum number of applicants before proceeding with the CSA.

Assessment Results - The Internationally Educated Respiratory Therapists and Other Health Professionals – Application and Assessment Process Policy was amended to clarify that assessment results are valid for up to two years following the Registration Committee’s review. Applicants directed by the Committee to complete targeted remediation will have a maximum of two years to complete the required remediation.

Assessment Results Appeals - Applicants who believe that the assessment results for any portion of the process are inaccurate may request an appeal.  Applicants must submit a request for appeal within 30 days of receipt of the Interim Report or the CSA Gap report. Applicants are notified of the outcome of their appeal within 30 days of the appeal deadline.

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

Clinical Skills Assessment (CSA) Schedule – Previously applicants were required to wait until there were at least three applicants registered for the CSA. With relatively low numbers of applicants going through the assessment, this created delays in the assessment process. The new (individual) format allows applicants to complete this stage of their assessment three to four months after they register for the CSA. This improves the assessment processing timelines, and makes scheduling of the assessments more responsive to individual applicants.

Assessment Results - the amended Internationally Educated Respiratory Therapists and Other Health Professionals – Application and Assessment Process Policy provides clarification that the assessment results are valid for up to two years following the Registration Committee review. Applicants directed by the Committee to complete targeted remediation have a maximum of two years to complete the required remediation.

Appeals Policy- Applicants who believe that the assessment results for any portion of the process are inaccurate may request an appeal. Applicants are notified of the outcome of their appeal within 30 days of the appeal deadline. The appeals policy ensures that there is a transparent process for the applicant to request an appeal of their assessment results.

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

The new Clinical Skills Assessment (CSA) format allows the CRTO to schedule assessments on an as needed basis. Previously, the CRTO required a minimum of three applicants for each CSA session. With relatively low numbers of applicants going through the assessment, this created delays in the assessment process. This change improves the CRTO’s assessment processing timelines; and makes scheduling of the assessments more responsive to individual applicants.

Appeals Policy – The appeal policy ensures that the CRTO has a timely process for dealing with applicant appeals.  The CRTO will ensure that applicants are notified of the outcome of their appeal within 30 days of the appeal deadline.

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

By-laws change – following several months of consultation, the CRTO Council approved a number of By-law changes, including:

  • The Fee By-law (discussed above);
  • Amendments that address the composition of decision-making panels (i.e. Registration, QA and ICRC panels) – that is a requirement that there be a minimum of one public member and one profession member to ensure a balance of perspectives on each panel.
  • Other revisions intended to update the language and reflect current CRTO practices.

The amended By-laws are now posted on the CRTO website.

 

The Internationally Educated Respiratory Therapists and Other Health Professionals – Application and Assessment Process Policy amendment

Under the Structured Interview and Feedback (section 2.2) a new requirement was added, that is; all applicants are required to meet with CRTO staff to review the interim report and next steps in the assessment process. The purpose of this amendment is to ensure that applicants have a clear understanding of their assessment results up to this point, and that they understand the next steps in the assessment process and the possible outcomes.

New Assessment Results section (4.0) was added to clarify that assessment results will be considered as valid for up to two years following the Registration Committee review. Applicants directed by the Committee to complete targeted remediation will have a maximum of two years to complete the required remediation.

The amended policy is now posted on the CRTO website.

Approval of Canadian Respiratory Therapy Programs Policy amendment

The policy was amended to address the issue of unaccredited Canadian programs. Under the revised policy, graduates of Respiratory Therapy programs offered in Canada that are not accredited by the Council on Accreditation for Respiratory Therapy Education (CoARTE) are referred to the CRTO’s assessment process to demonstrate that they have the required entry-to-practice knowledge, skills and judgment.

The amended policy is now posted on the CRTO website

 

New Appeal Policy – The CRTO assessment process is comprised of three main components: program review, structured interview and a clinical skills assessment. Applicants undergoing the assessment receive two reports during the process:

  • Interim Report – The report is provided to applicants after both the program review and the structured interview are completed. The report lists the assessment results up to that point in the assessment.
  • Clinical Skills Assessment Gap Report – The report is provided to applicants after the Clinical Skills Assessment stage. The report lists those competency areas where applicants scored below the minimum entry-to-practice standard.

Applicants who believe that the assessment results for any portion of the process are inaccurate may request an appeal.

The policy is now posted on the CRTO website.

 

Administrative procedures – CRTO staff developed a number of procedures for each stage of the assessment process. The procedures provide detailed overview of each stage of the assessment process.

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

Fee By-law – The registration fee increase will affect applicants once they are registered with the CRTO.  All CRTO Members are required to pay the registration fees as set in the CRTO By-law.

The Internationally Educated Respiratory Therapists and Other Health Professionals – Application and Assessment Process Policy amendment - Applicants are now required to meet with CRTO staff to review the interim report and next steps in the assessment process. The purpose of this amendment is to ensure that applicants have a clear understanding of their assessment results up to this point, and that they understand the next steps in the assessment process and the possible outcomes. The CSA assessment requires a significant investment of time and money on the part of the applicant. It is important that each applicant has a clear understanding of all assessment results to date, before making the decision to proceed. Applicants may attend the meeting in person or by teleconference.

The policy also clarifies that the assessment results are valid for up to two years following the Registration Committee review. Applicants directed by the Committee to complete targeted remediation will have a maximum of two years to complete the required remediation.

Graduates of Respiratory Therapy programs offered in Canada that are not accredited by CoARTE (and who are applying outside of the Labour Mobility provisions) are now referred to the CRTO’s assessment process to demonstrate that they have the required entry-to-practice knowledge, skills and judgment. The assessment process is the same process used for the assessment of IEHP applicants and includes an educational program review, structured interview and a clinical skills assessment.

Applicants who believe that the assessment results for any portion of the process are inaccurate may request an appeal in accordance with the appeal policy.

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

The CRTO’s Fee By-law - the approved increase in registration fees is expected to sustain the CRTO’s operations for the next 5 to 7 years if operating costs remain steady. Amendments that address the composition of decision-making panels ensure a balance of perspectives for the panels. Other revisions intended to update the language and reflect current CRTO practices.

The Internationally Educated Respiratory Therapists and Other Health Professionals – Application and Assessment Process Policy amendment. CRTO staff will meet with applicants to review the interim report and next steps in the assessment process.

Approval of Canadian Respiratory Therapy Programs Policy amendment  - graduates of Respiratory Therapy programs offered in Canada that are not accredited by the Council on Accreditation for Respiratory Therapy Education (CoARTE) are referred to the CRTO’s assessment process (the process used to assess IEHP applicants) to demonstrate that they have the required entry-to-practice knowledge, skills and judgment. The assessment process includes an educational program review, structured interview and a clinical skills assessment.

Appeal Policy - When a request for appeal is received, the Registrar will appoint an independent Appeal Panel to consider the appeal. The panel will consist of at least two subject matter experts who were not part of the applicant’s assessment, and if required CRTO staff with expertise in entry-to-practice competencies for respiratory therapy. Applicants will be notified of the outcome of their appeal within 30 days of the appeal deadline.

Procedures – the CRTO developed a number of procedures for each stage of the assessment process. The procedures provide detailed overview of each stage of the assessment process.

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

Applicants are now required to meet with CRTO staff to review the interim report and next steps in the assessment process. The purpose of this meeting is to ensure that applicants have a clear understanding of their assessment results up to this point, and that they understand the next steps in the assessment process and the possible outcomes.

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

The meetings allow applicants to ask questions regarding their assessment results, and ensure that applicants have a clear understanding of the assessment process and possible outcomes.

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

CRTO staff will meet with applicants to review the interim report and next steps in the assessment process. The meetings ensure that applicants have a clear understanding of their assessment results and the next steps in the assessment process.

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

The assessment process for Internationally Educated Health Professionals (IEHPs) is comprised of three main components: program review, structured interview and a clinical skills assessment. Applicants undergoing the assessment receive two reports during the process:

  • Interim Report – The report is provided to applicants after both the program review and the structured interview are completed. The report lists the assessment results up to that point in the assessment.
  • Clinical Skills Assessment Gap Report – The report is provided to applicants after the Clinical Skills Assessment stage. The report lists those competency areas where applicants scored below the minimum entry-to-practice standard.

Applicants who believe that the assessment results for any portion of the process are inaccurate may request an appeal. The Appeal Policy has been drafted to address the appeal process, including timelines, format, documentation and fees. The policy is now posted on the CRTO website.

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

Applicants who believe that the assessment results for any portion of the process are inaccurate may request an appeal. The Appeal Policy allows applicants to understand the steps in the process of requesting an appeal.

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

Appeal Policy – This policy clarifies the process by which appeals are addressed within the organization.  When a request for appeal is received, the Registrar will appoint an independent Appeal Panel to consider the appeal. The panel will consist of at least two subject matter experts who were not part of the applicant’s assessment, and if required CRTO staff with expertise in entry to practice competencies for respiratory therapy. Applicants will be notified of the outcome of their appeal within 30 days of the appeal deadline.

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

No changes this year

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

No changes this year

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

No changes this year

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

Members of the Registration Committee and staff attended a training session focused on decision making, dealing with special considerations, and issues related to human rights and anti-discrimination. In addition, Members of the Registration Committee and staff completed the OFC’s “Applying Fair Access Law” online learning modules. CRTO staff attended sessions on cultural diversity specifically as it pertains to internationally trained healthcare practitioners. All assessors who take part in any component of the assessment process receive ongoing training to ensure consistent, impartial and fair decision making.

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

The CRTO takes measures to ensure that those involved in registration decisions have the skills and knowledge necessary for unbiased and objective decision making. These steps include ongoing training for all assessors that are involved with any component of the assessment process ensuring consistent, impartial and fair decision making.

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

The CRTO takes measures to ensure that those involved in the assessment process have the skills and knowledge necessary for unbiased and objective decision making. All assessors involved with any component of the assessment process receive ongoing training.

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

No changes this year

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

No changes this year

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

No changes this year

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

The National Alliance of Respiratory Therapy Regulatory Bodies has approved a Harmonization Agreement outlining a common process for the assessment of IEHP applicants.

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

No changes this year

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

No changes this year

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

No changes this 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 Yes
Other (please specify)
Additional comments:
 
b) Gender of applicants
Indicate the number of applicants in each category as applicable.
Gender Number of Applicants
Male 55
Female 142
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 906
Female 2327
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
173 14 4
Egypt
1
India
2
Philippines
1
Sudan
1
Tunisia
1
Total
6
0
197

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
146 11 0
n/a
0
Total
0
0
157

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
2977 184 64
China
1
India
3
Iran
1
Philippines
2
Venezuela
1
Total
8
0
3233

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 173 14 4 6 0
197
Applicants actively pursuing licensing (applicants who had some contact with your organization in the reporting year) 27 3 4 6 0
40
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 4 0 0 0 0
4
Applicants who became FULLY registered members 124 11 0 0 0
135
Applicants who were authorized to receive an alternative class of licence3 but were not issued a licence 11 0 0 0 0
11
Applicants who were issued an alternative class of licence3 122 0 0 0 0
122

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)

A General Certificate of Registration is issued to an individual who has met all academic requirements and has successfully completed the registration examination or evaluation approved by the College. If a Member holds a General Certificate of Registration, he/she must use the designation RRT and may use “Registered Respiratory Therapist” or “Respiratory Therapist” as his/her professional title.

b) Graduate Description (b)

A Graduate Certificate of Registration is issued to an individual who has met all academic requirements but has not yet successfully completed the registration examination approved by the College. If a Member holds a Graduate Certificate of Registration, he / she must use the designation GRT and may use “Graduate Respiratory Therapist” as his/her professional title. The following conditions apply to a Graduate Certificate of Registration:

The (Graduate) member shall,

  1. at the first reasonable opportunity, advise every employer of any terms, conditions and limitations that apply to the member’s graduate certificate of registration if their employment is in the field of Respiratory Therapy;
  2. only perform a controlled act that is authorized to the profession if it is performed under the general supervision of a member of a College within the meaning of the Regulated Health Professions Act, 1991 who, the member holding the graduate certificate has reasonable grounds to believe, is authorized to perform the controlled act and is competent to do so and who is available to be personally present at the site where the authorized act is performed on ten minutes notice;
  3. not delegate a controlled act; and
  4. not perform advanced prescribed procedures below the dermis;
  5. not perform authorized act #5 “administering a prescribed substance by inhalation”; and
  6. not perform a tracheostomy tube change for a stoma that is less than 24 hours old.

This is a temporary class of registration and is automatically revoked after 18 months.

c) Inactive Description (c)

A Member registered with a General or Limited Certificate of Registration may apply for an Inactive Certificate of Registration provided he/she is not practising the profession in the broadest sense of that phrase.

The following conditions apply to an Inactive Certificate of Registration:

The (Inactive) member shall not,

(a)        engage in providing direct patient care;

(b)        use his or her professional title or designation;

(c)        supervise the practice of the profession; or

(d)        make any claim or representation to having any competence in the profession.

d) Limited Description (d)

Limited Certificates of Registration were issued to individuals who had not met all requirements for a General Certificate of Registration but provided sufficient evidence to a Panel of the Registration Committee of their competence to practice in a defined area of the scope of practice of the profession. (CRTO stopped issuing Limited Certificates of Registration on February 25, 1999). If a Member holds a Limited Certificate of Registration, he / she must use the designation PRT and may use “Practical Respiratory Therapist” as his/her professional title.

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 5 4 1 6 0
16
Applicants who initiated an appeal of a registration decision 0 0 0 1 0
1
Appeals heard 0 0 0 0 0
0
Registration decisions changed following an appeal 0 0 0 0 0
0
Additional comments:
 
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 9
Staff involved in appeals process 2
Staff involved in registration process 3
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:
Kevin Taylor
Title:
Registrar
Date:
2017/02/28

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