CRPO Dashboard 2017 - 2018
2017 - 2018 Committee Reports
CRPO has several statutory and non-statutory committees whose work allows CRPO to fulfill its regulatory mandate. CRPO Council provides an overall direction (and, as of the 2018-2019 fiscal year, strategic planning) and entrusts committees to do much of the work.
The Executive Committee is responsible for providing strategic direction, financial oversight and engaging in policy development and research. In addition, the Executive Committee makes recommendations on policy issues to Council. In certain circumstances, it may act on behalf of Council and will respond to issues that arise between Council meetings as required. During the 2017-18 fiscal year, the Executive Committee met in-person on six occasions and held seven meetings via teleconference.
Andrew Benedetto, RP (President), Malcolm MacFarlane, RP (Vice-President), Carol Cowan-Levine, RP, Mary Kardos Burton, Sheldon Kawarsky
- Development of needs assessment survey to determine ongoing Council member training and education.
- Professional Practice Working Group formed. Task group consists of the chairs of Registration; Quality Assurance; Inquiries, Complaints and Reports; and Client Relations committees, to address cross-committee practice issues that have arisen since proclamation.
- Approval and implementation of Registrar’s performance review process.
- Recommended to Council the approval of the Suitability to Practice policy.
- Recommended to Council the approval of by-law revisions pertaining to posting criminal charges and drug convictions on the public register.
- Development and implementation of policy on Council Question Period and Observer Guidelines.
- Approved website improvements.
- Approval of holding town halls to engage with membership.
- Directed staff to implement a process for separate, unique and specially trained discipline panel when the file involves allegations of sexual abuse.
- Approved the Indigenous Registration Task Group mapping tool.
- Approval of 2017-2018 budget.
- Approval of committee chair role description.
- Bill 87 by-law changes approved.
- Approval of Client Relations foundational definition document.
- Outreach planning.
Client Relations Committee
The Client Relations Committee (CRC) is responsible for the development, ongoing evaluation and maintenance of the Client Relations Program. The program includes the following requirements as set out in the Regulated Health Professions Act, 1991 (RHPA) (section 84) for preventing and dealing with the sexual abuse of clients by members:
a) Educational requirements for registrants;
b) Guidelines for the conduct of registrants with their clients;
c) Training for College staff; and
d) Providing information to the public.
Carol Cowan-Levine, RP (Chair), Shelley Briscoe-Dimock, RP, Mary Kardos Burton, Barbara Locke Billingsley, Susan (Sue) Lymburner, RP (non-council Committee member), Steven Stijacic
During the 2017-2018 fiscal year, the CRC had one teleconference and five in-person meetings. The Client Relations Committee engaged in considerable research, deliberation and policy development in anticipation of Bill 87, the Protecting Patients Act, 2017. This important legislation and CRPO’s work to realize actionable policy recognizes the need for the profession to support clients who have experienced sexual abuse by a Registered Psychotherapist. Work that took place during the meetings included:
- Periodic review of statistics on sexual abuse complaints received by the College.
- Research and data collection from other regulatory bodies regarding preventing and dealing with sexual abuse of clients.
- Staff and committee training regarding boundary violations by health care professionals.
- Adjusted language of the Jurisprudence (JRP) Manual to reinforce the College’s zero tolerance policy of sexual abuse of clients by members.
- Updated sexual abuse section on College website to improve understanding.
- Established funding forms for clients alleging sexual abuse and their primary support partner.
- Developed content addressing issues of sexual abuse and an update on the CRC’s activities in the June Communiqué.
- Client Relations Position Statement on Terminology Related to Sexual Abuse by Members presented and passed by Council in November 2017.
- Sexual Contact with Former Clients Within a Five-Year Cooling Off Period and Beyond the Cooling Off Period policy presented to Council in March 2018.
CRPO also administers a fund for therapy for persons who, while clients, were sexually abused by members. During the 2017-2018 fiscal year, the fund was not used.
Challenges and Opportunities
The Client Relations Committee plans to implement changes from Bill 87, the Protecting Patients Act, 2017.
The Committee determined that the primary partner of an individual alleging sexual abuse by an RP is eligible to apply for funding. The Committee looks forward to advancing a comprehensive and innovative Client Relations program.
The Discipline Committee is responsible for holding discipline hearings in accordance with the Regulated Health Professions Act, 1991. The Committee also sets policies and procedures for the discipline process. Matters arrive before the Discipline Committee as the result of a referral from the Inquiries, Complaints and Reports Committee, with specific allegations that a member has engaged in professional misconduct.
If a panel makes a finding that a member has committed misconduct, it can order one or more of the following penalties:
- direct the revocation of the member’s Certificate of Registration; direct the suspension of the member’s Certificate of Registration for a specified period of time;
- direct the imposition of specified terms, conditions and limitations on the member’s Certificate of Registration for a specified or indefinite period of time;
- require the member to appear before the panel to be reprimanded;
- require the member to pay a fine, up to $35,000, to the Minister of Finance; and
- require the member to pay all or part of the College’s costs and expenses regarding the matter.
Shikha Kasal (Chair), Heidi Ahonen, RP (non-council Committee member). All Council members serve on the Discipline Committee. Hearing panels are composed of three to five Committee members.
The Committee did not hold any plenary (policy-making) meetings this year but conducted one hearing in January 2018. At the end of the fiscal year, there was one outstanding referral from ICRC awaiting the scheduling of a hearing.
When a hearing is concluded, the panel develops their Decision and Reasons. Committee panels released Decisions and Reasons in relation to two hearings that had been conducted in the previous year. These documents are available on the Discipline page of CRPO’s website once they have been approved by panel members.
Fitness to Practise Committee
The Fitness to Practise Committee is responsible for holding hearings related to possible incapacity of members in accordance with the Regulated Health Professions Act, 1991. The Committee also sets policies and procedures for the fitness to practise process.
Barbara Locke Billingsley (Chair). All Council members serve on the Fitness to Practise Committee. Hearing panels are composed of at least three Committee members.
During the 2017-18 fiscal year, the Fitness to Practise Committee did not hold any meetings and no matters were referred to the Committee that would require a hearing. Committee members will receive the necessary training if there is a need to conduct a hearing.
Inquiries, Complaints and Reports Committee
The Inquiries, Complaints and Reports Committee (ICRC) screens and investigates complaints and other concerns about members and determines the appropriate action. The Committee also makes recommendations regarding practice standards and guidelines for members.
Kevin VanDerZwet Stafford, RP (Chair), Shelley Briscoe-Dimock, RP, Carol Cowan-Levine, RP, Kathleen (Kali) Hewitt-Blackie, RP (non-council Committee member), Mary Kardos Burton, Sheldon Kawarsky (as of December 2017), Kenneth Lomp, RP, Keith Marlowe, RP (until June 2017), Paula (Pat) Rayman, RP, Len Rudner, Steven Stijicac
Formal Complaints and Reports
Creating a draft guideline entitled Disclosing Information to Prevent Harm. The guideline was created in response to a large number of practice inquiries from members seeking more direction. The College held a stakeholder consultation to review the draft guideline in December of 2017.
References for Gender-Affirming Surgery
Discussing at length members’ ability to make referrals for clients requesting OHIP funding for gender-affirming surgery. In February of 2018, members were consulted about competence required to work with transgender and gender nonconforming clients, and qualifications needed to provide secondary referral letters for clients seeking gender affirmation surgery.
Bill 87: Protecting Patients Act, 2017
ICRC received training on Bill 87, the Protecting Patients Act, 2017, which became law in May 2017. Some relevant changes include:
- Stronger penalties for sexual abuse of clients;
- Withdrawal of a complaint by the Registrar at the request of a complainant when the withdrawal is in the interest of the public;
- The ability for the ICRC to impose an interim order to protect the public following receipt of a complaint or appointment of an investigator (previously this ability was only available after a referral to the Discipline Committee).
Other Topics Explored
- Evaluating the benefits and shortcomings of Alternative Dispute Resolution (ADR).
- Obtaining informed consent when providing psychotherapy to minors.
- Reviewing remedial resources such as ethics courses for members.
Challenges and Opportunities
The College saw an increase of approximately 70% of matters initiated compared with the previous year. This upsurge can be attributed to growing membership and an increase in public awareness. The ICRC continues to review and reflect on its processes to manage the growing workload.
The ICRC spent a considerable amount of time reviewing the factors impacting timelines for complaint resolution. The mean time for processing a formal complaint based on decisions released in the 2017-2018 fiscal year was 210 days (median 204) which is down from 239 days in 2015-2016 (median 251 days). The steady increase in matters before the ICRC is an ongoing issue for the College.
CRPO continues to receive a large number of complaints about members working with families involved in custody/access disputes. These complaints are highly contentious and often involve lengthy court documents. The ICRC is reviewing ways to help members and the public understand the RP’s role in these difficult circumstances.
Quality Assurance Committee
The mandate of the Quality Assurance Committee is to promote members’ continuing competence and encourage competency improvement. The Committee does this by designing and delivering the Quality Assurance Program, which consists of both self-assessments as well as peer and practice assessments, and developing member resources, such as guidelines and professional practice tools. The Program is educational and responsive, and, though it is mandatory and requires the participation of all members, every effort is made to work in collaboration with members toward the ultimate goal of improved public protection.
Mary Kardos Burton (Chair) (as of January 2018), Pat Rayman, RP (Chair) (until December 2017), Andrew Benedetto, RP, Glorie Taponeswa Chimbganda, RP (as of January 2018), Carol Cowan Levine, RP (until November 2017), Sheldon Kawarsky, Kenneth Lomp, RP (as of January 2018), Malcolm MacFarlane, RP, Keith Marlowe, RP (until November 2017), Len Rudner
- Changed the Professional Development submission deadline to November 30 with the aim of improving services available to members throughout the year.
- Expanded member resources by developing guidelines, a workbook, member tools and informational videos.
- Enhanced feedback gathering. Feedback is used to refine the tools, processes and overall experience with the QA Program. Feedback is also a key accountability measure.
- Refined policy to clarify expectations with respect to completion of the Professional Development tools.
- Established a strategy to engage new members in QA Program; in doing so, clarified requirements for new members.
- Built capacity by training staff and developing committee and staff resources.
Challenges and Opportunities
The Quality Assurance (QA) Program is becoming more proactive in identifying and addressing learning needs within the membership. For example, when changes in legislation occur, the QA Program can be leveraged to support members with integrating those changes into practice. Similarly, the Quality Assurance Committee is gathering information about these impacts and exploring how the QA Program can be used to provide useful, timely information to current and prospective members, and assure that supervisory relationships are meeting requirements and standards.
Delivery of the Peer and Practice Review can be a costly, time consuming endeavour for both members and the College; thus the QA Committee is considering right-touch regulation approaches that can be employed effectively in the QA Program. For example, evaluating very specific aspects of practice where need for improvement is commonplace, such as advertising practices. Or, identifying aspects of practice that present a higher degree of risk to the public, and assessing a member’s practice in light of the specific risks.
As a result of member participation in Peer and Practice Reviews, CRPO is able to anonymize and collate results to conduct an analysis of trends. This, along with information from other sources, is used to identify learning needs among the membership and prioritize resource development. In the past, electronic practice was identified as a learning need, and CRPO responded by developing an electronic practice guideline, which is expected to become available in winter 2018/19. Current trends have identified learning needs with respect to members’ assessment of risk to clients and safety planning.
Professional Development Component
Peer and Practice Review Component and Panel Cases