Council Minutes

L. Haugh, Chair
B. Anderson
J. Attwood
J. Badgerow
I. Bajnok
L. Baker
D. Barber
K. Campbell
T. Clifford
A. Cunningham (Wed.)
D. Dietrich

A. Cunningham (Thurs.)
D. Fox (Wednesday)

V. Kerr
J. Mac Eachern

A. Taylor

J. Hofbauer, Recorder

G. Mackay
P. Reinhart

G. Siskind
C. Stanford

AGENDA

The agenda had been circulated.

Motion 1

Moved by B. Weichel, seconded by R. Rupert,

That the agenda be approved.

CARRIED

MINUTES

The minutes of the Council meeting of June 5, 2001 had been circulated.

Motion 2

Moved by B. Anderson, seconded by R. Kitson,

That the minutes of the Council meeting of June 5, 2001 be accepted as presented.

CARRIED

Minutes of the Council meeting of June 5 and 6, 2001 had been circulated.

Motion 3

Moved by L. Ross, seconded by L. Baker,

That the minutes of the Council meeting of June 5 and 6, 2001 be accepted as presented.

CARRIED

RULES OF ORDER

J. Lochrie joined the meeting for a presentation on rules of order. He outlined the seven principles underlying all parliamentary procedure:

1. The purpose of parliamentary procedure is to facilitate the transaction of business and to promote cooperation and harmony.
2. All members have equal rights, privileges and obligations.
3. The majority vote decides.
4. The rights of the minority must be protected.
5. Full and free discussion of every proposition presented for decision is an established right of members.
6. Every member has the right to know the meaning of the question before the assembly and what its effect will be.
7. All meetings must be characterized by fairness and by good faith.

He highlighted the procedures related to making and determining motions and amendments, and reviewed selected parliamentary rules.

EVALUATION – JUNE COUNCIL

Council received a summary of the evaluations of the June meeting. There was discussion about mechanisms to improve response, and it was concluded that response will remain voluntary. It was noted that completion of the evaluation forms is part of the role and responsibilities of a Council member.

Beginning with this meeting, the scoring on the evaluation form has shifted from a qualitative system to a more objective frequency scale.

SELF-EVALUATION

In June, Council members were asked to complete a self-evaluation, identifying personal strengths and skills that the member may want to work on over the coming year. Council members were asked to share comments on the process.

A number of members identified that the process was helpful. Some had involved peer feedback and had found that particularly helpful. It was suggested that a similar process be used at the committee level.

GOVERNANCE

In June, Council, reviewed and approved a governance action plan. Council had suggested that the plan be reviewed at each meeting, together with a status report. The first status report was reviewed.

A session on conflict resolution is planned for December. There was some concern about the proposal that it be a "lunch and learn" as the lunch-hour provides for informal information sharing and whether the depth of the session would be sufficient. There will be an assessment after the session.

Channels of Communications

L. Haugh highlighted the protocol for addressing concerns. In all cases, the first step is to discuss the concern with the individual. If the concern remains, following the discussion, the next step varies depending on the individual concerned and the role in which the individual was acting. The protocol is outlined in the Council and committee member handbook.

Adding Items to the Council Agenda

L. Haugh outlined how the agenda is developed and the process for adding items. She noted that the Bylaw requires that any items for which a motion is required be added at least 15 days before the meeting. This is to ensure that all members have notice of the item, that the public knows what is on the agenda, and that background can be prepared to facilitate decision-making.

Concern was expressed that the 15-day requirement may be too lengthy, and that members should be able to add items to the agenda in a shorter time frame. Other options, such as adding items for discussion or information, or asking the Executive to address items were identified. The Executive will review the current process given the identified concerns.

Role Statements

The role statements for Council and Council members were revised substantially in 1999. The Executive found them to continue to reflect the roles.

The Executive suggested that the Governance Philosophy be integrated into the introduction of the Role of Council.

In relation to the role of Council members, two editorial changes were suggested, as was suggested addition of a term addressing the responsibility of Council members to participate in evaluation processes and other CNO surveys.

Since one of the editorial changes to the Council member role related to Council’s approval of the Bylaw related to the Conduct of Councillors and Committee members, it was decided to defer a motion on approval of the changes to the role statements pending Council’s decision on the Bylaw.

STRATEGIC PLANNING

B. Campbell reviewed strategic planning process to date and highlighted the key findings of the consultation.

He noted that the Ad Hoc Committee on Strategic Planning will be meeting October 22^nd and 23^rd to identify core objectives and key strategies and assess if the College’s mission and vision remain in line with objectives and strategies.

As a result of the consultation, there is new information that will help to shape and focus the plan. The importance of communications was reaffirmed.

It was noted that the outcome of the Five-Year Review of the Regulated Health Professions Act (RHPA) will serve as another source of information to be considered in shaping the plan.

There was some discussion about the potential for the use of technology in increasing the involvement of nurses in self-regulation. It was identified as a potential strategy to use technology to bring the Council table to remote areas of the province and reach students and members.

L. Haugh reiterated that the goal of the process is a plan that is strategic, focused, clear, and achievable.

CONDUCT Bylaw

A. Bromstein joined Council. L. Haugh reminded Council about its decision in March identifying it as a fiduciary conflict to serve on the Council and the board of directors of an international, national, or provincial nursing association, organization or union.

It was noted that the draft Bylaw addresses bias as well as conflict of interest. This is particularly important when dealing with decisions that impact on an individual or named person. The Bylaw addresses actual, potential, real or perceived, direct or indirect conflict of interest or bias.

Motion 4

Moved by M. Ternovan, seconded by L. Ross,

That the Conduct of Councillors and Committee Member Bylaw be approved, as presented.

It was noted that the Bylaw sets out a minimum standard. If a member feels conflicted, she or he should not participate in discussion and decision-making. The Bylaw puts into place processes to protect the organization, while providing the individual with procedural safeguards.

During the discussion, it was suggested that there be exploration of:

• expanding the Bylaw to address confidentiality; and
• considering whether there is a fiduciary conflict when serving on the Board of an association representing health service providers (e.g., OHA) and possibly even major employers.

It was also suggested that there be exploration of whether involvement in political parties might be a similar conflict, limiting participation on Council.

A few editorial and typographical errors were identified in the draft that had been presented to Council.

Amendment to Motion 4

Moved by L. Lillie, seconded by S. Keating

That the proposed draft Bylaw re. Conduct of Councillors and committee members referred to in Motion 4 be corrected by replacing references to Articles 7.02 and 7.03 in the definition of bias in Article 1.01 with references to Articles 7.03 and 7.04.

CARRIED

Amendment to Motion 4

Moved by P. Howe, seconded by B. Anderson

That the proposed draft Bylaw re. Conduct of Councillors and Committee members referred to in Motion 4 be further corrected by replacing references to "Ontario Public Service Employees International Union" with "Ontario Public Service Employees Union, Service Employees International Union" in Article 4.01.

CARRIED

It was identified that the wording in Article 4.01 did not make it clear that the fiduciary issue related to bargaining units did not include participation at the local level.

Amendment to Motion 4

Moved by R. Rupert, seconded by L. Vanson,

That the proposed draft Bylaw re. Conduct of Councillors and Committee members referred to in Motion 4 be further amended by including the phrase "international, national, or provincial" before the words "bargaining unit" in Article 4.01.

CARRIED

Amended Motion 4

The following motion had been duly moved and seconded,

That the Conduct of Councillors and Committee Member Bylaw be approved, as amended.

CARRIED

Staff were asked to return to the next meeting with proposals related to expanding the fiduciary conflict, as discussed, and addressing confidentiality.

GENERAL BYlaw: ELECTIONS PART

Introduction of the Conduct Bylaw necessitates changes to the Election Part of the General Bylaw. L. Haugh noted that the Elections Committee had reviewed the Bylaw in depth and was recommending the changes.

A. Bromstein reviewed the key changes in the proposal. It was noted that article 52.07 will be amended to reflect the changes made to the article 4.01 in the Conduct Bylaw.

Motion 5

Moved by M. Ternovan, seconded by R. Kitson,

That the proposed revisions to the Elections Part of the General Bylaw be approved, with Article 52.07 amended to reflect article 4.01 of the Conduct Bylaw.

CARRIED

ROLE STATEMENTS

Given Council’s decision to approve the Bylaw related to Conduct of Councillors and Committee Members, Council reconsidered approval of the role statements discussed previously.

Motion 6

Moved by P. Howe, seconded by M. Ternovan,

That the revisions to the Role of Council and Role of Council Members be approved as presented.

CARRIED

DOCUMENTATION STANDARDS

L. Bildfell and B. McCracken joined the table to review the proposed revisions to the Documentation Standards. The research and preliminary consultation to date was reviewed.

It was suggested that advice on how to use the document be included and the importance of charting be highlighted. The consultation plan was reviewed.

Motion 7

Moved by B. Rowley, seconded by R. Rupert,

That the Nursing Documentation Standards be approved for external consultation.

CARRIED

EXECUTIVE COMMITTEE

Minutes of the Executive meetings of June 6, 2001; July 5, 2001; August 25, 2001; August 30, 2001; and September 25, 2001 had been circulated. L. Haugh highlighted the major issues addressed at the meetings.

STATUTORY COMMITTEE

REPORTS

Semi annual reports of statutory committees as at June 30, 2001 had been circulated to Council. As part of the governance action plan, the Chairs each highlighted the role of their respective committees.

Executive Committee

L. Haugh noted that, in addition to its role in facilitating Council meetings, the Executive Committee has a statutory role related to individual members. She reviewed the Executive’s statutory role in relation to reports of terminations and incapacitated members.

Client Relations Committee

E. Howe noted that the Client Relations Committee’s statutory role relates to the program to prevent sexual abuse and funding for therapy for victims of sexual abuse by nurses. He highlighted some of the committee’s work in that area over the past six months.

Complaints Committee

P. Howe reviewed the role of the Complaints Committee in investigating complaints. He noted that the committee has a range of options that it uses in addressing cases. The committee used its ability to deem matters frivolous and vexatious at an early stage in 12% of the cases. A small increase in the use of the Participative Resolution Process was seen in this reporting period.

Discipline Committee

S. Richardson reviewed the role of the Discipline Committee in adjudicating cases. The cases considered have increased in complexity, resulting in an increase in the number of hearing days despite a decrease in the number of cases.

Fitness to Practise Committee

L. Vanson highlighted the role of the Fitness to Practise Committee. Since most incapacity matters are addressed in a rehabilitative manner through informal resolution, the committee continues to hold very few hearings.

Quality Assurance

L. Ross highlighted the report of the Quality Assurance Committee on behalf of M. MacLeod. The committee has a continuing role in the development of the College’s quality assurance program as well as a statutory role in monitoring participation of nurses in the program and evaluating the program. The key activities of the committee during the reporting period were highlighted.

Registration Committee

R. Rupert highlighted the role of the Registration Committee in relation to assessing applicants and also in addressing policies related to entry to practice. He identified the committee’s role in making recommendations related to the Mutual Recognition Agreements and ongoing discussions about the Quebec registration examination.

RECESS

Council recessed until 8:30 a.m. on Thursday, October 4, 2001.

Thursday, October 4, 2001

RHPA REVIEW

T. Blakley, P. Marshall and K. McGovern highlighted the history and background to the Five-Year Review of the Regulated Health Professions Act (RHPA). It was noted that the Ministry of Health and Long-Term Care has explicitly requested that College submissions on the legislation be brief and focused on key concerns.

CNO supports the majority of the recommendations in the reports, but has concerns with respect to the following four key areas:

• Expanding the public register;
• Giving Complaints and Executive committees party status at the Health Professions Appeal and Review Board (HPARB);
• Establishing criteria for referrals to Discipline Committee; and
• Giving Complainants automatic party status at Discipline hearings.

Council discussed the impact of these proposals on CNO’s processes and effectiveness. It was noted that member participation is essential for effective self-regulation and that some of these recommendations have the potential to alienate members.

Considerable concern was expressed that "party status" for complainants at Discipline hearings will change the nature of the hearing and is likely to impact on the length of hearings.

It was suggested that CNO’s response focus on the public interest and identify how these recommendations have the potential to place the public at risk. It was suggested that CNO’s tone in the submission be positive, and that the four issues be raised as constructive advice.

L. Haugh asked if there were other issues Council members felt needed to be included in CNO’s submission and none were identified.

Motion 8

Moved by L. Ross, seconded by M. Ternovan,

That CNO’s response to the HPRAC Reports on the Five-Year Review of the RHPA be approved.

CARRIED

L. Lillie noted that, in reviewing the recommendations, there are some that apply specifically to the appointment and orientation of public members. The recommendations are reflective of issues and concerns that have been raised by public members on an ongoing basis. She stated that a number of CNO public members would like to respond separately from CNO, supporting the thrust of the recommendations addressing public members. It was identified that there would be nothing in the response from public members that is not congruent with CNO’s response. It was suggested that the public members resolve this issue as a group.

EXECUTIVE DIRECTOR UPDATE

G. Mackay updated Council on key staff activities between June and October. It was noted that there is a trend across the country to separate the professional associations and the regulatory bodies. This is reflective of a national thrust to enhance the reality and perception of public protection by regulatory bodies.

FINANCE REPORT

J. Badgerow highlighted the report of the Finance Committee of September 24, 2001. She reviewed the committee’s recommendations regarding percentage budget increases and the rationale.

Motion 9

Moved by B. Anderson, seconded by J. Johnson,

That the percentage increase in the expense budget for 2002 be no more than 2.5%, excluding the potential impact of new Strategic Plan initiatives and any changes that need to be implemented in relation to the Five-Year Review of the RHPA.

CARRIED

Motion 10

Moved by S. Richardson, seconded by J. Atwood,

That the guideline for the capital budget not exceed $1.5 million for 2002.

CARRIED

JPNC

L. Haugh reviewed the function of the Joint Provincial Nursing Committee (JPNC) and the processes being put in place to facilitate more effective meetings.

ELECTIONS COMMITTEE

Council received the report of the Elections Committee. It was noted that the revisions to the Elections Part of the General Bylaw have implications for the terms of reference for the Elections Committee. The Committee is recommending the revision of its terms of reference.

Motion 11

Moved by B. Weichel, seconded by J. Sanger,

That the revision to the Elections Committee terms of reference be approved.

CARRIED

CRITERIA FOR RECONSIDERING DECISIONS

Review of the Criteria for Reconsidering Previous Council Decisions was deferred from the June Council meeting. The Executive proposed the criteria as part of the ongoing work on governance. It was confirmed that reconsideration of a previous decision should not be taken lightly and be based on sound rationale.

Given the seriousness of reconsidering a previous decision, Council agreed to amend the criteria to require a 2/3 majority of Council before an issue will be reconsidered.

Motion 12

Moved by M. Ternovan, seconded by L. Ross,

That the criteria for reconsidering of Council decisions be adopted as amended.

CARRIED

CRITERIA FOR LOOKING AT WHETHER TO CONSIDER AN ISSUE

The Executive is also recommending criteria to be used as a basis for considering whether to place putting an issue on a Council agenda. The Executive feels that the criteria will be a helpful tool for all Council members in determining whether an issue should be brought forward for inclusion on the Council agenda.

Motion 13

Moved by R. Kitson, seconded by L. Lillie,

That the Criteria for Consideration when Looking at Whether Council will Consider an Issue be adopted.

CARRIED

It was suggested that when the agenda is approved, the President ask if there is any new business. While decisions cannot be added to the Council agenda at the last minute, issues for discussion can be included.

ANNUAL MEETING

In June, Council deferred discussion about whether to change the format of the Annual Meeting. The current format was established when Council meetings were closed to the public.

There was some concurrence that the wine and cheese reception was no longer appropriate in this environment. The recent strategic planning consultation has shown that members are interested in increased communications with CNO. There was some discussion about whether it might increase interest if the meetings moved around the province and were well advertised. It was identified that going outside of Toronto has significant cost implications, a limited reach and that there may be other, more innovative ways to bring the Council meeting to more members across the province.

It was identified that the meeting in its current format provides an opportunity to interact with stakeholders. Other forums, such as the Federation of Health Regulatory Colleges and JPNC, have arisen to provide for regular and meaningful interaction with stakeholders.

It was suggested that CNO either needs to mount a significant event, such as a conference, or do the minimum required.

In the end, there was support for holding the Annual Meeting at the beginning of the June Council. It was noted that the Annual Meeting itself is not very interesting. It was suggested that there be some exploration of redirecting the savings into alternative methods of connecting and communicating with members and stakeholders, including the public, and bringing them to the Council table.

DATES

The Executive Committee recommended dates of Council meetings through December 2002.

Motion 14

Moved by T. Clifford, seconded by R. Rupert,

That the following be Council dates in 2002:
March 26 and 27;
June 5 and 6;
October 2 and 3; and
December 11 and 12

CARRIED

ELECTIONS COMMITTEE

The Executive recommended members of the Elections Committee from among volunteers.

Motion 15

Moved by S. Keating, seconded by S. Richardson,

That Council ratify the appointment of Paul Howe, Veronica Kerr, Kathy Lawrence, Lori Lillie, Angus Taylor and Sophie Young to the 2002 Elections Committee.

CARRIED

CONCLUSION

At 4p.m., it was,

Motion 16

Moved by L. Vanson, seconded by B. Turner,

That Council conclude.