Council Minutes

L. Haugh, Chair
B. Anderson
J. Attwood
M. Bestwick
J. Badgerow
I. Bajnok
L. Baker
D. Barber
K. Campbell
T. Clifford
A. Cunningham
D. Fox
L. Hall

B. Hill
E. Howe
P. Howe
S. Ireland
J. Johnson
S. Keating
V. Kerr
R. Kitson
K. Lawrence
L. Lillie
J. Mac Eachern
S. Richardson

L. Ross
B. Rowley
R. Rupert
J. Sanger
A. Taylor
M. Taylor
M. Ternovan
B. Turner
L. Vanson
B. Weichel
K. Wetherall
C. Weylie

D. Dietrich

S. Young

A. Coghlan
H. Crawford

J. Hofbauer, Recorder
P. Reinhart

G. Siskind
C. Stanford

AGENDA

L. Haugh noted that a discussion of stakeholder feedback on governance has been added to the agenda. She reminded Council members that time has been included at the end of the meeting questions about items distributed for information.

Motion 1

Moved by L. Ross, seconded by T. Clifford,

That the agenda be approved.

CARRIED

MINUTES

Minutes of the Council meeting of March 26 and 27, 2002 had been distributed.

Motion 2

Moved by S. Keating, seconded by J. Sanger,

That the minutes of the Council meeting of March 26 and 27, 2002 be approved as circulated.

CARRIED

MARCH COUNCIL EVALUATION

L. Haugh noted that the Executive reviews the evaluations at length to determine if there are new approaches to improve processes at Council meetings. There were a number of comments related to the need to ensure that the discussion remains on topic and L. Haugh will keep those comments in mind through the meeting.

ANNUAL GOVERNANCE EVALUATION

The Executive decided to change the timing of the evaluation of Council effectiveness to the end of the Council year. This change will allow for new members to have more experience and participate in a more meaningful way. The forms will be distributed in April, for discussion of the evaluation at the June Council meeting.

The Executive identified a need to do further work to clarify the evaluation tool. The development of indicators will be considered to provide for consistent interpretation in completing the tool.

The evaluation responses indicate that the work on governance over the past year has helped to clarify governance processes. L. Haugh highlighted the four areas identified for improvement in the 2002 evaluation, noting that they will be addressed over the coming year.

There was some discussion about the process for adding items to the agenda. This will be reviewed by the Executive, in the future, as part of the activities related to governance.

STAKEHOLDER FEEDBACK ON GOVERNANCE

Council members received copies of correspondence in relation to governance with the Ontario Nurses Association. Council members expressed appreciation to the President for her response.

MONITORING STRATEGIC OBJECTIVES

L. Haugh noted that it is a joint Council-staff role to monitor the implementation of the strategic objectives. Council received the first monitoring report, which was highlighted by A. Coghlan and B. Campbell. The report includes:

• performance indicators;
  
• an Action Plan update; and
  
• a quarterly Environmental Report.

It was noted that this is CNO’s first foray into developing performance indicators. An small but meaningful initial set of indicators has been developed, focused on customer service. Additional indicators will be added as CNO’s ability to collect and capture data improves.

There was some concern expressed about the number of nurses attending REN sessions. Strategies are being identified for marketing of sessions and to address relevance of the topics. It was confirmed that the REN provides a unique opportunity to assist members in understanding the privilege of self-regulation.

Action plans are the operational activities that will be implemented to move forward the strategies. As part of the Action Plan update, Council received a preliminary report related to developing and implementing a targeted strategy for engaging the public. There was some question as to whether the proposed target audience of active health care consumers was too narrow. It was confirmed that segmenting and targeting the audience is necessary for effective communications.

It was noted that the environmental report confirms the directions set by the strategic objectives.

Council confirmed that the monitoring report enables it to fulfil its obligations to monitor the implementation of the strategic objectives. Council noted that change reflecting the strategic objectives is already evident in CNO communications, such as the Annual Report.

RPN PROGRAM APPROVAL AND REVIEW PROCESS

When Council approved the regulations related to the change in RPN entry to practice, it was identified that there would need to be a program approval process. All programs will be initially approved by the Ministry of Training, Colleges and Universities after implementing the new program standards. A process needs to be identified for ongoing external program review and approval.

The Registration Committee presented a consultation paper and consultation process. If accepted, a summary of the consultation findings will be reported to Council in December, 2002.

Motion 3

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

That Council support consulting with key stakeholders on the development of an ongoing independent RPN program review process, and that the discussion paper entitled "RPN Program Approval and Review" be the basis for the consultation.

CARRIED

Concern was expressed about the timing of the process, and how it interfaces with the expectation that all 2005 applicants will graduate from an approved program. It was reiterated that a process exists for initial program approval through the Ministry of Training, Colleges and Universities, which will address the 2005 deadline. The issue for consultation is a mechanism for ongoing review.

DISABLED CLASS

Council had asked the Registration Committee to explore the feasibility of disabled class. A. Cunningham declared a conflict of interest and left the meeting.

R. Rupert highlighted the recommendation of the Registration Committee and the committee’s rationale.

Motion 4

Moved by R. Rupert, seconded by A. Taylor,

That CNO maintain the current registration classes.

CARRIED

Council supported the motion due to the difficulty in defining disability and the absence of a link between establishing a disabled class and CNO’s mandate of public protection.

Council did identify that there is a broad policy issue related to non-practising members, including issues related to competence and requirements for re-entry into practice.

Motion 5

Moved by L. Lillie, seconded by A. Taylor,

That Council direct the Registration and Quality Assurance committees to explore the feasibility of establishing a non-practising status of registration.

CARRIED

A. Cunningham returned to the meeting.

EMERGENCY REGISTRATION PROVISIONS

The Registration Committee has developed a policy allowing expedited registration of nurses in an emergency situation. The Registration Committee is recommending a revision to the Fees Bylaw allowing the Executive Director to waive fees when registering individuals coming to Ontario to provide short-term assistance in a crisis.

Motion 6

Moved by R. Rupert, seconded by P. Howe,

That Council approve for publication the proposed additional article to Bylaw 2: Fees as follows:

10.01 Despite any provisions contained in this bylaw, the Executive Director may waive the requirement for an individual applicant or member to pay a fee required by this bylaw where, in the Executive Director’s opinion, the circumstances are sufficiently extraordinary to warrant the waiver and are not based upon the ability of the individual applicant or member to pay the fee.

CARRIED

FEES BYLAW

The Finance Committee reviews fees and recommends change to Council.
Changes to the Fees By-Law need to be circulated to members for 60 days. For that reason, proposals brought forward to Council at this time are for approval for publication. Final approval will take place in December when Council has the opportunity to review the member feedback.

It was noted that most of the fees being reviewed have not changed in 10 years. The Finance Committee has given direction that fees be reviewed every two years.

Late Fee

The Finance Committee is recommending an increase in the late fee to enhance its effect as a deterrent to late registration.

Motion 7

Moved by B. Rowley, seconded by M. Ternovan,

That the following change to By-Law 2, be approved for publication in the Communiqué:

Amendment of Article 7.01 of By-Law No. 2 to replace "$20.56" with "$46.73".

There was some discussion about whether the proposed fee was a sufficient deterrent to late registration.

Amendment to Motion 7

Moved by D. Fox, seconded by L. Ross

That Motion 7 be amended by changing the fee from $46.73 to $100 (including GST).

DEFEATED

Council was concerned that the proposed $100 late fee would have a negative impact. It was suggested that the fee originally proposed be adopted and monitored to ascertain if it has the desired deterrent effect. Since the Finance Committee has a commitment to review fees every two years, it can be assessed at that time to determine if a further increase is necessary.

Motion 7

The following motion had been duly moved and seconded,

That the following change to By-Law 2, be approved for publication in the Communiqué:

Amendment of Article 7.01 of By-Law No. 2 to replace "$20.56" with "$46.73".

CARRIED

Application fee for a Certificate of Registration:

CNO's philosophy is that assessment and application processes be self-funding rather than being paid for by ongoing members. The fees no longer cover the costs of the assessment for Certificates of Registration.

Motion 8

Moved by B. Rowley, seconded by E. Howe,

That the following changes to By-Law 2 be approved for publication in the Communiqué:

1. Revoke Article 3.01 of By-Law No. 2 and substitute the following:
   3.01 A person who submits an application for a certificate of registration in the general class shall pay an application fee of
   1. $46.73 for the applicant who graduated from a nursing program in Canada in respect of the RN category or a practical nursing program, a nursing assistant program or a nursing program, in Canada, in respect of the RPN category; and
   2. $163.55 where the applicant did not graduate from a Canadian program as provided in (i) and the assessment of the application required the consideration of the equivalence of the applicant's program to the nursing program in Ontario or the additional nursing education or experience that the applicant had, or both.
      
2. Add to By-Law No. 2 the following new Articles:
   3.02.1Subject to Article 3.03, a person who submits an application for a certificate of registration for any other class of certificate other than the general or retired class shall pay an application fee of $46.73.
   3.05 No application fee shall be payable for a retired class of certificate of registration.

CARRIED

Initial Registration Fee

The Finance Committee is proposing a change to address an inequity in the way that the fee is collected.

Motion 9

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

That the following changes to By-Law 2 be approved for publication in the Communiqué:

1. Revoke Article 4 of By-Law No. 2 and substitute the following:
   
   4.01 Subject to Article 4.03, a person shall pay for registration as a member holding a certificate of registration of a particular class, other than a retired class, a registration fee of $163.55, which fee, for the purposes of Article 4.03, shall be deemed to include an annual fee of $116.82.
   4.02 Subject to Articles 4.03 and 4.04, a separate registration fee is payable upon the first issuance of each class of certificate of registration and upon each subsequent issuance to the person of a certificate of registration of a different class.
   4.03 A person who at the time of application is a member shall pay for registration in a different class of the same category in which he or she is a member, a registration fee which is the greater of
   1. $46.73 or
      
   2. the amount determined by subtracting from the fee otherwise payable under Article 4.01, the annual fee paid by the member for the calendar year in which the certificate of registration in the new class of the same category is issued.
      

   4.04 No registration fee is payable for the issuance of a certificate of registration in a retired class.
   4.05 The registration fee for a person who previously held a certificate of registration in the same class is the same fee as would be required if the person had reinstated his or her certificate of registration.

2. Amend Article 1.01 to add the following definition:

   "category" means one of the RN Category or the RPN Category.

   (c) Amend Articles 5.04 and 5.06 of By-Law 2 to replace the words "Article 4.01" wherever that occurs with the words "Article 4.01 or Article 4.03".

CARRIED

Reinstatement Fee:

The Finance Committee is recommending an increase to the reinstatement fee to address administrative costs.

Motion 10

Moved by B. Rowley, seconded by M. Taylor,

That the following changes to By-Law 2 be approved for publication in the Communiqué:

Amend Article 8.01 of By-Law No. 2 by deleting from clause (i) "$20.56" and substituting "$46.73".

CARRIED

Examination Re-score Fee

The fees set for examinations are based on the principle of cost recovery. ASI has increased the fees to re-score the RPN examination.

Motion 11

Moved by B. Rowley, seconded by L. Baker,

That the following changes to By-Law 2 be approved for publication in the Communiqué:

Amend Article 9.04 of By-Law No. 2 by deleting "$17.50" and substituting "$35.00".

CARRIED

RN(EC) application and assessment fee:

Based on the principles of cost-recovery, the Finance Committee is recommending a phased increase in the RN(EC) application and assessment fee.

Motion 12

Moved by B. Rowley, seconded by D. Barber,

That the following changes to By-Law 2 be approved for publication in the Communiqué:

(a) Revoke Article 3.02 of By-Law No. 2 and add to By-Law No. 2 the following new Article:

3.03 In addition to the fee payable under Article 3.01, a person who applies for an extended class certificate of registration as a registered nurse shall pay an application fee [which fee shall include the examination and evaluation process] of

1. $200 if the application is received on or before September 15, 2003 and the examination and evaluation process is completed by December 31, 2003;
   
2. $800 if the application is received after September 15, 2003 but on or before September 15, 2004 and the examination and evaluation process is completed by December 31, 2004;
   
3. $1,000 if the application is received after September 15, 2004 but on or before September15, 2005 and the examination and evaluation process is completed by December 31, 2005 ; and
   
4. $1,200 if the application is received after September 15, 2005.

(b)Renumber Article 3.02.1 as Article 3.02.

There was considerable concern that the proposed increase would pose a barrier to members considering the RN(EC) role. This was of particular concern because there are only 100 RN(EC)s in the province.

Given the identified public need for RN(EC) practitioners, it was suggested that it is in the public interest that CNO continue to support the RN(EC) assessment process. It was identified that the per member cost for supporting the RN(EC) assessment process is about 70¢.

It was suggested that CNO consult with members to determine whether they wish to subsidize this category of applicant. It was suggested that this issue be referred to the Finance Committee for further consideration, given the member feedback.

Motion 13

Moved by L. Ross, seconded by S. Keating,

That motion 12 be withdrawn.

CARRIED

Motion 14

Moved by I. Bajnok, seconded by L. Ross,

That the appropriate numbering changes be made to By-Law 2 given the withdrawal of motion 12.

CARRIED

Since the recommended change regarding refunds relates to the proposed increase for the RN(EC) application fee, it is no longer required.

DEFERRALS

The Executive Director update was deferred until the first meeting of the newly constituted Council on June 6th. The presentation on Practice Review was deferred until the October Council meeting.

EXECUTIVE COMMITTEE

Minutes of the Executive Committee meetings of April 17th and May 8th had been distributed. The minutes of the meeting of May 28th will be sent to Council when completed.

ELECTIONS COMMITTEE

Council received the report of the Elections Committee. V. Kerr reported that the committee confirmed the 2002 elections results.

FEDERATION OF HEALTH REGULATORY COLLEGES

L. Haugh reported on the Annual Meeting of the Federation of Health Regulatory Colleges held on April 24th . She informed Council that the Federation is embarking on negotiations with Ministry of Health and Long-Term Care regarding a comprehensive strategy for communications about self-regulation with the public. She noted that the Federation has a new website.

The activity of the Federation with respect to the proposed privacy legislation was reviewed. The Ministry of Health and Long-Term Care supports the recommendation that RHPA have primacy and will communicate that to the Ministry of Consumer and Business Information.

JPNC

L. Haugh updated Council on the recent activities of the Joint Provincial Nursing Committee. She noted that the Ministry of Health and Long-Term Care expressed appreciation CNO's data.

OTHER BUSINESS

Council members had received the 2001 statistics, for information. It was noted that it is important to review the statistics over time to note trends. It was identified that noted the recent trend shows membership increases.

Council had received an information note on the extension of the reciprocity agreement with Quebec to December, 2004. It was noted that CNO will be informing border educational facilities and employers that reciprocity is continuing.

CONCLUSION

Council concluded at 5 p.m.