S. Ireland , Chair
J. Attwood
D. Barber
C. Beemer
D. Bishop
S. Burnell-Jones
R. Cerrudo-Javier
K. Cook
F. Cole
G. Dhami
D. Dietrich

R. Fife
C. Genereux
R. Graham
E. Greenwood
G. Hayward
B. Hill
B. Hood
S. Islam
S. Keating
M. Lambert

M. McGinn
A. Mahdavian (Thursday)
M. A. Murray
K. Pederson
R. Rupert (Wednesday)
S. Seguin
A. Spacek
M. Taylor
M. Ternovan
D. Trouten (Thursday)
B. Weichel

Regrets:

E. Howe
A. Mahdavian (Wednesday)

D. Norling
R. Rupert (Thursday)

D. Trouten (Wednesday)
C. Zanchetta

Staff:

A. Coghlan
C. Campbell

J. Hofbauer, Recorder
P. Reinhart

G. Siskind
C. Stanford

Welcome

S. Ireland introduced the following new Council members: R. Cerrudo-Javier, G. Dhami, C. Genereux, S. Islam, and A. Mahdavian. She informed Council that resignations had been received from L. Hall and B. Noble.

Agenda

The agenda had been circulated.

Motion 1

Moved by B. Weichel, seconded by D. Bishop,

That the agenda for the Council meeting of December 8 and 9, 2004 be approved.

CARRIED

Closure

The Executive Committee is recommending closure of the Council meeting.

Motion 2

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

That the Council meeting be closed at 9:00 a.m. on Thursday, December 9, 2004 to discuss personal or personnel matters in accordance with clause 7(2)(d) of the Procedural Code.

CARRIED

Minutes

Minutes of the Council meeting of September 22 and 23, 2004 had been circulated. The attendance was corrected to show that E. Howe and B. Weichel had sent regrets.

Motion 3

Moved by R. Fife, seconded by M. McGinn,

That the minutes of the Council meeting of September 22 and 23, 2004 be approved as corrected.

CARRIED

Closed Session

Minutes of the closed session of September 22, 2004 had been circulated to those members who had attended the session.

Motion 4

Moved by S. Seguin , seconded by R. Graham,

That the confidential appendix to the minutes of the Council meeting of September 22 and 23, 2004 be approved.

CARRIED

Strategic Planning Workshop Notes

Notes of the Council/staff strategic planning workshop had been circulated.

Motion 5

Moved by D. Barber, seconded by R. Fife,

That the notes of the Council/staff strategic planning workshop of September 22, 2004 be approved.

CARRIED

Evaluation of September Council

Summaries of the evaluation of the September 2004 Council meeting had been circulated.

2002-2003

Strategic Plan

Council received an overview of the accomplishments related to the 2002 to 2005 Strategic Plan.

The College of Nurses of Ontario and You:
a student’s guide to self-regulation

Council reviewed a draft of the DVD The College of Nurses and You: A Student’s Guide to Self-Regulation. The DVD is an outcome of the 2002-2005 Strategic Plan and will be a support in continuing to build understanding about the College and self-regulation with nursing students. It was suggested that the DVD might be useful to orient new Council and committee members as it provides a broad overview of CNO’s role.

2005-2010 Strategic Plan

Council had received the report of the Ad Hoc Committee on Strategic Planning and the draft 2005-2010 Strategic Plan.

To illustrate the integration of the objectives included in the strategic plan into operational planning, Department Directors highlighted a few of the operating commitments from the 2005 Operating Plan.

S. Ireland noted that Council has provided input throughout the development of the plan. The feedback to the consultation from stakeholders confirmed the directions articulated in the draft plan. She reported that the Ad Hoc Committee believes it has developed a strong and proactive plan that will take the College forward in an exciting direction.

The development of indicators to measure the achievement of the outcomes of the plan is in process. The draft framework for the revised Results Report was highlighted by A. Coghlan and D. Franchi. The revised results report will be presented to Council in March of 2005.

S. Ireland noted that the Ad Hoc Committee had reviewed the fiscal implications of the plan and believed the resources were required to move the College forward in the directions supported by Council during previous discussions.

Through an informal show of hands vote, Council expressed unanimous support for the plan. Due to the fiscal implications of the plan, final decision was deferred pending decision regarding the 2005 budget.

Registration Regulation

S. Ireland reviewed the background related to amendment of the registration regulation. A. Coghlan updated Council on activity that has taken place since Council approved the regulation in September, 2004. On November 26 th, CNO signed a sealed regulation including all of the provisions approved by Council in September.

A. Coghlan informed Council that staff from the Ministry of Health and Long-Term Care have continued to express concern about the sunset clause included in the provisions for the Transitional Class, and have made verbal requests that Council consider its removal. In recent communication with the office of the Minister, CNO identified that it will table any request from the Minister with Council. It was noted that there is no urgency in bringing forward such a request because the sunset clause does not take effect until the end of 2007. If a request comes forward from the Minister, it will be tabled at the subsequent Council meeting.

The process for approval of regulations was reviewed. It was noted that if the regulation is not approved, quite a number of applicants will be disadvantaged. A number of stakeholders have independently written to the Ministers of Health and Long-Term Care and Training, Colleges and Universities raising concerns regarding the implications for applicants if the regulation amendments do not pass.

Practical Nurse Program Approval Committee Report

K. Conlin-Saindon highlighted the process used by the Practical Nurse (PN) Program Approval Committee in reviewing the programs. Since the practical nurse entry to practice regulation has not yet been approved, the four participating programs had all volunteered, and one program also volunteered for a site visit. The criteria used to determine whether to approve the programs were highlighted.

Motion 6

Moved by D. Dietrich, seconded by R. Fife,

That the Practical Nurse programs at Centennial College, Durham College, Humber College and St Lawrence College be approved for a 5 year term, to December 31, 2009.

CARRIED

Council commended the Program Approval Committee for implementing the approval process and review of the four programs in a timely manner.

Council also received a report of the Canadian Association of Schools of Nursing’s (CASN’s) review of BScN programs. CASN is the body Council selected to approve BScN programs. CASN had made a commitment to review all programs before December 31, 2004 . All programs except for one have been approved; decision regarding the final program will be made the week of December 13 th.

Practice Guideline:

Refusing Assignments and Discontinuing Nursing Services

• S. Avey-Morrison and M. Cyr highlighted the new practice guideline: Refusing Assignmentsand Discontinuing Nursing Services. This document consolidates previous information provided by the College in a variety of documents, includes a decision-framework, scenarios to demonstrate application of the content and decision process, and strategies for maintaining a quality practice setting. The process for developing the practice guideline was outlined.
•  It was noted that decisions regarding refusing assignments and discontinuing nursing services are often ethical dilemmas. The practice guideline provides parameters to consider in working through such a decision.

Council made a number of suggestions to clarify and enhance the guideline. It was suggested that the links between this practice guideline and other CNO documents and approaches, such as reflective practice and the Guide for Utilization of RNs and RPNs, be highlighted.

Motion 7

Moved by M. A. Murray, seconded by R. Graham,

That Council approve the new practice guideline Refusing Assignments and Discontinuing Nursing Services, for publication.

CARRIED

Discontinuing a Standard Document:
Nursing Footcare

S. Avey-Morrison and S. McNickle highlighted the rationale for discontinuing the Nursing Footcare Standard document. The document is outdated and, in addressing a clinical area, is outside of CNO’s role.

Motion 8

Moved by S. Keating , seconded by S. Seguin ,

That the Nursing Footcare Standards (1999) document be discontinued.

CARRIED

Executive Director Update

H. Campbell highlighted initiatives in the Practice and Policy Department, including the review of the Practice Setting Consultation Program, initiatives related to long-term care, issues that are identified through member and employer inquiries, and new approaches to consultation.

A. Coghlan presented the Executive Director update, including updates on the statistics package, the new College information system, regulations including those needed to implement CNO’s changes in entry to practice, and activities related to renewal. The biennial organizational awareness survey was repeated for the first time in 2004 and improvements in every indicator were reported.

Executive Committee

Council received notes of Executive Committee meetings of October 25 and 26, 2004 and November 17 and 18, 2004. S. Ireland highlighted the meetings. She reviewed committee assignments of newly appointed public members.

Motion 9

Moved by J. Attwood, seconded by R. Rupert,

That the following appointments to statutory committee to June 2005 be ratified:

Complaints Committee:

Discipline Committee:

Registration Committee:

G. Dhami

R. Cerrudo-Javier, C. Genereux, S. Islam

A. Mahdavian

CARRIED

Nominating Committee Report

D. Barber presented the report of the Nominating Committee’s review of the committee assignment process. She noted that statutory committee chairs and the Committee Staff Resource Group have raised some concerns with the current process.

The Nominating Committee identified that there is a tension between some of the goals underlying the process and that it would be helpful information for the incoming Nominating Committee to have the input of Council and committee members on the principles and goals underlying the process.

A survey will be undertaken early in the new year and the results will provide input to the incoming Nominating Committee when it determines the process to be used for committee assignments.

Liaisons

S. Ireland reported on liaisons with the Ontario Nurses’ Association and the Registered Practical Nurses Association. The liaisons are held to discuss areas of common interest, explore possible areas for collaboration and keep channels of communication open.

There was some discussion about correspondence with RPNAO regarding its publication Outcomes:Improved Patient and Fiscal Outcomes as a Result of Appropriate Use of Nursing Staff.

The Executive will be reviewing how the College will respond, and an update will be sent to Council.

On receipt of correspondence related to CNO, Council members are asked to provide the correspondence to the College for response. This ensures a consistent response which integrates all of the relevant background and research.

S. Ireland identified that notes from the liaison meetings will be sent to Council members when they are available.

2005 Nominating Committee

The Executive appoints the Nominating Committee from among volunteers, for ratification by Council.

Motion 10

Moved by S. Keating , seconded by R. Rupert,

That the following be ratified as the 2005 Nominating Committee: J. Attwood, D. Barber, R. Graham, M. McGinn, K. Pederson and M. Ternovan.

CARRIED

Council and Committee Vacancies

The Elections Committee makes recommendations to Council on filling elected Council and committee member vacancies. Council received a recommendation from the Elections Committee.

Motion 11

Moved by J. Attwood, seconded by R. Graham,

That Arlene Grant be appointed to serve as the RN Council member from the Central Eastern district until June 2007.

CARRIED

To facilitate integration of the new member into Council and committee functioning, the Executive recommended the committee appointments.

Motion 12

Moved by D. Dietrich, seconded by K. Pederson,

That Arlene Grant be appointed to fill vacancies on the Client Relations and Quality Assurance committees until June 2005.

CARRIED

Stipend Policies

The Executive is recommending changes to the stipend policies to clarify eligibility for chair stipend for panel chairs, and to address Fitness to Practise preparatory time for consent orders.

Motion 13

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

That Council approve the proposed revised stipend policies, as detailed in attachment 1 to the minutes.

CARRIED

Ad Hoc Committee Term of Office

Earlier in the meeting, there was discussion about the process for development of indicators, and the proposed revised Results Report framework was highlighted.

The Ad Hoc Committee on Strategic Planning is recommending extension of its term of office until March 2005 to allow it to serve as a resource in the identification of indicators. The fiscal implications of extending the term of office are included in the draft 2005 budget.

Motion 14

Moved by M. McGinn, seconded by R. Graham,

That the term of office of the Ad Hoc Committee on Strategic Planning be extended to March 2005 to allow the Committee to be a resource for the development of indicators.

CARRIED

Other Business

Question was raised about the outstanding RPN Initiation regulation and whether, given the changes to the Practical Nurse programs, the regulation is now outdated. A. Coghlan informed Council that the Ministry of Health and Long-Term Care is reviewing its approach to addressing long-outstanding regulations and will be forwarding further information to Colleges, to serve as a basis for discussion in the new year.

There was discussion about the timeframe for cases to go forward to Discipline. It was identified that CNO can only control some of the factors that may result in delays. CNO has seen an improvement in the proportion of cases where the hearing begins within 6 months of referral and is leading other colleges with respect to timeframes for referral. G. Siskind noted that cases are assessed on intake and those with serious allegations, especially those of abuse, are fast-tracked from the intake stage. In cases where there is concern regarding public safety, the Executive can suspend a member pending the hearing.

Recess

Council recessed at 4:00 p.m. to reconvene at 9:00 a.m. on December 9 th.

Thursday, December 9, 2004

Closed Session

Council moved into a closed session, which is recorded in a confidential appendix provided to those Council members in attendance at the session.

Finance Committee

S. Burnell-Jones and K. Cook presented the report of the Finance Committee. The Committee had reviewed the financial statements as at September 30, 2004 , which were briefly highlighted.

2005 Budget

S. Burnell-Jones outlined the process for the review of the budget. She highlighted the history of the accumulated surplus. She noted that the Finance Committee has identified that it would be appropriate for CNO to maintain a surplus of between 3 to 6 months expenditure. There may be circumstances where there would be a delay in collecting fees, such as a pandemic, and the surplus would provide resources for the College to continue operations.

P. Reinhart presented a summary of the budget development process. He identified the drivers causing the increases in the budget, including volume increases and strategic/regulatory demands.

S. Burnell-Jones reviewed the discussion and decision-making process of the Finance Committee. It was noted that the draft budget does not include the one-time payment for the pension plan, however that payment will not affect the 2010 date for a proposed fee increase.

Motion 15

Moved by S. Keating , seconded by M. Taylor,

That the 2005 Operating and Capital budgets be approved as circulated .

CARRIED ( Opposed – D. Trouten)

Strategic Plan

Council had supported the proposed 2005 to 2010 Strategic Plan in principle, pending decision on the 2005 budget. Following approval of the budget, Council was asked for a formal motion to approve the Strategic Plan.

Motion 16

Moved by J. Attwood, seconded by D. Barber,

That the 2005-2010 Strategic Plan be approved as presented.

CARRIED

Conclusion

At 11:00 a.m. , it was

Motion 17

Moved by D. Bishop, seconded by M. A. Murray,

That the Council meeting conclude.

CARRIED

Changes in bold face & italics

Stipend Policies

Overview

This policy on stipends covers elected members of Council and committees.

1. Stipend paid

Stipends payable under this policy are:

1. $200.00per day for Council and committee members; and
2. $300.00per day for Chairs of Council and statutory committees, Discipline and Fitness to Practise statutory committee panel chairs, when chairing meetings or hearings,including deliberations and reason writing (when done by the panel),except for chairing the Executive Committee .
3. $300.00per day for the President for any meeting attended or chaired on behalf of CNO except attendance at educational conferences and workshops; and
4. $250.00per day for each Vice-President for any meeting attended or chaired on behalf of CNO except attendance at educational conferences and workshops.

2. Automatic Stipend

A stipend payment under this policy will be automatically paid for:

• time in attendance at meetings of the Council and its committees;

• preparatory time for meetings attended for the following statutory committees where the preparatory time for statutory decision-making is ongoing and burdensome, at the rates stipulated:

1. Registration Committee – one half stipend day for each day of meeting;
2. Complaints Committee – two stipend days for each day of meeting;
3. Complaints Committee Chair – an additional one quarter stipend day for each day of meeting for review of decisions;
4. Executive Committee – one stipend day for each day of meeting (exemptions: brief meetings when not addressing statutory matters requiring preparation);
5. Board of Inquiry – one half stipend day for each day of meeting (including conference calls);
6. Discipline Committee Pre-hearing Conferences – one half stipend day for each pre-hearing conference;
7. Discipline Committee motion preparation on personal time – 1 hour stipend for every 30 pages of required reading; and
8. Quality Assurance Committee – 30 minutes for every Practice Review case.

ix) Fitness to Practise Consent Order meetings (conference calls included) – 1 hour stipend for every 30 pages of required reading.

3. Claimable Stipend

A stipend payment under this policy may be claimed for:

1. time while otherwise engaged in the business of Council (e.g., speaking engagements) for which prior eligibility for stipend has already been confirmed.
2. preparatory time payable under 2(b) if a member is suddenly and unexpectedly unable to attend a meeting and has done the preparatory work.
3. time spent in drafting the reasons and decision of a Discipline hearing, under the following circumstances:
   1. the member has been assigned the task of drafting reasons on behalf of the committee and is doing the work on her or his own time; and
   2. the amount paid is based on the amount of time spent in preparing the reasons, in accordance with the criteria itemized in section 4 of this policy.

4. Criteria for determining Amount Paid

The following criteria will be used in determining the amount of stipend to be paid/claimed for any one calendar day under any of the stipend policies:

• two to four hours of meeting time

• four to nine hours of meeting time

• over nine hours of meeting time

one half stipend day

one stipend day

one and a half stipend days.

5. Conference Call Stipend

Stipend is paid for conference call meetings at a rate of $28.57 per hour a half stipend day for three hours. The time value of a conference call will be determined by the Chair recorded in the minutes. Time spent by members in conference call meetings will be tracked by CNO. A half stipend day will be paid to a member when she or he has accumulated three hours in conference call meetings. If a member leaves before three hours is reached, a pro-rated stipend payment will be made for outstanding conference call stipends. Preparatory stipends will not be paid for conference calls unless otherwise stated in the policies for preparatory stipend regarding statutory committees [section2(b)].

6. Payee

Upon written confirmation from the member her or his stipend cheques for meeting attendance will be made payable to the member’s employer as a “fee for service” and no income tax deduction will be made. In all other instances, stipend cheques will be made payable to the member as taxable income, subject to income tax deduction and issuance of a tax form at year end. Income tax of 10% will automatically be deducted from member’s stipend unless specific direction is given by the member to deduct a greater or lesser amount.

7. President’s honorarium

The President will receive an annual honorarium of $3,000.

8. President’s Employer

CNO will offer to provide a lump-sum payment to the employer of the President of up to 25% of the President’s salary to a maximum of $20,000 in any one year.

9. Addressing Concerns

If a member is concerned about a decision regarding automatic or claimable stipend, the concern should first be discussed with the Executive Director. If the member is still concerned, she or he may appeal to the President.

Revised December 2004