COUNCIL

Present:

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

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

M. McGinn
A. Mahdavian (Thursday)
M. A. Murray
D. Norling
K. Pederson
M.L. Sivilia
A. Spacek
M. Ternovan
B. Weichel
C. Zanchetta

Regrets:

D. Barber
G. Dhami

A. Grant
R. Rupert

S. Seguin
M. Taylor

Staff:

A. Coghlan
H. Campbell

J. Hofbauer, Recorder
P. Reinhart

G. Siskind
C. Stanford

Welcome

S. Ireland welcomed M. L. Sivilia, public member of Council. She reminded members of Council to complete the evaluation of the Code of Ethical Conduct.

Rules of Order

The rules of order monitor for the meeting was S. Burnell-Jones.

Agenda

The agenda was circulated in advance.

Motion 1

Moved by D. Bishop, seconded by R. Graham,

That the agenda be approved as circulated.

CARRIED

Minutes of meeting of December 8 and 9, 2004 have been distributed.

Motion 2

Moved by M. McGinn, seconded by M. Ternovan,

That the minutes of the Council meeting of December 8 and 9, 2004 be accepted as circulated.

CARRIED

Minutes of the closed session of December 9, 2004 had been distributed to those members who attended the session.

Motion 3

Moved by F. Cole, seconded by M. Lambert,

That the minutes of the closed session of December 9, 2004 be accepted as circulated.

CARRIED

Evaluation of December Meeting

A summary of the evaluations of the December 2004 Council meeting had been distributed. Concern was expressed about the level of response and members were reminded of the importance of completing the evaluation.

Measuring Implementation of the Strategic Objectives

When the 2005-2010 Strategic Plan was developed, a commitment was made to identify outcome indicators to measure achievement of the plan. Council received the strategy-based Results Report, which links the indicators to the strategies in the Strategic Plan. E. Horlock presented the process used to identify the indicators and link them to the strategies.

There was a query about whether the indicator related to nurse “satisfaction” could be clarified. CNO is planning a member survey and once the questions are identified, it may be possible to refine the wording in the indicator.

March Results Report

Council members had received the March 2005 Results Report, the first report using the new format. It was noted that reports will be received on different indicators at each meeting, depending on the cycle for each of the indicators.

There was some discussion about difficulties that members had in accessing the College during the annual renewal timeframe. The Results Report shows an improvement over the previous year in addressing calls during the high-volume renewal timeframe. Strategies implemented in 2005 were highlighted. CNO is continually seeking to improve customer service, particularly at renewal time. The member survey may include an assessment of satisfaction with service, which will provide a baseline against which to measure changes in service in the future.

Examination Fees By-Law

In September, Council had approved an increase in the examination fee and a proposed By-Law amendment, for publication. Council received a report of the feedback to the proposed change.

There was some discussion about the feedback from the Registered Practical Nurses Association of Ontario. If there is a future increase in the cost of the Practical Nurse examination, Council will make a decision regarding subsidization based on the circumstances at that time.

Motion 4

Moved by S. Keating , seconded by D. Norling,

That Council approve the amendment of the College’s By-law No. 2 Fees by:

1. revoking clause i and ii of Article 9.01 and substituting the following:
   1. $200.93 if the examination is to be taken prior to June 1, 2005 ;
   2. $315.00 if the examination is to be taken on or after June 1, 2005 but prior to January 1, 2006 ;
   3. $373.83 if the examination is to be taken on or after January 1, 2006 but prior to January 1, 2007 ;
   4. 383.18 if the examination is to be taken on or after January 1, 2007 but prior to January 1, 2008 ;
   5. 392.53 if the examination is to be taken on or after January 1, 2008 but prior to January 1, 2009 ;
   6. 401.88 if the examination is to be taken on or after January 1, 2009 but prior to January 1, 2010 ; and
   7. 411.23 if the examination is to be taken on or after January 1, 2010 .
      
2. revoking the whole of Article 9.03 and substituting the following:
   
   9.03 A person who applies to have the results of an examination referred to in Article 9.01 re-scored shall pay a fee of:
   1. $35.00, if the examination to be rescored was taken prior to June 1, 2005 ; and
   2. $46.73, if the examination to be rescored was taken on or after June 1, 2005 .

CARRIED

Supporting Learners

Council received a revised draft practice guideline: Supporting Learners. The process for development and rationale for the changes from the previous guideline (Working with Students) was outlined. A number of suggestions were made for clarifying and strengthening the guideline.

Motion 5

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

That Council approve the practice guideline Supporting Learners, for publication.

CARRIED

The changes suggested by Council will be integrated into the guideline.

National Nurse Practitioner Core Competencies

C. Vigar and S. Galloway presented a brief overview of the National Nurse Practitioner Core Competencies. The relevance of the Core Competencies to the Ontario Primary Health Care Nurse Practitioner and Acute Care Nurse Practitioner roles has been confirmed through surveys and a focus group.

The development of National Core Competencies will enhance labour mobility and is the first major step in building the regulatory framework for the regulation of Acute Care Nurse Practitioners.

Motion 6

Moved by E. Howe, seconded by M. A. Murray,

That the National Nurse Practitioner Competencies be the entry to practice competencies for RN(EC)s in Ontario.

CARRIED

Annual Reports of Statutory Committees

S. Ireland noted that the committee reports are an important accountability mechanism.

Executive Committee

S. Ireland highlighted the report of the Executive Committee. She noted that there is an overall trend of increasing activity, with a 41.6% increase in 2004. It was reported that executive resolutions offer a positive and proactive way to address practice issues.

Client Relations Committee

R. Fife highlighted the report of the Client Relations Committee. The College continues to market the abuse prevention program to employers. The program is being refreshed with updated content. In addition, the witness of abuse survey first done in 1997 is being repeated in 2005. The data will be available for the June 2005 Council meeting.

Complaints Committee

M. A. Murray reported that the Complaints Committee has seen an increase in matters coming forward. In addition, more cases are being appealed to the Health Professions Appeal and Review Board (HPARB). Six matters have been returned to the committee by HPARB for rewording, which provides an opportunity for the committee to improve its processes.

Discipline Committee

M. Ternovan highlighted the report of the Discipline Committee. He noted that 31 of the 40 cases disposed of during the year were resolved through agreed statement of facts. In approximately 70% of cases, the Discipline Committee was able to release a decision within 60 days. Activity of the Discipline Committee continues to grow with 71 cases on the roster.

The Discipline Committee has undertaken a review of its rules and guidelines and concluded that there is a need to come up with targets for the key stakeholders (prosecution counsel, member and defense counsel) to ensure more fluid flow of cases. Stakeholders will be educated and it is hoped that they will commit to the guidelines.

Fitness to Practise Committee

R. Graham highlighted the report of the Fitness to Practise Committee. She noted that during the trial period, consent orders were determined via teleconference. Beginning in April, when there are more than two consent orders, the panels will review consent orders at the College.

Quality Assurance Committee

S. Keating highlighted the report of the Quality Assurance Committee. She reported that 94.3% of nurses who completed Practice Review were successful at the written assessment. The College can feel positive about the quality of nurses and ability of Ontario ’s nurses to practice to standard.

The Quality Assurance Committee is working on refining the process for RN(EC) practice review. It was reported that Practice Review for administrators will be pilot tested in 2005.

Registration Committee

C. Beemer reported that the Registration Committee is addressing an increase in activity, which may be partly due to the implementation of the new registration requirements. The committee has added meetings by teleconference to address the increase in applicants being brought forward. Key policy initiatives were highlighted.

Executive Director Update

A. Coghlan noted that the Minister has made an extensive and wide-ranging referral to the Health Professions Regulatory Advisory Council (HPRAC), requesting a review of the health regulatory legislation including a review of the recommendations made by HPRAC in 1999.

It was noted that, while information is limited, it is clear that the timeframes will be tight because of the deadline that the Minister set for HPRAC’s report. Through the Federation, there have been preliminary discussions with the Chair of HPRAC. HPRAC is in the process of developing a workplan and recognizes that there may be issues with Council schedules and HPRAC timelines. HPRAC has taken a very consultative approach to date, which is indicative of the approach it will take throughout the process.

The preliminary policy work to support Council input into the review has begun. Three key themes have been identified as a focus for background development and research:

• Ongoing competence and Quality Assurance;
• Scope of practice/controlled acts; and
• Privacy vs. openness and the public’s right to know.

The College staff are beginning to review and research issues in the absence of more specific information and in anticipation of multiple requests to respond to consultation with short turn-around times.

HPRAC has accountability for monitoring Quality Assurance and Patient Relations programs. Work has been initiated on the review of Patient Relations programs. The first step was to undertake a qualitative study of public opinion regarding the interface of the patient and the professional and with the College. On HPRAC’s request, CNO has forwarded letters from HPRAC to a random selection of members of the public who participated in the complaints process.

It was noted that CNO will need to be as flexible as possible to be responsive to the requests as they arrive. The governance model will guide the process, respecting Council’s role to establish policy positions and approve submissions. As has happened in the past, there may be times when submissions will need to go forward on the Executive’s approval with the caveat that there may be additions on deletions based on a subsequent review by Council.

It was noted that the Executive Committee terms of reference assign it a steering committee role for issues which are not related to another committee’s mandate, and allow the Executive to approve materials when required by time constraints.

The College will explore creative methods of seeking input from Council members when time is limited. As more information is known about HPRAC’s process, the Executive will discuss how to optimize Council’s input.

Executive Committee

Minutes of the Executive Committee meetings of December 15 and 16, 2004, January 19 and 20, 2005 and February 16 and 17, 2005 were highlighted.

Motion 7

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

That Council ratify the appointment of M. L. Sivilia to the Complaints Committee until June 2005.

CARRIED

Finance Committee

S. Burnell-Jones and K. Cook highlighted the report of the Finance Committee. The Finance Committee reviewed the approach for the 2004 audit with the auditors. The committee terms of reference were reviewed and amendments presented to Council (attached to minutes).

The unaudited year-end financial statements were highlighted. It was reported that the statements show an operating surplus of $1.95 million.

Council was informed that the Finance Committee is developing financial indicators, using the committee’s terms of reference as a framework. The committee is consulting with the auditors. When complete, the indicators will be shared with Council.

Motion 8

Moved by M. Ternovan, seconded by D. Norling,

That the revised Finance Committee Terms of Reference (appendix 1) be approved.

CARRIED

Motion 9

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

That the unaudited year-end financial statements as at December 31, 2004 be accepted.

CARRIED

Governance Survey

Council reviewed a draft governance survey. Some suggestions for re-focusing one section of the survey were identified. It was also suggested that space be included for comments related to the first section.

Scrutineers

The Executive recommends scrutineers for the election of Council officers.

Motion 10

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

That the following be ratified as scrutineers for the election of Council officers: D. Bishop, M.L. Sivilia, R. Rupert.

CARRIED

Nominating Committee

In December, Council had appointed the Nominating Committee. Subsequently, a member resigned and a request for volunteers was distributed. The Executive has recommended an appointment.

Motion 11

Moved by K. Pederson, seconded by B. Hood,

That M. Lambert be appointed to serve as a member of the Nominating Committee.

CARRIED

Other Business

Council discussed employer support for participation on Council and committees. It was identified that lack of employer support is a barrier to running for election and can cause stress for serving members. A number of suggestions were made including articles thanking employers in The Standard, articles in QP, and certificates for employers of Council/committee members. One member identified strategies that an individual member can use to add value to her/his employer, such as sharing pertinent information from the environmental scan and identifying for facility management the value of having a member at the Council table.

The Elections Committee was asked to identify strategies to promote the election and to encourage employer support.

Next Meeting

Council will meet June 8 and 9, 2005, with the Annual Meeting scheduled for June 9 at 9:00 a.m.

Conclusion

The Council meeting concluded at 3:00 p.m.