The RHPA requires each health profession college to establish seven statutory committees - Executive; Registration; Inquiries, Complaints and Reports; Discipline; Fitness to Practise; Quality Assurance; and Patient Relations.
The Executive Committee is composed of the president, the vice president and three members of Council, two of which are public members of Council appointed by the Lieutenant-Governor In Council. The president serves as the chair of the Executive Committee.
The Executive Committee has all the powers of the Council of the College between Council meetings and may exercise these powers if, in the Committee’s opinion, a matter requires immediate attention. It must report to Council and does so through minutes and with a formal report at each Council meeting.
It can also meet as a part of the Inquiries, Complaints and Reports Committee to review monitoring and mentoring reports and Registrar’s investigations. These meetings are confidential.
The Registration Committee is composed of dentists and at least one public member.
It deals with applications for member registration that have been referred to the Committee by the Registrar. The Registrar must refer an application if there is reasonable doubt that the applicant meets the registration requirements, or if the Registrar is of the opinion that terms, conditions or limitations should be imposed on a certificate of registration (licence to practise) to which the applicant does not give consent.
All applications that the Registrar proposes to refuse must be referred to the Registration Committee for its information or action. Decisions of the Registration Committee can be appealed to the Health Professions Appeal and Review Board (HPARB) and can advance to Divisional Court.
The Registration Committee is also responsible for setting registration policies, procedures and protocols, and advises the Council on “entry to practice” requirements. The Committee recommends amendments to the registration regulation when appropriate.
The College and the Registration Committee are routinely audited by the Office of the Fairness Commissioner to ensure the College’s registration practices are transparent, objective and fair.
The Inquiries, Complaints and Reports (ICR) Committee is composed of dentists and public members.
The ICR Committee initially reviews all dentist-specific concerns brought to the College’s attention from various sources such as formal complaints, mandatory reports or information brought to the Registrar’s attention. Such concerns include professional misconduct, incompetence and incapacity.
The law requires every complaint to be investigated. The quality of an investigation and reasons can be reviewed by the Health Professions Appeal and Review Board.
The ICR Committee meets in panels of at least three, appointed by the chair of the ICR Committee as standing panels. Panels must have at least one public member and typically have two dentists. This committee meets in camera. Any and all discussions of these matters are to take place in the meeting room with all members of the panel present.
Panels do not conduct their own investigation or research; they review the results of investigations conducted by College staff on its behalf and ultimately decide how to deal with the complaint or report.
In evaluating cases, panels of the ICR Committee use a Risk Assessment Framework and tool to assess the degree of risk to patient safety. The purpose of this framework and tool is to ensure consistent, fair and transparent decision-making that is guided by the panel’s thinking, analysis and assessment of risk.
Cases that pose a moderate or high degree of risk require a public outcome, whereas cases that pose low or no risk result in a non-public outcome.
Public outcomes include:
- requiring the dentist to appear for a caution
- requiring the dentist to complete a specified continuing education or remediation program (SCERP)
- accepting an undertaking from the dentist to restrict their practice. The Protecting Patients Act provides more substantial powers to the ICR Committee
- placing an interim order on the dentist’s certificate of registration/licence
- referring the dentist’s case to the Discipline Committee
- referring the dentist’s case to the Fitness to Practise Committee.
The College has an alternative dispute resolution (ADR) program through which it attempts to resolve certain types of complaints. Any resolutions reached through the ADR program are ratified by a panel of the ICR Committee.
The Discipline Committee is composed of elected and non-elected dentists and public members. From these members, the chair of the Discipline Committee may appoint a panel of at least three and no more than five persons, two of whom must be public members (in a panel of five).
The Inquiries, Complaints and Reports Committee refers specified allegations of professional misconduct or incompetence to the Discipline Committee. A panel of the Discipline Committee sits as judge and jury to hear evidence respecting these allegations in a formal tribunal setting. At the conclusion of the hearing, the panel must determine guilt of professional misconduct or incompetence and then, if guilt has been established, impose an appropriate penalty. The ultimate consideration in determining an appropriate penalty is protection of the public interest. The panel can also assess costs.
Members of a panel cannot know in advance anything about the case that they are hearing or do their own research. The panel must make its decision based solely on the evidence presented at the hearing. The burden of proof is on the College prosecutor to prove the case. The panel will have the assistance of independent legal counsel should the need for legal advice or interpretation arise.
Unless otherwise directed, hearings of the Discipline Committee are open to the public. Appeals of the decisions of a Discipline panel are heard by the Divisional Court.
The College has an active pre-hearing conference process, during which issues of a specific case are often resolved and then brought to a panel of the Discipline Committee for approval. At a pre-hearing conference, the College and the dentist try to reach agreements on issues of fact, plea and penalty. A pre-hearing conference presider will attempt to aid in the facilitation of reasonable agreements.
Pre-hearing conferences are confidential and without prejudice. That means, if no agreements are reached, even the fact that a pre-hearing conference was held is confidential.
The Fitness to Practise Committee is composed of elected and non-elected dentists and public members. From these members, the chair of the Fitness to Practise Committee may appoint a panel of at least three members, one of whom must be a public member.
A panel meets in a formal tribunal setting to determine whether a dentist is incapacitated – suffering from a physical or mental condition or disorder that makes it in the public’s interest to have the dentist’s certificate of registration (licence to practise) be subject to terms, conditions or limitations or revocation.
Unless otherwise directed, hearings of the Fitness to Practise Committee are closed to the public. Appeals of Committee decisions are heard by the Divisional Court.
The Quality Assurance Committee is composed of elected and non-elected dentists and public members.
The Committee is charged with the development, administrative review and ongoing evaluation of RCDSO’s Quality Assurance (QA) Program. The program is designed to ensure that the knowledge, skill and judgment of Ontario dentists remains current throughout their careers, and that they continue to provide safe, effective, appropriate and ethical oral health care to their patients. The Committee reviews standards of practise and approves Core One courses.
As outlined in the QA Regulation, the QA program includes requirements for all dentists with a general or specialty licence to practice to pursue continuing education (CE) activities and obtain at least 90 CE points in a three-year cycle.
The College e-Portfolio is an online program that allows dentists to enter and keep track of their CE points for each three-year cycle. In addition, all dentists are required to complete an online self-assessment program, known as the Practice Enhancement Tool (PET), at least once every five years.
The Patient Relations Committee is composed of public members, elected and non-elected dentists. This Committee is responsible for the College’s patient relations program which includes initiatives to prevent or deal with the sexual abuse of patients. The Committee works to:
- inform the public about the College and how to access its programs
- develop policies to support patients and individuals during the College’s investigations process
- provide guidance and education for members about appropriate professional behavior in the dentist-patient relationship
- educate Council and committee members about sexual abuse prevention and other patient-focused issues.
This Committee is also responsible for the administration of the funding program for therapy and counselling for patients who have been sexually abused by a dentist.
In addition to the seven statutory committees, RCDSO has several standing committees. While not required by the Act, these committees serve important functions in the operation of the College’s programs and services.
All decisions of the standing committees must be brought to Council for approval by way of formal recommendations to Council. The standing committees have little, if any, discretion or jurisdiction to operate or make decisions independent of Council.
The International Trade Committee assists Council in determining how to ensure that internationally trained dentists have the knowledge, skill and judgement to be easily integrated into Ontario practise to facilitate registration and ensure public protection. The committee provides advice and recommendations to Council on any other matters relating to trade agreements and labour mobility which, in the Committee’s view, may affect the College’s mandate to protect the public interest. The group is comprised of a Chair, the Registrar and no more than three other persons selected by the Executive Committee.
The Audit Committee makes recommendations regarding the appointment and reappointment of auditors and reviews reports from the Director of Finance and Administration. It has the responsibility of reviewing and acting on the College’s annual audited financial statements and presenting to Council the results of any recommendations to Council. It also reviews the per diems of Committee members.
The Elections Committee is made up of three public members of Council. It performs all functions required under the RHPA, as well as any other duties that may be assigned from time to time. Currently, it addresses eligibility of members to run for election. The Committee can also advise Council on the College’s technical compliance with the bylaws about how elections are run.
The Finance, Property and Administration Committee studies and makes recommendations to Council or the Executive Committee regarding the financial and property requirements of the College, prepares and reviews the annual budget and presents it to Council and recommends fees.
The Legal and Legislation Committee drafts amendments to College regulations and bylaws, as directed by the College’s Council and/or Executive Committee. It is composed of both dentists and public members, all of whom are members of the College’s Council.
The Professional Liability Program Committee recommends policy regarding the College’s Professional Liability Program (PLP) and considers issues relating to malpractice protection and claims, including risk management initiatives. It studies and makes recommendations with respect to policies and practices of PLP and, if appropriate, approves claims expenditures for sums in excess of delegated authority.
The Pension Governance Committee oversees the administration of the College’s pension plan, including compliance with legal and financial obligations. The Committee is composed of the President, two elected members of Council and one public member of Council. Its role is to advise Council on how the College meets each of its pension plan’s obligations, the sufficiency of each existing pension plan, the appropriateness of pension plan documents and administrative policies, the performance of each pension plan; and other matters as may be assigned by Council or the Executive Committee.