Council Highlights for June 20, 2024

The 443rd meeting of the RCDSO Council was held via Zoom on Thursday, June 20th, 2024. The meeting was also livestreamed. A video recording of the Council session is available on the College’s YouTube channel.

RCDSO President, Dr. Harinder Sandhu, provided opening remarks by acknowledging Pride Month, where we celebrate the 2SLGBTQ+ community, and also Indigenous History month, where we acknowledge and honor the contributions of First Nations, Inuit and Métis communities.

Dr. Sandhu noted that the Canadian Dental Care Plan (CDCP) eligibility criteria is expanding. On June 27th, Canadians under 18 as well as those with a disability tax certificate can apply to the program. Over 2 million seniors have been approved and are starting to receive care. On July 8th, dentists will no longer need to register and can instead, just direct bill Sun Life. As the federal government has indicated, the program will continue to improve over time. And in the meantime, Dr. Sandhu was pleased to note how many new patients are being seen.

Dr. Sandhu informed Council that he and the Registrar were invited to a meeting earlier this month with the Premier of Ontario and the Ontario Minister of Health. Along with the RCDSO, representatives from the other oral health colleges were there, as well as the Ontario Fairness Commissioner. The Minister and the Premier were open to strategic, coordinated suggestions for how we can collectively expand the number of Ontarians who have good oral health care.

The Procurement Review Group (PRG) is making good progress toward the divestment of the Professional Liability Program (PLP). Dr. Sandhu committed to regular updated on key project milestones to Council, to the profession and to PLP staff.

In his conclusion, Dr. Sandhu highlighted the important work that the Governance Committee has been doing. Since founding, he observed, they have been focused on a thoughtful and researched approach to governance modernization. This work will help Council become better governors in the public interest. 

Registrar & CEO Update

Registrar & CEO Dan Faulkner provided a verbal update to Council on the following subjects:

  • Updates to the regulatory and governance landscape included: 
    • The Heath Profession Regulators of Ontario (HPRO) welcomed Sylvia Jones, Minister of Health, to its annual general meeting. The Minister noted her appreciation for all the work that regulators do and underlined the government’s commitment to access to care, scope of practice and the patient experience. Ontario Fairness Commissioner, Irwin Glasberg, attended the HPRO board meeting to discuss the OFC’s Risk-Informed Compliance Framework for Ontario Health regulators. The RCDSO received a “moderately low” rating based on risks to our fair registration practices introduced by the national third-party examination provider, the National Dental Examining Board. Dan reported that at the annual meeting, he was re-appointed as Chair for a second one-year term.
    • In May, College leadership held its quarterly meeting with the Ontario Ministry of Health and the Fairness Commissioner. RCDSO was able to report that, with our support, the NDEB has been responding and addressing concerns expressed by the OFC and internationally trained dentists about the NDEB’s equivalency process.
  • The Commission on Dental Accreditation for Canada (CDAC) reported on its first year as an independent entity. All the concerns (fair funding formula, modern operations, enhanced transparency) expressed by dental regulators and by the RCDSO will be considered in the coming year.
  • The Association of Canadian Faculties of Dentistry (ACFD) has launched its Gap Assessment and Training Program development with about $8 million in federal funding over three years. This project will be led by dental faculties and will provide an alternative pathway to licensure for internationally trained dentists.
  • The College and the Ontario Dental Association (ODA) meet regularly—and the most recent discussion focused on potential improvements to CDCP; increasing access to care for patients in Ontario; and how our two organizations may work collaboratively to identify supervisors for candidates with the emergency class of registration.
  • The College has completed its fourth annual College Performance Measurement Framework (CPMF) report. We have also developed a summary of the changes over the last four years that were driven by the CPMF process. The reports are available here.
  • College staff attended the Alliance for Healthier Communities Conference and presented a poster on the RCDSO’s strategic project on Access to Care.
  • The RCDSO will host its first in-person Connect session at Western University on June 25th.The session will focus on patient communications and access to care and is open to about 150 people.

Professional Liability Program (PLP) divestment

In 2023, Council directed staff to proceed with exploring the transfer of the Professional Liability Program (including current liabilities and staff) to a third party, with the goal of allowing the program to continue to operate, under separate ownership.

PwC, the RCDSO’s financial advisor, responsible for managing the divestiture process, and the Procurement Review Group (consisting of Council members supported by staff) have been meeting regularly.

Council received an update which noted that flexibility in the transaction closing date would optimize outcomes for the College, current PLP staff as well as the profession.

Although it is possible that a transfer to a new provider could take place at some point during 2025, members’ professional liability coverage will continue for the entire 2025 calendar year.

Council will be provided with regular updates over the coming months and the College will continue to communicate developments, as appropriate.

Today, dentists should continue to contact the PLP. Stability for both patients and dentists is critical during the transition process. Please keep calling PLP and our staff will continue to assist you. New and existing PLP cases will be processed as they always have been.

Governance Committee Updates

Governance Committee Chair Anne Coghlan presented to Council a proposal for three integrated modernization concepts for the 2026 election term: adopting a province-wide election (one district for all registrants); reducing the size of Council from 12 to 10 elected dentists; and implementing staggered terms for Council members. Governance modernization is a priority for the College and is one of the six projects in the strategic plan. 

An Ontario-wide election would help reinforce that dentists elected to Council serve the public at large. It would also allow for greater diversity on Council (beyond geography). It would enable the selection of a slate of candidates who bring a mix of skills, lived experience, and attributes that reflect the diversity of the Ontario public and communities the College serves. Governance modernization initiatives at other Ontario health regulators include province-wide elections. 

Ms. Coghlan outlined the rationale for reducing the size of Council: better communication; more effective decision-making; and developing a culture of inclusiveness. Reducing the number of elected dentists by two further advances the parity of professional (12) to public (11) members and demonstrates RCDSO’s leadership in using existing legislative provisions to achieve governance goals.

The Governance Committee is exploring staggered terms for Council members. This would address the risk of complete or substantial turnover on Council. Staggered terms would support retention of institutional knowledge; continuity; effective transitions and succession planning; and a balance of experience and new perspectives on Council.

Council raised several issues for the Governance Committee’s consideration, including considering longer terms; implementing protocols to maintain geographic diversity; and ensuring sufficient diversity in other attributes.

Council provided the Governance Committee with direction to continue development with the three integrated modernization concepts.

Access to Care Survey Report

Council received a report on the Access to Care consultation that the College held earlier this year. Access to Care is a priority for the College and is one of the six projects in the strategic plan.  From January 30th to April 21st, the profession, the public and other interested parties were invited to provide feedback via an online survey and email. The objective of the consultation was to gather opinions so that the Working Group (Council members, faculty representatives and subject matter experts) supporting this program could consider a diversity of perspectives at the early stages of its deliberations.

The consultation generated significant interest and total of 628 responses were received. There were divergent views on a few key issues (obligations to accept patients who rely on publicly funded programs, balance billing, and making fees affordable), but general support for several concepts/issues explored in the survey (e.g., definition of professionalism, principles/values of professionalism, social contract, CDA duties.)

On the topic of accepting new patients, respondents thought that it would be appropriate to consider the following factors when taking on a new patient: if the person’s needs are within the dentist’s clinical competence and scope of practice; if the dentist has space or time in their practice to take a new patient on; or if the person is in great need of care (e.g., experiencing pain).

The majority of respondents felt that it was important to provide patient-centered care; to take steps to make their practice more accessible for people living with disabilities; and to provide care that is free from discrimination. Dentists raised concerns about the financial viability of practices, given rates of remuneration for some publicly funded programs.

Despite our best efforts to solicit feedback from members of the public, like all colleges, it is easier to hear from the profession than the public. The College has committed to taking further steps to obtain feedback from the public.

Audited Financial Statements 2023

Council heard an update on the College’s Audited Financial Statements for the RCDSO as well as Audited Fund Financial Statements for the RCDSO Pension Fund. Detailed financial commentary was provided, and the financial statements received an unqualified or clean audit opinion. Council also approved the appointment of Tinkham LLP to conduct the RCDSO Audit as well as the RCDSO Pension Fund Audit for the year 2024. Council approved both statements as presented and asked the President to sign an official copy on behalf of Council.

Jeffrey Gullberg, CFO, presented on the College’s Financial Reserves noting that Council had approved a policy in 2020 to ensure that the policy was reviewed by an auditor; that there were two reserve funds (Operating Reserve and PLP Reserve); and funding of new reserves must be approved by Council.

Reserves help enhance long-term stability and provide for unforeseen events and are required by the Ministry of Health’s College Performance Measurement Framework. The target for a fully funded reserve, based on 2023 Financial Statements, is $7 million. Council approved the transfer of $2 million of the 2023 surplus to the Operating Reserve to help make progress toward the goal of fully funding by the end of 2025.

Subject Matter Experts to Discipline Committee

Gillian Slaughter, Director of the Professional Conduct and Regulatory Affairs department, reported to Council that the Discipline Committee has been experiencing a much larger number of referrals to the Discipline Committee than has been seen in the College’s history. Other health care regulators have managed this challenge by making changes to their Discipline Committees or processes.

Council agreed that the appointment of Subject Matter Experts (SMEs) to the Discipline Committee would help to manage the current volume. The SMEs would, at the request of the Committee Chair, chair discipline panels; write or assist in panel decisions; and provide training and orientation. Proposed by-law changes will come to Council at its September meeting.

Next Meeting

The next meeting of Council will be a hybrid meeting on Friday, September 20, 2024, for a full day. We will host the meeting at Vantage Venues, 150 King St West, Toronto as well as on Zoom. The meeting will also be livestreamed.