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Council Highlights

Council highlights for June 15, 2023

The 437th Council meeting of the RCDSO was a virtual meeting held via Zoom on Thursday, June 15th, 2023. The meeting was also livestreamed; a video recording of the Council session will be available on the College’s YouTube channel.

RCDSO President Harinder Sandhu provided opening remarks underlining three very significant issues on the Council agenda: governance modernization, standards of practice work, and the RCDSO's regulation amendment creating a new emergency class certificate of registration.

Dr. Sandhu emphasized the need for Council to engage in continual work of governance improvement. Providing this level of attention will ensure we are serving the public interest to the best of our abilities with the most current thinking about how our profession is governed. Dr. Sandhu reported that we have heard from members of the profession; from the public; and from Council about various standards that need to be updated and developed. At his request, staff developed a proposal for additional contract staff to fast-track this work. Finally, Dr. Sandhu highlighted establishment of a working group to help with the potential implementation of the emergency class certificate of registration.

Dr. Sandhu noted that he has recently spoken at graduation events at the University of Toronto and at Western to underline the role as a College in new dentists’ professional lives. He delivered remarks to the ODA General Council on April 28th about many key topics including the strategic plan, COVID guidance standards and Council governance.

Governance Modernization

Council heard a presentation on Governance reform from the leaders of the Ontario College of Pharmacists (OCP), Shenda Tanchak, OCP Registrar & CEO and James Morrison, OCP Board Chair. The OCP engaged in a journey of modernization over a number of years, which included competency-based elections; reducing the number of elected members on the Council/Board; and eliminating district-based elections.

The presentation from OCP helped to set the context for the proposal to formally establish a Governance Committee of Council. The Government of Ontario’s vision for governance and regulatory reform includes establishing a “Nomination and Selection Committee” to oversee the selection of Council and committee members. Governance is also a critical input for regulatory performance and the Ontario Ministry of Health’s College Performance Measurement Framework (CPMF).

Council had previously established a Governance Working Group to develop sound governance practices and to support effective decision-making in the public interest. In 2022, given the changing landscape of regulatory governance, as outlined in the OCP presentation, Council requested the development and establishment of a permanent governance committee.

The new Committee will be the central governance body to review proposals for additional governance reform, and make strategic recommendations to Council regarding governance modernization initiatives in preparation for the 2024 Council district elections cycle.

The Governance Committee has now been approved as a standing committee of Council and will include the following composition: 

  • Two (2) professional members of Council;
  • two (2) public members of Council; and
  • at least two (2) individuals external to the College with regulatory and governance expertise.

Emergency Class Certificate of Registration

As noted at the April Council meeting, the Ontario Ministry of Health is requiring all of Ontario’s 26 health regulatory colleges to develop a new emergency class certificate of registration, which is designed for expedited registration of dentists to swiftly address an emergency. 

The proposed regulation amendment creates a new class of licensure – a term-limited emergency certificate of registration. The class of registration will only be open for applications if the government requests that the RCDSO open this class, or if Council decides that it is in the public interest to do so.

Since Council approved the draft regulation for submission to the Ministry, a summary of consultation feedback has been posted.

The College has established a working group comprised of the Chairs of the Registration and Quality Assurance Committees and public members of Council. The Working Group will focus on the development of supervision standards as well as identify the tools that are needed to ensure effective and responsible implementation, should the government or Council ever need to invoke the emergency provision.

It is expected that the regulation amendments for all RHPA colleges will be approved by government by the end of August 2023. 

Registrar & CEO Update

Registrar & CEO Dan Faulkner updated Council on several items:

  • A newly developed operational dashboard tool that will track key metrics from College operations which will be provided to Council at each meeting. Key metrics reported this meeting:
    • Since January 2023, the College has met the regulated times for registration application processing. (The requirement is less than 15 days). We have also met the requirement for application decision-making, the average being less than 7 days (The requirement is less than 15 days.)
    • The Facilities Inspection Program (FIP) has been phasing out provisional CT facility permits since 2020. Only 2 remain, which is a decrease of 97% from October 2022.
    • Professional Conduct and Regulatory Affairs (PCRA) has seen a 21% decrease in open case files compared to April 2022. Considerable work has gone into addressing the backlog. At April Council, 20% of open case files were from 2019-2021 and by June, 14% are from 2019-2021.
  • Council recently completed a series of orientation sessions to build foundational knowledge about the duties and responsibilities of a Council member including our regulatory responsibilities. On May 26th, the College participated in a joint Council training session with over 70 Council members and senior staff from all four oral health Colleges (Denturists, Dental Hygienists, Dental Technologists, Dentists). First Peoples Group provided the training and focused on First Nations, Inuit and Métis history and culture; as well as calls to action from the Truth and Reconciliation Commission.

  • The Government of Ontario recently passed Bill 60, An Act to amend and enact various Acts with respect to the health system (Your Health Act). Bill 60 amends profession-specific acts of medicine, nursing, medical laboratory technologists and respiratory therapists. This may permit out-of-province practitioners from the four professions to practice in Ontario without first registering with their respective College (known as the ‘As of Right’ legislation). The Bill does not impact the RCDSO at this time and regulations are in development by the Ministry of Health.

  • The first phase of a refreshed e-Portfolio will be launched shortly, where dentists can enter their CE credits and monitor their progress toward CE requirements. This is one of our ongoing modernization efforts which will eventually include automated messaging when new standards are available (for example).

  • The RCDSO has signed a Memorandum of Understanding (MOU) with the National Dental Examining Board of Canada (NDEB). The agreement aims to ensure that assessments are fair, transparent, impartial and objective.

  • As June is Pride Month, the College is hosting a workshop for staff on June 23rd with the Get Real Movement, a Canadian non-profit focused on building 2SLGBTQ+ awareness and empathy.

National Dental Examining Board (NDEB)

Council heard a presentation from Dr. Marie Dagenais, NDEB Executive Director & Registrar. Dr. Dagenais walked Council through the national examination process that her organization oversees. 

Created in 1952 by act of Parliament, the NDEB’s purposes is to support quality dental care across the country to help ensure that every patient sees a dentist who has met the rigorous national standard. They do this by establishing a fair and reliable standard of competence for certification.

The NDEB has experienced numerous challenges since the beginning of the pandemic. It is regularly reacting and responding to external stakeholders concerned about fairness of exams, pass rates and access for internationally trained dentists.

In dentistry, regulators are sustaining consistent licensure standards across all provincial and territorial jurisdictions, and are supporting a progressive and responsive national examination body (NDEB), accountable for equivalency and certification processes.

Standards of Practice

RCDSO’s Policy Team is implementing process improvements to enhance and modernize the College’s Standards of Practice and other resources. This work is part of the 2023-2025 Strategic Plan and will help us comply with the Ministry of Health College Performance Measurement Framework (CPMF). With over 25 Standards of Practice, Guidelines and Practice Advisories and related supporting documents, prioritization is essential. Council reviewed a transparent, risk-based approach to setting priorities and managing capacity which was designed to be responsive to emerging issues. Its purpose is to help determine which documents are most in need of updating based on (among other factors) patient risk, organizational risk, age of document, frequency of inquiries to the College, strategic considerations, errors and omissions. Work on modernizing standards is ongoing and essential to RCDSO’s regulatory responsibilities.

COVID-19 Guidance

Public health indicators for COVID case counts continue to improve and some health agencies have signaled the end of the emergency phase of the disease. Dentists have also been inquiring as to their ongoing obligations. Since substantially revising guidance in 2022, RCDSO staff along with staff dentists are now taking a renewed look at the College’s evidence-based guidance for in-person care. This work is presently underway and the College will keep the profession posted on developments.

Standard Consultation: Virtual Care (Teledentistry)

In 2019, the College (and the Quality Assurance Committee (QAC)) established a Working Group to develop a Standard of Practice on Teledentistry to set out dentists’ legal, professional, and ethical obligations when using technology to deliver dental care remotely.

The Working Group’s work on the draft Teledentistry Standard, including the draft positions they developed, helped inform the development of RCDSO’s COVID-19: Guidance for the Use of Teledentistry in 2020.

A revised Standard of Practice for Virtual Care has been drafted which sets out the legal, professional, and ethical obligations that Ontario dentists must adhere to when providing virtual care for the purpose of ensuring the delivery of safe, effective, and quality dental care that is in the patient’s best interest. It includes requirements for obtaining consent; ensuring the appropriate technology; and protecting privacy and confidentiality of the patients personal health information. This standard will help to ensure dentists can access and implement the latest clinical and professional best practices to support the provision of quality care to patients.

As a next step, Council has approved an external consultation on the draft Standard. The draft Standard and FAQs will be posted on the RCDSO’s Public Consultation webpage  and circulated to all interested parties. The Working Group will consider the feedback and propose revisions to the draft Standard and FAQs for the QAC’s and Council’s consideration at a future meeting.

Audited Financial Statements 2022

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. The College’s financial results for 2022 exceeded budget by more than $500,000 and improved on 2021 results by $1.7 million.

Detailed financial commentary was provided, and it is important to note that the auditor provided an unqualified opinion, also known as a clean audit, for both statements. Council approved both statements as presented and asked the President to sign an official copy on behalf of Council.

Based on noted experience and recommendation by the Finance, Audit & Risk Committee, Council approved the appointment of Tinkham LLP to conduct the RCDSO Audit, and the RCDSO Pension Fund Audit for the year 2023.

Next Meeting

The next meeting of Council will be hybrid and is scheduled for Thursday, September 21th, 2023. For those attending in person, Council will gather in Toronto and the meeting will also be livestreamed.