Phase 2 Transparency By-Law Consultation
Request for Feedback on Proposed Changes to the College’s By-laws
(Part 18 – Register)
The College Council is considering making more information about optometrists available to the public to help them make informed decisions about their health care. We are responding to the increased requests for transparency and accountability in professional regulation.
We are proposing amendments to Part 18 – Register of the General By-Laws, which set out what information about optometrists is included on the public register.
We are now asking for your comments on the proposed by-law changes. Some of these are related to the Inquiries, Complaints and Reports Committee (ICRC) outcomes of investigations into complaints and registrar’s reports; others are related to the information that is generated through other processes, such as the judicial system (federal, provincial, and other offence charges relevant to the optometrist’s suitability to practise) or regulatory authorities in other jurisdictions.
In particular, we are proposing that the following information about optometrists be included on the public register:
- Verbal cautions [S. 18.03 (23)]
- Specified Continuing Education or Remediation Programs (SCERPs) [S. 18.03 (24)]
- Undertakings [S. 18.03 (25)]
- Current provincial, federal, and other offence charges relevant to suitability to practise [S. 18.03 (13)]
- Current licences in other jurisdictions [S. 18.03 (6)]
- Discipline findings and incapacity findings in other jurisdictions relevant to suitability to practise [S. 18.03 (32)]
- Pending findings of professional misconduct or incapacity allegations in other jurisdictions relevant to suitability to practise [S. 18.03 (31)]
These proposed changes are a result of our participation in the Advisory Group for Regulatory Excellence (AGRE) with five other regulatory colleges (Physicians and Surgeons, Nurses, Dentists, Pharmacists, and Physiotherapists). The importance of the Transparency Project has also been acknowledged by the Minister of Health and Long-Term Care.
AGRE developed a set of transparency principles (approved by Council in 2013) to guide the decision-making process in the Transparency Project. These principles continue to inform all recommendations presented to college councils.
Question: Can you explain the changes to me in a simple way?
Here is a brief overview of the proposed changes. What is being proposed?
Question: When will these changes take effect? Will they be retroactive?
The proposed changes are expected to take effect for all complaints/registrar’s reports received by the College on or after October 1, 2015. The changes will not be retroactive. Information about current provincial, federal, and other offence charges that were laid out before this date and relevant to the optometrist’s suitability to practise will be posted.
A verbal caution (caution-in-person) is one of the most serious outcomes of a complaint or a registrar’s report investigation available to the Inquiries, Complaints and Reports Committee (ICRC), unless it decides to refer specified allegations of professional misconduct/ incompetence to the Discipline Committee. A verbal caution is issued when there is a significant concern about an optometrist’s conduct or practice that can have a direct impact on patient care, safety, or the public interest if it is not addressed.
Specified Continuing Education or Remediation Program (SCERP)
The ICRC may order a SCERP when a serious care or conduct concern has been identified requiring an optometrist to upgrade his or her skills. SCERPS are ordered in those instances when the ICRC believes that remediation is necessary.
An undertaking is a voluntary agreement between the College and an optometrist, which becomes binding once signed. It may include a number of different activities (coaching, continuing education seminars, etc.) to be completed by the optometrist in an effort to improve his/her practice. On occasion it may also include practice restrictions. A breach of a signed undertaking is considered an act of professional misconduct.
A summary of the complaint/registrar’s report and the disposition (verbal caution, SCERP, or undertaking) will be posted on the public register once the optometrist has received the decision, but no later than 10 days after the decision has been issued. Where applicable, a notation that it is subject to review will be posted. The disposition will remain on the public register unless it is overturned on appeal. The information may be removed if:
- more than three years have passed since the information was prepared or last updated; and
- the optometrist has made an application to the Registrar for the removal of the information from public access; and
- the Registrar is satisfied that the optometrist successfully fulfilled his or her obligations set out in the ICRC’s decision and that the information in the register is no longer relevant to his/her suitability to practise; and
- the information does not relate to sexual abuse.
Federal/provincial and other offence charges
The proposed by-law contemplates that all current federal, provincial, or other offence charges, which the Registrar believes are relevant to the optometrist’s suitability to practise, will be posted on the public register when they are known to the College. Information will include the fact and content of the charge and the place and date of the charge (where known).
Known licences in other jurisdictions
The proposed by-law will permit the College to post the notation of the fact that an optometrist is currently registered or licenced with a regulatory body to practise any profession, inside or outside of Ontario.
Known regulatory findings (including pending allegations) in other jurisdictions
The proposed by-law will permit the College to post information when an optometrist has been the subject of a finding (including pending allegations) by another regulatory body and that finding is relevant to the optometrist’s suitability to practise optometry in Ontario and is known to the College. The information may include pending allegations of professional misconduct, incompetence or incapacity, findings of professional misconduct or incompetence, or findings of incapacity, if relevant to the optometrist’s suitability to practise optometry in Ontario.
Read the full by-laws proposal.
To help you understand the changes we are proposing and the reasons behind them, here are some answers to common questions you might have.
Why is the College proposing these changes?
The College is not alone in proposing these changes. The Minister of Health and Long-Term Care (“Minister”) has asked all regulatory health colleges to move toward increased transparency. All colleges are in different stages of the Transparency Project; some of them have already approved similar Phase 2 transparency by-law changes.
Can we put a time limit on how long the information remains on the public register?
The current proposal does not include an automatic removal of information. By default, the information will remain on the register. There is a process to request removal of the ICRC disposition information three years after the information was posted, provided that certain criteria have been met. In addition, if any other information is obsolete and no longer relevant to the optometrist’s suitability to practise, the Registrar may decide to remove it. Any such requests will be considered by the Registrar on a case-by-case basis.
Why were verbal caution, SCERP, and undertaking dispositions singled out to be published?
In determining which ICRC outcomes should be made public, the Advisory Group on Regulatory Excellence (AGRE), of which the College is a member, used a risk assessment model (including no risk, low risk, moderate risk, and high risk). AGRE feels that the greater the potential risk to the public, the more important transparency becomes. Outcomes such as SCERPs, undertakings, and verbal cautions are reflective of moderate risk to the public in a particular matter. When these outcomes are known to the public, this allows them to make informed decisions about their health care. The ability of patients to make informed decisions about their health care is central to the Minister’s push for transparency in regulated health professions. Outcomes reflective of high risk to the public (such as referrals to Discipline) are already public information.
Is there information that will not be made public?
The outcomes of complaint and registrar’s report investigations that find no concerns with the optometrist’s care or conduct, or find concerns of a minor nature that are of low risk to the public, including “no action,” “advice/recommendation,” or “remedial agreement” outcomes will not be made public.
Why can’t this information be limited to patients who request it?
Providing information only if a member of the public requests it is a barrier to access to information. The College believes that if the information is public, it should reside on the public register.
The College invites and welcomes your input on these proposed by-law changes. Council will carefully consider all comments received before making final decisions and enacting these by-laws.
Please note: The consultation period has ended. Thank you for your feedback.
College of Optometrists of Ontario
65 St. Clair Ave. E., Suite 900
Toronto ON M4T 2Y3
Deadline for comments is Friday, August 28, 2015.