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Council Highlights

Council Highlights for September 20, 2024

The 444th meeting of the RCDSO Council was held in person at Vantage Venues, 150 King St West, Toronto and via Zoom on Friday, September 20th, 2024. The assembly was also livestreamed. A video recording of the session is available on the College’s YouTube channel.

RCDSO President Dr. Harinder Sandhu began the Council meeting by speaking about Canada’s National Day for Truth and Reconciliation. This commemoration day was recommended by the Truth and Reconciliation Commission and is one way for all of us to acknowledge the painful history and legacy of residential schools. The College is closed on September 30th to contribute to the reconciliation process.

On the subject of the Canadian Dental Care Plan (CDCP), Dr. Sandhu updated Council with Health Canada information. By early September, some 650,000 patients across the country have been seen. Participation by oral health professionals and by dentists is very high. In Ontario, 77 per cent of dentists are seeing patients under the program. Over 225,000 patients in Ontario have been seen. Any new program of this size and scale will have implementation challenges, but the numbers are clear, he noted—more Ontarians are getting the benefit of seeing a dentist. That is good for oral health and for overall health.

Dr. Sandhu expressed his very strong support for the work that has been done on the Standards modernization project. Renewed standards will be posted for consultation. He also underlined the importance of the commitment that the College is making to Equity, Diversity and Inclusion. He acknowledged that Council and the entire profession have a role to play in ensuring that we effectively serve Ontario’s diverse population.

Dr. Sandhu also highlighted the progress of the Procurement Review Group (PRG) in the divestment of Professional Liability Program (PLP). Dr. Sandhu again confirmed that staff, Council and the profession would be kept informed of all key developments.

In his conclusion, Dr. Sandhu highlighted the Governance Committee’s work on Council evaluation. As a critical element of good governance, regular evaluation helps to ensure that Council is meeting its mandate of public protection.

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 Ontario College of Pharmacists (OCP) continues to tackle the issue of commercial ownership of pharmacies and insurance carrier business arrangements that may impact clinical judgement and limit or eliminate patient choice. The OCP is exploring legislative and policy solutions. This is a very important regulatory issue that overlaps with considerations about corporate ownership of dental practices. As part of our strategic plan, RCDSO is exploring existing and emerging dental ownership models. The College will be closely monitoring the OCP’s deliberations and decisions.
  • The Office of the Chief Medical Officer of Health (Ontario) recently created a regulatory table to review Infection Prevention and Control (IPAC) standards for health care environments. A key part of the work will be dissemination to, and implementation by, health care professionals. Our representative to the group is Dr. Helene Goldberg, Team Lead and Senior Dental Consultant, Professional Conduct and Regulatory Affairs.
  • Dr. Noha Gomaa briefed Council on the inaugural Canadian Oral Health Summit, which was held in June Halifax, Nova Scotia. It was launched by the Canadian Faculties of Dentistry, the Canadian Association for Dental Research, the Network for Canadian Oral Health Research and the Institute of Musculoskeletal Health and Arthritis. The conference explored topics related to the health system, research and enhancing patient access to oral health care.
  • The College is currently working with both faculties at Western and Toronto to design remedial course opportunities for groups of dentists which are more effective and efficient than customized program development. The College is also collaborating with Western Schulich Medicine and Dentistry on applications to the Federal Government’s Oral Health Access Fund.
  • On August 7th the Federal Minister of Health, The Honourable Mark Holland, stated that over 75% of all oral health care providers are participating in the CDCP, and this includes approximately 77% of Ontario dentists.
    • The College will continue to work with Health Canada to design an appropriate on-site audit process for dentists.
    • The issue of de-listed dentists—namely some dentists are not permitted to participate in CDCP because they have been de-listed by Sun Life Canada—has been brought to our attention. The Association and the College are trying to gather more information to understand the criteria used by Sun Life and their appeals process. The College does not advocate for any dentist but is seeking clarity on how Sun Life determines “good standing”.
  • With significant feedback from the profession, the RCDSO Portal for dentists has been re-designed. The Portal is a secure site for dentists to renew their certificate of registration, apply for sedation authorization and facility permits, and to update their information with RCDSO. Staff will monitor the experiences of dentists.
  • The College recently made its Complaints Process Information Brochure available in English, French and nine other languages. This is part of our priority to improve the service experience for the public and profession by our commitment to inclusivity and accessibility.

Draft Standards of Practice: Consent to Treatment and Prevention of Boundary Violations and Sexual Abuse

As part of the RCDSO Strategic Plan 2023-2025, the RCDSO is undertaking a significant initiative to modernize and update the College’s guidance for the profession. Both the Practice Advisory Informed Consent Issues Including Communication with Minors and Other Patients Who May Be Incapable of Providing Consent (2007) and the Practice Advisory Prevention of Sexual Abuse and Boundary Violations (2017) are being updated as part of this initiative.

Cameron Thompson, Manager Standards & Strategy, and Shivani Sharma, Senior Policy Analyst, respectively, walked Council through the draft revisions to the two documents.

  • The proposed new Standard of Practice, “Consent to Treatment” includes a number of important updates, including improved definitions, revised guidance, and new requirements. It also reflects RCDSO’s new Standards format.
  • The proposed Standard of Practice, “Prevention of Boundary Violations and Sexual Abuse” updates the College’s current guidance to include improved definitions, revised requirements for the prevention of sexual abuse and boundary violations, and new areas of focus (e.g., managing dual-relationships). The draft is accompanied by case scenarios to further assist registrants in understanding requirements in the Standard

After Council deliberated, it agreed that the two revised standards can be released for broader consultation. To review the documents and provide your input, please see Public Consultations (rcdso.org). Consultations will go live the week of October 7th, and be open for 60 days.

Following the close of the consultation, the drafts will be revised and brought back to Quality Assurance Committee and Council for consideration prior to final approval.

RCDSO Equity Diversity and Inclusion

Equity, Diversity and Inclusion (EDI) is an important lens through which the College looks at its work, policies, and programs in pursuit of effectively serving Ontario’s diverse public.

Michelle Tremblay, Organizational Transformation & College Equity Officer, briefed Council on the College’s history and work on EDI over the past several years. The initiative in the EDI strategic project demonstrates the College’s firm commitment to become an equity-focused, diverse and inclusive organization, actively leading by example to implement change within the organization and in dental regulation. She outlined the substantive progress that has been made since 2023 on the project’s objectives which include:

  • Nurturing a culture at the RCDSO where diverse voices, perspectives, and experience are not only welcome, they are our strength;
  • Establishing and deepen partnerships with Indigenous communities;
  • Building EDI accountability into daily operations and regulatory work;
  • Supporting efforts to improve access to oral health care in Ontario.

Equity work is an ongoing journey of learning, understanding, and action. It will continue long after the 2023-2025 strategic project ends. Staff, Council, and committee members have demonstrated a strong commitment to EDI in both words and actions. This strategic project is laying a foundation for more inclusive practices and equitable innovation across all areas at the RCDSO.

Following Ms. Tremblay’s presentation, Council member, Nizar Ladak, discussed with Council the work that other Health Professional Regulators have done to incorporate EDI into regulatory work. The Health Profession Regulators of Ontario (HPRO) suggests that public commitments to EDI work help drive achievement and accountability. Council discussed and approved an EDI statement for the College.

RCDSO EDI Commitment Statement

The Royal College of Dental Surgeons of Ontario (RCDSO) and its governing Council value and embrace Equity, Diversity, Inclusion and Accessibility (EDIA) as fundamental to our role in ensuring the public has safe, equitable and competent oral health care. We strive to contribute to better experiences and outcomes for the diverse public and communities that we serve.

Every person has value. We have a role to play in addressing systemic barriers and historic as well as ongoing inequities, including harms caused by racism and discrimination.

The College is reviewing its assumptions, policies, and processes to incorporate EDIA in who we are as an employer and regulator. This is a conscious and intentional decision. As an employer, we prioritize and cultivate an inclusive workplace where everyone can bring their best self to work, have meaningful opportunities, and where diverse identities and perspectives are valued. As a regulator, we are responsible for reflecting principles of EDIA in education and registration requirements, developing professional standards, reviewing processes, enhancing continuing education expectations, and holding dentists accountable for concerns brought to us.

This work is never done. We are committed to listening, learning, reflecting, and taking necessary action to improve our work and carry out our regulatory mandate. As part of our 2023-2025 Strategic Plan, the RCDSO has prioritized embedding EDIA into everything that we do. We want real and meaningful change – this will take the collective efforts of staff, Council, committees, and Ontario’s dentists.

This statement is also posted on the RCDSO website here.

Professional Liability Program (PLP) divestment

Council has directed staff to design and deliver a procurement process to transfer 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.

As discussed at the June 2024 Council meeting, it is possible that a transfer to a third party could take place mid-way through the 2025 calendar year. Annual dues paid to the College in the Fall will provide professional liability coverage for the full 2025 calendar year.

PwC, in consultation with the Procurement Review Group and legal counsel, is seeking formal expressions of interest this fall. Successful proposals will move to the second phase of the transaction process.

Council will be provided with a briefing note at a future meeting to consider regulatory amendments to ensure adequate professional liability protection, once the program moves to a third provider. Council will continue to be provided with regular updates over the coming months and the College will continue to communicate developments, as appropriate.

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

Council performance evaluation is a required standard of regulatory performance in the Ontario Ministry of Health’s College Performance Measurement Framework (CPMF). Council performance evaluation enables Council to assess and report on how well it is executing its mandate. In 2021, Council engaged a consulting firm to develop a performance evaluation framework that included self and peer evaluation; overall Council effectiveness; and Committee Chair and President evaluation. The work took place over 2021 and 2022 and included personal feedback sessions.

Council discussed and approved a Council Performance Evaluation Framework for 2024/2025. It will include engaging a third-party vendor to observe Council meetings and assess Council meeting materials and to provide a report with recommendations. It also includes a survey to Council members that incorporates self-evaluation; overall effectiveness; Committee Chair and Council President evaluation; and method for the President to evaluate and provide ongoing feedback to individual Council members.

The third party will report to Council and will facilitate a debrief meeting to discuss results and create a Council level action plan. The evaluation will take place in 2025 after the election process has concluded.

Subject Matter Experts to Discipline and Fitness to Practise Committees

At its June 2024 meeting, Council agreed that the appointment of Subject Matter Experts (SMEs) to the committees would help to manage the current volume. Gillian Slaughter, Director of the Professional Conduct and Regulatory Affairs department, presented proposed by-law changes to allow the appointments to take place. Competencies for SME Adjudicators for both Discipline and Fitness to Practise Committees have been drafted to inform recruitment and appointments.

Council approved the by-law changes to appoint subject matter experts to the Discipline and the Fitness to Practise Committees and to add a provision for their compensation. This will offer Council the flexibility to appoint as many adjudicators as needed. The team will now develop recruitment strategies to reach applicants with the required expertise and competencies.

Next Meeting

The next meeting of Council will be a virtual meeting via Zoom on October 24, 2024, for a half day. The meeting will also be livestreamed.