Brian O'Riordan, Registrar

Brian O’Riordan
Registrar

One of the major tasks for any regulatory College is to make the public aware of its role in public protection and to ensure they realize the value of seeing a self-regulated professional.  This is part of why the Minister of Health and Long-Term Care, the Hon. Dr. Eric Hoskins, has been placing such major emphasis over the last two years on Colleges being more transparent about their processes and the information they collect and maintain.

What We Did to increase public awareness; Guided by Public Poll Findings
CASLPO has developed a public awareness campaign aimed at patients that use audiologist and speech-language services, emphasizing the importance of regulation and the overall role of the College. Based on public opinion survey feedback, videos and brochures were developed to reach a target audience of Ontario patients and caregivers, including school age children and seniors. The following indicates what was developed, implemented and what is planned to raise awareness of CASLPO and our members:

All members are reminded of the opportunity to use the new and existing resources to educate your patients on the advantages of regulation.

What's New?

New - Brochure in 8 Languages 

To access, click here.

New - 8 Short Videos; CHCH-TV Segment 

To view the videos addressing answers to questions about access to audiology and speech-language services and the importance of seeing a professional regulated by CASLPO, click here.

May 2017:  Re-launching the Initial Campaign

90-second video - Medical Office Screens:
Will be played in approximately 50 medical offices in May and September 2017 with a guaranteed reach of 250,000 impressions per month.

Two 30-second videos - Facebook Posts:
Will be amplified through Facebook sponsored video posts in May and September 2017. The Facebook campaign is projected to receive 75,000 views per month.

Best Health Magazine – Brochure Distribution:
Best Health Magazine's demographic is aligned with CASLPO's target audience.  CASLPO's new brochure will be printed and inserted in May and September 2017 in Ontario. Best Health is Canada's premier health and wellness magazine. To view brochure, click here.

What We Did in 2016

90-second video - Medical Office Screens
Was played in approximately 50 medical offices for two months, in May and October 2016 reaching our target audience. Reached 250,000 impressions per month. 

Two 30-second videos - Facebook Posts:
Were amplified through Facebook sponsored video posts in May and October 2016. The Facebook campaign received 80K+ views per month.

New CASLPO Brochure – Medical Offices
The new Brochure designed to complement the new motion graphics video was distributed in 68 Doctor offices across Ontario. To view brochure, click here.

eBadge: Members can insert the eBadge and video link and display it in their eMail signatures for communication with patients, colleagues and other health practitioners. Instructions for the email application are accessible on CASLPO's website, click here.

Communicatively Accessible Resources, Provides regulatory information for people living with communication barriers. click here

Expected Outcome:

The public will become more confident in their care. More of the targeted public audience will be made aware of CASLPO and its role, learn about what the College can do for them and appreciate the advantages of accessing a regulated health professional.

Enjoy ex•press issue 6!

Carol Bock, Deputy Registrar

Carol Bock
Deputy Registrar

Here's what happened at the September 23 and December 9, 2016 Council meetings:

For the Public

• Council reviewed the latest public awareness product which is a 7 minute educational health and wellness segment developed for CHCH-TV's "We Mean Business", which can be viewed here.
• The Annual Report, 2015 was approved for distribution and can be viewed here.

For the Members

• Council approved the publication of 2 practice documents, both found in "Resources" on the College website:
  • Practice Standards For the Provision of Hearing Aid Services By Audiologists, and
  • Guide For Service Delivery Across Diverse Cultures

National Initiatives

• The national regulators organization, Canadian Alliance of Audiology and Speech-Language Pathology Regulators (CAASPR), announced that they have just received federal funding of $1.3 million from the Government of Canada to complete the national projects relating to registering to practice in Canada.

Governance

• Committee compositions were determined for the coming year (fall 2016 to summer 2017) and can be found here.
• Council adopted a series of policies and procedures that will reflect the strong values both Council and staff hold regarding Respect in the College. 
• Council also adopted the first College governance manual, CASLPO's Guide to Governance: Principles and Practices, accessible here.
• The first year of CASLPO's 2015-2018 strategic plan was reviewed and Council approved continuation without any substantial changes to the plan. You can view the 2015-2018 plan here.

Finances

• The budget for 2016/2017 was reviewed and approved. The details can be found in the Council materials for the September 23rd meeting (page 92).
• Blair MacKenzie, Managing Partner, Hilborn, presented to Council his review of CASLPO's audit 2015-16, which was "clean".  The details can be found in the Council materials for the December 9th meeting (page 129).

Celebrating Service to CASLPO

Council recognized the dedicated services to the College of Mary Suddick, by placing her on the CASLPO Honour Roll, and Ferne Dezenhouse by awarding her Honourary Membership.

Formal presentations were made at the September 29, 2016 Council meeting to past Council Members, Mary Suddick, professional member (SLP) and Ferne Dezenhouse (Public Member) for their significant years of service.

Mary Suddick was presented with a certificate honouring her appointment to the Honour Roll of the College "in recognition of outstanding contributions to furthering the mission of the College and fulfilling its mandate and objects relating to the regulation of the professions of audiology and speech-language pathology in Ontario, in the public interest".

Mary Suddick, of Markham, has worked as a speech-language pathologist since 1978.  She started her career at York County Hospital in Newmarket.   She began working at the Scarborough Board of Education in 1980 and continues to work there since amalgamation with the Toronto District School Board.    Privately, Mary works with preschool and school age children.  Mary has a bachelors degree in psychology from the University of Toronto and a master's degree in speech-language pathology from Clarion University of Pennsylvania.  Mary served as a member of Council from 1994 – 2003 and again from 2006 to 2015.  During her two terms on Council, Mary served on and/or chaired many committees, including Executive, Registration, SLP Practice Advisory, Quality Assurance and Discipline.  She represented District 2 (Greater Toronto) for a combined total of 18 years.  She also was an active member of OSLA.

Ferne Dezenhouse was presented with a certificate granting her "Honourary Membership" in the College "in recognition of outstanding contributions to furthering the mission of the College and fulfilling its mandate and objects relating to the regulation of the professions of audiology and speech-language pathology in Ontario, in the public interest".

Ferne Dezenhouse, of Toronto, is a former Health Care Sciences Lecturer at the Career Development Institute, Addiction Worker Program.  Ferne taught addictions and mental health courses to individuals seeking employment in the addictions field.  Prior to this, she was a Social Worker at Toronto Grace Hospital and a Community Program Consultant at the Ontario Substance Abuse Bureau, Ministry of Health.  Ferne currently operates a private part-time counselling practice for families, couples and individuals that she established in 1977.  Most importantly, from the College's point of view, Ferne served 4 terms as a Public Member of Council, from 2006 to 2016, the most of any Public Member.  She served on the Executive Committee, the Practice Advisory Committees and just about every other Committee, including Discipline, which she chaired.

Please join the College in congratulating both Mary and Ferne on these significant accomplishments!                    

Remember, all Council meetings are open to the public, which includes you!

Click here for upcoming dates, instructions for attendance and past meeting information.

Annual Election is Approaching – Now Is the Time to Think About Becoming Involved

Watch for the ‘Call for Nominations Notice to all Professional Members’ via email this March in advance of the May 2017 election.  Four seats, two races; District 1 (Eastern) and District 3 (South-West). 

Take advantage of the professionally rewarding opportunity to participate.  Click here for details.

Brian O'Riordan
Registrar

Just before the end of last year, the government at Queen's Park introduced an important piece of legislation, Bill 87, which makes significant amendments to the Regulated Health Professions Act (RHPA).  The RHPA is the framework legislation for all self-regulated health professionals in the province.

Bill 87 is part of the Government's response to the Sexual Abuse Task Force Report released last summer.  As expected, the bill provides expanded grounds for mandatory revocation of a professional's license in cases of sexual abuse/touching.  As well, the Minister can now make specific changes to a regulatory College's complaint and discipline committees in the areas of composition, procedure and other functions and duties.  More support for sexual abuse complainants must be provided by Colleges and gender-based restrictions on a member's practice are no longer to be allowed.

The Minister will also now have the power to define the term "patient" for purposes of sexual abuse cases.  Former patients of a practitioner are covered by the amendments for a period of at least one year after treatment has been ended.

As expected, the Bill contains transparency revisions with respect to information about members on a College's Public Register.  CASLPO is already publishing such information.  There are also new requirements concerning openness with respect to meetings of College Councils.  Again, CASLPO already posts notices of meetings, agendas and meeting materials.

The Council of CASLPO will be discussing Bill 87 at its meeting on March 3, and will be part of the submission on the Bill by the Federation of Health Regulatory Colleges of Ontario (FHRCO).

It is expected that Bill 87 will receive Second Reading approval by the provincial Legislature and then be referred to a standing committee for public hearings.  The Bill could be approved by late spring or early summer.

The Provision of Hearing Aid Services by Audiologists

Carol Bock, Deputy Registrar and Alex Carling, Director of Professional Practice and Quality Assurance

You may notice from the title that this document is different from our other “PSGs”. It contains only standards. Guidelines have not been included.   As we move forward, CASLPO will be developing documents that comprise what you want most: the standards. Have a look at the Practice Standards for the Provision of Hearing Aid by Audiologists to see what we mean.

The new Practice Standard reflects members’ current practice environments and replaces:

• the Preferred Practice Guideline (PPG) for The Prescription of Hearing Aids to Children
• the PPG for the Prescription of Hearing Aids to Adults and;
• The PPG for Ear Impressions.

The most significant change to the practice standard is the new definition of hearing aid prescription. In 2013 the College sought a legal opinion on CASLPO’s definition of hearing aid prescription to ensure it is in keeping with the intention of the Regulated Health Professions Act (RHPA).The legal opinion led CASLPO to clearly distinguish and define the following:

1) Prescribing
2) Prescription
3) Dispensing
4) Fitting

Although this document was developed by the Audiology Practice Advisory Committee with contributions from audiology members, speech language pathology members may also benefit from reviewing the new Practice Standard.

For this Practice Advice article we have included the FAQs from the Practice Standard.  They address many clinical scenarios and the answers relate to the Practice Standard or other CASLPO documents.

FREQUENTLY ASKED QUESTIONS

QUESTION 1:

I recently assessed a developmentally delayed child and was unable to complete a standard audiological assessment. Consequently, I do not have an audiogram but I do have other audiometric information that I feel allows me to prescribe a hearing aid.
Can I generate a “prescription” and if so, what do I include in it?

ANSWER 1:

Yes, you can generate a prescription. The requirements of a prescription allow for those situations in which, for a variety of reasons, you may have incomplete data. However, you must provide further information such as,

“… other appropriate data from the assessment required for dispensing (e.g. RECD, electrophysiological data) along with any necessary patient-specific information (e.g. unreliable respondent, auditory neuropathy spectrum disorder) from the assessment that would be required for dispensing.”

In the above scenario, you would provide information regarding the factors that prevented you from obtaining complete data, along with the audiological information that you used to generate the prescription.

QUESTION 2:

What is considered to be a “reasonable effort” in relationship to socio-cultural factors?

I have had some patients whose attire presented a challenge when attempting to accomplish some of the tasks, such as using the headphones, inserting the earmolds, etc. In order to respect my patient’s religious expressions that their attire represents should I forego some of these procedures?

ANSWER 2:

It is important that you always provide an effective, quality service and at the same time be responsive to your patient. In instances where you may adapt your tasks or materials without undue cost or time, you should make that effort. If there are no adaptations available, or you would need to go to unreasonable lengths to create new materials or approaches for your clinical tasks, then it is advisable that you discuss with the patient what the options are, and what the impact of the choices may be. If the patient decides that they will not remove the particular attire so that you may complete the tasks and procedures, that decision must be respected. If you end up deviating from the standard as a result of your discussions with the patient, then be sure to document what you discussed and why and how you deviated from the standard.

Guide for Service Delivery Across Diverse Cultures
Guide sur la Prestation de Services Adaptés à la Culture

QUESTION 3:

I have recently had a patient return to me with their hearing aids, which they have been wearing for approximately 2 weeks. I had provided the original prescription but did not dispense the hearing aids. Instead, the patient went to a dispenser closer to their home. The patient cannot remember where or with whom they worked, but they reported that the person did “check to see if the hearing aid was working as expected”.
Can I rely on this report and assume that verification has occurred?

ANSWER 3:

When you are confident that the verification has been conducted according to the standards outlined in the document (e.g. when a member or another health care professional who you know is competent to provide verification has conducted the process), you are not required to repeat this process. However, if you are not confident that the verification process has been conducted appropriately, then you must complete that process to your satisfaction.

QUESTION 4:

I frequently see patients with hearing profiles that suggest there is a possibility of an underlying neurological condition, for example a sudden onset of hearing loss. I realize I am required to refer them to the appropriate professional, which would either be an otolaryngologist or a neurologist, however, I am unable to make direct referrals to specialist physicians within the Ontario health care framework. Does this potentially put me in a position of professional misconduct because I am not meeting the Standard E4 in this document?

ANSWER 4:

No, you would not be in a position of professional misconduct because you are unable to make a direct referral to a specialist. You cannot be held responsible for the framework of the Ontario health care system, which prevents you from making direct referrals to specialists. You are however, responsible for working within the framework to facilitate such a referral. This may be achieved by referring your patient to their family physician with the recommendation and rationale for requesting that the family physician make such a referral.

QUESTION 5:

My employer, who is not a member of CASLPO, has set a policy whereby the audiologists are prohibited from providing the patient with a prescription. The rationale is that the company will lose the opportunity to sell the patient a hearing aid if needed. This makes sense from the business perspective, as the company does not charge for the entire assessment so if the patient takes the prescription and purchases the hearing aids elsewhere, my employer has invested manpower resources, but loses the opportunity to recuperate the investment. Can I abide by this policy?

ANSWER 5:

Employers may set their own requirements for their employees, however, you still must adhere to the minimum standards set by CASLPO. If you are developing the prescription, it

“… must communicate the necessary information in order to direct the accurate dispensing and fitting of the intended hearing aids.” (Standard H4).

Furthermore, if you are communicating this information to a third party (e.g. the patient would like to purchase the hearing aid elsewhere and/or the patient wants the prescription), then the prescription also must be in a consolidated format and include the following additional information:

• member’s name
• member’s contact information
• member’s CASLPO registration number
•  member’s signature

It is expected that you would inform your employer of the standards you must meet and establish a method by which you can do so. CASLPO is happy to support you in these efforts.

QUESTION 6:

I work for a hospital where I provide hearing assessments and prescriptions but do not dispense the hearing aids. I realize I must provide the third party who is dispensing the hearing aids an accessible, consolidated hearing aid prescription. In situations where I feel it is imperative that the patient come back to me for the fitting and verification, can I ask the audiologist who is dispensing to not fit the hearing aids?

ANSWER 6:

You may wish to convey to your patient to return to you and you may request the audiologist dispensing the hearing aids to convey to the patient that they should return to you. Ultimately, it is the patient’s choice as to what they will do. In order to mitigate risk and to ensure quality care, the College requires any audiologist who is dispensing the hearing aids to adhere to the standards of practice set out in this document.

Specifically, those related to dispensing hearing aids include but are not limited to the following:

Standard H8: Audiologists must ensure that the physical fit of the hearing aids is appropriate.

Standard H9: Audiologists dispensing and fitting hearing aids must ensure that the hearing aids are programmed using a fitting formula or approach that is appropriate for the patient.

Standard H11: Audiologists must take reasonable steps to verify the hearing aid settings.

Standard H14: Audiologists must inform the patient regarding the importance of verification and validation and make reasonable efforts to ensure they make arrangements to do so.

It should also be noted that if in the process of dispensing the audiologist feels it is appropriate to change the prescription, then it is also a requirement that they make reasonable efforts to contact you to discuss the changes and determine if the changes are in the best interests of the patient.

QUESTION 7:

My patients routinely access third party funding to assist with the costs of their hearing aids. Many of these funders, such as the Assistive Device Program (ADP) and the Workplace Safety and Insurance Board (WSIB), have requirements that differ from the College requirements. Which set of requirements must I meet?

ANSWER 7:

The simple answer is you must always meet the standards set out by the College. If the funding body has additional standards, then in order for your patient to receive the funding, you must also meet those standards. However, sometimes, the funder has requirements that fall short of the College’s. For example, an ADP application form, in and of itself, fails to satisfy the College’s requirements for a prescription. Similarly, WSIB has a validation questionnaire that may not address all the areas this document identifies when completing the process of validation. It is expected that audiologists will apply their professional knowledge, skill and judgement to determine the gaps between any third party funder’s requirements and the College requirements and ensure, first and foremost, that they meet all the College requirements.

QUESTION 8:

Recently, I have noticed that certain products I have used for many years have new labels indicating “single use”, although nothing else appears to be different about the product. Up until this time, I have applied rigorous disinfection procedures so that I can reuse them. Must I now dispose of these items after each use, even if I am reusing them with the same patient?

ANSWER 8:

When manufacturers’ specifications indicate “single use”, generally, you should not disinfect for reuse, regardless of whether it is with the same or different patients. The manufacturer may have a variety of reasons for applying the “single use” label. For example, they may have changed the physical properties in such a manner that disinfection is no longer effective. If you are considering reusing any items that are labelled “single use”, you must exercise extreme caution. It is your professional responsibility to determine if your disinfection procedures are effective for a particular product in a particular situation and you must be prepared to justify that decision with current, concrete evidence. Typically, this is very difficult to achieve so we recommend not reusing single use items.

QUESTION 9:

I work in a clinic in which there are several audiologists and we occasionally will share patient interventions due to scheduling needs, absences, etc. How do I know if the previous audiologist has completed the prescribing process?

ANSWER 9:

Regardless of whether patient records are shared or not, all members are required to ensure the patient record is complete and accurate. Further, the definition of a prescription speaks to documentation (see page 20):

“The documented directive, given by an audiologist, specifying the hearing aid to be dispensed to an individual.”

Therefore, it is incumbent upon any audiologist who has completed the prescribing process to document that in some manner in the patient record. The documentation may be as simple as “Prescribed XX hearing aids. See details in record”. If there is no documented directive, the audiologist must apply their professional judgement. They must consider the given information in the patient record, determine if they are able to provide a prescription and document this in the patient record.

QUESTION 10:

My patient has a limited budget for hearing aids but based on my assessment of needs, the hearing aids I would recommend are beyond the patient’s ability to pay. Do I recommend a product that I do not believe is ideal in order to accommodate the financial constraints?

ANSWER 10:

Determining the patient’s needs includes considering their financial situation. In fact, one of the required competencies for prescribing is the demonstration of the knowledge, skill, and judgement in order to:

“Map the patient’s hearing and/or communication needs to the level of technology that would best meet the goals given the patient’s financial considerations” (page 19)

It is your responsibility to find a solution that accommodates the financial needs as well as all other needs. This process must include collaboration with the patient. It is important to explain to the patient how your recommendations for hearing aids relate to all their needs. This includes informing the patient of all the benefits and drawbacks of each option, and how these relate to pricing. Similarly, you must not assume that patients with unlimited financial resources may wish to have the most expensive hearing aids. Again, your recommendations must map all the needs of the patient to the level of technology.

QUESTION 11:

Occasionally, at my agency I do not perform the entire assessment because another non-audiologist has provided me with some of the data, including an audiogram. I do not supervise this person and they are not considered my support personnel. Can I use the assessment data to generate a prescription? Similarly, at times, someone else may end up dispensing and fitting the hearing aids that I have prescribed and that individual may not be an audiologist. Can I rely on that other professional to dispense and fit the hearing aids?

ANSWER 11:

You may use the assessment data already generated provided you are confident the data is accurate. However, you cannot merely take assessment data and prescribe hearing aids without direct contact with the patient in order to thoroughly understand their needs, capabilities and goals as part of the full assessment. The Code of Ethics states that the member:

4.2.5 shall ensure that the primary assessment/treatment/consultation with patients/clients will be a face-to-face or other professionally appropriate encounter;

In addition, you as the audiologist must be the one to determine the specific hearing aids to be prescribed and you cannot rely on any recommendations regarding the specific hearing aids made by the non-audiologist. Standard H4 addresses this, stating:

“Audiologists must determine the specific hearing aid based on a comprehensive evaluation in order to issue a prescription.”

So for example, it would not be appropriate for the audiologist to simply sign a form that contains the specific hearing aids that are recommended. The audiologist “must determine the specific hearing aid”. Also be reminded that you have requirements regarding documentation, including, documenting what you have prescribed. With regard to dispensing and fitting, again, you must be confident that it was performed thoroughly, otherwise, you should perform this function yourself or if that is not possible, encourage the patient to see someone who you are confident will do an adequate job.

When considering your level of confidence in other professionals providing aspects of hearing aid services, it is reasonable to have confidence in another audiologist, given they are regulated and required to meet practice standards (unless, of course, you have a reason to think otherwise). Your confidence in a non-audiologist performing aspects of the hearing services would be guided by your professional judgement.
 

Colleen Myrie

Director of Registration Services

Membership Suspensions and Revocations

Colleen Myrie
Director of Registration Services

The Health Professions Procedural Code of the Regulated Health Professions Act, 1991 requires information about suspended members to be made available to the public by each regulatory college.

The following individuals are currently under suspension for failing to pay their annual fees for 2016/2017 in accordance with section 24 of the Code:

Speech-Language Pathology Certificates Suspended

While under suspension:

1. The individual is not permitted to practice as an audiologist or as a speech-language pathologist in Ontario.
2. The individual is prohibited from using the titles "audiologist", "speech-language pathologist" or "speech therapist" or a variation or abbreviation or an equivalent in another language in Ontario.
3. The individual is prohibited from holding himself or herself out as a person who is qualified to practice as an audiologist or a speech-language pathologist in Ontario.
4. The College will inform the individual's last employer on record of the individual's suspension.
5. A notation of the suspension appears indefinitely in the College's public register.

In addition, the following certificates were revoked for failing to pay the annual fees for 2015/2016 in accordance with section 26 of Ontario Regulation 21/12:

AUDIOLOGY CERTIFICATES REVOKED

SPEECH-LANGUAGE PATHOLOGY CERTIFICATES REVOKED

After a certificate has been revoked:

1. A notation of the revocation appears indefinitely in the College's public register.
2. The former member must satisfy the following requirements for reinstatement to the College:
   1. The former member must pay any applicable fees and penalties required by the by-laws.
   2. The former member must satisfy the Registrar that he or she has corrected the deficiency or deficiencies that provided the grounds for the revocation of his or her certificate.
   3. The former member must meet all of the requirements in force for the class of certificate of registration being reinstated on the day that the former member submitted their new application to the Registrar. 

Tax Receipts

Baron French Director of Information Technology and Colleen Myrie, Director of Registration Services.

On March 1, 2017, your 2016 tax receipts may be downloaded in a PDF format from the Tax-Receipt page of CASLPO's Member Portal.  The College will email a reminder to members when the tax receipts are ready.

Your tax receipt includes any payments made to the College for the calendar year of January 1st to December 31st, 2016.  This includes annual membership fees and other fees such as application fees, registration fees, late penalties, etc. 

For example, below is chart representing the transaction history for a member for 2016 and 2017:

In 2016, this member's tax receipt would show membership fee payments of $424.66 (i.e. $60.66 + $364) and other fees totalling $300 (i.e. $100 + $200). In 2017, this member's tax receipt would show membership fee payments of $940.31 (i.e. $212.31 + $728) and other fees totalling $0.

Tax receipts from previous years starting in 2008 are also available in the Member Portal for downloading throughout the year. Tax receipts prior to 2008 may be obtained by contacting the College.

Members who wish to obtain a printed copy of their tax receipt by mail must pay a fee of $50 for each receipt. Support is available for members who need help downloading their tax receipts.  Contact Registration Services:

By email: [email protected]
By phone:  Jessica LaForet, Program Assistant (Registration Services)
416-975-5347 ext. 213 or (toll free in Ontario) 1-800-993-9459 ext. 213.

A Truly Committed Membership

Alexandra Carling Ph.D.

Alex Carling
Director of Professional Practice and Quality Assurance

Congratulations to you, CASLPO members, for your participation in the 2017 Self-Assessment Tool (SAT) submission. They show that you are committed to providing quality service to your patients and families and that you are rigorous in pursuing ongoing, goal directed learning.

As you know, all self-regulated health professionals are required to comply with their College's Quality Assurance Program that comprises:

• Continuing education and professional development
• Self, peer and practice assessment
• A mechanism for the College to monitor participation and compliance

Here are the results for the last four years that show a steady increase in compliance rates:

SAT Submission Data

Alex Carling
Director of Professional Practice and Quality Assurance

Your e-Forum feedback

In 2016 we very much enjoyed meeting members face to face in Toronto, Thunder Bay, Brantford and Whitby/Oshawa.  We would like to thank:

Karen Halvorson, Paola Humeniuk and Thunder Bay Regional Health Sciences Centre
Lisa Sylvester and Landsdowne Children's Centre
Anila Punnouse and Durham District School Board

We had good interactive discussions everywhere we went, and, as always, learned more about the issues that are important to our members. From these discussions, combined with the reasons members contact the College through Practice Advice, the topics for the e-Forums were established.

e-Forums

Three e-Forum webinars took place in 2016.  They focussed on the Circle of Care, Record Keeping, and Discipline Issues. You can find links to the slides and the recordings of the e-Forums on the Events section of our website.

In total 330 members registered for the e-Forums.  We sent surveys to all registered members for their feedback and 67 members responded.

Amalgamated Survey Results for 2016 e-Forums

e-Forums 2017

Changes we have made from your feedback:

• We will post the slide deck before the webinar
• Some webinars will take place at different times of the day
• We will use more scenarios to illustrate practice standards and regulation
• Webinars will take place throughout the year

Stay tuned for e-Forums on Advertising and Hearing Aid Services. 
If you have any requests for other topics, please contact me.
Alex Carling, Director of Professional Practice and Quality Assurance
[email protected]

Can audiologists use the doctor title in practice?

Preeya Singh
Director of Professional Conduct 

On November 29, 2016, the Divisional Court released its decision regarding the appeal made by Brenda Berge (the Member) regarding a decision of a Discipline Committee panel. On March 31, 2015, the Member was found to have engaged in professional misconduct for using the title doctor in her practice. The Court considered the following grounds on which the Member made her appeal: 

•  The Court was asked to consider whether section 33 of the Regulated Health Professions Act 1991 violated the Member’s freedom of expression under section 2(b) of the Canadian Charter of Rights and Freedoms. The Court relied on binding case law from the Supreme Court of Canada (SCC) to conclude that s.33 did not violate the Member’s Charter Rights.
  
  On the possibility that the Court was incorrect about the applicability of the SCC case law, it went on to apply the constitutional test (known as the Oakes test) to determine whether any infringement of the Member’s right could be justified. Ultimately, the Court determined that s. 33 had a pressing and substantial objective in that it protected a vulnerable group of society. Vulnerable groups, in this case, are those dealing with health hearing concerns or illnesses and the legislative objective is to prevent those vulnerable people from being confused when making decisions about their health care. The Court also found that the restriction was rationally connected to this objective, that the provision minimally impaired the right of the Member (as it did not prevent her from practising) and that the restriction was proportionate to the protection objective. In drawing from previous case law, the Court noted that "substantial latitudes should be given to legislatures that act to protect a vulnerable group".

• The Court also considered whether the College had the jurisdiction to hold a hearing in the absence of a French version of the Professional Misconduct Regulation (Regulation). It found that the Member had offered no basis for this argument and further found that the panel’s decision was reasonable as the right to use French (contained in the Health Professions Procedural Code) did not create a right to take advantage of inconsistencies that could arise between the two languages. 
• The Member argued that the Regulation was ultra vires (outside the authority of the College). However, the Court had no compelling case law before it to support this argument. Moreover, it found that there was clear legal authority under the Code to define acts of professional misconduct in the Regulation (see ss. 95(1)(j)). Further the Court found that a “basket clause” (section 37 of the Regulation) was valid because it would be impossible to define all acts that could give rise to professional misconduct.
• Contrary to the Member’s position, the Court found that the College did in fact have the jurisdiction to discipline the member. This authority is clearly laid out in section 51(1)(a) and (c) of the Health Professions Procedural Code, as well as paragraph 31 of the Regulation.
• The Court found that the ICRC had followed a two-step process to complete its referral of specified allegations. The process, as outlined by Richard Steinecke, author of “A Complete Guide to the Regulated Health Professions Act”, describes the two-step process as one in which the member is first referred to the Discipline Committee in principle and then formally referred with drafted specified allegations. The Court was satisfied with the evidence submitted that the ICRC had followed this process and so determined that the allegations had been properly referred.
• Despite the Member’s submission, the Court had before it ample evidence to support the costs that were ordered. The Court went on to note that the award of costs is highly discretionary and it is a mechanism to lighten the burden of hearing costs for the membership. In light of the fact that the Committee directed costs that were less than the usual 66% normally ordered, the Court found that the costs order was reasonable. In addition, the Court did not take issue with the 3-month suspension handed down by the Committee. 

The conclusion of the court was to dismiss the Member’s appeal. This means that, in Ontario, audiologists are not permitted to use the doctor title while providing or offering to provide health care in Ontario. As noted by the Court, this does not restrict an Audiologist from using the doctor title in a non-health care setting, such as in an educational institution. The College has received information confirming that the Member intends to appeal the decision of the Divisional Court. Please check www.caslpo.com regularly for updates on this matter.

Carol Bock
Deputy Registrar

The National Essential Practice Competencies Are Changing

WHAT ARE THE CHANGES?
The Canadian Alliance of Audiology and Speech-Language Pathology Regulators (CAASPR) is embarking on a competency review project and we need your help. These competencies will become the foundation for determining if someone is prepared to practice as an audiologist or speech-language pathologist in Canada. So CAASPR needs all our regulated practitioners across Canada to weigh in on whether the revised competencies are truly reflective of your practice.

Your feedback is essential to set the bar for applicants wanting to practice in Canada.

WHY CHANGE?
Audiologists and Speech-Language Pathologist are among some twenty targeted professions for immigration purposes, as national shortages for each profession have been identified.  We need to ensure anyone wanting to practice in Canada meets consistent and robust requirements.

To support this review and other related projects, the government of Canada awarded $1.3M to CAASPR, chaired currently by CASLPO Registrar, Brian O'Riordan.  To underline the importance placed on this work by the federal government, Marco Mendicino (MP, Eglinton-Lawrence, Chair of the Ontario Caucus and Parliamentary Secretary to the Minister of Justice) presented a certificate of official congratulations to CAASPR.

WHAT'S BEEN DONE SO FAR?
Expert panels, composed of experienced and new practitioners, regulators, Speech-Language and Audiology Canada (SAC) and University staff, recently reviewed the existing set of essential competencies. They have recommended changes that will better reflect the competencies required by audiologists and speech-language pathologists, who are newly entering the professions in Canada.

WHAT'S NEXT?
You will receive a very important survey about the competencies in spring 2017! The results will form the foundation of changes to what Canadian regulators consider competent practitioners.
It is expected that by the end of 2019, CAASPR will have achieved the following:

• establishment of a revised set of national essential competencies for both professions with accompanying performance indicators
• standard entry-to-practice national regulatory exams;
• common language proficiency standards and benchmarks;
• harmonized academic standard equivalencies;
• an on-line pre-arrival and centralized assessment Portfolio and Information Tool for Internationally-educated applicants

Please watch for the survey and participate!

All of this work will allow all provinces to rely on the assessment processes used across Canada for both Canadian and internationally-educated applicants.  This will improve labour mobility and facilitate enhanced and consistent protection of patients across Canada.

Lisa Gibson

[email protected]

Do you or your colleagues have a positive patient impact story to share?

Consider sharing an experience about either your practice setting, technology usage or innovative programs implemented.  Email Lisa Gibson, Communications and Executive Office Manager for more information.