Registrar and CEO
In this newsletter, you will find valuable information on how to continue to keep up to date with useful, accurate resources and practice advice.
Also, this ex.press issue offers you important new information on a variety of topics to assist you to better serve your patients as a self-regulated health professional including:
As always, be sure to visit CASLPO’s website often, - it’s your main source of the latest information and supports developed to fulfill our mandate to serve in the public interest.
Let me again extend my thank you to all registrants for your continued outstanding service to your patients.
Director of Professional Conduct, General Counsel & Diversity, Equity and Inclusion (DEI) Officer
During CASLPO’s 2022-2023 annual renewal, registrants were asked for the first time to participate in a voluntary demographic data collection survey. Registrants were asked questions relating to race/ethnicity, gender identity, sexual orientation, ability, language fluency, religion and geographic location.
The data collected will allow the College to track any changes to the demographics of registrants and provide guidance as to what professional development resources should be developed.
With 67% of registrants responding to the survey, the following information was collected:
Based on the data collected, we were also able to identify the following prevailing characteristics of registered audiologists and speech-language pathologists in Ontario:
The data collected will help inform areas of professional development and can be used to identify when potential bias exists in an environment where everyone appears to look and behave the same. Further, the College is interested in how to encourage a more diverse registrant base, and by tracking this data over time, we will be able to identify whether our efforts have been effective.
This information is also important for registrants to know, as the demographics of Ontario’s population differs from CASLPO’s registrant base. This data highlights that we can share some characteristics with patients and colleagues, but there may also exist significant differences that may not be easily seen on the surface. Data such as this reminds all of us that each person is comprised of a multiplicity of factors, and these factors can impact the way we interact with each other. For a complete summary of the collection results, please refer to the College’s DEI web page.
Director of Professional Practice & Quality Assurance
Have you read CASLPO’s new Advertising Standards?
Also published are revised Dysphagia Intervention Standards, and Guide for Equitable and Inclusive Services. …More
Director of Registration Services
On October 28, 2022, the Ministry of Health announced new registration requirements for Ontario health regulatory colleges, summarized below. These specifications are set out in O. Reg. 508/22 under the Regulated Health Professions Act, 1991.
Timely Decisions: All individuals that are applying for registration to practice as audiologists or speech-language pathologists in Ontario must receive either an acknowledgement of their application within 15 calendar days, or an indication that additional information is required. There are other timelines for CASLPO to meet, which vary, depending on whether it is necessary to verify the authenticity of documents received, or assess an applicant’s prior learning experience. For example, the Registrar must make a decision to either register an applicant or refer the applicant to the Registration Committee within 30 days. If the College needs to verify an applicant’s educational program for equivalency, CASLPO must complete the assessment within a “reasonable period of time”.
Language Proficiency: An applicant satisfies language proficiency requirements if they meet a threshold to be established by CASLPO on a test that is approved for purposes of the Immigration and Refugee Protection Act (Canada). CASLPO is now accepting the results of the Canadian English Language Proficiency Index Program (CELPIP) General test and the test de connaissance du français pour le Canada to demonstrate language proficiency in English and French, respectively. This is in addition to the other language tests previously accepted by CASLPO.
Exemption from Canadian Experience Requirements: Ontario health regulators cannot require Canadian experience unless there is a valid exemption. For example, if a requirement must be met while the applicant is registered in a different class of registration established by the College (i.e., CASLPO’s Initial Practice Certificate), it will not be considered to be a Canadian experience requirement.
Emergency Class: Health regulators which do not have an emergency class of registration will be required to establish a regulatory framework to allow this. This framework must specify the circumstances that would apply for the emergency class registration to be available. Among other things, the emergency class of registration will not expire until at least one year has passed after the emergency certificate is initially issued by the College. It can be renewed an unlimited number of times while the emergency exists. The holder of an emergency class of registration must be able to apply to CASLPO for another class of registration. The Ministry of Health has advised health regulatory colleges that they must submit their draft regulation for review by May 1, 2023. CASLPO will be consulting with registrants regarding this new requirement. It is anticipated that all College regulations in this area will come into effect in September 2023.
By Dana Prutschi, Director of Professional Practice & Quality Assurance
Whether you work at a big company, are in a sole practice or anything in between, the Records Regulation 2015 (s. 33(1)), requires you to ensure that your patient financial statements include the following information:
The CASLPO Code of Ethics requires that patient financial records are transparent, honest and truthful.
Principle 3 – Accountability provides that audiologists and speech-language pathologists shall:
When billing for training the parent or caregiver of a child, the child’s name must be on the financial record as they are the ultimate patient. For example, Miguel (parent) attends a session for their child, Alex. In the patient financial record you would write,
Intervention: Parent Training for Miguel Smith (patient is Alex Smith)
It is up to the patient’s family to find out if they are covered for education and training sessions through their health insurance.
For more information, see CASLPO’s webinars (E-Forums) and documents on CASLPO’s Advertising, Billing, and Private Practice page.
Advisor, Professional Practice and Quality Assurance
Audiology Advisor and Manager of Mentorship
Please consider ways to share CASLPO’s public register instructional videos. Together we can help patients and families living with communication and English literacy barriers to use CASLPO’s public register and improve understanding of its content.
The instructional videos can be accessed directly from CASLPO’s website in these 3 areas:
In 2019, CASLPO’s Practice Advice team began to develop new resources and supports to help patients use CASLPO’s public register. Patients needed more support to navigate the current public register, which is a list with information about all audiologists and speech-language pathologists in Ontario.
At the time, the College had a Strategic Plan Goal to:
‘Directly engage patients and other stakeholders to inform our work’.
CASLPO consulted with the Citizen Advisory Group (CAG). Members of the general public gave feedback to CASLPO on what would make our public register easier for the public and patients to navigate and understand. The CAG consultation raised an important and relevant question:
What supports do people with speech, language, hearing or other communication barriers need to successfully navigate CASLPO’s public register?
To explore this question further, a patient outreach group with audiologists and speech-language pathologists was assembled. The outreach group recruited 20 patients and family members with spoken or written English language challenges or a communication barrier, such as aphasia or hearing loss. Each were asked to find key information on CASLPO’s public register, such as:
The outreach group’s feedback was that the following changes would benefit patients and families:
This important feedback led to several changes to make the public register clearer and more accessible for all users, including:
The outreach group said that instructional videos would be an effective support. Videos would help patients and families living with communication and English literacy barriers navigate CASLPO’s public register and improve understanding of its content.
3 instructional videos for the public have been developed incorporating the suggested feedback including speaking with pauses, clear visual cues, plain language and embedded closed captioning.
CASLPO wishes to thank the Citizen Advisory Group for their invaluable contribution to this work, the Citizen Advisory Group, and the public who have provided feedback contributing to the development of these videos.
For any questions, please contact the Practice Advice team.
Speech-Language Pathology Practice Advisor
Family custody and consent matters are very common themes for Practice Advice questions. Obtaining and documenting consent is essential in all situations. Consent involving children and parental custody situations can be challenging to navigate.
A: No. Either parent has authority as the Substitute Decision Maker (SDM) to provide consent for services for the child. If the parent you are speaking with indicates they are providing consent on behalf of both parents, and you believe this is the case, then consent from only one parent is acceptable. Ensure all consent discussions are documented.
A: It depends. CASLPO recommends confirming who has the authority to consent to services (i.e., all interventions). Check if there is a legal arrangement regarding custody in the court order or divorce agreement. In some situations, you may also want evidence of this authority. Document all consent discussions.
A: Yes, if you confirm that both parents have authority to consent to services, you will need to obtain and document consent from both parents before proceeding with intervention.
A: There are many arrangements that would determine who has authority to make treatment decisions, so it is prudent to ask for clarification directly when you are unsure. Document all discussions.
Sometimes, one parent may have the authority to provide consent for services and the other parent does not -- For example, when one parent has sole custody. In this instance, the custodial parent is the Substitute Decision Maker (SDM) and will give or refuse consent for services for the child. The other parent may be the “access parent”. They have the same right as the custodial parent to make inquiries and to be given information about the health, education and welfare of the child. The “access parent” does not have the right to make a decision about their child’s health, education or welfare, even if they do not agree with the audiologist’s or speech-language pathologist’s intervention plan.
A: It depends. You can proceed if the parent who has sole authority to give consent for services provides it.
If the parents are separated or divorced and have joint custody, then both parents must come to an agreement on giving consent to services, prior to starting intervention. Document all consent discussions.
A: If you feel that the child is at risk and consent is being withheld, then you could consider contacting the Office of the Public Guardian and Trustee (OPGT). The OPGT has a Treatment Decision Unit staffed by consultants who consider themselves to be ‘decision makers of last resort’. On contacting them, you will be assigned a consultant according to your geographic area who will discuss the options with you first, before making a decision on behalf of the child. Ensure that all consent discussions are documented.
A: Consent needs to be obtained and documented from the child’s designated legal guardian. If needed, you can request evidence confirming who has the authority to provide consent. Examples of designated legal guardians may include another family member (e.g., grandparent) or a case worker with a Children’s Aid Society (CAS). In the case of CAS, consent must be obtained prior to contacting the child’s foster parents.
A: Yes. There is no age criteria for capacity to consent to intervention. If you believe that the child or youth can understand the intervention plan and can appreciate the consequences of their decision to participate, then you can obtain and document consent directly from the child or youth.
Capacity to provide consent is not determined by age. The Health Care Consent Act 1996 indicates capacity to consent to intervention is determined by whether a person is able to understand the information relevant to making the intervention decision and appreciates the reasonably foreseeable consequences of moving forward with or rejecting the proposed intervention. Therefore, a child or youth could be capable of providing consent to services.
A: No. If the student understands and appreciates why you are assessing or treating, including the nature, risks, benefits, consequences and alternatives of the services, then they have capacity to consent (refer to the Consent Tool for suggestions on what to discuss in the consent conversation).
Explain to the parents how the legislation defines capacity and share your evidence of the student’s ability to understand and appreciate the consent decision. Be sensitive and respectful of the parents’ concerns regarding their child, but if you have the evidence that the child has capacity to consent or refuse consent, you should trust your professional judgement. If the issue remains contentious, consult colleagues or your manager. Finally, you can call the Consent and Capacity Board for advice. Document these discussions.
A: Yes. If you decide to evaluate a child’s or youth’s capacity to consent, adapt your conversation to their level of understanding. Use the same strategies and resources you would use for intervention (repetition, picture supports, key words, large font, verifying the information is understood). Document your findings, including evidence of the child’s ability to understand and appreciate in detail in the patient or student record. See also Evaluating Capacity to Consent FAQs and Obtaining Consent for Services Guidelines for more information.
In the Child, Youth and Family Services Act 2017 (CYFSA), every child and young person receiving services has the following rights:
By Colleen Myrie, Director of Registration Services
Audiologists and speech-language pathologists in Ontario must maintain professional liability insurance coverage in accordance with CASLPO By-law #6. Further, if you do not have adequate professional liability insurance, you will have 30 days from the date that the Registrar sends you a notice to obtain coverage that complies with CASLPO college By-laws or your certificate of registration will be suspended.
The College’s Registration Department staff are often asked by audiologists and speech-language pathologists what to look for when determining if the professional liability insurance provided by an employer is adequate.
If you decide to rely on your employer’s policy to meet CASLPO’s insurance requirements, ask your employer for a copy of the policy’s certificate of insurance or for a letter confirming the following details regarding your coverage:
If the insured is your employer, the employer's certificate of insurance must list which employees are also covered by the policy as “additionally insured,” such as:
This policy's definition of "Insured" includes Audiologists and Speech-Language Pathologists who work for XXX company.
These details also apply to any personal professional liability insurance you may wish to purchase independently.
Your employer’s coverage is not mobile and only covers you while you are practising at a setting covered by the policy. If you have your own coverage, you are protected anywhere that you practice.
Your employer’s policy would typically have an aggregate limit of liability. It is important that the aggregate limit meets the minimum coverage requirements set out in CASLPO By-law #6 for all employees who are covered by the policy.
General Liability Coverage
General liability insurance protects against claims arising from bodily injury and or property damage.
Professional liability insurance protects against claims arising from professional negligence.
Per claim limit of liability
The per claim limit is the maximum amount of money the policy will pay for a single claim.
Aggregate limit of liability
The maximum amount the insurance policy will pay in one year notwithstanding the number of claims.
The person/entity insured under an insurance policy. This party enjoys the benefits of the policy and has the duties and obligations set forth in the insurance policy.
The person/entity that is added as an insured under and insurance policy at the request of the named insured person/entity.
An occurrence-based policy covers incidents that happened during the policy period, regardless of when the incident is reported.
A claims-made policy can cover an incident only if it’s reported during a period of time specified in the policy.
By Samidha Joglekar, Audiology Advisor and Manager of Mentorship
Data collected from CASLPO’s Mentorship Self-Assessment Tool (MSAT), based on mentors’ input between June 2019 and December 2022, identifies the standards of practice that mentors most frequently encounter as challenges for their mentees (i.e., initial practice registrants).
The first step to improving audiologists’ and speech-language pathologists’ practice is to take the time to reflect on areas that need work. The information that the mentorship period is providing is helping to support registrants with continuous improvement, which, in turn, benefits the public by ensuring quality service.
At the onset of their mentorship period, mentees reflect on the application of CASLPO practice standards and indicators that must be met during their day-to-day practice. The MSAT contains standards and indicators that are identical to CASLPO’s Self-Assessment Tool (SAT).
The charts that follow show the indicators that are most often marked by mentors as “needs work to meet the standard” for mentees at the midterm stage.
The first chart focuses on indicators in the Management Practice, Patient Centred Practice and Communication areas.
The need for additional time to reflect on meeting these indicators in every day practice may be attributed to the limited experience and exposure to clinical situations that mentees have at this stage. The same can be said for the top indicators that mentors identify as “needing work” in the Clinical Practice area, shown in the next chart.
Identification of these standards as areas for improvement at the midterm stage helps mentees to focus their learning goals and mentors to focus their guidance on these areas for the remainder of the mentorship period. Mentees can focus on these areas and ensure they meet these indicators by the end of their mentorship period at a level commensurate with their career stage as confirmed by their mentor.
The MSAT also identifies certain indicators as “red flag” areas. These are indicators that, while not necessarily more important than the others, pose a higher risk if not addressed early on. The final chart shows the top “red flag” indicators that show up most often in mentorship as “needing work to be met” according to the mentors’ ratings.
Interestingly, the clinical reasoning indicator shows up more often as an area that mentees need to work on. However, the other red flag indicators are also areas that often require reflection from experienced registrants as well.
To learn more about mentorship, visit the Mentorship Overview webpage.
By Colleen Myrie, Director of Registration Services
The Health Professions Procedural Code of the Regulated Health Professions Act, 1991 requires information about suspended registrants to be made available to the public by each regulatory college.
The reason for this is to ensure that the public knows that they should not be receiving services from these suspended registrants. In CASLPO’s case, this means audiologists and speech-language pathologists. These identified individuals should not be using the protected titles.
The following individuals are currently under suspension for failing to pay their annual renewal fees for 2022/2023 in accordance with section 24 of the Code:
Tara Michelle Warren
Andrea Carolynn Kuntz
Kendra R. Di Bacco
Cheryl Ann Turner
While under suspension:
In addition, the following certificates were revoked for failing to pay the annual fees for 2021/2022 in accordance with section 26 of Ontario Regulation 21/12:
Laurie Patricia Light
Illana Gurevitch Morton
Taelor Elizabeth Smith
After a certificate has been revoked:
By Dana Prutschi, Director of Professional Practice & Quality Assurance and Sarah Chapman-Jay, Advisor, Professional Practice and Quality Assurance
Congratulations to the 4192 registrants whose Self Assessment Tool (SAT) was submitted by the January 31 deadline. You have taken part in this essential component as a self-regulated professional!
The 2023 Self-Assessment Tool submission period is now completed. 99.6% of CASLPO’s general registrants have each submitted their individual practice descriptions, self-evaluation on professional standards, new learning goals and 2022 Continuous Learning Activity Credits (CLACs).
Annual SAT Completion – Tips:
Registrants who did not complete their SAT on time will have to pay a fine and comply with any Quality Assurance Committee decisions. Find out more by reading Consequences of Missing the SAT Submission Deadline.
Please contact the Practice Advice team with any questions about the annual Self-Assessment Tool.
By Dana Prutschi, Director of Professional Practice & Quality Assurance and Colleen Myrie, Director of Registration Services
Stay tuned for upcoming CASLPO E-Forums. Topics: Record-keeping, Dysphagia Standards, Guide for Equitable and Inclusive Services, and Mentor Training.
CASLPO’s E-Forum about the College’s new Advertising Standards, applicable to all audiologists and speech-language pathologists, took place on January 26, 2023. The recording, slides and answers to Frequently Asked Questions (FAQs) are accessible from CASLPO’s website E-Forums page.
In 2022, CASLPO hosted E-Forums covering the following topics:
Recordings and slides are available from CASLPO’s website.
By Preeya Singh, Director of Professional Conduct, General Counsel & Diversity, Equity and Inclusion (DEI) Officer
The Board of the College approved amendments to CASLPO’s Professional Misconduct Regulation. To be proclaimed, the amendments must be approved by the province. The approval has not happened yet, but College staff are working with the Ministry of Health officials to bring these important amendments into force.
As a result of the revisions, the following are some important changes all registrants, Ontario's audiologists and speech-language pathologists should become familiar with:
Registrants have always been required to supervise support personnel appropriately. Previously, if allegations of failing to appropriately supervise had been referred to a panel of the Discipline Committee, the allegation would be captured under paragraph 2 of the current Regulation (i.e. Failing to maintain a standard of practice of the profession.) This amendment will now classify a failure to appropriately supervise support personnel as an act of professional misconduct.
While this may seem like a minor requirement, it is important for practitioners to understand that patients and family members have a right to access College information and resources. These parties trust that you, as a regulated health care professional, will provide them with accurate information upon request. This new act of professional misconduct also speaks to the overall obligation to behave honourably and truthfully in all professional relationships (see paragraph b of Principle 3 “Accountability” from the College’s Code of Ethics.)
It is important to note that this revision relates to the discontinuation of services that are needed. It does not apply to intervention that has concluded and no more services are required. The important change to this provision is that it consolidates some of the qualifiers currently contained in paragraph 8. For instance, subparagraph iv. (restrictions in length or type of service are imposed by an agency) and vi. (discharge criteria are imposed by the employing agency) are now captured within: i. registrant’s reasons for discontinuing the services.
To review the complete list of proposed amendments, please refer to the College website.
The amendments to the College’s Professional Misconduct Regulation have completed the Ministry’s consultation period, which closed on December 18, 2022. The College is waiting for confirmation from Ministry officials that the amendments have been proclaimed. While it was previously expected that the amendments would come into force on January 1, 2023, this date was not confirmed. The College will keep registrants advised of the progress and will send notice to all registrants once a proclamation date has been confirmed. A CASLPO E-Forum will also be hosted to further discuss the changes to this Regulation.
It is important for all registrants to review and understand the Professional Misconduct Regulation. Engaging in professional misconduct is a serious offence and can carry significant disciplinary penalties, including loss of registration. Failing to understand the Professional Misconduct Regulation is no defence and so if you have questions about this Regulation, please do not hesitate to contact the College’s Conduct Department