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CMTO Annual Report 2023

From Our Leaders

Message from the Board Chair

As Chair of the Board, it is my privilege to present to you CMTO’s 2023 Annual Report. As I look back on the year, I am grateful for the commendable dedication of CMTO’s Board, non-Board Committee Members, staff, RMTs, and our health system partners all working together toward a common goal that has remained unchanged since CMTO’s inception: serving the public interest.


Over the past year, we worked on evolving as a responsive and modern regulator to ensure we remain resilient in times of change. We modernized how we govern and oversee the Massage Therapy profession by updating By-Laws to enhance the College’s succession planning. These changes included refining and modernizing our use of language and adjusting the timeline of our annual Board elections to ensure seamless governance transitions going forward. Additionally, we established an Inaugural Governance Committee (IGC), which operates independently from the Board. The IGC ensures that current and future Committee Members possess the required skills, knowledge, and judgment, to align with the College’s mandate and make decisions to best serve the public interest.  

​

We continued our partnership with the Ontario Physicians and Surgeons Discipline Tribunal and other health system partners on the Health Professions Discipline Tribunals Pilot (HPDTP). This innovative pilot helped streamline CMTO’s hearings and decision-making processes and widened the separation between CMTO’s Board and the Discipline Committee to achieve greater transparency.

​

Beyond CMTO’s notable work with health system partners, our Board also oversaw the launch of the new Risk-based Assessment, part of our Quality Assurance Program. This new approach to assessments helps strengthen Massage Therapy care for Ontarians by focusing on RMTs who require greater support in effectively meeting CMTO’s Standards and requirements.

​

As I conclude, I want to pay tribute to the life and commitment of Lloyd White, our esteemed Public Board Member. In his fourteen years with the College, Lloyd served on several Committees, and was the Vice-President of CMTO’s Board for multiple terms. He played a pivotal role in steering key initiatives at CMTO, including the enhancement of our Quality Assurance Program, modernizing governance practices, and shaping our evolving strategic vision. In his professional life, Lloyd was deeply committed to serving the public through his lifelong career in education. Lloyd made significant contributions to the betterment of society and to individuals whose lives he touched.

​

Sincerely,

​

Jay Mathers, Public Member, Board Chair

Who We Are

CMTO is the regulatory body that oversees Registered Massage Therapists (or RMTs/MTs) working in Ontario. CMTO is not a school or an organization that advocates on behalf of RMTs.

We exist to protect the public interest.

We do this by:

Ensuring that Massage Therapy graduates have the right skills and knowledge before becoming an RMT/MT. We also do this through rigorous testing and education requirements.

Maintaining an up-to-date online register, Find an RMT, to help Ontarians verify whether the person they are visiting for Massage Therapy treatment is registered and qualified to practise.

Developing and enforcing rules, Standards of Practice, and expectations for RMT’s practice and conduct.

Running a Quality Assurance Program called “STRiVE” to ensure RMTs keep their knowledge and skills up-to-date.

Addressing concerns or complaints about Massage Therapy care and taking disciplinary action when necessary.

2023 Highlights

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Prevention of Sexual Abuse

CMTO is committed to preventing and eliminating sexual abuse in the Massage Therapy profession. We aim to achieve this by focusing on high-quality Massage Therapy education and collaborating with health system partners in implementing impactful solutions.

​

In November, CMTO held a Prevention of Sexual Abuse Symposium, the first event for the organization which focused entirely on sexual abuse prevention. CMTO brought together RMTs, employers, client advocates, and other regulators to share their perspectives on the issue of sexual abuse in Massage Therapy.

​

By reviewing data and case studies, participants discussed how CMTO and other health system partners can collaboratively strengthen sexual abuse prevention efforts. CMTO is working on several items that resulted from the symposium discussions. These include:

​

 

CMTO has also released a client-focused poster for RMTs to use in their practice settings to increase awareness of clients’ rights and CMTO’s role in public protection. The symposium concluded with a collective commitment to enact steps to help prevent sexual abuse in Massage Therapy.

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New Online Jurisprudence Program

In 2023, CMTO launched a new online Jurisprudence Program. The program focuses on the prevention of sexual abuse, Standards of Practice and expectations on maintaining professional boundaries. The program is mandatory for all new applicants who applied to CMTO for registration after January 2024. Current registrants of CMTO are also able to complete the program as part of their continuing education and professional development goals.

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Building Engagement and Partnerships

We believe effective regulation starts with meaningful engagement and strong partnerships. Throughout the year, CMTO’s leadership team and Board Members presented updates on regulatory changes at Massage Therapy schools, and regulatory and health conferences, and participated as thought leaders in several panel discussions.

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2023 Open Houses

Last fall, CMTO held in-person Open Houses in different regions of Ontario (Districts 1, 2, 5, 6), as well as a virtual event for District 7 registrants. The Open House in Toronto (District 5) was also accessible via livestream. The Open Houses provided opportunities for CMTO to hear from over 120 RMTs, and for Maureen Boon, Registrar & CEO, to present an overview of regulatory changes impacting Massage Therapy practice and answer questions.

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Enhanced Consultation Process

To enhance transparency and promote engagement between CMTO, RMTs, educators, employers, and the public, we expanded our online consultation process by introducing a new online discussion board. During the summer of 2023, CMTO used the new platform to encourage discussion and gather feedback as part of its consultation process on the draft Standard of Practice: Advertising and Standard of Practice: Records. Going forward, we will continue using the online discussion board as part of our broader consultation process to gather input from the profession, and public, to better inform decision-making.

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Collaborating with other Regulators

CMTO actively engages in collaborative efforts and knowledge exchange with other Ontario health regulators through ongoing participation in the Health Profession Regulators of Ontario (HPRO) groups. Recently, we partnered with several regulatory colleges on the HPRO’s Anti-Racism Steering Committee. The Committee works to identify systemic racism and implement tangible solutions that help build equitable health system practices.

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Guidance on Collecting Client’s Personal Health Information

The collection of Personal Health Information from clients is important for the provision of effective and client-centred treatment. CMTO’s Guide to Record Keeping Requirements outlines the minimum amount of information that must be documented in a client’s health record.

 

In addition to this guidance, CMTO issued a directive to RMTs that the collection of sensitive information, such as someone’s HIV status, should not be collected. In addition to HIV, other types of sensitive health information (e.g., certain mental health information, or unconditionally asking for every medication a client takes) could also be classified as over-collecting in some circumstances. Over-collection of sensitive health information creates the potential for discrimination and does not comply with the Personal Health Information Protection Act, 2004 (PHIPA).

 

CMTO is currently developing new guidance on collecting health history information with input from the profession.

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CMTO’s Commitment to Regulatory Excellence

As the health regulatory landscape shifts and evolves in Ontario, CMTO is dedicated to remaining a modern, nimble and responsive regulator in times of change. By encouraging a culture of accountability, professionalism and continuous quality improvement, we strive to inspire the public’s trust and confidence in our regulatory oversight.

​

CMTO developed Risk-based Assessment as part of STRiVE, CMTO’s Quality Assurance Program. Each year, all RMTs complete the first phase of Risk Based Assessment: Practice Profile. This new annual process consists of:

​

  • Self-Inventory of Risks and Supports; and

  • Standards of Practice Quiz.

​

After Practice Profile is completed, a small proportion of RMTs will then be selected for the second phase of the process: Practice Assessment. This selection process involves multiple risks, including RMTs’ relative performance on the Standards of Practice Quiz. This multi-step approach to assessment helps CMTO identify and assist those RMTs who require additional support in fulfilling the Standards and requirements and ensures RMTs’ ongoing competence in providing safe Massage Therapy care to the public.

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CMTO Collaborates on Innovative Tribunal Pilot

In spring 2023, CMTO joined the Ontario Physicians and Surgeons Discipline Tribunal and other health system partners to launch the Health Professions Discipline Tribunals Pilot (HPDTP), an innovative and progressive approach to managing hearings.

 

Participation in HPDTP involves the appointment of six experienced adjudicators as non-Board Public Members to CMTO’s Discipline Committee. By appointing experienced adjudicators to conduct case management and chair hearing panels for select sexual abuse matters, CMTO can:

​

  • Demonstrate regulatory leadership and collaboration by testing innovative approaches;

  • Achieve greater independence between CMTO’s Discipline Committee and Board; and

  • Improve the efficiency of discipline processes and consistency of discipline decisions.

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Regulatory Modernization: Governance

CMTO is committed to achieving regulatory excellence. In 2023, we made notable progress implementing changes to our governance processes to ensure all CMTO’s decision-making prioritizes the public interest.

 

Throughout the year, we introduced progressive changes to our By-Laws, including:
 

  • Strengthening succession planning to ensure smooth transitions;

  • Clarifying and modernizing terms and language (e.g., the terms “Council” and “President” have been updated to “Board” and “Board Chair”);

  • Creating an Inaugural Governance Committee (IGC) that ensures that all Board and Committee Members possess the required skills, knowledge, and judgment, to perform their duties.

  • Eliminating Committee Chair/Vice-Chair elections; and

  • Shifting the timing of the appointment/election processes to ensure that Board and Committee terms are aligned with the financial year.

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Championing Equity, Diversity and Inclusion (EDI)

CMTO is committed to embedding EDI into our organizational programs and processes, and reporting publicly on EDI progress.

​

EDI Committee

In 2023, CMTO advanced our strategic goal of championing equity, diversity and inclusion (EDI) by creating a permanent EDI Standing Committee for the College. The EDI Committee will support CMTO’s strategic plan and commitment to promoting and upholding the principles of equity, diversity, and inclusion in its practices, policies, and programs.

​

EDI Webpage

CMTO recently launched a webpage that contains helpful resources on EDI for RMTs, clients and others who want to learn more on this topic as it relates to Massage Therapy.

​

Reporting on EDI Progress

We also identified and reported on CMTO’s EDI progress using the Ontario Ministry of Health’s College Performance Measurement Framework (CPMF) tool. The 2023 report is available on CMTO’s website

Snapshot of Massage Therapy in Ontario

(As of December 31, 2023)

RMTs registered with CMTO

General Certificate

15,079

Inactive Certificate

609

Total

15,688

Total Number of RMTs Year-Over-Year

A graph showing the year-over-year increase in the total number of RMTs in Ontario over a 10 year period. From 2013 to 2023, there has been a 30% increase in the number of RMTs in Ontario from 12,054 to 15,688.

From 2013 to 2023 there has been a 30% increase in the number of RMTs in Ontario.

Gender of RMTs

Female

12,103

Male

3,557

"X"*

28

1,006 new RMTs registered

* “X” is not directly associated with male or female, including but not limited to Trans, Two-Spirit, Non-Binary, and/or Binary people. CMTO recognizes that there may be more terms that represent the diverse and unique forms of gender expressions/identities, including those of the LGBTQ2S+ community, and we will continue to respond to developments.

Most RMTs are between 41 and 50 years old

Age

Number of RMTs

<31

31 - 40

41 - 50

51 - 60

>60

2,145

4,588

4,808

3,094

1,053

There are 2,145 RMTs under the age of 31. 4,588 RMTs between 31 and 40. 4,808 RMTs between 41 to 50. 3,094 RMTs between 51 to 60. 1,053 RMTs over the age of 60.

Top 3 practice settings

7,571 RMTs

50% of General Certificate Holders

Clinical setting

Clinical setting (e.g., multi-disciplinary clinic, hospital, urgent care clinic, rehabilitation facility)

4,220 RMTs

28% of General Certificate Holders

Solo practice

1,338 RMTs

9% of General Certificate Holders

Spa

Solo practice (e.g., home-based and solo office practice)

Note: These represent the top 3 most common practice settings, the other 13% of General Certificate holders practice between an additional 17 practice settings.

Most asked practice questions of 2023

In 2023,

1,159

practice questions were received by CMTO’s Practice Specialist.

The Practice Specialist answered questions from RMTs, clients, employers, and insurance companies on the topics of:

​

  • Preparing receipts;

  • Setting and adjusting fees;

  • Cancellation policies; 

  • Collecting health information (e.g., health history); 

  • Modalities, techniques, and Scope of Practice; 

  • Leaving a practice; 

  • Client privacy and confidentiality; and 

  • Records.

Executive Committee Report

Committee Mandate

The Executive Committee assumes leadership, in collaboration with the Board, the Committees and the Registrar, in its financial monitoring, strategic planning, governance and supervisory responsibilities. The Committee monitors the administration of the College and relies on the Registrar and other staff to implement its decisions.

Committee Members

Jay Mathers, Public Member, President

Christin Mandalentsis, RMT, Vice President

Sean Adderley, RMT, Executive Officer

Jalpa Patel, Public Member, Executive Officer

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The Committee met 6 times in 2023.

Summary of 2023 Accomplishments

The Executive Committee reviewed the following items for the Board’s approval:

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Governance

  • Statutory Committee Applications

  • Executive Committee Terms of Reference

  • By-law revisions for Governance Modernization

  • Appointment of the Inaugural Governance Committee

  • Revisions to Section 4.9 of the Governance Handbook relating to Board Members attendance at conferences

  • Process for the creation of a Standing Equity, Diversity and Inclusion (EDI) Committee

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Strategy/Issue Management

  • Workplan and Preliminary KPIs

  • HPDTP Pilot Extension Proposal

  • Opening and Closing Emergency Class Registration Policy 

  • Health History

In 2023, the Committee oversaw the following items:

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Financial/Risk

  • Appointment of the Auditors for 2023

  • Annual Fee 

  • 2022 Draft Audited Financial Statements

  • 2024 Draft Budget

  • Investment Portfolio

  • Revisions to the following Financial Policies:

    • Policy F05: Bank Reconciliation

    • Policy F10: Corporate Credit Cards

    • Policy F11: Contractual Arrangements

    • Policy F15: Journal Entries

    • Policy F20: Reporting Fraud and Irregularities.

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Registrar/CEO Oversight

  • CEO Performance Evaluation Process

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Registration Committee Report

Committee Mandate

The Registration Committee has responsibility for determining the eligibility for registration of all applicants where there is a question about capacity, training, experience or education, and/or when the Registrar believes that terms, conditions or limitations should be imposed on a certificate.

Committee Members

Sean Adderley, RMT, Chair

Jennifer Da Ponte, RMT, non-Board Member, Vice Chair 

Carolyn Watt, Public Member

Eric Wu, RMT, non-Board Member

James Johnson, RMT, non-Board Member

Jay Mathers, Public Member

Suja Biber, RMT

Quick Stats

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CMTO registered 1,006 Registered Massage Therapists (RMTs).

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  • In 2023, 5 application(s) for registration were referred by the Registrar to the Registration Committee for review and decision. Reasons for a referral can include conduct concerns, a criminal conviction or findings of misconduct with another regulatory body.

Summary of 2023 Accomplishments

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Recommended to the Board proposed amendments to Registration Regulation related to Emergency Class Registration and a transition period for Massage Therapy education program approval.

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Recommended to the Board the Certification Examinations content outlines for 2024.

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Reviewed Quarterly Certification Examination Reports.

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Completed a Risk-Informed Compliance Framework questionnaire developed by Ontario's Fairness Commissioner, a survey to understand the risks that may hinder fair registration practices. CMTO was placed in the low-risk category.

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Reviewed proposed Supervision of Emergency Class Registrants policy.

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Reviewed the Certificate of Registration Policy.

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Fair Registration Practices Report for 2022.

Registration Committee Decisions

Application Decisions

Direct the Registrar to refuse to issue a Certificate of Registration - 3

Other Decisions

Approve registration with TCLs proposed by the Registrar - 2


Category 3 Refresher Course Requests - 6

Quality Assurance Committee Report

Committee Mandate

The Quality Assurance Committee has responsibility for overseeing the development and implementation of a Quality Assurance Program in accordance with the Regulated Health Professions Act, 1991 and College regulations.

Committee Members

Christin Mandalentsis, RMT (Chair)

Carolyn Watt, Public Member (Vice Chair)

Sandra Cina, RMT

Sasha Goudriaan, RMT

Brianne Lalande, RMT

Jianjiang Li, RMT

Jennifer McGill, RMT

Jay Mathers, Public Member

Dawn Ricica, RMT

Summary of 2023 Accomplishments

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STRiVE’s blueprint framework, uses the Standards of Practice as a foundation. It is reviewed and approved by the Quality Assurance Committee each year for implementation.

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The 2023 select Standards of Practice and Regulations were incorporated into all components of STRiVE – The Quality Assurance Program.

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STRiVE – Part 2: October marked the launch of Risk-based Practice Assessments with a total of 434 Practice Assessments being completed between October and December 2023. This included both first and second Practice Assessments.

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In November, Massage Therapy program administrators and educators were invited to a discussion of health information collection. Participants shared thoughts on changing expectations from clients, better alignment of practices with legal requirements, and appropriate limits on collection of health information.

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With the framework implementation, 2023 marked the launch of Risk-based Assessment.

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STRiVE – Part 1: Be the Best You can Be launched on the updated platform on
September 1, 2023, with a completion deadline of October 31, 2023.

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The Quality Assurance Committee reviewed and approved the 2024-2026 Risk-based Assessment Blueprint for implementation.

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The Jurisprudence Program was made available to all RMTs in June. It includes three parts, each with a corresponding test, that cover prevention of sexual abuse, Standards of Practice, legislation, and the Code of Ethics. Additional improvements were made to the program in preparation for requirement for it to be completed.

STRiVE Update

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13,638 RMTs completed a Practice Profile as part of the new Risk-based Assessment (RBA).

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391 RMTs underwent a Practice Assessment as part of the RBA.

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In 2023, CMTO’s STRiVE
Part 1: Be the Best You Can Be
 closed on October 31, 2023, with a completion rate of over 94%.

2023 Assessment Outcomes (RBA and Other)

517

No further action

3

Terms, Conditions and Limitations

2

Specified Continuing Education or Remediation Program (SCERP)

16

Referral to the Inquiries, Complaints and Reports Committee (ICRC):

Professional Misconduct
(non-compliance)

0

Recommendations

0

Referral to the Inquiries, Complaints and Reports Committee (ICRC):

Incapacity or Incompetence

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Client Relations Committee Report

Committee Mandate

The Client Relations Committee has responsibility for all programs and measures that are designed to address preventing or dealing with sexual abuse of clients by registrants. This responsibility has been extended to address any aspect of relations between registrants and their clients.

Committee Members

Ravara Van Vliet, RMT (Chair) 

Howard Shears, Public Member 

Lloyd White, Public Member 

Eric Wu, RMT, non-Board Member

Quick Stats

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The Committee Members met a total of 3 times over the year.

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The Committee received and reviewed 19 applications for funding for therapy/counselling.

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The Committee approved 18 applications for funding for therapy/counselling.

Summary of 2023 Accomplishments

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CMTO held its Prevention of Sexual Abuse Symposium on November 10, 2023, which concluded with a collective commitment by attendees to enact steps to prevent sexual abuse in Massage Therapy, and a recognition that there are no quick or simple solutions. This event led to action items including:

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The development of a client-focused poster to be displayed in RMT practice settings to increase awareness of CMTO and remind clients of their rights.

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A post-event report summarizing themes and action items.

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CMTO hosting additional events focusing on sexual abuse prevention in 2024.

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The revised Policy: Funding for Therapy and Counselling improved processing efficiency for applications, while the total number of approved applications remained unchanged.

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Inquiries, Complaints and Reports Committee Report

Committee Mandate

Committee Members

The Inquiries, Complaints and Reports Committee is responsible for handling registrant specific concerns regarding professional misconduct, incompetence and incapacity from various sources, e.g., formal complaints, mandatory reports, information coming to the attention of the Registrar.

Lloyd White,
Public Member, Chair

Sean Adderley,
RMT, Board Member

Simon Adeseko,
RMT, non-Board Member

Tammy Contois,
RMT, non-Board Member 

Rebecca Cleaveley,
RMT, non-Board Member 

Krista Cranston,
RMT, non-Board Member 

Imelda Garce,
RMT, non-Board Member

David Janveau,
RMT, non-Board Member 

Nevenko Jeftic,
RMT, non-Board Member 

Elisabeth Mathers,
RMT, non-Board Member 

Dawn Oehring,
RMT, Board Member

Alpa Patel,
RMT, non-Board Member 

Jalpa Patel,
Public Board Member

Howard Shears,
Public Board Member

Ashley Van Zelst,
RMT, Board Member

Meetings

In 2023, the Committee’s work was completed by three Panels, each comprised of five Committee members. The Panels met 22 times over videoconference and three times over email.

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In 2023, ICRC processed 183 new cases.

Number of New Cases by Type

61

Sexual abuse

4

Registrant incapacity

8

Unauthorized practice

1

Advertising

21

Intent to mislead, including fraud

45

Professional conduct & behaviour

0

Billing and fees

3

Harassment/boundary violations

10

Communication

22

​Competence / patient care

5

Record keeping

3

Other (COVID-19-related concerns)

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183

Total cases

Incapacity Cases

4

New Cases Received in 2023

5

Cases Disposed of in 2023

Details

1

Referral to Fitness to Practise Committee

3

Accepted Undertaking

1

No further action

Decisions: Complaints and Registrar’s Reports

34

Specified Continuing Education or Remediation Program (SCERP)

29

No further action

3

Oral caution

0

Complaint withdrawn

33

Referral to discipline

29

SCERP with an oral caution

1

Undertaking/Agreement – Remediation

0

Initiate incapacity inquiry

30

Recommendation and/or advice

13

Undertaking/Agreement – resign and never reapply

1

Frivolous and vexatious/moot

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173

Total decisions

Decisions: Complaints and Registrar’s Reports

Details

9

New HPARB Reviews in 2023

7

HPARB Reviews Completed in 2023

3

Decision upheld

4

Appeal withdrawn

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Discipline Committee Report

Committee Mandate

Committee Members

The Discipline Committee is responsible for hearing and determining allegations of professional misconduct or incompetence against registrants.

All Board Members

David Wright,
non-Board Public Member, Co-Chair

Bobbie Flint,
RMT, non-Board Member,
Co-Chair

Raj Anand,
non-Board Public Member 

Allie Bisset,
RMT, non-Board Member

Shayne Kert,
non-Board Public Member

Sarah Kingsbury,
RMT, non-Board Member

Cheryl Lewin,
RMT, non-Board Member

Sherry Liang,
non-Board Public Member

Sophie Martel,
non-Board Public Member

Jim Marinow,
RMT, non-Board Member

Amy McElroy,
RMT, non-Board Member

Jennifer Scott,
non-Board Public Member

Karalyn Van Aken,
RMT, non-Board Member

Summary of 2023 Accomplishments

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In 2023, the Discipline Committee operated remotely and held all its hearings virtually.

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In March 2023, the Discipline Committee began participating in the Health Professions Discipline Tribunals Pilot (HPDTP), a one-year pilot project in collaboration with the discipline committees of three other health regulatory colleges. The pilot explores innovative approaches to adjudication and achieves greater independence between CMTO’s Discipline Committee and Board, including by appointing experienced adjudicators as non-Board Public Members.

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In April 2023, the Committee amended its rules of procedure to introduce a new case management process for cases assigned to the HPDTP. It also added a rule to prohibit improper use of sexual history evidence in hearings.

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Continued education and training of members remained a priority. This included an annual orientation, attendance at the annual HPDTP conference, dissemination of a monthly newsletter, and training sessions on:

  • Procedural fairness and the role of panel members;

  • Decision writing and review, and conducting productive deliberations; and;

  • Key concepts and principles related to the law of evidence.

Cases Open in 2023, by Primary Allegation

34

Sexual abuse

7

Professional conduct & behaviour

3

Other (i.e., primary COVID-19 related concerns)

3

Unauthorized practice

0

Record keeping

9

Intent to Mislead, including fraud

0

Harassment/boundary violation

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56

Total cases

Findings of Misconduct from Closed Matters

1

Conduct unbecoming

7

Falsifying records or documents

16

Failure to maintain professional standards

18

Disgraceful, dishonourable and unprofessional conduct

4

Convicted of an offence relevant to suitability to practise

9

Sexual abuse

Penalty Outcomes from Closed Matters

19

Reprimands

13

Revocations

6

​Suspensions

6

Terms, conditions
or limitations

Note: Matters typically have more than one penalty outcome, and these numbers do not need to add up to a particular total.

Discipline Decisions

Decisions and reasons issued in matters closed in 2023 are linked below. On occasion, two or more discipline matters related to the same registrant are heard at the same hearing. In these cases, a single decision is issued that sets out the outcome for multiple matters.

Hearings

13

Contested

11

Uncontested

24

Total

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Fitness to Practise Committee Report

Committee Mandate

The Fitness to Practise Committee is responsible for hearing and determining allegations of incapacity made against a registrant.

Committee Members

All Board Members

Jalpa Patel, Chair

Bobbie Flint, RMT, non-Board Member,
Vice-Chair

Allie Bisset, RMT, non-Board Member

Summary of 2023 Accomplishments

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The Committee completed its annual orientation.

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The Committee held an incapacity proceeding in 2023.

Revewing Graphs

Summary Financial Statements

2023 Board

(As of December 2023)

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