About this consultation
The Fees and Remuneration By-law has been reviewed by Council and the College is consulting on several proposed changes.
The goals of Council’s review of the by-law were to:
- Ensure that fees and fee practices are equitable and proportional.
- Ensure that fees reflect operational resources and to streamline fee practices and processes.
- Alignment of the by-law with other College governing documents.
Council and staff collaborated on this data-informed process to propose an updated by-law. We also reviewed the by-law through an equity lens and considered potential unintended consequences. Lastly, in reviewing the by-law, an environmental scan took place to compare fees, fee practices, and per diems with those of other regulated health Colleges.
The proposed changes to the by-law are open to a 60-day public consultation from Thursday, April 4, 2024 to Monday, June 3, 2024. Following the 60-day consultation, the Fees and Remuneration By-law will be brought to Council for final review and approval at its June 2024 meeting.
Consultation request
The comparison table outlines the current provisions in the by-law, along with proposed changes and their respective rationales.
Update: April 8, 2024.
To provide greater clarity on the proposed changes to the Fees and Remuneration By-law, we would like to highlight three substantial areas of change for consideration. Please refer to the full consultation table to learn of all proposed changes and give your feedback after reading the document.
Changing the automatic annual increase in fees:
Currently, registrant fees in all classes of registration increase 2% per year without any option for the College to raise fees by a lesser amount. The proposed by-law allows for consideration of an inflationary increase that may be up to 2% and rounded up to the nearest dollar. This would allow for the College to decide to freeze fees in a given year, as is being proposed for the 2024 renewal period.
Elimination of installment payments:
Council is proposing the removal of installment payments in article 4.8. Current practice involves allowing payment of the annual fee in two installments on specific dates. Registrants facing financial challenges will still have the option to request a modified payment plan.
Changes to administrative fees in some areas:
The College is proposing to increase administrative fees in some instances and removing administrative fees in other areas. Please review the comparison document for more information.
How to provide feedback
You may submit your comments on this page below until Monday, June 3, 2024. You may also email your comments to cmo@cmo.on.ca.
Anonymous on April 20, 2024
The CMO needs to look at drastically reducing costs and therefore fees, not increasing fees. I disagree with any increase in fees. We need incentives to remain active and inactive members. The fee for inactive status needs to be drastically reduced, and at least a cap on the active fees.
Anonymous on April 14, 2024
I agree with many of other comments here I do not support these fee increases, they are proportionally difficult to afford. I am also concerned about the removal of the instalment fees. There should be a move to monthly rather than taking away instalments. This disadvantages midwives who are struggling financially and new registrants who have high upfront costs, student loans.
Midwife on April 11, 2024
I am really upset about our exorbitant CMO fees. this recent increase up to 2706 is roughly a thousand dollars over where our fees were.
So the CMO has decided to charge midwives a FULL COURSE OF CARE, just to have a job!!! A full time midwife carrying 40 clients, a part time midwife carrying 20+ clients? has to send an ENTIRE course of care to the CMO just so she can have a job. between our CMO and AOM fees and continuing education/recertifications, midwives basically provide care for 3 clients FOR FREE every year just so we can work!!
our CPSO colleagues pay $1795 yearly.
$2706 per active midwife per year is ridiculous. no fee installments is ridiculous.
midwives are already unpaid for a myriad of work we provide.(eg first trimester losses) because our fee schedule with the government doesn’t allow for us to receive ANY funding for care less than 12 weeks and/or midwife attended birth. I and my midwife colleagues have provide care to countless women in clinic and over the phone and at their homes following first trimester losses and don’t get paid for that work. and yet we’re charged an entire client by our college so that we can work and provide that unpaid care
I am just outraged at the cost of our college fees and I don’t understand where all this money we pay to the CMO actually goes. ridiculous.
Midwife on April 11, 2024
I am not in favour of an increase in fees this significant. Yes, costs rise with inflation, but CMO overhead should not be managed by midwife members. We’ve worked hard – and paid through the nose – to see our compensation increase and now that little extra is going to be consumed by the CMO?
I’ll have to pay a lump sum fee for the year on return from a maternity leave when over a quarter of my mat leave income was consumed by benefits payments? I have to pay $100 just to return to active status? That seems punitive to parents. A classic misogynistic move. Punish women for having families.
I know the CMO exists to protect the midwifery consumers and not midwives, but Ontario midwifery will cease to exist if attrition continues at the rate we’re seeing. Practicing in Ontario is already so expensive. Support midwives, do not carry out these prohibitive fee increases and schedules.
Midwife on April 11, 2024
The AOM has found a way to allow monthly installments. The College must do the same, or at the very LEAST allow the fees to be paid in two payments like it has been done until now. Talk to the people at AOM and find out how they do it. You cannot bring up the excuse of a hugs drain on the resources twice per year when the Association does it 12 times. You must find a way to at least keep it as it has been.
Member of the public on April 10, 2024
As a midwifery student these proposed changes are terrifying and out of touch. I completely agree with the other points made by others commenters. Though I would also add that as a previously registered health care professional in Ontario my regulatory college did not charge annual fees as steep as this and yet they were still able to protect the public. Please listen to your members and reassess.
Member of the public on April 10, 2024
These fee increases are going to hurt the public. Burdening under supported healthcare workers with significant steep increases de-incentivizes knowledgeable , skilled, talented and compassionate midwives from remaining in the field. As the purpose of the college is to act in the best interest of the public and protect us, this can best be accomplished by supporting midwives. These increases are out of line with cost of living pay increases of your staff members putting further behind every month. The public is served and protected by supporting incentivizing talented individual practices. If the college requires an increase in finances starting by looking at ways to minimize waste and downsize expenses of the college and advocating for appropriate subsidies from the government
Midwife on April 10, 2024
I echo the sentiment of the rest of the profession it seems. Why anyone needs offices since Covid is beyond me. Home was good enough during the pandemic and probably a great deal cheaper than Toronto real estate. I do not agree with any fee increase. Fees continue to rise and yet very little (if anything) is given in return. We continue to fight for equal pay and basically have to work 1-3 bcc for some to simply pay for the fees to have the privilege to work (AOM included) How is the increase more than inflation? I honestly thought NMC was expensive when it moved from 75 to £125 a year . Maybe the CMO could take note of the other midwifery governing bodies whom also manage the same job for next to nothing in comparison to CMO fees. It certainly feels like we are fighting a loosing battle as a profession. Increased workload without any financial gain, lump some payment (even the AOM are stopping monthly paying adding tot the financial burden) benefit cost increase whilst the cover is getting worse.
As for inactive fees… what is this even paying for. Who pays NOT to work? Could they simply not be put ok hold during the leave.
I hope in future someone stands up for the midwives who continue to work on the front line and advocates for us as fiercely as we do our clients.
Midwife on April 10, 2024
Here to echo what countless other midwives have already said. please figure your overhead out, work diligently on reducing spending, for goodness sake move to more affordable office space, allow us to pay in monthly installments. our fees are so high as is. your model is not sustainable as it is and college members are paying the price for it. please fix it.
Midwife on April 10, 2024
I do not agree with or support any increase in fees. Midwives already pay one of the highest college membership fees out there in the healthcare industry. Especially the inactive fee. Asking someone who’s not currently practising to pay over $1000 a year just for the possibility of returning to work when they are able, is ridiculous. It should be cut in half at least. Increasing the inactive fee will cause many more midwives who are currently on leave to simply resign instead of maintaining the possibility of returning. We already have a horrifying attrition rate. Let’s not make it worse. Let the inactive midwives remain inactive for less, and perhaps some of them will return to work when they are ready. Once they resign it’s so much more difficult and more unlikely they will ever return. I know that’s the case for myself and many of my Midwife colleagues. And active Midwives who are trying to practice part time already struggle to pay the enormous membership fees. Midwives in Ontario are dealing with a lot right now. The college should support them not charge them more. The college needs to find other ways to reduce their costs. Perhaps finding less expensive rent for their office or look at salary cuts.
Do not increase membership fees active or inactive.
Anonymous on April 9, 2024
I agree with other comments. Fees continue to increase with more restrictive access to services and despite the fact that fees were supposed to decrease with the growth of the profession. It costs money to go inactive when someone is usually going inactive due to a leave of some sort which often results in significantly less income to pay for the fees the CMO is charging to go inactive. Why is the inactive fee so high, what exactly are we paying for when we are not working????? Seems like we are paying to be penalized for a leave. This is ridiculous, punitive and I agree makes it more and more difficult for people to remain in the profession. Then when you want/need to become active again you have to pay more fees plus the full amount of the active membership fee when you have not been working and therefore likely do not have the money to pay these fees. Plus when you have gone inactive for ANY reason you are scrutinized very closely, and often restricted in your ability to work when the CMO FINALLY decides you can work again as the process to become active again has become a very lengthy one over the last few years and has caused many delays in people being able to return to work. This process further penalizes people when they are already often in a vulnerable financial position.
I have also thought for a VERY long time (as I have been in the profession for more than 20 years now) that we should have the option to pay the CMO fees monthly as the AOM does. Why has the AOM been able to figure out this option but the CMO has not and is in fact now making it MORE difficult to pay fees we have no choice but to pay if we want to continue in the profession. I understand the role of the CMO is to protect the public but this should not come at the expense or determent to its members, the midwives who are providing care to the public.
As for hybrid work I agree with others in that it’s not my problem your overhead is high. If you are paying for office space then paying for people to work from home it seems you would be paying more to accommodate this model of work. Plus I presume you are paying double for services such as phones, internet and other office expenses as the CMO would be paying for all of this in the physical office in Toronto plus in peoples homes. If the AOM is also working in a hybrid model why not have one office space for both CMO and AOM if you have to continue with any physical office space at all.
Midwife on April 8, 2024
I echo other comments that fee increases are unmanageable for midwives; we are STILL struggling for pay equity and grossly underpaid. I understand that fees will not be increasing in 2024; however, that is small compensation. We were assured that as the profession grew, the fees would decrease. When will this happen? I also understand the CMO is already doing a hybrid model, with some staff working from home; therefore decreased overhead costs will have to come from moving away from Toronto real estate. As for the Inactive class fee, this should be reduced even further. $1,187 + $50 admin fee is a hefty amt. to ask someone to pay when they have no midwifery income. If we want to encourage midwives to stay involved with the CMO then I recommend fees be changed to 25% of the Active class fee, instead of 50%.
Anonymous on April 7, 2024
I understand the increasing costs of life currently and wanting to reenumerate staff accordingly, however I am not in agreeable with a fee increase. At a time when attrition rates are high and recruitment is difficult the fee increase is prohibitive and restrictive for midwives. The astronomical amounts that we pay in fees for AOM and CMO make it challenging to go part time.
I feel that the college needs to look at other creative ways of lowing overhead costs. Hybrid work from home models? Why do we need an office downtown Toronto with high rent costs etc?
Anonymous on April 6, 2024
Years ago we were told that once midwifery grew as a profession our fees would finally decrease. Now instead we are being asked to pay $2,700 a year. Worse we are being asked to pay in one lump sum. Most of the comments say the changes are to reflect inflation and align with other Colleges. Are you saying other professional members are actually paying that much?
Anonymous on April 6, 2024
I am also in agreement with other comments that reviewing operational costs- downtown site-should be considered. Midwives are forced to pay the extra downtown costs to provide care within our catchment area- however this is not needed by our College. In addition- the cost savings for the College with regards to instalment payments vs lump sums: does not reflect in our fees. If this is costing the college extra to have the instalment payments- but you are eliminating- where does this reflect in our “the applicant” savings?
Midwife on April 5, 2024
I don’t agree with these changes. Reduce costs, as opposed to passing those costs onto us. I get it…inflation is a thing. But now my minimal pay increase (which I’m thankful for) is going to be gobbled up in increased fees. I agree with others…the fees of doing this job make it prohibitive to want to continue.
Midwife on April 5, 2024
Absolutely not surprised that fees are increasing to match inflation and cover overheads of running the college while the registrants who have to pay the CMO for the privilege of working (or not in the case of inactive members). As many in the comments here have expressed, reducing overheads is the responsibility of the College. I suggest financial transparency to assist the registrants understanding the need for increases and to ensure the College is accountable for reducing their financial burden for the sake of the environment, the public and most importantly, the registrants who leave the profession due to the seemingly limitless barriers to practice.
Anonymous on April 5, 2024
I am rather disheartened by the increases suggested. I as many have suggested this before but the CMO has to seriously consider reducing their large overhead expenditures such as eliminating Downtown Toronto office and moving to hybrid work situation so people at CMO can work from home and reduce rent costs and not insist on midwives to continuously have fee increases that affect our earnings. This comment feels like a broken record as every fee increase we see, we ask for this model of increasing fees be examined and find cost savings yet the fees go up. It is also rather harsh to expect midwives to pay fees of this size once a year. I think as a bare minimum this needs to be reevaluated as the AOM has found ways to manage a monthly fee system. Although it doesn’t fix the increase, it at a minimum allows midwives to balance their expenses in relation to their earnings.
Anonymous on April 5, 2024
I think the increase should be 2-3%, as the rest of us have the same increase. We have a costly job. This job costs us our health, finances, and many other aspects of our lives. As an experienced midwife, I think I will work less, but at the same time, I have to pay at least 7-8 thousand dollars to be eligible to work. Maybe CMO and AOM will consider moving to another location with lower rent at least.
Anonymous on April 5, 2024
I would agree, the cost of fees for being a midwife is prohibitive and may discourage midwives working part time. Without a viable option to work part time, many more midwives will be leaving the profession. I believe the College should be looking aggressively at ways to reduce costs.
Midwife on April 4, 2024
Asking an already inactive member (likely on some kind of leave with a reduced income) to pay $100 to change their membership status seems steep, and presents another barrier in addition to the many expenses of taking and returning from a leave.
Midwife on April 4, 2024
both AOM and CMO pay rent in expensive places of Toronto, so now is the time to think of bringing costs lower, rather than working almost 3 caseloads to pay for the membership of CMO and AOM, plus when it gets to benefits, as a midwife I have to pay a lot more for medical and dental expenses for myself and my family ,…
Midwife on April 4, 2024
Agreeable with proposed amendments
Midwife on April 4, 2024
These increases are basically horrifying given midwifery salaries do not increase to “reflect inflation”. Our pay is increase 3% this year. You could increase everything by 3% and take away any gains we are achieving with our pay. Instead, you are increasing our (already completely outrageous fees) by 8%. I suggest matching increases in midwifery pay if you have to increase at all.
Between the CMO and the AOM, it costs us over 8000$ to be midwives every year. These proposed changes make me want to cry. At least the AOM allows us to pay monthly to reduce the financial burden, particularly on those of us who do not have a second income in our families or new midwives who are starting lower on the pay scale/etc. I propose you allow the choice of monthly payments. Or have the first half remain as a lump sum and the second half as monthly payments. Something to be kind as we all face lives that “reflect inflation”.
It is getting harder and harder to justify the costs of being a midwife and I worry that the decisions of the college, including these changes, are contributing to attrition rates within midwifery.