Note: This public consultation is now closed.
This March, the College of Midwives of Ontario Council proposed changes to our Fees and Remuneration By-law that include a registration fee increase. If approved, this increase would bring the fees to $2150 for general class of registration and $1075 for inactive class of registration, effective for this year’s renewal. Fees would then increase by inflation, at 2% per year. While this was not an easy decision for Council, it is necessary in order for the College to continue fulfilling its mandate of public protection and meeting the cost of regulation.
As members are aware, the College’s statutory work is mandated by our governing legislation and we do not have the option of reducing or shifting our regulatory focus. This means that while we are fully committed to prudently managing our financial resources, we cannot avoid certain expenses.
Member fees cover the work that the College does; setting standards for the profession; registering new midwives and renewing existing members; administering the quality assurance program; and handling complaints and discipline cases; among other functions. These all work together to create a system of professional regulation, where Ontario families know that when they opt for a midwife, they are getting a professional that they can trust.
The complexity of the registration applications reviewed by the College has increased due to greater differences in the way midwifery is practised in other Canadian jurisdictions and due to alternative practice models becoming increasingly available in Ontario. While the number of complaints and discipline has not increased, we continue facing an increase in the number of complex investigations and preliminary inquiries.
The College’s work is also driven by external developments and the directives received from the Ministry of Health and Long-Term Care. Most recent examples include the work required by the Protecting Patients Act, 2017 and the Minister’s scope of practice and transparency requests.
As a member-funded organization, we are constantly examining our spending and looking for efficiencies. Last year, we embarked on a major change program to cut operational costs and to support more effective ways of working in the future. This includes streamlining our processes, reducing the number of staff where possible, and maximizing the use of available technology to create administrative efficiencies.
Through temporary expense savings we were able to hold membership fees for 2017-18. At the time, based on long term estimates, we calculated that fees would likely need to raise by a larger amount in October 2018. This year, the College has done a careful examination of the revenue and expenses of the College over the coming years and it has been determined we will need to raise general registrant fees by $200 in October 2018 followed by 2% inflationary increases each year thereafter, which is less than originally projected.
The relatively small size and slower growth of our membership mean that in order to maintain our core statutory functions, our fees do need to be higher than some other regulated health professions in the province.
A fee comparison shows that our fees are in the middle of the other midwifery colleges in Canada, as you can see below.
Another proposed change to the Fees & Remuneration By-law is to the way the College processes instalment payments. Currently, processing instalment payments adds about 60 hours of staff time each year. Council is proposing to add an additional administrative cost to registration fees paid in instalment. Members experiencing financial difficultly are able to apply to the Registrar for compassionate consideration and an altered payment plan.
Our consultation is open until June 3rd, 2018, and all members of the public, stakeholders, and midwives are invited to share their thoughts below.