REPORT TO THE BOARD – March 26, 2025
Submitted by: Kelly Dobbin, Registrar and CEO
The Registrar-CEO Quarterly Report assures the Board that the College operates effectively and achieves its strategic goals, and that the Registrar performs in accordance with the expected duties outlined in the Board’s Governance Policies.
The Registrar-CEO is accountable for the College’s performance in six main areas:
- Strategic Leadership and Direction Setting
- Development and Achievement of Goals
- Reputation and Relationship Management
- Financial Accountability and Management
- People and Organizational Leadership
- Board Governance and Engagement
Strategic Leadership and Direction Setting
Registration Regulation
The College has not received approvals or an implementation date for the proposed Registration Regulation. We continue to develop the policies required to support the changes in the proposed Registration Regulation, including the Midwifery Practice Requirement Policy.
Following the direction of the Registration Committee, the College initiated a consultation in early 2025 to gather feedback on a proposed Midwifery Practice Requirement Policy designed to address the following:
- Define minimum requirements that demonstrate whether the registrant has the judgment, skills, and knowledge necessary to practise safely and ethically.
- Establish an inclusive framework that recognizes various ways and volume in which a registrant remains current.
- Define midwifery activities that are directly connected to and support safe practice.
The survey received a robust response, with over 300 respondents, and all 27 questions in the survey specific to midwives prompted substantial feedback. This high level of engagement indicates a strong interest in the issues raised and underscores the importance of addressing them effectively.
Staff have thoroughly reviewed all feedback to propose an approach that both protects the public and reflects the insights shared by respondents. The Registration Committee will ensure that registrants’ feedback has been appropriately considered, and the public is sufficiently protected, when recommending the policy for Board approval at a later date.
Laboratory and Specimen Collection Center Licensing Act, General Regulation
The College has not received an update from the Ministry since our December 2024 Board meeting regarding the proposed amendments to the laboratory tests and point of care tests that midwives may order and/or perform.
Strategic Planning
Work is underway to support the Board in the development of our next strategic plan which will launch on April 1, 2026. A partner engagement plan has been developed to engage with members of the public, midwives, health regulatory system partners, and other key stakeholders to obtain feedback on how the College can best ensure that midwives provide safe, competent, and ethical care and how the College can better serve the interests of equity-deserving groups within our role and mandate. This information will be provided to the Board when available in preparation for the strategic planning session to be held on June 24, 2025, at the College’s office.
Development and Achievement of Goals
Strategic Initiatives
We are pleased with our progress on our current strategic initiatives, as indicated in the 2025 Operational Plan Progress Report (please see attached for details on our success and progress).
Peer and Practice Assessment
The 2024-2025 cycle of the Peer and Practice Assessment Program of the Quality Assurance Program is underway. Seventy-two midwives registered in the general class were randomly selected to participate in the peer assessment process. Selected midwives are provided scenarios that are typical of midwifery clinical practice and reflect real-life clinical issues and are asked a series of questions about their approach to care. The process is non-punitive, and assessors provide formative feedback to facilitate professional development and identify learning opportunities. This year, we have included a mandatory post-assessment survey for all participants to inform improvements to our program. We will report on the outcomes of the cycle in the Q1 2025-2026 Quality Assurance Committee Report.
Professional Development Portfolio Review
An in-depth review of the Professional Development Portfolio Learning Plans (which were selected for audit of 20% of the reporting midwives) has been completed. The College collected data on registrant demographics, types of learning goals, and activities completed by midwives (clinical and non-clinical). We now understand more about where midwives go to seek professional development programs and education, as well as the topics of learning they engage in. The College shared this information with midwives through the On Call newsletter in January, and with relevant system partners. Our review will also inform quality improvement for the program as we enter the next reporting year.
Competency-Based Assessment Program
The Competency-Based Assessment Program (CBAP) assesses midwives against the competencies outlined in the Canadian Competencies for Midwives in a transparent, objective, and fair manner. It offers a consistent and valid approach to assess former registrants re-applying for registration, midwives who are not able to demonstrate ongoing clinical currency, and inactive midwives returning to practise. By providing an objective method for assessing skills and knowledge, the program is primarily focused on the protection of the public and the identification of areas where further development in skills and knowledge may be needed.
At their February 2025 meeting, the Registration Committee recognized the CBAP as an effective tool for determining if candidates have the necessary skills, knowledge, judgment, and competence to practise midwifery safely and ethically. The program will be used by the Registration Committee panels to inform their decision-making process, where appropriate.
Given the uncertainty about the timing of the proposed amendments to the Registration Regulation, the Registration Committee has directed the College to implement the program as soon as possible under the authority of the current regulation. Implementation is now focused on the administrative aspects of the program and updating registration policies to identify those who would be required to complete it. We expect the CBAP to launch before the end of the calendar year.
Health Professions Discipline Tribunal
The Discipline Committee met on December 11, 2024, and received a presentation from David Wright and Dionne Woodward of the Health Professions Discipline Tribunal (HPDT). Following the meeting, the Discipline Committee directed staff to further explore the feasibility and implications of joining the HPDT and report back their findings. This work is currently in progress. One of the key considerations in joining the HPDT is to support governance modernization. We acknowledge that the volume of cases referred to the Discipline Committee by the Inquires, Complaints, and Reports Committee (ICRC) at our College has historically been low.
Migration to Thentia Cloud Database
The College is migrating to Thentia Cloud, a highly configurable platform provided by our existing database provider, Thentia. This new database offers enhanced automation, improved data capabilities, and greater flexibility in configuration, which will help streamline workflows across departments. The migration project is expected to take approximately five months, starting in March 2025. Staff are actively involved in the development and implementation of the project, working to tailor the system to our specific needs and enhance operational efficiencies. A communication plan for midwives who access the database through their online portal will also be included as part of the overall project plan to support with implementation.
Reputation and Relationship Management
Unauthorized Practice of Midwifery / Use of Title
Within our mandate to protect the public, the College monitors reports and issues related to the unauthorized practice of midwifery and unauthorized use of title and takes action where appropriate. This past quarter, the College has noted the following:
- College staff attended a webinar on February 11, entitled Freebirth in Ontario presented by Dr. Sharon Dore, hosted by the Ontario Perinatal Death Review Committee (OPDRC). Topics covered in the presentation included defining freebirth and unattended birth, outlining the scope of freebirth worldwide, describing outcomes of freebirth, discussing the motivating factors that influence parents to choose to freebirth, and examining strategies to improve the birth experience.
- The College received and reviewed the 2021-2022 annual report of the OPDRC. The report speaks to their review of maternal and newborn deaths identifying an unexpected cluster of deaths occurring at planned freebirths. Between 2020-2022, seven cases were reported, compared to three between 2013 and 2019. This resulted in the committee strongly supports the attendance of a recognized obstetrical care provider (i.e., midwives or physicians) at all births. Please refer to the relevant excerpt here.
- The College has seen an increase in former registrants of the College continuing to use the protected title of midwife after resigning from the College. Only registrants of the College are entitled to use the protected title. While we recognize the deep connections these individuals maintain with the profession and the value midwifery holds in their life and career, the College is required to act on reports on the inappropriate use of title.
Winter Edition of On Call Digital Newsletter Published
This edition of the College’s digital newsletter included information on how to stand for election to the College’s Board, summary information from the 2024 Professional Development Portfolio reporting cycle, updates for internationally educated midwives, and Board highlights from our December meeting. The email had a 62.5% open rate and a 6.5% click rate, both of which are higher than industry standard.
Meeting with the Association of Ontario Midwives
The College met with the Association of Ontario Midwives on February 10, 2025. We discussed areas of mutual interest, including the status of regulatory changes the College has submitted to the government, the timing of new registrant offers, midwifery sustainability, and impacts of the new global liability insurance for midwives.
College Meetings with Members of Provincial Parliament
Following the Association of Ontario Midwives’ reception at Queen’s Park, the College requested to meet with elected officials who spoke about midwifery scope of practice in their remarks. College staff met with Official Opposition Health Critic MPP France Gélinas and MPP Aislinn Clancy at the end of 2024. The purpose of these meetings was to listen to their scope of practice questions and share changes the College believes would be in the best interest of the public. Meeting requests with Deputy Premier and Minister of Health Sylvia Jones, and MPP Adil Shamji have not been responded to.
College Presentation at McMaster University
The College recently presented to the soon-to-be graduates of the midwifery education program at McMaster University. One of the activities in our Student Engagement Strategy is to visit midwifery education program classrooms and provide essential information about our mandate and the steps for registration upon program completion. We regularly engage with students to ensure that they are well-informed about our work and processes from the outset, facilitating a smoother transition as they embark on their midwifery career.
Financial Accountability and Management
Statement of Operations
The Q3 Statement of Operations was approved by the Executive Committee at its most recent meeting and is included in the Executive Committee’s report to the Board for your reference.
2025-26 Budget
The proposed 2025-26 budget was presented to the Executive Committee in February. The budget development process was collaborative, involving staff input to forecast anticipated revenue and expenses based on assumptions and estimates. The College is pleased to propose a balanced budget and maintain the freeze on registrant fees. The Executive Committee is now presenting the proposed budget to the Board for approval.
People and Organizational Leadership
Recruitment
We are pleased to announce that David Tallo joined the College in January 2025 as a Policy Development Officer in the Registration Department. With over 25 years of experience in the regulatory field, David brings extensive expertise in policy development, project management, and stakeholder engagement.
Organizational Effectiveness Survey
The College conducted its annual Organizational Effectiveness Survey in January 2025. This survey provides an opportunity to gather feedback on the College’s strengths and areas for improvement in key areas of organizational effectiveness. The results will guide activities and actions throughout the year. The Board will receive a presentation of the results during its in camera session.
Equity, Diversity, and Inclusion Initiatives
During Black History Month College staff reflected on the rich history and the profound impact Black midwives have had on maternal health and reproductive justice, both historically and today. The history of Black midwives in Canada is not forgotten, and while much of it has been erased, there are many initiatives rediscovering their legacies and celebrating their enduring impact. For example:
- Colour of Birth, produced by the Canadian Midwives of Colour History Project is a multimedia experience exploring and documenting the history of Canada’s earliest, racialized, immigrant midwives and their communities during the 19th and early 20th centuries.
- Learn More: Ontario Midwifery – a project inspired by Black communities, birthing people, children, midwives, and midwifery students – presents public information about midwifery care in Ontario with the aim of increasing public awareness about midwifery care across Black communities.
During Black History Month, College staff took time to view an episode of For the Culture with Amanda Parris – a personal documentary series where Amanda goes on a revelatory journey into some of the most important stories impacting Black people around the world – called “The Standard of Care.” This episode explores the Black maternal health is in crisis in the Canadian context and asks: What is the standard of care necessary for Black birthing people to feel safe in childbirth? After viewing, staff engaged in a discussion about the connections between the troubling truths explored in the episode and our role as a public interest focused midwifery regulator, then began identifying opportunities to advance our commitment to anti-racism in response. In addition to the viewing and discussion, a list of resources, events, and initiatives was developed and shared to support staff in further learning and celebration of Black History Month. These discussions and explorations are ongoing and essential as we continue developing our comprehensive Equity, Diversity, and Inclusion strategy and move into the strategic planning process.
Board Governance and Engagement
Professional Director Elections
The College officially launched the 2025 Professional Board Director elections on January 27, 2025, by sending a call for nominations to all registrants. This election cycle is to fill three Professional Director positions with successful candidates beginning their terms at the June 25, 2025, Board meeting.
The College sent three emails to all registrants regarding to call for nominations and included information in our Winter On Call newsletter. We shared it on our social media channels during the nomination period. The call for nominations was also shared with system partners, posted strategically, and the Association of Ontario Midwives included our information in an edition of their newsletter. College staff and the Chair conducted two information sessions – one general session for all interested midwives, and one specifically for midwives who identify as Black, Indigenous, and/or racialized – on February 6, 2025, to meet prospective candidates, answer questions and provide more insight into the opportunity.
Nominations were due to the College on February 28, 2025, and three nominations were received. In accordance with the eligibility criteria outlined in article 5.08 in the College’s General By-law, one candidate was deemed to be ineligible to stand for election. The other two candidates will be acclaimed of their positions, and a by-election was launched on March 13, 2025, to fill the final seat in time for the June Board meeting.
Third Party Board Evaluation
The College’s Governance Policies, specifically GP10: Governance Evaluation, dictate that the Board will evaluate its effectiveness annually and conduct a third-party Board effectiveness assessment every three years. In accordance with this schedule, the Board is due to implement another third-party assessment this year. This requirement is also in keeping with the standards outlined in the College Performance Measurement Framework (CPMF), one of the College’s accountability reports that is submitted to the Ministry of Health on an annual basis.
Staff have conducted an environmental scan of several regulatory Colleges to determine what work they have undertaken with respect to third-party assessments. This scan aids us in identifying a scope of work for our request for proposals to obtain a consultant for this purpose.
The core objective of this assessment will be to build on the Board’s current annual evaluation process while enhancing our understanding and identification of key metrics for strategic and effective Board performance and competencies. A consultant will be recruited to implement the assessment with the assistance of the Governance and Strategy Department, in alignment with ongoing governance modernization initiatives and governance best practices.
The College aims to implement the evaluation in November 2025, and report results back to the Board in early 2026.
Governance Modernization
The Executive Committee is guiding the Board’s governance modernization efforts. Please refer to the Executive Committee Report in the Board materials for details.