REPORT TO THE BOARD – June 25, 2025
Submitted by: Kelly Dobbin, Registrar and CEO
The Registrar-CEO 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
Strategic Planning
After a competitive process, the College has awarded a contract to Yves Doyon of Doyon Plus to be our strategic planning partner. Doyon Plus was selected based on the strength of their proposal, alignment with our goals, and their unique human-centred design thinking approach to strategic planning. They use an empathetic, co-design and iterative approach centering on lived experience and helping to ensure system alignment to arrive at a practical, inspirational, and innovative strategic plan. Anti-racism/anti-oppression principles are embedded throughout their process. We have met with them regularly in preparation for our in-person strategic planning workshop on June 24, 2025, and will continue to do so as we co-develop, finalize, and validate the strategic framework through to the end of the year.
In support of this work, we have reached out to registrants and a select group of system partners to help inform our direction. Midwives were surveyed as part of our initiative working with The Strategic Counsel (see “Registrant Survey” in Section 2 below), where other system partners were recently surveyed to gather perspectives on sector trends, key priorities, and opportunities for collaboration. Insights from both surveys will help ground our strategy in the realities of the system and will support thoughtful, values-driven decision-making.
Designated Drugs and Substances Regulation
The College is recommending to the Board to replace the category “Vaccines and Immune Globulins” in schedules 1 and 3 of the Designated Drugs and Substances Regulation O. Reg. 188/24 with the broader and more inclusive term “Immunizations and Immune Globulins”. This change would permit newborn midwifery clients to receive the recommended RSV protection treatment directly from their midwife as originally intended. Please refer to the briefing note under Agenda Item 10.
Laboratory and Specimen Collection Center Licensing Act, General Regulation
The College communicates regularly with Ministry staff regarding the proposed changes to the General Regulation under the Laboratory and Specimen Collection Centre and Licensing Act, 1990. We have made ourselves available for further discussion on our proposed changes but have not received any updates since the March Board meeting. As well, we continue to engage in strategic discussions with our system partners regarding access to appropriate tests for midwifery clients, which can best be achieved through midwives ordering and performing tests to their full scope of practice.
Registration Regulation
The College has not received any recent updates from the Ministry of Health regarding our proposed changes to the Registration Regulation. We have continued developing implementation policies based on the anticipated amendments.
Bill 2 – Protect Ontario Through Free Trade Within Canada Act, 2025
On April 16, 2025, the Ontario government introduced a new bill to boost interprovincial trade in response to U.S. tariff pressures. The proposed initiatives are as follows:
- Expand the “As of Right” rules to additional out-of-province regulated health professions including midwives. The rules were initially intended for doctors, nurses, respiratory therapists, and medical laboratory technologists registered in another Canadian jurisdiction to immediately begin working in Ontario, provided they register with the relevant Ontario health regulatory college within six months.
- Allow impacted health professionals to work in all types of settings.
- Expand the “As of Right” rules to include American-licensed physicians and nurses seeking to live and work in the province.
- Automatically recognize another provincial/territorial certificate of registration as a valid Ontario certificate of registration when the professional is practising in Ontario, beginning with nurses and physicians.
When the government went out for public consultation on proposed initiatives, we submitted a response expressing our support for improving labour mobility for health professionals but highlighting important concerns about maintaining public safety. We emphasized that assessing professional suitability (which includes good character) should remain our responsibility as the regulator, not that of employers, particularly in community midwifery practice settings. If exemptions are implemented, we recommended that employers be required to obtain a letter of professional standing and a vulnerable sector check. We also clarified that labour mobility is not a barrier for our applicants, as we typically register qualified labour mobility applicants within a day of receiving a complete application. We further urged the government to work with us to address the increasing number of midwives leaving Ontario, stressing the importance of balanced solutions that reduce barriers while ensuring safe, competent care for the public. Our complete response to Bill 2 is attached to this report.
Increasing Pathways to Registration
International Midwifery Pre-Registration Bridging Program (IMPBP)
The IMPBP’s Midwifery Skills Assessment Week is scheduled for early June, with the Chang School of Continuing Education confirming registrations from candidates across nearly all Canadian jurisdictions, the majority from Ontario. The intent of the week is to assess candidates’ skills through written assessments, OSCEs, and interviews, to determine their likelihood of success in the IMPBP. Successful participants will be invited to complete the remaining components of the IMPBP in September, with clinical placements taking place in spring 2026. Those who successfully complete the program will be invited to write the Canadian Midwifery Registration Examination in May 2026.
Baccalaureate Degree in Midwifery from Indigenous Institutes
The Registration Committee is recommending to the Board to recognize programs accredited by the Indigenous Advanced Education and Skills Council as being qualification that is equivalent to a midwifery education program delivered at an Ontario university. Please refer to the briefing note under Agenda Item 11.
Development and Achievement of Goals
Peer and Practice Assessment
The 2024-2025 cycle of the Peer and Practice Assessment Program of the Quality Assurance Program is complete. Ten per cent of midwives registered in the general class were randomly selected to participate in the peer assessment process. Seventy-four midwives were included in the program this year, and all midwives successfully met the requirements for peer assessment, with no midwives needing to advance to the practice assessment phase of the program (which is required should a midwife fail to achieve a satisfactory result in the first phase). This year, a post-assessment survey was included as a required component. We have reviewed the post-assessment survey results where key strengths and areas for improvement were identified by the midwives who were assessed. We will use this data to improve the program to reflect our regulatory aims.
Competency-Based Assessment Program
The Competency-Based Assessment Program (CBAP) was recognized earlier this year by the Registration Committee as a valid measure of entry-to-practise competence. The results of this assessment will inform the development of the requalification program for inactive or former registrants wishing to return to general class and for practising midwives not able to demonstrate currency requirements. The Registration Committee will continue to work on finalizing the criteria for an assessment referral, with the intention to approve the policy change at its October meeting.
Registrant Survey
The College retained The Strategic Counsel to conduct a survey of registrants to advance our initiatives under Strategic Priority 2: effective use of data to identify and act on existing and emerging risks, to better understand client’s needs and expectations of midwifery care. This survey will also serve as a baseline, tracking midwives’ perceptions of the College so we can better understand the impact of our work, an initiative under Strategic Priority 3: building engagement and fostering trust with the public and the profession. Through the survey, we aim to better understand midwives’ relationships and interactions with the College to identify areas for improvement. The survey was in the field from May 21, 2025, to June 4, 2025. Three hundred and sixty-three midwives (representing 33% of the registrant base) participated, spending over 17 minutes on average on their responses. This high response rates demonstrates engagement from the profession. We expect to be able to share high-level insights at the June Board Meeting.
Database Implementation
The College continues to work on the implementation of a new, cloud-based database. This database will replace existing information technology and provide a more reliable integrated system to support all aspects of registrant and applicant information management, including increased automation of application and registration processes; improved data management and reporting capabilities; the centralization and coordination of multiple stand-alone data and document management systems; and improved reliability. College staff have worked closely with the vendor to identify business needs and requirements, and the progress of the project, including staff training, has been on schedule. The College expects the transition to the new system to be complete this year, and a blackout period across the College’s information systems will occur as we transition data from the legacy system to the new system.
Reputation and Relationship Management
Spring Edition of On Call Digital Newsletter Published
This edition of the College’s digital newsletter included information on our survey for midwives, practice advice, Board acclamations, database updates, and Board highlights from our March meeting. Our digital newsletters are sent to our full email list of approximately 3,000 subscribers. This includes registrants, system partners, members of the public, staff, and Board and Committee members. The email was opened by 58.1% of subscribers, and 5.7% of subscribers clicked a link from the email to read more or access a resource. These metrics are higher than industry-standard. In our recent registrant survey, we asked midwives how useful they have found College resources, including the newsletter, in the past few years. This information may inform our new strategies for communicating with registrants.
Ontario Midwifery Strategy Council Meeting
The College met with the Association of Ontario Midwives, representatives from the Midwifery Education Program (MEP), staff from the Ottawa Birth Centre and the Toronto Birth Centre on April 28, 2025. The College’s staff leadership team had an opportunity to tour the Toronto Birth Centre and learn more about the Indigenous-led facility and practices. We discussed areas of mutual interest, including challenges related to developing, recruiting, and retaining adequate numbers of midwives to meet the public’s demands, and the role of midwives in the government’s primary health team plan.
College Communications with Members of Provincial Parliament
The College sent letters congratulating new and returning MPPs on their election earlier this year. In the letters, we requested they collaborate with us to develop, recruit, and retain midwives in Ontario, and ensure, as a matter of public interest, that the people of Ontario have adequate access to sexual and reproductive health care in the future. We shared that midwifery in Ontario is at a tipping point, and that there are currently just 913 practising registered midwives in Ontario, who oversee 26,000 births each year.
As the Board is aware, the College identified a notably high number of midwives leaving the profession in Ontario over the last few years, primarily to practise in other Canadian jurisdictions. In that time, we have not seen adequate numbers of midwives entering practice in Ontario to meet the needs of midwifery clients. We shared our concern that, without intervention, this trend will continue, and Ontarians will be without access to midwifery care. We requested to meet with MPPs to discuss possible legislative action to address this risk.
In accordance with our Government Relations Strategy, we sent letters to: Premier Ford; Deputy Premier and Minister of Health Sylvia Jones; Official Opposition Leader Marit Stiles; Official Opposition Health Critic France Gélinas; Official Opposition Primary Care Critic Robin Lennox; Parliamentary Leader for the Third Party John Fraser; MPP Adil Shamji; and MPP Aislinn Clancy. College staff also attended the provincial Speech from the Throne and spoke with elected officials at the reception.
Financial Accountability and Management
2024-25 Audit and Financial Statements
The College completed its annual financial audit in May. On May 7, 2025, the Executive Committee met with the auditors via videoconference to observe the audit process and ask questions. On June 11, 2025, the Executive Committee reviewed the draft Financial Statements with the auditors and is now presenting them to the Board for approval. Please refer to Agenda Item 6.
Q4 Statement of Operations
The Q4 Statement of Operations was initially presented to the Executive Committee in May for informational purposes only, as adjustments from the audit were expected. After the audit, the revised Q4 Statement of Operations was reviewed and approved by the Executive Committee on June 11, 2025. It is included in their report to the Board for your information. Please refer to Agenda Item 12.
People and Organizational Leadership
The College has developed a new Learning and Development Plan for the upcoming fiscal year. This plan was informed by feedback from the Organizational Effectiveness Survey, ongoing culture discussions, and operational planning activities. Looking ahead, we aim to develop a more comprehensive Organizational Development Plan in alignment with the new Strategic Plan.
In April, staff participated in a Foundations for Disability Inclusion training session led by the Centre for Independent Living in Toronto (CILT). This spring, the staff are also participating in ongoing training to prepare for the launch and implementation of the new cloud-based database.
Board Governance and Engagement
By-Election Results
The College issued a call for nominations for the 2025 Professional Board Director elections on January 27, 2025, and received two (2) eligible nominations for three (3) open positions. In accordance with the College’s General By-law, the two eligible candidates, Isabelle Milot, RM, and Abir Hoblos, RM were acclaimed for their positions. To fill the one (1) remaining Professional Elected Board Director position, the College initiated a by-election on March 13, 2025, by sending a call for nominations to all registrants. By the deadline for nominations on April 11, 2025, the College had received one (1) eligible nomination. The candidate, Jyothy Nair, RM, was therefore acclaimed for the position. We are pleased to have both Isabelle and Jyothy returning for another term and look forward to welcoming Abir to the Board for the first time in June.
Executive Committee Elections
The Executive Committee election period was launched on May 9, 2025, with a notice of elections sent to all Board Directors via email. The notice of elections highlighted the unique role that the Executive Committee members play in providing strategic organizational direction and oversight, outlining the strategic planning opportunities expected in the upcoming year. Through the notice of elections, the College invited all Directors to consider running and advised them to reach out to staff or the Chair with any questions. The Chair followed up with all Directors to encourage them to put their names forward and pursue the opportunity, ensuring that support will be provided to anyone who may have reservations. The election will be held at this meeting during Agenda Item 7.
Committee Appointments
The Executive Committee is recommending annual committee appointments for the 2025-2026 governance year. While appointments were approved by the Board at its December 2024 meeting, the governance calendar – now beginning in June, in alignment with the College’s fiscal year – requires them to be made again at this time. Committee appointments will be approved under Agenda Item 12.
Board and Committee Changes
Anna Boudria, Public Appointed Board Director, has submitted her resignation from the Board. We thank Anna for her contributions to the Board over the past year. On June 5, the College received notice of a signed Order in Council for Christopher Panos, who was approved for a one-year appointment to the Board as a Public Director. College staff have initiated Christopher’s orientation and onboarding process, which will continue into the summer months. We look forward to having Christopher join our Board of Directors.
Abir Hoblos, RM will be joining the Board for a first term beginning on June 25, 2025, having been acclaimed in this year’s Professional Director Elections. Abir has met with the staff team to undergo the orientation and onboarding process, which took place throughout the month of June leading up to the June 25 Board meeting.
Attachments:
College of Midwives of Ontario April 30, 2025- Response to Bill 2