Council Meeting Highlights - February 27, 2009
Prior to their regular Council meeting, Council members met for two hours with the Chair of the EMS Review Committee, Don Cummings. Council presented a brief and engaged Mr. Cummings in discussion of the College recommendations (see EMS Brief). Council stressed the key issue for EMS in Saskatchewan is the inequity in available patient care across the province and made four main recommendations to Mr. Cummings with numerous strategies to improve EMS services and recruitment, retention and competence of paramedics in the province:
- Broaden opportunities for paramedics to practice advanced skills
- Establish and enforce minimum standards for EMS staffing and responsiveness across the province
- Address the lag in scope of practice at the EMR and EMT/PCP levels to ensure adequate care is available in rural SK
- Ensure competency of EMS personnel
At its regular meeting on February 27, 2009, Council considered many issues. The highlights are presented below.
Approval of Continuing Medical Education Programs
Council adopted standards for approval of individual courses for CME credit (see CME Credit Courses) and also standards for approval of agency annual CME programs. Council noted that the CME Program approval standards for 2009 reflect a transition year and that the 2010 CME program proposals would need to include reference to the National Occupational Competency Profiles for paramedics at the various levels and more information on quality assurance measures.
The 2009 proposals for agency CME programs must be submitted to the College for approval before June 30, 2009, in order to be used to meet the requirements for licensure for 2010. If a program is approved, a summary assessment can be used by the practitioner in submitting application for 2010 license renewal. Without approval each individual activity will have to be submitted. Proposals for 2009 CME programs must include the following:
- An outline which clarifies how the program will meet all mandatory certification and CME credit requirements for the target practitioner level(s);
- For each course or activity for CME credit, clear outline of course objectives and duration to enable assessment for CME credit purposes;
- Information on instructor qualifications which demonstrates that appropriate qualifications are required for each element of the program;
- Description of the system to be used for registration and tracking of participants, and for issuing and maintaining official records of attendance and assessment outcomes;
- Declaration that the program can be audited at any time by the College.
Guidelines for Audit of the 2008 Agency CME Programs
Council also set guidelines respecting what factors should be considered in an audit of the 2008 agency CME programs. Council encouraged the College to begin random audits immediately. Council recognized that each agency could take a different approach or use differing tools, however, the fundamental elements should be observable and addressed to the satisfaction of the auditors. The guidelines include the following factors:
- Evidence of learning objectives, scheduling and duration of CME activities
- Random sampling of course content including participant materials, powerpoint presentations, etc.
- Currency of reference materials being used
- Appropriate qualifications of instructors
- Verification of participant attendance including participant name and registry number
- Evidence of appropriate evaluation including quizzes, examinations and skills assessments
- Random interviews with participants to verify their CME experiences
- Accurate record keeping and effective records management
Interim Licensing Examination Policy
Council noted the recent meeting of Canadian Paramedic Regulators (see February 19 2009 communique) which urged Saskatchewan to address the problem of graduates from other provinces avoiding the licensing examination in their home jurisdiction by applying for licensure in Saskatchewan (even if they did not intend to work here). These practitioners then use the Saskatchewan license to obtain a license in their home province without having to write the exam there. Council agreed this was problematic in view of the new labour mobility requirements as well as not wanting to attract to Saskatchewan practitioners who could not meet minimum qualifying requirements in other provinces.
Council adopted an interim licensing examination policy which requires all initial applicants for membership to have written an approved licensing examination effective immediately. Council noted that the Regulatory Bylaws Pursuant to the Paramedics Act say, in part:
Where a person can demonstrate that the content of the licensing examination was complete as part of the educational program completed for initial registration or through further education, the council may waive the requirement that the person complete the examination. (Section 3(b)(ii))
In accordance with the Bylaws, Council waived the licensing examination requirement for any graduate of a SIAST program. Council also waived the requirement for all EMR applicants.
Council also noted the Bylaws reference that applicants must “provide evidence of successful completion of the licensing examination approved by Council” (Section 3(b)). For purposes of this section Council approved the existing licensing examinations used by the paramedic regulators in other jurisdictions.
In effect, any paramedic applying for licensure in Saskatchewan must have successfully completed the licensing examination in the jurisdiction where they took their training. The SIAST comprehensive examinations will satisfy this requirement for Saskatchewan graduates.
This policy takes effect immediately. Council has also directed the College to move as quickly as possible to develop and implement a Saskatchewan licensing examination which would replace this policy.
AGM and Council Elections
Council noted that the Call for Resolutions is now active (see LINK). None have been received to date from the membership. Council approved resolutions to be put forward to amend the Act and Bylaws.
Council approved the Ballot to be used for Council elections and the procedure for ensuring a secure ballot process while still being able to track who has submitted a ballot through the mail. This information is necessary to manage the potential for members to vote at the AGM, rather than through the mail. The College would need to ensure that they are not voting for a second time.
The approach Council has adopted is similar to that used by SALPN, i.e. the ballot is sealed in a small envelope and placed in a larger envelope along with a signed statement by the practitioner which gives his or her registry number. When the College opens the larger envelope, the two items are separated. The practitioner’s name can be checked on the election registry, and the sealed ballot can be provided, unopened, to the appointed ballot counters at the AGM. An envelope containing a sealed ballot but no identifying signed statement will be considered a spoiled ballot.
The ballots will be mailed to members on March 8th and must be received by the College Executive Director by mail by May 7th or in person by noon on May 8th at the AGM.
Nominations closed on February 6, 2009. Council was advised that only the 3 positions of Members-at-Large would be contested in the election. All other positions have been filled by acclamation.
Audited Financial Statement for 2008
Council accepted the audited financial statement for 2008. Auditor Larry Baran addressed Council. Mr. Baran drew Council attention to the fact that revenues for the year 2008 were about half of the expenses incurred. He noted that the operational deficit for 2008 was $74,795 and that, with one-time start up costs, the total deficit for the year was much higher at $116,489. In essence although the College took in fee revenue for 2009 of $290,494, we will start the 2009 year with only $174,005 to cover the full year’s operating expenditures. Mr. Baran cautioned Council that they need to address revenue so that the College will have adequate funds for operational costs. Mr. Baran noted the audit was a “clean audit” with no concerns to report to Council.
Budget 2009 and Fees for 2010
Council considered proposals from the staff to curtail the 2009 budget to keep expenditures within the available revenue plus the $200,000 line of credit. Council confirmed its direction to staff to keep expenditures within this ceiling. Council noted that this will mean no new activity can be undertaken in 2009. Council further noted that the College financial situation should be reviewed again with the Auditor at mid-year.
Council examined several options for budget and license fees for 2010. Council noted that the original plan approved by the Board of Directors in spring, 2008, was for the fees in 2009 to be $300 and the fees for 2010 to be increased to $400. Council noted that because the Ministry of Health intervened to freeze the 2009 fees at $175, the College will have to incur a deficit in 2009. Now, in addition to operating costs which the original plan had estimated to require $400 fees, the College must also secure enough in fees to retire the debt over a period of time. Together with the debt incurred in 2008, it is possible that the College debt by the end of 2009 would be in the order of $300,000. To retire that debt in one year would require a license fee of approximately $600.
Council observed that the 2010 fee would have to be considerably more than $400 but judged $600 to be too high a price to pay and asked staff to prepare options that would retire the debt over a four year period.