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Council Highlights

Council Highlights for December 5, 2024

The 446th meeting of the RCDSO Council was held via Zoom on Thursday, December 5th, 2024. The assembly was also livestreamed. A video recording of the session is available on the College’s You Tube channel.

RCDSO President, Dr. Harinder Sandhu opened the meeting by acknowledging the success of the College’s most recent RCDSO Connect session of November 26th. Over 660 people attended to learn about antimicrobial stewardship. Dr. Susan Sutherland walked through the chair-side tool: Taking the Bite Out of Tooth Pain (Antibiotic Use in Dentistry). There will be many more RCDSO Connect sessions in 2025 with relevant regulatory and practical education topics.

Dr. Sandhu informed Council of his (and the Registrar’s) recent attendance at the ODA General Council. ODA members raised several interesting topics including health human resources and CDCP billing matters. Dr. Sandhu noted that there has been a significant increase in demand for oral health care in 2024 with the introduction of the CDCP. It is very positive for those who have not had care for a long time. However, accommodating all these new patients can be a challenge and we continue to hear that there is a significant shortage of dental hygienists and dental assistants. Dr. Sandhu underlined the importance of expanding interest in oral health as a profession—particularly for hygienists and assistants.

Connected to the CDCP, Dr. Sandhu clarified that co-pays are part of the CDCP, depending on income level. And they are required. Balance billing, he noted, is the difference between CDCP payments for procedures and the recommended ODA fee guide. The College permits balance billing, but it is not required.

Dr. Sandhu updated Council on changes to their membership. Public member, Christina Codeiro, former Royal Bank leader and contributor to Macau arts and culture, was reappointed for three more years. Council congratulated Ms. Cordeiro on her reappointment. Later in the meeting, Dr. Sandhu delivered a tribute and thanks to David Bishop, Dr. Amelia Chan, and Dr. Mark Eckler who have left, or are about to leave Council. Dr. Sandhu and Council thanked them for their exemplary service.

Dr. Sandhu thanked Council and staff for a productive and rewarding year in the service of the public interest.

Registrar & CEO Update

The written report from the Registrar & CEO, Dan Faulkner, included information on:

Updates to the regulatory and governance landscape:

  • The Alberta Government has indicated its intention to review legislation governing professional regulatory bodies, including health care regulators, with a focus on freedom of expression.
  • In October 2024, the Canadian Judicial Council issued Guidelines on the Use of social media by Federally Appointed Judges. The purpose is to provide guidance about the safe and appropriate use of social media, reinforcing that improper use of social media can undermine public confidence. The guidelines can be found here.

Partners and Collaborators:

  • In July, the College submitted an Expression of Interest to the Federal Government’s Oral Health Access. We learned that we have not been asked to develop a full proposal for this project. The President and the Registrar have been exploring other opportunities for possible funding sources. The project, if implemented, will add value to three areas of interest:
    • appropriately utilizing internationally trained dentists pursuing full licensure under supervised conditions in dental practices;
    • addressing access to care in underserved communities; and
    • building capacity in dental practices that have difficulty sustaining optimum staffing levels.
  • In October, Council endorsed Taking the Bite out of Tooth Pain, a toolkit for dentists to address appropriate antibiotic prescribing. The College will also be offering educational credits to dentists. By downloading the toolkit and using it in practice, dentists are eligible for up to five continuing education credits in Category 2. As of Dec 5, 231 dentists had downloaded the toolkit and indicated that they were implementing one or more of its resources. The link to obtain a CE certificate is Continuing Education Points: Self-Study Activity / e-Learning Program

College News

  • The College is making changes to its ongoing supervision and monitoring of dentists associated with investigative decisions. Self-reflection and peer review were recently added to augment the educational tools of ICRC. These self-guided options are used when the risk to patients is relatively low. These changes and additions help standardize approaches and build proportionate responses to investigative findings. They also utilize more effective educational tools to increase the likelihood of behaviour changes in practice.
  • Staff are learning more about the experiences of equity-deserving groups to help create an inclusive culture for staff, registrants and the public. In October, the College hosted a screening of Working While Black - TAIBU Community Health Centre. In November, the College staff welcomed the  Get REAL Movement to lead a Trans 101 workshop. Both events were well attended and created a space for meaningful conversation.
  • The College’s annual renewal cycle is nearing completion on December 15th. We have once again included a survey. The College is planning improvements to the survey and the survey platform for the Fall 2026 annual renewal. More information will be available in the coming months.
  • Two RCDSO Connect webinars have been held since the October Council meeting. In October, the College provided over 300 dentists with a session on cybersecurity in professional practice and described opportunities for non-Council committee membership. In November, the College hosted a sold-out webinar to present Taking the Bite out of Tooth Pain for Category 1 CE points. Both are available on RCDSO - YouTube.

Budget 2024

The College is in a healthy financial position. Each year, staff prepare a budget to fund the operations and business plan for the College. The Finance, Audit and Risk (FAR) Committee annually sets out the budget principles. The 2025 Operating and Capital Budgets were guided by the following:

  • a surplus operating budget that is reasonable and achievable;
  • adequate resources dedicated to the strategic plan and projects (required by CPMF);
  • operation in a flexible work environment to best meet the needs of Council, committees and staff;
  • incorporation of PLP divestment costs; and
  • workforce planning analysis which informs staff complement.

Highlights of the 2025 Budgets include a surplus, a record-low capital budget, and multi-year forecasts. Significantly, the 2024 operating surplus and the 2025 surplus plan will allow the College to meet the required Operating Reserve one year early—by the middle of fiscal year.

RCDSO CFO, Jeffrey Gullberg outlined the risks that shape assumptions and planning including cybersecurity, geopolitical tension, government direction and regulation. Council discussed and approved the 2025 Operating and Capital Budgets, with planned surpluses for the next four years.

Risk Management

The College has developed a formalized Enterprise Risk Management (ERM) framework. At the December 2023 Council, with the aid of a risk consultant, articulated an approach to risk appetite statements and ratings for each outcome. The Risk Appetite information was used to inform development of a risk framework was then reviewed by Finance, Audit & Risk Committee and brought to Council.

During 2024, management met with departments in the College to develop risk register for each area, based on the above framework. Risk registers were created for regulatory programs, information technology, human resources, finance, facilities, and communications and the office of the registrar. Across these departments a total of 107 risks were identified and assessed. These risks were incorporated into the six categories discussed by Council. They are, in no ranked order:

  • Council PLP Reserve Depletion (divestment transfer of liability exceeds reserve)
  • PLP Settlement Costs (large class action lawsuit);
  • Dental Competency Reporting (College cannot act on competence issues reported to PLP);
  • Disreputable comments (public comments by registrants that impair public trust);
  • Dental Practice Gaps (new procedures/processes not addressed by College e.g. AI);
  • College Standards (out of date standard);
  • Privacy Breach (unauthorized access to records or credit card information); and
  • Cyber Security Threats (ransomeware, phishing).

Access to Care

As part of the RCDSO Strategic Plan 2023-2025, work on the Access to Care strategic project continues to advance with the support of the Working Group. At this meeting, the focus was on a preview of what the Working Group is contemplating for the draft Professionalism document.

The Working Group has reviewed foundational research along with consultation feedback and continues to provide direction on the contents of the draft document. Ms. Cabrero Gauley, Senior Policy Analyst, led Council through a discussion of the provisional  recommendations the Working Group has made. The document is intended to:

  • Replace the RCDSO Code of Ethics and set out the principles and duties of professionalism.
  • Describe professionalism in the context of the key duties dentists have (i.e., fiduciary duty) as they are clear and relatable.
  • Organize the principles and duties by the classic bioethical principles of patient autonomy, beneficence, nonmaleficence (do no harm) and justice. These principles are common among health care professions and appear in most health care professionalism documents.
  • Incorporate provisions that speak to patient-centeredness, including that dentists provide care that is responsive to patient’s needs, values, beliefs, goals, social identities, and economic circumstances.
  • Set out the core duties dentists have (e.g., boundaries, consent, conflicts of interest), which may be expanded on in greater detail in Standards of Practice or other College resources.
  • Encourage dentists to participate in initiatives to help improve access to dental care due to the social or economic factors that disproportionately affect the health of some people. Dentists would decide which specific initiatives they would like to participate in Participation would not be required.
  • Embed language and ideas related to equity, diversity and inclusion.

Council was very supportive of the direction of the Professionalism document and had a number of suggestions for how to communicate the final content to registrants including via RCDSO Connect sessions, videos, and reminders on the portal at registration.

Council’s feedback from the discussion session will be shared with the Working Group and it will be considered, along with the public polling results (coming to Council in 2025). The draft Professionalism document will be reviewed by the Quality Assurance Committee and Council review in 2025.

The profession and other interested parties will be invited to provide feedback. Information will be available on social media and in the College newsletter.

Service Experience

Michelle Tremblay, Organizational Transformation & College Equity Officer, updated Council on the progress of the Service Experience project, one of the six projects under the 2023-2025 Strategic Plan. Improving the service experience for the public and the profession is part of the role of any modern regulator. This project work seeks to deliver more agile, seamless and responsive service for all who contact the College.

Ms. Tremblay outlined progress toward the four objectives of the program.

  • The RCDSO’s capacity to actively offer French service has been improved with updated phone queues, French website enhancements, translation of key documents and French staff recruitment.
  • Compliance with AODA requirements and the cultural support of accessibility has been improved with AODA customer training (100% of staff), AODA Compliance Working Group, Accessibility Policy and webpage.
  • The emphasis on service experience has deepened with the collection of service data, analysis of live answer call service, extended IT support and customer service training.
  • Improvements to the RCDSO portal, phone system refinement and the development of a web-based feedback offer have helped to improve our delivery of service to the public and registrants.

Professional Liability Program (PLP) divestment

Council received a brief update on the procurement process to transfer the Professional Liability Program (including current liabilities and staff) to a third party, with the goal of allowing the program to continue to operate, under separate ownership.

PwC, in consultation with the Procurement Review Group and legal counsel, has received formal expressions of interest. These proposals were reviewed by Procurement Review Group and PwC and a shortlist of proponents has moved to the second phase of the transaction process. In this phase, proponents will have access to a data room to enable deeper analysis of the business. In the new year, the proponents will be invited to management meetings.

College staff are currently working on a proposed by-law to establish what each registrant must obtain as minimal insurance requirements once this transaction has taken place.

The RCDSO will continue to keep the profession informed as the process progresses. In the meantime, PLP staff are available for inquiries. New and existing PLP cases will be processed as they always have been.

Governance

Several changes to Council membership were acknowledged and celebrated:

  • Christina Cordeiro, public member, who serves on the ICRC Committee and the Registration Committee, was reappointed to Council for a three-year term from November 26th, 2024, to November 25th, 2027.
  • David Bishop, public member, who has served the ICRC, Elections, International Trade and Executive Committees has stepped down from Council and submitted his resignation to the Public Appointments Secretariat.
  • Dr. Amelia Chan, who has served Council for eight years as a professional member, has reached her term limit. Dr. Chan has served on five committees: Audit, Discipline, Fitness to Practise, Legal & Legislation and Patient Relations.
  • Dr. Mark Eckler, who has served Council for eight years as a professional member, resigned from Council effective October 11th, 2024. Dr. Eckler served as the Chair of the Finance, Audit and Risk Committee and the Audit Committee. He was a member of the Fitness to Practise, Legal & Legislation and the Pension Governance committees as well as serving on the Procurement Review Group.

Election results for professional Council members were announced on December 12th. New Council members will attend the January meeting of Council. In addition, committee appointments will be recommended to Council on that date.

Next Meeting

The next meeting of Council will be hybrid (in person and via Zoom) on January 23rd, 2025. The meeting will also be livestreamed.