2018 Annual Report

100 Years of Quality, Integrity and Competence in Massage Therapy

College of Massage Therapists of Ontario | 2018 Annual Report

Table of Contents

From Our Leaders ……………………………………………………………………..…………….………………………PG 3

2018 Strategic Plan Update …………………………………………………………………….….……………….....PG 6

A Visual Snapshot of Massage Therapists in 2018…………………………………….……………….……PG 15

2018 Committee Reports……………………………………………….……………………………..………………..PG 20

Summary Financial Statements……………………………………………………..………………………………..PG 34

2018 Council……………………………………………………………………………………………………..…………….PG 37

2018 Committees………...………………………………………………………………………….………...………..…PG 37

College of Massage Therapists of Ontario

1867 Yonge Street, Suite 810

Toronto, ON, M4S 1Y5

Phone: (416)489-2626

Toll Free: (800)465-1933

Fax: (416)489-2625

E-mail: cmto@cmto.com

Website: www.cmto.com

Twitter: @CollegeofMT

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LinkedIn: College of Massage Therapists of Ontario

College of Massage Therapists of Ontario | 2018 Annual Report

From Our Leaders

Message from the PresidentReflecting on 100 Years of Regulation of Massage Therapy

Lisa Tucker, RMT President

With 2018 behind us and 2019 well underway, we mark 100 years of regulation in Massage Therapy in Ontario.

100 years of providing ethical care for clients, of being recognized as healthcare professionals, and 100 years of regulation that protects the public interest. A century of regulation that has helped shape Ontarians’ expectations of quality, competence and accountability in Massage Therapy care.

While Massage Therapy has been part of healthcare for a century, the needs and expectations of the public have constantly changed and evolved. As the public’s expectations for quality care evolve, so must the profession, and importantly, so must the College. Some of the key milestones in the regulation of the Massage Therapy profession are highlighted on pages 17 to 20 of this year’s Annual Report.

In 2018, the College of Massage Therapists of Ontario (CMTO)’s Council focused on propelling the College on its path to becoming a more agile, accountable and modern regulator. We did this by reviewing progress against our 2016-2018 Strategic Plan, renewing our Strategic Plan for 2019-2021, overseeing and approving CMTO’s Annual Workplan, guiding the College’s decision-making, and supporting the organization in its implementation of continuous quality improvement and organizational effectiveness initiatives.

Our Council is an almost equal (one more professional member than public

appointee) mix of public members (appointed by government) and professional members (Registered Massage Therapists or RMTs). To guide our deliberations and decision-making, we focus on – first and foremost – protecting the public interest, and using our knowledge of the healthcare and practice environments to ensure the College is regulating in a risk-based and proportionate way that meets the evolving needs of the public.

The number of Massage Therapists has grown steadily over the years. Today, there are over 14,500 Massage Therapists registered with CMTO. As Council President, I am extremely proud of the work that CMTO accomplished in 2018, and honoured to have the opportunity to serve the public interest as we enter into our second century of Massage Therapy regulation in Ontario.

College of Massage Therapists of Ontario | 2018 Annual Report

From Our Leaders

Message from the CEO & RegistrarReflecting on Our Achievements in 2018 and Welcoming a New Century of Massage Therapy Regulation

Corinne Flitton, RMT, Registrar & CEO

As our President Lisa Tucker describes in her message, Massage Therapy is marking 100 years of regulation that guides Massage Therapy care.

CMTO’s mandate as set out in legislation is to govern the Massage Therapy profession while serving and protecting the public interest. We are guided in regulation by the College’s Strategic Plan which sets out the vision for the College to be positioned at the forefront of evolving professional regulation; inspiring trust and confidence.

The Annual Workplan enables the Strategic Plan.

This year’s Annual Report summarizes the progress we have made in achieving CMTO’s Strategic Goals in 2018, and sets the stage for the College’s refreshed 2019-2021 Strategic Plan.

The Strategic Plan (2016-2018) has three interrelated goals. The definition of each goal clarifies the specific value that the public will receive from the plan.

Our Goals

- Transparency: Well-informed stakeholders (public and RMT clients)- Quality: Clients receive evidence-informed Massage Therapy- Regulatory Modernization: The public and MT clients are protected through balances

and proportionate risk and outcomes-based regulation

Each Strategic Goal has several outcomes, which is what regulation under each goal looks like when the Strategic Plan is fully implemented. To achieve the outcomes, CMTO developed specific strategies. Some of the strategies are developed to align with the priorities of Ontario’s Ministry of Health and Long-Term Care; others align with the needs of Massage Therapy clients, or with proportionate, evidence, risk and outcomes-based regulation, or Right Touch Regulation as articulated by the Professional Standards Authority in the UK. Specific projects and activities relating to the strategies are added to our Annual Workplan, which breaks down the strategies further into yearly projects.

To support achievement of the Strategic Plan, CMTO has also undertaken continuous quality improvement and organizational effectiveness initiatives to ensure that it has the capability,

College of Massage Therapists of Ontario | 2018 Annual Report

capacity and resources (HR, Finance, IT and data and facilities and infrastructure). An update on the College’s progress in 2018 against each of the goals is described in this report.

CMTO takes the privilege of regulating in the public interest very seriously and we look forward to carrying out Council’s Strategic Plan for 2019-2021 in what will mark the beginning of the second century of Massage Therapy regulation in Ontario.

College of Massage Therapists of Ontario | 2018 Annual Report

2018 Strategic Plan Update

Transparency

Transparency defined as ‘Well-informed stakeholders (public and RMT clients).’

What Transparency Looks Like

TRANSPARENCY OUTCOMES

- CMTO makes more information publicly available by providing access to reliable and credible information about Registered Massage Therapists (RMTs).

- CMTO’s decision-making process is open and accountable by providing meaningful opportunities for the public to inform the College’s decision-making.

- CMTO’s culture is transparent and open.- CMTO provides information that is easy to understand and accessible.

TRANSPARENCY STRATEGIES

Strategies 2018 AccomplishmentsPublic InformationCMTO expands the public register and posts more information about RMTsin a timely manner.

Over the last two years, the Regulated Health Professions Act, 1991 (RHPA) has been amended to expand and clarify what must be contained on the public register. CMTO has made a number of improvements to the public register to support the legislative changes. In 2018, CMTO’s Ad Hoc Committee on Governance reviewed By-Law No. 8 – The Register and Registrant Information to ensure it was consistent with the updated RHPA. Council considered and approved the recommendations by the Ad Hoc Committee on Governance and directed that the proposed amendments be approved for circulation to stakeholders for comment. This consultation opened in the last quarter of 2018, and closed in the first quarter of 2019.

Public EngagementCMTO develops a public engagement plan, posts public input andconsistently and systematically evaluates feedback to measure whether the public is receiving the information it needs to make informed decisions.

In 2018, the College undertook a number of new public awareness initiatives, including:• a public awareness campaign encouraging RMT clients to learn about their Massage Therapist before booking an appointment (‘Look Before You Book’) which includes systematically measuring campaign reach to see whether public awareness of the public register has increased;• two new public awareness videos: Five Things to

College of Massage Therapists of Ontario | 2018 Annual Report

Know Before Getting a Massage and Maintaining Professional Boundaries;• a consultations page on www.cmto.com to advance its mandate ofprotecting the public interest;• new educational resources were made available online for RMTs to usein their practice for educating clients about their rights, including a trifold pamphlet and poster;• articles were published in local newspapers to promote public awarenessof the work of the College; and• the College posted its updated Sexual Abuse Prevention Plan online in order to outline its initiatives in preventing sexual abuse of clients.

Improved ReportingCMTO enhances its reporting mechanisms to support the culture of transparency.

CMTO reported publicly on the outcomes of all consultations undertaken to date, and is currently awaiting further direction from the Ministry ofHealth and Long-Term Care on additional performance metrics that should be collected and reported by all health regulatory colleges in the province.

Strategy ImplementationCMTO works with the Ministry of Health and Long-Term Care and other health regulatory colleges to develop and maintain consistent terminology and information resources, and implements the Ministry’s Openness and Transparency Strategy.

CMTO communicated a number of regulatory changes (and associated terminology) from the Ministry of Health and Long-Term Care (e.g., definition of client for the purposes of sexual abuse) and consulted with the Citizen Advisory Group (a group that helps bring the patient perspective to health regulation in Ontario) on what topics clients are most interested in reviewing on a new publicly-focused page for CMTO’s website.CMTO continued collaborating with the Federation of Health Regulatory Colleges of Ontario (FHRCO) on public awareness and engagement activities (e.g., a new website for all health regulators, attending the Zoomer show [an expo for Ontarians 45 years and older] to promote the work of health regulatory colleges and engaging a group of patients [i.e., the Citizen Advisory Group] in regulatory decision-making).

College of Massage Therapists of Ontario | 2018 Annual Report

2018 Strategic Plan Update

Quality

Quality defined as ‘Clients receive evidence-informed Massage Therapy.

What Quality Looks Like

QUALITY OUTCOMES

Clients of RMTs receive quality care reflecting the best available evidence related to:

- safe and effective health outcomes as a result of RMT clinical practise and,- professionalism and ethical conduct.

CMTO requires participation in the updated Quality Assurance Program, the foundations of which are CMTO’s Standards of Practice, Career-Span Competencies, and an evidence-informed approach that integrates research, practitioner experience, client perspective and the practice context.

QUALITY STRATEGIES

Strategies 2018 AccomplishmentsProgram RedevelopmentCMTO will review and revise its policies, standards, competencies, programs, resources and processes to ensure that they are based on the best available evidence and provide effective support to facilitate provision of evidence-informed Massage Therapy care to clients.

CMTO began the development of the Career-Span Competencies for the new Quality Assurance Program (QAP). As of October 2018, the College made its updated QAP available for pilot and feedback from registrants.

Communication and EngagementEstablish and communicate CMTO’s position regarding the strategy of evidence-informed Massage Therapy provision to inform and engage stakeholders.

CMTO held focus groups over the summer of 2017 to discuss competencies for the newly designed QAP. In 2018 CMTO sought input on the new framework for the QAP.

ResearchCMTO will develop and implement a directed multi-year research program that will, to the extent possible, provide evidence regarding the effectiveness of CMTO strategies to advance evidence-informed Massage Therapy practice and its impact on improved quality of care provision.

CMTO will work on this strategy in 2019 and beyond as part of the refreshed and updated 2019-2021 Strategic Plan.

College of Massage Therapists of Ontario | 2018 Annual Report

EvaluationThe evidence that CMTO collects/generates, and its evaluation of that evidence will be readily available and accessible to the public, RMT clients, RMTs, Massage Therapy educational programs, and other regulated health professions as appropriate. CMTO will also proactively engage with stakeholders regarding the implications of this evidence and its evaluation as it pertains to Massage Therapy regulation in Ontario.

CMTO will work on this strategy in 2019 and beyond as part of the refreshed and updated 2019-2021 Strategic Plan.

College of Massage Therapists of Ontario | 2018 Annual Report

2018 Strategic Plan Update

Regulatory Modernization

Regulatory Modernization defined as ‘The public and RMT clients are protected through balanced and proportionate risk- and outcomes-based regulation.’

What Improving Regulatory Modernization Looks Like

REGULATORY MODERNIZATION OUTCOMES

The public and RMT clients are protected through regulation that:

- is client-centered, outcome- and evidence-informed;- identifies, assesses and prioritizes risks to Massage Therapy clients and the public

interest;- reflects an understanding of those risks and their underlying causes;- works with system partners to ensure that the most effective and efficient means of

mitigating risk and achieving the desired outcomes are in place;- targets regulatory focus and resources on risks and outcomes that can be best mitigated

by the regulator and works with other stakeholders to develop other means to mitigate risks and achieve outcomes when a regulatory response will not be the most effective means; and

- places an emphasis on proactive regulation through improved knowledge translation of regulatory responsibilities and professionalism, rather than reactive regulation involving penalties and punishment.

REGULATORY MODERNIZATION STRATEGIES

Strategies 2018 AccomplishmentsResearchCMTO will research and gain a strongunderstanding of evidence-informed practices in risk- and outcomes-based regulation and will proactively and transparently engage with stakeholders on whether/how to translate these approaches to Massage Therapy regulation.

In 2016, CMTO completed a research project to develop a baseline understanding of the major elements of modern regulation in a healthcare context and insight into how other jurisdictions and/or organizations have moved or are moving in this direction.

Risk AssessmentCMTO will undertake a regulatory risk assessment that identifies the range of health outcomes and professional risks to clients and the public interest, including an assessment of likelihood and impact, to inform CMTO’s programs and services.

Regulatory risk (risk assessment) project will be undertaken over the next several years.

College of Massage Therapists of Ontario | 2018 Annual Report

During the risk assessment, CMTO will engage broadly and transparently with RMT clients, Massage Therapy educational programs, the RMT community, other regulated health professions and the Government of Ontario.Data AnalyticsCMTO will collect, analyze and use regulatory data and information to inform risk- and outcomes-based regulatory decision-making and will make this data and analysis available and accessibleto the public, RMT clients, Massage Therapy educational programs and the RMT community.

After undertaking an initial data assessment and identifying key gaps in 2017-2018, CMTO continued preparation to launch a comprehensive data management strategy in 2019.In 2018, CMTO also prepared to initiate work in 2019-2020 and beyond, to update key performance indicators, and to align with the Ministry of Health and Long-Term Care’s focus on performance metrics.

Policy FrameworkCMTO will apply principles that reflectproportionate, risk- and outcomes-basedregulation to the ongoing review of regulatory policies, programs and services.

In 2018, CMTO developed and introduced a New Practice Resource Framework. Council approved a standardized process for developing new practice resources for RMTs (e.g., Standards of Practice, practice guidelines). The new process is grounded in “right-touch regulation” modernization principles and includes steps involving research, data assessment, engagement/consultation and monitoring for unintended consequences.

College of Massage Therapists of Ontario | 2018 Annual Report

2018 Strategic Plan Update

Other Notable Initiatives

Continued Implementation of Protecting Patients Act, 2017

CMTO continued to implement new provisions to eradicate sexual abuse by Massage Therapists in 2018 through a new Funding for Therapy and Counselling Policy, enhancements to the public register, and operationalizing other legislative changes and regulations (e.g., mandatory revocation and defining patient (client) for the purposes of sexual abuse).

Organizational Review

After revising and updating its organizational structure for optimal performance, CMTO continued its recruitment strategy in 2018. CMTO’s organizational structure will ensure the College has the human resources capability and capacity to achieve departmental quality improvements; ensure that CMTO’s statutory mandate is met and further the refreshed 2019-2021 Strategic Plan.

New Professional Misconduct Regulations

In 2018, CMTO worked to increase the accountability of registrants for conduct associated with a high degree of risk to the public. In preparing new professional misconduct regulations, CMTO will facilitate greater clarity for registrants. Stakeholder consultation on the proposed new regulations will take place in 2019.

New Policy: Inappropriate Touch of a Client by a Candidate During the OSCE

To ensure that the Objectively Structured Clinical Evaluation (OSCE) environment is respectful and safe for all participants, Council approved a policy in 2018 regarding inappropriate touch of a client during the OSCE.

Open House Events: Building Engagement with Registrants and Stakeholders

CMTO held three Open House events for stakeholders in the three Electoral Districts (Districts 3, 4 and 8) in 2018. The Open House events were held to foster engagement with registrants, students and other stakeholders. As a result of the Open Houses, registrants reported that they felt more engaged and informed about regulatory changes and CMTO’s priorities. Additional Open House events will take place in 2019.

College of Massage Therapists of Ontario | 2018 Annual Report

Looking Ahead to 2019 and Beyond

In putting our minds towards the next iteration of Council’s Strategic Plan (2019-2021), the College completed an environmental scan in 2018, and has extended the same strategic goals of transparency, quality and regulatory modernization for another three-year cycle. The updated and refreshed 2019-2021 Strategic Plan will continue to refine and strengthen:

- regulatory efficiency and effectiveness;- risk- and outcomes-based approaches;- movement away from traditional, prescriptive, activity-based rules;- an approach to reduce unnecessary regulatory burden for Massage Therapists; and- development of regulation that is in the public interest (i.e. that responds more broadly

to the needs of the public and clients of RMTs).

The updated 2019-2021 Strategic Plan is available here.

College of Massage Therapists of Ontario | 2018 Annual Report

100 Years of Quality, Integrity and Competence in Massage Therapy: A Historical Timeline

The timeline below illustrates how the regulation of Massage Therapy has evolved over the past century.

2019: This year marks the 100th anniversary of Massage Therapy regulation in Ontario.

2019: Massage Therapy becomes a regulated profession in Prince

Edward Island on March 1, 2019.

2018: Registration at the College of Massage Therapists of Ontario surpasses 14,500 Massage Therapists.

2016: The four member Colleges of FOMTRAC release an update to the Interjurisdictional Practice Competencies and Performance Indicators for Massage Therapists at Entry-to-Practice (PCs/PIs).

2014: The Canadian Massage Therapy Council for Accreditation (CMTCA) is established to accredit Massage Therapy educational programs from coast-to-coast.

2013: Registration at CMTO surpasses 12,000. The College introduces new Practice Competencies and Performance Indicators (PC/PIs) for the use of Acupuncture by Massage Therapists in Ontario.

2013: Massage Therapy becomes a regulated profession in New Brunswick.

2012: FOMTRAC adopts the Interjurisdictional Practice Competencies and Performance Indicators for Massage Therapists at Entry-to-Practice (PCs/PIs), a benchmark that ensures Canadians receive safe and effective Massage Therapy care.

2010: The OMTA is renamed to the Registered Massage Therapists’ Association of Ontario (RMTAO).

2009: CMTO regulates 10,500 Massage Therapists.

2005: Massage Therapy becomes a regulated profession in Newfoundland and Labrador.

2003: The Federation of Massage Therapy Regulatory Authorities of Canada (FOMTRAC) is established to promote a common national entry-level education standard in Massage Therapy care.

2002: CMTO oversees 6,000 registrants.

1994: On January 1, 1994, the Regulated Health Profession Act, 1991, is proclaimed.College of Massage Therapists of Ontario | 2018 Annual Report

1991: CMTO is established to replace the Board of Directors of Masseurs after the Regulated Health Professions Act, 1991, is introduced.

1946: The Canadian College of Massage & Hydrotherapy is established to train Massage Therapists across Canada.

1936: The Ontario Massage Therapist Association (OMTA) is formed to advocate on behalf of Massage Therapists.

1935: The province of Ontario expands the professional recognition of Massage Therapy through the DPA.

1925: The Drugless Practitioners Act (DPA) is revised and establishes register of physiotherapeutic and massage practitioners.

1919: Ontario regulates Massage Therapy.

College of Massage Therapists of Ontario | 2018 Annual Report

A Visual Snapshot of Massage Therapists in 2018

CMTO REGULATES OVER 14,500 RMTS

In 2018, 14,567 Registered Massage Therapists (RMTs) were registered with the College. Of these RMTs, 13,512 held a General Certificate of Registration, while 1,055 registrants had an Inactive Certificate as they were not currently practising Massage Therapy but intended to return to practice in the following year.

Total Number of Registrants in 2018General Certificate 13,512Inactive Certificate 1055TOTAL: 14,567

Age Distribution of Massage Therapists in Ontario

Most RMTs are between the ages of 31-40. The second largest age cohort is between 41-50 years old.

Registrants by Age in 2018Range # of Registrants< 31 2,64531-40 4,68841-50 4,39151-60 2,130> 60 713

Gender Distribution in Massage Therapy Care

In 2018, the number of male registrants practising the profession increased by about 4.5%, in line with total RMT growth. Females represented the majority of Massage Therapists in Ontario (at 78%) for 2017 and 2018.

Gender (2018)Female 11,388Male 3,179Total 14,567Gender (2017)Female 10,933Male 3,042Total 1,975

College of Massage Therapists of Ontario | 2018 Annual Report

Total Number of Registrants (2011-18)

From 2011 to 2018, the number of CMTO registrants has continued to grow steadily each year. In 2018, CMTO had a total of 14,567 registrants; an increase of nearly 33% from 7 years ago.

Year Number of Registrants2011 10,9862012 11,2002013 12,0542014 12,6602015 13,1142016 13,6672017 13,9752018 14,567

College of Massage Therapists of Ontario | 2018 Annual Report

A Visual Snapshot of Massage Therapists in 2018

Top 5 Practice Settings

Registered Massage Therapists were most commonly employed in the following 5 practice settings across Ontario: a group clinic, home-based practice, spa, office-based clinic, and rehabilitation facility.

Registrants by Practice Settings # of RegistrantsGroup (Clinic Setting) 5,569Solo, Home-based (Clinic Setting) 2,059Spa 1,286Solo, Office-based (Clinic Setting) 1,165Rehabilitation Facility 622

Attrition Rate* in Massage Therapy

Over the past 5 years, the attrition rate remained steady at around 4%.

2018 2017 2016 2015 2014 2013 2012 2011 2010 20094.30% 4.15% 3.40% 3.91% 4.24% 5.00% 5.96% 5.72% 7.41% 7.26%

*This represents the percentage of RMTs leaving the profession annually.

How Many New Applicants Registered with CMTO in 2018?

A total of 896 applicants became registered with the College in 2018.

How Long Does an RMT Remain in the Profession?

Nearly 25% of all registrants have been practising the profession between 6 and 10 years. About one-third of RMTs have been in Massage Therapy for less than 5 years, while the remaining 42% have provided Massage Therapy care to Ontarians for more than 11 years.

Number of Years in Practice

# of Registrants % of Registrants

< 1 862 -1-5 4,055 33%6-10 3,485 25%11-15 2,621 -16-20 2,102 -21-25 945 ->26 497 -

A Visual Snapshot of Massage Therapists in 2018College of Massage Therapists of Ontario | 2018 Annual Report

Number of RMTs by city

City # of RegistrantsToronto 1,902Mississauga 526Ottawa 499London 405North York 308Scarborough 299Markham 285Brampton 282Kitchener 253Burlington 250Barrie 242Richmond Hill 232Hamilton 228Windsor 211Oakville 196Waterloo 195Guelph 190Etobicoke 184Whitby 174Cambridge 166Peterborough 148Newmarket 126Kingston 118Orleans 114Thornhill 113Niagara Falls 109Sudbury 108St. Catharines 105Ajax 100Oshawa 98

College of Massage Therapists of Ontario | 2018 Annual Report

2018 COMMITTEE REPORTS

Executive Committee

Committee Members

- Lisa Tucker, RMT, President, Chair- Kim Westfall-Connor, RMT, Vice-President- Jocelyn Acheson, Public Member, Executive Officer- Lloyd White, Public Member, Executive Officer

The Executive Committee assumes leadership, in collaboration with Council, Committees and the Registrar, in financial monitoring, strategic planning, governance and supervisory responsibilities. The Executive Committee monitors administration of CMTO and relies on the Registrar and other staff to implement its decisions.

Summary of 2018 Accomplishments and Activities

In 2018, the Executive Committee met six times and continued its monitoring and oversight role for strategic, governance and financial planning initiatives for CMTO.

As part of its financial oversight, the Executive Committee reviewed the results of the 2017 Financial Audit with the CMTO’s auditor prior to its presentation to Council, met with CMTO’s investment advisor to review the annual performance of the College’s investment portfolio and approved the draft 2019 budget to go to Council. The Committee also conducted the Registrar’s 2017 Performance Appraisal and reported the results to Council.

The Executive Committee considered 30 applicants for CMTO’s non-Council Committee positions, and based on their expertise and knowledge, selected eight registrants for the positions. The Committee also conditionally approved a funding proposal in the amount of $40,000 on the topic of myofascial release in children with cerebral palsy as the successful grant recipient for the 2017 Massage Therapy Research Fund Competition.

Based on the feedback from stakeholders, the Committee recommended to Council that the proposed increase in the certification examination fees should be staggered over a three-year period. The Executive Committee also recommended an increase to the annual registration fees for 2019 which would allow CMTO to respond to the evolving needs of the College and the regulatory environment.

The Committee retained a consultant to assist in conducting a refresh and update to CMTO’s Strategic Plan which was presented to Council for approval. The Committee recommended a Practice Resource Development process which Council approved. The framework will provide registrants with a simplified view of what they are responsible for (by topic), align with expectations articulated by the Ministry of Health and Long-Term Care, result in outcomes-College of Massage Therapists of Ontario | 2018 Annual Report

focused, concise Standards of Practice that are developed through a risk and regulatory modernization lens and provide resources and advice along with the Standards of Practice.

In the fall of 2018, the Committee approved a draft Practice Resource: Cannabis, which was circulated to registrants for information.

College of Massage Therapists of Ontario | 2018 Annual Report

Ad Hoc Committee

Committee Members

- Lloyd White, Public Member, Chair- Jennifer Da Ponte, RMT- Lesley Hargreaves, RMT- Hedy Miszuk, Public Member- Lisa Tucker, RMT- Karen Sosnowski, RMT- Kim Westfall-Connor, RMT

The Ad Hoc Committee on Governance was established to review the College’s governance processes, which included a review of the relevant by-laws and updating the Governance Handbook.

Summary of 2018 Accomplishments and Activities

The Ad Hoc Committee on Governance was formed to review the College of Massage Therapists of Ontario’s governance processes. The Committee met twice over the course of 2018, to discuss the following governance items:

- Council/Committees meeting evaluation process; - Mentoring process;- Strategic planning process;- CMTO’s crisis communications process;- CMTO Council Member Position Description; and- CMTO Council Member Competencies.

The Committee brought proposed amendments to By-Law No. 8 - The Register and Registrant Information to ensure that it was consistent with recent changes to the Regulated Health Professions Act, 1991, and to provide clarity on what will be posted on the public register.

The Committee also discussed governance reforms and how it may impact the CMTO’s election process if the Council moves towards a competency-based model.

College of Massage Therapists of Ontario | 2018 Annual Report

Client Relations Committee

Committee Members

- Lloyd White, Public Member, Chair- Laura DiMarco, RMT Non-Council Member- Nancy Engstrom, RMT- Hedy Miszuk, Public Member

The Client Relations Committee is composed of at least one elected Council member, two appointed Council members, and one non-Council member. The Committee has responsibility for all programs and measures that are designed to prevent or deal with sexual abuse of clients by registrants. This responsibility has been extended to address aspects of relations between registrants and their clients.

Summary of 2018 Accomplishments and Activities

The Committee met five times in 2018.

The Committee focused its efforts on public-facing initiatives, updating and approving a new Funding for Therapy and Counselling Policy, and approving new requests for funding for therapy and counselling in 2018.

Committee members evaluated the results of the College’s 2017 Sexual Abuse Prevention Plan, and reviewed and approved an updated Sexual Abuse Prevention Plan for 2018. Once approved, the 2018 Plan was reviewed by Council and posted publicly on CMTO’s website.

The Client Relations Committee also recommended that Council consider a new policy that would broaden the College’s ability to provide funding for therapy and counselling to clients who report sexual abuse by Massage Therapists. Council subsequently considered and approved the policy. CMTO’s Funding for Therapy and Counselling Policy anticipated and included changes made by regulation by the Province of Ontario in 2018. Twenty applicants were approved for CMTO’s funding for therapy and counselling program in 2018, which is a considerable increase from 2017, when two applications were received and approved.

Regarding new public awareness initiatives, the Client Relations Committee discussed and reviewed several public awareness initiatives that are planned for 2018-2019 including: - Updating CMTO’s website with a new information page for the public; - A video to inform the public about professional boundaries in the therapist-client

relationship; - Articles written for the public that will provide information on what to expect when

visiting an RMT;- Promoting the annual Look Before You Book campaign; and - A new informational resource (PDF poster) to be provided to RMTs for clients.

College of Massage Therapists of Ontario | 2018 Annual Report

Quality Assurance Committee

Committee Members

- Andrew Flint Public Member, Chair- Nancy Engstrom, RMT- Nevenko Jeftic, RMT- Christin Mandalentsis, RMT, Non-Council Member - Lloyd White, Public Member

The Quality Assurance Committee has responsibility for overseeing the development and implementation of a Quality Assurance Program in accordance with regulations within the Regulated Health Professions Act, 1991 (RHPA).

Summary of 2018 Accomplishments and Activities

Throughout 2018, 13 Quality Assurance Committee meetings were held to consider a number of initiatives.

With the support of the Committee, the development of a competency-based Quality Assurance Program continued to unfold as steps were taken to collect feedback from registrants through focus groups and online surveys.

The anticipated launch of new program components in 2019 prompted a decision in July 2018, to discontinue the requirement for registrants to complete the Self-Assessment Tool (SAT) and submit Continuing Education Units (CEUs).

Peer assessments were conducted across the province to assess registrant compliance with the Standards of Practice. Identified deficiencies were addressed using a streamlined approach designed to provide meaningful outcomes, enhance client care, and support registrant success.

In an effort to ensure registrant perspectives are considered prior to implementation of new projects, a Standards and Policies Advisory Working Group was created to provide clinical expertise on implementation of new Standards and Policies, and profession-specific advice. The group met on five separate occasions during 2018 to review proposed content and offer recommendations for consideration by the Committee and Council.

Building on the successes of 2018, the Committee will continue to develop and introduce resources and programming aimed at ensuring registrants across Ontario are adequately supported to deliver quality client care.

# of cases

Required to submit additional

No Further Action

Specified Continuing Education or

Terms, Conditions, or

Referral to Inquiries, Complaints

College of Massage Therapists of Ontario | 2018 Annual Report

information (NFA) Remediation Program (SCERP)

Limitations (TCL)

and Reports Committee (ICRC)

Post Peer Assessment

108 8 24 60 16 7

Incapacity Inquiries

2 0 0 0 0 2

TOTAL: 110 8 24 60 16 9

* case totals may not add up as a single case may have multiple outcomes (e.g., TCL and a SCERP).

College of Massage Therapists of Ontario | 2018 Annual Report

Registration Committee

Committee Members

- Murthy Ghandikota, Public Member, Chair- Jocelyn Acheson, Public Member - Anna Cantalini, RMT Non-Council Member- Dawn Oehring, RMT- Karen Sosnowski, RMT

The Registration Committee is responsible for developing policies and processes related to registration that are transparent, objective, impartial and fair. The Committee reviews applications that have been referred by the Registrar on a case-by-case basis to ensure that all applicants meet the requirements set out by the regulation.

Summary of 2018 Accomplishments and Activities

The Registration Committee held four meetings in 2018; of these, one meeting was in-person and three were by teleconference.

During the year, the Committee reviewed:- Registration Photo ID Card process.- Administrative policies:

o Issuing a New Registration Number; and o Refresher Course Tutors Under Investigation.

- Inappropriate Touch of a Client by a Candidate during the Objectively Structured Clinical Evaluation (OSCE) Policy.

- Massage Therapy Graduates/Students Practising Without Being Registered Policy.- Office of the Fairness Commissioner Reports.- Vulnerable Sector Check Process. - Updates to the Refresher Competencies Assessment Tool (RCAT).- Certification Examination cut scores and cut score process.

Matters for DecisionConcerns about the applicant’s past/present conduct 3Request to be exempted from the requirement to provide a minimum of 500 hours of direct client care in the previous three years

2

Decision SummaryDirecting the Registrar to refuse to issue a Certificate of Registration

2

Directing the Registrar to issue a Certificate of Registration 1Exemption from the requirement to provide a minimum of 500 hours of direct client care in the previous three years

2

College of Massage Therapists of Ontario | 2018 Annual Report

Requests for Review of Registration Committee Decisions to the Health Professions Appeal and Review Board (HPARB)

Applicants have the right to appeal the decision of the Registration Committee within 30 days.The review process is handled by the HPARB, which is composed of members of the public appointed by the Lieutenant Governor in Council on the recommendation of the Minister of Health and Long-Term Care. More information about HPARB is available at www.hparb.on.ca.

Applicants Requests for HPARB Review 2HPARB Decisions 1 (Registration Committee decision confirmed)Reviews to be held in 2019 1

College of Massage Therapists of Ontario | 2018 Annual Report

Inquiries, Complaints and Reports Committee

Committee Members

- Karen Sosnowski, RMT Chair- Jocelyn Acheson, Public Member - Jennifer Da Ponte, RMT- Laura DiMarco, RMT, Non-Council Member- Murthy Ghandikota, Public Member- Lesley Hargreaves, RMT - Clinton Jack, RMT, Non-Council Member- Shannon Marshall, RMT- Debra Mattina, Public Member- Hedy Miszuk, Public Member- Martez Schembri-Diskey, RMT, Non-Council Member- Theo Parusis, RMT, Non-Council Member

The Inquiries, Complaints and Reports Committee (ICRC) investigates complaints and reports about registrants’ conduct, care and capacity, in accordance with the legislation. Following an investigation, the ICRC may refer allegations of professional misconduct and/or incompetence to the College’s Discipline Committee. The ICRC also has the power to make other dispositions following an investigation, including: requiring a registrant to complete a Specified Continuing Education or Remediation Program; requiring a registrant to appear before a panel of the ICRC to be cautioned in person; or to take no further action. The ICRC may also make inquiries into a registrant’s capacity to practise, and following such an inquiry, it may refer information regarding the registrant’s capacity to the College’s Fitness to Practise Committee.

Summary of 2018 Accomplishments and Activities

The Committee reviews three types of cases:

Formal Complaints: The complaint process is a formal process set out in legislation. Complaints may be submitted by any member of the public.

Registrar’s Report Investigations: Registrar’s Report Investigations commence as a result of concerns that are not submitted as a formal complaint. Based on the information, the Registrar determines that there are reasonable and probable grounds to believe that a registrant may have committed professional misconduct, or the registrant may be incompetent, and initiates an investigation.

Incapacity Concerns: The incapacity process deals with registrants who may have an illness that has the potential to interfere with their practise. This process commences as a result of concerns that are brought to the attention of the Registrar or another panel of the ICRC, which

College of Massage Therapists of Ontario | 2018 Annual Report

leads them to believe a registrant may be incapacitated. After preliminary inquiries are made, a panel of the ICRC may inquire into the capacity of the registrant, which may include requiring the registrant to undergo a health examination.

In 2018, the Committee’s work was completed by two Panels (A and B) with each panel comprised of six Committee members. The Panels met collectively 20 times for in-person meetings, twice via teleconference, and five times electronically. The Committee made 70 complaints dispositions, 73 Registrar’s Report Investigations dispositions, and four Incapacity Inquiries dispositions for a total of 147 dispositions in 2018, a sharp increase over the 94 dispositions made by the ICRC in 2017.

The number of new cases included 94 complaints, 66 Registrar’s Report Investigations and eight incapacity matters, for a total of 168 new cases in 2018, which represents a substantial upward trend from 2017 (137 cases) and 2016 (93 cases).

Four complaints were before the Health Professions Appeal and Review Board (HPARB) in 2018; and the College is awaiting HPARB’s decision regarding these four reviews.

The charts below represent a summary of the work completed by the Committee in 2018.

New Cases

Type 2016 2017 2018Complaints Received 55 67 94Registrar’s Report Investigations 38 66 66Incapacity Inquiries 0 4 8Total Number of New Cases 93 137 168

Sources of Information Number received in 2017

Number received in 2018

Public (e.g., clients, police, media) 86 87Other RMTs 4 7Other Health Professionals 7 15Insurance Companies 18 27Employers 8 30Self disclosure 2 2

Requests for Review of Complaint Matters to the Health Professions Appeal and Review Board (HPARB)

Complainants and registrants have the right to appeal the decision of the ICRC within 30 days unless the decision is to refer the matter for incapacity proceedings or to the Discipline Committee.

College of Massage Therapists of Ontario | 2018 Annual Report

The review process is handled by HPARB, which is composed of members of the public appointed by the Lieutenant Governor in Council on the Minister of Health and Long-Term Care’s recommendation. More information about HPARB is available at www.hparb.on.ca.

Requests for Review of Complaints to the Health Professions Appeal and Review Board (HPARB)Total number of cases before HPARB in 2017 3 casesDetails of disposition 1 closed (decision confirmed)Total number of cases before HPARB in 2018 4 casesDetails of Disposition 4 reviews outstanding

Number of New Complaints, Registrar’s Report Investigations and Incapacity Concerns by Type (2018):

Nature of Concern # of casesSexual Abuse 54Unprofessional Conduct 37Inappropriate Billing Practices 37Treatment Causing Injury 12Failing to Maintain Records 9Incapacity 8Breach of Standards 4Practising While Suspended 3Quality Assurance Program Non-Compliance 2ICRC/Discipline Non-Compliance 1Practising Outside Scope of Practice 1

Dispositions: Complaints, Registrar’s Reports and Incapacity Concerns (2018)

Nature of Concern # of casesNo Further Action 39Referral to Discipline 24Specified Continuing Education or Remediation Program (SCERP) with an Oral Caution

20

Specified Continuing Education or Remediation Program (SCERP) 19Recommendation and/or Advice 17Undertaking/Agreement – Resign & Never Reapply 17Undertaking/Agreement – No Further Action 5Withdrawal of Complaint 4Caution – Oral 1

College of Massage Therapists of Ontario | 2018 Annual Report

Undertaking - Monitoring 1

College of Massage Therapists of Ontario | 2018 Annual Report

Fitness to Practise Committee

Committee Members - Lesley Hargreaves, RMT Chair- Jocelyn Acheson, Public Member- Jennifer Da Ponte, RMT- Nancy Engstrom, RMT- Andrew Flint, Public Member- Murthy Ghandikota, Public Member- Nevenko Jeftic, RMT- Shannon Marshall, RMT- Debra Mattina, Public Member- Hedy Miszuk, Public Member- Dawn Oehring, RMT- Karen Sosnowski, RMT- Lisa Tucker, RMT - Kim Westfall-Connor, RMT- Lloyd White, Public Member-

The Fitness to Practise Committee is responsible for conducting hearings to determine the capacity or “fitness” of a registrant to practise the profession, in cases where information has come before the Committee that reveals that the registrant may be incapacitated. As part of this process, the Committee may make decisions to suspend or revoke a registrant’s Certificate of Registration, or impose other terms and conditions, where appropriate. Summary of 2018 Accomplishments and Activities

There were no incapacity hearings or other proceedings before the Fitness to Practise Committee in 2018. The Committee did not receive any referrals in 2018 and there were no matters carried over from 2017.

College of Massage Therapists of Ontario | 2018 Annual Report

Discipline Committee

Committee Members

- Kim Westfall-Connor, RMT, Chair- Jocelyn Acheson, Public Member- Kyle Bonnyman, RMT, Non-Council Member- Anna Cantalini, RMT, Non-Council Member- Jennifer Da Ponte, RMT- Nancy Engstrom, RMT- Andrew Flint, Public Member- Murthy Ghandikota, Public Member- Susan Glass, RMT, Non-Council Member- Lesley Hargreaves, RMT- Nevenko Jeftic, RMT- Christin Mandalentsis, RMT, Non-Council Member- Shannon Marshall, RMT- Debra Mattina, Public Member- Hedy Miszuk, Public Member- Dawn Oehring, RMT- Karen Sosnowski, RMT- Lisa Tucker, RMT - Lloyd White, Public Member

The Discipline Committee is responsible for conducting hearings related to allegations of registrants’ professional misconduct or incompetence. As part of this process, the Committee may make decisions about revoking or suspending a registrant’s Certificate of Registration or imposing other terms and conditions, where appropriate.

Summary of 2018 Accomplishments and Activities

The Discipline Committee had a total of 76 cases before it in 2018. Of these cases, 52 cases were carried forward from 2017 and 24 new referrals were made in 2018.

The Committee held 45 hearings and released 36 discipline decisions in 2018.

Of the 45 hearings, five involved indefinite adjournments because the registrant entered into an agreement to resign and never reapply. If the registrants breach their agreements, the College has the ability to resume discipline proceedings against them. In addition, there was one case where the Committee withdrew the allegations of professional misconduct made against the registrant.

A summary of the types of discipline proceedings that took place in 2018 is contained in the table below. College of Massage Therapists of Ontario | 2018 Annual Report

As noted, there were 36 matters that were completed and had discipline decisions released in 2018. For a summary of each discipline hearing and accompanying decision, please refer to the links below.

Registrant W (2018)Ewa Tekien (2017)Oleg Volochay (2018)Jose Alberto Tena Schoelly (2018)Daocheng Li (2018)Guifen Hou (2018)Robert Boghossian (2018)Ashley Evans (2018)Mingya Kennedy (2018)Victor Mendoza (2018)Julia Elliott (2018)Michael Mah (2018)Xiao Di Min (2018)Qiong Tang (2018)Saltanat Rahimi (2018)Suvijek Janthavong (2018)Artur Plachcinski (2018)Collin Dolny (2018)Hongxu Zhang (2018)Bin Zhao (2016-2017)Xue Li (2018)Ron Devos (2018)Daryosh Goldar (2018)Luong Thieu (2018)Arsen Korol (2018)Stefan Stefanov (2018)Stefan Stefanov (2018)Sarah McIlquham (2018)Zaisheng Ling (2018)Zaisheng Ling (2018)Zaisheng Ling (2018)Dikran Masrob (2018)Massimo Park (2018)Fazena Ally (2018) Hong Wang (2018)Bo Lu (2018)

College of Massage Therapists of Ontario | 2018 Annual Report

Types of Discipline Committee ProceedingsUncontested hearings 23Contested hearings 17Indefinite adjournments 5

S u m m a r y F i n a n c i a l S t a t e m e n t s

REPORT OF THE INDEPENDENT AUDITOR ON THE SUMMARY FINANCIAL STATEMENTS

To the Council of the College of Massage Therapists of Ontario

OpinionThe summary financial statements, which comprise the summary statement of financial position as at December 31, 2018, and the summary statement of operations for the year then ended, and related note, are derived from the audited financial statements of the College of Massage Therapists of Ontario (the “College”) for the year ended December 31, 2018.

In our opinion, the accompanying summary financial statements are a fair summary of the audited financial statements, on the basis described in the note to the summary financial statements.

Summary Financial StatementsThe summary financial statements do not contain all the disclosures required by Canadian accounting standards for not-for-profit organizations. Reading the summary financial statements and the auditor’s report thereon, therefore, is not a substitute for reading the audited financial statements of the College and the auditor’s report thereon.

The Audited Financial Statements and Our Report ThereonWe expressed an unmodified audit opinion on the audited financial statements in our report dated May 13, 2019.

Management’s Responsibility for the Summary Financial StatementsManagement is responsible for the preparation of the summary financial statements on the basis described in the note to the summary financial statements.

Auditor’s ResponsibilityOur responsibility is to express an opinion on whether the summary financial statements are a fair summary of the audited financial statements based on our procedures, which were conducted in accordance with Canadian Auditing Standard (CAS) 810, Engagements to Report on Summary Financial Statements.

Toronto, Ontario Chartered Professional AccountantsMay 13, 2019 Licensed Public Accountants

College of Massage Therapists of Ontario | 2018 Annual Report

COLLEGE OF MASSAGE THERAPISTS OF ONTARIO

SUMMARY STATEMENT OF FINANCIAL POSITION

2018 2017December 31 $ $

ASSETS

Current assetsCash 9,882,284 8,239,882Short-term investments 533,560 -Investments 697,999 1,026,218Prepaid expenses 46,787 7,245

11,160,630 9,273,345

Investments6,379,390 6,004,840

Capital assets 591,095 547,928Intangible assets 53,019 149,470

7,023,504 6,702,23818,184,134 15,975,583

LIABILITIESCurrent liabilitiesAccounts payable and accrued liabilities 2,053,966 2,493,463Deferred registration fees 10,091,318 7,794,757

12,145,284 10,288,220Deferred lease incentives 107,351 120,912

12,252,635 10,409,132NET ASSETS Invested In capital and intangible assets 644,114 697,398Internally restricted for complaints and discipline 1,500,000 1,500,000Internally restricted for national incentives 1,176,000 702,750Internally restricted for massage therapy research 250,000 250,000Unrestricted 2,361,385 2,416,303

5,931,499 5,566,45118,184,134 15,975,583

College of Massage Therapists of Ontario | 2018 Annual Report

2018 2017

Year ended December 31 $ $

RevenuesRegistration fees 8,385,328 7,987,830Examination fees 1,439,550 1,373,005Investment income 236,407 170,779

10,061,285 9,531,614

ExpensesCouncil and committees 409,057 312,858Complaints and discipline 1,529,515 2,375,028Examinations 1,534,947 1,515,299Quality assurance 20,121 144,137Communications 176,848 141,335Salaries and benefits 2,953,864 2,522,723Consulting fees 707,616 732,629Professional fees 319,823 408,123Rent and operating costs 589,644 518,379Office and general 871,400 758,186Contributions to national initiatives 347,490 356,477Amortization - capital assets 118,727 135,312Amortization - intangible assets 117,185 141,707

9,696,237 10,062,193Excess of revenues over expenses (expenses over revenues) for year

365,048 (530,579)

NOTE TO SUMMARY FINANCIAL STATEMENTSDecember 31, 20181. Basis of presentationThese summary financial statements have been prepared from the audited financial statements of the College of Massage Therapists of Ontario (the “College”) for the year ended December 31, 2018, on a basis that is consistent, in all material respects, with the audited financial statements of the College except that the information presented in respect of changes in net assets and cash flows has not been presented and information disclosed in the notes to the financial statements has been reduced.

Complete audited financial statements are available to members upon request from the College.

College of Massage Therapists of Ontario | 2018 Annual Report

2018 Council (as at December 31, 2018)Lisa Tucker, RMT, President Kim Westfall-Connor, RMT, Vice PresidentJocelyn Acheson, Public Member, Executive OfficerLloyd White, Public Member, Executive OfficerJennifer Da Ponte, RMTNancy Engstrom, RMTAndrew Flint, Public MemberMurthy Ghandikota, Public MemberLesley Hargreaves, RMTNevenko Jeftic, RMTShannon Marshall, RMTDebra Mattina, Public MemberHedy Miszuk, Public MemberDawn Oehring, RMTKaren Sosnowski, RMT

2018 Committees (as of December 31, 2018)

Executive Committee Lisa Tucker, RMT, PresidentKim Westfall-Connor, RMT, Vice-PresidentJocelyn Acheson, Public Member, Executive OfficerLloyd White, Public Member, Executive Officer

Ad Hoc Committee on GovernanceLloyd White, Public Member, ChairJennifer Da Ponte, RMT Lesley Hargreaves, RMTHedy Miszuk, Public MemberLisa Tucker, RMTKim Westfall-Connor, RMTKaren Sosnowski, RMT

Client Relations CommitteeLloyd White, Public Member, Chair Nancy Engstrom, RMTHedy Miszuk, Public Member Laura DiMarco, RMT (Non-Council)*

Discipline CommitteeKim Westfall-Connor, RMT ChairAll Council Members

College of Massage Therapists of Ontario | 2018 Annual Report

Kyle Bonnyman, RMT (Non-Council)*Anna Cantalini, RMT (Non-Council)*Susan Glass, RMT (Non-Council)*Christin Mandalentsis, RMT (Non-Council)*

Fitness to Practise CommitteeLesley Hargreaves, RMT, ChairAll Council Members

Inquiries, Complaints and Reports Committee (ICRC)Karen Sosnowski, RMT, ChairJennifer Da Ponte, RMTMurthy Ghandikota, Public MemberLesley Hargreaves, RMTShannon Marshall, RMTDebra Mattina, Public MemberHedy Miszuk, Public MemberJocelyn Acheson, Public Member Laura DiMarco, RMT (Non-Council)*Clinton Jack, RMT(Non-Council)*Theo Parusis, RMT(Non-Council)*Martez Schembri-Diskey, RMT (Non-Council)*

Quality Assurance CommitteeAndrew Flint, Public Member, ChairNancy Engstrom, RMTNevenko Jeftic, RMTChristin Mandalentsis, RMT (Non-Council)*Lloyd White, Public Member

Registration CommitteeMurthy Ghandikota, Public Member, ChairJocelyn Acheson, Public Member (as of May 14, 2018)Anna Cantalini, RMT (Non-Council)*Dawn Oehring, RMTKaren Sosnowski, RMT

*”Non-Council” means an RMT who is not a member of Council, but has been appointed by CMTO’s Council to serve on a College Committee for a one-year term.

College of Massage Therapists of Ontario | 2018 Annual Report

College of Massage Therapists of Ontario

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College of Massage Therapists of Ontario | 2018 Annual Report