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Public Consultation: Fee and Remuneration By-law 2019

Public Consultation: Fee and Remuneration By-law 2019

The College of Midwives of Ontario’s Council has proposed changing the Fees and Remuneration By-law to raise membership fees from $2193 to $2550 for all classes of registration other than Inactive.  This represents a $357 increase effective October 2019 registration renewal.  The Inactive class of registration will not be affected by these changes, and will increase at 2%, as per the existing by-law.

The College’s Council has approved a deficit budget for 2019-2020 and projects two additional deficit budget years before our revenue equals our expenses. A combination of increased membership fees, operational expense cuts, and the use of the College’s existing net assets will allow us to achieve financial sustainability. The College will continue to ensure that midwifery care in Ontario is provided safely, by skilled and qualified midwives.

We invite midwives, stakeholders, and members of the public to comment on the proposed changes to the Fees and Remuneration By-law below. Council will consider your feedback and make a final decision at its June 26, 2019 meeting.

Our consultation is open until Thursday, May 30, 2019 and all members of the public, stakeholders, and midwives are invited to share their thoughts below. Click here to review the College’s posting guidelines in advance of leaving a comment.

Questions and answers:

What is the College’s role?

The College of Midwives is the regulator of midwives in the province of Ontario. We regulate midwives practising in Ontario by ensuring that midwives meet high standards and acting when risks are identified. All midwives follow the same professional principles and standards of practice. We provide guidance to help them do so. Our purpose is to serve the public and the public interest.

Will funding changes impact the College’s ability to regulate midwifery?

No. Changes to our operational funding from the Ministry will not impact the public. The College will continue to regulate midwifery in the public interest and ensure that midwives in Ontario are qualified, skilled, and competent to practise. Ontarians can be confident that the College makes decisions in their best interest.

Can the College increase its membership numbers?

The College has no role in increasing numbers of midwives in the province. The Ministry of Health and Long-term Care sets the number of midwives able to practise in Ontario each year, and the number of baccalaureate midwifery education program positions are determined by the Ministry of Training, Colleges, and Universities.

Did the College expect to receive Ministry funding forever?

No. Despite our small numbers, the College has been working steadily toward financial independence. The College submitted two different plans to the Ministry which detailed possible paths to financial independence – one in 2014 and one in 2016. While these plans were not implemented by the Ministry, the College has continued to work toward financial independence.

When will the College be financially independent?

The College is financially independent as of April 1, 2019.  The College projects deficit budgets for three years and will use net assets to cover the projected deficits.  The College anticipates revenue will equal expenses in the fiscal year 2022-2023.

Why did the College not increase Inactive fees?

Historically, fees for members who were registered in the Inactive class were set at 50% of the General membership fee. The College’s Council considered previous member feedback that raising Inactive class fees would disproportionality affect non-practising members as they were not earning a midwifery income. Council proposed maintaining the Inactive fees with a 2% increase annually, as outlined in the current By-laws. This makes the fee for Inactive members for October 2019 $1097.

How do these new fees compare to other midwifery Colleges across Canada?

Most midwifery regulatory authorities and Colleges throughout Canada continue to receive funding from their provincial Ministries, so their membership fees are subsidized. The fees in other financially independent Colleges are comparable to ours: Practising midwives in British Columbia paid $2340 in 2018; and practising midwives in Alberta paid $2750 in 2018.

How do Ontario midwives’ fees compare to other regulated health professions in Ontario?

With the proposed fee increase, practising midwives will pay the highest membership fees among regulated health practitioners in Ontario.

Can the College cut programs to reduce the proposed membership fees?

The College does not have the option to reduce costs by eliminating programs because all College programs are mandated by governing legislation.

What kind of expense cuts were made at the College to minimize the expected fee increase?

The College made every effort to reduce costs in all spending areas.  Some examples are listed below.

  • Cuts to Council expenses:
    • The president stipend has been eliminated, and the president will be paid on a per diem basis only
    • Committees and panels will meet electronically whenever possible, resulting in reduced travel and accommodation costs
    • One Council training day was eliminated, resulting in reduced travel and accommodation costs
  • Cuts to operational expenses:
    • There will be no merit increases for staff for the next two years
    • There will be cuts to the staff benefits package for the next two years
    • There will be an indefinite hiring freeze and only existing positions will be replaced

Does Council anticipate that fees will need to increase more than 2% annually?

No.  Council has proposed a plan that places the College in a stable and sustainable position and expects to hold fees to what is proposed in the By-laws.

Can members pay in installments?

Yes.  Members continue to have the option to pay annual registration fees by cheque in two installments.  Initial registration fees continue to be pro-rated based on the months of practice before registration renewal in October.  Members who have extenuating circumstances can continue to apply to the Registrar for consideration of alternate payment plans or reduced fees.

Feedback Form


All Feedback

  1. Member of the public

    Reading through the comments, it makes a lot of sense to reconsider the location of the College. This is something I think should be assessed. Significant cost savings could be achieved by moving out of Toronto.

    As a former midwifery student and current registered nurse, I am amazed at how difficult the system is for midwives. I support the CMO, however the membership fees are shocking – $2550 for just the CMO. Other provinces are paying midwives better and are still subsidizing portions of their college fees; I worry that this will cause a loss of midwives for Ontario.

    New Registrants and midwives who work PT will be particularly affected by these fee increases. In the case of those who work PT, this could mean less midwives in rural/remote areas. It could also impact if/when midwives decide to return to work following certain leaves (maternity/parental/sick).

    It seems like everyone is well aware of how challenging it is to become/practice as a midwife. Six years ago while in the MEP, I remember learning the burnout stats and writing papers on the challenges of being a midwife. It blows my mind that nothing has changed, and if anything, the system is continuing to make things harder for midwives.

    • Are you a: Member of the public
    • On behalf of: Yourself
  2. Midwife

    It is very upsetting to hear that the CMO fees are increasing so substantially especially considering how high the fees are already. These fees will make it very difficult, if not impossible, for part time midwives to stay in the profession. Another burden for already over worked, grossly underpaid, and undervalued midwives whose workload and scope keep expanding!. For many it may be time to consider another career. This profession is in dire straits!

    • Are you a: Midwife
    • On behalf of: Yourself
  3. Midwife

    I also would like to add my voice to the concern of higher fees and how we can afford to pay for them. Our clinic doesn’t have enough clients for the midwifes who want to, to work full time, so this increase will be felt. We pay so many fees! Some of us also have student loans.

    How many employees does the CMO have? Can one job be cut? I love the suggestion of moving the College out of Toronto. Hamilton would be a cheaper location, and close to Mcmaster University.

    I just finished my new registrant year and it was very difficult to pay the fees when I wasn’t making money yet….and that contributed to a loan that is getting paid off. Please give NRs a break!

    • Are you a: Midwife
    • On behalf of: Yourself
  4. Midwife

    I am a General Resident and I believe that New Registrants, like those in Inactive Practice, would also be disproportionately affected by a rise in college fees. I would prefer to see no increase for NRs and that GRs shoulder the balance of this burden.

    • Are you a: Midwife
    • Organization: Midwifery Services of Lambton Kent
    • On behalf of: Yourself
  5. Midwife

    I am extremely disappointed and discouraged at the thought of any increase to our already expensive fees. I was informed in 1994 that our then fees that were so much higher than our RN fees would decrease as our members increased!! I have yet to see a decrease.
    I am so disappointed that any fees are increased to our already overpriced fees: COM, AOM, legal fees, parking fees, continuing education fees, benefits fees (in arrears for those midwives working part time)
    It has come to a point where midwives will not be able to afford working part time.
    This is yet another slap to the face of already over worked and undervalued midwives

    • Are you a: Midwife
    • Organization: Community Midwives of Brantford
    • On behalf of: Yourself
  6. Midwife

    I feel any increase for membership fees needs to be delayed until midwives receive their appropriate pay increase. Our membership fees continue to increase, while our income appears be at a stalemate. I recall being told that our membership fees would decrease (after complaining that our College fees were so munch more than RN fees) when number of members increased!! It makes it difficult to continue to afford working as a midwife with the COM fees, AOM fees, parking, continuing education requirement costs, benefit costs not completely covered when working part-time (yet expected to be payed in arrears)
    We are already paying so much more than most of us can afford, with the added legal expenses.
    I am extremely disappointed! And if my vote counts for anything I most definitely vote AGAINST this fee increase!

    • Are you a: Midwife
    • Organization: Community Midwives of Brantford
    • On behalf of: Yourself
  7. Midwife

    One area in which the College could significantly reduce cost is to move. The CMO is located in prime downtown Toronto real estate – moving the CMO into a more economical space could help to mitigate the costs that are being passed onto members.
    There is plenty of class “B” office space available that would have enough space to house the college. The priority here should be functionality – not showmanship.

    • Are you a: Midwife
    • On behalf of: Yourself
  8. Midwife

    I am deeply disappointed that the Ministry has placed the CMO in the position of having to increase fees for Registered Midwives effective October 2019. While it is appreciated that the CMO has made every effort to reduce expenses, the impact this will have on already underpaid, under appreciated midwives can NOT be under-estimated. Death by a thousand cuts…. It’s hard to imagine this won’t potentially eventually have an impact on the quality of care we provide at the front line. It’s hard to maintain a high level of excellence despite our commitment to high quality care and to our clients, when we are constantly undermined.

    • Are you a: Midwife
    • On behalf of: Yourself
  9. Midwife

    I wanted to sent a note of appreciation for the clarity of questions and answers. It’s an unfortunate situation, and appears that you have made a thoughtful approach.

    My only concern is the disproportionate affect on New Registrants starting their careers who need to register in order to work – but will often not be paid for their work for months. Thanks for your thoughtfulness towards inactive members.

    • Are you a: Midwife
    • Organization: Countryside Midwifery Services
    • On behalf of: Yourself
  10. Midwife

    I thank the CMO for the work that has been done this year. I would like to be a voice for the New Registrants. I believe they should be exempt from this increase. There aren’t many of them, and I think the General Registrants can easily carry the slightly additional increase this would create. Starting a career in midwifery is incredibly difficult financially, per our pay structure. I propose us GRs cover the increases for these 90 NRs, or at least offer NRs delayed payment of this increase.

    • Are you a: Midwife
    • On behalf of: Yourself
  11. Midwife

    Our College fees are already so high. With the pay equity ruling confirming that there has been systemic and sustained gender based pay equity discrimination against midwives, and no response from government regarding this ruling, it is difficult to imagine paying even more to maintain our registrations at this time. I deeply value the work the College does, but these fees for individual midwives are unsustainable.

    • Are you a: Midwife
    • Organization: South Riverdale Community Health Centre
    • On behalf of: Yourself