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2019-2020 Registration Renewal, APR & QAP Requirements

2019-2020 Registration Renewal, APR & QAP Requirements

Members are required to submit the following three items by October 1, 2019, Registration Renewal and Continuing Competencies, Active Practice Reports, and Quality Assurance Program Requirements.

1. Registration Renewal

2. Active Practice Reports (APR)

3. Quality Assurance Program (QAP)

1. Registration Renewal

The College’s online registration renewal period runs from August 1 to October 1, every year. Members are required to renew their certificates of registration on an annual basis.

Online renewals are deemed complete if by October 1:

  1. The member has completed the online renewal application;
  2. The College has received accurate and legible proof of continuing competencies, if applicable; and,
  3. The College has received the member’s annual fee payment(s).

Accessing the Online Renewal Application

The online renewal site is live and available during the renewal period (August 1 to October 1) in the Member Portal of the College website. You will need your username and password to access the site.

Follow these steps in our Registration Renewal Guide to renew your registration. If you’d like to download a copy of the guide, click here.

Step 1 & 2. Getting Started & Renewal Route

The electronic renewal application will automatically recognize your current class of registration, as noted on the Public Register.

You will be asked to select your registration renewal route for the October 1 renewal: General, Supervised Practice, Transitional, Inactive or Resignation.

Step 3. Home Address & Contact Information

Personal Contact Information – Private (not noted on the Public Register)

Please ensure that the College has your current home address and contact information. The College uses your personal contact information-not your practice contact information-to contact you for all College business. All members must provide email address*, per the College’s General By-law 14.05(e).

*If you change your email address in this section, your newly entered email address will be your user login for the Registrant Self-Service/Member Portal.

Step 4. Practice Location(s) & Information

Practice Location(s) – noted on Public Register

In accordance with Articles 14.05 (c) and (d) of the College’s General By-law, you are required to provide all practice location(s) and dates where you currently provide and previously provided midwifery services. This includes all other places you practise midwifery if not in a midwifery practice group. In addition, ensure to answer the questions about your position at each practice location.  Inactive members are asked to complete this section in order to provide all historical practice information and ensuring the Public Register is up-to-date. If a correction is required to your past practice locations and information, including corrections to start or end dates, please send the correction/s required to regadmin@cmo.on.ca

Practice changes?

The practice information previously provided by you will appear in this section. You may review both your current and past practice information. If your practice information has changed, please click the EDIT button and update the information. If adding past practice information, please include an end date. You may also add a new practice by selecting your current practice from the drop-down menu. Please indicate the start date for the new practice.

Multiple practices?

Please add all practices you work with by selecting the +Add Practice button in the top left-hand corner.

Not affiliated with a midwifery practice group?

If you are currently practising midwifery outside a midwifery practice group, please provide the College with information on where you are practising, including your position title, if not currently listed on your College profile. To add new information, please email the information to regadmin@cmo.on.ca and the information will be added to your profile.

Step 5. Other Registrations

Other current and past registrations in any profession-noted on the Public Register.

All members are required to provide information pertaining to current or past registrations or licences held in any profession in any jurisdiction. As per Article 14.02 (cc) of the College’s General By-law, members are asked to provide the following information where applicable.

  • Name of the regulator/licensing body
  • Profession
  • Province/State/Territory (Canada/US)
  • Country
  • Start and End date

Add a new registration by clicking the +Add Registration button. To edit the existing information, click Edit.

Not registered or licensed to practise midwifery in another jurisdiction or any other profession in any jurisdiction? Click the Next button in the lower right-hand corner to continue.

Step 5.2. Hospital & Birth Centre Privileges (hidden for Inactive members)

Current Hospital & Birth Centre privileges – noted on the Public Register

All members must provide the College with the names of all Ontario hospitals and birth centres where you hold privileges in accordance with Article 14.05 (f) of the College’s General By-law.  Any current hospital/birth centre privilege information on file with the College will be visible in this section.  Please review the list in this section and make any necessary changes.  Choose +Add New to add to the list or EDIT to add an end date.  Where an end date is entered, the hospital/birth centre privilege will appear under Past Privileges, unless the end date is a future date.  In addition, please indicate whether you are the head midwife at each hospital where you have privileges.

If your hospital/birth centre is not in the drop-down menu, please contact the College at regadmin@cmo.on.ca for an adjustment to the drop-down menu.

Step 6. Continuing Competency Evidence

Continuing Competency Requirements and Approved Courses

Courses completed after October 1, 2018 must be in compliance with the College’s Continuing Competency Requirements and Approved Courses document, which may be reviewed here.  All courses must include training in the areas outlined under Course Requirements. 

General, Supervised Practice or Transitional class members must ensure that continuing competency certificates (NRP, CPR, ES) are current on October 1 and are on file with the College. Continuing competency data on file at the College, and review status of each certificate, will be visible to you in this section, however, expired competencies will not be visible. Complete this section by clicking +Add New and selecting the course and course provider from the drop-down menus. Then upload legible electronic copies, in PDF format only, of all individual certificates issued by the course provider.  

Any document submitted that does not include the date of completion, is expired, is illegible, is not in PDF format or is not in compliance with the College’s Continuing Competency Requirements and Approved Courses document, will not be accepted and your renewal application/package will be considered incomplete and the 15% penalty fee will be applied. View each upload carefully and make corrections where necessary to ensure the 15% penalty fee cannot be levied on your renewal application/package.

Inactive class members are not required to provide the College with proof of continuing competency. If you intend to return to practice soon and/or wish to complete this section, you may do so. Select NEXT to skip and proceed to the next section. 

Instructions to Attach (Upload) Evidence of Continuing Competency:

  1. Scan and save each continuing competency proof separately in a legible PDF file in your computer directory.  Note: Your name, the course name, and the completion date must be visible on the evidence of continuing competency. 
  2. For each continuing competency, click the CHOOSE FILE tab (bottom left of the screen)
  3. Locate the file in your computer directory and select OPEN
  4. The file name (in blue) will appear underneath the CHOOSE FILE tab
  5. Click SAVE, which will add the continuing competency to the list on file with the College
  6. To view, change or re-upload a certificate on file with the College, follow the onscreen prompts.

Continuing Competency Evidence After Submission of a Renewal Form

To upload evidence of continuing competency after a renewal form has been submitted to the College, simply use/click the Certifications tab in the Member Portal.  The upload process is the same as noted in the instructions above.  Please do not fax or email your continuing competency evidence to the College.

Any upload after the October 1 filing deadline will be considered late despite the actual certification date and will be subject to the 15% penalty fee.

Frequently Asked Questions Re: Continuing Competency Evidence

Instructors

As noted in Continuing Competency Requirements and Approved Courses document, instructors must include both (1) evidence of being an instructor and (2) evidence that a course has been taught or instructor training has been completed.  These two documents should be combined in one PDF file and uploaded as evidence of continuing competency. 

Alternative Evidence

The College will accept a letter from a course instructor confirming the completion of a continuing competency course when the issuance of the usual wallet card or certificate is delayed.  The letter must include the date of course completion, the member’s name, the course name, course details, and the instructor’s name, contact information, and signature.

Expired Continuing Competency Evidence

All continuing competencies must be current as of October 1, 2019.  If a member cannot provide valid evidence, the 15% penalty fee will be levied, and a letter of default and intention to suspend will be issued.  A member in this situation will have 30 days from the date the letter is issued to both pay the penalty fee and to provide evidence of the missing competency. A suspended member cannot practise midwifery in Ontario until the suspension is lifted.

Step 7. Ministry of Health and Long-Term Care (MOHLTC)

HealthForceOntario Health Professions Database (HPDB)

The next sections relate to HPDB requirements. Accurate completion of this section helps the College fulfill its role as a source of information concerning the Ontario midwifery profession. The College is required to report this information directly to the government in accordance with section 36.1 of the Regulated Health Professions Act, 1991. Most of the questions have drop-down menus from which you must select an answer.

HPDB Section 1 – Languages of Care

Any languages previously provided will be visible in this section. Please review the list of languages, Edit, Delete, or +Add New to indicate languages in which you can competently provide midwifery services. The comprehensive list of languages provided in the drop-down menu are those approved by the MOHLTC. A maximum of five languages from the drop-down menu provided may be selected. Select French and/or English to continue to the next page.

HPDB Section 2 – Education Details

Enter education details related to your professional qualifications as a midwife as well as any additional post-secondary education you have completed, which does not appear in this section.  Please select +Add New for each education detail to be added separately.

After clicking +Add New you will see three tick boxes:

The education that I am now reporting on was granted in:

  •  Canada
  •  United States
  •  Outside of Canada & the United States

Each tick box will take you to a different screen; Canada will include an institution and province drop-down menus with Canada for Country pre-populated; United States will preselect “Out of Country” for institution and show a drop-down menu for state with USA for country pre-populated and; outside of Country preselects “Out of Country” for institution, will show N/A for province/state and show options for all countries.

IMPP graduates will select Ryerson University for institution name and Diploma for education level. Michener graduates are listed with Michener for institution name and Diploma for education level. PLA and PLEA graduates are listed with PLA or PLEA for institution name and Diploma for education level.  

Education required for entry-to-practice in Ontario cannot be edited.  If there is a concern or missing data, please contact the College by email at regadmin@cmo.on.ca.

HPDB Section 3- Current Practice Location(s) (Not visible for Inactive Members)

Please edit your current practice location(s) to provide any missing or updated information.  Select the Edit button (pencil symbol) on each practice listed to complete or update the required practice information. The information listed will show your current places of practice, as provided in Step 4.

HPDB Section 4 and 4.1 – Practice Information & History

Section 4

Please complete this section to reflect your initial year and location of your first midwifery practice and to indicate your current practice status.

Section 4.1

Please complete this section to reflect your most recent previous location of practice outside of Ontario and the last year you practised in that location outside of Ontario.  If Canada or the USA, please indicate province or state.  If this does not apply to you, please proceed to the next section.

HPDB Section 5 – Practice Information within the past 12 months

Section 5: First Page / Screen

All members are required to complete the first question to indicate preferred work status, based on the options provided by HealthForceOntario in the drop-down menu.

The remainder of this section (not visible to Inactive Members) relates to the amount of time you have spent practising midwifery within the past 12 months (weeks and hours). Please review all of the bullet points before answering the remaining questions in this section.

Section 5: Second Page/Screen (Not visible for Inactive Members)

This section relates to your allocation of time to different activities. You are asked to break your workweek down into percentages. If the question does not apply to you, enter ‘0’ (zero) to reflect ‘Not Applicable’. All questions that ask for a percentage value must add up to 100%. If you did not practise, enter ‘100’ to indicate time spent on all other activities (last question on the list) and enter ‘0’ (zero) for the preceding percentage questions.

Step 8. Disclosures

The disclosure questions are to be answered ‘Yes’ or ‘No’. Any question answered with a ‘Yes’, must include details in the space provided. Please answer each of the disclosure questions carefully as they have changed slightly from last year.   

Step 9. Authorization

Certify that you have current professional liability insurance as required or will hold an Inactive class of registration as of October 1st.  All General, Supervised Practice, and Transitional members must maintain professional liability insurance at all times as a condition of registration.  Inactive members are not required to maintain professional liability insurance. 

Additionally, certify that all information provided is true, complete and accurate in order to proceed to the next section. Failure to provide complete and accurate information to the College may be considered professional misconduct.   

Step 10. Payment

Confirm and submit your method of payment in this section. The renewal system will guide you through the secure online payment process.

Note: Your registration renewal application/package will not be processed until payment has been received and processed. If you are paying by cheque, please ensure that your payment is received well before October 1 to ensure your renewal is not deemed late.

College fees can only be paid by:

  1. Visa or MasterCard through the Member Portal (full annual fee only)
  • Cheque (full annual fee or two installments, as noted in the table above)

To be accepted by the College, cheque payments must be:

  • Payable to the “College of Midwives of Ontario”
  • Signed and dated accordingly with member’s name and College registration number clearly visible on the face of the cheque
  • Not understated, not overstated, and dollar amount on cheque matching written text
  • Received after the submission of a renewal form, but not later than October 1
  • One cheque per member for full payment or two cheques for installments
  • For payments by installment:
    • Installment amounts on cheques are exactly as indicated on chart above
    • Both installment cheques are received no later than October 1
    • Second installment cheque is dated February 1, 2020
  • One cheque per member for full payment or two cheques for the installments option.  The College enters payment information only once a member has submitted a renewal application to the College.  For this reason, cheques covering multiple members is strongly discouraged.
  • Each cheque, including second installment cheques, not honoured by the bank are subject to a $40 NSF processing fee, in addition to the penalty fee as the renewal application may be deemed late. 

FINAL Step - Confirmation Page

VERY IMPORTANT: Only once you have reached the page labeled “Submitted” you have successfully submitted your online renewal application to the College. 

Please ensure that your renewal is complete and received by the College by October 1. Incomplete or late renewals will be subject to a penalty of an additional 15% of the annual membership fee and a notice of default will be issued.

Complete Renewal Applications/Packages are deemed complete once:

  1. The College has received your completed online renewal application.
  2. The College has received accurate and legible continuing competency certificates/evidence, except from inactive class registrants.
  3. The College has received your annual fee payment(s).

Annual Registration Card

An updated annual registration card will be available through the Member Portal, as soon as the College reviews and deems an application for registration renewal as completed. Notification will be sent to you by email when your renewal is marked completed.

Receipt for Payment

A receipt for payment is available through the left-hand menu in the Member Portal. Official Income Tax Receipts will be available in the Member Portal in early 2020.

Reminder: Active Practice Requirement and Quality Assurance

Please ensure you also complete and submit your Active Practice Requirement (APR) and your Quality Assurance reporting before the deadline of October 1, 2019. Access to reporting is available on the left-side menu of the Member Portal and on the Welcome page of the Member Portal.

Renewal after October 1

All renewals submitted/received after October 1 are subject to the late penalty fee (15% of the total annual membership fee), which will be automatically added to the total fees owed. If paying in installments, the penalty fee is due with the first installment cheque.

2. Active Practice Requirements (APR)

Members must satisfy active practice requirements as outlined in the Registration Regulation, and therefore are required to submit Active Practice Reports by October 1, 2019.

Active Practice Requirements and Submission

To learn more about the active practice requirements, please click here.

In order to meet the requirements in the Registration Regulation, members must have the following birth numbers:

Members are required to report their active practice birth numbers annually by October 1 each year through the online Member Portal. Members holding an Inactive certificate for a year or partial year, are also required to submit a report and enter “o” (zeros) where applicable. Members report each year based on the births they attended in the reporting period of July 1 – June 30.

Review of APR

Post October 1 annually, all members who were due to have met their active practice requirement are identified, 2-year or 5-year, as of October 1. Each member’s active practice report as submitted via the Member Portal are reviewed. If reports are missing the member is contacted to submit the missing reports.

Meeting APR

Members in the General class who met their APR will be notified and their subsequent APR due date will be updated in the Member Portal.

APR Shortfalls

Members in the General class who have an APR shortfall are reviewed a second time to determine if the member continues to have a shortfall after determining the following:

At any point during the 2- or 5-year reporting period was the member registered in the Inactive class? If yes, the member’s due date is adjusted to account for the amount of time the member was registered in the Inactive class and not subject to APR.

Example 1: A member was due to meet their 2-year APR by October 1, 2018, review of the submitted APR reports indicate that the member does not have the required birth numbers. However, the member was Inactive for 6 months during the reporting period. The member will next need to meet their 2-year APR by October 1, 2019.

Example 2: A member was due to meet their 5-year APR by October 1, 2018. Review of the submitted APR reports indicate that the member does not have the required birth numbers. However, the member was Inactive for 2 years during the reporting period. The member will next need to meet their 5-year APR by October 1, 2020.

b. If the member was not in the Inactive class at any point during the reporting period, then the member’s birth numbers in the shortfall category are reviewed and the reported births where the member provided care in the role of second midwife are considered. When both categories are considered, does the member still have a shortfall?

Example: The member was due to meet the 5-year APR by October 1. The member has a shortfall in primary out-of-hospital births having only 20 out of the required 25. However, the member also reported 6 out-of-hospital births as a second. Therefore, the member has a total of 26 out-of-hospital births for the reporting period. The member is considered to have met the requirements.

i. If the member no longer has a shortfall and meets the requirement, the
member will be notified and their next APR due date will be available in
the Member Portal.
ii. If the member continues to have an APR shortfall even after accounting
for the births attended as seconds, the member will be notified of the
shortfall and referred to the Registration Committee.

Referral to Registration Committee for an APR Shortfall

Members who continue to have an APR shortfall, after a second review as outlined above, are referred to the Registration Committee in accordance with the Registration Regulation.
Members will be asked to make written submissions to the Registration Committee within 30 days of receiving a notice of referral. The member’s written submission must include the following:

Reason for the shortfall and explanation of how they have been maintaining their knowledge and skills to practise safely in all birth settings;

  1. Where applicable, the member must demonstrate that extenuating circumstances exist (i.e. circumstances that are beyond the member’s control) that prevented the member from meeting their APR. For example:
    • Low home birth rate practice
    • Unplanned changes to birth location
  2. Where applicable, an explanation of how the member’s practice
    environment/employment contributed to the shortfall and may continue to
    contribute to a shortfall. For example:
    • Hospitalist midwife
    • Expanded Midwifery Care Models and not providing intrapartum care
    • Birth Centre Clinical Director
    • MEP instructor
    • Other

Members in the Inactive Class

The APR due dates for Inactive members will be reviewed and adjusted when they apply for and are granted a General certificate of registration unless the member currently meets their requirement.

Example 1: A member was due to meet their 5-year APR as of October 1, 2018. However, at the time of reviewing APR for 2018, the member is registered in the Inactive class. A review of the APR birth numbers indicate that the member has an APR shortfall. The member applies and is granted a General certificate of registration as of January 1, 2019, having been registered in the Inactive class for two years. Assuming the member has sufficient current clinical experience and active practice to meet the requirements for a General certificate, the member’s APR due date will be changed to October 1, 2021, when the member is issued a General certificate.

Example 2: A member was due to meet their 5-year APR as of October 1, 2018. However, at the time of reviewing APR for 2018, the member is registered in the Inactive class. A review of the member’s APR numbers indicate that the member meets the requirements, therefore the member’s due date is adjusted to October 1, 2023. The member will still be required to meet the current clinical experience and active practice requirements outlined in the Registration Regulation if the member applies to be re-issued a General certificate of registration.

Example 3: A member was due to meet their 5-year APR as of October 1, 2018, and is currently registered in the Inactive class. The member has been registered in the Inactive class for 3 years. However, the member applies to be re-issued a General certificate in order to change class on October 1, 2018.

A review of the member’s application reveals that the member does not meet the requirements of current clinical experience and active practice required under section 15(4)(a) of the Registration Regulation and therefore is referred to the Registration Committee for approval of a requalification program. The member completes the requalification program and becomes registered in the General class, their APR due date is now October 1, 2023.

Members in the Supervised Practice Class

An APR due date for Supervised Practice members will be added and visible when a General certificate of registration is granted. Supervised Practice members should also report birth numbers.

3. Quality Assurance Program (QAP)

The College’s Quality Assurance Program (QAP) is designed to ensure that the knowledge, skill and judgment of Ontario midwives remains current throughout their careers, and that they continue to provide safe, effective, appropriate and ethical midwifery care to their clients. The QAP is mandated under the Regulated Health Profession’s Act, 1991 (RHPA). The components of the QAP can be found under the Quality Assurance Regulation (O. Reg. 335/12) made under the Midwifery Act, 1991.

The Quality Assurance Program is intended to be supportive in nature. It is meant to promote and enhance members’ understanding of the practice of the profession of midwifery through:

Continuing Education and Professional Development

A continuing education activity is one that maintains or improves a member’s knowledge, skills or judgment as related to the practice of midwifery.

Acceptable activities for continuing education and professional development are indicated in the  Guideline on Continuing Education and Professional Development

Note: the Policy on Continuing Education in Fetal Health Surveillance was rescinded by the College Council on December 12, 2018.

Peer & Practice Assessment

Peer Case Reviews

Members in the general class (including new registrants) and supervised practice class of registration must participate in at least six sessions of peer case review each reporting year (October 1- September 30).  Peer case reviews should be educational and should be conducted in a confidential and non-punitive environment.

In accordance with the Quality Assurance Regulation, the peer case review sessions must include a minimum of four participating midwives from at least two separate midwifery practice groups.

Members may report on up to two interprofessional case review activities (e.g., hospital morbidity and mortality or departmental meetings, MORE OB interprofessional care reviews), provided that the review consists of at least four participants.

For more details on peer case reviews, please review the Guideline on Peer Case Review

Quality of Care Evaluation Records

The Quality of Care Evaluation (QCE) Form must be provided to each client upon or after discharge from care to encourage client feedback on midwifery services.

The returned QCEs should be reviewed on a regular basis.  Members are required to provide each client with a QCE within six months of discharge from care and retain returned evaluations for five years.

Quality of Care Evaluation Form (English)

Formulaire d’evaluation de la qualité des soins (Français)

Quality of Care Evaluation Action Records

Each practice should develop a method for reviewing the returned Quality of Care Evaluation Forms in order to decide if any action is necessary in response to client feedback.  Periodic reviews of a group of client evaluations may help the practice identify areas requiring change or improvement.

Read more in our Guideline on Quality Care Evaluation.

Self-Assessment

The College has recently submitted proposed changes to the Quality Assurance Regulation.  While this revised regulation is being considered by the Ministry of Health and Long-Term Care (MOHLTC), the College’s Quality Assurance Committee approved the use of an interim Self-Assessment Questionnaire (SAQ). Read our Guideline on the SAQ for more information.

Reporting QAP Activities

How do I track and report my QAP activities?

The Quality Assurance Program (QAP) reporting portal is back online. Members may track and report their 2018/2019 QAP activities through this portal.

If you have been using the Quality Assurance Program (QAP) Annual Record form to track activities, please log in to the Member Portal to transfer your activities to your QAP profile.

Members will be required to submit their activities through the portal as the College will no longer be using the Annual Record form.