GENERAL

Respiratory Therapy Act, 1991
Loi de 1991 sur les thérapeutes respiratoires

ONTARIO REGULATION 596/94

GENERAL

Historical version for the period May 19, 2005 to January 23, 2008.

Last amendment: O. Reg. 235/05.

This Regulation is made in English only.

PART I (ss. 1-19) Revoked: O. Reg. 470/99, s. 1.

PART II (ss. 20-22) Revoked: O. Reg. 470/99, s. 1.

PART III
ADVERTISING

23. (1) In this Part, an advertisement with respect to a member’s practice includes an advertisement for gases used for medical purposes, equipment, supplies or services that includes a reference to the member’s name.

(2) An advertisement with respect to a member’s practice must not contain,

(a) anything that is false or misleading;

(b) anything that, because of its nature, cannot be verified;

(c) a claim of expertise in any area of practice, or with respect to any procedure or treatment, unless the advertisement discloses the basis of the expertise;

(d) an endorsement other than an endorsement by an organization that is known to have expertise relevant to the subject-matter of the endorsement;

(e) a testimonial by a patient or client or former patient or client or by a friend or relative of a patient or client or former patient or client; or

(f) anything that promotes or is likely to promote excessive or unnecessary use of services.

(3) An advertisement must be readily comprehensible to the persons to whom it is directed.

(4) A member must not permit his or her name to be used in an advertisement that contravenes subsection (2) or (3).

(5) A member must not advertise by initiating contact, or causing or allowing any person to initiate contact, with potential patients or clients or their personal representatives either in person or by telephone, in an attempt to solicit business.

(6) Despite subsection (5), a member may advertise by initiating contact with a potential client or a personal representative of a potential client if the potential client does not personally use or consume the gases, equipment, supplies or services that are the subject of the advertisement.

(7) A member must not appear in, or permit the use of his or her name in, an advertisement that implies, or could reasonably be interpreted to imply, that the professional expertise of the member is relevant to the subject-matter of the advertisement if it is not relevant. O. Reg. 596/94, s. 23.

PART IV (ss. 24-29) Revoked: O. Reg. 470/99, s. 1.

PART V
NOTICE OF MEETINGS AND HEARINGS

30. (1) The Registrar shall ensure that notice of every Council meeting that is required to be open to the public under the Act is given in accordance with this Part.

(2) Notice of a meeting of the Council that is required to be open to the public shall be published in a daily newspaper of general circulation throughout Ontario no less than 14 days before the day of the meeting.

(3) The notice shall be published in English and in French.

(4) The notice shall contain the date, time and place of the meeting and a statement of the purpose of the meeting.

(5) The Registrar shall give notice of a Council meeting that is open to the public to every person who requests it. O. Reg. 130/97, s. 1.

31. (1) The Registrar shall ensure that a notice of a hearing of the Discipline Committee respecting allegations of a member’s professional misconduct or incompetence is given to every person who requests it.

(2) The notice shall be given,

(a) if the request is received 32 days or more before the date of the hearing, at least 30 days before the date of the hearing; and

(b) if the request is received less than 32 days before the date of the hearing, as soon as reasonably possible after the request is received.

(3) The notice shall be available in English and in French.

(4) The notice shall contain,

(a) the name of the member against whom the allegations of professional misconduct have been made;

(b) the member’s principal place of practice;

(d) a statement of the purpose of the hearing. O. Reg. 130/97, s. 1.

PART VI
QUALITY ASSURANCE

General

32. In this Part,

“Committee” means the Quality Assurance Committee. O. Reg. 68/99, s. 1.

33. The Committee shall administer the quality assurance program, which shall include the following components:

1. Continuous quality improvement activities by members.

2. Assessment of members’ knowledge, skills and judgment and remediation of members whose knowledge, skills or judgment have been assessed and found to be unsatisfactory.

3. Assessment of members who are alleged to have demonstrated behaviour or made remarks of a sexual nature towards a patient or client and remediation of members. O. Reg. 68/99, s. 1.

34. The College shall monitor the members’ compliance with the quality assurance program. O. Reg. 68/99, s. 1.

Continuous Quality Improvement Activities

35. (1) Every member shall participate in continuous quality improvement activities which shall include,

(a) self-assessment of the member’s knowledge, skills and judgment;

(b) development of a plan to improve one or more of the member’s knowledge, skills or judgment;

(d) self-evaluation of the improvement in one or more of the member’s knowledge, skills or judgment.

(2) Every member shall maintain records of his or her continuing quality improvement activities in accordance with the guidelines published by the Committee and delivered to the members.

(3) A member shall, on request,

(a) provide accurate information to the College about his or her continuing quality improvement activities; and

(b) make his or her records available to the College for inspection. O. Reg. 68/99, s. 1.

Assessments

36. (1) Each year the Committee shall select at random the names of members required to undergo an assessment of their knowledge, skills and judgment.

(2) A member shall undergo an assessment of his or her knowledge, skills and judgment if his or her name is selected at random or if the member is referred to the Committee by the Registrar, the Executive Committee or a panel of the Complaints Committee. O. Reg. 68/99, s. 1.

37. (1) An assessment under section 36 shall be conducted by an assessor appointed under section 81 of the Health Professions Procedural Code.

(2) A person may be appointed to conduct an assessment of a member even though the person,

(a) is an employee of the College; or

(b) is acquainted with the member who is to undergo the assessment.

(3) The assessment may include,

(a) inspecting and reviewing the member’s premises and records relating to patient and client care, continuing quality improvement activities and equipment maintenance and quality control;

(b) interviewing the member, his or her colleagues, staff, supervisors or employers;

(d) requiring the member to participate in one or more evaluations of the member’s knowledge, skills or judgment including practical evaluations such as simulated situations, peer assessments or practice setting reviews.

(4) An assessor may obtain the assistance of other persons for the purposes of conducting an assessment. O. Reg. 68/99, s. 1.

38. (1) When an assessment is directed under section 36, the chair of the Committee shall select a panel from among the members of the Committee.

(2) A panel shall be composed of at least three persons, at least one of whom shall be a person appointed to the Council by the Lieutenant Governor in Council and at least one of whom shall be both a member of the College and a member of the Council.

(3) If one or more members of a panel become ill or are otherwise unable to continue as members of the panel,

(a) the panel may continue to act with respect to the assessment so long as there are at least two members remaining on the panel; or

(b) the chair of the Committee may appoint other members to replace the previous panel members.

(4) An assessor shall give a written report of the results of an assessment to the panel appointed under subsection (1).

(5) The panel shall review the assessor’s report and recommendations.

(6) If the report indicates that any of the member’s knowledge, skills and judgment are unsatisfactory, the panel shall make reasonable efforts to obtain and review the member’s records relating to his or her quality improvement activities, and after doing so, it may do one or more of the following:

1. Give the member an opportunity to correct the aspects of the member’s knowledge, skills and judgment that the panel believes are unsatisfactory.

2. Require the member to undertake specified remedial or refresher measures or education.

3. If the panel finds that the member’s knowledge, skills or judgment are unsatisfactory and the panel believes that any action taken under paragraph 1 or 2 would be inadequate, direct the Registrar to impose, subject to section 42, terms, conditions or limitations on the member’s certificate of registration for a specified period not exceeding six months. O. Reg. 68/99, s. 1.

39. (1) Subject to section 42, a panel may direct the Registrar to impose terms, conditions or limitations on a member’s certificate of registration, for a specified period not exceeding six months, if,

(a) the member refuses to undertake the specified remedial or refresher measures or education required under paragraph 2 of subsection 38 (6); or

(b) the member has undertaken the specified remedial or refresher measures or education required under paragraph 2 of subsection 38 (6) and the measures or education have not been successfully completed.

(2) If a term, condition or limitation is imposed for a specified period by the Registrar as a result of a direction made under subsection (1) or paragraph 3 of subsection 38 (6), the panel may direct the Registrar to remove the term, condition or limitation before the end of the specified period if the panel is satisfied that the member’s knowledge, skills and judgment are satisfactory. O. Reg. 68/99, s. 1.

40. (1) If a panel takes action under subsection 38 (6) or 39 (1), it may, at the time it communicates its decision to the member or at any time thereafter, require the member to undergo a follow-up assessment to determine whether the member’s knowledge, skills and judgment are satisfactory.

(2) Sections 37, 38 and 39 apply with necessary modifications to a follow-up assessment under this section. O. Reg. 68/99, s. 1.

41. (1) A panel may refer a member to the Executive Committee if,

(a) the member fails to comply with the requirements of the quality assurance program; or

(b) the member poses a risk of harm to patients or clients.

(2) A panel that refers a member to the Executive Committee under subsection (1) may provide the Executive Committee with such information as it considers appropriate, except for information that may not be disclosed under section 83 of the Health Professions Procedural Code. O. Reg. 68/99, s. 1.

42. A panel shall not act under paragraph 3 of subsection 38 (6) or under subsection 39 (1) unless it gives the member written notice of what it intends to do, a copy of the assessor’s report and at least 14 days to make a written submission to the panel. O. Reg. 68/99, s. 1.

Behaviour and Remarks of a Sexual Nature

43. (1) The chair of the Committee shall select a panel from among the members of the Committee to deal with any matter relating to sexual abuse as defined in clause 1 (3) (c) of the Health Professions Procedural Code that is referred to the Committee under paragraph 4 of subsection 26 (2) or section 79.1 of the Health Professions Procedural Code by the Complaints Committee, the Executive Committee or the Board.

(2) Subsections 38 (2) and (3) apply to a panel selected under this section. O. Reg. 68/99, s. 1.

44. (1) The panel appointed under subsection 43 (1) may require a member in respect of whom a matter mentioned in subsection 43 (1) has been referred to the Committee to undergo a psychological assessment or an assessment of the member’s needs for education about sexual abuse.

(2) The person conducting the assessment shall provide a written report of the results of the assessment to the panel. O. Reg. 68/99, s. 1.

45. After considering the assessment report and subject to section 47, the panel may require the member to undergo specified therapy or to participate in a sexual abuse education program. O. Reg. 68/99, s. 1.

46. (1) Subject to section 47, the panel may direct the Registrar to impose terms, conditions or limitations on a member’s certificate of registration, for a specified period not exceeding six months, if,

(a) the member refuses to undergo an assessment required under section 44;

(b) the member refuses to undergo therapy or to participate in the sexual abuse education program as required under section 45; or

(c) the member participates in the specified therapy or the sexual abuse education program but fails to successfully complete the therapy or program.

(2) If a term, condition or limitation is imposed for a specified period by the Registrar as a result of a direction made under subsection (1), the panel may direct the Registrar to remove the term, condition or limitation before the end of the specified period if the panel is satisfied that it is no longer needed.

(3) A panel may refer a member to the Executive Committee if a term, condition or limitation has been imposed on the member’s certificate of registration for a specified period of time under this section and the member,

(a) continues to refuse to undergo an assessment;

(b) continues to refuse to undertake the specified therapy or to participate in a sexual abuse education program required under section 45; or

(4) A panel that refers a member to the Executive Committee under subsection (3) may provide the Executive Committee with such information as it considers appropriate, except for information that may not be disclosed under section 83 of the Code. O. Reg. 68/99, s. 1.

47. A panel shall not act under section 45 or subsection 46 (1) unless it gives the member written notice of what it intends to do, a copy of the assessor’s report and at least 14 days to make a written submission to the panel. O. Reg. 68/99, s. 1.

PART VII
PRESCRIBED PROCEDURES

48. The following procedures are prescribed as procedures below the dermis for the purposes of paragraph 1 of section 4 of the Act:

1. Basic procedures:

i. Arterial puncture.

ii. Capillary puncture.

iii. Tracheostomy tube change for an established stoma.

iv. Transtracheal catheter change for an established stoma.

2. Added Procedures:

i. Removal of a cannula.

ii. Manipulation or repositioning of a cannula.

iii. Aspiration from a cannula.

iv. Venipuncture.

v. Suturing to secure indwelling cannulae.

vi. Transtracheal catheter change for a fresh stoma that is less than seven weeks.

vii. Tracheostomy tube change for a fresh stoma that is less than seven days but not less than 24 hours.

viii. Manipulation or reposition of a cannula balloon.

3. Advanced Procedures:

i. Insertion of a cannula.

ii. Chest needle insertion, aspiration, reposition and removal.

iii. Chest tube insertion, aspiration, reposition and removal. O. Reg. 68/99, s. 1.

49. (1) It is a condition of a general certificate of registration that a member not perform an advanced procedure unless the member has, within two years before the procedure is performed, successfully completed a certification process or program approved by the Registration Committee of the College.

(2) The following are conditions of a graduate certificate of registration:

1. A member shall not perform advanced procedures.

2. A member shall not perform an added procedure unless the member is permitted to perform the procedure by the terms and conditions of his or her certificate of registration imposed under subsection 15 (2), 18 (2) or 19 (6) of the Health Professions Procedural Code.

(3) The following are conditions of a limited certificate of registration:

1. A member shall not perform a basic or added procedure unless the member is permitted to perform the procedure by the terms and conditions of his or her certificate of registration imposed under subsection 15 (2), 18 (2) or 19 (6) of the Health Professions Procedural Code.

2. A member shall not perform an advanced procedure unless,

i. the member is permitted to perform the procedure by the terms and conditions of his or her certificate of registration imposed under subsection 15 (2), 18 (2) or 19 (6) of the Health Professions Procedural Code, and

ii. the member has, within two years before the procedure is performed, successfully completed a certification process or program approved by the Registration Committee of the College. O. Reg. 68/99, s. 1.

PART VIII
REGISTRATION

50. The following are prescribed as classes of certificates of registration:

1. General.

2. Graduate.

3. Limited. O. Reg. 69/99, s. 1.

51. A person may apply for a certificate of registration by submitting a completed application in the form provided by the Registrar, together with the application fee. O. Reg. 69/99, s. 1.

52. It is a requirement for the issuing of a certificate of registration of any class that the applicant pay the required annual fee for that class of certificate. O. Reg. 69/99, s. 1.

53. (1) An applicant for a certificate of registration of any class must satisfy the following requirements:

1. The applicant has not been found guilty of a criminal offence or an offence under the Controlled Drugs and Substances Act (Canada) or the Food and Drugs Act (Canada).

2. The applicant is not currently the subject of a professional misconduct, incompetence, incapacity or other similar proceeding nor been the subject of a finding of professional misconduct, incompetence, incapacity or other similar finding while registered or licensed in Ontario in another profession or in another jurisdiction in respiratory therapy or another profession.

3. The applicant is able to communicate effectively in English or French in a health care environment.

4. The applicant is a Canadian citizen or a permanent resident of Canada or is authorized under the Immigration and Refugee Protection Act (Canada) to engage in the practice of respiratory therapy. O. Reg. 69/99, s. 1; O. Reg. 235/05, s. 1.

(2) An applicant shall be deemed not to have satisfied the requirements for a certificate of registration if the applicant made a false or misleading statement or representation in the application. O. Reg. 69/99, s. 1.

(3) An applicant who, after having applied but before being issued a certificate, is found guilty under paragraph 1 of subsection (1) or becomes the subject of a proceeding or of a finding described in paragraph 2 of that subsection shall immediately inform the Registrar. O. Reg. 69/99, s. 1.

54. (1) In addition to the requirements set out in section 53, an applicant for a general certificate of registration must satisfy the requirements set out in subsections (2), (4) and (5). O. Reg. 69/99, s. 1.

(2) Subject to subsection (7), an applicant must,

(a) have successfully completed a respiratory therapy program offered in Canada that, at the time of completion, was approved or accredited by the Council or by a body approved by the Council;

(b) have successfully completed a program offered outside Canada for training respiratory therapists that, at the time of completion, was considered by the Council to be equivalent to a program referred to in clause (a); or

(c) demonstrate through a prior learning assessment approved by the Registration Committee that he or she has knowledge, skills and judgment equivalent to those of a person who has successfully completed a program referred to in clause (a). O. Reg. 69/99, s. 1.

(3) The College shall provide the applicant with a copy of the list of programs referred to in clause (2) (a) upon request. O. Reg. 69/99, s. 1.

(4) An applicant must have successfully completed the examinations set or approved from time to time by the Council. O. Reg. 69/99, s. 1.

(5) An applicant must have met the requirements of subsection (2) within the two years immediately preceding the application for registration unless the applicant was practising respiratory therapy within that two-year period. O. Reg. 69/99, s. 1.

(6) Subject to subsections (7), (8) and (9), the requirements in subsections (2) and (4) are non-exemptible. O. Reg. 235/05, s. 2 (1).

(7) An applicant for a general certificate of registration is exempt from the requirements of subsection (2) if the applicant previously held a general certificate of registration and, prior to being issued the general certificate, held a limited certificate of registration. O. Reg. 69/99, s. 1.

(8) An applicant is exempt from the requirements of subsections (2) and (4) if,

(a) the applicant,

(i) is registered with a statutory regulator of practitioners of respiratory therapy in another jurisdiction in Canada and has a general or full registration status that is not subject to individual terms, conditions or limitations, or

(ii) is a member of a professional association of practitioners of respiratory therapy in another jurisdiction in Canada that does not have a statutory regulatory body for practitioners of respiratory therapy, if the professional association is recognized by the Registration Committee and the applicant has a general or full membership status in the professional association that is not subject to individual terms, conditions or limitations;

(b) the applicant has safely practised the profession in that jurisdiction, with the general or full registration or membership status that is not subject to individual terms, conditions or limitations, for at least 720 hours within the four years before the date of the application; and

(c) the occupational standards and requirements for practitioners of respiratory therapy who are registered in that jurisdiction or who are members of a recognized professional association in that jurisdiction, as the case may be, are, in the opinion of the Registration Committee, substantially equivalent to those for respiratory therapists registered in Ontario. O. Reg. 235/05, s. 2 (2).

(9) An applicant who would meet the requirements of subsection (8) except for having a registration or membership status that is subject to individual terms, conditions or limitations is exempt from the requirements of subsections (2) and (4) and may be registered with similar terms, conditions or limitations if the Registration Committee believes that to do so would be in the public interest. O. Reg. 235/05, s. 2 (2).

55. (1) In addition to the requirements set out in section 53, an applicant for a graduate certificate of registration must meet the following requirements:

1. The applicant must have successfully completed the requirements of subsection 54 (2).

2. The applicant must not yet have completed the examinations referred to in subsection 54 (4).

(2) The College shall provide the applicant with a copy of the list of programs referred to in clause 54 (2) (a) upon request.

(3) An applicant must have met the requirements of subsection 54 (2) within the two years immediately preceding the application for registration unless the applicant was practising respiratory therapy in a jurisdiction outside Ontario within that two-year period.

(4) The requirements referred to in paragraphs 1 and 2 of subsection (1) are non-exemptible.

(5) A graduate certificate is deemed to have been revoked 18 months after its date of issue. O. Reg. 69/99, s. 1.

56. (1) A member who, on or before February 25, 1999, held a limited certificate of registration may continue to hold such a certificate, subject to such terms, conditions or limitations as may be specified on the certificate.

(2) A limited certificate of registration shall not be issued to a person other than a person referred to in subsection (1) after February 25, 1999.

(3) A holder of a limited certificate who wishes to obtain registration in another class must satisfy the requirements for the certificate of the other class. O. Reg. 69/99, s. 1.

57. (1) It is a condition of a certificate of registration of any class that the holder inform the College of the details of,

(a) any finding of guilt against the member in relation to a criminal offence or an offence under the Controlled Drugs and Substances Act (Canada) or the Food and Drugs Act (Canada) made at any time after the holder’s certificate is issued;

(b) any finding of professional misconduct, incompetence, incapacity or other similar finding in Ontario in relation to another profession or in another jurisdiction in relation to respiratory therapy or another profession that occurs or arises at any time after the holder’s certificate is issued;

(c) any proceeding for professional misconduct, incompetence, incapacity or other similar proceeding in Ontario in relation to another health profession or in another jurisdiction in relation to respiratory therapy or another profession that occurs or arises at any time after the holder’s certificate is issued.

(2) It is a condition of a certificate of registration of any class that the holder provide the College with satisfactory evidence of professional liability insurance coverage in the amounts and coverage set out in the policies of the College. O. Reg. 69/99, s. 1.

58. (1) A member may resign his or her membership by giving written notice to that effect to the Registrar and paying all outstanding fees, penalties or other amounts owed to the College.

(2) A member who resigns shall return his or her certificate of registration to the Registrar. O. Reg. 69/99, s. 1.

59. (1) It is a condition of a general certificate of registration and of a limited certificate of registration that a member comply with the requirements of subsections (2), (3), (4) and (5).

(2) A member may become an inactive member if the member,

(a) holds a general or limited certificate;

(b) notifies the Registrar in writing of his or her intention to become an inactive member; and

(c) pays any outstanding fees, including any annual fee owing for the current membership, penalty or other amount owed to the College.

(3) An inactive member shall not,

(a) provide direct patient care within the scope of practice of the profession;

(b) act as an administrator, supervisor or educator in the field of health care;

(d) provide consultations for respiratory care and related care, equipment and services; or

(e) conduct research related to respiratory therapy.

(4) Upon doing any of the things referred to in subsection (3), an inactive member shall be deemed to have resumed active membership and shall promptly pay,

(a) any outstanding fees or penalties in accordance with clause (5) (b); and

(b) a penalty for failure to have given notice under clause (5) (a).

(5) An inactive member may resume active membership if he or she,

(a) notifies the Registrar in writing of his or her intention to become an active member; and

(b) pays any outstanding fee, including the annual fee for the class of registration, penalty or other amount owed to the College. O. Reg. 69/99, s. 1.

60. A member who holds a certificate of registration listed in Column 1 of the following Table,

(a) may use a title listed in Column 2 or 3 opposite the certificate of registration; and

(b) shall use the designation listed in Column 4 opposite the certificate of registration.

Column 1	Column 2	Column 3	Column 4
Certificate of Registration	English Title	French Title	Designation
General	Registered Respiratory Therapist; or Respiratory Therapist	Thérapeute Respiratoire Autorisé(e); or Thérapeute Respiratoire	RRT
Graduate	Graduate Respiratory Therapist	Thérapeute Respiratoire Diplômé(e)	GRT
Limited	Practical Respiratory Therapist	Thérapeute Respiratoire Auxiliaire	PRT

O. Reg. 235/05, s. 3.

61, 62. Revoked: O. Reg. 235/05, s. 3.