2016-2017 annual report · 2016-2017 annual report. 1 came into effect we needed to respond...
TRANSCRIPT
1 Message from Chair & Registrar/CEO 4 Strategic plan 6 Nursing in the public interest 7 Year in review 10 Resources and services
15 Complaints process18 Our board19 Board chair profile20 Annual committee reports26 Financial statements
2016-2017 Annual Report
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came into effect we needed to respond
quickly, and collaborate closely with
the nursing community, the Ministry of
Health and other stakeholders to ensure
we responded in a timely manner. By
collaborating with these stakeholders
we were able to revise our standards
to support nurses and provide the
foundation they need to safely and
ethically serve the province in a rapidly
changing health care landscape.
While we focused on the regulatory
response needed in 2016-17, we also
continued our work to prepare for the
future. In 2016 and 2017 we made strong
strides toward becoming one nursing
regulator in partnership with the two
other B.C. nursing regulators — the
College of Licensed Practical Nurses
of BC (CLPNBC) and the College
of Registered Psychiatric Nurses of
As a nursing regulator our mandate is
to protect the public through the annual
registration of nurses, assessing education
programs in B.C., addressing complaints
about registrants and setting standards
of practice. In 2016-17, nurses in our
province faced a series of challenges,
including legislative changes to an
unprecedented public health crisis —
in addition to the ongoing challenge
of delivering world-class health care
across urban and rural settings in British
Columbia.
Throughout the year, CRNBC supported
more than 40,000 self-regulating
professionals by providing a regulatory
framework to help nurse practitioners
(NP) and registered nurses (RN) meet
high practice standards. As the opioid
crisis escalated and legislative changes
around medical assistance in dying
1Mary Kjorven, BoarD CHaIr
CyntHIa joHansen, reGIstrar/Ceo
“ A strong and flexible
regulatory framework
can improve access
to care and help
health care providers
respond to current
health challenges.”
© Copyright CrnBC / june 2017 Pub. no. 245
“Public protection and safety is our utmost concern, and we believe we can best achieve this through collaborative approaches with nurses and the health care community.”
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BC (CRPNBC). This year we worked
together to begin co-creating a new
nursing regulatory body that will replace
the existing colleges. This new nursing
regulator will help us achieve our
mandate more efficiently, and serve the
public interest for all British Columbians.
Responding today
A strong and flexible regulatory
framework can improve access to care
and help health care providers respond
to current health challenges. In 2016-17
CRNBC worked closely with stakeholders
to respond rapidly to challenges and
balanced this with the need to protect the
public with responsible regulation.
The opioid crisis
In April 2016, the opioid crisis was
officially declared a public health
emergency by B.C.’s health officer. The
scale of the opioid crisis meant that all
parts of the health care system had to
come together to address the issue. And
in keeping with our regulatory philosophy
of “collaborative self-regulation,” we
worked closely with other health care
providers, first responders, service groups,
non-profit organizations, volunteers, the
nursing community and provincial health
authorities to react to the challenge.
At different points in the year the
board approved revisions to the scope
of practice for NPs and RNs, to give
them the appropriate framework and
guidance to respond to the needs of the
community. Changes to the RN scope
around compounding, administering,
and dispensing naloxone, and expanding
the NP scope to allow continuation
prescribing of buprenorphine-naloxone
(Suboxone) were rolled-out in a timely
manner. We continue to monitor the
situation and support registrants as they
work to prevent morbidity and mortality
in their clients.
An ongoing dialogue around medical
assistance in dying
When the Bill passed, also known as An
Act to amend the Criminal Code and to
make related amendments to other Acts
(medical assistance in dying), we had
long been part of the dialogue that would
shape how these changes would affect
nurses nationwide.
In our role as a regulator we were asked to
consult on the details of medical assistance
in dying. Our consultation included
presenting to the Standing Senate
Committee on Legal and Constitutional
Affairs, where we were able to comment
on several aspects of the legislation.
When the Bill passed we continued to
respond to the unfolding changes by
keeping registrants up-to-date with the
legal progress, as well as the regulatory
changes in this important area of practice.
In July 2016, the board approved revisions
to the standards, limits and conditions
related to the role of NPs in determining
eligibility for, and providing, medical
assistance in dying. These standards,
limits and conditions were incorporated
into the NP Scope of Practice document,
and the process of collaboration continues
with our provincial counterparts and
stakeholders including the Ministry
of Health, Vital Statistics, BC Health
Authorities, College of Physicians and
Surgeons of BC, and the College of
Pharmacists of BC as we each carry
out our respective roles related to
implementing standards, protocols
and safe approaches for providing and
aiding medical assistance in dying.
Prescribing Controlled Drugs and
Substances
The changes announced by the Minister
of Health to the Nurses (Registered) and
Nurse Practitioners Regulation meant
that NPs can compound, dispense and
administer Schedule IA drugs, further
enhancing the role NPs play in the safe
and efficient provision of health care in
British Columbia.
To help NPs prepare for these changes,
we introduced a self-directed learning
module available to all registered NPs to
articulate the requirements set out in the
regulations.
NCAS takes the next step
With a successful pilot of the Nursing
Community Assessment Service (NCAS)
completed, we launched the service to
replace the Substantially Equivalent
Competence assessment tool used in
previous years.
This innovative new tool is the first
of its kind and is another way we are
reducing the burden on the health care
system, while continuing to maintain
strong effective regulation. NCAS helps
to ensure that capable, internationally-
educated health practitioners are
evaluated efficiently and consistently
and made available to practice
throughout the province.
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Preparing for tomorrow
In 2016-17 we needed to be nimble
to keep up with the rate of change
happening across British Columbia, but
we also cast our minds forward into the
future to work on a number of initiatives
to better serve our registrants, key
stakeholders and the public.
Major milestones for creating one nursing
regulator in B.C.
In 2016 we achieved yet another major
milestone in our journey towards
creating one nursing regulator in
British Columbia. Along with the two
other nursing regulators, CLPNBC and
CRPNBC, we announced that we would
co-create the new body to regulate all
nurses in the province: licenced practical
nurses, nurse practitioners, registered
nurses and registered psychiatric nurses.
Throughout the year we worked together
with consultants and key stakeholders to
map out the next steps and make the new
regulatory body a reality.
In 2016 we completed the first steps
towards becoming one nursing
regulator which included preliminary
implementation plans for each
core function (Education Program
Review, Inquiry and Discipline,
Policy and Practice, Quality Assurance,
and Registration) and supporting
teams (Communications, Information
and Finance, Governance, Human
Resources, Operations, and Facilities.)
We will continue a dialogue with
government, the B.C. nursing
community and other key stakeholders
through newsletters, surveys and other
communication tools as we work towards
realizing a single, harmonized nursing
regulator for the province.
Setting the standard for regulation
Part of preparing for the future is
engaging in continuous improvement
to ensure we maintain our world-class
standard of professional regulation.
Over the past decade we have honed
our regulatory philosophy, focussing on
a just culture, right-touch regulation,
collaborative self-regulation, using
a principle-based approach and a
commitment to continuing professional
development for registrants. This
philosophy is the foundation of what we
do, and we can always do more to achieve
our mandate and protect the public
through the regulation of NPs and RNs.
With this in mind, in 2015 we engaged
the Professional Standards Authority
(the Authority) to review our regulatory
processes. In May 2016 the Authority
handed down their report examining our
approach to, and compliance with, 33
standards of good regulation covering
four regulatory functions (Guidance and
Standards, Education, Registration, and
Complaints) – as well as governance.
Overall, the Authority found CRNBC
is meeting its statutory responsibilities.
Our Quality Assurance program and our
efforts to co-create a new collaborative
and unified approach to regulation with
other health professional regulators and
the two other B.C. nursing regulators was
identified as significant strengths.
Areas for improvements included
increased transparency, greater
engagement with patients and the public
to inform and comment on the College’s
regulatory approach, an overarching
quality control system and additional
methods to evaluate the effectiveness of
our regulatory work.
Just as our regulatory philosophy
includes continuing professional
development and self-reflection for our
registrants, this philosophy also extends to
our staff and the College. We are excited
to improve and continue delivering on
our areas of strength.
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Public protection and safety is our
utmost concern, and we believe
we can best achieve this through
collaborative approaches with nurses
and the health care community. This
philosophy permeates the culture of
the College as well.
As a relational regulator, we build
positive relationships by being
transparent, respectful, inclusive,
and accessible. Our philosophy of
relational regulation is based on the
following principles:
Right-touch regulation: Minimum
regulatory force required to achieve a
desired result.
Just culture: Develop and deliver
programs to help nurses make safe
choices and learn from mistakes.
Collaborative self-regulation: Enhance
the individual professional and
strengthen their contribution to the
inter-professional team.
Purpose
Regulate registered nurses and nurse
practitioners in the public interest.
What we want to be known for
• Right-touchregulationinthepublic
interest
• Buildingandmaintainingthe
credibility of the nursing profession
• Leadershipandinfluence
• Partnershipandcollaboration.
How we do it
We’re committed to our philosophy of
relational regulation. We believe it’s
possible to build genuine relationships
with nurses and other stakeholders,
including our staff, while at the same
time, regulate effectively in the public
interest.
“CRNBC puts the public interest first. As a result, we focus on regulatory work and make decisions based on public needs and societal expectations.”
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Principles-based approach: Supports that
encourage nurses to use their professional
judgment.
Continuing professional development:
Promote the enhancement of professional
practice to benefit both the public and the
nurse.
Relational regulation means
• Webuildstrongrelationships
with nurses, the public and other
stakeholders.
• Wekeepthingssimpleand
communicate in easy-to-understand,
plain language.
• Weacceptthatmistakeshappenand
believe that open conversations with
nurses and the health care community
help promote safety and reduce risks.
• Weusetherightamountofregulation
needed and only use it when necessary.
• Weuseprinciples,ratherthanrules,to
guide nursing regulation.
Strategic themes
• CRNBC is a relational nursing regulator.
As a result, we maintain our right
to self-regulation for RNs and NPs.
Relational regulation is reflected in
our programs and services, and other
regulators emulate us.
• CRNBC puts the public interest first. As
a result, we focus on regulatory work
and make decisions based on public
needs and societal expectations.
• CRNBC delivers a positive stakeholder
experience. As a result, our stakeholders
understand our role, staff deliver
customer service that is timely and
relevant, and stakeholders believe
and trust that we are genuine in our
relationships.
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The College’s legal obligation is to protect the public through the regulation of
registered nurses and nurse practitioners. The College meets this obligation by:
• Settingstandardsforpracticeandregistration;
• Supportingnursestomeetpracticeandregistrationrenewalstandards;and
• Actingifstandardsarenotmet.
Nursing in British Columbia has been a self-regulating profession since 1918.
Regulation helps to protect the public by ensuring that professional care or service
received by the public is provided by competent and ethical individuals who meet
the standards society views as safe and acceptable.
Through the College, registered nurses — as a group of professionals — have
the authority and responsibility for self-regulation and governing the practice of
registered nursing. In turn, the College is responsible for registering and regulating
registered nurses and nurse practitioners.
Registered nurses and nurse practitioners in B.C. participate in self-regulation
through the election of registered nurses and nurse practitioners to the CRNBC
board, participation in annual general meetings, membership on committees,
providing input on standards development and participating in other college
activities. The board also includes members of the public, bringing other
professional perspectives to the table.
The College of Registered Nurses of British
Columbia is the regulatory body for registered
nurses and nurse practitioners in British
Columbia. The college receives its authority
from the Government of B.C. through the
Health Professions Act.3
Tel: 604.736.7331
Toll-free: 1.800.565.6505
www.crnbc.ca
2855 Arbutus Street
Vancouver, British Columbia
Canada V6J 3Y8
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In early 2016 the three boards
commissioned a report to be completed
by a consultancy group, Western
Management Consultants (WMC). The
report is part of our ongoing process of
consultation with the nursing community
and other relevant stakeholders.
Later in 2016, stakeholders were invited
to take part in a survey which would
help the colleges gain feedback from
nurses, staff and other stakeholders. Over
2,300 responses were collected and the
insights and data generated by this report
will continue to help the boards, senior
leaders and staff of the three regulators to
co-create a new entity.
Response to the opioid crisis
In April 2016, B.C.’s provincial health
officer declared a public health emergency
in response to the opioid overdose crisis.
The CRNBC board moved quickly to
One nursing regulator
In 2016-17 the College of Licensed
Practical Nurses of BC (CLPNBC), the
College of Registered Nurses of BC
(CRNBC) and the College of Registered
Psychiatric Nurses of BC (CRPNBC)
announced they are working together to
co-create a new nursing regulatory body
that will replace the existing colleges.
This new body will regulate all nurses in
B.C.: Licensed Practical Nurses (LPNs),
Nurse Practitioners (NPs), Registered
Nurses (RNs) and Registered Psychiatric
Nurses (RPNs).
4
“CRNBC continues to leverage our board, staff,
and stakeholders to review and implement
the Professional Standards Authority’s
recommendations, for future strategic planning,
and help inform the approach the College will
take as it co-creates the one nursing regulator.”
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approve changes to both RN and NP
scope to allow nurses to better respond
and uphold our public protection
mandate.
CRNBC staff worked closely with
the Ministry of Health, the nursing
community and other health authorities
to react to the situation as it unfolded and
reflect changes made by provincial and
federal governments to the scheduling of
naloxone in our standards and guidelines.
On Dec. 2, 2016 the CRNBC board
approved changes to both RN and NP
scopes of practice to allow registered
nurses and nurse practitioners to better
respond to this crisis.
Changes to the Scope of Practice for RNs:
• Thelimitsandconditionsforthe
compounding, administering, and
dispensing of naloxone outside of
hospital settings no longer require the
use of a decision support tool (DST),
additional education, and competencies.
• Thelimitsandconditionsfor
dispensing naloxone in both “in
hospital” and “outside of hospital”
settings have been rescinded. In this
instance, nurses follow the Dispensing
Medications practice standard as well as
other applicable scope of practice and
practice standards.
Changes to the Scope of Practice for NPs:
• TheCRNBCboardonDec.2
approved the expansion of NP scope
to include continuation prescribing of
buprenorphine-naloxone (suboxone).
CRNBC, other health authorities and
nurses are working in non-traditional
ways with other health care providers, first
responders, service groups, non-profit
organizations, volunteers and others to
provide overdose prevention services in
response to this public health crisis.
Controlled Drugs and Substances Prescribing
On July 26, 2016, the Minister of Health
amended the Nurses (Registered) and
Nurse Practitioners Regulation to clarify
that NPs may compound, dispense and
administer Schedule IA drugs. This
follows the December 2015 amendments
which added authority for NPs to
prescribe Schedule IA drugs. The revised
Nurse Practitioner Prescribing Standards,
Limits and Conditions, as passed by
the CRNBC board in June 2016, and
incorporating the prescribing of federally
controlled drugs and substances, also
came into effect in July 2016.
These updates to the CRNBC regulations
were complimented by a self-directed
learning module — the Controlled Drug
and Substances Prescribing module —
which was made available to registrants to
support NPs in:
• Applyingtherelevantfederaland
provincial legislation.
• UnderstandingtheCRNBCStandards,
Limits, Conditions and Competencies
for prescribing Controlled Drugs and
Substances (CDS) in the context of NP
practice.
• Recognizingtherisksandmitigating
factors associated with prescribing CDS.
• Utilizingpharmacovigilanceand
applying best practices to mitigate these
risks.
• Beingawareandapplyingthe
requirements of the Controlled
Prescription Program and PharmaNet
when prescribing CDS.
Medical assistance in dying
On June 17, 2016 Bill C-14, An Act to
amend the Criminal Code and to make
related amendments to other Acts
(medical assistance in dying), was passed
by Parliament and received royal assent
bringing in new provisions that enable
nurse practitioners to provide medical
assistance in dying, subject to the same
legislated requirements as physicians.
In order to respond appropriately to
this legislative change, a number of
provincial working groups were formed
and supported by Ministry of Health staff
to enable continued collaboration among
key stakeholders, and ensure all British
Columbians have access to safe and ethical
medical assistance in dying.
Following the provincially coordinated
discussions and consultation, CRNBC’s
board approved, and put into immediate
effect, standards, limits and conditions
related to the role of NPs in determining
eligibility for and providing medical
assistance in dying. These standards,
limits and conditions were incorporated
into NP scope in July 2016. Scope of
practice for registered nurses was also
amended to clarify the RN role in aiding
in the provision of medical assistance in
dying.
Professional Standards Authority
In 2015 CRNBC invited an independent
regulatory advisory group from the
UnitedKingdom,theProfessional
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Standards Authority (the Authority), to
conduct an audit of CRNBC’s regulatory
processes. In May 2016, the Authority
handed down its findings.
The Authority’s review examined
CRNBC’s approach to, and compliance
with, 33 standards of good regulation
covering four regulatory functions
(Guidance and Standards, Education,
Registration, and Complaints) — as well
as governance.
CRNBC received the Authority’s final
report in May 2016.
The Authority’s review of CRNBC’s
performance and governance found
that the College is fulfilling its statutory
responsibilities, and identified three
areas where CRNBC is performing
particularly well:
• Our Quality Assurance program: The
Authority found our process of ongoing
professional development, for nurses
and nurse practitioners — which
includes a variety of developmental
activities — to be of a very high-caliber.
• TheRegistrar’spioneering of a more
collaborative and unified approach to
regulation with other health professional
regulators and the two other B.C.
nursing regulators was also identified as
a strength.
• TheAuthority commended CRNBC’s
efforts to identify ways to innovate
our regulatory approach, and build on
our published work on developing a
relational regulatory philosophy.
The Authority also identified four areas
where CRNBC can make improvements:
• Improvementstotransparency in
relation to the College’s work, and in
keeping with the College’s regulatory
philosophy.
• Greater engagement with patients and
the public to inform and comment on
the College’s regulatory approach.
• Anoverarching quality control system to
allow the College to deliver a program of
continuous improvement.
• Evaluationoftheeffectiveness of our
activities and whether they are achieving
the desired aims.
CRNBC continues to leverage the board,
staff, and stakeholders to review and
implement the Professional Standards
Authority’s recommendations, for future
strategic planning, and help inform the
approach the College will take as it co-
creates one nursing regulator.
Policy Program review
CRNBC completed an internal review of
its Policy Program work, related to the
development of the Standards of Practice
and CRNBC’s approaches for regulating
scope of practice.
The report complements the Professional
Standards Authority assessment and
highlights a number of strengths of
CRNBC’s work, including the proactive
involvement of stakeholders throughout
our policy development work. The report
also points to areas that require further
assessment and evaluation to ensure
that the methods align with the role of
the regulator, our relational regulation
approach and mandate.
Nursing Community Assessment Service (NCAS)After the success of a three-month pilot
in November 2015, CRNBC formally
launched the Nursing Community Assess-
ment Service (NCAS) on January 4, 2017.
The new assessment service evaluates the
competence of internationally educated
health practitioners (IEPs) applying to
register in British Columbia. The NCAS
assessment replaced the Substantially
Equivalent Competence assessment used
by CRNBC for RN applicants.
NCAS increases the capacity for
competence-based assessment in the
province and enables the nursing partners
to consistently evaluate IEP applicants’
skills against competencies required
for entry-level practice. If gaps are
identified, it will assist in determining
what education is required to transition to
practice in British Columbia.
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information relevant to the regulation of
registered nurses and nurse practitioners.
Electronic newsletters published in 2016-17
In 2016-17 we sent 11 issues of Nursing
Matters, our registrant newsletter
that delivers the current regulatory
information that nurses need to know
for their practice including regulatory
changes, news and case studies.
Additionally, we tailored each issue to
create editions for registered nurses,
nurse practitioners, and nurses with
certified practice designation. All current
newsletters are posted on our website.
Regulation Matters is a quarterly
subscription-based newsletter emailed
to employers of registered nurses and
nurse practitioners. It includes timely
information about nursing regulation
that may have an impact on employers.
Four issues were sent in 2016-17 and are
posted on our website.
Communications
Email and newsletters
As part of our commitment to being a
relational regulator, we work to improve
communication and engagement with
nurses and other stakeholders, including
opportunities for feedback and two-way
communication. Email is our primary
method for notifying nurses and others of
5“As part of our commitment to being a
relational regulator, we work to improve communication and engagement with nurses and other stakeholders.”
CRNBC Nursing Matters electronic newsletter
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Nurses with the certified practice
designation were sent a Decision Support
Tools notification along with a summary
of key changes in September 2016.
CRNBC website
In 2016-17, the CRNBC website
continued to grow with a 20% increase,
up to 925,000 visits over the 12 months.
Traffic to the website translated into more
than 2,300,000 page views, up 10 per cent
from last year.
Desktop computers continue to be the
preferred device (69 per cent) used to visit
our website. However, the mobile segment
grew to represent about 25 per cent of the
web traffic, which is up from 21 per cent
in 2015-16. The tablet segment dropped
to six per cent, down from eight per cent
in the previous fiscal year.
Most of CRNBC website visitors originate
from Canada and predominantly from
British Columbia. However, we also
receive visitors from all over the world.
Professional liability protection fees
Professional liability protection is a
registration requirement for all practising
registrants. In 2016, The Canadian
Nurses Protective Society (CNPS) began
providing professional liability protection
for all CRNBC practising registrants.
CRNBC paid for the first year of
protection in full, on behalf of registrants.
Nursing library
In 2016-17, the CRNBC library service
conducted 437 literature searches and
delivered over 3,100 books and articles to
library users in response to almost 1,200
inquiries received from CRNBC staff and
registrants.
In addition to providing direct reference
and research services, the library also
provided self-help login access to its full-
text electronic resources: the CINAHL
Complete nursing article database, the
DynaMed Plus clinical information
resource and the EBSCO eBook
Collection. Staff and registrants recorded
almost 5,000 logins to these information
sources.
The library continued to be an active
participant in the North America-wide
DOCLINE interlibrary loan network of
healthsciencelibrariesrunbytheUS
National Library of Medicine, loaning and
borrowing over 800 articles in the 2016-17
fiscal year.
Quality Assurance program
Our Quality Assurance program
provides a framework for registered
nurses and nurse practitioners to assess
and improve their practice, with the goal
of promoting high practice standards and
ensuring clients receive safe, competent
and ethical care.
Quality assurance activities completed by
registered nurses and nurse practitioners
include a self-assessment, seeking and
receiving peer feedback, creating and
CRNBC website homepage
The top 5 origin of website visitors from outside of Canada
United States 8%
United Kingdom 3%
Australia 2%
India 2%
Philippines 1%
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implementing a professional development
plan and ongoing self-reflection.
This cycle of activities helps nurses
identify opportunities for professional
development and demonstrates to the
public how nurses are meeting the
Standards of Practice.
In 2016 we conducted a pilot of My
Professional Plan and multisource
feedback. In this study nurses volunteered
to receive online, anonymized feedback
from their nursing peers. One hundred
and sixty nurses and nurse practitioners
completed the pilot and received
constructive feedback on where they are
meeting standards, and areas in which
they can improve. This was the first
step towards full implementation of
multisource feedback as part of the quality
assurance program. Nurse practitioners
complete an onsite peer review every five
years, which provides a structured way
for nurse practitioners to receive feedback
from a peer assessor through the review
of recent client documentation and
identification of professional development
opportunities and strategies.
• In2016-17,morethan35,000registered
nurses and nurse practitioners
completed the professional standards-
based self-assessment questionnaire as
part of registration renewal.
• Thisyear,70nursepractitioneronsite
reviews were completed.
Continuing professional development
and the principle of lifelong learning are
important to maintaining competence.
Regulatory learning advisors provide
learning events to help nurses and
employers understand the Standards of
Practice in day-to-day practice, and we
continue to provide and refine tools and
resources to assist nurses in implementing
and evaluating their professional
development plans.
• Thirteenweblearningmodulesand
an online tutorial are now available
on our website. These modules
stimulate systematic, reflective
thinking and understanding of how
the standards provide direction and
guidance with practice. Together,
these learning modules were visited
more than 10,000 times during the
2016-17 fiscal year, an increase of over
1,000 visits from the previous year.
• Twonewwebmodules,one
on prescription of Controlled
Drugs and Substances by nurse
practitioners and the other on the
topic of nursing jurisprudence,
were officially launched in June
2016, with significant uptake and
positive feedback. Another module
highlighting the application journey
for Internationally Educated Nurses
seeking registration in B.C. was
launched in 2017.
Registration
Anyone wanting to practice as a
registered nurse or nurse practitioner
in B.C. must have current practising
registration with CRNBC. Registered
nurses and nurse practitioners must
meet annual requirements and renew
their registration each year.
To become registered, an applicant
must meet all registration requirements,
including passing the required
examination(s). Applicants who do not
meet all requirements may be granted
provisional registration, which allows a
person to work as a nurse while
meeting outstanding requirements.
Applicants granted provisional
registration are assigned conditions that
must be met to be eligible for practising
registration. Provisional registration is
granted only if the College is satisfied
that the nurse can practise safely while
meeting the conditions.
Standards of practice and regulatory practice support
CRNBC sets the Standards of Practice
for registered nurses and nurse
practitioners in British Columbia. We
work collaboratively with the board,
registrants, health regulators, employers,
the government and other external
stakeholders to update existing standards
or create new standards to address
changes in practice and legislation.
In 2016-17, we made updates or
developed new policy in a number of
areas. Over the year, CRNBC collaborated
with the College of Registered Psychiatric
Nurses of BC (CRPNBC) to develop
and disseminate three scope of practice
standards: Acting Within Autonomous
Scope of Practice, Acting with Client-
specific Orders and Giving Client-specific
Orders. These standards update and
rename two existing standards related
to acting with and without an order. We
also developed a new standard — Giving
Client-specific Orders — which provides
clarity for nurses, their organizations, the
public and other stakeholders about the
expectations for nurses when giving a
client-specific order for activities within
their autonomous scope of practice.
The policy and practice programs at
CRNBC work with partners and other
stakeholders. In 2016-17, nursing
policy consultants continued updates,
development and communication
related to the December 2015 revisions
to the Nurses (Registered) and Nurse
Practitioner Regulation. An important
accomplishment this year was making
the scope of practice document for RNs
accessible on mobile devices.
Other policy initiatives of note for
2016-17 include: medical assistance
indyingforRNsandNPs;controlled
drugs and substances prescribing by
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NPs;nationaldevelopmentofentrylevel
competenciesforNPs;minorrevisions
to the Documentationpracticestandard;
revisions to limits and conditions for
naloxonedispensing;removaloflimits
and conditions for levonorgestrel
dispensing;additionoflimitsand
conditions for oral corticosteroid
administration by RNs in pediatric
settings, and administration and scope
of practice changes for NPs including
enabling of buprenorphine-naloxone
continuation prescribing.
To support the translation of the
standards of practice into day-to-day
nursing practice, our regulatory practice
consultants are available to support
registered nurses, nurse practitioners,
employers and other stakeholders to
understand and apply the regulation,
legislation and the standards of practice to
diverse and complex practice situations.
Number %
Philippines 82 38.32%
United States 42 19.63%
India 35 16.36%
United Kingdom 15 7.01%
Australia 12 5.61%
Comparison of renewal fees year-over-year (RN practising)Top 5 countries of initial education for international RN new registrants in 2016-17
2014-15 2015-16 2016-17
CRC** 5.60 - -
GST* 21.15 - -
ARNBC/ CNA 54.95 98.82 98.55
CRNBC 368.05 351.36 350.40
Total 449.75 450.18 448.95
*As a non-profit organization, CRNBC elected to stop charging GST on renewal and registration fees in 2015.
**In 2015, the cost of criminal record checks (required every five years) was incorporated into the CRNBC renewal fee.
Where your fees go
Operations $4,781,000 20%
Practice support $2,503,000 11%
Inquiry and Discipline $2,143,000 9%
College oversight $2,062,000 9%
Managing our registry $1,735,000 7%
Nurse Quality Assurance $1,268,000 5%
Education review, exams and new applicants $978,000 4%
Regulatory policy development $672,000 3%
Liability insurance $2,856,000 12%
ARNBC $4,332,000 19%
Grand Total $23,330,000 100%
Liability insurance
College oversight
Regulatory policy
development
Nurse Quality Assurance
ARNBCPractice support
Operations Inquiry and Discipline
Managing our registry
Education review, exams and new applicants
14
New RN registrants by registration year and initial education
2014-15 2015-16 2016-17
BC Grad 1,439 1,205 1,483
CA Grad 108 132 156
CA Applicant 482 595 687
IEN 258 273 214
RN TOTAL 2,287 2,205 2,540
New NP registrants by registration year and initial education
2014-15 2015-16 2016-17
B.C. Grad 34 22 48
CA Grad 4 4 17
CA Applicant 9 6 17
IEN 2 1 4
NP TOTAL 49 33 86
New RN certified practice registrants by registration year and initial education
2014-15 2015-16 2016-17
B.C. Grad 100 95 115
CA Grad 3 3 2
CA Applicant 26 29 35
IEN 7 5 12
TOTAL 136 132 164
Registrant breakdown as of February 28, 2017
* RN-certified practice must have a valid RN practising status.
**Totals do not include registrants who have limits and conditions placed on their practice, or have a suspended registration. This information can be found in Section 6: Complaints Process.
B.C. grad: new graduate of a B.C. nursing program
CA grad: new graduates in another jurisdiction in Canada
CA applicant: practising RN in another jurisdiction in Canada
IEN: Internationally educated nurse
Definitions:
RN & NP registration application received by registration year (submitted by applicants)
2014-15 2015-16 2016-17
BC Grad 1,652 1,334 1,395
CA Grad 142 192 207
CA Applicant 620 671 842
IEN 413 325 529
TOTAL 2,827 2,522 2,973
Feb 28, 2015 Feb 29, 2016 Feb 28, 2017
Registered nurses
Practising 35,999 36,400 37,699
Provisional 152 341 301
Non-Practising 2,979 3,079 2,136
RN-certified practice* 1,066 1,013 1,086
Nurse practitioners
Practising 319 339 413
Provisional 6 26 13
Non-practising 23 24 29
Licensed graduate nurses
Practising 61 52 46
Non-practising 3 4 2
Employed student nurses
Practising 362 756 824
TOTAL** 40,970 42,034 42,549
15
• Conductingwitnessinterviews.
• Reviewingrelevanthealthcarepolicies
and procedures.
In every case, the registrant is provided
an opportunity to review the evidence
and respond to the allegations. This
is required by law. In most cases,
the complainant is then given the
opportunity to review and comment on
the registrant’s response to the complaint.
Registrar’s actions
Uponreviewofawrittencomplaint,the
Registrar is authorized under Section
32 of the Health Professions Act (the
Act) to dismiss the complaint or request
remedial actions of the registrant in
specific circumstances, including when
the subject matter of the complaint
would not ordinarily result in limits or
conditions on practice, or suspension.
As part of our mandate to protect the
public, CRNBC addresses complaints
about registered nurses, nurse
practitioners and licensed graduate
nurses.
Investigations are overseen by the
Inquiry Committee, an impartial
decision-making committee made up of
registered nurses and members of the
public. The Inquiry Committee also has
the authority to initiate investigation on
its “own motion” upon receiving certain
types of information, such as notice that
a registrant has failed to meet the terms
of a current consent agreement.
The nature of an investigation
depends on the allegations. Common
investigative steps include:
• Obtainingadditionalinformationfrom
the complainant.
• Obtainingmedicaldocuments.
6“Investigations are overseen by the Inquiry
Committee, an independent decision-making committee made up of registered nurses and members of the public.”
“ In every case, the
registrant is provided
an opportunity to
review the evidence
and respond to the
allegations. This is
required by law.”
16
The Inquiry Committee reviews all
decisions made by the Registrar and can
direct additional investigation if deemed
necessary.
In 2016-17, a total of 32 decisions were
made by the Registrar: four remedial
actions and 28 complaint dismissals.
The Inquiry Committee reviewed and
approved the 32 decisions.
Inquiry Committee investigation
In the majority of cases, the Inquiry
Committee investigates written
complaints. In 2016-17, the Inquiry
Committee directed investigation into 152
matters. Complaints were received from
employers, colleagues and members of the
public. Investigation was also directed on
the Inquiry Committee’s own motion.
Interim action to protect the public
In urgent circumstances, the Inquiry
Committee is authorized — following a
legal proceeding under Section 35 of the
Act — to order limits or conditions on, or
suspend, a nurse’s registration if necessary
to protect the public during the course of
an investigation or pending a discipline
hearing. In many cases, registrants enter
voluntary undertakings to protect the
public while CRNBC investigates and, for
this reason, the Committee is not required
to impose additional measures by way of
interim order.
The most common interim undertaking
is temporary relinquishment of
practising registration. In other cases,
interim measures may be directly related
to the subject matter of the allegations
and include disclosure of the allegations
to all current employers. The Inquiry
Committee suspended one registrant by
interim order in 2016-17.
Inquiry Committee dispositions
When an investigation is complete,
the Inquiry Committee reviews the
complaint and investigative materials to
direct the appropriate outcome.
In 2016-17, the Inquiry Committee
convened on 89 occasions to review
complaint files and concluded 163
matters. In total the Registrar and
inquiry Committee completed 195
complaint investigations with the
following directions:
Investigations directed by the Inquiry Committee in 2016-17
Employer 80
Own motion 39
Public 30
Peer/colleague/health professional 3
“ When the Inquiry
Committee directs
a final disposition
of a complaint, the
complainant is advised
of the outcome”
No further action 72
Other actions deemed appropriate 6 to resolve the matter by the Inquiry Committee
Investigations were closed 34 because the registrant allowed practising registration to expire and the complaint would be considered by the Registration Committee should reinstatement of registration be sought
Citations for hearing by the 5 Discipline Committee were directed
Consent resolutions were * 78 obtained, which included as the most significant intervention
17
Hearings by the Discipline Committee
Following the investigation of a written
complaint, the Inquiry Committee may
direct the Registrar to issue a citation for
a discipline hearing. This is most likely
to occur when the Inquiry Committee
determines that a competency, conduct,
or fitness concern impacting practice is
supported by evidence, but the registrant
denies the allegations, or — despite
admission — is unwilling to enter an
appropriate resolution agreement to
remedy the matter in the public interest.
In this case, the competency, conduct, or
fitness concern will be evaluated by the
Discipline Committee in a hearing setting
in which witnesses are called to testify,
and documentary evidence is presented.
Discipline Committee members work in
panels of three to conduct hearings. The
Discipline Committee weighs the evidence
to make factual findings about what
happened and determine whether and
what type of regulatory intervention in a
registrant’s practice is required to ensure
public safety.
Two discipline hearings were held in
2016-17. One citation charged a registrant
with failing to respond to CRNBC
communication in a manner constituting
unprofessional conduct. After a hearing,
the Discipline Committee unanimously
found that the registrant had committed
unprofessional conduct. Submissions
on penalty are forthcoming. The second
citation charged a registrant with, by way
of summary, accepting an appointment
of Power of Attorney and personal
financial benefits from two individuals
to whom she provided nursing care. The
hearing has concluded, but the decision
of the Discipline Committee remains
outstanding.
Monitoring compliance
CRNBC staff monitor registrants’
compliance with the remedial actions,
limits and conditions on registration
agreed to in consensual resolution or
imposed by order. On February 28, 2017,
CRNBC was monitoring 150 registrants
for compliance with consent agreements.
When information is received that
demonstrates a registrant may not be
in compliance with the conditions of
their consent agreement or other order,
staff prepare a report for review by the
Inquiry Committee for consideration of
authorizing an own motion investigation.
Review by Health Professions Review Board
When the Inquiry Committee directs
a final disposition of a complaint, the
complainant is advised of the outcome. In
accordance with Section 50.6 of the Act,
a complainant has the right to request
that the Health Professions Review Board
conduct a review of the adequacy of the
investigation and the reasonableness of
the disposition.
A review was requested by six
complainants in 2016-17. Two
applications for review were dismissed
by the Health Professions Review Board.
Four remain open at this time. One review
application from a prior fiscal year was
also completed in 2016-17. In that case,
the Health Professions Review Board
returned the Inquiry Committee decision
with directions. This matter has been
concluded by the Inquiry Committee.
* 78 consent resolutions were obtained, which included as the most significant intervention
Cancellations 2
Suspensions (may have conditions 4 and limits on return and other terms)
Limits and conditions (may have 8 educational and other terms)
Public reprimands (may have 2 educational and other terms)
Voluntary relinquishment 14 of registration
Reprimands (may have 12 educational and other terms)
Educational or regulatory 19 practice consultation programs
Medical monitoring or counselling 7 terms (may have educational and other terms)
Agreements not to repeat 10
18
Stephanie Buckingham, registrant member – at-large, Nanoose Bay
Retired university-college professor, Bachelor of
Science in Nursing Program, Human Health and
ServicesDepartment,VancouverIslandUniversity
Rob Calnan, registrant member – urban, Cobble Hill CoordinatorofSiteOperationsandPatientFlow;
Victoria General and Royal Jubilee Hospitals
(casual);formerco-chairofARNBCandpast
president and chair of CNA and RNABC
Brenda Canitz, registrant member – at-large, Victoria
Consultant;healthcareresearcher,policyand
education;adjunctfaculty,sessionallecturer,
UniversityofVictoriaSchoolofNursingand
School of Public Health and Social Policy
Colleen Driscoll, registrant member – rural, Nelson Registered nurse, Daycare/Pre-surgical screening,
KootenayLakeHospital,InteriorHealth
Sheila Farrell, registrant member – urban and board vice-chair, Kelowna
Clinical practice educator, Health Services for
Community Living, Interior Health
Colleen Hay, registrant member – rural, Dawson Creek
Registerednurse(casual),EmergencyRoom,ICU
and Post-Anesthetic Recovery, Northern Health
Mary Kjorven, registrant member – rural and board chair, Peachland
Clinical nurse specialist, gerontology, nurse
continence advisor, ALC Support Team, Interior
Healthandclinicalinstructor,UBCDepartment
of Medicine and associate member, Division of
Geriatric Medicine
David Kruyt, public representative, Campbell River
VP Finance, AllWest Insurance
Services Ltd.
Marilyn Loewen Mauritz, public representative, Vancouver
General counsel and corporate secretary for
International Forest Products Ltd.
Tricia Marck, registrant member-at-large, Victoria
Professor and dean, Faculty of Health and Social
Development,UniversityofVictoria
Michelle Mollineaux, public representative, Vancouver
CEOandco-founderofKoolProjectsMediaInc.
Jocelyn Stanton, public representative, Victoria
Previously communications advisor for Island
Health and chief of staff to the Minister of Health
in British Columbia
7BACK ROW (FROM LEFT):
Cynthia Johansen (Registrar/CEO),
Rob Calnan, David Kruyt, Michelle Mollineaux,
Mary Kjorven (Board Chair),
Stephanie Buckingham
FRONT ROW (FROM LEFT):
Colleen Driscoll, Sheila Farrell, Colleen Hay,
Jocelyn Stanton
NOT SHOWN:
Brenda Canitz, Marilyn Loewen Mauritz,
Tricia Marck
19
nationally and internationally, and above all
the public.”
Leveraging relationships built up over many
years, meant the College could rapidly enact
changes to the regulatory framework that
guides nurses and protects the public. “We
already had relationships with the other
regulators who were also affected by these
issues,” she said, “and because we had a
history of regulatory collaboration, we
were able to work together and respond
collectively and timely.”
While 2016-17 required a focus on pressing
issues, Mary, the board and the staff of
CRNBC also looked to the future, with a
vision for a more streamlined regulator for
B.C. nurses. Over the past few years the
College started mapping out a plan with two
other provincial nursing regulators — the
College of Licensed Practical Nurses of BC
(CLPNBC) and the College of Registered
Psychiatric Nurses of BC (CRPNBC) — to
form a new integrated nursing regulator. In
June 2016, the three colleges were able to
announce an important milestone.
MaryKjorveniscurrentlyinhersixthand
final term as a member of the CRNBC
board, and has served as the board chair for
the past four years. As she brings her time
as a member of the board to a close, Mary
takes a look back at 2016-17.
There were many regulatory challenges
facing registered nurses and nurse
practitioners of B.C. in the past year: the
opioid crisis, the introduction of medical
assistance in dying legislation and related
standards, to name a few. With this came
the need for a thoughtful yet timely
response, and Mary credits the College’s
success in these areas to our commitment to
responsive and relational regulation.
“Without a doubt, our philosophy of
relational regulation was the foundational
driver that helped us respond to these
challenges,” Mary said. “Relational
regulation is greater than only being
relational with our registrants. It includes
broader relations with others who are
invested in regulation: government, other
regulatory bodies both provincially,
“This year we received commitment from all
three nursing colleges to move forward with
co-creating one nursing regulator. This is
significant as we were able to gain consensus
from all three colleges. I remain proud of
our ability to collaborate with the CLPNBC
and CRPNBC, not only on the vision for
co-creating one nursing regulator, but also
in harmonizing nursing standards for the
province, sharing resources and developing
new tools,” Mary said. “Collaboration is not
easy, it takes time, and it can be frustrating.
However, I can attest that it has been worth it.”
As she completes her final term on the board,
Mary is excited about the positive changes that
will shape the future. “Going forward I am
excited about moving to a competencies-based
framework for our board. Whether individuals
come onto the board with these competencies
or whether we have a plan to develop and
build those capabilities over time, I believe this
framework will enable us to strengthen and
enhance the board and the College.”
Mary is a clinical nurse specialist in gerontology, she holds a Master’s degree in nursing, and is nearing completionofherPhDfromtheUniversityofBritishColumbia. A resident of Peachland, Mary works for Interior Health focusing on mitigating the risk of hospitalization for older patients.8 Mary Kjorven,
BoarD CHaIr
20
The Board Review Panel held three
meetings in 2016-2017 and reviewed 13
requests to write the registered nurse (RN)
exam for a fourth or further time and two
requests to write the nurse practitioner
(NP) exam for a fourth time. For the RN
exam, they granted 12 requests for a fourth
writing, and granted one for a fifth writing.
For the NP exam, they granted one and
denied one request for a fourth writing.
Effective November 1, 2016, there is no
limit to the number of times candidates can
write the NCLEX-RN, as long as they have a
valid CRNBC application. This change was
made to harmonize exam administration
policy, by regulators, across the country.
The Board Review Panel will only review
requests to re-take NCLEX-RN for a fourth
or additional time if the Registrar brings
forward applicants who have circumstances
which, in the Registrar’s opinion, warrant
review by the Board.
Board Review Panel
Committee Members (2016): Stephanie
Buckingham, Colleen Hay, Colleen
Driscoll, Anne Gavey, Sheila Farrell,
Marilyn Loewen Mauritz, Ana-Maria
Hobrough and Stephen Bishop.
Committee Members (2017): Stephanie
Buckingham, Colleen Hay, Colleen
Driscoll,SheilaFarrell,DaveKruyt,
Brenda Canitz and Michelle Mollineaux.
The College Bylaws provide that the
board may meet in panels to review
specific issues related to the granting
of certified practice registration, the
approval of a fourth or further writing
of an examination required for
registration, and a review of a decision
made by the Nurse Practitioner
Examination Committee regarding
an applicant’s score on the Objective
Structured Clinical Examination.
9“During an investigation, or pending a Discipline Committee Hearing, the Inquiry Committee may set limits and conditions on the practice of the registrant in question or suspend the registrant’s registration.”
The committee weighs
the evidence to make
factual findings about
what happened and
determine whether
and what type of
regulatory intervention
in a registrant’s practice
is required to ensure
public safety.
21
Certified Practice Approval Committee
Committee Members: Dr. Shona
Johansen (Co-Chair), Janine Lennox
(Co-Chair), Virginia Ann Jacklin, Helen
Jackson,SamarjitDhillon,SherryKatz,
GulshanKhudra,JanetMurphy,Susanne
Niewiadomski and Blake Reynolds.
The Certified Practices Approval
Committee approves the Decision Support
Tools (DSTs) and reviews certified
practice courses according to standards
and indicators for certified practice
education, and makes recommendations
to the board regarding approval. The
Committee also reviews and recommends
policies and procedures pertaining to
certified practice to the board.
The Committee held four meetings in
2016-17. The Committee has reviewed
and approved 39 DSTs based on the
recommendations from Think Research
in accordance with the agreement between
CRNBC and Think Research. Three
certified practice courses were reviewed
and a recommendation made to the board
for approval.
Discipline Committee
Committee Members: Marilyn Loewen
Mauritz (Chair), Bob Johnstone (Vice-
Chair), Tracey Martindale, Sheila
Cessford, Brenda Downey, Sarah Virani,
Laurie Ledger, M. (Star) Mahara and
Sylvia Wilson.
Following the investigation of a written
complaint under Part 3 of the Health
Profession Act, the Inquiry Committee
may direct the Registrar to issue a citation
for a discipline hearing. This is most likely
to occur when the Inquiry Committee
determines that a competency, conduct,
or fitness concern impacting practice is
supported by evidence, but the registrant
denies the allegations, or — despite
admissions — is unwilling to enter an
appropriate resolution agreement to
remedy the matter in the public interest.
In this case, the competency, conduct, or
fitness concern will be evaluated by the
Discipline Committee in a hearing setting
in which witnesses are called to testify,
and documentary evidence is presented.
Discipline Committee members work in
panels of three to conduct hearings. The
Discipline Committee weighs the evidence
to make factual findings about what
happened and determine whether and
what type of regulatory intervention in a
registrant’s practice is required to ensure
public safety.
Two discipline hearings were held in
2016-17. One citation charged a registrant
with failing to respond to CRNBC
communication in a manner constituting
unprofessional conduct. After a hearing,
the Discipline Committee unanimously
found that the registrant had committed
unprofessional conduct. Submissions
on penalty are forthcoming. The second
citation charged a registrant with, by way
of summary, accepting an appointment
of Power of Attorney and personal
financial benefits from two individuals
to whom she provided nursing care. The
hearing has concluded, but the decision
of the Discipline Committee remains
outstanding.
Early Intervention Program Health (EIPH) – Inquiry Sub-Committee
Committee Members: Damen Deleenheer
(Chair), Judy Chorney (Co-Chair), Don
Dixon (Co-Chair), Marshall Smith,
Hilary Planedin, Sharon Thomson, Eileen
Maloney-White and Betty Jo Tunks.
The Inquiry Sub-Committee (EIPH)
works in panels of three to review
information that is received about
registrants with a health issue that could
affect their ability to provide safe patient
care. The panel reviews information
electronically and by teleconference.
The Sub-Committee has the authority
toreferregistrantsintotheEIPH;
reviews registrant’s compliance with the
requirements for participation in the
EIPH;refersregistrantstoCRNBC’s
formal complaint process should concerns
regarding a registrant’s competence or
goodcharacterbeidentified;reviews
information regarding conclusion of a
registrant’s participation in the EIPH.
The EIPH Sub Committee of the Inquiry
Committee referred eight CRNBC
registrants into the program between
March 1, 2016 and February 28, 2017. All
of the registrants were self-reports. Three
of these registrants agreed voluntarily to
convert to non-practicing registration
while they are seeking medical assistance
for their health condition. Six of the
registrants have received medical
clearance for a return to practice and
five have entered into an EIPH Contract.
They are actively monitored by the EIPH
to ensure ongoing fitness to practice. One
EIPH case was closed because the file was
referred to the Inquiry and Discipline
process for investigation. One EIPH
case file was closed when evidence was
reviewed by the Sub-Committee and a
determination was made that no further
monitoring of their health condition was
required.
CRNBC is currently reviewing regulatory
opportunities under the Health
Professions Act to best ensure effective
collaboration with health employers and
registrants to identify and intervene in
cases where an emerging health issue may
lead to negative impacts in the workplace.
22
Education Program Review Committee
Committee Members: Linda Pickthall
(Chair),KristineWeatherman(Vice-
Chair), Dr. Alan Davis, Nicholas Fitterer,
Cat Martin, Edna McLellan, Tracy Schott,
Dr. Ann Syme, Dr. Landa Terblanche and
Leanne Thain.
The Education Program Review
Committee (EPRC) reviews nursing
education programs and qualifying
courses required by applicants for
registration and makes recommendations
about whether the board should
recognize them for the purpose of
registration, and any terms or conditions
of recognition. The Committee also
regularly reviews and recommends
policies and procedures pertaining to
the review of nursing education
programs and courses.
The Committee held three, full-day
meetings for the above reviews and to
complete a comprehensive revision of
all guidelines for programs preparing
for program/course review. The EPRC
guidelines supplement board policy for
the purposes of facilitating the program
review process. The revisions clarify the
evidence needed to demonstrate how
programs/courses meet CRNBC nursing
education standards and streamline the
requirements for self-evaluation reports
submitted by programs.
Finance and Audit Committee
CommitteeMembers:DaveKruyt(Chair),
MaryKjorven(Vice-Chair),BarbCrook,
Marti Harder, Gwen Herrington, Tricia
Mark and Sheila Farrell.
The Finance and Audit Committee advises
the board on the needs of the College
in regard to financial administration
and the financial implications of
boarddecisions;theapplicationof
legislative, regulatory and other financial
requirementstotheCollege;andfinancial
risk management and audit issues related
to the administration of the College. In
addition, the Committee recommends,
for board approval, financial policies
essential to the financial administration
of the College.
Recommendations from the Finance and
Audit Committee include:
• Approvingupdatestofinancial
policies.
• Approvingthe2016-17audited
financial statements.
• Approvingoperationalandrisk
budgets for the 2017-18 fiscal year.
• Approvingchangestofees.
Inquiry Committee
Committee Members: Donna Bentham
(Chair), Diane Thiessen (Vice-Chair),
Linda Nelson (Vice-Chair), Jim Hunter
(Vice-Chair), Richard Walker (Vice-
Chair), Alexander Danilovic, Deborah
Austin, Landon James, Laura Bickerton,
Maneet Samra, Tracy Christianson,
Brenda Canitz, Jason Faulkner, Shelley
Scarlett, Gerry McIntyre, Meghan
Shannon,JoshuaTan,KevinRyan,
Leonard (Jim) Aldrich, Catherine
Czechmeister, Jackie Demmy, Lynn
Dowsley, Patty Garrett, Christina
Lumley, Alison Swalwell-Franks, Daphne
Williscroft, Michelle Mollineaux,
Graham Brownmiller, Graham Garner
and Gary Noble.
Inquiry Committee members work in
panels of three to review complaints
about registrants that are received
by CRNBC. A member of the public
participates in every panel meeting. The
Committee authorizes investigations
of complaints, reviews investigative
materials, and makes decisions about
a registrant’s professional conduct,
competence, and fitness to practice.
Nursing education programs reviewed
Registered Nurse 4 Baccalaureate Programs
Registered Nurse Qualifying 6 Courses
23
After reviewing investigative materials,
the Committee has the authority under
the Health Professions Act to take no
further action or to request a registrant
to consent to: remedial actions,
reprimands or other types of disciplinary
action, limits or conditions on their
practice and various undertakings.
Where consensual resolution is not
possible, it also has the authority to issue
a citation for a hearing by the Discipline
Committee.
If deemed necessary to protect the public
while an investigation is underway,
or pending a Discipline Committee
hearing, the Inquiry Committee
may set limits and conditions on the
practice of the registrant in question
or suspend registration. In order
to do so, the Inquiry Committee
convenes for an in-person proceeding
that allows the registrant in question
to provide submissions about why
an interim order is not necessary. If
the Inquiry Committee limits or
suspends registration at the close of the
proceeding, the decision is appealable to
the B.C. Supreme Court.
The Committee also reviews and makes
decisions regarding a registrant’s
compliance with and fulfillment of terms,
limits or conditions on the registrant’s
practice.
The Committee held 89 panel meetings by
teleconference in 2016-17.
In total, they directed CRNBC staff to
further investigate 152 written complaints.
Investigation of many of these matters
remains underway.
The Committee also reviewed, and
approved, the Registrar’s investigation
into 32 complaints, 28 of which resulted
in dismissals and four of which resulted in
remedial action by consent.
The Inquiry Committee concluded
investigation into 163 complaints.
In total the Registrar and Inquiry
Committee completed 195 complaint
investigations, with the following
directions:
• 72nofurtheraction
• 6otheractionsdeemedappropriate
to resolve the matter by the Inquiry
Committee
• 34investigationswereclosedbecause
the registrant allowed practising
registration to expire and the complaint
would be considered by the Registration
Committee should reinstatement of
registration be sought
• 78consentresolutionswereobtained
• 5citationsforhearingbytheDiscipline
Committee were directed.
In addition, the Inquiry Committee
ordered one interim suspension under
Section 35 of the Health Professions Act.
The Committee reviewed requests of
registrants to conclude agreements based
on requirements in the agreement format
that was used prior to April 2014 and 2015
agreements were concluded.
Nominations Committee
Committee Members: Gwen Herrington
(Chair), Pam O’Sullivan and Suzanne
Tytler.
The Nominations Committee implements
the election procedures established by
the Registrar/CEO. The Committee also
determines whether the nominations
received comply with the eligibility
requirements set out under the College
Bylaws.
Four meetings of the Nominations
Committee were held between December
2016 and February 2017 to review
nominations strategies and prepare the
draft Ticket of Nominations.
2017 Ticket of Nominations
The Nominations Committee presented
the draft Ticket of Nominations to the
Registrar/CEO for approval on February
22, 2017.
The 2017 Ticket of Nominations was
approved by the Registrar/CEO on
February 24, 2017.
24
There are two candidates for the at-
large position: Stan Marchuk and Tricia
Marck. There are two candidates for the
rural position: Barb Crook and Gwen
Herrington. There is one candidate for the
urban position: Helen Jackson (election
by acclamation).
Terms of office for all positions is three
years. Election ballots for the contested at-
large and rural board member positions
will be mailed in late June to all registrants
in good standing. The ballot count will
be conducted by the election trustee in
mid-August.
Nurse Practitioner Examination Committee
Committee Members: Morley Jameson
(Chair), Suzanna McRae (Vice-Chair),
Clea Bland, Alyson Chin, Sue Lawrence,
KathleenFyvie,StevenHashimoto,Sherry
Katz,PhilSweeneyandKeithWhite.
The Nurse Practitioner Examination
Committee directs the development and
administration of the CRNBC nurse
practitioner Objective Structured Clinical
Examination (OSCE) and scores the
OSCE.
The Committee held five meetings in
2016-17 to consider and render decisions
on the OSCE.
Nurse Practitioner Standards Committee
Committee Members: Erin Wilson
(Chair), Esther Sangster-Gormley (Vice-
Chair), Dr. Trevor Corneil, Lorraine
Grant,KimberlyHayter,MonaKwong,
Stan Marchuk, Erica Maynard, Debbie
McLachlan, Minna Miller, Jocelyn Ann
Stanton and Barb Radons.
The Nurse Practitioner Standards
Committee develops and recommends
to the board, standards, limits and
conditions for the practice of nurse
practitioners in accordance with
the Nurses (Registered) and Nurse
Practitioners Regulation.
In 2016 the Committee met three
times in person and held four
conference calls. The major focus of
the Committee’s work has been on the
following complex items:
• Thefive-yearreviewofthedocument
Scope of Practice for Nurse Practitioners:
Standards, Limits and Conditions.
• Thedevelopmentofstandards,limits
and conditions for the NP role in
assessing eligibility for and providing
medical assistance in dying under the
Criminal Code of Canada.
• Furtherrevisionstotheprescribing
standards, limits and conditions in
relation to the prescribing of controlled
drugs and substances.
• Thedevelopmentofastandard
for continuation prescribing of
buprenorphine-naloxone for opioid
agonist treatment.
CRNBC’s board approved the
standards for the NP role in medical
assistance in dying, the prescribing
of controlled drugs and substances,
and continuation prescribing of
buprenorphine-naloxone. These new
authorities were incorporated into the
NP scope of practice in 2016.
It is expected that the updated
standards in the NP scope document
will go forward to the board for
approval in 2017.
Quality Assurance Committee
Committee Members: Prab Gill (Chair
to September 23, 2016), Jacqueline Per
(Vice-Chair to September 23, 2016: Chair
2016-17),BarbaraKorabeck(Co-Chair
2016-17), Cammie Lewis, (Co-Chair 2016-
17),EdKry,BarbThompson,Marilyn
Kelly(toApril1,2016),CherylPrescott,
Annaliese Hasler and Susan Shumay.
The Quality Assurance (QA) Committee
is responsible for administering and
maintaining CRNBC’s QA Program.
The Committee responsibilities include:
policy development and implementation,
and review of individual registrant QA
data to determine whether high practice
standards are being achieved.
On August 15, 2016, the board approved
quality assurance bylaw amendments
for submission to government regarding
the QA Committee composition,
and to support the introduction of
prescription review and strengthen data
confidentiality for both prescription
review and multisource feedback (MSF).
In September 2016, the QA Committee
reviewed and approved QA Program
policy pertaining to registrant quality
assurance assessments and deferral.
QA Committee decisions are made in
the public interest to sustain public
confidence in nurses’ self-regulation, and
to support nurses to meet high practice
standards in order that the public
experience nurses to be safe, competent
and ethical practitioners. When assessing
QA data to determine a registrant’s QA
standing, the Committee meet in-camera
and apply the Health Professions Act
Sections26.1and26.2;otherlegislation
relevanttoregistrants’practice;CRNBC
Bylaws,Section1.19andPart5;CRNBC
StandardsofPractice;andCRNBCand
QA Program policies. In the majority of
cases, the committee finds that standards
Examination Results
OSCE Pass Rate:
January 2016 (Family and Adult) 74%
June 2016 (Family and Pediatric) 83%
November 2016 (Family and Adult) 78%
25
are being met or exceeded. When it
appears that higher standards could be
achieved by the registrant, the Committee
may make specific recommendations
and/or require follow-up to support the
individual registrant to raise the standard
of their practice.
The QA Committee work closely with
12 NP assessors who are appointed by
the QA Committee and conduct the NP
onsite peer review assessments. The onsite
peer review involves a review of client
documentation by a NP assessor, as well
as a post-review discussion between the
NP and the assessor. The review criteria
used by the assessor, the nurse practitioner
and the QA Committee are based on the
CRNBC Standards of Practice and the
competencies for NPs practicing in British
Columbia. In 2016 the QA Committee
met 11 times and determined the onsite
peer review results for 70 NPs.
Registration Committee
Committee Members: Donna Murphy
(Chair), Jocelyn Stanton (Vice-Chair,
Board Member), Jeff Silvester, Sheila
Gordon-Payne, Janine Lennox, Tracy
Hoot, Amelia Chauvette, Anita Lam, Anil
Aggarwal, Ann Laing, Catharine Schiller,
KylePearce,RobertHalliday,andMarilyn
Loewen Mauritz (Board Member).
Initial and reinstating applicants for
registration are required to demonstrate
to the satisfaction of the Committee their
identity, good character, fitness, and
competence. Those granted registration
may renew their registration if they are
able to demonstrate to the Committee
they have met continuing competence
requirements.
The Committee is responsible for
registration policies, which guide the
Committee in managing applications
consistently and allow staff to carry out
the daily processing of applications.
When an applicant does not clearly meet
registration requirements and policy
does not direct otherwise, an applicant’s
file and supporting documentation are
presented to the Registration Committee
for consideration and decision.
In October 2016, the Committee began to
meet every two weeks (previously every
three weeks). The increase in meetings is
to address concerns raised by Committee
members in relation to the volume of
material, and to better accommodate the
increasingly complex files reviewed by the
Committee.
The Committee met 27 times in 2016-
17 to consider 162 files and to approve
changes to 11 policies.
Health Professions Review Board
CRNBC informs applicants and
registrants when they can request a
review of a Committee decision by the
Health Professions Review Board (HRBP).
During 2016-17, 14 requests for review
by the HPRB were received in relation
to registration decisions: 13 were from
internationally educated registered nurses
applying for registration and one was an
applicant for reinstatement. Three were
dismissed. Nine applicants withdrew
following mediation and/or review by the
Registration Committee. Two 2016-2017
files remained open as of March 1, 2017,
with a third open file carried over from a
previous year.
26
To the Registrants of College of Registered Nurses of British Columbia
We have audited the accompanying consolidated financial statements of the
College of Registered Nurses of British Columbia (“CRNBC”) which comprise
the Consolidated Statement of Financial Position as at February 28, 2017, and the
Consolidated Statement of Operations and Changes in Net Assets and Cash Flows
for the year then ended, and a summary of significant accounting policies and other
explanatory information.
Management’s Responsibility for the Consolidated Financial Statements
Management is responsible for the preparation and fair presentation of these
consolidated financial statements in accordance with Canadian accounting standards
for not-for-profit organizations, and for such internal control as management
determines is necessary to enable the preparation of consolidated financial
statements that are free from material misstatement, whether due to fraud or error.
Auditor’s Responsibility
Our responsibility is to express an opinion on these consolidated financial statements
based on our audit. We conducted our audit in accordance with Canadian generally
accepted auditing standards. Those standards require that we comply with ethical
10
27
requirements and plan and perform the audit to obtain reasonable assurance about
whether the consolidated financial statements are free from material misstatement.
An audit involves performing procedures to obtain audit evidence about the amounts
and disclosures in the consolidated financial statements. The procedures selected
depend on the auditor’s judgment, including the assessment of the risks of material
misstatement of the consolidated financial statements, whether due to fraud or error.
In making those risk assessments, the auditor considers internal control relevant to
the entity’s preparation of the consolidated financial statements in order to design
audit procedures that are appropriate in the circumstances, but not for the purpose
of expressing an opinion on the effectiveness of the entity’s internal control. An audit
also includes evaluating the appropriateness of accounting policies used and the
reasonableness of accounting estimates made by management, as well as evaluating the
overall presentation of the consolidated financial statements.
We believe the audit evidence we have obtained is sufficient and appropriate to provide
a basis for our audit opinion.
Opinion
In our opinion, the consolidated financial statements present fairly, in all material
respects, the financial position of CRNBC as at February 28, 2017, and the results of
its operations and its cash flows for the year then ended in accordance with Canadian
accounting standards for not for profit organizations.
Chartered Professional Accountants
Vancouver, British Columbia
May 23, 2017
Financial statements
28
Consolidated Statement of Financial PositionThe accompanying notes are an integral part of these financial statements
February 28 , February 29 , 2017 2016
assetsCurrent
Cash and cash equivalents (Note 2) $ 14,555,278 $ 11,422,240 Short term investments (Note 3) 561,869 677,537 amounts receivable 1,110,854 686,502 Income taxes recoverable 24,557 21,995 Prepaid expenses 376,667 3,020,437
16,629,225 15,828,711
Investments (Note 3) 11,446,967 9,753,926 Property and equipment (Note 4) 2,589,609 2,767,842 Intangible asset (Note 5) 1,098,463 1,494,855
$ 31,764,264 $ 29,845,334
LIabILItIes and net assetsLiabilitiesCurrent
accounts payable and accrued liabilities $ 1,237,889 $ 693,932 Government remittances payable 153,016 20,358 amounts due to arNbC (Note 7) 2,663,933 2,283,612 amounts due to CNPS (Note 17) 2,394,361 - accrued sick, vacation and severance 450,317 502,422 Deferred revenue 15,019,265 13,770,150 Capital leases payable current portion (Note 6) 13,800 13,561
21,932,581 17,284,035
Capital leases payable (Note 6) 28,335 42,135
21,960,916 17,326,170
net assetsunrestricted 5,157,411 6,429,617 Internally restricted 1,000,000 1,882,546 equity in capital (Note 1(c)) 3,645,937 4,207,001
9,803,348 12,519,164
$ 31,764,264 $ 29,845,334
Contingent liability (Note 14)
29
Consolidated Statement of Operations The accompanying notes are an integral part of these financial statements
February 28 , February 29 ,For the year ended 2017 2016
revenueregistration $ 14,053,771 $ 13,957,922 Credentials processing 827,825 638,061 examinations 154,600 144,900 Investment income (loss) (Note 12) 1,224,285 (198,134) Sundry 19,741 360,583
16,280,222 14,903,332
exPensesexecutive office 1,838,899 1,488,677 Information and finance 3,611,553 2,822,084 Communications and human resources 1,657,859 1,723,996 Policy, practice and quality assurance 3,531,735 3,591,270 registration, inquiry and discipline 4,838,731 5,008,345 equipment lease interest 887 872 amortization 472,827 504,999 Insurance administration expenses 103,194 116,162 registrants professional liability protection 2,753,199 427,335
18,808,884 15,683,740
deFICIenCy oF revenue over exPenses beFore other Items (2,528,662) (780,408)
other Items:IT shared services (Note 9) 45,355 50,200 CrNbC contribution to NCaS pilot (Note 10) (25,531) (161,388) CrNbC’s share of co creation costs (Note 11) (209,540) - CrNbC contribution to NCaS operations (Note 10) - -
(189,716) (111,188)
deFICIenCy oF revenue over exPenses beFore InCome taxes (2,718,378) (891,596)
Income tax recovery (Note 13) 2,562 63,584
deFICIenCy oF revenue over exPenses For the year $ (2,715,816) $ (828,012)
30
Consolidated Statement of Changes in Net AssetsThe accompanying notes are an integral part of these financial statements
unrestrICted InternaLLy equIty In February 28 , February 29 ,For the year ended restrICted CaPItaL 2017 2016
balance, beginning of year $ 6,429,617 $ 1,882,546 $ 4,207,001 $ 12,519,164 $ 13,347,176
Deficiency of revenues over expense (2,242,989) - (472,827) (2,715,816) (828,012)
Purchase of property and equipment (16,418) - 16,418 - -
Capital lease principle repayments (13,561) - 13,561 - -
Shared system participation contribution (Note 5) 642,168 - (642,168) - -
additions of intangible assets (523,952) - 523,952 - -
Transfers 882,546 (882,546) - - -
balance, end of year $ 5,157,411 $ 1,000,000 $ 3,645,937 $ 9,803,348 $ 12,519,164
31
Consolidated Statement of Cash Flows The accompanying notes are an integral part of these financial statements
February 28 , February 29 ,For the year ended 2017 2016
Cash FLows From oPeratIng aCtIvItIesDeficiency of revenues over expenses $ (2,715,816) $ (828,012) add items not involving cash
amortization of property and equipment 194,651 226,162 amortization of intangible assets 278,176 278,837 unrealized investment (gains) losses (761,464) 715,919
(3,004,453) 392,906 Changes in working capital items
amounts receivable (424,352) 130,061 Prepaid expenses 2,643,770 (2,673,231) Income taxes recoverable (2,562) 64,418 accounts payable and accrued liabilities 543,962 (207,821) Government remittances payable 132,658 13,868 amounts due to arNbC and CNPS 2,774,681 168,360 accrued sick, vacation and severance (52,107) (31,657) Deferred revenue and grants 1,249,113 160,405
3,860,710 (1,982,691)
Cash FLows From InvestIng aCtIvItIesredemption of investments (815,909) 2,380,280 Purchase of property and equipment (16,418) (23,418) Purchase of intangible assets (523,952) (444,224) Shared system participation contribution 642,168 26,578
(714,111) 1,939,216
Cash FLows From FInanCIng aCtIvItyCapital lease principal repayments (13,561) (23,504)
net change in cash and cash equivalents 3,133,038 (66,979)
Cash and cash equivalents, beginning of year 11,422,240 11,489,219
Cash and cash equivalents, end of year $ 14,555,278 $ 11,422,240
32
Notes to Consolidated Financial StatementsFebruary 28, 2017
1. nature oF oPeratIons and summary oF sIgnIFICant aCCountIng PoLICIes
(a) nature and Purpose of the College
Pursuant to the Health Professions Act, the College of Registered Nurses of British Columbia (“CRNBC”) is
a corporation consisting of the members of the board and committees, the staff and registrants of CRNBC.
CRNBC’s board is composed of 9 nurses elected from amongst the registrants and 5 members of the public
appointed by the provincial government. CRNBC works in the public interest by regulating registered nurses,
nurse practitioners and licensed graduate nurses in British Columbia.
CRNBC, with the support of the Association of Registered Nurses of British Columbia, purchases professional
liability protection and commercial general liability insurance for the College’s practicing registrants.
CRNBC provides back-office support to other health profession organizations, including a shared information
system on a cost recovery basis. The College also collaborates with other stakeholders on projects of shared
interest, including piloting and operating a Nursing Community Assessment Service.
(b) basis of accounting
The consolidated financial statements have been prepared using Canadian accounting standards for not for
profit organizations (“ASNPO”).
These consolidated financial statements include the accounts of CRNBC and 0359298 BC Ltd. (formerly
CRNBC Captive Insurance Corporation), a wholly owned subsidiary. Balances and transactions between
0359298 BC Ltd. and CRNBC have been eliminated on consolidation.
(c) Internally restricted net assets
The total net assets amounts, less those invested in capital and intangible assets and internally restricted funds,
are available for any appropriate use in future.
The “Equity in Capital” fund represents the net funds invested in property, equipment and intangibles, net of
accumulated amortization and related capital lease obligations.
Internally Restricted Funds, represent operating funds that have been appropriated by CRNBC’s board for
specific purposes.
(d) revenue recognition
Revenue is recognized as it is earned in accordance with the following:
- Registration fee revenues are recognized as revenue of the Operating Fund in the period that corresponds
to the registration year to which they relate. Registration fees collected for the following year are deferred
as appropriate.
- Credentials processing revenue is recognized as revenue in the year fees are received once applications are
completed.
- Grants received are deferred and recognized as revenue in the year in which the related expenses were
incurred.
33
Notes to Consolidated Financial StatementsFebruary 28, 2017
1. nature oF oPeratIons and summary oF sIgnIFICant aCCountIng PoLICIes - ContInued
(d) revenue recognition - Continued
- Examination fees received are deferred and recognized as revenue in the year the applicant completes the exam.
- Investment revenue includes interest and dividend revenue, realized gains and losses on sale of investments and unrealized gains and losses from changes in the fair market value of investments during the year ended.
- Consulting services are recognized when the service is performed, the revenue can be reasonably measured and collection can be reasonably assured.
- Through collaboration with other stakeholders, CRNBC entered into various cost sharing agreements. Where CRNBC acts as an agent, the revenue earned on the cost sharing transactions is recognized on a net
basis against the costs incurred.
(e) use of estimates
The preparation of financial statements in accordance with Canadian Accounting Standards for Not-For-Profit Organizations requires management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. Significant estimates included in these financial statements are the estimate of useful lives of property and equipment and intangible assets for calculating amortization, the allocation of salary expense to the appropriate programs, and the estimate of the staff severance liability. Actual results could differ from management’s best estimates as additional information becomes available in
the future.
(f) Financial Instruments
Financial instruments are recorded at fair value when acquired or issued. In subsequent periods, equities traded in an active market and derivatives are reported at fair value, with any unrealized gains or losses reported in operations. In addition, all bonds and guaranteed investments certificates have been designated to be in the fair value category, with gains and losses reported in operations. All other financial instruments are reported at costs or amortized cost less impairment, if applicable. Financial assets are tested for impairment when changes in circumstances indicate the asset could be impaired. Transaction costs on the acquisition, sale or issue of financial instruments are expensed for those items remeasured at fair value at each statements of
financial position date and charged to the financial instrument for those measured at amortized cost.
(g) Property and equipment
Purchased property and equipment are recorded at cost less accumulated amortization. Amortization is based
on the estimated useful life of the assets as follows:
building 5% diminishing balance basis building improvements 3-10% straight line basis Office furniture and equipment 10% straight line basis electronic office equipment 33% straight line basis equipment under capital lease Straight line over lease term
34
Notes to Consolidated Financial StatementsFebruary 28, 2017
1. nature oF oPeratIons and summary oF sIgnIFICant aCCountIng PoLICIes - ContInued
(h) Intangible assets
Intangible assets represents internally customized software and other purchased software. Intangible assets are
recorded at cost less accumulated amortization. Amortization is based on the estimated useful life of the assets
as follows:
Custom developed software 20% straight line basis Other software 50% straight line basis
(i) Leases
Where substantially all of the risks and rewards incidental to ownership of a leased asset have been transferred
to the College (a “capital lease”), the asset is treated as if it had been purchased outright. The amount initially
recognized as an asset is the lower of the fair value of the leased asset and the present value of the minimum
lease payments payable over the term of the lease. The corresponding lease commitment is shown as a liability
and lease payments are analysed between capital and interest. The interest element is charged to the statement
of operations over the period of the lease.
(j) related Party transactions
All monetary transactions in the normal course of operations are measured at the exchange value. Non-
monetary transactions in the normal course of operations that have commercial substances and do not involve
the exchange of property or product held for sale are also measured at exchange value. The commercial
substance requirement is met when the future cash flows associated with the transfer of property are expected
to change significantly as a result of the transaction. All other related party transactions are measured at
carrying value.
(k) allocation of salaries and wages
Salaries and wages are allocated proportionately on the basis of time spent by each employee on each of the
programs.
(l) Cash and Cash equivalents
Cash and cash equivalents include investments having a maturity date of three months or less from the date of
purchase.
(m) accrued sick, vacation and severance Pay
CRNBC accrues all earned but unpaid cash entitlements for severance pay, sick leave and vacation pay.
(n) Income taxes
CRNBC is exempt from income tax under Section 149(1)(c) of the Canadian Income Tax Act. 0359298 BC Ltd.
is subject to income tax and income taxes are accounted for using the taxes payable method.
35
Notes to Consolidated Financial StatementsFebruary 28, 2017
2. Cash and Cash equIvaLents
Cash and cash equivalents are comprised of the following:
2017 2016
Cash $ 13,506,657 $ 10,403,021
Cash equivalent 1,048,621 1,019,219
$ 14,555,278 $ 11,422,240
CRNBC’s and 0359298 BC Ltd’s cash is held in bank accounts and investment accounts held at a Canadian credit
union and at a Canadian investment brokerage. Cash equivalents consist of money market funds which are
redeemable at any time.
3. Investments
2017 2016
Government bonds $ 2,558,412 $ 2,455,674
Corporate bonds and notes 9,450,424 7,975,789
12,008,836 10,431,463
Less short term investments 561,869 677,537
Long term investments $ 11,446,967 $ 9,753,926
Government bonds consist of provincial and municipal bonds and bear interest ranging from 1.75% to 3.70%
(2016 - 1.75% to 3.70%) with maturities ranging from June 2017 to June 2024. Corporate bonds and notes bear interest
ranging from 2.20% to 4.89% (2016 - 2.20% to 4.89%) and have maturities ranging from October 2017 to June 2023.
36
Notes to Consolidated Financial StatementsFebruary 28, 2017
4. ProPerty and equIPment
Cash and cash equivalents are comprised of the following:
2017 2016
aCCumuLated net book net book
Cost amortIzatIon vaLue vaLue
Land $ 472,500 $ - $ 472,500 $ 472,500 building 4,172,941 2,912,118 1,260,823 1,327,182 building improvements 1,612,808 913,203 699,605 733,472 Office furniture and equipment 623,416 519,149 104,267 141,446 electronic office equipment 616,631 605,813 10,818 37,780 equipment under capital lease 140,840 99,244 41,596 55,462
$ 7,639,136 $ 5,049,527 $ 2,589,609 $ 2,767,842
5. IntangIbLe assets
aCCumuLated net book
Cost amortIzatIon vaLue
balance, March 1, 2015 $ 3,002,027 $ 1,645,980 $ 1,356,047 additions, CrNbC portion 444,224 - 444,224 One time Shared System Contributions (70,250) (43,672) (26,578) amortization - 278,838 (278,838)
balance, February 29, 2016 $ 3,376,000 $ 1,881,146 $ 1,494,855
balance, March 1 2016 3,376,000 1,881,146 1,494,855 additions, CrNbC portion 523,952 - 523,952 One time Shared System Contributions (642,168) - (642,168) amortization - 278,176 (278,176)
balance, February 28, 2017 $ 3,257,784 $ 2,159,322 $ 1,098,463
Intangible assets are comprised of an information technology system which was initially configured and
customized for CRNBC’s purpose.
Due to the similarity in the nature of information technology requirements for CRNBC and other Health
Professional Organizations (HPOs), CRNBC has entered into a Shared System Participation Agreement
with various HPOs to fund the development and support services of the information technology system on
a cost recovery basis.
37
Notes to Consolidated Financial StatementsFebruary 28, 2017
5. IntangIbLe assets - ContInued
Pursuant to the Shared System Participation Agreement, each participating HPO pays the following cost:
i) a one-time Shared System Contribution to CRNBC based upon the net book value of the shared system and the
proportionate amount of health professional members registered to that HPO.
ii) shared system annual costs based on approved budget.
iii) a license fee if a withdrawing participating HPO wants to acquire a license to use the CRNBC technology.
iv) to recognize the financial contribution of each participating HPO towards the Shared System, CRNBC agrees to
distribute and pay a portion of the Shared System Contribution and any license fee to existing participants.
6. CaPItaL Leases PayabLe
CRNBC has entered into various lease agreements for photocopiers.
2017 2016
Obligations under capital lease $ 42,135 $ 55,696
Less current portion of capital lease payments 13,800 13,561
$ 28,335 $ 42,135
7. assoCIatIon membershIP Fees
Pursuant to the Health Professions Act and CRNBC’s Bylaws, CRNBC collects fees on behalf of an association. The
fees are remitted to the association in the year they are received. During the year, the total fees collected on behalf
of the Association of Registered Nurses of British Columbia (“ARNBC”) were $4,331,743 (2016 - $3,783,199). As
at February 28, 2017, CRNBC had collected but not yet transferred $2,663,933 to ARNBC (2016 - $2,283,612). The
amounts to be remitted are non-interest bearing.
38
Notes to Consolidated Financial StatementsFebruary 28, 2017
8. munICIPaL PensIon PLan
The employer and its employees contribute to the Municipal Pension Plan (a jointly trusteed pension plan).
The board of trustees, representing the plan members and employers, is responsible for administering the plan,
including investment of assets and administration of benefits. The plan is a multi-employer defined benefit pension
plan. Basic pension benefits are based on a formula. As at December 31, 2016, the plan has about 189,000 active
members and approximately 85,000 retired members. Active members include approximately 37,000 contributors
from local governments.
Every three years, an actuarial valuation is performed to assess the financial position of the plan and adequacy of
plan funding. The actuary determines an appropriate combined employer and member contribution rate to fund
the plan. The actuary’s calculated contribution rate is based on the entry-age normal cost method, which produces
the long term rate of member and employer contributions sufficient to provide benefits for average future entrants
to the plan. This rate is then adjusted to the extent there is amortization of any funding deficit.
The most recent valuation of the Municipal Pension Plan as at December 31, 2016, indicated a $2,224 million
funding surplus for basic pension benefits on a going concern basis.
The College of Registered Nurses of B.C. paid $836,496 (2016 - $808,180) for employer contributions to the plan in
fiscal 2017.
The next valuation will be as at December 31, 2018, with results available in 2019.
Employers participating in the plan record their pension expense as the amount of employer contributions made
during the fiscal year (defined contribution pension plan accounting). This is because the plan records accrued
liabilities and accrued assets for the plan in aggregate, resulting in no consistent and reliable basis for allocating the
obligation, assets and cost to individual employers participating in the plan.
39
Notes to Consolidated Financial StatementsFebruary 28, 2017
9. ContrIbutIons From other heaLth ProFessIon organIzatIons
During the year, contributions were received from other Health Profession Organizations (HPO) that have agreed
to participate in adopting a shared information technology system and support services. The funds were received as
consideration for the shared system support services and a corresponding overhead allocation.
2017 2016
Contributions from HPO $ 1,986,058 $ 805,034
expenses allocated to HPO 1,940,703 754,834
Net overhead recovery $ 45,355 $ 50,200
10. ContrIbutIons From the bC mInIstry oF heaLth - nursIng CommunIty assessment servICe ProjeCt
During fiscal 2016, contributions were received from the British Columbia Ministry of Health (“BC MoH”) to pilot
their Nursing Community Assessment Services (“NCAS”) project. The funds were received on behalf of the BC
MoH to pay for the NCAS program pilot ending March 31, 2016. In April 2016, CRNBC received a grant of $1.4
million from the BC MoH to support placing the NCAS program into operation.
2017 2016
NCaS pilot contribution by bC MoH $ - $ 1,157,949
Pilot expenses 25,531 1,319,337
CrNbC contribution to NCaS pilot $ (25,531) $ (161,388)
2017 2016
NCaS operating grant $ 761,476 $ -
Operating expenses 761,476 -
CrNbC contribution to NCaS operations $ - $ -
40
Notes to Consolidated Financial StatementsFebruary 28, 2017
11. Co-CreatIon oF “one nursIng reguLator”
During the year, the College of Licensed Practical Nurses of B.C. (“CLPNBC”), CRNBC and the College of
Registered Psychiatric Nurses of B.C. (“CRPNBC”), announced that they will be working towards, in co operation
with the Ministry of Health of BC, the co-creation of a new nursing body that will replace the existing colleges.
This new body will regulate all nurses in B.C.: licensed practical nurses, nurse practitioners, registered nurses, and
registered psychiatric nurses.
The three nursing colleges have agreed to cost share certain incremental costs related to the co-creation of the
new college. These shared co-creation costs are allocated to each college based on their proportion of the total
registrant population. In addition to CRNBC’s share of co-creation costs, other non-shared costs incurred by the
college for this co-creation are included in the Statement of Operations.
2017 2016
Total shared co-creation costs $ 294,483 $ -
Shared costs allocated to other colleges (84,943) -
CrNbC’s share of co-creation costs $ 209,540 $ -
12. Investment InCome (Loss)
2017 2016
Interest and dividend revenue $ 366,668 $ 427,322
realized gain on sale of investments 96,153 90,463
unrealized gain (loss) from changes in fair market value 761,464 (715,919)
$ 1,224,285 $ (198,134)
13. InCome taxes
Income taxes for 0359298 BC Ltd. for the year ended February 28, 2017 was a recovery of $2,562
(2016 - tax recovery of $63,584), net of refundable taxes.
41
Notes to Consolidated Financial StatementsFebruary 28, 2017
14. ContIngent LIabILIty
In2014,theBCNurses’Union(“BCNU”)initiatedacivilclaimagainstCRNBC,0359298BCLtd.and
CRNBC’s Registrar/CEO, challenging CRNBC’s authority to have made a $1,500,000 grant to ARNBC, using
funds derived from the redemption of preferred shares. These matters are ongoing and their outcome and an
estimate of loss, if any, is not determinable.
CRNBC has also received notification of other claims related to various matters arising in the ordinary course
of its business. These matters are at a preliminary stage and their outcome and an estimate of loss, if any, is
not determinable. CRNBC has no reason to expect that the ultimate disposition of any of these matters will
have a material adverse impact on its financial position, results of operations or its ability to carry on any of its
business activities.
15. aLLoCated exPenses
Salaries and wages are allocated as follows:
2017 2016
executive office $ 1,130,939 $ 708,843
Information and finance 1,311,915 943,075
Communications and human resources 1,175,419 1,258,433
Policy, practice and quality assurance 3,263,643 3,342,726
registration, inquiry and discipline 3,564,686 3,501,136
Capitalized to IT projects 523,952 176,289
total $ 10,970,554 $ 9,930,502
42
Notes to Consolidated Financial StatementsFebruary 28, 2017
16. FInanCIaL Instrument rIsks CRNBC’s activities result in exposure to a variety of financial risks including risks related to credit and market,
foreign exchange, interest rate and liquidity. The risks that CRNBC are exposed to this year are consistent with
those identified in prior years.
(a) Credit risk and market risk
Credit risk is the risk that CRNBC will incur a loss due to the failure by its debtors to meet their contractual
obligations. Financial instruments that potentially subject CRNBC to significant concentrations of credit risk
consist primarily of cash and cash equivalents, long-term investments and accounts receivable. Market risk
is the risk that the value of an investment will fluctuate as a result of changes in market prices, whether those
changes are caused by factors specific to the individual investment or factors affecting all securities traded in
the market. CRNBC limits its exposure to credit risk by placing its cash and cash equivalents and short term
investments with high credit quality governments, financial institutions and corporations in accordance with
investment policies adopted by the board. Risk and volatility of investment returns are mitigated through the
diversification of investments in different geographic regions and different investment vehicles.
(b) Foreign exchange risk
Foreign exchange risk is the risk that the fair value or future cash flows of a financial instrument will fluctuate
because of changes in foreign exchange rates. CRNBC limits its exposure to foreign exchange risk through
its investment policy, which sets a maximum percentage of equity investments that can be held in foreign
currencies.
(c) Interest rate risk
Interest rate risk is the risk that the fair value or future cash flows of a financial instrument will fluctuate
because of changes in market interest rates. CRNBC is not exposed to interest risk on its capital leases
payable as lease payments are fixed to the end of the lease term. The interest rates and terms of cash and cash
equivalents and long-term investments are as disclosed in Notes 2 and 3.
(d) Liquidity risk
Liquidity risk is the risk that CRNBC will not be able to meet its obligations as they fall due. CRNBC maintains
adequate levels of working capital to ensure all its obligations can be met when they fall due. Long-term
investments are also held in securities that can be liquidated within a few days notice.
43
Notes to Consolidated Financial StatementsFebruary 28, 2017
17. CommItments CRNBC entered into an agreement with the Canadian Nurses Protective Society (CNPS) to provide retroactive and
ongoing Professional Liability Protection for CRNBC’s practicing registrants over five years at approximately $2.8
million per year expiring in 2021. As at February 28, 2017, CRNBC had collected but not yet remitted $2,394,361 to
CNPS (2016 - $Nil). The amounts to be transferred are non interest bearing.
18. ComParatIve FIgures The comparative figures have been reclassified to conform to the current year’s presentation.