Message from the President

This past year has been an extraordinary year of evolution for CMTO.

Most notably, we concluded our Strategic Plan (2019-2021) and developed a new plan for 2023-2025. To start this process, Council appointed a Strategic Planning Ad Hoc Committee that provided invaluable guidance and oversight in each step of the development process. Council also appointed an Equity, Diversity and Inclusion Ad Hoc Committee to provide direction on this important topic that became a focus of the new Strategic Plan.

We conducted an environmental scan and sought feedback from several partners, such as RMTs, educators, clients, regulatory agencies and government to help us understand various perspectives on Massage Therapy regulation. Through an online survey, interviews and focus groups we heard from 2,455 participants. Findings from the scan helped inform the development of new goals and priorities.

The new Strategic Plan includes the following goals:

• Sexual Abuse Prevention
  
• Engagement and Partnerships
  
• Regulatory Excellence
  
• Equity, Diversity and Inclusion (EDI)
  

I’d like to sincerely thank our partners for providing invaluable feedback, as well as CMTO’s Council for their dedication and hard work on this plan. We look forward to seeing the plan come to life over the coming years.

And finally, I want to end on a personal note. 2022 marks my final year as Council President. It has been an honour and privilege to serve in this role, and I’m grateful I had the opportunity to meet and work alongside CMTO staff, Council members, RMTs, and so many others who are working with unwavering passion and dedication on developing quality and safe health care for all.

Yours in Health,

Kim Westfall-Connor, RMT, LLM, President

Message from the Registrar & CEO

At CMTO, we recognize that change, growth and lessons learned are all necessary to ensure we continue serving the people of Ontario as a responsive regulator.

As Kim noted in her message, Council approved a new Strategic Plan for 2023-2025. Through the new Strategic Plan, we reaffirmed our commitment to sexual abuse prevention and began identifying concrete actions to achieve this important, but ambitious goal. These priorities are just the beginning, and we will be looking for ways to collaborate with others to help protect Massage Therapy clients. In our plan, we’ve committed to:

• Collaborating with health partners on prevention initiatives.
  
• Educating and engaging students, educators, RMTs and the public on sexual abuse and boundaries.
  
• Embedding sexual abuse prevention into CMTO programs.
  
• Optimizing existing regulatory tools and advocating for additional tools to prevent and respond to sexual abuse.
  

As part of our effort to prevent sexual abuse, we worked on finalizing our new online jurisprudence program. The new program will support new applicants to CMTO in understanding their obligations relating to Massage Therapy legislation and regulations, sexual abuse, and the Standards of Practice and Code of Ethics.

CMTO’s Standard of Practice on Prevention of Sexual Abuse is also a focus of the new Risk-Based Assessment that will launch in 2023. We also embarked on a new collaborative pilot with the Ontario Physicians and Surgeons Discipline Tribunal (OPSDT). The pilot aims to streamline CMTO’s hearings and decision-making processes by appointing experienced adjudicators as non-Council Public Members to the Discipline Committee as non-Council public members. When the pilot begins in 2023, we expect it will help increase the separation between CMTO’s Council and Discipline Committee and strengthen transparency.

As I look back over my first year in this role, I’m grateful for the opportunity to work with a dynamic and hardworking team of staff and Council. I want to give special thanks to Kim Westfall-Connor, who finished her last term as CMTO’s President in 2022. Under Kim’s leadership, we were able to establish a new strategic vision that I’m confident will help us continue to evolve as an organization.

Maureen Boon, Registrar & CEO

Who We Are

CMTO is the regulatory body that oversees Registered Massage Therapists (or RMTs/MTs) working in Ontario. CMTO is not a school or an organization that advocates on behalf of RMTs.

Our Mission

CMTO is dedicated to excellence in protecting the public interest, guiding registrants and promoting the highest possible quality of the practice of Massage Therapy.

Our Vision

Regulatory excellence, promoting public trust, and safe, quality Massage Therapy.

We do this by:

• Setting the requirements for becoming an RMT so that only qualified professionals are allowed to practise and use the protected titles “RMT” and “MT.”
  

• Maintaining an up-to-date online tool, “Find an RMT” to help Ontarians verify whether the person they are visiting for Massage Therapy treatment is registered and qualified to practise.
  

• Developing and enforcing rules and expectations for RMT’s practice and conduct.

• Running a Quality Assurance Program called “STRiVE” to ensure RMTs keep their knowledge and skills up-to-date.
  

• Addressing concerns or complaints about Massage Therapy care and taking disciplinary action when necessary.
  

CMTO’s Strategic Plan 2023-2025

In 2022, CMTO worked to develop a new strategic plan for 2023 – 2025.

Following an analysis of the environmental scan and assessment of future needs, CMTO developed the following strategic goals, each of which is supported by priorities that will help achieve the goals:

1. Sexual Abuse Prevention

• Collaborate with partners on prevention initiatives.
  
• Educate and engage students, educators, RMTs and the public on sexual abuse and boundaries.
  
• Embed sexual abuse prevention in CMTO programs.
  
• Optimize existing regulatory tools and advocate for additional regulatory tools to prevent and respond to sexual abuse.
  

2. Engagement and Partnerships

• Engage with the public, RMTs, educators, students, employers and health system partners, including an annual engagement survey to ensure CMTO understands diverse perspectives.
  
• Promote transparency through open consultations, performance metrics and new communications tools.
  
• Demonstrate accountability and the value of regulation through organizational reporting of results, public awareness, and open dialogue with the profession and stakeholders.
  

3. Regulatory Excellence

• Modernize governance through CMTO initiated reform and working with government.
  
• Support a healthy organizational culture that is equitable, diverse, and inclusive.
  
• Improve efficiency and effectiveness of processes and committee decision-making by prioritizing the reduction of harm.
  

4. Equity, Diversity and Inclusion (EDI)

• Embed EDI into organizational programs and processes.
  
• Report publicly on EDI progress.
  

In 2023, CMTO will work to develop key performance indicators to measure the College’s progress on these goals, both in the short and long-term.

Snapshot of Massage Therapy in Ontario

(As of December 31, 2022)

“X” is not directly associated with male or female, including but not limited to Trans, Two-Spirit, Non-Binary, and/or Binary people. CMTO recognizes that there may be more terms that represent the diverse and unique gender experiences, including those of the LGBTQ2S community, and we will continue to respond to developments.

Top 3 Practice Settings

Most asked practice questions of 2022

About 50% of all questions were about COVID-19, scope of practice, record keeping and advertising. The Practice Specialist also answered questions from RMTs, the public, employers and others relating to:

• The public register;
• Practice processes and concerns (e.g., leaving a practice, issues with clients);
• Requirements of the Standards of Practice; and
• Insurance, billing and taxes.
  

2022 Highlights

New Standards of Practice Come into Effect

On January 1, 2022, new Standards of Practice came into effect. The Standards are one way that CMTO ensures RMTs provide ethical and quality care to Ontarians. The new Standards focus on client outcomes, and provide RMTs with flexibility to meet the requirements based on their unique practice setting and situation.

To support RMTs in applying the Standards to their practice, CMTO also released corresponding Standard Spotlights. The Spotlights are one-page documents that highlight the expectations of each Standard and contain a list of questions to help RMTs reflect on whether they are meeting the requirements.

Getting Ready for Risk-Based Assessments

Throughout 2022, CMTO developed a new risk-based approach to assessments as part of STRiVE – the Quality Assurance Program. The new assessment process will:

• Select RMTs for Practice Assessment based on multiple risk factors;
  
• Support all RMTs in meeting the Standards of Practice and Regulations;
  
• Make assessments easier to schedule and conduct; and
  
• In the longer term, reduce the number of RMTs referred to the Quality Assurance Committee.
  

As part of this process, RMTs will complete a Practice Profile annually starting in spring 2023.

“Look Before You Book” Goes Fully Digital

CMTO’s longstanding awareness campaign, Look Before You Book (LBYB), has evolved in recent years. The campaign began in 2014 with community radio and newspaper advertising and has now evolved to a fully digital awareness initiative. LBYB has also been extended from fall-only to a six-month campaign. In 2022, CMTO refreshed its campaign with the goal of reaching a wider and more diverse audience across Ontario.

CMTO did this by:

• Updating the LBYB campaign awareness materials, including its flagship video;
• Leveraging its existing social media channels (Twitter, LinkedIn);
• Introducing new social media channels (Instagram and Facebook);
• Using Zoomer Media’s online promotional e-blasts to help spread awareness; and
• Promoting the LBYB on blogTO and Spotify’s advertising platforms.
  

Working with Other Colleges to Support Equity, Diversity and Inclusion

CMTO recognizes the importance of fostering a culture of equity, diversity and inclusion (EDI) in Massage Therapy. CMTO collaborated with the College of Physiotherapists of Ontario to deliver a workshop series titled, “Reimagining Relationships to Work and Self”. This two-day workshop encouraged RMTs and other health professionals to explore and reflect on principles of equity, diversity and inclusion in their workplace and within therapeutic relationships. Over 350 RMTs participated in this workshop.

CMTO actively participates in the Health Profession Regulators of Ontario (HPRO)’s Anti-Racism Steering Committee which recently initiated an Anti-Racism in Health Regulation (ARHR) Project. The project will produce an Equity Impact Assessment toolkit and a training package to help regulatory health colleges uncover unconscious biases and create a strategic framework for becoming more inclusive and equitable organizations. When the project concludes, CMTO will adopt these tools and lessons learned to enhance its own EDI efforts.

Developing a Jurisprudence Program

Over the past year, CMTO continued the development of a new online Jurisprudence Program, which consists of three parts:

1. Legislation and regulations;
2. Standards of Practice and prevention of sexual abuse; and
3. Professionalism and Code of Ethics.

The program launched in Q1 of 2023 for individuals required to take a Refresher Course and some applicants (i.e., those from outside of Ontario). The program will be available to RMTs who wish to complete it in Q2 of 2023 and will be a requirement for all applicants beginning January 1, 2024.

Pilot Project with the Ontario Physicians and Surgeons Discipline Tribunal

Over the past year, CMTO explored a pilot project with the Ontario Physicians and Surgeons Discipline Tribunal (OPSDT). The project will involve the appointment of six experienced adjudicators from the OPSDT to CMTO’s Discipline Committee to conduct active case management and chair complex hearings. These enhancements are expected to streamline hearings and deliberations and achieve more separation between Council and the Discipline Committee.

Livestreaming Council Meetings

To increase transparency and accessibility, CMTO began livestreaming its Council meetings on its YouTube channel. Moving forward, all Council meetings will be livestreamed on CMTO’s YouTube channel to allow observers to join the meeting from anywhere in Ontario and beyond.

Update on COVID-19 Response

Throughout 2022, CMTO continued to monitor the COVID-19 pandemic and guidance from the Ontario Ministry of Health. As the province began easing public health restrictions, CMTO continued to keep RMTs informed on COVID-19 guidance through email and social media. CMTO also continued supporting the Ontario Government’s vaccination campaign by encouraging RMTs to become vaccinated.

Executive Committee Report

Summary of 2022 Accomplishments and Activities

The Executive Committee met nine times in 2022. In addition to monitoring the administration of the College, the Committee accomplished the following activities throughout 2022:

Governance

• Approved the response to the Ministry of Health’s Governance Reform Consultation;
• Recommended the 2022 Committee Composition and circulated it to Council for ratification;
• Approved mentorship for new Council members;
• Supported the creation of an Ad Hoc Diversity, Equity and Inclusion Committee;
• Supported the creation of an Ad Hoc Strategic Planning Committee to develop the 2023-2025 Strategic Plan;
• Recommended to Council revisions to By-Law No. 9 “The Registrar”, s3, Deputy Registrar that enabled the Registrar to appoint anyone as Deputy Registrar for any period of time and distinguish the roles of Deputy Registrar and Acting Registrar;
• Recommended to Council increases to the Application Fee, Inactive Fee and General Certificate Fee;
• Council was unconstituted for its September meeting due to a lack of Public Members and the Executive Committee acted on its behalf; and
• Approved the appointment of six Ontario Physicians and Surgeons Discipline Tribunal (OPSDT) experienced Adjudicators to CMTO’s Discipline Committee.
  

Financial Reporting

• Approved and recommended to Council the unaudited Statement of Operations and Statement of Financial Position;
• Recommended to Council the appointment of the Auditors for 2022;
• Approved the Internal Controls and Financial Policies Advisory Project;
• Reviewed the College’s Investment Portfolio; and
• Approved and recommended to Council the 2023 Operating and Capital Budget.
  

CEO Performance Management

• Reviewed the proposed evaluation timelines and process for the CEO’s Performance Appraisal to ensure consistency, and also agreed that a review of the CEO’s compensation is conducted at the same time as the general review for staff;
  
• Discussed the CEO Performance Evaluation Results and shared them with Council; and
  
• Approved the CEO Compensation Policy.
  

Risk Management

• Reviewed Management’s assessment of critical risks and uncertainties that may affect the College.
  

Executive Committee Self-Assessment

• Reviewed the Executive Committee Terms of Reference which provides an overview of their accountabilities, including financial monitoring, strategic planning and governance.
  

Other

• Recommended to Council that CMTO commit to a one-year contract with the Canadian Massage Therapy Council Accreditation (CMTCA);
  
• Approved under section 34(2)(b) of the Ontario Regulation 544/94, that registrants who were non-compliant with STRiVE undergo a practice assessment and complete all outstanding STRiVE requirements; and
  
• Discussed the issue of cheating on the OSCE portion of the CMTO entry to practice exam.
  

Client Relations Committee Report

Summary of 2022 Accomplishments and Activities

The Client Relations Committee met twice in 2022. The Committee received and reviewed 16 applications for funding for therapy/counselling and approved 13 applications. In addition to updates on the administration of the program for funding for therapy/counselling and approval of funding requests, the Committee:

• Reviewed staff’s evaluation of the 2021 Sexual Abuse Prevention Plan;
• Approved a Sexual Abuse Prevention Plan for 2022 – 2023; and
• Approved updates to the Funding for Therapy and Counselling Policy. The policy was updated to help ensure the funding for therapy/counselling program remains transparent, sustainable and consistent with the supportive provisions of the Regulated Health Professions Act, 1991, while maintaining equitable access to the program. Council approved the policy changes in November 2022.
  

Quality Assurance Committee Report

Summary of 2022 Accomplishments and Activities

In 2022, the Quality Assurance Committee (QAC) met eight times and 20 panel meetings were held to consider assessment outcomes.

STRiVE - the Quality Assurance Program ran for its fourth year. RMTs were responsible for submitting four components by November 30, 2022. By the deadline, 92% of RMTs submitted all components. CMTO followed up with RMTs who did not complete the above requirements by the deadline and the completion rate increased to 97.4% by December 31, 2022.

Throughout 2022, CMTO continued developing its new approach to risk-based assessments. While testing the new approach during the transition year, 376 practice assessments were conducted virtually to assess RMTs’ compliance with the Standards of Practice. Panels of the Committee identified and addressed gaps by using a decision-making framework that maintains client care and supports continuing competence and quality improvement.

Standards of Practice

After a review of the General Regulation, which includes requirements for advertising and record keeping, a decision was made to develop two new Standards of Practice as eventual replacements for those sections. The format of these new Standards will closely align advertising and records with the existing Standards of Practice (2022), including:

• Outcomes statements for RMTs and clients around advertising and records;
• Outcomes-based requirements in simpler language; and
• References, glossary items and supporting documents.

The draft Standard of Practice: Advertising and draft Standard of Practice: Records were developed with input from a Standards of Practice Advisory Group, a comparison of other similar health professions and a Quality Assurance Committee review. In 2023, the draft Standards will be shared for feedback from the profession, the public, and others.

Jurisprudence Program

To support RMTs’ knowledge of the laws, regulations and rules for the profession, CMTO developed an online Jurisprudence Program. There are three components:

1. Legislation and regulations;
2. Standards of Practice and prevention of sexual abuse; and
3. Professionalism and Code of Ethics.

The program will be part of the Refresher Course (starting in 2023), a mandatory requirement of registration (starting in 2024), and optional continuing education for all RMTs.

Registration Committee Report

Summary of 2022 Accomplishments and Activities

The Registration Committee met six times in 2022. In addition to considering cases referred to it by the Registrar, the Committee approved:

• The new Jurisprudence requirement; and
• Changes to the Language Fluency Policy.

The Committee recommended that Council approve the:

• 2023 Certification Examination content outlines effective January 1, 2023;
• Acupuncture Education and Authorization Policy; and
• Refresher Course Policy.

The Committee also received updates on the following:

• Draft registration regulation amendments and Bill 106, the Pandemic and Emergency Preparedness Act, 2022, which requires all health regulatory colleges to create an emergency class of registration;
• 2022 certification examination reports;
• Prometric’s accommodation process;
• Office of the Fairness Commissioner (OFC) Risk Informed Compliance Framework and CMTO’s rating;
• Administrative changes to the professional liability insurance process that included adding attestations to the annual renewal form and conducting a compliance audit of 3% of General Certificate holders every January; and
• The 2022 Objectively Structured Clinical Evaluation (OSCE) breach investigation and actions taken by CMTO to address the concerns.
  

Statistics:

• CMTO registered 909 Registered Massage Therapists (RMTs).
• In 2022, one application for registration was referred by the Registrar to the Registration Committee for review and decision. Reasons for a referral can include conduct concerns, a criminal conviction or findings of misconduct with another regulatory body.
  

Registration Committee Decisions

Inquiries, Complaints and Reports Committee Report

Summary of 2022 Accomplishments and Activities

The ICRC reviews three types of matters:

• Formal complaints
• Registrar Reports, which involve matters outside the formal complaints process that come to CMTO’s attention (e.g., information from mandatory reports, criminal investigations, employers, insurance companies, etc.)
• Incapacity concerns, which deal with RMTs who may have a health condition that impacts their ability to practise safely.

In 2022, the Committee’s work was completed by three Panels, each comprised of four or five Committee members. The Panels met 28 times over videoconference and one (1) time over email.

The charts below represent a summary of the work completed by the Committee in 2022.

Requests for Review of Formal Complaint Matters

Complainants and registrants have the right to request a review of the ICRC’s decision within 30 days unless the decision is to refer the matter to the Discipline or Fitness to Practise Committee.

The review process is handled by the Health Professions Appeal and Review Board (HPARB).

Discipline Committee Report

Summary of 2022 Accomplishments and Activities

The Discipline Committee operated remotely and held all its hearings virtually. The Committee considered feedback submitted by hearing participants through a post-hearing evaluation survey in its continuous review of online hearing processes.

Continued education and training of members remained a priority. This included an annual orientation and training sessions on:

• conducting witness credibility assessments;
• drafting and delivering reprimands;
• active adjudication and best practices in assisting self-represented parties; and
• confronting unconscious bias in tribunal proceedings.
  

Hearings

1.2 The chart below displays hearing outcomes from matters closed in 2022. Most cases had more than one finding of professional misconduct. The 18 cases that resolved through an undertaking, where a registrant resigns and promises to never reapply for registration, are not included in the below outcomes because the Discipline Committee does not hear evidence in those cases to decide if misconduct occurred. Outcomes in the remaining 28 matters are set out below.

1.3 The chart below displays the number and types of penalties ordered in matters closed in 2022. Most cases had more than one penalty outcome.

Discipline Decisions

Decisions and reasons issued in the 46 matters closed in 2022 are linked below. On occasion, two or more discipline matters related to the same registrant are heard at the same hearing. In these cases, a single decision is issued containing the outcome for all matters.

Jeffrey Addley

Nenad Andrejic: Liability Decision, Penalty and Costs Decision

Sarah Bennett

Gail-Anne Cumberbatch (2 matters)

Julie Demore

Domenic Falvo (2 matters)

Xin Feng (2 matters)

Megan Harrison

Jin Min Huang

Gregory Jessup

Yucong Jing

Meagan Kennedy

Atul Khosla

James Kim

Lauren Klippenstein

Haomiao Liu

Cameron Locke

Registrant L

Brian Murray

Fitness to Practise Committee Report

Summary of 2022 Accomplishments and Activities

There were five matters before the Fitness to Practise Committee in 2022, of which four were new referrals received in 2022. As a result of registrants’ resignations, two of the five matters were closed as the Committee no longer had jurisdiction to proceed with the hearings. Another matter was closed when the Committee issued its Decision and Reasons following a hearing.

2022 Council

(as of December 2022)

Financial Statements

CMTO Council approved the audited financial statements for 2022.

Use the link above to view the audited report from the independent auditor.