Rules and Procedures

The Canadian Board for Certification of Prosthetists and Orthotists - MAY 2004

Article I. Responsibility and Objectives of the Character and Fitness Committee

Section 1. Objectives

The fundamental objective of the committee on character and fitness is to enforce the Character and Fitness Rules and Procedures ("rules") and the Canons of Ethical Conduct ("canons") to ensure that certified orthotists, certified prosthetists, residents, registered technicians, and facilities (collectively the "certificants") are practising in accordance with industry and community standards and to protect the public against unprofessional and unethical conduct by the certificants.

Section 2. Rules

The committee shall review and analyze the rules and canons and shall propose recommendations regarding the rules and canons for adoption by the board of directors of the Canadian Board for Certification of Prosthetists and Orthotists, hereinafter sometimes called the corporation.

Section 3. Conduct

The committee is responsible for receiving, reviewing and, if appropriate, investigating complaints of unprofessional conduct or ethical violations of the rules or canons or of customary practices in the field of orthotics and prosthetics.

Section 4. Resolution of Complaints

The committee shall resolve all complaints of unprofessional and unethical conduct or other violations of the rules or canons and, if necessary, shall recommend to the board of directors such other action as is necessary to achieve the objectives of the rules and canons.

Article II. Protocol for Handling Complaints

Section 1. Appointment of the Committee

Annually, the board of directors shall appoint the chair and members of the standing and special committees (By-law, Article XV, Section 1). The committee on ethics is a standing committee of the corporation. To carry out the duties of the committee on ethics, the committee shall consist of 18 members who shall serve the two branches of the committee on ethics on a rotational basis, so that there are three members sitting for the character and fitness (complaints) committee, and three members sitting for the peer review panel, at any one time. The chair of the committee on ethics will be responsible for assigning committee responsibilities on a rotational basis.

Section 2. Complaints

A complaint may issue from the public, another member, or the peer review panel. Complaints shall be in written form and sent to the head office of the corporation. Upon receiving a complaint, the associations manager will forward the complaint to the chair of the committee on ethics, who will review the complaint to determine if it merits an investigation. If the complaint does not merit investigation (for example, if no breach of the Canons of Ethical Conduct is alleged or if the complaint falls outside the jurisdiction of the committee), it shall be dismissed with notice to the complainant and the involved member. If the chair of the committee on ethics determines a complaint merits investigation, the associations manager will:

• forward the complaint to the members of the peer review panel or to members of the character and fitness complaints committee on behalf of the chair of the committee on ethics;
• forward the complaint to the named member ("involved member"), on behalf of the character and fitness complaints committee, informing the involved member that the members of the character and fitness complaints committee will be in touch with him/her shortly to discuss the matter;
• if named individuals are included in the complaint, obtain written consent from those named individuals, permitting contact by members of the CBCPO ethics committee for the purposes of any necessary investigation. Such consent is essential for named individuals to be included in an investigation, and the inability to obtain such consent may prevent an investigation from proceeding; and
• if the member involved has been the subject of a previous complaint(s), which complaint(s) was not dismissed, send to the members of the peer review panel or to members of the character and fitness complaints committee a copy of the previous decision(s) of the committee regarding the involved member; and
• advise the complainant that the complaint has been forwarded in accordance with the above.

Section 3. Bias of Committee Members

When the chair of the committee on ethics and the sitting members of the character and fitness complaints committee, or the peer review panel, receive the complaint, the members will review the names of the complainant, the involved member, and the alleged matter, to ensure there is no bias, nor likely any apprehension of bias, with respect to their hearing the matter. The chair of the committee on ethics will canvass each of the three members with respect to bias, and if any member has any relationship with any of the parties which would likely cause an apprehension of bias, that member shall be relieved from sitting on this matter, and the next member on the committee on ethics on the rotation schedule shall be appointed. If it is the chair of the committee on ethics that has a relationship with any of the parties that is likely to cause an apprehension of bias, the chair shall choose another member of the committee on ethics to make the initial determination whether a complaint merits investigation as contemplated in Section 2. That member of the committee on ethics shall not sit on the complaints committee investigating the complaint.

Section 4. Appointment of the Chair of the Complaints Committee

The chair of each committee will ensure that a written or audio record of the minutes of all committee meetings and activities will be maintained by an appointed person within the committee, or by the CBCPO head office on an ongoing basis.

Section 5. Duties of the Peer Review Panel

The duties of the peer review panel are two-fold:

• to act as the consumer advocate for the prosthetic and orthotic profession. The panel may assist the consumer in determining whether an investigation is further warranted.
• to review and monitor a member if required to do so by an order of the character and fitness complaints committee.

The chair of the panel shall convene a meeting of the panel to review the consumer complaint to determine whether there has been an ethical breach. If, after reviewing the consumer complaint, it is determined that an ethical breach has occurred, the panel shall follow the guidelines as set out in Section 2.

Section 6. Investigation

If the chair of the committee on ethics finds a complaint merits investigation, a three member complaints committee shall be formed to investigate the complaint. The chair of the complaints committee shall send a letter, signed by all three members, to the involved member informing him/her that an investigation is to be conducted. The letter shall set out the details of the complaint, together with a reference to any rules or section of the canon the involved member is alleged to have violated. The involved member will be asked to respond, in writing, to the complaint, within 30 days of receipt of the letter. The letter shall also set out that the involved member may elect to have a hearing before the committee, and will contain a copy of Complaints Hearing Rules and Procedures. Any election to have a hearing must be made within the 30-day response period. The committee will provide the complainant with a copy of any response received from the involved member.

Section 7. Hearings

If a hearing is requested or if a hearing is set by the committee of its own accord, the hearing shall be scheduled within 60 days of the request or determination for a hearing, at such place and time as is mutually convenient for all parties. The complainant and the involved member shall each pay their own transportation, lodging and other costs. Factors the committee will consider in whether to set a hearing of its own accord include the seriousness of the complaints made, credibility issues raised in the complaint, and the public interest.

Section 8. Powers of the Committee

Subsequent to the investigation, whether conducted through correspondence or by way of a hearing, the committee may:

• issue an order dismissing the complaint;
• issue an order that the involved member cease the particular conduct;
• issue an order for supervision of the involved member;
• issue a reprimand to the involved member;
• determine the involved member be on probation and subject to monitoring by the peer review panel. Subject to the laws of Canada and the laws of the province of the involved member, the peer review panel shall have the power to examine patient records during an involved member's probation;
• determine the information shall be provided to other professional associations, both national and provincial, and/or to provincial licensing or certifying authorities;
• determine that information shall be provided to authorities for criminal prosecution;
• recommend suspension or permanent revocation of the involved member's certified status and refer the recommendation to the board of directors for its approval; and/or
• make such order of costs as the committee deems appropriate

The committee's decision shall be in writing and shall give consideration to the evidence before it and its reasons for determination made. The written decision, together with the procedure for appealing its decision, shall be sent to the complainant and the involved member.

Section 9. Appeals

An appeal of any decision of the character and fitness complaints committee shall be sent to the president by certified mail, return receipt requested, setting out the grounds of the appeal. An appeal must be requested within 30 days of receipt of the committee's decision by the appellant.

Section 10. Request for an Investigation

A complainant whose complaint is dismissed without an investigation may request that an investigation be conducted. This request shall be sent to the chair of the committee of ethics by certified mail, return receipt requested within 15 days of the complainant receiving the chair's decision. Upon receipt of the request for an investigation, the chair of the committee of ethics shall refer the complaint to a complaints committee in accordance with Section 2 as though the complaint was found to merit an investigation.

Section 11. Appeal Hearing

If the appeal request meets these requirements, an appeal hearing shall be conducted in Manitoba and shall be scheduled within 60 days of the president's receipt of the appeal request. If the appeal request is submitted by the involved member, the complainant need only appear if the board of directors requires it. The involved member shall pay his/her own transportation, lodging, and other costs to attend the appeal hearing. If the appeal request is submitted by the complainant, the involved member need only appear if the board of directors requires it. The complainant shall pay his/her own transportation, lodging and other costs to attend the appeal hearing.

Section 12. The Appeal Hearing Process

The appeal hearing shall be conducted by the board of directors, except those members who sat on the character and fitness complaints committee or the peer review committee, if relevant, in the original investigation or hearing of the matter. The board of directors shall consider all available evidence, the record and any new evidence submitted at the appeal hearing.

Section 13. Powers of the Board of Directors

The board of directors shall only overrule the committee's decision or dismiss the committee's recommendations in the event of the following:

• the rules or canons were incorrectly applied;
• the findings of fact by the committee were clearly erroneous;
• it would be unjust or unfair to implement the committee's decision;
• the procedures followed by the committee were in serious and substantial violation of the rules, canons or this protocol; and/or
• the disciplinary sanctions recommended by the committee were grossly disproportionate to the facts surrounding the violation.

Section 14. Report

The committee on ethics shall report the names of the members whose names have been stricken from the rolls due to violations of the canons or the rules. In addition, the board of directors shall notify all interested national, regional and provincial professional associations as well as provincial licensing and certifying authorities, and on request, any interested person or public agency deemed necessary to protect the public and/or who maintains the standards of the corporation.

Section 15. Assessing Costs

The decision of a committee or the board of directors may include an award of costs against either the complainant or the involved member, and payable to CBCPO and/or the opposing party. The determination of whether costs should be awarded and in what amount shall be based on:

• expenses incurred in serving any documents or hearings;
• fees and expenses incurred as a result of an investigations;
• fees and expenses of the counsel for the committee or the board of directors related to services performed in connection with any of the foregoing;
• fees and expenses of counsel for the involved member or complainant, if applicable; and
• any other relevant factor.

Article III. Certificants Convicted of or Charged with a Serious Crime or Disciplined in Other Authorized Tribunals

Section 1. Conviction/Charge

If the committee finds that the involved member has been convicted of and/or pled guilty to a serious crime and such conviction is not under appeal, the committee shall review the record leading to the conviction and/or plea in accordance with the rules as set forth in Article II.

Section 2. Other Memberships

If the committee finds that the involved member has been expelled or suspended for unethical or unprofessional conduct from a national, regional, or provincial professional association, or had his/her/its licence or certificate revoked on ethical grounds by a provincial licensing or certifying authority, the committee shall review the records leading to the sanctions in accordance with the rules as set forth in Article II.

Section 3. Malpractice

If the committee finds that the involved member has been found to have committed malpractice by a court, or an acknowledged peer group which shall be authorized to conduct peer reviews of certificants, and such finding is not under appeal or is not currently being contested, the committee shall review the record leading to the findings in accordance with the rules as set forth in Article II.

Article IV. Close of Case

Section 1. Close of Case

Once the final ruling has been made by the committee or the board of directors, the matter shall be closed and the files shall be retained in the corporation's head office with the associations manager, located in Winnipeg, Manitoba, Canada.