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Fee Amendment

The following proposed amendments were approved by government and became effective March 1, 2011.

 Proposed Amendment

On December 3, 2010, the Board of the College of Registered Nurses of British Columbia (CRNBC) approved bylaw amendments to Schedule D: Examination and Registration Fees.

Schedule

The Bylaws made by the College of Registered Nurses of British Columbia under the authority of the Health Professions Act are amended by repealing Schedule D and replacing it with the attached new Schedule D.

The following questions and answers provide background information to the CRNBC Board's decision to raise fees as of March 1, 2011. If
you have additional questions, please forward them to feequestions@crnbc.ca

 Questions & Answers

Why are CRNBC’s registration fees changing?

To fulfill its obligation to protect the public, CRNBC carries out foundational work related to registration and renewal, standards of practice, supporting registrants to meet standards and governance. The vast majority of CRNBC’s revenue to carry out this work comes from registration fees collected annually. A small amount of revenue comes from other fees such as examination fees and credentials processing fees as well as from interest earned on investments.

Since CRNBC was established as the regulatory college for registered nurses and nurse practitioners in 2005, the Board has kept fee changes to a minimum. There were no fee increases from 2005 throughout 2007 and only incremental changes the past three years.

Here is a brief overview of some of the significant new cost drivers for CRNBC:

Health Professions Review Board

The Health Professions Review Board (www.hprb.gov.bc.ca) was established by the B.C. government in 2009 to review certain decisions of B.C.’s health professions colleges. CRNBC and other colleges are required to provide extremely detailed information for any review of a college decision that the Review Board is undertaking.

For 2011, CRNBC budgeted legal fees associated with Health Professions Review Board are 120% higher than the 2010 legal fees. This trend in higher legal fees associated with the Health Professions Review Board will continue into the future.

Technology

CRNBC is upgrading its entire electronic communications platform, data management processes, and document records management and registration systems. These extensive projects are being developed in phases and will help CRNBC to be more efficient and cost-effective in meeting its obligations to:

  • Process online applications and renewals expediently.
  • Support registrants with flexible, effective online learning tools and modules, including a Learning Management System.
  • Provide accurate information to registrants, the public and other stakeholders via various electronic channels.
  • Manage registrant data.

By enhancing electronic systems, turnaround time for responding to requests for information will be significantly improved and greater staff resources will be able to be spent on core business matters, such as registration and professional conduct.

Quality Assurance

CRNBC is in the process of establishing a Quality Assurance Program for Registrants, which will soon be required under the Health Professions Act.

Nurse Practitioners

The number of nurse practitioners is increasing, resulting in higher costs for administering both the nurse practitioner registration examinations and the CRNBC Quality Assurance Program for nurse practitioners. Nurse practitioner regulatory examinations consist of two examinations — a written examination and a clinical examination that are administered separately, the latter of which is more costly to run as simulated clinical scenarios are utilized for examination purposes.

As part of the CRNBC’s Nurse Practitioner Quality Assurance Program, onsite peer reviews of nurse practitioner practice are conducted using chart audits. All nurse practitioner registrants are required to have a practice review within the first two years of registration and, subsequently, at least once every five years. Over the past five years, the number of reviews has increased significantly as the number of nurse practitioners increases. Moving from a paper-based system of chart audits to an electronic system will make the onsite peer review process more expedient. The Nurse Practitioner Quality Assurance Program is expanding to include a second arm that will oversee nurse practitioner prescribing of drugs using PharmaNet data. There are start up costs and ongoing maintenance costs associated with the program.

Other Cost Drivers

  • Costs associated with reviewing and updating decision support tools for certified practice (previously covered by a government grant).
  • Increase in fees charged by credit card companies for each time a credit card is used to pay CRNBC fees. More and more of CRNBC’s 40,000 registrants renew their annual registration by using credit cards.
  • CNA fee increase for 2011. Registrants have been informed that CRNBC will end its jurisdictional membership with CNA in the near future. Once a decision has been made regarding how registrants may continue their affiliation with CNA, including how membership fees will be managed and how this may be reflected in CRNBC registrant fees, this information will be communicated. Until that time, a portion of registration fees equivalent to $54.95 per practising registrant will be collected in 2011 to cover CRNBC’s assessed affiliation dues with CNA.
How much have fees increased since CRNBC was established?

A look at the registrant fee history since CRNBC was established in 2005 shows that, when averaged out on a per year basis, fees changed $13.83 per year: 

Year

Amount

2005
$340
2006
$340
2007
$340
2008
$350
2009
$350
2010
$370
2011
$423
How do CRNBC’s fees compare to other B.C. health regulatory colleges regulated under the Health Professions Act?

Profession

Amount

Midwives
$1,800
Physicians and Surgeons
$1,300
Psychologists
$1,200
Dentists and Surgeons
$951
Pharmacists
$650
Dietitians
$525
Occupational Therapists
$423
Registered Nurses
$423
Dental Hygienists
$400
Pharmacy Technicians
$370
Psychiatric Nurses
$370
Physiotherapists
$350
What do RNs in other Canadian jurisdictions pay?

Province/Territory

Amount

Northwest Territories/Nunavut
$656.00
Saskatchewan
$510.00
Yukon
$502.86
Alberta
$480.00
Newfoundland
$426.16
British Columbia
$423.00
Nova Scotia
$393.30
New Brunswick
$364.00
Prince Edward Island
$360.00
Manitoba
$320.00
Quebec
$268.26
Ontario
$155.00
Will the new fees be used to hire more CRNBC employees?
The number of FTE positions at CRNBC has increased by 2.9. It has been necessary to hire staff with particular skills and knowledge for the Quality Assurance Program, Education Recognition Program, certified practice and the College’s increasing needs for information management/information technology support.
Are there areas of work that the College can cut back or eliminate?

A full review of CRNBC’s finances resulted in savings through:

  • Decreased costs associated with governance.
  • Decreased costs in office support services. 
  • Decreased salary costs in practice support to offset increased costs for certified practice and education recognition program.
  • Eliminating costs for annual report production and the year in review.
It seems that CRNBC is doing less for me as a registrant, yet I am paying higher fees.

CRNBC continues to provide a number of long-standing programs of direct benefit to registrants. These include:

  • Development of standards to support registrants in their practice.
  • A confidential practice consultation program.
  • A full service, 24-hour, nursing practice reference library program.
  • Learning and development, including online learning modules.
  • A regionalized professional support program.
  • A wide variety of reference materials and information on a re-designed website.
    Current regulatory information disseminated to registrants through an electronic newsletter.

Learn more about what CRNBC does.

What other fees have changed?

Most other fees are charged on a cost-recovery basis, in accordance with policy established by the Board. Some fees, such as reinstatement fees and some examination fees are close, but not quite cost-recovery due to the fact that the resources required per applicant for reinstatement and examination vary.

Assessment Fees

Fees to assess applications for registration from outside Canada have changed to reflect the increasing demand on staff time and resources since the implementation a few years ago of the Substantially Equivalent Competent Assessment process. The new fee parallels fees charged in Ontario, Alberta, Saskatchewan and Quebec.

The Canadian applicant assessment fee has changed for the first time since the College was established in 2005. A new application fee for B.C. graduate applicants has been established to offset the resources required to assist B.C. registered nurse and nurse practitioner applicants throughout the registration process. A new fee for international nurse practitioner applicants has also been established which parallels the fee charged for Canadian nurse practitioner applicants.

A new fee for the competency assessment of some nurse practitioner applicants reflects the development and piloting of a competency assessment process tool. It will be offered on an as needed basis. Uptake is extremely limited due to the fact that very few, if any, nurse practitioners without master’s degrees are moving to British Columbia. However, the process is in place should the College receive an application in the future.

Examination Fees

The change in the examination fee reflects the increase in cost that CNA (ASI) has passed on to CRNBC for the Canadian Registered Nurse Examination. The change in the examination fees for the Nurse Practitioner Objective Structured Clinical Examination (OSCE) reflects the partial costs for administering the examination and complying with requests for a re-score.

Reinstatement Fees

The reinstatement fee is prorated at 50% of the registered nurse registration fee. Although this formula remains the same, the reinstatement fee now applies to both practising and non-practising applicants.

Student Fees

The change in the student registration fee to $100 is a more accurate reflection of the costs associated with regulating working nursing students (e.g., investigations, inquiry and discipline) and providing practice support resources to students.

 

 Proposed Bylaw Amendment

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