Responding to Complaints at the CASLPO: What Audiologists and Speech-Language Pathologists Need to Know
Regulatory proceedings against audiologists and speech-language pathologists at the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) are often initiated by way of a complaint. The pressures of the formal complaint process, including the possibility of professional consequences, may negatively impact audiologists and speech-language pathologists, who may not know exactly how to respond. In light of these potential difficulties, we have prepared this brief guide to responding to complaints at the CASLPO.
The CASLPO notifies audiologists and speech-language pathologists that they are subject to a complaint. Upon receiving all relevant documents and information, a panel of the Inquiries, Complaints and Reports Committee (ICRC), comprised of both professional members and government appointed public members, reviews the audiologist or speech-language pathologist’s complaint file. Corresponding with the CASLPO’s role as the regulator of two different professions, the ICRC also has two sub-committees. The composition of a panel will reflect whether the member in question is an audiologist or a speech-language pathologist. The ICRC is responsible for determining the outcome of the matter, which may include ordering further investigation.
The CASLPO generally must address all complaints it receives against audiologists and speech-language pathologists, who themselves are obligated to cooperate with any formal investigation. The complaint investigator may interview the audiologist or speech-language pathologist, as well as any other persons and witnesses, and may seek an expert opinion. Regardless of whether or not audiologists or speech-language pathologists consider the allegations against them legitimate, they should prepare a response.
Responses are only accepted in writing, as the ICRC operates the complaint process by exchanging and reviewing documents rather than through a hearing. These written responses should comprehensively address every point raised by a complainant, as audiologists and speech-language pathologists cannot explain in person to the ICRC their decision making or reasons for providing care. Neglecting any area of concern from the original complaint has the potential to contribute to a negative finding by the ICRC.
The CASLPO typically provides the audiologist or speech-language pathologist with 30 days to respond to the complaint. Writing an appropriate response may be time consuming and can add to the strain on the audiologist or speech-language pathologist. A lawyer who practices in the area of professional regulation can assist audiologists and speech-language pathologists through this potentially difficult period. Legal counsel typically becomes the primary point of contact with the CASLPO, editing and submitting the written response, and generally helping the audiologist or speech-language pathologist navigate the process.
Unique elements in the audiologist or speech-language pathologist’s case warrant inclusion in their response. Such details may include when the audiologist or speech-language pathologist provided the care, the level of complexity of their care, and the possibility that someone could initiate a civil lawsuit. In our experience, it is helpful to organize responses as a chronology of any relevant events.
Deficiencies in an audiologist or speech-language pathologist’s care that are exposed in the complaint may call for a conciliatory approach in the written response. Under appropriate circumstances, the audiologist or speech-language pathologist may find it beneficial to assume responsibility for any mistakes they made or any improper practices that took place in the context of the specific complaint. In some cases, acknowledging the error and demonstrating any efforts to improve may impart the ICRC with confidence that the audiologist or speech-language pathologist has learned from their experience and may not require further action.
Along with their finalized response to the CASLPO, the audiologist or speech-language pathologist or their legal representative should enclose the patient’s records and any other relevant documents or information. As a matter of general practice, audiologists and speech-language pathologists should follow the recordkeeping guidelines set out in the Audiology and Speech-Language Pathology Act, 1991. Even if the ICRC favourably disposes of the complaint, it may still evaluate the quality of the audiologist or speech-language pathologist’s records, as deficient recordkeeping is an independent act of professional misconduct.
The CASLPO receives the finalized response, its investigator determines whether further investigation is required, and then the findings of any investigation are submitted in a report to the ICRC. After reviewing the complaint file, the ICRC may do any of the following: take no further action; caution the audiologist or speech-language pathologist in person before the ICRC; inquire into the audiologist or speech-language pathologist’s professional capacity; refer the matter to the Discipline Committee; or take any other appropriate action. Typically, the audiologist or speech-language pathologist and the complainant receive written reasons for any decision of the ICRC. Reasons are not provided when a matter is referred to discipline or to another panel of the ICRC for incapacity proceedings.
In accordance with a recent transparency initiative at the CASLPO, the following ICRC dispositions are now posted on the Public Register: Specified Continuing Education or Remediation Programs (SCERP); oral cautions; and referrals to discipline. Any person accessing the public profile of an audiologist or speech-language pathologist can view these details.
While subject to a complaint, audiologists and speech-language pathologists may generally continue practicing. To safeguard the public during the potentially lengthy formal complaint process, the Regulated Health Professions Act empowers the ICRC to address more serious allegations with an interim order, which can last until a disposition is reached. Where the audiologist or speech-language pathologist’s alleged conduct exposes or is likely to expose their patients to harm or injury, an interim order is available to impose terms, limitations, or conditions on the member’s certificate of registration, which may even rise to the level of licence suspension. The Registrar may also address serious complaints with the appointment of a special investigator. Section 75 of the Health Professions Procedural Code stipulates that this kind of special investigation can cover a much broader scope than a standard complaint investigation.
Comparatively less serious complaints may qualify for the CASLPO’s Alternative Dispute Resolution (ADR) process. ADR is a confidential and referral-only process that aims to resolve complaints in a less adversarial manner, providing the audiologist or speech-language pathologist and the complainant with an opportunity to achieve a mutually agreeable outcome. The audiologist or speech-language pathologist cannot request ADR if their file does not pass the screening stage. ADR only proceeds upon the consent of both the audiologist or speech-language pathologist and the complainant, at which point a CASLPO appointed neutral facilitator attempts to negotiate an agreement. Depending on the wishes of the parties and the nature of the complaint, the facilitator can work with the audiologist or speech-language pathologist and the complainant separately or together. A resolution reached through ADR is not final until ratified by the ICRC. If for any reason ADR is unsuccessful, the formal CASLPO complaint process resumes.
Cases at the CASLPO eventually reach a decision of the ICRC. Audiologists, speech-language pathologists, and complainants are generally entitled to request a review before a panel of the Health Professions Appeal and Review Board (HPARB), which exclusively looks at the adequacy of the CASLPO’s investigation and the reasonableness of the ICRC’s decision. The panel’s review relies on any documents and materials that were provided to the ICRC, and the same materials are typically disclosed to the audiologist or speech-language pathologist and the complainant.
A complaint to the CASLPO can materialize against any audiologist or speech-language pathologist. Working through this process can impose demands that the audiologist or speech-language pathologist need not face alone. It is prudent to contact a lawyer who practices in the area of professional regulation, as they can assist with preparing a response to the CASLPO, as well as addressing any other procedural issues that may arise. When faced with a complaint and its potential for professional and personal consequences, audiologists and speech-language pathologists should respond accordingly.
Josh Koziebrocki, is the principal lawyer and founder of Koziebrocki Law. He represents audiologists and speech-language pathologists and has extensive experience dealing with regulatory issues. He can be reached at 416-925-5445.
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