Council voted unanimously to move to a single mandate regulatory organization with a commitment to develop and grow a new association
CARNA Council voted unanimously on August 19, 2020 to move to a single mandate regulatory organization with a commitment to develop and grow a new association.
CARNA will begin work immediately on a transition plan to separate the two existing mandates. We will be thoughtful and supportive as each organization focuses on its own uniqueness - one as a healthcare regulator to protect Albertans through safe and competent care and one as an association to evolve the profession of nursing.
Further details, as they evolve will be added to our website so please check the CARNA website for further information and updates.
This decision comes as a result of lengthy research and consultation and will set a new way forward, both as the regulator of the nursing profession and as well to help frame a vision for a new association. You may recall that in late 2019, CARNA’s Provincial Council commissioned a review of its governance functioning with the goal to review and identify governance principles, structures and best practices. CARNA’s dual mandate was also examined for its suitability as a modern structure fit for an evolving healthcare landscape. All nine recommendations of the Governance Task Force were accepted and approved on August 19. The full Task Force report is available here.
“CARNA Provincial Council recognizes the importance of protecting Albertans by ensuring safe and competent care. We can now dedicate our regulatory mandate to this exclusively” says CARNA President Dennie Hycha. “Nurses are critical in the delivery of quality care and this new chapter in nursing regulation evolution is a positive and progressive development. This decision will also see the continued work toward advancement of the nursing profession in Alberta.
Frequently Asked Questions
Fees Questions
What is happening with my fees?
Practice permit fees will remain flat for the upcoming 2021-22 permit year.
The following year (October 1, 2022-September 30, 2023) you will see changes. One of the changes is that we will no longer be collecting fees for the Canadian Nurses Association (CNA), the Alberta RN Educational Trust (ARNET), and there may be a change in how liability protection/insurance is managed. Our base fees will be reviewed at that time.
Earlier this year the Canadian Nurses Protective Society (CNPS) notified us that it will be increasing its fee by $20 per member for the upcoming permit year. In Alberta, registered nurses are required by legislation to carry liability insurance and CNPS provides you with professional liability protection, as well as offers legal advice, risk management services and legal assistance. We recognize the impacts to Alberta’s economy because of the pandemic. On March 19, 2021, Council voted to maintain the current fees and to absorb the $20 fee increase by CNPS. Absorbing the cost of the increase is only sustainable for this year.
Nurses can make payments for their registration renewal through online or telephone banking, credit card, debit or money order.
Will I have to pay fees for the new Association?
CARNA has committed resources and expertise to develop the new independent nursing association. Nurses will not be mandated to pay fees for the new association, once established. The new association will operate independently and will be responsible for determining its own fee structure. As this foundational work progresses and more decisions are made, more information will be shared.
Will nurses need to pay their own liability insurance after 2022?
All nurses are required by legislation to have liability insurance. This requirement will not change. Nurses have always been required to pay for their own liability protection. Previously, CARNA has collected this on behalf of registrants and submitted it to the Canadian Nurses Protective Society (CNPS).
There may be a change in how liability protection/insurance is managed in future. This direction has not been set yet.
Why is the fee so expensive and offered on an annual basis, compared to other countries like the United States, especially in light of the Pandemic?
CARNA’s base registration fees for RNs and NPs are in line with other provinces. The registration fees CARNA collects are used to:
Set the requirements for becoming an RN or NP in Alberta and ensure registrants meet them.
Ensure registrant's awareness of their accountabilities to deliver safe, competent, ethical nursing care.
Ensure registrants engage in continuous professional improvement throughout their careers.
Develop and set standards of practice for the profession.
Respond to concerns about nurses’ conduct, competence, and fitness to practice.
In addition, there are different fee requirements for nurses applying for partial year practice permits, nurses transferring from another jurisdiction, courtesy registrations and non-practicing members.
CARNA and the many other health profession regulators in Alberta require registrants to renew their practice permit on an annual basis.
More information is available on our fees and payments page.
Why is CARNA not advocating for registered nurses in Alberta? We pay almost $700 a year for our licenses and indicate how we advocate for our patients. What about CARNA? Many nurses are leaving the province (or nursing in general). This will have a direct impact on patient care. I want to know what CARNA will be doing to support registered nurses in this very difficult time.
In August 2020, CARNA Council decided to separate CARNA’s dual mandate as a college and an association. Council’s decision was reinforced by amendments to the Health Professions Act later that year, requiring colleges to divest themselves of their association functions. Council’s decision and the amendments to the Act are intended to enhance the focus on protecting the public.
It is not the role of a college, such as CARNA, to advocate for regulated members. Advocacy for the profession and its regulated members is aligned with the mandate of a professional association or a union.
Association Questions
Is the Association membership mandatory?
Membership in the new nursing Association is not mandatory. Alberta nurses will have a choice to join or not.
Who is setting up the Association?
The Joint Steering Committee of the new nursing Association is made up of the Association’s inaugural board members and the original steering committee. It is responsible for developing the groundwork and strategic directions for the Association. The Joint Steering Committee is composed of nurse leaders from all designations of nursing. In late February, the newly appointed inaugural board selected a President and Vice President.
What is the role of the Association?
The new Association will decide on its own direction. Areas of focus could range from political influence and action focused on the health care system to advocacy around public health policy and the profession of nursing, educational opportunities, and ongoing support for nursing leadership.
Will self-regulation still be represented throughout the new association policies, vision and leadership?
The Association’s role is to advocate for the profession rather than regulate the profession.
The College, as a regulatory body, has a mandate to protect the public by ensuring the care or service they receive from nurses is competent and ethical, and meets professional standards.
To follow government direction and to echo the importance of the public interest, we have transitioned to a shared model in which nurses and members of the public work together on Council, in equal numbers. This will bring in new perspectives and diversity, and balance both the perspectives of the public and the role of the profession in public safety. while keeping the crucial input and experience of nurses.
As Nurse Practitioners have an established association currently, the Nurse Practitioner Association of Alberta (NPAA), how does this impact the work to create a new nursing association? Will there be duplication of efforts, will there be collaboration with the existing NPAA?
The nursing association will operate independently and will develop its own collaborative working relationships with other organizations.
How will this effect specialty practice groups currently under CARNA?
Specialty Practice Groups play a valuable role in promoting the profession.
As we move to transition to a single mandate, the College will divest itself of functions that focus on promoting the profession, such as Specialty Practice Groups.
Specific details and dates have not been decided yet, but CARNA will ensure that information is provided to Specialty Practice Groups, registrants and other stakeholders once decisions are made.
Who is the contact or how can I stay informed about the progress of the Association?
The Alberta Association of Nurses is working diligently to be up and running very soon. They are looking forward to welcoming you to join and you can expect an update in early November. Stay tuned.
College and Regulation Questions
Will CARNA change its name?
The College is in the process of transitioning to a single mandate, which we expect to fully complete in late 2022.
At its March 2021 meeting, Council approved a new trade name for the College. The College will operate as the College of Registered Nurses of Alberta (CRNA) until the Health Professions Act is updated, enabling us to legally change our name. All legal agreements will remain under the name CARNA until the legal name change.
The College is looking to change its brand identity along with the new trade name.
Is there is any issue with using the trade name CRNA? This trademark has been used to denote certified registered nurse anesthetists in the US and could potentially be utilized as a title in Canada in the future.
There is no legal barrier to using CRNA as the trade name for the College. Though it has been used for other organizations in other countries, it is rare for any acronym to be used by only one organization.
In what way will the College and Association be made separate?
The College will focus on regulating Alberta’s registered nurses and nurse practitioners in the public interest. The new association will focus on the profession of nursing, advocacy and other programs as the new Association moves forward.
What is the role of the College?
The College, as a regulatory body, has a mandate to protect the public by ensuring the care or service that the public receives from nurses is competent and ethical, and meets professional standards.
We are undergoing an organization-wide “right touch” review. In other words, our policies and procedures are being reviewed to ensure they are proportionate, consistent, targeted, transparent, accountable, and agile.
The College will continue as the regulatory body for Alberta’s registered nurses and nurse practitioners. Our responsibility is to protect the public from unsafe practice and hold members of the profession accountable for the care they provide. This includes setting entry-to-practice requirements; developing and updating professional practice standards; offering professional practice advice; providing access to the conduct program; requiring continuing professional development; and, approving education entry-level nursing programs.
With a move towards 50 per cent public representation, how will the college ensure that the regulatory board remains non-partisan?
The provincial government will recruit and appoint public members for the CARNA Council. The Province follows an objective and fair recruitment processes as outlined in the Centralized Recruitment Process document.
If the Regulatory body is responsible for "setting entry-to-practice requirements; developing and updating professional practice standards; offering professional practice advice; providing access to the conduct program; requiring continuing professional development; and, approving education entry-level nursing programs. " will increases or changes in scope be under CRNA's purview? Or will it be the Association's role to advocate for RNs to play a larger role in healthcare and avoid obsolescence as CLPNA pushes for LPN practice to expand (and very soon CLPNA will support health care aids (AHS is already training health care aids to administer medications, insulin, do dressing changes etc). Many sites have already begun replacing RNs with LPNs or have built RN losses into upcoming rotations) I think many Alberta nurses are concerned that the college/association separation will weaken the RN position in healthcare and compromise patient safety if the people who regulate our scope and practice standards are not responsible for advocating for nurses.
RNs and NPs are vital to Alberta’s health system. Having scopes of practice that reflect RNs, NPs and other health professionals training and experience helps facilitate the delivery of appropriate, effective and timely patient care.
Ensuring that RNs, NPs and other health professionals have the appropriate scope of practice to deliver optimal care is a shared responsibility among many stakeholders and organizations. Associations, employers, unions, educators and regulated health professionals all have a role to play.
A regulatory college’s role is not to advocate for scope expansions, rather it is to work with government to ensure any scope expansion being contemplated is appropriate for the profession and serves the public interest. Regulatory colleges are also responsible for developing standards of practice and other regulatory processes to support expanded scopes of practice. The College has always taken this approach and nothing about its approach will change.
General Questions
Why was the decision made to separate the College and Association?
CARNA’s Council took the initiative to position itself as a leader and separate as a College and Association beginning with Council’s vote to separate its dual mandate in August 2020. Our Council could see that there was a potential for new legislation that would change our organization and wanted to take the first step, rather than waiting to be mandated to do so.
In the late fall of 2020, Bill 46: The Health Statutes Amendment Act, 2020 (No.2) received Royal Assent in the Legislative Assembly and amended the Health Professions Act. Among the numerous amendments, Colleges are required to divest themselves of Association functions. This amendment will enhance regulatory colleges' focus on protecting the public.
Will there be an Indigenous advisory capacity at both the professional Association and the College?
CARNA remains committed to culturally safe and competent care for Indigenous people. We regularly work with an Indigenous advisor both within the organization and at the governance level.
While the new Association will ultimately decide on its direction, cultural safety and humility is a commitment that all organizations should make, including healthcare systems, associations, and regulatory bodies alike. Learning more about racism within our healthcare system and using this knowledge to change practice is an ongoing journey to which the College has fully committed.
Why are council members no longer sectioned by region?
The College Council has moved away from a regional representation model enabling nurses from across the province to serve on Council and use their expertise to support the delivery of the regulatory mandate of protecting the public. This better aligns with the College’s transition to a single mandate. Registrants may contact any of our councilors with questions. If you would like to raise a concern, the Chair would be the best contact.
Does this affect our CCP? Is there a new process to the CCP?
This change will not affect the Continuing Competence Program (CCP). We are however, looking at streamlining the process.
The Health Professions Act (HPA) requires us to establish a continuing competence program for registrants. Nurses must meet the CCP requirements as part of their annual registration renewal.
The CCP ensures that nurses engage in continual professional development to maintain their competence and apply advances in their profession. The CCP contributes to nurses providing safe and competent care to the public.
How will this impact the different councils within the current structure of CARNA ? Will the hearing tribunal / membership need to renew their agreement under a new organization ?
The separation will not change requirements for regulatory committees or hearing tribunals. Our legislative mandate under the Health Professions Act has not changed, which means these committees will continue to function as they always have.
The process to select and appoint members to hearing tribunals and regulatory committees has not changed.
Why is there a need to go through a rebranding again?
The current brand reflects CARNA’s dual mandates (protecting the public and advocating for the profession). The College needs to rename and rebrand to support our transition to a single mandate, and to make it clear to Albertans, employers and registrants that our mandate is to protect and serve in the public interest.
How will the separation of college and association affect the member?
The separation will enable the College to focus on its mandate to protect the public interest. The legislative and regulatory requirements that registrants must meet in order to practice in Alberta are unchanged.
Is there a document that simply outlines the difference between the two separate organizations including their roles and responsibilities?
The Health Professions Act Handbook provides information on a regulatory college’s roles and responsibilities, which is to protect and serve the public. The Health Professions Act and Registered Nurses Profession Regulation establish CARNA’s mandate and outline CARNA’s roles and responsibilities.
An association’s role is to serve members. This role is not outlined in a specific document; however, the new association will be responsible for determining what activities it will focus on in the future.
Some professional organizations that separated the professional association from the professional regulatory body have run into difficulties in sorting out what the association would do and what the professional regulatory body would do. What is the process and criteria which have, or will be, used to decide who will do what?
CARNA’s focus now and in the future will be on fulfilling its roles and responsibilities under the Health Professions Act and Registered Nurses Profession Regulation, which includes registration, professional conduct, continuing competence and setting standards of practice.
The new association is responsible for determining what activities they will focus on to fulfill their mandate to serve nurses.
A previous answer states: "Our Council could see that there was a potential for new legislation that would change our organization and wanted to take the first step, rather than waiting to be mandated to do so." Clearly, the Legislative Assembly did see problems with dual mandate arrangements. Would CARNA have separated College and Association if the Legislative Assembly had not moved in that direction? On its own, had CARNA identified problems with its dual mandate arrangement?
In 2019, CARNA initiated a governance review, and in 2020 the review was complete. It recommended that the organization move to a single mandate. The review identified a number of challenges with continuing to operate under a dual mandate.
On August 19, 2020, CARNA Council unanimously voted in favour of a move to a single mandate regulator. The governance review and Council’s decision occurred before amendments to the Health Professions Act were introduced into the Legislative Assembly in late 2020.
Will the nursing shortage be addressed by CARNA?
The College recognizes the significant challenges nurses are facing and the immense strain on Alberta’s health system. As the pandemic continues, nurses and other healthcare professionals are experiencing increased frustration and exhaustion.
The College’s mandate is to protect and serve the public interest under the Health Professions Act. Within its legislated mandate, the College has taken several steps to address nursing shortages.
The College has introduced no cost emergency permits for former registrants and former RNs or NPs from other jurisdictions (that meet registration requirements). The College is also working with employers to address critical nurse shortages by expediting applications for graduate nurses and nurses returning to practice. Additionally, the College has streamlined its continuing competence program requirements to make them more proportionate and efficient.
Nursing shortages are a very significant issue in our province, and addressing these shortages is a shared responsibility for many organizations.
We are facing the fourth wave of the Pandemic, and the Delta variant is putting extraordinary stress on our healthcare system, but more importantly our healthcare professionals. I understand your role is to protect the public, not Nurses. Yet you seem to be silent regarding the impact of Covid on the public’s ability to access appropriate, safe and competent Nursing care. I am referring to Registered Nurses and their requirement to self assess fitness to practise, and practice according to the standards of care. Fitness to practice in body, mind and spirit as well as being able to work competently in their specific area. Registered Nurses are having their holiday time withdrawn. Registered Nurses are being forced to work in areas outside their expertise. Registered Nurses are facing mandated overtime in many areas. Registered Nurses are being told by our provincial government that they are over paid, layoffs are in the future and are dealing with uncertainty as union contracts are still being negotiated. Registered Nurses are facing public protests outside of some workplaces, some also dealing with verbal harassment and abuse. What actions has CARNA undertaken in light of the current crisis in our province?
The College’s mandate is to protect and serve the public interest under the Health Professions Act. The College appreciates that the ongoing pandemic and other challenges are having a significant effect on nurses, other health professionals and the healthcare system.
The College’s statement on COVID-19 is available here.
In response to challenges brought forward by the pandemic and other situations, the College:
- Developed processes to facilitate and expedite registration,
- Streamlined its continuing competence program,
- Provided registrants with COVID-related practice consultations, among other initiatives,
- Developed resources for nurses outlining what to do if they are asked to perform duties outside of their normal job; and
- Is actively reviewing its regulatory processes and policies to ensure they follow right-touch principles and elements and consider challenges brought forward by the pandemic.
The Alberta Government has also recently announced measures to protect patients, families and health care workers accessing hospitals and other health care facilities. Specifically, protests restricting health-care services will now be subject to the same protection as railways, highways and pipelines receive under the Critical Infrastructure Defence Act. The full statement is available here.