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New changes to the Protecting Patients Act

The CMTO would like to notify the industry of recent amendments to the Regulated Health Professions Act, 1991. On May 1st, 2018, changes made by the provincial government came into effect. For Ontario's Registered Massage Therapists (RMTs), most changes are not new, they were contained in the College of Massage Therapists of Ontario (CMTO)'s by-laws and Standards of Practice for Maintaining Professional Boundaries and Preventing Sexual Abuse. The changes relate to the passage of the Protecting Patients Act, 2017, and apply to all regulated health professions in Ontario. The new changes relate to:

May 17, 2018  By College of Massage Therapists of Ontario

1) One-Year Post-Termination Waiting Period Now Legislated;
2) New Information to Appear on CMTO’s Public Register; and
3) Additional Criminal Offenses will Trigger Mandatory Revocation.

1) One Year Post-Termination Waiting Period Now Legislated

The Government of Ontario has now legislated the one-year post-termination waiting period for beginning a sexual relationship with a former client (as is currently outlined in CMTO’s Standards of Practice).

In the legislation, the definition of client, in relation to sexual abuse, will include any individual who was an RMT’s client within one year from the date on which the individual ceased to be the RMT’s client. This means that any RMT who is found to have engaged in a sexual or intimate relationship with a client within one year of the termination of the RMT-client relationship will be subject to mandatory revocation.


The Government of Ontario has also clarified the definition of “patient” (CMTO refers to patients as “clients”) for the purpose of sexual abuse cases. Prior to May 1st, 2018, the definition of “client” was only based on case law and was not specifically defined in the legislation. However, as of May 1st, in addition to the usual indicators of being a client, there are additional new specific criteria in regulation for who will be considered to be a client in the context of sexual abuse.

In addition to the existing indicators from the case law, the new regulation adds that:

An individual is a client of an RMT if there is direct interaction between the RMT and the individual and any of the following conditions are met:

The RMT has, in relation to a healthcare service provided by the RMT to the individual, charged or received payment from the individual or a third party on behalf of the individual.
The RMT has contributed to a health record or file for the individual.
The individual has consented to the healthcare service recommended by the RMT.
If any of the above interactions take place between an individual and an RMT, then that individual will be considered, for the purposes of sexual abuse, to be that RMT’s client.

Further, as described above, that individual will continue to be a client (in the context of sexual abuse) for a minimum of a full year after the termination of the therapeutic relationship.

The regulation provides an exception (from the sexual abuse provisions) if the treatment given to a person with whom the RMT was in a sexual relationship (such as a spouse), was emergency treatment or treatment that was minor in nature, and the RMT has taken reasonable steps to transfer the care of the individual to another registrant. CMTO is currently reviewing emergency/minor care as it pertains to Massage Therapy.

2) New Information to Appear on CMTO’s Public Register

Under the new regulations, CMTO’s public register must now contain the following information:

Criminal or drug offence findings;
Conditions of release for criminal or drug offence charges or findings;
Outstanding criminal or drug offence charges;
Disciplinary findings by another regulator; and
Registration status with another regulator.
As authorized by by-law, CMTO had been proactively collecting some of this information already, and registrants will notice new questions at renewal this year to allow the College to capture this information going forward.

Please remember that the information noted above must be reported by RMTs to CMTO as soon as possible, and RMTs must file another report if/when there is any change to the information (e.g., a criminal charge that was reported to CMTO has resulted in a finding of guilt or been withdrawn).

3) Additional Criminal Offenses will Trigger Mandatory Revocation

The list of mandatory revocation provisions has been expanded. As of May 1st, 2018, under the new regulations the existing mandatory revocation provisions apply to RMTs found guilty of the following offences (listed by criminal code reference):

• 151 – Sexual interference
• 152 – Invitation to sexual touching
• 153 – Sexual exploitation
• 153.1 – Sexual exploitation of a person with disability
• 160 (3) – Bestiality in the presence of or by a child
• 162 – Voyeurism
• 162.1 – Publication, etc., of an intimate image without consent
• 163.1 – Child pornography
• 170 – Parent or guardian procuring sexual activity
• 171.1 – Making sexually explicit material available to a child
• 172.1 – Luring a child
• 172.2 – Agreement or arrangement – sexual offence against a child
• 271 – Sexual assault
• 272 – Sexual assault with a weapon, threats to a third party or causing bodily harm, and
• 273 – Aggravated sexual assault.

The Government of Ontario implemented the changes described above as part of its commitment to eradicate sexual abuse of clients by health professionals. If you have questions about what the changes mean for your practice, please contact the College at

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