As RNs in British Columbia are painfully aware, the registration renewal fees for the College of Registered Nurses of British Columbia (CRNBC) have been increased this year.

It’s interesting being a spectator to this as a former nurse and former CRNBC registrant, particularly watching the issue develop over social media platforms. I’ve seen a lot of outrage about this increase, much of it criticizing CRNBC for spending nurses’ fees on a fancy waterfront office. Others accuse CRNBC of doing nothing for nurses yet charging such high fees. While my goal here isn’t to criticize what CRNBC does (although I won’t let them off lightly), it is important to understand where this money goes.

The 2017 Fee Increase

 For six years the CRNBC fees have been stable.1 The increase in 2017 wasn’t actually an increase in CRNBC fees because the entire amount a nurse pays when renewing their license does not go to just CRNBC. The increase in 2017 went to two things. First, there was an increase of $12.00 to the funds allocated for the Canadian Nurses Association and the Association of Registered Nurses of British Columbia (ARNBC). In a YouTube video ARNBC attributes this increase in fees to be due to the lawsuits BCNU has raised against them.2 But that’s a blog post for another time.

The increase was also due to the addition of personal liability protection (PLP) through the Canadian Nurses Protective Society (additional fee of $66.41). RNs in BC have had PLP since 2016, but it was paid for with existing funds that year. PLP is offered (and appears to be often required) by nursing regulatory colleges and/or associations across the country, and is not CRNBC singling out BC nurses. Currently BC nurses pay more for PLP because there is also a five-year supplemental fee ($29.25 plus tax) that protects BC nurses for liabilities prior to 2016.3 The final supplemental fee payment will be 2020.

In short, 2017 saw an increase of $78.41. While CRNBC collected this money, none of that was an actual increase to CRNBC fees.

The 2018 Fee Increase

Now, the increase in fees in 2018 will be an actual increase to CRNBC fees. While CNA / ARNBC fees and PLP remain the same as last year, the funds allocated for CRNBC are being raised from $350.40 to $448.95, an increase of $98.55.1 Overall, since 2016 the cost of renewal for a practicing RN has increased $176.96, now sitting at $625.91 per year.1,3 So I can certainly understand why many CRNBC members are upset.

CRNBC renewal increase 3yrgraph
PLP includes GST

According to CRNBC, these additional funds will be allocated as follows:

CRNBC pie graph

CRNBC explains these increases as follows:

“Work required to meet our regulatory mandate has increased. This includes responding to increasingly complaints, the complexity of the investigations, and implementing the quality assurance program. This led to hiring more staff and ultimately the need to move to a new location to accommodate our size. We are also anticipating additional work as we collaborate closely with CLPNBC and CRPNBC to amalgamate the three colleges.”1

Comparison to Other Provinces

Another comment I’ve seen a lot on social media is that BC RNs pay more than other provinces. This isn’t something I knew much about so – being a researcher – I naturally wanted to investigate.

While my inquiry found that BC nurses do pay more than most provinces, they don’t pay the most. That distinction goes to their colleagues in the North, who already have to deal with an outrageously high cost of living.

Regulatory websites
Figures based on a practicing RN trained in Canada who is renewing their license for a full year.

The above figures are listed on the CRNBC website,1 and I double-checked them with the actual websites of each regulatory body (and good thing too because the Ontario figure was incorrect.) While there seems to be a great deal of variation between renewal fees, this may be artificially high. CRNBC groups a number of fees together, while in other provinces they are paid separately. For example, the College of Nurses of Ontario’s renewal fee does not include PLP and membership in the professional association. Some Colleges also include GST/HST in their listed fees, while others do not.

Here’s a more accurate representation of what nurses across Canada actually have to pay out of pocket to be comparable to BC renewal fees (i.e. including registration renewal, PLP, professional association fees if applicable, and tax):

Adjusted fee
PEI excluded due to lack of detail on the ARNPEI website regarding their fee schedule.

This brings the average cost of renewal up from $563.70 ($574.04 when PEI is not included) to $620.68. While there are certainly some outliers impacting this figure, it isn’t quite as far off from CRNBC renewal rates.

Concluding Thoughts and Calls to Action

 Admittedly I’m not fully against the CRNBC fees being increased. Granted, I would probably feel differently if I was still paying for CRNBC registration. But CRNBC needing more money to address new challenges to practice and increased complaints seems logical. Plus there’s been no increase to CRNBC fees for six years. Fees are bound to increase due to organizational growth and inflation.

That being said, CRNBC acquiring waterfront real estate does sound like a rather extravagant use of funds. I’m not sure how true this claim is, but it is listed on their website that they are moving to downtown Vancouver.1 I certainly understand needing a larger space if the organization has expanded. I also understand not wanting it to be a total dump (that would be a bit embarrassing when there are visiting officials and scholars!) But perhaps a more realistic facilities budget needs to be considered.

Nurses upset about the fee increase can do a few different things:

  1. Learn more about CRNBC and ARNBC. You can better utilize these organizations and advocate for change by learning about how both operate.
  2. Demand accountability and transparency from CRNBC and ARNBC. I’ve heard a lot of nurses comment that these organizations don’t seem to do anything for them. This could be due to a lack of transparency, or it could just be a break down in communication. Either way, this isn’t acceptable. Nurses need to know what these organizations are doing, and where their fees are going.
  3. Sign the petition protesting such a dramatic fee increase https://www.change.org/p/crnbc-stop-the-fee-hike
  4. Support the North. Those living and practicing in Northern Canada face greater disparities and inequities when it comes to registration rates, practice conditions, cost of living, access to care, and the health status of their clients. Spread awareness, be an advocate, and be prepared to support your colleagues in Northern and/or rural communities in ways they identify as helpful.

 

Works Cited:

  1. College of Registered Nurses of British Columbia. CRNBC registration renewal fees are increasing for 2018-19. December 5, 2017. Retrieved from CRNBC website https://www.crnbc.ca/crnbc/Announcements/2017/Pages/registration_fees_2018.aspx
  2. Association of Registered Nurses of British Columbia. ARNBC legal update – May 2017. May 4, 2017. https://www.youtube.com/watch?v=w3gcfQeC7do&feature=youtu.be
  3. College of Registered Nurses of British Columbia. 2017 renewal fees for practicing registrants. November 18, 2016. https://www.crnbc.ca/crnbc/Announcements/2016/Pages/2017Fees.aspx
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