WHERE WE STAND
The Ontario Physiotherapy Association (OPA) ensures the voice of its members and the physiotherapy profession is heard on important issues in all areas of the health care system.
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ADVOCACY
Highlights – Ontario Budget 2024
Highlights – Ontario Budget 2024
The 2024 Ontario Budget was released yesterday and highlights for the physiotherapy community include:
- Additional $2 billion over three years in Home and Community Care to address workforce issues including compensation for frontline care providers.
OPA has highlighted the issues faced by rehabilitation professionals in home care in multiple submissions and meetings and will continue to advocate for the inclusion of physiotherapists in the roll out of this funding.
- $546 million over three years for new and expanded interprofessional primary care teams to ‘connect people to a range of health professionals who work together, including doctors, nurse practitioners, registered and practical nurses, physiotherapists, social workers and dietitians, among others. Interprofessional primary care teams enhance the quality of patient care, improve health outcomes, and increase the efficiency of health service delivery by relieving pressures on emergency departments and walk‐in clinics.’– 2024 Ontario Budget, p. 85
OPA is very pleased to see physiotherapists included specifically in this funding and encourage the Government to move forward with fully implementing the remaining scope of practice changes from Bill 179 to optimize the impact primary care can have on system pressures.
Auto Insurance
- EHB as first payor: ‘The government will be proposing to make auto insurance pay for medical and rehabilitation benefits following an auto accident before extended health care plans do. This would apply to all automobile accidents, regardless of the injury sustained. The proposed change would ensure that auto insurance companies pay for health care costs before extended health care plans and it would also help reduce paperwork and red tape for patients and their health care providers.’– 2024 Ontario Budget, p. 74
- Review the Professional Services Guideline fees: ‘The government is committed to ensuring that those injured in auto accidents continue to receive the care they need and that health service providers are compensated appropriately for their services. The government is requesting that the Financial Services Regulatory Authority of Ontario (FSRA) review the Professional Services Guideline and the Attendant Care Hourly Rate Guideline, and consider updating these guidelines based on their findings. The government will consider FSRA’s findings in future reviews of the Statutory Accident Benefits Schedule.’ – 2024 Ontario Budget, p. 74
These are important first steps in addressing these issues for which OPA has long been advocating, most recently in our Pre-Budget Submission on January 30, 2024. OPA will continue to advocate for improved access and reduced barriers to receiving care after motor vehicle accidents and for fair compensation for providers.
Contact Amy Hondronicols, Director, Practice, Policy and Member Services with any questions.
Provisional Practice and Entry to Practice
CPO’s Consultation on Ontario Clinical Exam Fees By-law – November 23, 2022
OPA submitted a response to the College of Physiotherapists of Ontario’s (CPO) by-law consultation for the Ontario Clinical Exam fees.
The submission supports the cost-recovery approach detailed by CPO, especially in light of the recent fee increase to all registrants. However it also highlights concerns around the potential financial impact on candidates.
OPA highly recommends that the bylaw be reviewed at the earliest opportunity to ensure no unintended impact on health human resources in Ontario.
Updated Eligibility for Exemption from PCE-Clinical for Provisional Practice Registrants – March 9, 2022
The College of Physiotherapists of Ontario (CPO) has updated the eligibility criteria for their Policy for Exempting Provisional Practice Registrants from the PCE-Clinical. This Policy provides guidance for the CPO’s Registration Committee to allow individuals under provisional practice to apply for an Independent Practice Certificate. The updated eligibility criteria outlines that you may be eligible if:
- If you have accumulated 1,200 hours since receiving your Provisional Practice certificate
- If you have at least one College-approved Practice Supervisor who has supervised you for at least 600 hours over 6 months (you do not have to work with at the same employer/practice location)
- If you have worked at no more than 4 employers/practice locations
For more detailed information on eligibility and next steps, along with how to submit an application, please visit the College website. Please review the College’s FAQ as well.
OPA supports the expansion of the eligibility criteria as it will allow more Physiotherapy Residents to apply for an Independent Practice. There are still candidates who do not have a pathway to independent practice as this time including those who are not eligible for provisional registration. OPA continues to work with the College, Academic Leaders and other stakeholders to move forward solutions for all who have been impacted by delays in registration for independent practice in Ontario.
Update on Entry to Practice – February 9, 2022
On February 2, 2022 the Council of the College of Physiotherapists of Ontario (CPO) passed a motion to submit a proposed amendment to the General Regulation (O. Reg 532/98) under the Physiotherapy Act, 1991 to the Ministry of Health as an emergency regulation change. The amendment, should it be passed by the government, would enable those who have failed the practical examination one time to apply to the CPO Registration Committee to be eligible to practice provisionally (with or without additional terms and conditions) in exceptional circumstances such as when the practical examination is not available. Details on the amendment can be found in the materials for the meeting.
OPA has, and will continue to support actions that move forward solutions for candidates affected by the lack of an available practical examination. We are concerned though that solutions proposed or implemented to date are not comprehensive enough to meet the specific circumstances of many candidates who face barriers to timely entry to practice. As this amendment would enable a process for application for provisional registration (with or without additional terms and conditions), and applications will be evaluated on an individual basis, it is unclear why candidates who failed the practical examination twice, and are eligible to take the practical examination again, are not included. OPA has reached out to the CPO to seek clarification on this and requested more information on next steps in the submission of the emergency regulation change.
We continue to work with the College, Academic Leaders and other stakeholders to move forward solutions for all who have been impacted by delays in registration for independent practice in Ontario.
Joint Statement from Branches of the Canadian Physiotherapy Association – January 20, 2022
Provincial/territorial Physiotherapy Associations across the country have been working with regulators, academic leaders and government (where applicable) to speed up solutions for the full entry-to-practice for candidates affected by delays in the clinical component of the Physiotherapy Competency Examination (PCE).
In response to the announcement by the Canadian Alliance of Physiotherapy Regulators (CAPR) regarding the discontinuation of the clinical component of the PCE and the statement from the Canadian Physiotherapy Association (CPA) we have noted some concerning misinformation on various social media platforms. As Branches of the CPA we have joined in this statement to ensure that candidates have the information they need to understand the impact of this announcement.
The discontinuation of the provision of the clinical component of the examination by CAPR does not remove any requirements referring to clinical or practical examinations within bylaws or regulations for entry to independent practice specific to each province and the Yukon.
As a result there is no consistent, national process for entry to independent practice. With each province and the Yukon acting individually to determine how to meet their requirements, candidates face different challenges depending on where they are seeking licensing/registration. The loss of a component of a national examination, where it is still embedded in College bylaws and/or regulations, impacts most jurisdictions, especially smaller ones with more limited resources. In addition, for some candidates, including those who have previously failed the clinical examination, and who have not been eligible for alternate routes to independent practice proposed to date in most provinces, this announcement removes any hope that a clinical examination would be available nationally within the first months of 2022.
Though we welcome the announcement as a clarification of CAPR’s intent moving forward, we call on all national stakeholders – association, regulators, academics, and accreditor – to work in partnership and engage with experts and candidates to determine a national process for entry to independent practice as soon as possible. In the interim the provincial/territorial Associations across Canada will continue to work together and with all stakeholders, sharing resources, advocating and working to remove barriers to independent practice in each region.
Manitoba Physiotherapy Association
New Brunswick Physiotherapy Association
Newfoundland and Labrador Physiotherapy Association
Nova Scotia Physiotherapy Association
Ontario Physiotherapy Association
Physiotherapy Association of British Columbia
Physiotherapy Association of Yukon
Prince Edward Island Physiotherapy Association
Saskatchewan Physiotherapy Association
OPA’s Submission to CPO’s Consultation on Registration Regulation – January 7, 2022
OPA submitted feedback and recommendations to the College of Physiotherapists of Ontario’s (CPO) consultation on their proposed registration regulatory amendments. The submission focused on areas of the regulation and proposed changes that would, or potentially could, create barriers to fair, timely, and safe entry-to-practice for applicants that are not necessary for public protection. Main points included:
- The definition of examination for the purpose of entry-to-practice and the need to ensure that ‘practical component’ is not embedded in the regulation
- How exceptional circumstances are determined
- The roles of Council and the Registration Committee
- The criteria for exemptions
In addition to regulatory changes, OPA advocates for, and devotes our resources to achieving pathways to registration for affected candidates. We continue to work with stakeholders involved in this issue to move solutions forward.
Pathway to Independent Practice Registration in Ontario – December 21, 2021 Update
The College of Physiotherapists of Ontario (CPO) announced the approval of their Policy for Exempting Provisional Practice Class Registrants from the PCE-Clinical. On December 14, information and FAQs regarding this policy were posted that addresses questions from Physiotherapy Residents and other individuals. OPA has met with the College to highlight specific concerns including the requirement for 600 hours with supervisor at same worksite, and seek clarity on what timelines are being applied to the ‘1200 hours over a year’ requirement.
We strongly encourage all who have questions or concerns regarding the exemption policy after reviewing the FAQs in the link above to share those directly with the College in addition to bringing them to our attention.
At the CPO Council meeting, two additional next steps were approved by Council including:
- Access to a French language examination through the University of Sherbrooke; and
- Approval to proceed with development of a pathway to independent practice registration through a clinical exam based on elements of the CPO’s Quality Assurance (QA) program.
It was also stated in the briefing materials and in the meeting that additional solutions are being pursued to ensure a pathway to independent practice for all candidates including those not currently eligible for provisional practice.
Though OPA supports these developments as a step forward, we remain concerned about the timelines for implementation and the impact on candidates who, at this time, do not have a solution that will address their specific situation. We continue to work with the College, Academic Leaders, and other stakeholders to expedite solutions for all who have been impacted by delays in registration for independent practice in Ontario.
Announcement from the College of Physiotherapists of Ontario Regarding Independent Practice Registration – December 9, 2021 Update
The CPO communicated the December 7th decision of the Registration Committee to approve a Policy for Exempting Provisional Practice Class Registrants from the PCE-Clinical. This policy will allow the waving of the requirement of the Physiotherapy Competency Exam (PCE) for some applicants with a current Provisional Practice Certificate and facilitate an application for Independent Practice. The announcement set out specific eligibility criteria, timelines when further information will be available and when the application processes will begin.
Though there are many questions regarding this announcement OPA does support it conditionally as the first of many steps to address the needs of all candidates who are waiting for a pathway to independent practice. We are hearing from candidates and members who are expressing concerns regarding the criteria and/or are seeking further information on this announcement. We encourage you to submit your questions to the College as they work to provide more information through the forthcoming FAQs.
We anticipate further information on next steps from the College to be included in the December 15 and 16 Council Meeting. We encourage you to visit the College website for access to meeting materials and the livestream link to the meeting when available.
Independent Practice Registration for Ontario Physiotherapy Candidates – October 18, 2021 Update
At their meeting on October 14 the College of Physiotherapists of Ontario (CPO) Council passed several motions to move forward the work to expedite the registration of candidates affected by the delays in the clinical component of the national examination. These motions directed the following actions:
- To pursue other mechanisms to facilitate the granting of independent practice certificates until such time as CAPR examinations are once more available
- To recommend that the Registration Committee explore the use of its authority to exempt individuals and groups of candidates from the clinical exam requirement
- The exploration of the defensibility and appropriateness (legal and psychometric assessments) of designating the College’s QA program as an alternate to the clinical examination
- The approval in principle of the proposed changes to the College’s registration regulation.
OPA supports the pursuit of multiple options to expedite the registration process and safe entry to practice for candidates especially the use of the QA program and exemptions as the timeliest of options available.
In a follow-up letter to CPO President Theresa Stevens, OPA President Paulette Gardiner Millar shared our support on these steps and the critical importance of clarifying timelines for addressing these motions and regular communications on this work so that all, especially candidates, are informed of progress. OPA also proposes a multi-stakeholder meeting inclusive of the College, Association, five Ontario academic programs and IEPT bridging program to share resources and expertise in order to help move this work forward.
OPA remains committed to working with the College, our academic leaders and all stakeholders towards an expedited path to full registration for qualified candidates.
Next Steps to Expedite Independent Practice Registration for Physiotherapy Candidates – September 21, 2021 Update
OPA is pleased that the College of Physiotherapists of Ontario has stated that it places a priority on finding a solution to quickly address the barriers faced by approximately 1000 physiotherapy graduates in registering for independent practice. However, we are concerned that in a special meeting of the College Council held on September 20, 2021, the solutions proposed focused primarily on continuing with a clinical exam component and not on the full exploration of options that would expedite solutions to this crisis. Those solutions include changes in regulation, discretionary authorities of the Registration Committee to grant exemptions for those who qualify, or other avenues to assess competency at the entry to practice level. The urgency of the issues requires a strategy consisting of multiple options moving forward at the same time so that viable solutions are available as soon as possible.
In a letter to the College and shared with the Fairness Commissioner and the five Ontario physiotherapy academic programs we have set out regulatory changes and concurrent options available within regulation including our support of the proposed solutions outlined in the open letter from the five Ontario Physiotherapy Programs.
OPA remains committed to working with the College, our academic leaders and all stakeholders towards an expedited path to full registration for qualified candidates.
Entry to Practice Issue for Ontario Candidates – September 16, 2021 Update
With the Canadian Alliance of Physiotherapy Regulators (CAPR) announcement that all future scheduled virtual clinical exams are cancelled and that they would be returning to in-person examinations at a future date (to be determined), candidates in Ontario are facing further unacceptable delays to entry to full licensure as physiotherapists in the province.
OPA has been meeting with the College of Physiotherapists of Ontario (CPO) prior to the announcement by CAPR and since then to find solutions that expedite the full licencing of qualified candidates. We are pleased to receive the notice from the CPO of the Special Meeting of Council which will be held on Monday to consider options to address the cancellations. View information about the meeting.
We have held firm in our position that there needs to be an expedited path to full registration for qualified candidates.
OPA continues to advocate for regulatory changes that will allow greater flexibility in determining entry to practice processes especially in times like the pandemic. At the same time work on options currently available through registration and quality management to safely register candidates must move forward now to address this crisis. There are complexities with any changes and OPA continues to offer all available resources to work with the CPO and other stakeholders to get this work done.
Cancellation of the Virtual PCE – September 14, 2021 Update
The Ontario Physiotherapy Association is disheartened that once again the virtual PCE was unsuccessful and is now cancelled. We strongly empathize with all of the candidates and want to express our full support at this time.
We continue to work closely with the College of Physiotherapists of Ontario and all stakeholders to find and implement the most expedient path forward to full registration.
Canadian Alliance of Physiotherapy Regulators Announcement
Message Regarding the Virtual PCE – September 13, 2021 Update
The Ontario Physiotherapy Association expresses our full support to all candidates in the face of the ongoing issues with the virtual PCE. We continue to work with the College of Physiotherapists of Ontario and all stakeholders to find and implement the most expedient path forward to allow full registration of our candidates to provide safe and competent care to Ontarians.
The issue was highlighted nationally through the CBC Vancouver story.
Message Regarding the Relaunch of the Virtual PCE – September 9, 2021 Update
The Ontario Physiotherapy Association (OPA) joins with the College of Physiotherapists of Ontario (CPO) to express our deep disappointment with the challenges with the Canadian Alliance of Physiotherapy Regulators (CAPR) exam held on September 8. As noted in the statement from the CPO though some candidates were able to complete the exam successfully others faced obstacles that caused delays or the need to reschedule completion of the exam. We have directly heard from candidates and members of the impact of these challenges including the personal and professional costs.
Though it is our sincere hope that issues experienced yesterday are addressed and that all candidates will be able to successfully complete the next exam scheduled for Saturday September 11, it is incumbent on all that we be ready as soon as possible should an alternate pathway to registration be needed. OPA has been in discussions and will continue to work with the CPO and all stakeholders on the most expedient path to allow full registration of our candidates to provide safe and competent care to Ontarians.
We also restate our call for a multi-stakeholder approach to address the critical questions surrounding the future of entry to practice processes and examinations in Ontario and nationally. So much has been learned through these challenges and together we can find a better way forward for the physiotherapy community of Canada.
We express our full support to all candidates and will update all as soon as possible.
Entry to Practice – June 23, 2021 Update
The Fairness Commissioner of Ontario (FCO) has written to the College and the letter can be seen on pages 17-22 of the Council package.
OPA is pleased to see that the letter included recommendations to improve communications with candidates and explore an alternate approach to entry to practice that would expedite that process when the current process is not available. The letter states: states: “The OFC believes that, to effectively act upon this important objective, regulators need to implement fair and efficient registration processes. It is imperative that registration pathways proceed expeditiously both in normal times, but particularly during emergency situations. It is not acceptable, for example, that registration processes stop applicants “in their tracks” during a pandemic.”
OPA wrote on June 18, 2021 to the College to offer our full cooperation and assistance in acting on the advice tendered in the letter of the FCO. We are fully committed to collaborating with the College to resolve the situation delaying entry to practice in both the short and long terms and to expedite a path to registration as soon as possible for those who have been affected.
At the College Council meeting on June 22, 2021, Council passed a motion to now begin exploring whether the approaches taken in BC and Alberta would be feasible as an alternate approach or if another approach is needed should the CAPR exam not be successfully implemented at end of August and fall. That work would begin now to ensure that a process would be available as soon as possible if needed. We are very pleased to see this critical work being prioritized by the CPO.
Delays in Registration for Independent Practice – June 16, 2021 Update
In response to OPA’s letter, we were pleased to meet with the Fairness Commissioner of Ontario (FCO), Irwin Glasberg, to discuss the delays and need for an interim solution from the College of Physiotherapists of Ontario to expedite entry to practice. We thank all, both internationally educated and new graduates from Ontario programs, who shared their stories and impact statements. They were anonymized and shared with the FCO. OPA also used data from our recent Health Human Resource survey to demonstrate how this situation has contributed to shortages of available physiotherapists. All helped make the case for urgency for an interim solution as BC and Alberta have done. As a result of the meeting with the FCO, OPA has written to the Assistant Deputy Minister (ADM) responsible for health professions at the Ministry of Health and requested a meeting.
Help Amplify Our Voice! Write your MPP and amplify the voice of the profession.
Message Regarding the Virtual PCE – September 13, 2021 Update
The Ontario Physiotherapy Association expresses our full support to all candidates in the face of the ongoing issues with the virtual PCE. We continue to work with the College of Physiotherapists of Ontario and all stakeholders to find and implement the most expedient path forward to allow full registration of our candidates to provide safe and competent care to Ontarians.
The issue was highlighted nationally through the CBC Vancouver story.
Message Regarding the Relaunch of the Virtual PCE – September 9, 2021 Update
The Ontario Physiotherapy Association (OPA) joins with the College of Physiotherapists of Ontario (CPO) to express our deep disappointment with the challenges with the Canadian Alliance of Physiotherapy Regulators (CAPR) exam held on September 8. As noted in the statement from the CPO though some candidates were able to complete the exam successfully others faced obstacles that caused delays or the need to reschedule completion of the exam. We have directly heard from candidates and members of the impact of these challenges including the personal and professional costs.
Though it is our sincere hope that issues experienced yesterday are addressed and that all candidates will be able to successfully complete the next exam scheduled for Saturday September 11, it is incumbent on all that we be ready as soon as possible should an alternate pathway to registration be needed. OPA has been in discussions and will continue to work with the CPO and all stakeholders on the most expedient path to allow full registration of our candidates to provide safe and competent care to Ontarians.
We also restate our call for a multi-stakeholder approach to address the critical questions surrounding the future of entry to practice processes and examinations in Ontario and nationally. So much has been learned through these challenges and together we can find a better way forward for the physiotherapy community of Canada.
We express our full support to all candidates and will update all as soon as possible.
Entry to Practice – June 23, 2021 Update
The Fairness Commissioner of Ontario (FCO) has written to the College and the letter can be seen on pages 17-22 of the Council package.
OPA is pleased to see that the letter included recommendations to improve communications with candidates and explore an alternate approach to entry to practice that would expedite that process when the current process is not available. The letter states: states: “The OFC believes that, to effectively act upon this important objective, regulators need to implement fair and efficient registration processes. It is imperative that registration pathways proceed expeditiously both in normal times, but particularly during emergency situations. It is not acceptable, for example, that registration processes stop applicants “in their tracks” during a pandemic.”
OPA wrote on June 18, 2021 to the College to offer our full cooperation and assistance in acting on the advice tendered in the letter of the FCO. We are fully committed to collaborating with the College to resolve the situation delaying entry to practice in both the short and long terms and to expedite a path to registration as soon as possible for those who have been affected.
At the College Council meeting on June 22, 2021, Council passed a motion to now begin exploring whether the approaches taken in BC and Alberta would be feasible as an alternate approach or if another approach is needed should the CAPR exam not be successfully implemented at end of August and fall. That work would begin now to ensure that a process would be available as soon as possible if needed. We are very pleased to see this critical work being prioritized by the CPO.
Delays in Registration for Independent Practice – June 16, 2021 Update
In response to OPA’s letter, we were pleased to meet with the Fairness Commissioner of Ontario (FCO), Irwin Glasberg, to discuss the delays and need for an interim solution from the College of Physiotherapists of Ontario to expedite entry to practice. We thank all, both internationally educated and new graduates from Ontario programs, who shared their stories and impact statements. They were anonymized and shared with the FCO. OPA also used data from our recent Health Human Resource survey to demonstrate how this situation has contributed to shortages of available physiotherapists. All helped make the case for urgency for an interim solution as BC and Alberta have done. As a result of the meeting with the FCO, OPA has written to the Assistant Deputy Minister (ADM) responsible for health professions at the Ministry of Health and requested a meeting.
Help Amplify Our Voice! Write your MPP and amplify the voice of the profession.
Ontarians need more physiotherapists now and it is time for a Plan B for entry to practice process in Ontario!
1. Close to 1000 qualified physiotherapy candidates are waiting to practice their chosen profession
- It has been impossible for new graduates and internationally educated to register with the College of Physiotherapists so they can enter independent practice in Ontario since November 2019 when the last clinical component of the national examination* was held.
- June 2020 and the November 2020 exams were cancelled as pandemic restrictions prevented in-person exams.
- The March 2021 virtual exam was cancelled due to technical issues and others scheduled for June and November also cancelled.
- At the earliest, virtual exams by CAPR are expected to start by the end of August or early fall but it will take time to address the backlog which, in Ontario, will be well over 1300 by fall of 2021.
*The exam used for registration purposes by physiotherapy regulators in Canada, including the College of Physiotherapists of Ontario, is offered by the Canadian Alliance of Physiotherapy Regulators (CAPR). The exam has two components, written and clinical and passing both components is the current requirement for registering for independent physiotherapy practice in Ontario.
2. Physiotherapists are needed now to address the current health care crisis and future needs of Ontarians.
- We are experiencing an unprecedented shortage of physiotherapists in Ontario just at a time that demand is expected to grow tremendously due to the backlog of surgeries and other procedures and the impact of long COVID-19 restrictions.
- In a survey OPA recently conducted, 87 respondent organizations reported 133 vacancies for physiotherapists – in private clinics, hospitals, home care and in urban and rural and northern – no area of the province has not felt the impact of the lack of available physiotherapists.
- 43% of respondents indicated that delays in the clinical exam have impacted their health human resources.
3. Time is now for the College of Physiotherapists of Ontario to put forward an interim ‘Plan B’.
- The importance of a national approach to entry level competencies and registration for practice is not in question but relying on one option with no alternative or plan B should the exam not be available has limited entry to practice for qualified candidates when they have been most needed by r Ontarians.
- The College has a legislated duty, as a matter of public interest, to ensure that the people of Ontario have access to adequate numbers of qualified, skilled and competent regulated health professionals (RHPA Schedule 2 Health Professions Procedural Code). They also have the authority to set or approve the registration examination (Regulation 532/98) and are not obligated to rely solely on the Alliance exam.
- There are viable solutions that mitigate risk, address public safety and can be implemented while the CAPR clinical examination is not available now or any time in the future.
- Physiotherapy Alberta – the regulatory college has engaged the Faculty of Rehabilitation Medicine Continuing Professional Education Unit University of Alberta to administer an in- person, hands-on, 12 station exam based on the CAPR exam blueprint. The exam will be available to those who have been under provisional licence since March 2020 and will offered June 11 and 12.
- College of Physical Therapy of BC has expedited bylaw changes supported by the Ministry of Health to be able to substitute a clinical evaluation administered by UBC that assesses entry level competence when the clinical component of the CAPR exam is not available – they will run their exam on June 24.
- The CPO has just completed a multi-year review and update of their quality assurance program which includes an online screening review and onsite assessments. Both of which can be expedited for any individual or group to mitigate any risks in advancing to independent practice those who have passed the qualifying written examination and have only the clinical component left to meet the current registration requirements.
- Waiting any longer is not an option for needed health human resources for the physiotherapy and, more importantly, the health of Ontarians.
May 12 Update
OPA has a long history of collaborative work with the College of Physiotherapists of Ontario on behalf of the public and the profession. We have brought the issues faced by those impacted by the delayed national clinical examination over the time of the pandemic to the attention of the College many times and we remain committed to working with the College and all stakeholders to expedite a solution so that qualified candidates can enter practice as soon as possible. Nevertheless, due to the lack of transparency and action by the College, we have reluctantly concluded that we have no option but to elevate this matter to the Fairness Commissioner of Ontario on behalf of candidates and the public. We will update members when we have more information.
Letter to the Fairness Commissioner – May 12, 2021
Letter to the College of Physiotherapists of Ontario – May 5, 2021
Letter from the College of Physiotherapists of Ontario to OPA – May 11, 2021
Statement from the Ontario Physiotherapy Association regarding the Physiotherapy Competency Examination – March 22, 2021 Update
On March 20-21, 2021 the clinical component of the Physiotherapy Competency Examination (PCE) was again postponed this time due to technical issues. This represents the third cancellation of the examination since the beginning of the pandemic. We acknowledge that these delays are not acceptable and have resulted in significant personal and professional hardship for candidates.
At this time the health care system must increase its capacity to meet the diverse health needs of Ontarians. This situation will negatively impact the availability of qualified physiotherapists to meet this increasing demand. This will be amplified with higher numbers of registered physiotherapists choosing to exit the profession as they near retirement age during these challenging times.
The Ontario Physiotherapy Association (OPA) supports the call to action by the Canadian Physiotherapy Association (CPA) and associations across Canada to ensure that any exam fees paid by candidates be reimbursed and that regulatory Colleges in each province engage in processes to facilitate entry to practice by candidates as soon as possible.
Specifically OPA calls on the Council of the College of Physiotherapists of Ontario to:
- Petition the Minister of Health for regulatory changes to Ontario Regulation 532/98 section 23 to allow for the up to 77 candidates who were not successful in their challenge of the clinical exam in November 2019 to practice under a renewed provisional license; and
- Set and approve the Qualifying Exam (the written examination) given and adjudicated by the Canadian Alliance of Physiotherapy Regulators (CAPR) as the examination that fulfills the requirement for Independent Practice.
All candidates who are eligible to challenge the clinical exam have completed physiotherapy degree programs through accredited Canadian Universities or have been educated internationally and credentialed individually through a rigorous process by CAPR. They have completed the knowledge testing Qualifying Examination successfully. All will be subject to the regulation and standards of practice by the College of Physiotherapists of Ontario and quality management programs and other systems can be adjusted to mitigate any concerns by these proposed actions.
These are extraordinary times. Where regulation becomes a barrier to meeting the needs of Ontarians and our health system, it must be addressed. We request the Council of the College of Physiotherapists of Ontario consider and implement these proposed actions and steps that both meet the bar for public safety and allow the profession of physiotherapy to respond to the challenges of today and the future on behalf of all the people of Ontario.
Provisional Practice and Entry to Practice – December 2020 Update
In Ontario, a provision within Regulation 532/98, section 23 under the Physiotherapy Act does not allow an individual who has not been successful in their first attempt of the clinical exam to continue to practice as a physiotherapist resident or to apply for a provisional practice certificate of registration. As a result of the pandemic, the Canadian Alliance of Physiotherapy Regulators had not been able to administer the clinical part of the national exam since November 2019. This has led to some 77 individuals in Ontario being unable to practice under a provisional practice certificate, some for up to a year, since the first attempt of the clinical exam. There are many implications of this including: for individuals they lose the opportunity to practice in a supervised setting and maintain their skills in preparation for their second attempt at the exam, and for the health system it represents a challenge to meeting increased demand for health professions during the time of the pandemic.
On Dec 1, 2020 Paulette Gardiner Millar, OPA President, on behalf of the Board of Directors, wrote to the President of the College of Physiotherapists of Ontario Council asking them to consider taking remedial action to address these concerns for this cohort and future cohorts affected by delays in examinations during the pandemic.
Manulife FollowMe Plan
Joint advocacy, OPA and CPA, alongside grassroots member action resulted in a reversal of the removal of physiotherapy coverage for 19 or younger and 65 or older Ontarians on the Manulife FollowMe Plan. In addition the new requirement for a referral to access physiotherapy for policy holders across Canada has been cancelled.
OPA thanks our partner CPA, members and the public for reaching out and their advocacy and Manulife for their responsiveness and their decision to reverse these impending change to physiotherapy coverage.
Physiotherapy is essential healthcare and the reversal of these changes will ensure that timely access to care for Ontarians with these policies continues.
COVID-19 Pandemic
Read all the OPA advocacy initiatives during the COVID-19 pandemic
Home Care
Home Care Modernization – November 8, 2023
OPA has submitted a response to proposed changes in the home care sector through Home Care Modernization. We took this opportunity to re-emphasize our concerns regarding the issues identified by members including those on working conditions and non-equity in compensation between professions and regions in this sector.
Virtual Fees for Physiotherapy in Home Care – Important Update
OPA has advocated successfully for significant changes to how virtual visits are valued and how wellness checks impact total number of visits available to patients. The OPA Home Care Advisory Committee provided insightful information and evidence that was instrumental in supporting our many discussions and communications with the Ministry on virtual fees in home care. With this critical input OPA was able to present concerns to the Ministry of Health regarding the interim home care virtual fees and the concern of short ‘well check’ visits taking away from a patient’s complement of full scope visits. This work was in addition to our collaboration with the shared and individual advocacy of our rehabilitation health professional associations in home care colleagues
The Ministry updated billing codes for virtual home care delivery and virtual visits will be valued at the same rates as in-person visits in all regions of the province. Effective November 24, LHINs and approved agencies are to apply the same locally negotiated rates for care provided virtually for the full scope of the planned visit as for services delivered in-person. This billing structure will be in place until at least March 31, 2021 with ongoing review to inform a sustainable approach to virtual care in the home care sector. In addition, the memo from the MOH indicates that Wellness/Health Check-ins and Assessment or Care Monitoring visits should be used to complement and do not replace full scope professional visits. It is noted that ‘additional visits may be required to ensure client care is not reduced due to the use of these (Wellness/Monitoring) virtual visits.’
Read the memo re: updated to billing codes for virtual home care delivery
Advocating for Equitable Rates for Physiotherapy Providers through Home & Community Care
On April 17, the Ministry issued a memo outlining their COVID-19 Plan for home and community, including updated guidelines for virtual visit rates. Though we were pleased to see the recognition that the per visit rate should be increased for full scope visits by the professions, rates varied significantly between the professions and what would define a full scope visit was to be determined by each LHIN. These matters were addressed in a letter to government submitted by OPA on behalf of the profession and a separate joint letter signed by the Ontario Associations representing OT, Dieticians and Social Workers. OPA has also requested a follow up meeting with the Executive Lead, Ontario Health Teams and the Director, Home and Community Care Branch, at the Ministry of Health.
Read the Joint Association letter
On March 31, the Associations representing dietitians, rehabilitation therapies and social work regulated health professions in home care jointly submitted a letter to the Director, Home and Community Care Branch, Ministry of Health to bring attention to the issue of funding for virtual visits in home care, the availability of PPE and the impact on health human resources and access to care in the home.
WSIB
Annual WSIB Fee-for-Service Increases 4.4% – Effective January 1, 2024
Effective January 1, 2024, in line with the consumer price index (CPI), a 4.4% increase to fee-for-service service codes will be applied. Fee schedules and billing information have been updated on the WSIB website.
All services up to and including December 31, 2023 should be billed under the current service fees. The new fees apply to services delivered on or after January 1, 2024.
Auto Insurance
November 2, 2022 Update: Included in the recent government of Ontario budget were goals to reduce the red tape in the auto insurance system that impact Ontarians. OPA, as Co-Chair of the Coalition of Health Professions in Auto Insurance, wrote a letter to the Minister of Finance, Hon. Peter Bethlenfalvy. The Coalition reiterated our position that, on behalf of consumers and claimants, removing the requirement to access employer-based extended health care benefits prior to accessing auto insurance benefits is critical to reducing red tape, ease access to needed health care and reducing complexities in the system for claimants and providers.
On March 27, the Coalition sent a letter to the Insurance Bureau of Canada, FSRAO, and the Minister of Finance outlining guiding principles and recommendations to ensure that Ontario’s auto insurance industry can temporarily adapt its policies and processes for accident benefits to ensure safe and efficient care delivery during this time.
Recommendations included:
- Funding services accessed through virtual care, including telephone and/or video contact with clients
- Adjustments to provisions under the Minor Injury Guideline (MIG), Medical and Rehabilitation and Attendant Care Benefits (Non-Minor), Insurer’s Examiners (IE)
- Provisions to the administration processes including completion/submission of forms and receiving payment
- Funding support for caregivers fulfilling PSW roles
- Funding to ensure appropriate access to personal protective equipment (PPE)
POSITION STATEMENTS
SUBMISSIONS & RESPONSES
OPA Submission to CPO – August 13, 2024
OPA submitted comments to the College of Physiotherapists of Ontario on the open consultation on four Standards:
- Collaborative Care Standard
- Conflict of Interest Standard
- Dual Practice Standard (NEW)
- Infection Prevention and Control Standard
This is the third set of consultations in the CPO’s process of adapting the revised Core Standards of Practice for Canadian Physiotherapists, developed in 2023 by the Canadian Alliance of Physiotherapy Regulators.
Pelvic Floor Muscle Training Submission – June 4, 2024
We are pleased to provide our feedback to the Ontario Health’s draft recommendation on Pelvic Floor Muscle Training for Stress Urinary Incontinence, Fecal Incontinence, and Pelvic Organ Prolapse.
OPA supports the recommendation for publicly funding pelvic floor muscle training for stress urinary incontinence and pelvic organ prolapse. We commend Ontario Health for recognizing the evidence for this intervention, and how public access will help ensure that Ontarians have the rehabilitative care needed to improve their function, health, and quality of life.
In this submission, OPA highlights the following areas with further comments:
- The role of physiotherapists
- Equitable patient care: reducing stigma and increasing access
- Additional considerations to support cost-effectiveness
- Feasibility: how physiotherapists are currently prepared and equipped to act on
this recommendation - Need for consultation
OPA is committed to supporting any outcomes from this recommendation through consultation with experts in pelvic health, research and system planning.
OPA Letter to the Minister of Health & Meetings with MPs – May 28, 2024
During National Physiotherapy Month in May, OPA joined CPA and physiotherapists to meet with federal MPs from Ontario ridings, with more to come in the next few weeks. These meetings have highlighted the benefits of full implementation of physiotherapy scope of practice, and how enabling physiotherapists to order diagnostic imaging and lab tests will improve care for the people of Ontario while reducing costs.
Some of the meetings to date:
- Pam Damoff, MP Oakville-North Burlington
- Peter Fragiskatos, MP London North Centre
- Lindsay Mathyssen, MP London-Fanshawe
- Anthony Rota, MP Nipissing-Timiskaming
- Valerie Bradford, MP Kitchener South-Hespeler
OPA President, Courtney Bean, and OPA CEO, Sarah Hutchison, have followed up with Ontario’s Minister of Health, Sylvia Jones, and requested a meeting with her and the Deputy Minister, to discuss the outstanding regulations needed.
OPA Letter to the Minister of Health & Meeting with MPP France Gélinas, PT – April 30, 2024
On Tuesday, April 23, 2024, OPA had the privilege of meeting virtually with MPP France Gélinas, PT, to discuss a letter OPA sent a few days prior to the Minister of Health, Sylvia Jones. Many thanks to Ms. Gélinas, who delivered the letter to Minister Jones that day, for her support for physiotherapists and her work to improve healthcare for Ontarians.
The letter calls for action by the provincial government to fully implement the scope of practice of physiotherapists already passed in legislation in Bill 179. The regulation changes needed for physiotherapists to order diagnostic imaging and lab tests have been outstanding for too long. With scope of practice as the focus for National Physiotherapy Month, it is a timely reminder of how full scope implementation will improve access to health care, cost-effectiveness, and health outcomes for the people of Ontario.
OPA Letter to the Minister of Health – Scope of Practice – August 8, 2022
There are many challenges facing the health system and OPA strongly believes that allowing physiotherapists to work up to their full legislated scope of practice would be one solution to improve the efficiency and effectiveness of healthcare in the province. More and more, we are hearing that same message from system leaders and decision-makers, including a recent article in the Toronto Star that cited optimizing the scope of practice of professions, such as pharmacists and physiotherapists to respond to these challenges.
OPA has written to the Minister of Health, The Honourable Sylvia Jones, M.P.P., to congratulate her on her appointment and to seek completion of the remaining regulations needed to fully implement the scope of practice of physiotherapists (i.e., ordering diagnostic imaging and laboratory tests within practice).
Submission to Consultation on Healing Arts Radiation Protection Act (HARPA)
On April 15, 2021, the Government of Ontario announced new red tape and burden reduction measures intended to minimize existing barriers on businesses and support a long-term recovery plan. This included a commitment to consult on opportunities to enhance the Healing Arts Radiation Protection Act (HARPA) to better enable innovation and the use of new and emerging technology.
OPA was invited to participate as a stakeholder and submit a written response to the consultation. OPA used this opportunity to highlight our previous engagement and feedback on consultations related to HARPA and the fact that until a regulation that will permit physiotherapist to order x-rays is finalized, our scope of practice changes from Bill 179 remain outstanding.
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Advocating for Implementation of Physiotherapy Scope Changes
The Standing Committee on Finance and Economic Affairs Pre-Budget Consultations invited written submissions with a focus on input on improving critical public services such as healthcare and education, improving quality of life for Ontarians, creating jobs and attracting business to the province. OPA submitted and highlighted how implementing the outstanding scope of practice for physiotherapists in Ontario would lead to healthcare and system improvements on behalf of patients while bringing no additional costs to the system.
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Joint Submission on Implementing Outstanding Scope of Practice Changes for Physiotherapy
On September 20, 2017, Minister Hoskins announced that the Ministry of Health and Long-Term Care would be moving forward with expanding the scope of practice for regulated health professionals, including physiotherapists. In December 2017, the Ontario Physiotherapy Association and the College of Physiotherapists of Ontario jointly submitted a response to the Ministry’s request for information to facilitate the creation of regulations that would permit physiotherapists to order specific x-rays, diagnostic ultrasound and lab tests within their scope of practice.
The Healing Arts and Radiation Protection (HARP) Act Review
Health Quality Ontario (HQO) formed an Expert Panel to Enhance the Safety and Quality of Energy-Applying Medical Devices in Ontario (“the EAMD Panel”). The mandate of this group was to provide recommendations and advice to HQO on the modernization of the HARP Act. Changes to the HARP Act are needed to allow PTs to order x-rays. OPA was identified as a stakeholder in this process and was invited to provide feedback to the Panel.
Physiotherapy Scope of Practice Changes Proclaimed April 1, 2011
In 2011, the OPA and its advocacy partners celebrated the proclamation of changes to the Physiotherapy Act that expanded the scope of practice of physiotherapists and allowed them to deliver more services, and authorized acts within that scope. Read the Physiotherapy Scope of Practice Announcement.
Most of these changes came into effect September 1, 2011; however, those relating to ordering diagnostics are still outstanding. The OPA continues to advocate for the implementation of the full scope of practice for physiotherapists. To learn more or to get involved please contact the OPA.
View the Physiotherapy Scope of Practice Review submission to the Health Professions Regulatory Advisory Council
OPA Submission to CPO – May 28, 2024
OPA submitted comments to the College of Physiotherapists of Ontario on the open consultation on two standards:
- New standard, Evidence-Informed Practice
- Revision to, Titles, Credentials, and Specialty Designations
This is the second set of consultations in the CPO’s process of adapting the revised Core Standards of Practice for Canadian Physiotherapists, developed in 2023 by the Canadian Alliance of Physiotherapy Regulators.
Community Surgical and Diagnostic Centres: Joint Letter Wwith tThe Ontario Orthopaedic Association (OOA) – May 15, 2024
Building on the shared work with the Ontario Orthopaedic Association (OOA) of meeting with MPPs in March, OPA and OOA collaborated on a call to include frontline health care expertise in the planning of the proposed Community Surgical and Diagnostic Centres. As hip and knee joint replacement surgeries are slated to take place at these Centres, the expertise of physiotherapists and orthopaedic surgeons is essential to ensure the provision of clinically effective care with assured access to rehabilitation.
Read the joint letter submitted to the Minister of Health, the Honourable Sylvia Jones, and the President & CEO of Ontario Health, Matthew Anderson.
OPA Submissions to CRPO Consultations – March 27, 2024
The College of Physiotherapists of Ontario (CPO) recently closed their 60-day consultation period for their proposed Code of Ethical Conduct and Standards Review. OPA submitted a response for each consultation, and the recommendations are summarized as follows:
In reviewing the Code of Ethical Conduct as proposed, OPA made three high level recommendations:
1) Build on the concept of informed consent;
2) Recognize the role of substitute decision makers in patient care;
3) Build on our ethical responsibility and role to address instances of discrimination, racism, and prejudice in healthcare.
OPA recommended that the College establish a Standard of Ethical Conduct to demonstrate a strong commitment to anti-racism and cultural safety, and create a strong structure that the public, physiotherapists, and policy makers can depend on to provide safe, equitable and high-quality health care services.
In reviewing the Standards consultation, OPA has recommended minor changes, without any significant needs for amendment to the proposed standards: Assessment, Diagnosis, Treatment, Communication, and Risk Management and Safety.
OPA provided substantial recommendations for amendment to the Duty of Care Standard, which includes clarification of definitions and language that is in alignment with provincial regulations, specifically the Ontario Code of Misconduct (O. Reg 388/08) as it pertains to the discontinuation of care in both the presence and absence of continuing need.
Home Care Submission
OPA was invited to attend a webinar by the Ministry of Health to provide feedback on the process for developing new service provider organization contracts. The Home and Community Care Branch asked for input specifically related to the patient and family experience of care, staffing and workforce issues and service performance. Discussion included how there needs to be more transparency on how contracts work and how funds are distributed, more information on who works in the home care sector, reduced disparity in wages across professions and methods to increase hiring and retention.
OPA’s submission identified eight recommendations for service provider contracts based on the themes of enhancing equity and fairness across professions and contracts, working to full scope of practice, and increasing and ensuring access to home care for everyone.
Pre-Budget Submission
OPA recently filed our recommendations to Ontario’s Standing Committee on Finance and Economic Affairs. Pre-budget submissions are an opportunity to inform the Government of Ontario’s priorities, as addressed in the budget. Our submission focuses OPA’s continued advocacy on three main objectives, to:
- Fully implement the legislated scope of practice for the physiotherapy profession;
- Ensure a viable and sustainable publicly-funded community physiotherapy clinic program for vulnerable Ontarians, including seniors; and,
- Reduce red tape in the automobile insurance sector that creates barriers to timely access to care for Ontarians and imposes costly and undue burden on health care businesses, and address stagnant caps and fees.
OPA continues to advocate on each of these issues through 2024.
CPO Consultation on the Collection of Demographic Information
OPA submitted comments as part of CPO’s consultation process on bylaw changes related to collecting demographic information. It is essential to include a robust explanation about the purpose of collection, policies related to storage, use and dissemination, procedures for members to request corrections, and who has ownership of the data. It is not sufficient to make the information sharing optional, especially as the examples noted pertain to sensitive questions about identity. There should be consultation on the appropriateness of each question included for collection.
OPA’s Submission to Home Care Modernization– November 8, 2023
OPA has submitted a response to proposed changes in the home care sector through Home Care Modernization. We took this opportunity to re-emphasize our concerns regarding the issues identified by members including those on working conditions and non-equity in compensation between professions and regions in this sector.
OPA’s Submission to CPO’s Emergency Class Registration Consultation – April 18, 2023
The Ontario Physiotherapy Association submitted feedback to the Ministry of Health and the College of Physiotherapists of Ontario’s consultation to their proposed amendment of the general regulation to establish an Emergency Class of registration.
Bill 106, the Pandemic and Emergency Preparedness Act, which came into effect in April 2022, made amendments to the Regulatory Health Professions Act (RHPA) Procedural Code that, requires all Health Profession Regulatory Colleges to establish an Emergency Class of Certificate of Registration. The aim is to reinforce the province’s health workforce planning and create an alternative pathway to register individuals in an expedited manner during emergency situations, such as a pandemic.
Our key feedback focused on ensuring that the Province and regulatory College have tools in place to address health workforce issues in an effective and expedited manner during the time of emergency, while also ensuring that any proposed regulatory amendments not add complexity that negatively impacts the safety of the public, creates confusion for employers and health system managers, or has unintended negative impacts on health human resources during an emergency situation.
Submission to Standing Committee for Finance and Economic Affairs Pre-Budget Consultations – February 14, 2023
The OPA pre-Budget submission highlighted four areas that would bring substantial returns through increasing capacity in Ontario’s health care system and achieving the government’s objectives.
- Remove the barriers to physiotherapists working up to full scope;
- Facilitate successful entry to independent practice for internationally educated PTs by reinstating funding for the Ontario Internationally Educated Physical Therapy Bridging Program;
- Address program issues for community rehabilitation, including Community Physiotherapy Clinics and bundled care programs and resource appropriately to meet rehabilitation needs and help address surgical backlogs; and,
- Reduce red tape that is a barrier to care and imposes undue burden on health care businesses by removing requirement to exhaust extended health care benefits before accessing auto insurance benefits.
OPA Submission on College Governance Changes and Modernization Consultation – March 9, 2022
OPA submitted feedback on the Ministry of Health’s consultation on their proposed changes to College governance and regulatory modernization. The proposed changes would impact all regulatory Colleges of health professions in Ontario, including the College of Physiotherapists of Ontario.
Although modernization is required to strengthen our current model, OPA is concerned that the proposed governance changes do not enable Colleges to meet the requirements, needs, and circumstances for the individual profession(s) and to fulfil their mandate of public protection. Some of our feedback focused on:
- Ensuring and enhancing diversity of representation on Councils, along with adequate turn over of members to enhance diversity of thought and progress over time regarding decision making
- Ensuring a competency-based process to identify a slate of candidates and making elections province-wide
- Supporting time limits for registration decisions.
OPA Submission on Home and Community Care Transformation Consultation – February 23, 2022
OPA met with the Ministry of Health and submitted feedback for their consultation on home and community care transformation, which focused specifically on provider partnerships and improving accountability in delivery in the home and community care sector. Some of OPA’s feedback focused on:
- Greater equity and fairness across many aspects, including compensation between rehabilitation professionals, workplace conditions and safety, funding, along with care coordination and determination of care plans to enhance equitable access to care;
- Ensuring sufficient funding to achieve desired patient outcomes;
- Ensuring processes, contracts, and accountability structures do not add undue complexity or administrative burden;
- Outlining the cost-effectiveness of rehabilitation and advocating for greater investment in rehabilitation;
OPA Submission on the Provision of Health Support Services in Schools Consultation – February 23, 2022
Service in school settings are managed through a tripartite agreement between the Ministry of Education, Ministry of Health, and Ministry of Children, Community and Social Services. OPA submitted feedback on their consultation on the redrafting of Policy/Program Memorandum No. 81, which intends to provide expectations on the delivery of evidence-based health services, rehabilitation services, and other community-based clinical services in schools and to clarify the roles and responsibilities of school boards and community partners as they relate to the provision of these services in school settings in Ontario.
OPA’s feedback focused on ensuring that the document enabled the required collaboration between organizations to optimize local innovations that reflect best practices.
Ontario government Standing Committee on Finance and Economic Affairs’ pre-budget consultation – January 26, 2022
OPA submitted to the Ontario government Standing Committee on Finance and Economic Affairs’ pre-budget consultation.
OPA recommended that the Government:
- Invest in a comprehensive health human resource strategy, including addressing entry-to-practice issues, to address the growing crisis of increasing shortages;
- Implement the scope of practice changes legislatively enabled for physiotherapy and enable physiotherapists to provide a more seamless and cost-effective continuum of care;
- Allow health care clinics and practices to be eligible for pandemic-related, government financial and other supports that apply to small businesses; and
- Increase the amount of Episode of Care Allocation that CPCs can retain in response to pandemic-related reductions in utilization and, for the remaining amount, roll forward non-utilized funds into the following fiscal years to be absorbed through future utilization.
OPA’s Submission to CPO’s Consultation on Registration Regulation
OPA submitted feedback and recommendations to the College of Physiotherapists of Ontario’s (CPO) consultation on their proposed registration regulatory amendments. The submission focused on areas of the regulation and proposed changes that would, or potentially could, create barriers to fair, timely, and safe entry-to-practice for applicants that are not necessary for public protection. Main points included:
- The definition of examination for the purpose of entry-to-practice and the need to ensure that ‘practical component’ is not embedded in the regulation
- How exceptional circumstances are determined
- The roles of Council and the Registration Committee
- The criteria for exemptions
In addition to regulatory changes, OPA advocates for and devotes our resources to achieving pathways to registration for affected candidates. We continue to work with stakeholders involved in this issue to move solutions forward.
Home and Community Care Modernization – Proposed Regulations Engagement – July 13, 2021 Update
OPA was invited to participate in the consultation on the updated summary of proposed home and community care regulations that will be included in the Connecting Care Act, 2019. We were pleased that some of our feedback from previous consultations was incorporated and took this opportunity to address other areas of concerns, including the need for the Ministry to address health human resource issues and funding for home and community care services as part of their key areas for modernizing this sector.
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OPA Responds to Proposed New Regulation Under the Connecting Care Act – July 2020
In July 2020, OPA was given the opportunity to provide feedback on the proposed home and community care regulations related to the Connecting People to Home and Community Care Act, 2020.
Bill 175-Connecting People to Home and Community Care Act, 2020 received Royal Assent on July 8, 2020 and, once proclaimed, it intends to modernize the home and community sector by allowing Ontario Health Teams and health care providers to deliver better integrated home and community care.
The Ministry only provided a summary of the regulations and OPA’s response focused issues of funding, human resources and growing administrative layers that have impacted access to quality care for Ontarians.
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Levels of Care Framework – July, 2016
The MOHLTC’s Levels of Care Framework discussion paper was released in July, 2016 as part of the Patients First Roadmap. The discussion paper outlines a proposal for a province-wide framework that will guide decisions around service levels and access for home and community care. The aim is to improve consistency in access to high-quality care across Ontario. OPA submitted a written response to the discussion paper that highlighted the need for a greater focus on the rehabilitative potential of people receiving care, and the value of early rehab intervention.
Read OPA’s response
Auditor General’s special report on CCACs, 2015
Recently, the Auditor General of Ontario released the special report Community Care Access Centres- Financial Operations and Service Delivery.
Login to read OPA’s comment on the report Auditor General Report on Home Care to learn more about current discussions in home care.
OPA encourages members in all sectors to join the conversation.
On March 6, 2018, Ontario passed new legislation, Rowan’s Law (Concussion Safety), and made amendments to the Education Act. The intent of this new legislation is to address concussion safety protocols for amateur athletes. As indicated on Ontario’s Regulatory Registry, Rowan’s Law establishes mandatory requirements for:
- Annual review of concussion awareness resources that athletes, coaches, educators and parents would be required to review before registering in a sport;
- Removal-from-sport and return-to-sport protocols, to ensure that an athlete is immediately removed from sport if they are suspected of having sustained a concussion; and
- A concussion code of conduct that would set out rules of behaviour to minimize concussions while playing sport.
Public consultation on the legislation was conducted to inform implementation including the drafting of regulations. OPA, in consultation with Sports Physiotherapy Canada and the Canadian Physiotherapy Association, submitted a response on behalf of the profession.
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Following the consultation on the implementation of the legislation, on April 18, OPA submitted a response on behalf of the profession on the draft regulations focusing our response on the Concussion Awareness Resources, Concussion Code of Conduct and Removal/Return-to-sport Protocols.
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Health Quality Ontario (HQO), now Ontario Health (Quality) engages in public consultation on their draft Quality Standards and Health Technology Assessments (HTA). Quality Standards and HTAs have an impact on the health system and the physiotherapy profession. OPA monitors these consultation opportunities and brings relevant standards to the attention of the profession so that PTs can provide feedback to inform Ontario Health (Quality)’s work in this area. The following are submissions from OPA with our feedback sent on behalf of the profession and our membership:
Login to read all of the feedback on:
- Heart Failure Quality Standard
- Compression Stockings for the Prevention of Venous Leg Ulcer Recurrence
- Structured Education and Neuromuscular Exercise Programs for Hip and/or Knee Osteoarthritis
- Low Back Pain Quality Standard: Care for Adults with Acute Low Back Pain
- Health Technology Assessment: Continual Long-Term Physiotherapy After Stroke
- OPA Response to HQO Consultation on Diabetes Standards
- OPA Response to Patient Transition Quality Standard
- Quality Standard and Patient Guide for Concussion
In April 2019, as part of the Ontario Budget, the Government released their Blueprint for Putting Driver’s first, a plan to reform the auto insurance industry in Ontario. This plan focuses on addressing high costs for insurance and barriers to participating in/accessing programs and services for those injured in a car accident. As Co-Chairs of the Coalition, OPA has been at numerous tables participating in an advisory capacity. The Coalition has also been responding to consultation opportunities. Recent submissions are below:
Response to The Marshall Report – Fair Benefits, Fairly Delivered: A Review of the Auto Insurance System in Ontario
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Response to FSCO’s report on Minor Injury Protocols, August 2015
Read OPA’s response to FSCO’s Final report titled ‘Enabling Recovery from Common Traffic Injuries: A Focus on the Injured Person, Ontario Protocol for Traffic Injury Management Collaboration’ and our response to the Common Traffic Impairment Guideline.
As co-chair of the Coalition of Health Professional Associations in Automobile Insurance Services (The Coalition), OPA participated in both the Coalition Response to MIG Final Report and the Coalition CTI Guideline Response. The draft CTI guideline is the first step in the development of policy based on the Final Report. OPA will remain involved in any further consultation opportunities with FSCO and the Ministry of Finance regarding this guideline and implementation plan.
FSCO Annual Statement of Priorities, 2015
FSCO is required by law to release an annual Statement of Priorities (“Statement”) outlining its proposed activities for the coming year. These priorities are made available for comment prior to being finalized.
Read the Coalition’s response to the 2015 FSCO Draft Statement of Priorities
Proposed Changes to the SABS, 2015
The 2015 Ontario Government Budget announcement included areas specific to auto insurance that would require a number of amendments to the Ontario Regulation 34/10 (Statutory Accident Benefits Schedule) of the Insurance Act.
In December 2015, the Minister of Health and Long-Term Care released a proposal to address structural issues that will improve inequities and access to care. Stakeholders were invited to provide a written response as part of the consultation phase to this proposal.
OPA submitted a response on behalf of its members at the end of February. This response touched on key issues for the profession including:
- The importance of sound transition planning
- The need to optimize the role and scopes of practice for physiotherapists, especially in primary care
- The need to remove barriers to integration and funding for services across the system and
- The need for a set provincial standards and definitions of care and establish an evaluation system.
Read OPA’s full response
OPA Response to CPO’s Consultation on Revised Standards
Advertising
OPA has submitted a response to the CPO consultation on the revised Standard for Advertising. We thank members who took time to share their thoughts about the revised Standard.
Read OPA’s Response
Performing Controlled Acts and Other Restricted Activities and Physiotherapists Working with Assistants
OPA has submitted a response to the CPO’s consultation on revised professional standards for Performing Controlled Acts and Other Restricted Activities and Physiotherapists Working with Assistants. We thank members who took time to share their thoughts with us about the revisions. Many noted concerns regarding the delegation of controlled acts by physiotherapists. The ability to delegate controlled acts has been in place for some time for physiotherapists but the revision of the standard made this more clear. As with physicians and most other regulated professions, we believe that physiotherapists have the knowledge and judgement to be able to decide whether delegation of a controlled act is appropriate. We do understand members’ concerns and for this reason have recommended that the standard include reference to the regulation that states that it is professional misconduct to delegate to someone who isn’t appropriate in competence or judgement so that all understand the elevated risk of delegation.
Read OPA’s Response
OPA closely monitors reductions and/or closures of physiotherapy services in the public sector. Reductions and closures affect physiotherapists and patients, the profession as a whole, as well as the entire health care system. When reductions to physiotherapy services are announced the OPA takes a series of steps to advocate on behalf of physiotherapists and their patients.
Login to read the important steps and view the current list current list of Reductions in Physiotherapy in Hospitals by LHIN (2008-Present)
Learn about these important steps: OPA Outpatient closure procedures
View the current list of Reductions in Physiotherapy in Hospitals by LHIN (2008-Present)
July 2019
In response to the feedback survey and consultation conducted on the New Government-wide Seniors Strategy consultation, OPA submitted feedback on the 2019 Seniors Strategy report. We highlighted the importance of developing a strategy that enables seniors to live safely and healthy so they can stay in their community and live as independently as possible for as long as possible.
October 2012
In conjunction with the Ontario Society of Occupational Therapists (OSOT), the OPA responded to an invitation by Dr. Samir Sinha to provide a submission on the importance of the inclusion of physiotherapy and occupational therapy services within the Ontario Government’s Seniors Care Strategy. The Seniors Care Strategy is part of Patient’s First: Action Plan for Health Care and aims to help seniors live healthier and longer within their homes.
Read the Seniors Care Submission
KEY MESSAGES
Ontarians need more physiotherapists now and it is time for a Plan B for entry to practice process in Ontario!
1. Close to 1000 qualified physiotherapy candidates are waiting to practice their chosen profession
- It has been impossible for new graduates and internationally educated to register with the College of Physiotherapists so they can enter independent practice in Ontario since November 2019 when the last clinical component of the national examination* was held.
- June 2020 and the November 2020 exams were cancelled as pandemic restrictions prevented in-person exams.
- The March 2021 virtual exam was cancelled due to technical issues and others scheduled for June and November also cancelled.
- At the earliest, virtual exams by CAPR are expected to start by the end of August or early fall but it will take time to address the backlog which, in Ontario, will be well over 1300 by fall of 2021.
*The exam used for registration purposes by physiotherapy regulators in Canada, including the College of Physiotherapists of Ontario, is offered by the Canadian Alliance of Physiotherapy Regulators (CAPR). The exam has two components, written and clinical and passing both components is the current requirement for registering for independent physiotherapy practice in Ontario.
2. Physiotherapists are needed now to address the current health care crisis and future needs of Ontarians.
- We are experiencing an unprecedented shortage of physiotherapists in Ontario just at a time that demand is expected to grow tremendously due to the backlog of surgeries and other procedures and the impact of long COVID-19 restrictions.
- In a survey OPA recently conducted, 87 respondent organizations reported 133 vacancies for physiotherapists – in private clinics, hospitals, home care and in urban and rural and northern – no area of the province has not felt the impact of the lack of available physiotherapists.
- 43% of respondents indicated that delays in the clinical exam have impacted their health human resources.
3. Time is now for the College of Physiotherapists of Ontario to put forward an interim ‘Plan B’.
- The importance of a national approach to entry level competencies and registration for practice is not in question but relying on one option with no alternative or plan B should the exam not be available has limited entry to practice for qualified candidates when they have been most needed by r Ontarians.
- The College has a legislated duty, as a matter of public interest, to ensure that the people of Ontario have access to adequate numbers of qualified, skilled and competent regulated health professionals (RHPA Schedule 2 Health Professions Procedural Code). They also have the authority to set or approve the registration examination (Regulation 532/98) and are not obligated to rely solely on the Alliance exam.
- There are viable solutions that mitigate risk, address public safety and can be implemented while the CAPR clinical examination is not available now or any time in the future.
- Physiotherapy Alberta – the regulatory college has engaged the Faculty of Rehabilitation Medicine Continuing Professional Education Unit University of Alberta to administer an in- person, hands-on, 12 station exam based on the CAPR exam blueprint. The exam will be available to those who have been under provisional licence since March 2020 and will offered June 11 and 12.
- College of Physical Therapy of BC has expedited bylaw changes supported by the Ministry of Health to be able to substitute a clinical evaluation administered by UBC that assesses entry level competence when the clinical component of the CAPR exam is not available – they will run their exam on June 24.
- The CPO has just completed a multi-year review and update of their quality assurance program which includes an online screening review and onsite assessments. Both of which can be expedited for any individual or group to mitigate any risks in advancing to independent practice those who have passed the qualifying written examination and have only the clinical component left to meet the current registration requirements.
- Waiting any longer is not an option for needed health human resources for the physiotherapy and, more importantly, the health of Ontarians.
On February 2, 2015, the Honourable Dr. Hoskins, Minister of Health and Long-Term Care released Patient’s First: Action Plan for Health Care. OPA supports this next phase of the Plan, specifically as it relates to the access to physiotherapy in primary care and increased services for seniors. The Plan also speaks to the importance of the expanding scope of practice and removing barriers to health care professionals practicing to their full scope.
Ontario’s Premier, Kathleen Wynne released 30 letters, one to each member of the cabinet and their ministry, outlining each ministry’s mandate as well as the government’s collective priorities and objectives.
OPA has selected several points from the Premier’s letter to Dr. Eric Hoskins, Minister of Health and Long-Term Care, as areas of particular interest to our members.
Login to read key messages