June 2020
This month: Tips for returning to practice in person, Public Consultations, Peer and Practice Reviews and more
Coronavirus Resources
Looking for information, resources and advice about your practice during the coronavirus pandemic? We’ve got you covered , including new information about returning to in-person practice.
Deborah Adams, Registrar
Deborah Adams, Registrar
Registrar's Message
Pandemic Planning Update
As I write this, we have received an amended  Directive #2 for Health Care Providers from the Chief Medical Officer of Health. Along with the Ministry of Health’s Operational Requirements : Health Sector Restart , the amendment serves to provide clarity about expectations and requirements related to the gradual return to in-person work as part of the Framework for Re-Opening Our Province: Phase One

While it is a hopeful sign that the government has decided to continue with re-opening the province, I would ask registrants to be mindful of what a gradual restart means. There are many interdependencies in our health care system; coordination and cooperation with guidance from your Public Health Unit and the Ministry of Health is important and should consider the spread of COVID-19 in your community.

Everyone has a role to play in adjusting and re-designing their service provision to implement the hierarchy of controls. There must be a balance between providing services in person and virtually to address client needs in a measured way. Your clinical judgement and adherence to relevant guidance will be fundamental in directing the necessary shift in services so that it happens safely.

Given this, I want to highlight that CRPO’s recommendation is that RPs continue to work remotely wherever they reasonably can. In cases where in-person appointments are necessary, RPs must ensure that they follow infection and prevention control guidelines.

We have updated our Guidance to In-Person Practice to assist registrants with assessing the risks in their practice and putting place the concrete steps needed to ensure that they are able to provide in-person case in a way that protects their health and safety and that of their clients. Please ensure that you review Guidance in Assessing Necessity of In-Person Practice and Risk of Transmission in Your Setting and Developing a Return to In-Person Practice Plan and implement any of the required practices that you do not already have in place.

For those whose work poses unique risks (e.g., those who make home visits, work in congregate settings or provide services to particularly vulnerable populations) the Ministry of Health has a COVID-19: Guidance for the Health Sector page that includes specific guidelines that you should consider.

We will continue to monitor the situation closely and communicate as needed. Over the coming days, we will be updating the FAQs for RPs on COVID-19 and releasing any other guidance that is necessary in light of the evolving situation and direction from government and health officials.

Registrant Outreach and Professional Development Update
I also want to let you know that the town halls that we had planned for this fall will be going ahead virtually. While it’s not ideal – I very much enjoyed the in-person sessions we held in 2018 and felt that it was a real benefit to be able to meet and speak with so many registrants – we are keen to have the opportunity to reach out and connect with you via videoconference. The good news is that the virtual format will allow us to run more sessions than would have been the case if we were travelling. Our plan is to hold one session for each of the seven CRPO districts so that we can hear from you about issues that are specific to your community. If it is not possible for you attend on the date for your district, you would be welcome at any of the other sessions (just know that the focus of questions may not be as germane to your practice). Specific dates, a request that you register for a session and an opportunity to help shape the agenda for your town hall will follow in our July Communiqué.

Additionally, we will be moving the planned Peer Circle events to an online format. These will be scheduled in October; case writing is already underway with a committed group of volunteer registrants – many thanks to them all for their excellent work! – and facilitator training will be happening later this summer. We will provide more information closer to the dates, but I would encourage everyone to consider participating in this professional development offering. Since it’s a pilot, we will be looking for registrant feedback to determine if and how we continue to develop these kinds of initiatives.

Wishing everyone the best as we all navigate the next few months.

Public Consultations
Two public consultations are now open regarding policies brought forward by the Registration Committee. On May 19, 2020, CRPO Council approved the following policies for 60-day public consultation:

  • Review & Recognition Policy
  • Clinical Experience for Registration Policy

For more information, visit the Public Consultations page of the CRPO website . Feedback is invited until July 31, 2020.
Peer and Practice Reviews delayed until June
The 2020 administration of the Peer and Practice Reviews (PPRs) for randomly selected registrants usually commences in May of each year. In view of COVID-19, CRPO delayed notifications by a month and, in addition, will keep the number of registrants randomly selected to approximately fifty. Delaying the PPRs and doing a small number of assessments allows CRPO to meet our mandate while also taking into consideration the unusual circumstances of COVID-19 which may be causing registrants stress.

In June 2020, registrants randomly selected for the PPR will be notified through their CRPO account. The first step of the PPR is a remote interview conducted over the phone by a trained assessor. Most of these interviews will take place in July and August. Any registrant requiring a subsequent or “step 2” interview, which takes place in person, will not be expected to do so until the fall. In the event that in-person interviews are deemed to be unsafe, step 2 interviews will be deferred until it is safe to conduct them.
Practice Matters: Is fee-splitting allowed?
“Fee-splitting” is a term that is used to describe many kinds of financial arrangements where the fee a therapist collects for providing services to a client is divided between the therapist and another person. In some situations, fee-splitting can be considered an appropriate financial arrangement, while in others, it is considered conflict of interest.

An example of an acceptable form of fee-splitting would be when a CRPO registrant makes arrangements with another regulated health professional to use office space and amenities in exchange for a percentage of the fee charged to the therapist’s clients. This is considered a form of revenue sharing. Registrants should be aware that specific requirements apply in arrangements where revenue is shared. These are set out in Professional Practice Standard 1.6: Conflict-of-Interest , where it says that registrants may only share revenue with one or more of the following persons or entities:

i.               another member of the College;
ii.              a member of another regulated health profession;
iii.             a health professional corporation;
iv.             a social worker or social service worker or a professional corporation for a social worker or a social service worker; or
v.              any other person if there is a written contract with the person stating that the member will have control over, and be responsible for, his/her own professional decisions, and for maintaining professional standards.

An example of an unacceptable form of fee-splitting would be if a registrant agreed to split their fee with another person or business to compensate for receiving a referral. Similarly, a registrant cannot accept a benefit for referring a client to another professional. Splitting fees or otherwise exchanging payment for referral could create an actual or perceived conflict of interest because it creates the appearance that the referral is made for the purpose of monetary gain. Standard 1.6: Conflict-of-Interest explains that a referral should be made for the benefit of the client, and made only where a client requires or requests a service. Standard 1.9: Referral further explains that, in making a referral, registrants should take reasonable steps to ensure that the other professional is appropriately trained and/or certified and that they adhere to accepted standards of their profession.

Have a practice-related question? Please send it to our Practice Advisory Service at practice@crpo.ca .
The next meeting of CRPO Council will take place on  August 20, 2020, 9:30 to 3:30 . Want to attend? Register ahead of time and review the  guidelines on attendance
Given the uncertainty around when restrictions will be eased to allow in-person meetings, CRPO is waiting to determine whether this session will be virtual. If we can hold an in-person meeting, please note that seating is limited and so you are asked to ensure you have a confirmation before attending.
Open for Business
A reminder that, although the CRPO offices are physically closed and staff are working offsite, our day-to-day business is ongoing. This includes processing registration applications. Staff are currently reviewing applications that were submitted in February. Be sure to follow us on Facebook where we post updates about which batch of applications we’re reviewing. 
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