CPM COVID-19 Bulletin #10

CPM COVID-19 Bulletin #10

CPM is now into week 3 of working from home. Staff are very busy answering your inquiries and trying to be responsive in a timely fashion.

We know that your life has seen a lot of upheaval in those three weeks as well. Some of you have had to make difficult decisions about whether to close, to stay open, decide who requires urgent care or not, how to provide tele-rehab services and sometimes, whether to re-open your clinic. We have heard your concerns, and especially over the shortages of Personal Protection Equipment.

CPM staff have been monitoring what is happening in physiotherapy across the country, which is useful since we are a little further behind in this pandemic than most provinces. As well, through the regulated health professions group in Manitoba, we have direct links to Shared Health and indirectly to Dr. Roussin and Lynette Siragusa.

We have been contacted by members who wish to volunteer to assist Shared Health and today we received this message (attached) which welcomes your participation and tells you how to become a volunteer.

We have received several calls from registrants about doing assessments by Tele-Rehab. While our resource guide states that this is not allowed, for the times we are living in now, we have revised this statement.  CPM recommends that registrants undertake an assessment/ re-assessment on clients but recognizes that a full assessment may not be possible by Tele-Rehab.  Clients should be advised that the physiotherapist cannot perform a full assessment at this time, but a partial assessment may provide enough information to plan a course of treatment for a client. Permitting assessments by Tele-Rehab is a temporary measure and will be re-evaluated when the pandemic is over.

The Chief Public Health Officer, Dr. Brent Roussin, advised the public on Monday that he was extending the Public Health Act Orders for a further two weeks. This means that gatherings cannot be over 10 people, only urgent/essential clients must be seen, plus the other provisos of the Public Health Orders. Click here to see the Public Health Act Order that was put in place on April 1, 2020.

CPM sought clarity from Dr. Roussin about MPI and WCB clients. His response was

WCB and MPI are government agencies and their status may be further clarified if revised CPPHO orders are issued, but the schedule to the orders does address WCB and MPI and private insurance companies in item 33:

  1. A business that provides insurance services, including adjustment of claims.    

MPI provides public insurance, as do private insurance companies and they may require the services of health professionals in managing and processing claims.  WCB is essentially providing “insurance” as it provides for:

(a) collective liability of employers for workplace injuries and diseases;

(b) compensation for injured workers and their dependents, regardless of fault;

(c) income replacement benefits based upon loss of earning capacity;

Health professionals are per the orders permitted to provide services to insurers and any other businesses that are permitted to remain open per the orders.  They are not restricted to providing only urgent/emergent services in those cases.  It is the same if they provide services for any govt services (including publicly funded health care operations e.g. in hospitals, PCHs, RAAM clinics, community care clinics, home care, public health services, etc.). 

Private practice operations like physio clinics, private chiro practices, dental practices, etc. are limited to urgent/emergent services in the clinics except for services they provide for a publicly funded entity or for a business that is permitted to remain open. 

Some of the Ontario regulators have published information to clarify this in that province which I think is a useful reference.  The Manitoba Chiropractors Association used this information to craft guidance for their members. Dr. Roussin has reviewed and agreed they were reasonable.   Theirs was:

  1. Treating patients who are currently experiencing incapacitating neuromusculoskeletal dysfunction or pain;
  2. Any scenario where the inability to initiate care or the withdrawal of care would lead to the significant deterioration of a patient’s condition and the patient is at risk for imminent hospital admission or re-admission.
  3. Patients who have suffered from severe musculoskeletal dysfunction or pain;
  4. Patients such as a health care provider in an essential service in an acute care setting or other setting deemed to be essential, whose injury or condition requires the input of a Doctor of Chiropractic to return to work safely as soon as possible.

Useful information from the Ontario Colleges is available through the following links:

https://www.collegept.org/news/2020/03/24/college-update-premier%27s-announcement-on-emergency-carephysiotherapists

 

There is also clarity on whether or not home visits can occur:

The orders permit publicly funded and private home care services to continue to be provided as well as private personal support services.  This may include services such as Physio or OT necessary for the continued functionality of the patient, as well as of course nursing services.

However, it is not consistent with the intent of the orders for example for a physio to provide individual patient pay non-urgent/emergent care that they would normally provide in their private practice setting  in a patient’s home to attempt to circumvent the orders, i.e. the take their treatment table on the road.

 

Just a reminder to social distance, wash your hands, and wear PPE when indicated. The government has now implemented fines for those who are not social distancing and there has also been a whistleblower line established by government.

CPM thanks you for continuing to work on the frontlines and by providing tele-rehab services to the public.  To those of you who continue to monitor your clients to ensure they are not falling too far behind, we thank you! For those who are staying home and social distancing, thank you for assisting to flatten the curve.

Stay healthy. Stay Safe.

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