The monies should be wholly directed to the client ‘s Registered Physiotherapy services, transparently sent via the CCAC. The RPT should be contracted directly to the CCAC at a rate consistent with College & OPA guidelines for each current year. No intermediate agency is required and the software can be secure for the PT to bill using CCAC billing system. (This model was done very successfully for many years in York Region) No skimming off by the RH can take place this way, as the funds set aside for the client are intended for the client !! If the RH hires the PT they will surely chip away at the RPT’s wage for their own profits! The RPT will directly invoice the CCAC ( the CCAC will manage the fund transition transparently. The PTA must by hired by the RH at their cost.
I have witnessed so many funding models in 38 years and participated in fundraising until a program became MOH funded. Also the making of a model of service delivery designed with “York Region Home Care” by a group of contracted Physiotherapists for client care, which was personable, reliable, efficient and seamless.
We can learn from the past and if I can be consulted for the my experiences of participating in the changes in funding models please contact me! Elizabeth D

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bottom line–
each RH should be provided with an envelope of funding, hire PT and PTA directly–“in house”
STOP the “for profit” skim off and PLEASE get CCAC out of this totally–they add only delay, confusion and cost.
ccac is needed elsewhere but NOT in determining who would benefit from PT interaction in a RH!!!!!!

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I wish the association or the ministry or the college would do an economic analysis of this change. I was one of the physios sent in to do assessments during the transition period. For each of my visits, I believe the company that contracted my services was paid $115.00. ($52.oo of that went to me). Factor in the hours of useless paper work done by the CCAC’s case managers ( no all of their work is not useless, but time to look at the value added here!) and I would wager that the “old modet” was much cheaper–more clients were seen -much more emphasis on hands on- fewer transitions -much more responsive, eliminating the ridiculous referral through the CCAC.
Once these assessments were completed, I continued treatment plans. If I saw 6 people in the RH–6x $115.00 equals $690 to the agency–PLUS all the convoluted cost of CCAC involvement. Those same 6 people would have been seen under the old model along with a dozen if not dozens of other, at the same cost.
Forget the old model, a PT could be hired at 70.00 an hour to spend a day in that RH. In 7 hours ($490.00), the therapist could see those 6 people, 10 more, run classes, respond to immediate needs, referrals, consult on the spot, eliminate transitions, lag time, CCAC beaurocracy! (I was able to talk to Nurse Practitioner on the spot re: Parkinson-like symptoms of a 93 year old. without dragging her to a specialist, without enlisting a “case manager”, the client’s medication was appropriately adjusted)

I also take issue with the challenges of the “old model” of “only spending a few minutes with people”
PLEASE–go work with a few 94, 97, 89, 91 year olds and tell me how long you think it is reasonable, safe to exercise or work with these people!

The old model had its weaknesses. The new model is ridiculous. the new model is encouraging the contracted companies to use PTs, just as the old model did, because it makes sense. I suspect it will not be long before the new model looks an awful lot like the old model, but much more expensive,

Please get someone to explore funding envelopes that pay physiotherapists directly, as employees, in these RH, one or two half days a week. Add the PTA several half days. Pay the therapists a reasonable rate. Have them IN THOSE homes, knowing the people, responding to needs without the CCAC involvement at no added value. Advocate for therapists to do the work they are trained to do-pay them a decent wage and stop diverting money to “non direct care”. It is so painful to watch!

The “old model” provided comfort measures, activation, another pair of hands, socialization. I am not saying these are necessarily “physiotherapy” BUT while a paid therapist and aid are in a facility doing “therapy” for reasonable compensation, there will be time for these “extras” worked into the “working day”

I am was never employed under the “old model”. I believe it needed to be looked at but I agree our association has not done its work in improving delivery of therapy to this population nor has it supported the therapy community as nurses’ association or doctors’ association or chiropractors’ associations do when their memberships are so threatened and the situation is so poorly represented , particularly by the Ministry of Health.

We need a funding model to replace the “old model” for sure, but get the CCAC and for profit agencies out of this. Let the RH hire who they need, with an envelope of money dedicated to “therapy services”, that require a PHYSIOTHERAPIST who brings the knowledge, skills and desire needed to work with this population. Stop supporting “non treatment time” models that eat up our health care dollars.

OPA, where were you??????

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college should clearly define PTA’s role in patient care. PTA’s shouldn’t be treating patients without Physiotherapist onsite.

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Physiotherapy assistants are taking over Physiotherapist job now days. I was told by my home care service provider to transfer all my CCAC patients to my supervisors name after I completed my initial assessments at the retirement homes. They told me they are implementing PTA model for retirement homes so they no longer need my service. PTA will see all the patient. CCAC physio providers are hiring Physio’s just for assessments only. I feel like I went to PT school just to do paper work. Do you call this quality care??. Billing CCAC $120 for PTA treatments are not improper billing??. Only in our profession carrying this assistant business.

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“We weren’t able to do that at the time, but we are hoping to help now.”

Now? what help and how? its too little and too late. i strongly believe that the college has failed its mandate.

I dont understand, what “quality care” you are talking about?

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OPA is the only association that does not support their own members or profession it represents. they shall learn from physicians’, teachers’ and auto workers’ association. exercises classes are delegated to yoga teachers, PSWs, activation departments and fitness trainers who dont know what hip and knee arthroplasty precautions are or back care is. this also elimiated need for PT / PTA with heavy cut. i guess in college’s eye, public is safe so there are no worries there. PTs and PTAs have no job, but i guess OPA is happy and do not see any problems there.

bottom line is, you are shooting your own feet…

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OPA is a Voluntary organisation.It’s not represent all Physiotherapist in ontario.
Please College will conduct the webinar without OPA,I will attend the webinar.
Dont support or friend with OPA ..Ther are aganist Physiotherapist

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In my opinion, the OPA has disgraced the profession. They claimed to support the funding changes on behalf of the Ontario PTs, yet never consulted with its membership regarding the changes. The OPA does not represent all PTs in Ontario, as membership is voluntary, and were not representing their own members during this process. There was a drastic drop in OPA membership renewal this fall, based completely on their unilateral support of the funding changes and the public deception on the part of the OPA president. Longstanding (25-35 years) CPA members cancelled their membership, myself included, so as not to be associated with the OPA. From what I understand, the OPA membership dropped by almost 50%.
The physiotherapists and the Seniors in Ontario, are collateral damage in a war the OPA has been fighting against the DPCA. I am surprised the College has partnered with the OPA. They did not look out for physiotherapists or patients interest. They damaged the reputation of physiotherapists, and made life for Ontario Seniors very difficult and costly. Sadly, many physiotherapists have become so disillusioned, they are seriously considering leaving the profession.
People are judged by the company they keep. I hope the OPA is not the College’s new friend.

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Dear Shenda,
In your most recent blog post you state, “The Association is your advocacy group, they loook out for physioterapists’ interest”. Personally, I could not disagree more with this statement.I have learnt the hard way that my association has in fact worked against me by advocating that those working in publicly funded physio were billing inappropriately, and were providing low quality treatment. Insulting to say the least. The new model of funded physiotherapy which the OPA supports involves physiotherapy treatments being delegated to anyone BUT physiotherapists. PTA’s, PSW’s, Family members, caregivers etc, eliminating the need for skilled physiotherapists involvement in ongoing patient care. How can this possiby be better for Ontarians? Currently in all areas of practice where publicly funded physiotherapy is being provided(clinics,retirement homes, and LTC’s), patients are receiving less physiotherapy and less contact with skilled professionals. Your opinion about the OPA should have been stated as your own. It certainly is not mine.

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I too am very disapointed in the college response to the funding changes-,it was frequently quoted by the Minister of Health in many newspapers that the College endorsed the changes. However if your mandate is to protect the public then why not speak up about the clearly inadequate transition time frame, communication methods to the public and the true reduction in PT service dollars per patient compared to the old system- how is accepting less PT so more will get it with no provision for ongoing preventative and maintenance treatment for those who struggle with chronic disease- a large percent of whom live in nursing homes better? I too was embarassed by your silence when the papers reported the ministry comments that overbilling and billing abuses had resulted in unsustainably high costs in treatment delivery – did you ask the ministry to see the report these claims were made on- seeing as this report was used as justification for a new model how could it not be in the publics best interest to get all the real facts before giving your stamp of approval- if there were aspects of the new funding model you had concerns about did you inform the public and PT’s so we could voice our views as democracy should allow. Please visit Owen Sound and see how their community elderly along with long term care and retirement home residents have been adversely affected by the changes- i have family there who have raised seriuos and valid concerns. i feel you give the appearance of being caught in a government smoke and mirror political campaign and now are trying to save face- who will track if this plan you endorsed in fact improves elderly ontario citizens access to quality PT services especially outside major cities like toronto? I mean no disrespect and i appreciate the complexities of health care in politics but i do feel you let both the public and PTs down on this one despite your best intentions.
P.S. FYI i was dismayed to find when my father was on the cardiac unit at Sunnybrook this past month that there is a volunteer who goes to patients who are in bed and guides them through active ROM exercises even for a patient who had had a proceedure that day- i believe they also walk patients but did not see this personally- there is a PT on the unit who is far better qualified to deliver exercises to this at risk population- worrisome because the patients are not always aware of risks precautions/ who supervises the volunteer and does patient understand this is not therapy? Thank you for this opportunity!

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