OPA recently sent a letter to the Ministry of Health with important feedback about the integration of physiotherapy in the Call for Applications for Integrated Community Health Services Centres (ICHSCs). We thank members who provided feedback which helped inform our letter. 

The Impact

We recognize the impact that ICHSCs will have in all sectors where physiotherapists work, and in particular, the direct impact that will be imposed upon physiotherapists working in the private sector and those who currently operate within the Community Physiotherapy Clinic (CPC) Program.

Several significant points we made include: 

Insufficient Compensation 

Compensation for physiotherapists serving patients within the ICHSC model remains unclear. We are very concerned that insufficient funding that is not based on current market rates for physiotherapists will not result in a sustainable program.

OPA has previously expressed concerns with the existing Bundled Care program and the distribution of funds within the bundle that has resulted in underpayment of physiotherapy services. Given the Ministry’s goal of improving access to community-based surgery for hip and knee replacements, our concerns have escalated about the ability of the public to access rehabilitation before and after surgery if there are not appropriate resources and funding available for community physiotherapy partners. 

Complexity of Patients 

It is essential that funding for physiotherapy services reflects the rehabilitation complexity of the patient regardless of where they have surgery. Physiotherapy should NOT be discounted in the community because they are considered low risk from just a surgical perspective.

Navigation 

As noted in OPA’s ongoing communications with the Bundled Care team at the Ministry of Health, there have been increasing challenges in system navigation of services for patients as the hospital role in navigation has eroded over time. OPA maintains the position that patient choice continues to be a priority. Currently, patients who undergo surgery at a hospital can choose where they access post-operative physiotherapy services, and the hospital bundle-holder is responsible for reimbursing the clinic of choice. This model has not been presented as a feature of the ICHSC program and has the potential to adversely impact accessibility and care outcomes.

Communication 

OPA asks that the current communication issues be addressed that exist in the Bundled Care program prior to ICHSCs opening. Communication to and from bundled care holders to the patient and to physiotherapists are all needing to be addressed.  

Why this is Critical for our Profession

Insufficient Compensation Impacts all Physiotherapists 

A compensation model that is both underfunded and shifts the risk to physiotherapists for rehabilitation outcomes not only impacts physiotherapy clinics providing care for ICHSC patients but erodes the value and compensation of physiotherapists in all sectors.

Current Status

This is an important issue for the profession and we commit to communicating any response we receive from the Ministry that responds to the concerns we have identified.

Advocacy is Continuous

Advocating with the Ministry and government will be ongoing until we believe that needed program changes are in place and are communicated to the profession. We know that rehabilitation for patients is critical to support good surgical outcomes. The service model needs to be built on a fair and transparent framework so that our members can participate knowing that they will be equitably treated at fair market rates. Read more news related to ICHSCs linked below. 

We encourage all members of the physiotherapy community to email the Ministry of Health and share your concerns. Use content from our letter and contact us for any additional resources at physiomail@opa.on.ca.