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What is the CPA doing to advocate for members as communities are experiencing a second wave of COVID-19?
Working with our partners in the provincial Branches and with other regulated health professions, the CPA is calling on governments to ensure physiotherapy and other essential health services remain available to Canadians during the ongoing COVID-19 pandemic. We want to ensure that governments recognize and value the essential role and contributions of physiotherapists, physiotherapist assistants (PTAs), physiotherapy technologists (Phys.T.s), and physiotherapy students working and training in all settings and sectors of health care as they contemplate and implement policies that respond to surges and additional waves of COVID-19. We developed this statement to guide our interactions with governments. We’re advocating for physiotherapy services in all settings (in-person, virtual, for acute and chronic injuries, illnesses, and conditions) to remain available to the patients who need them, beyond only urgent/emergency care during the second and any subsequent waves of the ongoing COVID-19 pandemic.
Along with our colleagues in other regulated health professions, we’ve sent this joint letter to the Prime Minister and all of the provincial/territorial premiers. We’ve also shared this letter and ask with the Federal Minister of Health and Chief Public Health Officer of Canada and worked with the provincial Branches to make the same statements to the provincial ministers of health and chief medical officers of health. As cases of COVID-19 surge in particular regions of the country, the CPA will continue to work with decision makers to support the position that physiotherapy care is essential care in all settings and that it must continue to be available to Canadians, should future shutdowns or restrictions be required.
The federal government has recently made several changes to the financial supports available to individuals and businesses to address the hardships faced due to the COVID-19 pandemic. See a summary of the major programs and access the full list of federal government supports here.
In addition to advocacy to ensure physiotherapy services are not shutdown during future surges/waves of the COVID-19 pandemic, the CPA’s current advocacy priorities related to COVID-19 with the federal government include the following:
- Access to PPE in all settings: The CPA is calling for continued leadership by the federal government to ensure health care professionals working in all settings have access to appropriate personal protective equipment that meets guidelines established to safely provide care during the COVID-19 pandemic. Costs for PPE have soared due to scarcity of supply, making access to these items a barrier to sustainable operations for many physiotherapists and physiotherapy clinics.
- Inclusion of contract workers in CEWS: The CPA is advocating for adjustments to the Canada Emergency Wage Subsidy (CEWS) that would allow business owners to include contract and sub-contract workers as employees under the program. Excluding these workers means the many physiotherapy clinics and businesses who operate under this model but are still facing a significant reduction in operations due to COVID-19 are unable to be aided by CEWS. By allowing businesses to include contract service providers within the CEWS program, they would have access to additional funds needed to bridge this difficult time. This would also be a measure that would help transition self-employed physiotherapists from the Canada Emergency Response Benefit or Employment Insurance and get them back to work providing physiotherapy services at a time when Canadians are feeling the impacts of reduced physical activity due to quarantine, isolation, and physical restrictions.
- Commercial Rent Relief: The CPA is advocating for the creation of a new commercial rent assistance program to replace the Canada Emergency Commercial Rent Assistance Program (CECRA) that provides rent relief directly to small businesses and takes the form of a grant, rather than a loan. With some degree of physical distancing expected to be the new reality for some time, the number of patients that can come in the door is limited, in turn limiting potential revenues. Loans only push the impact of this revenue decline down the road. Additionally, flexibility and accomodation on the part of landlords and commercial property owners is not universal, thus, in many cases, dependency on the willingness of the property owner to incur debt has left small businesses in a precarious position. Providing more comprehensive and direct commercial rent relief would help provide the support many physiotherapy businesses need to weather the ongoing financial hardships of the COVID-19 pandemic while continuing to provide care for their patients.
- Investments to meet the needs of Canada’s aging population and improve access to physiotherapy: The CPA has been advocating for new federal investments in community and home-based care and a healthy and active aging strategy – both measures that would help better-support Canadians remain in their homes for longer and stay mobile, healthy, and active. By improving access to physiotherapy professionals through these means, the federal government can better meet the needs of our aging population within their homes and communities, decreasing the reliance on more costly acute and institutionalized care. This is particularly important in the context of the ongoing COVID-19 pandemic (and other highly contagious illnesses, like influenza), as our communities are expected to continue to experience exposure risk and recurrent outbreaks for the foreseeable future, placing further strain on acute care and institutional settings.
- Measures to improve access to physiotherapy professionals: The CPA has recommended that the federal government expands the existing Student Loan Forgiveness program for rural/remote health professionals to include physiotherapists, physiotherapist assistants, and physiotherapy technologists. The CPA has also recommended that the federal government accelerates the timeline and increases investments in Canada’s Connectivity Strategy to implement the infrastructure needed to ensure connectivity for health and remove barriers to access of the internet, phone, and electronic health technologies. These measures would help improve access to virtual care so many of our communities have come to depend on during the COVID-19 pandemic.
Earlier on in the COVID-19 pandemic, the CPA was successful in advocating for several changes to the federal government’s financial supports for Canadians to ensure the needs of physiotherapists were included in the programs. Supports for small businesses and sole-proprietors who ceased or reduced operations during the pandemic were a top priority. When the federal government announced the Canada Emergency Response Benefit (CERB), the CPA voiced the need for some income to be earned while still qualifying for the benefit. This ensured that physiotherapists providing virtual or urgent/emergency care to patients would not be left out of the benefit. We raised this issue with the Ministers of Finance, Small Business and Employment, and their departments, and were pleased when they announced a change to the CERB to allow up to $1,000 to be earned a month and still access the benefit.
We also called for a lower payroll threshold to access the Canada Emergency Business Account (CEBA) and advocated for those who earn income through dividends to be eligible to ensure that many common physiotherapy and health clinic business models were not excluded from the program. The federal government heard us on both of these issues and the Prime Minister and the Minister for Small Business named physiotherapists in their examples of professionals who would benefit when they announced these changes to the programs.
The CPA also advocated for a commercial rent assistance program and worked with several provincial Branches to call for a moratorium on commercial evictions when it became apparent that the Canada Emergency Commercial Rent Assistance program (CECRA) had large gaps and was leaving many businesses out.
The CPA has been advocating for direct access to physiotherapy under the Public Service Health Care Plan (PSHCP) – the extended health benefits program for federal employees, which has more than 600,000 plan members across Canada. In late March, the federal government temporarily removed the requirement for a prescription for physiotherapy services under the PSHCP for a period of about one month. The CPA immediately responded by engaging with the federal government to encourage them to extend this direct access throughout the course of the pandemic and, ultimately, to make this permanent. The government has extended the exemption twice (it is in place until “non-critical business is authorized to resume”) and the CPA continues to work with them to consider making this a permanent change.
The CPA made recommendations to the House of Commons Standing Committee on Health and on Finance to accelerate and increase investments in the infrastructure needed for all Canadians to access virtual care. We also raised this recommendation with the Prime Minister and Ministers of Finance, Health, Small Business, Employment, and Seniors. We were pleased to see a commitment in the recent Speech from the Throne, which indicated the government will accelerate actions under the Universal Broadband Fund to improve access to the internet, regardless of where people live.
In the Speech from the Throne, the government also made a commitment to accelerate action on the Truth and Reconciliation Commission’s calls to action, which aligns with recommendations made by the CPA in our submission to the House of Commons Standing Committee on Health under their study on the government’s response to COVID-19.