This issue of ex.press offers you important new information on a variety of topics to assist you to better serve your patients as a self-regulated health professional.
First, you may have noticed in the media that the College of Nurses of Ontario was recently the victim of a Ransomware cybersecurity attack. I want to assure you that CASLPO is exploring every avenue to boost our own internal cybersecurity measures to continue to keep our data safe and secure.
This is our first newsletter since the onset of the COVID-19 pandemic. In this newsletter, you will find more valuable information on how to keep on top of useful and accurate resources concerning practice advice relating to the pandemic, including an article on the College’s recently released Standards for the provision of Virtual Care in Ontario. It is vitally important to stay engaged with the College at this critical time as we move into the second wave of the pandemic. Continue to access our website’s COVID-19 Information and ‘Providing Patient Care in a Pandemic’ pages.
Due to the pandemic situation, we have extended our annual registration renewal deadline to December 1, 2020. See the important 15 FAQs for this year’s renewal process. Also, see the articles on changes in this year’s Mentorship program and Peer Assessment process.
Another major focus for the College in recent months concerns the area of Diversity, Equity and Inclusion (DEI). Our College has been at the forefront in taking initiatives in this area, including our Policy Statement declaration in June, the creation of a dedicated DEI resources page on the College website, a DEI registrant e-Forum in July and the appointment of Preeya Singh of our staff as the first regulatory College DEI Officer. If you would like to contact Preeya, you can do so at [email protected].
In addition, you will find in this issue of ex.press a valuable article on Advertising complaints and an update on what is happening with regard to health care regulation in British Columbia. Are these changes coming to Ontario? We also pay very special tribute to our Life Members on the retirement of this designation.
Finally, let me express our thank you to all registrants for your amazing service to your patients during this very difficult pandemic period.
As always, be sure to visit CASLPO’s website often, - it’s your main source of the latest information.
Learn how your fees are at work protecting the public interest by reviewing the Registrant Fees at Work infographic.
Director of Professional Practice and Quality Assurance
We are pleased to report that the new Standards for Virtual Care in Ontario by CASLPO Audiologists and Speech-Language Pathologists have been approved by Council and are published on the website in both English and French.
The new standards are especially timely as the COVID-19 pandemic has made health care sectors rethink how patient services can be provided while reducing the risk of infection. Many audiologists and speech-language pathologists are now providing all, or part, of the patient’s screening, assessment, treatment and education via virtual care.
There are seven new standards for virtual care addressing consent, security and confidentiality, virtual services and technology.
The Standards replace the Position Statement on the Use of Telepractice Approaches in Providing Services to Patients.
The College would like to thank the 532 registrants, members of the public, professionals and 10 other professional health colleges who reviewed the Standards and completed the feedback survey.
many registrants service more than one population
Given that a “standard” generally reflects the professions’ minimal level of safe and competent practice, high agreement, as evidenced from the stakeholder review (97% to 83%), confirms that these are appropriate standards for the provision of virtual care in Ontario.
Thanks to the stakeholder comments we are developing FAQs on the following topics:
We will let you know when these have been published.
Finally, we will be hosting an e-Forum on the new standards later in 2020 – stay tuned for more information.
All regulated healthcare professionals in British Columbia are preparing for a sweeping overhaul to the entire structure of regulation. On August 27, the Ministry of Health’s all-party Steering Committee on Modernization of Health Professional Regulation released their report outlining the changes they recommend that are designed to meet the following 3 objectives:
The Steering Committee report is based on a review of the healthcare regulatory framework in the province which was completed 18 months ago for the BC Government by Sir Harry Cayton of the Public Standards Authority in England.
In addition to these objectives, there was a strong recommendation that all changes to modernize the regulatory framework “…be interpreted and implemented in a manner that acknowledges deeply rooted, historic health inequalities and combats systemic racism in order to enable access to high quality health-care services for all British Columbians”.
What does this mean for our colleagues in the West?
These recommendations are true game changers. To start with, they are recommending that the College of Speech and Hearing Health Professionals of B.C. amalgamate with 6 other Colleges under one large College, called the “Regulatory College of Allied Health and Care Professionals”. The 7 professions under this umbrella will be:
Furthermore, the Board, which will govern this, and the other new Colleges will be smaller (8 to 12) than is typically seen in Ontario, and will be comprised of 50% public members and 50% professional members.
Both public and professional members of the Councils will be appointed by a new oversight body based on governance competencies, which will include diverse perspectives that reflect the community at large. Professional members will no longer be elected by their peers in the respective professions.
What does this mean for the other health care professionals in B.C.?
The recommendations involve the amalgamation of many other Colleges, resulting in 6 Regulatory Colleges in total, instead of the current 20, including the above-mentioned, Regulatory College of Allied Health and Care Professionals. The other 5 Colleges are as follows:
When will these changes take place?
Some have taken effect already. The others require additional legislative changes, which are anticipated in April 2021.
What does this mean for audiologists and speech-language pathologists in Ontario?
It is difficult to predict specific impacts on registrants, but we do anticipate that there will be changes to how we collaborate with our B.C. counterparts, what will be the focus of our work together, and the degree of harmonization we may achieve. We may see future standards of practice coming out of the larger B.C. Regulatory College that reflect the wider set of allied health professionals that they regulate, which in turn may set the stage for opportunities to harmonize Ontario’s allied health professionals’ standards. If you are contemplating a move to B.C., it is not anticipated that labour mobility provisions will change. Finally, other provincial governments may contemplate similar changes, including the Ontario Ministry of Health.
CASLPO will keep a close eye on this modernization effort in BC and a similar initiative just launched for consultation by the government in Alberta in order to position ourselves to seek opportunities to enhance regulation here in Ontario, as appropriate.
Director of Professional Practice and Quality Assurance
This time last year we could not have possibly imagined how the world and our lives would change as a result of the Corona Virus pandemic. In this challenging time, audiologists and speech-language pathologists (SLPs) have stepped up to the plate to provide services to Ontario’s infants, children, adults and seniors. Audiologists and SLPs have had to adapt their services, be redeployed to other roles, work all day wearing personal protective equipment (PPE), learn technologies to provide virtual care, actively screen patients and worry about contracting the virus.
One positive aspect of this unprecedented situation is the increased interaction between the College and audiology and SLP registrants. The two-way communication between the College and Registrants has been busy like never before.
The College has two dedicated pages on the website for COVID-19. The first page provides updates from the Ministry of Health, Ministry of Education, Ontario’s Chief Medical Officer of Health and Public Health Ontario. The second page is devoted to audiologists and speech- language pathologists providing Patient Care in a Pandemic. Here you will find ten Pandemic Practice Advisories, FAQs and links to the e-Forums.
The College has sent out over thirty communications to registrants related to COVID-19. If you think you may have missed one, you can find the communication and the date it was sent on the COVID-19 web page. Thank you for reading the communications, it is very gratifying to know that we have such conscientious and engaged registrants.
For the seven months of March to September 2020, Practice Advisors received 3,324 calls and emails from audiologists and SLPs, a huge increase (60%) from 2019 where 1,394 queries were answered. These questions helped us to determine topics for FAQs and the Pandemic Practice Advisories.
As the pandemic progressed during the spring months, the College decided to reach out to the registrants with a live Town Hall webinar. To ensure its effectiveness, we relied on you to send in questions and issues, and we received over 150 questions. The final registration for the Town Hall was 1,110, over a quarter of all registrants. Three subsequent e-Forums have taken place focusing on audiology services (279 registrants), speech-language pathology services (851) and school services (951) in a pandemic. For the four events we had 3,191 registrations, further evidence of truly dedicated audiologists and SLPs. If you missed an e‐Forum, you can find the recording and slides on the website.
Practice Advice staff held five Practice Advice e-forums at the request of registrants.
If you would like to connect with Practice Advice and your organization or department can promise 10 or more registrants, we would be happy to arrange a mutually convenient date and join you virtually to discuss your questions and issues.
Brian O’Riordan, registrar, signed many communications with the message “We are in this together. We will get through this together.” As we work together to provide quality service to patients, families and care givers during the COVID-19 pandemic please know that we are here to help you.
Director of Registration Services
To give you more information about the 2020 Renewal, CASLPO’s Registration Team has put together some answers to commonly asked questions. If you have a question that you can’t find the answer to, please contact us at [email protected]
Registrants have been impacted by the COVID-19 pandemic in many ways and to varying degrees across the professions. We are therefore providing the following support to all registrants, as well as, additional support to those individuals who have experienced significant financial hardship.
CASLPO Council has extended the period to renew so that the typical annual October 1, 2020 renewal deadline will be extended to December 1, 2020. Therefore, this year's renewal period will start on August 4, 2020 and continue to December 1, 2020.
Although the Council had approved a 2% increase for the 2020/21 renewal year two years ago, they have decided to forego the fee increase this year as another measure to support your renewal.
As in the past, we have a process for considering registrants with extenuating circumstances that impede their renewal (Eg. illness). This year, due to the pandemic, we also recognize that some registrants have experienced serious financial hardship. Those registrants can contact the Director of Registration Services at [email protected] to ask about additional assistance.
CASLPO’s online renewal system is available in the Registrant Portal on the College’s website.
The College is responsible for protecting the public’s right to the provision of safe, quality services from audiologists and speech-language pathologists. CASLPO’s currency hours requirements are one way that the College ensures that registrants are maintaining their clinical competence. For this reason, it is not possible to lower this standard during the pandemic.
Registrants holding a general certificate are required to report truthfully whether they have provided 750 hours of patient care or related work between October 1, 2017 to September 30, 2020. Registrants who do not meet this requirement should provide information in the description box about how many hours they have provided in this time frame and the circumstances that impacted their currency.
The College will review a registrant’s submission and CASLPO’s Registrar may require registrants who fail to meet the above-mentioned requirement to undergo a peer assessment to ensure that the registrant is meeting CASLPO’s practice standards.
Registrants of CASLPO are required to maintain professional liability insurance in the amount and in the form required by CASLPO By-law #6. Ensure prior to making a declaration in the renewal that the professional liability coverage states the following details:
"The definition of Insured under this policy includes Audiologists & Speech-Language Pathologists of Ontario employed by XXX company"
No. The College will no longer offer a Life Member certificate of registration. Consequently, effective October 1, 2020, the titles "retired audiologist" and "retired speech-language pathologist" (or any variation or abbreviation) will no longer be permitted for use as a designation or title.
If you choose NOT to renew your certificate of registration, you must formally resign from the College. To resign, log into CASLPO's Registrant Portal and click on the link to Renew. Then select the link to change your registration status and select Resigned. Follow the instruction to complete your resignation request. The College will contact you by email when your request has been processed.
Due to the COVID-19 pandemic, the College is currently operating a virtual office until further notice. So, please make sure we have at all times, your latest email address where we can reach you.
Please note: At this time, the best way to contact us is by email. There will be no in person visits or document drop-offs to the College until further notice.
In order to reduce the risk of COVID-19 infection, the College will only accept online Visa or Mastercard payments. We will no longer accept cheques, money orders or cash payments for renewal.
What are the annual registration renewal fees for 2020-2021?:
If you need assistance, please refer to the following available resources on our website:
Still need assistance?
After you have completed your renewal, a summary of your renewal, including your payment information, is displayed for you to print. Your summary remains available via the Top Items section on the portal Welcome Page.
In an effort to prevent the possibility of inaccurate information being communicated to the public through the use of a membership card, CASLPO is no longer providing a PDF of membership cards.
The most effective method to confirm registration status is through the College's Public Register, Find an Audiologist or Speech-Language Pathologist, where the information is current and accurate.
Your official tax receipt for 2020 may be downloaded from your Registrant portal account in February 2021.
If you fail to complete your renewal before the December 1st deadline, a 20% late fee in addition to the annual fee must be paid to complete your online renewal.
After the December 1st deadline has passed, the Registrar will send you a notice of the College’s intention to suspend your certificate of registration. If you have not completed the online renewal within 30 days of the notice being sent, the Registrar will proceed with the suspension of your certificate of registration.
If you are suspended, you must cease using the title “audiologist”, “speech-language pathologist” or “speech therapist”, a variation or abbreviation thereof, or an equivalent in another language. You must also not hold yourself out as a person who is qualified to practise in Ontario as an audiologist or a speech-language pathologist or in a speciality of audiology or speech-language pathology.
Your employer will also be notified of your suspension.
In addition, a permanent notation of the suspension will appear in your record in the College’s public register. Your name may also be included on a list of the suspended members appearing in CASLPO’s newsletter ex.press.
If any of the following information changes after you renew, you must update the information in the Registrant portal within 30 days of a change:
Carol Bock, Deputy Registrar and Colleen Myrie, Director of Registration Services
As you may know, CASLPO, as of October 1 2020 will no longer offer the “Life” designation to registrants. However, the Council would like to extend our deep and sincere gratitude and appreciation for the voluntary support given to the professions of audiology and speech-language pathology by registrants who held the “Life” designation.
We hope, however, you will continue to take advantage of the benefits now available to you through CASLPO's website and Facebook posts: including:
The Council and College staff would like to thank all those who have held the designation over the years, and in particular the following registrants for their commitment to the College:
Audiology Advisor and Manager of Mentorship
Despite obstacles presented by the COVID-19 pandemic, many mentors and CASLPO initial registrants (mentees) have found ways to continue with the mentorship process. CASLPO is very appreciative of our mentors as they continue to creatively connect with their mentees to provide support through virtual means and using the Mentorship Self-Assessment Tool (MSAT) online communication functions. Approximately 130 mentorships are expected to be in progress by the end of 2020, with more commencing as graduates become initially registered to practice. Due to pandemic-related obstacles, however, some mentorships have required more time and we continue to grant extensions.
Mentorship is crucial in helping initial registrants understand and meet the minimum expected standards of practice in Ontario at an early career stage. Through the process, mentees reflect on and learn about provincial standards, regulations, legislation and the Quality Assurance (QA) process and how these principles apply in their own practice. Mentors provide invaluable support through guided discussions, record reviews, the MSAT and a connection to other professional resources.
As such, the College continues to prioritize and invest in improving our mentorship program by supporting our mentors and mentees. In 2019 we launched our first mentorship webinar, “A Conversation About Consistency”, and received high praise for the content. In 2020, two major enhancements to the mentorship process will be introduced along with an additional webinar for mentors!
For mentorships that begin October 1st, 2020 and onwards, mentors will be asked to complete the Clinical Reasoning Tool (CRT) with the mentee by or at the midterm evaluation. A version of the CRT for mentors has been devised based on the version developed and validated by the Quality Assurance Program. The integration of the CRT in the mentorship process will assist mentors, and mentees, in evaluating this skill more effectively and early during mentorship.
For mentorships that begin October 1st, 2020 and onwards, mentors and mentees will see four new practice indicators in the MSAT that they are to evaluate. These indicators are aligned with the new 2020 indicators in the Self-Assessment Tool (SAT) and include indicators on:
The MSAT has eight red flag indicators, which are standards that present a higher risk of patient harm if not met by mentees at the midterm evaluation. Clinical reasoning has been added to the list of red flag indicators. The complete list of MSAT red flag indicators include:
1.2 I maintain records which accurately reflect the services provided
1.3 I perform the controlled act of prescribing a hearing aid for a hearing impaired person according to the practice standards and the position of the College
1.7 I follow health and safety procedures and practices
3.1 I obtain and document consent for all intervention plans or courses of action and any significant changes thereafter
3.2 I obtain and document consent to collect, use, retain, and disclose personal health information as required
3.6 I maintain patient confidentiality at all times
3.7 I use clinical reasoning at every phase of intervention
4.4 I accurately communicate my professional credentials to my patients and others
Mentees are contacted and are advised to prioritize red flag indicators for their learning goals during mentorship if not met by midterm.
Once again, we thank all our mentors who have continued to support their mentees through these challenging times and hope we can continue to support you!
For more information about CASLPO’s Mentorship Program, visit the following webpages:
Advisor, Professional Practice and Quality Assurance
In March 2020, due to the evolving COVID-19 pandemic at the time, the Registrar of the College recommended that the 2020 peer assessment site visits be postponed to September 2020. Considering CASLPO registrant and staff safety, under these circumstances, arranging in-person site visits for the spring and summer was not a feasible option. The annual in-person peer assessor training was also postponed.
In July, after much consideration, the Quality Assurance (QA) Committee decided that it was possible to move ahead with a modified Peer Assessment process for 2020.
The peer assessors were educated about the modified process in July 2020, via a virtual meeting.
The process was adapted to eliminate the site visits and the in-person patient records review. The QA Committee also recognized that some registrants were working virtually, making the standard Peer Assessment impossible to conduct.
In order to be fair and transparent, yet fulfill the College’s mandate to protect the public interest, the focus of the Peer Assessments this year was on the registrant’s evidence which had been uploaded to the Self-Assessment Tool (SAT) showing that they meet the standards, along with their Learning Goals and Continuous Learning Activity Credits (CLACs).
Deferrals were considered for registrants who were unemployed, on medical or parental leave, or for other serious extenuating circumstances, including circumstances arising from the pandemic. Out of the 65 registrants selected for 2020, 62 were able to continue with the process.
The Quality Assurance Committee will be meeting regularly for the remainder of 2020, as the modified peer assessments are completed, and they will decide the following:
So far, feedback from the registrants and peer assessors has indicated that the modified process for 2020 has been manageable and each registrant has adapted creatively.
The QA Committee appreciates that participating in peer assessment is challenging, especially in a pandemic, and recognises all the hard work and commitment the registrants have shown to quality assurance.
Director of Professional Practice and Quality Assurance
Two significant events occurring world-wide were the catalyst for our e-Forums in 2020, the Corona Virus Pandemic and the Black Lives Matter Movement.
If you missed any of them, go to our Events Page on the website and click on E-Forums (web based) in the left hand menu to view the recording and/or read the presentation slides.
Director of Professional Conduct
One of the most common issues considered by the Inquiries, Complaints and Reports Committee (ICRC) relates to advertising of services and devices. In many cases, the advertisement is not created by the Registrant, but rather, it is created by their employer. Sometimes the person creating the advertisement is not regulated and is not aware of the College’s proposed Advertising Regulation (“Regulation”), which sets out the requirements in which all advertising, relating to registrants services is evaluated. Other times, the advertisement is created by a marketing team which has reviewed the Regulation and applied their own interpretation of it. In the College’s experience, employers generally do not want to contravene the College’s Regulation. But, advertising that does not meet the requirements under the Regulation can lead to complaints or investigations directed at a Registrant.
When investigating an advertisement created by an employer, the following are a few common misconceptions and statements of defence frequently seen by the ICRC:
This is an incorrect argument. Registrants continue to bear the responsibility to proactively address the advertising issue with their employer. This can include:
It is important to remember that proactively correcting an employer’s advertising takes time and effort. It may include the above steps or different options entirely. It is the Registrant who bears the responsibility of navigating their clinical environment to determine the best steps for effecting change. Registrants are also encouraged to document and maintain a record of their efforts to address advertising issues.
This is an incorrect argument. It is important to remember that an advertisement must be readily comprehensible to the audience to whom it is directed. Therefore, if a patient review does not identify a particular Registrant, it may be reasonably interpreted as applying to any and all employees of a particular clinic or company.
Like most regulated health care professionals, audiologists and speech-language pathologists are not permitted to post patient testimonials and reviews relating to their practice. Should your employer insist that testimonials and reviews are an important marketing tool, a Registrant should recommend the inclusion of a disclaimer to make it clear that any testimonials or reviews do not relate to registered audiologists or speech-language pathologists. The prohibition on patient testimonials and reviews reflects the approach of the Ministry of Health when approving Advertising Regulations proposed by health regulatory colleges
All Registrants have been advised that, despite the fact the Regulation has not yet been enacted, the ICRC expects all Registrants will follow the proposed Regulation as being reflective of the current standards of practice.
Therefore, the argument that the Regulation is not enforceable because it is “proposed” has been rejected by the ICRC. The Health Professions Appeal and Review Board has also upheld the ICRC’s decision to reject this line of reasoning.
It can be difficult to voice concerns respecting advertising with an employer. But, it is also important to remember that audiologists and speech-language pathologists are regulated health care professionals. The public places trust in you to communicate with them in an honest and transparent manner.
If you have any questions or comments, please contact the College’s Practice Advice or the Professional Conduct department at [email protected].