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Need To Know

Changes Affecting Registrants

Government - Legislative Changes / Announcements

Practice Advice

Registration and Mentorship

Quality Assurance

CASLPO Forums

Complaints and Hearings

ex•press | Volume 8 - Issue 2 - September 2022

Need to Know

Brian O'Riordan
Brian O'Riordan

Registrar and CEO

In this newsletter, you will find valuable information on how to continue to keep up to date with useful and accurate resources as well as practice advice.  As the pandemic continues to evolve, it is important to continue to stay engaged with the College. Continue to access our website’s COVID-19 Information and ‘Providing Patient Care in a Pandemic pages.

Also, this ex.press issue offers you important new information on a variety of topics to assist you to better serve your patients as a self-regulated health professional including:

As well, learn about changes to CASLPO senior staff and the Board.

Let me again extend my thank you to all registrants for your continued outstanding service to your patients during this challenging time.  

As always, be sure to visit CASLPO’s website often, - it’s your main source of the latest information.

Please keep safe and stay healthy!

CASLPO’s Senior Staff has Undergone Changes Recently.

By Brian O'Riordan, Registrar and CEO

Carol Bock, Deputy Registrar at CASLPO since 2008 has decided to retire from the College this Fall. Carol has contributed in many ways to the success and growth of the organization, particularly in her oversight of the Registration, Mentorship, Quality Assurance and Practice Advice programs. As well, Carol has developed and monitored the College’s Strategic Plans, the Board Governance Assessment tools, and development of many innovative communication vehicles including the familiar “Did You Know…?” and most recently Indigenous language community posters. Carol has also made many presentations to Association and Regulatory conferences as well as university students in both Audiology and Speech-Language Pathology programs across the province. She has spear-headed several important national projects including the establishment of Cross-Provincial Practice registration agreement across 5 provinces.  Please join me in thanking Carol for her outstanding contributions and wishing her well.

I am pleased to announce that Margaret Drent, who is currently the College’s Special Advisor, Innovation and Collaboration, will become the new Deputy Registrar for CASLPO, effective October 1st.

Margaret has held a variety of roles at various public sector organizations including the Ontario Court (Superior Court of Justice), the Legislative Assembly of Ontario, the Office of the Information and Privacy Commissioner/Ontario, the Health Professions Regulatory Advisory Council, and the Law Society of Ontario.

Margaret was CASLPO’s first Director of Professional Conduct in 2011-2012 and served as Acting Director of Professional Conduct, General Counsel and Diversity Equity and Inclusion (DEI) Officer when Preeya Singh was on leave in 2020-2021. Margaret is a bilingual lawyer with degrees in civil and common law from McGill University. Margaret currently serves on the Board of Directors of the Canadian Network of Agencies for Regulation (CNAR).

Margaret so far, has initiated individual meetings with CASLPO Staff to build upon a collaborative and cohesive team environment.  She looks forward to engaging with the public, registrants and stakeholders in her new role.

New Directors to CASLPO Board
New Elected Professional Members

The registrants of CASLPO have recently elected two new professional registrants to CASLPO's Board of Directors.

Emily Rosen
Audiologist – District 1

Read biography

Kanwar Anit Singh Saini
Speech-Language Pathologist – District 6

Read biography

New Public Members

The provincial government has also recently appointed two new public members to CASLPO’s Board of Directors

Brian Mason
Public Member

Read biography

Thomas Robson
Public Member

Read biography

 

Please join us in welcoming CASLPO’s new public members to the Board.


COVID-19 Resources

By Dana Prutschi, Director of Professional Practice & Quality Assurance

Keep up-to-date with public health information, resources and CASLPO practice advice by accessing CASLPO’s COVID-19 Information and  Providing Patient Care in a Pandemic web pages.


Top 5 Questions About Cross Provincial Practice Answered

By Carol Bock, Deputy Registrar

Now that the much anticipated Cross Provincial Practice Agreement is in place, here are the top 5 questions answered for you:

  1. What is the Cross Provincial Practice (CPP) Agreement?
    A Cross Provincial Practice registration allows you to provide a maximum of 200 direct client/patient care hours in the secondary province over a 12-month period. The care can be delivered in person or virtually. The agreement makes it easier, faster, and less expensive than applying for full registration in the secondary province.
  2. Which provinces have signed the agreement?
    Alberta
    Manitoba
    New Brunswick
    Ontario
    Saskatchewan
  3. What are the requirements for a Cross Provincial Practice Registration?

There are four common requirements for the Cross Provincial Practice registration across the participating provinces:

  1. The applicant must ask the regulator in their primary province to send a “Verification of Registration – Cross Provincial Practice” form directly to the secondary province’s regulator. The Verification of Registration- Cross Provincial Practice form must state:
    • The name of the certificate, license, or permit they hold in the primary province, and
    • That the applicant is in “good standing,”
  2. The applicant must complete an “Application” form for the province to which they are applying.
  3. The applicant must pay all applicable fees in the secondary province to register for Cross Provincial Practice.
  4. You must be a fully practicing registrant in your primary province. This means you cannot be practicing under supervision, nor mentorship.

There will be additional requirements for each province you apply to for Cross Provincial Practice registration (such as police checks), as well as differing processes, and fees.

  1. Can I renew the CPP registration once I’m registered?
    No. The CPP registration in any of the participating provinces expires 12 months after you are granted registration. If you wish to continue practicing under the CPP registration, you must reapply to the province and demonstrate you meet the requirements at the time of reapplication.
  2. Do I have to be working in my primary province?
    Yes, not only must you be working in your primary province, the majority of your direct client/patient care must be in your primary province. The total amount of client/patient care across all the secondary provinces in which you are registered must be less than the total amount of care you provide in your primary province. For example, if your primary registration is in New Brunswick and you work ½ time, this can be considered approximately 672 hours of direct client/patient care (approximately 17.5 hours per week over 48 weeks and assuming 80% of your working hours are direct client/patient care). Therefore, you must keep the total direct client/patient care hours, across all provinces where you hold a secondary registration, under 672 hours.

    For more information on the Cross Provincial Practice opportunities, review:

2021 CASLPO Annual Report

By Brian O'Riordan, Registrar and CEO

Learn how your fees are at work protecting the public interest. Visit our Annual Report Archive, or view the 2022 Annual Report PDF [English | Français].


Changes Affecting Registrants

Carol Bock
Carol Bock

Deputy Registrar

Trust Matters. Supporting Ontario’s Indigenous Communities.

Over 200 contacts across Ontario’s Indigenous communities have now received our ‘Trust Matters posters’, translated into 3 Indigenous languages (Ojibway, Oji-cree and Cree)!

As we reported back in early spring, we worked with 7 dedicated CASLPO registrants who helped us by reaching out to the Indigenous communities that they work in, to find out what CASLPO materials would be best to translate, and into which Indigenous languages.

Based on the advice of these communities, we translated the original ‘Trust Matters’ poster from English into the top 3 preferred languages and used new imagery that reflects the Indigenous Peoples of Ontario. We were fortunate to also engage a company that works directly with Indigenous communities, who helped us to modify the design, translate and distribute these posters.

Through this project, we hope that more diverse communities across Ontario will find out about audiologists and speech-language pathologists and appreciate that they are trusted, regulated health professionals.

If you wish to share the message, simply contact us and we will send you the requested posters or you can download them from our website’s Patient Resources section.


Colleen Myrie
Lisa Gibson

Communications Manager

New CASLPO website – launched; check it out!

Now, it’s easier for you to find the information you need.

The new CASLPO website features updated navigation, a refreshed design and offers a streamlined way to help you find the information that you’re looking for. 

New website development considered survey feedback received from the public via the ‘Citizen Advisory Group’, a CASLPO registrant focus group, and staff. Input was also received from College staff leadership in response to facilitated vendor design presentations and from the CASLPO Board’s Patient Relations Committee. 

Summary of improvements:

If you have questions about the new website or want more information about CASLPO’s public awareness initiatives, please contact us at [email protected]


Dana Prutschi
Dana Prutschi

Director of Professional 
Practice & Quality Assurance

Upcoming Dysphagia & Advertising CASLPO consultations

Have your say! CASLPO’s revised Dysphagia Standards and new Advertising Standards will be out for stakeholder review this fall.  This is your opportunity to provide feedback on these standards. We value your input. Standards must reflect the safe, quality practice that you provide.

Practice Standards for Dysphagia Intervention by Speech-Language Pathologists

CASLPO’s Practice Matters Committee has a mandate to provide practice advice to the Board on regulatory matters affecting audiologists, speech-language pathologists and the practices of audiology and speech-language pathology. The Committee recommended the revision of CASLPO’s Practice Standards and Guidelines for Dysphagia Intervention by Speech-Language Pathologists (2007). The Committee felt that revising the Practice Standards would mitigate potential for high risk of harm.  A detailed environmental scan informed the standards revision. An Advisory Working Group of ten speech-language pathologists who work in diverse dysphagia practice settings across Ontario also met to provide additional feedback.

The Practice Standards document was reduced from 24 to 13 standards with increased focus on:

Practice Standards for Advertising by CASLPO Registrants

In September 2021, CASLPO’s Board approved the conversion of the Proposed Advertising Regulation, 2013 into Advertising Standards. CASLPO consulted with several health professional regulators in the process of drafting the standards.  An Advisory Working Group, consisting of seven audiologists and three speech-language pathologists, provided input on the draft standards.  All participants worked in a variety of private practice settings, some also in the role of clinic owner and operator.   

Registrants, members of the public, associations, and regulatory colleges across Canada will have 30 days to review both draft standards and provide feedback. Stay tuned for an email from CASLPO in the fall of 2022. All feedback will be considered by the Practice Matters Committee and Board before approving the final version.


Government - Legislative Changes / Announcements

Accountability

By Brian O'Riordan, Registrar and CEO

How well are Ontario’s health professional regulatory colleges protecting the public interest?” This is the question the Ontario Ministry of Health asked health profession regulators to answer when it developed the College Performance Measurement Framework (CPMF).  In case you missed it, access CASLPO’s 2021 College Performance Measurement Framework submission and our recently published Annual Report. Watch for new CPMF updates… more


Practice Advice

Answers to Your Virtual Care Questions

By Dana Prutschi, Director of Professional Practice & Quality Assurance

What are common questions that the College has received from CASLPO’s registered audiologists and speech-language pathologists and the public? How does virtual care work with the Cross Provincial Practice agreement that allows registrants to provide clinical services to patients in the participating provinces?

While 2020 started with few CASLPO registrants providing virtual care, the number of registrants actively providing these services has exploded.  The CASLPO Virtual Care Standards were published in September 2020.  Questions continue to reach CASLPO’s Practice Advice team. The new Cross Provincial Practice Agreement may answer some of your questions.

When thinking about virtual care as an option, two big issues are: Where is the patient located? Where is the registrant located?

Q: Can I provide weekly health care services when my patient is outside of Ontario?

A: You must check with the applicable regulatory authority (college, state board, association, etc.) where the patient is to find out what the jurisdictional requirements are. Ask if you can provide virtual services, and then follow all their licensing requirements and standards (Virtual Care Standards FAQs). 

Q: Can I provide weekly health care when I am outside of Ontario?

A: As a CASLPO registered audiologist or speech-language pathologist, you do not need to be physically in Ontario to provide virtual care services to patients in Ontario. However, other provinces, states or countries may have a different set of rules. You may have to be registered there, as well. You would need to check with the regulatory body where you, the registrant, will be located for the intervention.

You must continue to comply with CASLPO’s Code of Ethics and all other standards while providing virtual care. 

Q: My patient is traveling to Saskatchewan/Manitoba/New Brunswick/Alberta. Can I treat them while they are away?

A: Those four provinces are part of the Cross Provincial Practice (CPP) Agreement. You can apply to the province(s) of interest for a CPP registration to determine if you are eligible. The 12-month certificate allows you to:

Find out more in the article ‘Top 5 Questions About Cross Provincial Practice Answered

Q: My patient is going to Panama. I called the regulator in Panama and they said I can’t practice there. The world is changing. Why can’t our virtual care rules change too?

A: Every province, state or country that regulates audiologists and speech-language pathologists has the responsibility of protecting its residents or people receiving care in the jurisdiction. Consequently, they will typically have some rules in place about whether someone else can provide intervention or a method of registering a care provider. This process allows the area some level of assurance that any poor care or, even worse, harmful care can be managed effectively.

CASLPO put a lot of resources and energy into establishing an agreement with four provinces for the Cross Provincial Practice. The agreement allows CASLPO and the other provinces assurance that quality care is provided to anyone in our respective provinces.

Without an agreement, any province, state or country that regulates audiologists and speech-language pathologists must be the ones to determine if, when and how a professional may provide care in their jurisdiction. Agreements within Canada are now in place. Agreements with other Countries or states may some day be possible but until then, you must always respect the rules each jurisdiction applies to protect their residents.

Q: Are there any other things to think about when I am considering providing service to my patient while I’m out of the province?

A: If you, the registrant, will be out of the province:


Registration and Mentorship

Colleen Myrie
Colleen Myrie

Director of Registration Services

Make sure you renew your Annual Registration Now!

Audiologists and speech-language pathologists are required to be CASLPO registrants to practice in Ontario. Thanks to those who have already renewed their CASLPO registration for 2022-2023! Your annual registration renewal is an important part of the College's work as an audiology and speech-language pathology regulator in Ontario.  Your renewal helps to provide the College with valuable registrant information, enables CASLPO to keep our public register of audiologists and speech-language pathologists current, and helps us to identify trends that we can use to make policy.

If you have not finished your renewal yet, you have until October 1, 2022, at 11:59 p.m. Eastern Daylight Time (EDT) to do so. If you do not renew your registration when it is due, it will cost you a late fee of $156 and it could result in the suspension of your certificate.

RESIGNATION

If you do not wish to renew your registration with CASLPO for 2022-2023, you must submit a request to resign from the College in one of the following ways:

  1. Login to your Registrant Portal account, click on your renewal and request a change of status to “Resigned” or
  2. Email [email protected] to submit a written request to resign from the College that includes the reason you wish to resign (i.e., leaving province for another province/territory in Canada, leaving Canada, changing profession, retiring, on leave).
TO KEEP YOU ON TRACK:

Start the Renewal/Resignation Process

QUESTIONS?
  1. Email [email protected]
  2. Call 416-975-5347 or Toll-free (ON) 1-800-993-9459, Monday -

Friday (excluding statutory holidays) between 9 AM to 5 PM (EDT) to

leave a voicemail message for a Renewal Team member:

Your time is important to us. Including your name, registration number and a brief issue summary or question (via email or voice message) will enable us to respond faster and find a solution.

We will do our best to respond to all messages within 2 business days. Your patience is greatly appreciated.


Samidha Joglekar
Samidha Joglekar

Audiology Advisor and Manager of Mentorship

A Mentor’s Voice

We asked some of CASLPO’s audiologist and speech-language pathologist mentors to share their reflections on the mentorship experience.  What they shared shines a light on how mentorship supports quality practice, and how it helps both mentors and mentees with practice reflection and continuous learning and improvement.

Q. In what area did you observe significant development in your speech-language pathologist mentee’s practice?

A. I was very impressed by my mentee's development in independent clinical reasoning throughout our mentorship. Initially, when presented with a challenging case, I had to ask many prompting questions to support her in identifying the important information and in finding a solution. As the mentorship progressed, she would come to our meetings and independently start asking herself insightful questions and discussing her observations such that she came to a solution without my advice. It was so nice to see her confidence grow as she was able to reflect and navigate through these scenarios on her own. I found myself saying more and more, “I would do the same”!   

- speech-language pathologist mentor in a Children’s Treatment Centre

Q.  What has been an interesting aspect of mentoring initial registrant audiologists in a rural practice setting?

A.  We work primarily with pediatric patients in Indigenous communities.  Our services are adapted in many ways, as we fly into these communities to serve our patients.        

An important focus of mentorship has been on developing cultural competence.  To support this, my mentee had a learning goal and together we attended weekly sessions with a cultural liaison from the community who provided lessons on topics impacting the communities where we provide our services. In one session, the liaison discussed how we dress when we go to see patients on the reserve. He mentioned that often if health care professionals who are visiting the reserve are wearing formal clothing and look "business oriented", then people within the community could associate this with traumatic childhood experiences. He explained that, for the communities we serve, knowledge or skills are rarely associated with how you dress, and people will be more open if we are in casual clothing. This was an interesting dialogue and really made us think.

- audiologist mentor in rural Northern Ontario

Q.  What do you enjoy most about being a mentor?

A. It is always so beneficial to ensure that I, as a mentor, can clearly explain every step of my own assessment and treatment process and to always be aware of exactly why I am doing something. I love reflecting on my own practice by mentoring and learning from mentees. They share their current knowledge, and it is inspiring to watch how different speech-language pathologists target different goals. For example, I was impressed by my mentee’s ability to move from targeting a goal herself to being able to teach a parent to target a goal. As she gained confidence in her skills, I observed that she was able to coach parents and effectively involve them in the speech-therapy session.  Even something as simple as observing how mentees use toys to engage our clients is very refreshing for me as a clinician. 

- speech-language pathologist mentor in a pre-school speech and language program

The College appreciates and thanks CASLPO audiology and speech-language pathology mentors for the valuable contributions they make in supporting their peers!


Considerations for Employer-Provided Professional Liability Insurance Coverage

By Colleen Myrie, Director of Registration Services

As you know, all audiologists and speech-language pathologists in Ontario must maintain professional liability insurance coverage in accordance with CASLPO By-law #6.  Further, if you do not have adequate professional liability insurance, you will have 30 days from receipt of a notice from CASLPO to obtain coverage that complies with College by-laws or your certificate of registration will be suspended.

Confirming the Details of Your Coverage

We are often asked what to look for when determining if the professional liability insurance provided by the employer is adequate.

If you decide to rely on your employer’s policy to meet CASLPO’s insurance requirements, ask your employer for a copy of the policy’s certificate of insurance or for a letter confirming the following details regarding your coverage:

If the insured is your employer, the employer's certificate of insurance must list which employees are also covered by the policy as “additionally insured,” such as:

This policy's definition of "Insured" includes Audiologists and Speech-Language Pathologists who work for XXX company.

These details also apply to any personal professional liability insurance you may wish to purchase independently.

Know The Limits of Your Employer's Coverage

Your employer’s coverage is not transferable and only covers you while you are practising at a setting covered by the policy. If you have your own coverage, you are protected anywhere that you practice.

Your employer’s policy would typically have an aggregate limit of liability. It is important that the aggregate limit meets the minimum coverage requirements set out in CASLPO By-law #6 for all employees who are covered by the policy.

Glossary of insurance Terms

General Liability Coverage
General liability insurance protects against claims arising from bodily injury and or property damage.

Professional Liability
Professional liability insurance protects against claims arising from professional negligence.

Per claim limit of liability
The per claim limit is the maximum amount of money the policy will pay for a single claim.

Aggregate limit of liability
The maximum amount the insurance policy will pay in one year notwithstanding the number of claims.

Named Insured
The person/entity insured under an insurance policy. This party enjoys the benefits of the policy and has the duties and obligations set forth in the insurance policy.

Additional Insured
The person/entity that is added as an insured under and insurance policy at the request of the named insured person/entity.

Occurrence-Based Coverage
An occurrence-based policy covers incidents that happened during the policy period, regardless of when the incident is reported.

Claims-Made Coverage
A claims-made policy can cover an incident only if it’s reported during a period of time specified in the policy.


Quality Assurance

Do you know... How to Manage Conflict of Interest?

By Dana Prutschi, Director of Professional Practice & Quality Assurance

Can you identify when you are in a conflict of interest situation? There are many examples of conflict of interest that need to be managed.  For example, what do you do if…

Practice Advice gets questions about situations like these. As a result, “Did You Know… how to manage conflict of interest?” tells you at a glance:


CASLPO Forums

CASLPO E-Forums Update

By Dana Prutschi, Director of Professional Practice & Quality Assurance

Upcoming E-Forums:

Watch for CASLPO E-Forum invitation emails closer to the dates.

Past E-Forums:

Have you seen the latest CASLPO E-ForumsInvestigations and Complaints and Fireside Chat with CASLPO’s Registrar, Brian O’Riordan? Hundreds of viewers watched the E-Forums, now posted on CASLPO’s website.

The Professional Conduct and Practice Advice teams have responded to questions submitted both before and during the webinars.  Questions included:

 


Complaints and Hearings

Preeya Singh

Preeya Singh

Director of Professional Conduct

Common Areas of Investigation

While each investigation that comes before CASLPO’s Inquiries, Complaints And Reports Committee (ICRC) is considered on its own unique facts and details, there are several trends that have emerged over time.

For instance, during CASLPO’s 2021-2022 fiscal year, the most common areas of investigation considered by the ICRC included unethical or unprofessional behaviour, record keeping issues, Standards of Practice, and communication breakdown.  Below are some general observations and decisions that have been provided by ICRC panels.

Unethical or Unprofessional Conduct (16 instances)

The ICRC consistently relies upon the College’s Code of Ethics (English | French) when considering complaints received from the public. Ontario’s regulated audiologists and speech-language pathologists, can, at times, find themselves in difficult and contentious situations with patients and people who have a significant relationship to a patient. ICRC Panels will frequently remind registrants of Principle 2 (Patient Benefit) and Principle 3 (Accountability) in terms of their communication. Opportunities to reflect, pause and perhaps seek guidance on how to manage difficult situations are important to address concerns when raised.

Recordkeeping (12 instances)

Records are an important part of the delivery of care. In many cases, the ICRC panels observe problems with records when a registrant is struggling with meeting their practice obligations. Causes come from both professional and personal sources, including poor workplace fit, large patient case loads, and potential health issue(s). Registrants who find themselves in these circumstances often feel that they have few avenues available to assist with meeting their recordkeeping obligations. Registrants are encouraged to proactively address their record-keeping obligations and seek assistance to avoid growing issues that eventually surface with unmet documentation record-keeping requirements.

Speech-Language Pathologist Standards of Practice (9 instances)

When there are concerns that a registrant is not meeting CASLPO’s standards of practice, the ICRC panels will consider whether there are in fact gaps in the registrant’s practice and evaluate whether these gaps pose a risk of harm to patients. This is a broad category of investigation and can relate to different categories of standards affecting patients. In many cases, where a registrant is struggling to meet the standards of practice, the work environment is either new or unfamiliar, and so it is important to always practice within one’s knowledge and competencies.

Communication Breakdown (8 instances)

As with unethical and unprofessional conduct, registrants can find themselves in situations in which the communication exchanged between a person and an audiologist or speech-language pathologist, demonstrates a breakdown in respectful or professional communication.  The ICRC panels will remind registrants to take a patient-centered approach, and consider why there has been a breakdown in communication from the perspective of the patient or concerned party. It is important to remember that, as health care professionals, the public expects responsive and professional correspondence from their providers. The public may come with expectations that do not align with the service delivery model and so it is important for registrants to consider the perspective of their patients and proceed accordingly.

There are always lessons to be learned from our own experience as well as the experience of our colleagues. Implementing changes to your practice based on the concerns that are trending can be a useful way to recognize potential issues, and to address concerns before they become a problem.

In case you missed CASLPO’s ‘Investigations and Complaints’ webinar, what factors affect the College’s investigation, & who makes case decisions... More


© 2022 CASLPO

© 2022 CASLPO

This website is intended to provide information to the public and registrants. Should there be difference in documentation previously distributed to CASLPO registrants, it is up to the registrant to source the latest version posted on the CASLPO website. Note: the term "member" and "registrant" are used interchangeably throughout CASLPO's website and documents. Both terms are synonymous with "member" as defined in the Regulated Health Professions Act, 1991, the Audiology and Speech-Language Pathology Act, 1991, and the Regulations under those Acts.