Advice to RPs re: COVID-19

By March 13, 2020March 31st, 2020News

Revised March 31, 2020

Looking for our COVID-19 FAQ? Click here.

In light of the rapidly evolving situation with COVID-19 infections, daily updates are being provided on the websites of the Ontario government and government of Canada. Registrants are encouraged to use these trusted sources to stay current about the situation and guidance for health care professionals.

The Ministry of Health has also set up a Health Care Provider Hotline at 1-866-212-2272 that you may wish to call if you have specific questions or concerns about your practice.

This situation presents an excellent opportunity to review infection prevention and control policies and procedures in your work environment. Whether you work in a hospital, agency, community clinic or private practice, we encourage you to have conversations with your colleagues, managers and directors (as applicable) about the measures you can take to help reduce the risk of infection spreading.  Note that some settings will already have a protocol to manage these situations.

As of March 24, 2020 as part of the declaration of emergency to protect the public, all non-essential business and services in Ontario have been ordered by the premier to close. RPs should use professional judgement to determine which of your clients require ongoing care. The directive from Dr. David Williams, Ontario’s acting Chief Medical Officer of Health, includes some useful parameters that you may wish to consider in determining where and for whom your care is essential.

You are also no doubt aware that, as of March 30, 2020, the provincial government extended the emergency declaration to include the closure of all outdoor recreational activities, based on the advice of the Chief Medical Officer of Health.

As such, CRPO is strongly advising that all registrants move to providing only remote care. We have posted resources and advice on Implementing Electronic Practice to support you in making this move.

Registered Psychotherapists who continue to see clients in person on an urgent, essential or emergency basis are urgent to consider putting in place the following measures until the risk passes:

  • Actively screening clients over the phone before scheduling or confirming appointments for any symptoms and travel history that may be related to COVID-19
  • Asking clients with fever, cough or difficulty breathing to make appropriate alternate arrangements for appointments, including distance appointments or rescheduling appointments for a later date
  • Posting signs in your reception area identifying concerning symptoms and asking clients to identify themselves if they are experiencing any of them
  • Relaxing appointment rescheduling and cancellation policies until such time that risk has passed, e.g. by waiving cancellation fees
  • Making tissues, a garbage can, and hand sanitizer (or a handwashing station) available in your setting
  • Ensuring high-touch surfaces (such as doorknobs, light switches, phones and sink faucets) are cleaned with a disinfectant regularly, or even between client appointments
  • Engaging in proper handwashing technique between sessions with clients
  • Seeking medical care early if you yourself are experiencing symptoms and providing your health provider with information about travel

RPs and other health care providers can also review Public Health Ontario’s Routine Practices and Additional Cautions materials.

Trusted information sources:

Ontario’s chief medical officer of health, David Williams, has issued this advice for health care providers and their employers. He also issued an order on March 20 indicating that health care providers should cease or reduce any non-essential or elective services.

Looking for our COVID-19 FAQ? Click here.

What is known about COVID-19?

“Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV), Severe Acute Respiratory Syndrome (SARS-CoV), and COVID-19. A novel coronavirus is a new strain that has not been previously identified in humans.

Common signs of infection include fever, respiratory symptoms such as cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, kidney failure and even death.

Recommendations to prevent infection spread include performing hand hygiene (either use of alcohol-based hand rub or hand washing with soap and water), respiratory hygiene and cough etiquette (e.g., covering mouth and nose when coughing and sneezing, using tissues to contain respiratory secretions).”

Novel Coronavirus (COVID-19) Guidance for Primary Care Providers in a Community Setting

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What should I know now about the COVID-19 pandemic?

CRPO has posted Advice to RPs Regarding COVID-19 that we will continue to update. It provides general information and important links to trusted sources of information regarding health care practice,  the COVID-19 infection as well as the status of the pandemic. You are encouraged to educate yourself using these links and to check periodically for updates.

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I just got back from a trip outside of Canada OR I think I may have been exposed to someone who has tested positive for COVID-19. What should I do?

The government of Ontario has a COVID-19 self-assessment tool online that you may wish to use to assess your situation and that will help you decide what steps you should take. If your circumstances dictate that you should self-isolate, CRPO expects that you will do so in order to limit the possibility of exposing your clients to infection.

If you are an employee in an agency, hospital or community clinic, your employer might already have a policy in place. In this case, we would encourage you to work with your employer to determine an appropriate course of action regarding self-isolation after a period of travel outside of Canada or possible exposure to someone who has tested positive for COVID-19.

Those in private practice, including group private practice, are encouraged to assess the situation and establish a responsible policy that is proportional to the risks that COVID-19 presents.

Recognizing that self-isolation could impact your ability to provide services to clients, we encourage you to consider options for alternate arrangements. See our COVID-19 FAQ response regarding Electronic Practice (below).

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Do I have to report clients to public health if I suspect they have COVID-19?

Primary health providers, hospitals and long-term care facilities are required to report confirmed or probable cases. RP’s are not required to report suspected cases.

Under powers granted by Ontario’s public health laws, public health authorities can issue an order directing any health information custodian to provide information, including a client’s personal health information.  This order can only be made where there are grounds to believe the information is necessary to investigate, eliminate or reduce the immediate and serious risk to the health of any persons.

During a pandemic, public health officials will be making every effort to trace contact for individuals with confirmed cases of COVID-19. If you receive a request from a public health authority for the personal health information of one of your clients for this reason, you may cooperate with the request if you have reasonable grounds to believe that the disclosure is necessary for the purposes of eliminating or reducing a risk of harm. In the event you ever receive an order, you should only provide as much information as is necessary for the purposes. See section 77.6(1)-(7) of the Health Protection and Promotion Act

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What advice can you provide about planning?

You may wish to review the sites below for specific guidance for health care providers.

Keep in mind that this information is targeted toward professionals in primary and acute care settings  and so – in addition to useful general guidance – includes information on treatment and infection control measures that are likely not relevant to psychotherapy practice. 

We would recommend that you consider a phased approach to planning. What do you need to do today? What do you need to do if circumstances change?

Some practical steps to consider include:

  • Develop a communication plan to let your clients know what to expect with regards to your practice during the pandemic. Let them know if you will be screening to confirm appointments, if or how you will enforce your cancellation policy during the pandemic, what they should be looking for in self-screening before attending appointments.
  • Use communication with clients as an opportunity to provide accurate information to those who might be feeling anxious because of the news coverage of the pandemic. Direct them to trustworthy sources of information.
  • Consider moving to electronic practice (see guidance on this below) in order to ensure continuity of care.
  • Have hygiene supplies such as tissues, a garbage can, and hand sanitizer (or a hand-washing station) available in your setting

We would also encourage you to check with your professional association as they may have guidance or resources that would be useful to you in planning.

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Can I switch to electronic practice?

If you have the appropriate technology in place and the possess the array of competencies that are necessary to engage clients in a safe, effective therapeutic process,  electronic practice may be an option for you to continue to provide care to clients remotely.

Please ensure that you consider issues such as consent, confidentiality, and professional liability insurance.  CRPO has information to provide guidance on electronic practice available on the website:

For more specific guidance, please see the latest post on Implementing Electronic Practice as a way of providing care during the pandemic.

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What platform should I use if I decide to provide services over videoconferencing?

CRPO can’t recommend a specific platform because technology is constantly evolving and there are so many options available.   However, we are aware that many RPs may be considering implementing electronic practice over the short term and need immediate support.

Considering this, we wanted to share VIRTUAL CARE AND THE 2019 NOVEL CORONAVIRUS (COVID-19). This resource includes a comprehensive list of electronic tools that were developed specifically for ‘video visits’ and other forms of virtual or remote medical practice. The list was put together by the professional association for physicians in this province – the Ontario Medical Association  – and an eHealth delivery partner – OntarioMD – who are working together to support physicians in providing care during the pandemic.

Please note that CRPO cannot attest to the effectiveness or appropriateness of these platforms.

Please also note that privacy requirements should be considered from end to end – from the security of your internet access point, to the devices you use, to the features of the specific platforms you use.

Your professional association or an information technology consultant may be able to offer guidance or support on this front.

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Will hours accumulated by delivering online therapy count for those who are in the application process or accumulating hours for category transfer?

Yes, if the hours of online therapy are providing care within the scope of psychotherapy and are appropriately supervised, they will count toward the direct client contact hours that are required for registration and for category transfer

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Can I provide/receive supervision online?

Clinical supervision can be undertaken using the same electronic platforms as remote psychotherapy. Supervisors and supervisees are encouraged to look at the information CRPO has provided about how best to ensure that the approach taken and platform being used will comply with the standards of practice and be an effective way of connecting.

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Will the processing of my application be impacted by the pandemic?

While the CRPO team is operating remotely, staff continue to work full time to process and approve applications.

Transcripts & Credential Assessments
As of March 16, 2020  and until further notice, we are unable to receive official transcripts and credential evaluations by mail.

During this time, applicants can upload an unofficial transcript to the ‘Documents’ tab of their CRPO account. Applicants must send a message to notify CRPO staff once they have uploaded the documentation.  A hard copy official transcript mailed to CRPO at a later date will be required in order to sign up for the Registration Exam after approval.

Internationally trained applicants are encouraged to obtain a credential assessment through World Education Services since they send CRPO the completed evaluations with transcripts electronically.

Statutory Declaration
CRPO normally requires the statutory declaration to be signed by an authorized individual (e.g. Commissioner of Oaths, notary public or judge). Until further notice, CRPO will accept statutory declarations only signed by the applicant. At a later date, in order to sign up for the Registration Exam, a statutory declaration signed by an authorized individual will be required.

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Is the April 30, 2020 exam still taking place?

No. The April 30, 2020 Registration Exam is postponed until further notice. We will continue to monitor the situation to determine the first possible date to reschedule and will communicate next steps after May 1, 2020.

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