January 2019 News - Dalton Associates

Welcome to our New Format of Communication!

We are excited to be releasing this new Dalton Associates Communication Bulletin!

On a monthly basis, we’ll be sending this interactive newsletter to all of our associates to keep you up-to-date on memos, updates to the practice, changes in practice standards and legislation, important information, professional development opportunities, etc. The newsletter will be emailed to all associates, as well as posted on the Intranet for your reference.

This newsletter will become part of Dalton Associates’ quality assurance standards, to ensure that we have regular communication with our associates, and that you have the information you need to keep our practice and our clients safe.

Staff Bio of the Month – Candice Thornton

An employee since 2007, Candice Thornton’s role has dramatically evolved throughout her career with Dalton Associates. Initially hired as a summer student to close clinical records, Candice has contributed to nearly every major Practice initiative over the past decade and currently holds the position of Manager of Administrative and Rehabilitation Services.

Since returning from maternity leave last year, Candice’s focus has been on developing our new electronic health record platform, in partnership with our external IT consultants.

Candice also works, through Dalton Associates, with the Ontario Rehabilitation Alliance (ORA) as Help Desk and SABS Guru. In this role, she provides support and guidance to allied health professionals treating MVA clients, with respect to healthcare legislation, privacy law, and the Statutory Accident Benefits Schedule.

Candice is also a regulated health professional and maintains a busy massage therapy practice, part-time.

Changes to MVA Practices for Psychotherapists

Over the past several months, many Psychologists in Ontario, including within our own practice, have experienced difficultly with auto insurers not accepting a supervised practice model and/or confusing psychological services with the Controlled Act of Psychotherapy, and as a result, are refusing to approve and pay the appropriate fees for psychological services.

Two of such insurers are Intact and Aviva.

Intact

Intact has been partially approving requested Psychological Services at a reduced rate of $99.75 per hour. They claim that the services we are requesting are in fact, “the Controlled Act of Psychotherapy” (CAOP) and not Psychological Services. This, of course, is not the case as psychological services, rehabilitation and counselling all fall outside of the scope of the CAOP. Despite continuous attempts, over the past several months, to educate Intact regarding the difference between the Controlled Act of Psychotherapy and Supervised Psychological Services, they are unwilling to change their position.

Our response to Intact: Dalton Associates is not able to provide psychological services at a rate of $99.75 per hour (the Professional Service Guideline rate for a Psychologist is $149.61 per hour). It seems that Intact is confusing the Controlled Act of Psychotherapy with the commonly utilized supervised Psychological Services model, and is refusing to pay the appropriate rate for Psychologists, thus creating a barrier to Psychological Services for clients. As such, our recommendation for these clients is to engage in Psychotherapy Services through Dalton Associates, provided by a Registered Psychotherapist, independently of a Psychologist. This service can be performed at the approved rate of $99.75 per hour (plus hst*).

Clients treated through the Psychotherapy model are not overseen by a Psychologist. The Psychotherapist is 100% responsible for their treatment, and is not required to seek supervision. Should the Psychotherapist require clinical support, they may contact the Psychologist, who assessed the client, for consultation (although the responsibility for the client remains with the Psychotherapist). The Psychologist will become involved in the client’s treatment again, towards the end of the treatment plan for re-assessment and to submit an additional OCF18 for Psychotherapy services, if applicable.

At the insurance approved rate of $99.75 (plus hst), Dalton Associates pays the Psychotherapist $70.00 per hour (plus hst, if the psychotherapist is a registrant for hst). Dalton Associates will continue to administer the insurance billing, treatment plans, record storage, etc.

It should be noted that we are also experimenting with requesting more than $99.75 per hour for Psychotherapy services, as Registered Psychotherapists are not recognized in the Professional Services Guideline and as such, there is no set fee (Intact has arbitrarily assigned the fee of $99.75 per hour for Psychotherapy services; in line with the hourly rate of an Occupational Therapist or Physiotherapist, according to the Professional Services Guideline). Should Dalton Associates successfully obtain approval for more than $99.75 per hour for Psychotherapy services, then the therapist will be paid the regular MVA rate of $76.67 per hour (plus hst, if the psychotherapist is a registrant for hst).

Aviva

Typically, Aviva has been approving requested Psychological Services at a reduced rate of $58.19 per hour, when delivered under a supervised practice model. Their stance has been that if a Psychotherapist is delivering the service to the client (despite it being under the clinical supervision of a Psychologist), then they will not pay the Psychologist rate. Rather, Aviva has opined that since Registered Psychotherapists are not recognized in the Professional Services Guideline, they should be paid at the “Unregulated Provider” rate of $58.19 (ignoring the fact that Registered Psychotherapists are in fact, Regulated Health Professionals in accordance with the Regulated Health Professions Act).

Our response to Aviva: Dalton Associates is not able to provide Psychological Services or Psychotherapy Services at a rate of $58.19 per hour. Aviva’s stance has created a barrier to both Psychological Services and Psychotherapy Services for clients. As such, we are no longer able to serve any new MVA clients who have auto insurance through Aviva unless the adjuster agrees specifically to pay the Psychologist rate and accept a supervised practice model.

Next Steps

Associates should continue to treat their current Intact and Aviva clients as usual, with no changes to the workflow. If your MVA client(s) are affected by either of the above noted insurers, then Taylor Annett, Rehabilitation Services Coordinator, will be in communication with you at time of the next treatment plan submission to discuss the plan of action for your particular client on a case by case basis.

Dalton Associates has partnered with the Ontario Rehabilitation Alliance, an advocacy association for service providers working with MVA clients. Our common goal is to lobby the provincial government (who currently regulates auto insurance) to implement a system which improves access to mental health services without barriers, and to pay providers fairly for services rendered to MVA clients.

Updated Consent to Service Forms

The past year has seen a lot of changes to our practice based on new provincial legislation and CPO standards of practice with which we must abide. As a result, we released some updates to our policies and procedures, and want to ensure that all associates are aware of, and are using, the most current consent to service forms.

The Consent to Services forms for our general counselling services (supervised psychological counselling services), MVA, and WSIB clients were updated as of the end of August this year. Many of you may not access the Intranet every time you use the Consent to service forms with new clients, so we wanted to ensure you knew that these documents have been updated. You can access them on the Intranet under Forms > Client Record-Keeping Forms, or you can download them from this article.

Please familiarize yourself with the Consent to service forms and review them with your clients before they sign them at the first session. We’d be glad to hear from you if you have questions or require clarification.

In future, all updates to forms, policies and procedures will be advertised through the Communication Bulletins, to ensure everyone is informed! If you have any questions or concerns, please do not hesitate to contact Candice Thornton, Manager of Administrative and Rehabilitation Services, at 1-888-245-5516 Ext. 131 or candice@daltonassociates.ca.

Click here to download the new Consent to Service Form. Fillable PDFs and Consent to Service Forms for MVA and WSIB services can be found on the Intranet.

Dalton Associates Serving Sioux Lookout First Nations Health Authority

Dalton Associates has partnered with Sioux Lookout First Nations Health Authority (SLFNHA), who has connected with organizations able to provide a variety of psychological and mental health support services to the First Nations communities of Northern Ontario.

SLFNHA and the remote First Nations communities they serve have established a local mental health and wellness strategy for addressing mental illness, addictions, psychoses, etc. in their communities; however, there continue to be challenges with bringing in qualified, adaptable service providers who can sustainably support the wellness goals in these remote communities of Ontario’s north. We are honoured to have been invited to participate in the work being done towards these goals through specialized case management and triaging, counselling, and psychological assessment, diagnosis and treatment planning.

In early October, our team visited Sioux Lookout to meet the SLFNHA team and commence our support of their psychological and mental health services. We have a fantastic group of experienced, skilled psychologists and therapists as part of the team attending Sioux Lookout and the remote communities, including:

As part of our commitment to SLFNHA and the communities they serve, our team will be planning monthly trips to Sioux Lookout and the Northern communities. If you are interested in joining our team serving the First Nations communities, or to learn more, please contact Carl Dalton at carl@daltonassociates.ca.

Dalton Associates at HRPA 2019 (Jan 30, 2019 to Feb 1, 2019)

Dalton Associates will be attending HRPA’s (Human Resources Professionals Association) annual conference and trade show in 2019 as an exhibitor. HRPA is Canada’s largest human resources conference and attracts more than 4,500 HR and business professionals. The conference will be held at the Metro Toronto Convention Centre, South Building. For more information about the HR services offered by Dalton Associates, please contact Carl Dalton at carl@daltonassociates.ca.