• The Designated Physiotherapy Clinics Association (DPCA) and the Ontario Ministry of Health and Long Term Care share a goal to provide equitable access to OHIP-funded physiotherapy for children, seniors, welfare recipients and disabled persons across the province.
  • The 94 Designated Physiotherapy Clinics (DPC) in Ontario provide community access to physiotherapy in the municipalities in which their licenses are registered. They employ over 3,000 physiotherapy staff.
  • In 2010-11 DPCA members provided physiotherapy treatments to over 150,000 Ontario seniors, children, welfare recipients and disabled persons.
  • DPCA members provide services in almost every community in Ontario through their work in Long Term Care Homes and Retirement Residences.
  • Community access for ambulatory patients is restricted to the communities in which the 94 licenses are registered. There have been no new licenses granted since the 1960s.

DPCA Offer to Expand Community Services While Addressing Fiscal Challenges

  • The current DPCA proposal seeks to leverage existing infrastructure of Retirement Residences, Seniors Activity Centres, Long Term Care Homes, and other community resources that could be a host/hub for community patients to access OHIP-funded physiotherapists already working in those communities.
  • By partnering with government and the operators of these homes, DPCA proposes a cost-effective way to expand access using existing facilities and human resources without a significant impact on the OHIP budget.
  • If DPCA members did not have this presence in Long Term Care and Retirement Residences, it would be unable to make this offer to expand community service.

Freezing DPCA Fee Rate to Help Government with Fiscal Challenge

  • The OHIP payment per treatment from DPCA providers has been frozen at $12.20 since 1996. DPCA proposes to maintain this freeze for two more years (2014-2015) in order to assist the government with its current fiscal challenge.
  • DPCA proposes to introduce new restrictions on patient to physiotherapy ratios in Retirement Residences, introduce tighter guidelines to assess the clinical need for physiotherapy, and is offering to provide reduced rates for post-surgical rehab patients.
  • The average cost per physiotherapy treatment via CCAC is approximately $120 per treatment – largely due to overhead and administration. DPCA has offered to government to provide those same treatments for half the cost of the current amount spent through CCACs.

Increasing Community Need for Physiotherapy

  • Hospitals are increasingly closing or limiting their out-patient rehabilitation services, putting increased pressure on other providers. This highlights the need to use existing resources and providers to do more in these communities. This is what DPCA proposes to do.
  • In October 2011, the Ontario Physiotherapy Association, Ontario Society of Occupational Therapists, and the Ontario Orthopedic Expert Panel jointly published a current state review of outpatient rehabilitation services at Ontario acute and rehabilitation hospitals.1 Some of the key findings include:table4
    • Of 120 sites that responded (a 66% response rate):
      • 59 hospitals provided both PT and OT
      • 50 hospitals provided only PT
      • 3 hospitals provided OT only
    • There is a marked increase in reductions/closures of outpatient services in the past two years with 3% of respondents reported having no services
    • 50% of respondent sites who had indicated they provide outpatient services had reduced those services within the past two years.
    • Additionally 16% indicated planned reductions in 2011

Conclusion

  • OHIP Physiotherapy delivered by DPCA members and their over 3,000 physiotherapy staff in Ontario saves the health care system money in fewer emergency department visits and hospitalizations, fewer surgeries; and helps seniors age at home more successfully, delaying the need for use of Long Term Care beds.
  • DPCA services are effective and cost-effective. By partnering with government, Long Term Care Homes, Retirement Residences and other community resources, DPCA intends to provide more equitable access to OHIP-funded physiotherapy across Ontario.

1 Current State Review of Outpatient Rehabilitation Services Available at Ontario Acute and Rehabilitation Hospitals and Recommendations to Optimize the System. Oct 2011. http://www.eophysio.ca/attachments/article/100/Outpatient_Rehabilitation_Oct_2011.pdf Accessed Nov 2012.