Government announces Increased Funding to
Interprofessional Primary Care Organizations to attract and
retain non-physician health care professionals
Fulfilling a Budget 2016 commitment to provide up to $85 million over the next three years to support interprofessional primary care organizations, the Minister of Health and Long-Term Care has announced that funding will be transferred to organizations within the next few weeks. $22.2 million this year and $31.7 million in each of the next two years will support 75 Community Health Centres, 184 Family Health Teams, 25 Nurse Practitioner-Led Clinics and 10 Aboriginal Health Access Centres and nursing stations across the province serving nearly 4 million people.
Funding is intended to enable organizations to better attract and retain non-physician health care professionals such as nurse practitioners, social workers, nurses, dietitians, occupational therapists and is retroactive to April 1, 2016.
View Government Press Release.
What does this mean for occupational therapists working in primary care?
Even as occupational therapists were included in the roster of interprofessional team members that Family Health Teams and Nurse-Practitioner Led Clinics back in 2010 it was asserted by OSOT and recognized by government that FHT compensation guidelines placed OT compensation levels in this sector lower than other practice sectors. OSOT's early compensation advocacy promoted a salary range of $70,200 - $78,000 in addition to a competitive benefits package, paid vacation and support to continuing professional development. Regretfully, just as OTs were being integrated into Teams, the public service compensation freeze was applied across all publicly funded health care sectors.
An Alliance of the Association of Family Health Teams of Ontario, the Association of Ontario Health Centres and the Nurse Practitioners Association of Ontario has advocated in recent years for attention to interprofessional compensation funding because their members (FHTs, CHCs, etc.) find it hard to recruit and retain professionals at current salary levels. OSOT has supported their advocacy including a prepared a briefing submission to the budget review process in January 2014 making the case for compensation review and adjustment in the primary health care sector. Their positions, based on recommendations to achieve greater equity with the hospital sector and based on Hay Group analyses and recommendations, recommended a required increase to the sector of $121.87 million over 4 years to accommodate transitions to Hay Group recommendations of 2012 and inclusion of HOOP benefits for employees of primary care organizations. View Toward a Primary Care Recruitment and Retention Strategy for Ontario: Compensation Structure for Ontario's Interprofessional Primary Care Organizations.
OSOT understands that primary care organizations have been provided guidance regarding distribution of enhanced compensation funds from the Ministry of Health and Long-Term Care. This guidance is NOT prescriptive but provides a rationale for the budget allocation afforded to each organization. View the Ministry Planning Document. OTs should be aware that Executive Directors or organizational leads will have received this document to guide their allocation of resources but they are not bound to follow its guidance if their discretion would distribute funds differently. Some key elements of the rationale for the guidelines include:
- a global increase to benefits rates and programs to assure better equity with other sectors
- incremental steps in compensation to bridge inequities with other practice sectors
- provision of a salary grid for all personnel which may guide funding allocation
- special attention to nurse practitioners, dietitians and health promoters who have most notable differentials from other sectors
- intention to provide some level of increase to all staff
The Ministry document does not specifically "band" professions with similar salary ranges, however, the Association of Family Health Teams of Ontario (AFHTO) has provided guidance to its members in their document Compensation Planning & Administration: Guidance Document for Primary Care Organizations. Not surprisingly, AFHTO suggests that OTs and PTs be in the same salary band. This is consistent with much of the banding in the hospital and community sectors.
Occupational therapists will note in the Ministry's Planning Document that the salary range for physiotherapists is considerably higher than that of occupational therapists. Rightfully, this has caused concern, confusion and frustration. This differential exists as a result of the funding mechanism that brought physiotherapists into primary care after the 2013 Physiotherapy Funding Reform. When the funding structure for physiotherapy delivered through Designated Physiotherapy Clinics was dismantled in 2013, the Ontario Physiotherapy Association was able to support this reform with the proviso that the funding would remain dedicated to physiotherapy albeit distribution in other mechanisms through the system. The government's support for this position allowed for funds, external to the Primary Care funding envelopes that FHTs, CHCs, etc. are funded through to engage physiotherapy.
As such, they were able to support integration of physiotherapists at the high end of the recommended salary scale. While this would appear to create internal inequities, it was not driven by the position that their services were more valued than others. Other professionals were, unfortunately, hindered by the public sector funding freeze until this recent compensation adjustment. OSOT does not support a differential in salary banding between OT and PT. Individual FHTs or CHCs may not support this differential either. OTs will need to address this issue with their organizations who have some discretionary ability to manage their funds.
Members are encouraged to link their advocacy to the outcomes they assist the organization to achieve - keeping people well at home, out of hospital, reducing hospital admissions, reducing visits to the physician or NP, supporting caregivers more effectively, etc.
OSOT continues to support the AFHTO/AOHC/NPAO positions and advocacy and will communicate this to the Ministry of Health and Long-Term Care.
OSOT’s Primary Health Care Team will assist OSOT to monitor and explore this issue further and to consider how the Society can best support members to achieve the compensation we believe they deserve.