RETURN TO WORK PLANNING
As you are aware, Premier Doug Ford made an announcement today regarding the first stage in Ontario’s reopening. The announcement listed a number of services and businesses that may be able to reopen on Tuesday, May 19, 2020. It is important to remember that this may change between now and Tuesday and members should continue to follow the Ontario government press releases.
The Detailed list of Stage 1 Openings noted that “In-person counselling to resume including psychotherapy and other mental health and support services. Some of these services were available in-person for urgent needs. For example: Addiction counselling, Crisis intervention, Family counselling, Offender rehabilitation, Palliative care counselling, Parenting services, Rape crisis centres, Refugee services”.
The College is seeking clarity regarding the range of psychological services that are included in this Stage 1 announcement and the status of Directive #2 which prohibits non-urgent in-person psychological services.
Please note that although the province may permit some businesses to reopen, this is not required. Members who believe that this would not be appropriate at this time are free to make their own judgment about when it is in the best interests of the client, the community and themselves to see clients again in person.
The College continues to recommend that when practical and clinically appropriate in keeping with client’s best interest, members are encouraged to provide services virtually rather than having clients receive psychological services in person. In cases where clients are returning to in-person service, members must remember the need for physical distancing and proper infection control. The College very strongly recommends members consider the following:
- Client appointments should be scheduled to limit and, where possible, eliminate having people gather in waiting areas. Scheduling should provide for a time interval between the end of one appointment and the start of the next, and clients should be asked to arrive as close to their appointment start time as possible. This will minimize the overlap of clients in waiting areas.
- Seating in waiting areas should be spaced to maintain a minimum physical distance of two metres (note that household contacts are not required to maintain this separation). Members may wish to consider marking minimum distances with tape and, if the physical office space allows, arrange for one-way person traffic flow [i.e., in one door and out another with staff and clients travelling one way in the same direction as much as possible]. This may not always be practical, but the objective is to minimize recurring contact.
- Members may wish to employ alternative solutions to having clients waiting in the waiting room. This could include asking them to wait in their vehicles for a text message or telephone call when it is their appointment time.
- Individuals who are accompanying clients but are not participating in the service, such as those providing transportation to clients should be asked to wait elsewhere and return to meet the client after the client’s appointment is scheduled to end.
- Inner office rooms should be furnished to allow physical distancing between members and clients. If this is not possible then masks should be worn by all parties.
- A notice should be placed on the outer office door directing clients and those accompanying them, to ‘self-screen’. If a client/visitor has any of the symptoms noted, [i.e., fever, cough or difficulty breathing], or if they are feeling unwell generally, they should not enter but should telephone the office. Here is a link to an example of such a Visitors Notice.
- At the time when appointments are being booked, clients should be asked if they have been experiencing symptoms of illness consistent with COVID-19; anyone who has symptoms should be offered a virtual visit or be scheduled for a later time.
- Clients should be asked to self-screen or be screened by member or staff for visible symptoms consistent with COVID-19. Appointments for anyone who is symptomatic should be cancelled.
- A daily log of everyone coming to the office, staff and visitors alike, should be kept in order to provide contact tracing should a case of COVID-19 be associated with your office. Arrival and departure times of each individual, including members themselves, should be recorded accurately and the log maintained.
- Non-essential items such as magazines and toys, etc., should be removed from client waiting areas.
- Common areas and other high-touch surfaces and objects handled by clients (e.g., reception counters, chairs and seating areas, door handles, handrails, credit card machines, washroom fixtures, etc.) be cleaned and disinfected after each use with a hard surface area cleaner approved by Health Canada.
- Assessment materials or other equipment or items handled by multiple clients should be cleaned and disinfected after each use as above.
- Barriers to transmission (e.g., a physical barrier at reception, use of masks) should be considered and implemented where possible.
- Use of masks by staff and clients should be considered generally and, in particular, in situations where adequate physical distancing is difficult.
- Members and support staff must practice effective hand hygiene after each client, washing their hands with soap and water or an alcohol-based hand sanitizer approved by Health Canada. It is important to ensure there are are sufficient supplies on hand for proper hand hygiene, including pump soap, warm running water and paper towels or hot air dryers. Non-touch, lined waste disposal receptacles for use by both staff and client should be provided throughout your professional office.
- Additional visitors to the office, such as delivery persons, should be discouraged or scheduled after hours where possible. Delivery packages should be left at the entrance. Staff should be encouraged to bring meals from home, rather than going out and returning to the office at lunch or introducing additional individuals to the workplace [i.e., meal delivery services]. If the professional office is in a clinic setting, the use of common areas should be discouraged and minimized [i.e., kitchens] as should sharing of common utensils, plates and drinking cups.
- Wherever possible, members and staff should refrain from sharing phones, desks, offices and other tools and equipment. This may involve temporary reallocation of staff resources and job functions such that, rather than several people doing the same thing, one individual is responsible exclusively for each unique task.
- Minimize support staff physically in the office. To the extent possible, have support staff work from home, and equip them with the means to do so.
The Ministry of Health has provided a resource entitled, COVID-19 Guidance: Essential Workplaces. This document provides a variety of information, some of which may not be applicable to your office, but which was prepared to assist with the minimization of COVID-19 transmission in workplaces generally.
Keep healthy and safe,
Rick Morris, Ph.D., C.Psych.
Registrar & Executive Director