On March 27,2020, Alberta’s Chief Medical Officer of Health (CMOH) issued an order that prohibits non-essential places of business from offering or providing to offer services to the public at a location that is accessible to the public. The decision includes any place of business that offers or provides non-essential health services or any retail store or similar place of business that offers or provides only non-essential goods and services. Information on the order can be found at https://www.alberta.ca/restrictions-on-gatherings-and-businesses.aspx

Background and Definitions

For the purposes of the CMOH’s order, ACSLPA members may use the following definitions to assist in interpreting this order:

  • Non-essential health Service includes any service that is generally done to protect, promote or maintain the health of an individual and where the interruption in the provision of services will not result in an individual’s life, health or safety being immediately endangered.
    • Despite the general prohibition on non-essential services, regulated health professionals can offer or provide non-essential health services at a place of business if the services are deemed urgent by the health professional providing the service.
  • Non-essential goods and services includes goods and services that are not critical to preserving life, health, public safety and basic societal functioning.
  • Non-essential places of businesses include businesses that are not deemed essential by the CMOH. A full list of essential services can be found at https://www.alberta.ca/essential-services.aspx

Any business that is still permitted to operate that provides a service to the public at a place that is accessible to the public must:

  • prevent the risk of transmission of infection to co-workers and members of the public by a worker or member of the public;
  • provide for rapid response if a worker or member of the public develops symptoms of illness while at the place of business; and
  • maintain high levels of workplace and worker hygiene.

It is ACSLPA’s understanding that the CMOH, through this order, is trying to limit non-essential close interactions in the community in an effort to prevent the spread of COVID-19, while at the same time keeping people out of emergency departments for services that regulated health professionals could provide in the community.

As of March 25, law enforcement agencies have been granted full authority to enforce the public health orders, including this one, and can issue fines to individuals and businesses. ACSLPA members can also be the subject of professional conduct complaints from the public for violating public health orders.

Any regulated member’s business that is temporarily closing, and as a result, cannot provide urgent, critical or emergency care to patients, is expected to provide to provide information to patients on where they can access urgent, critical or emergent care.

What does this mean for ACSLPA members?

  1. This order applies to business that offer an in-person service at a place of business. If your business is providing services to the public via telepractice, virtual care, curbside pick-up/drop-off service, or parcel delivery service, this order does not affect your business.
  1. ACSLPA members who provide in-person services or goods to the public, whether that is in a home or a place of business, have a responsibility to determine if the service or goods that they provide are essential or not.
    • This decision can be made generally OR can be made on a case by case basis.
    • If the decision is made on a case by case basis, the nature of the service or goods and the needs of the specific client should both be considered.

ACSLPA members may use the decision-making checklist (below) to assist in this determination.

  1. ACSLPA members have an ongoing professional responsibility to the public, to co-workers and to clients.
    • If they are continuing to provide products or services, they must do so in a manner that is responsible and complies with all public health directions for limiting the spread of COVID-19.
    • If they are discontinuing products or services, they must provide information to clients and the public that the services are discontinued and how they can access urgent or critical assistance if needed.
  1. ACSLPA members who work in a public health care setting should follow their employer’s direction regarding which SLP/audiology services will be discontinued or continued. In addition, these employers may redeploy their staff to meet patient needs during pandemic. If you are unsure if you should be continuing to provide services, contact your manager and or professional practice lead.
  1. ACSLPA members in private practice continue to have the option to close their business during the pandemic. If closing, members must direct clients to where they can receive urgent, critical or emergent care.

Decision-making Checklist

Question
1.  Does the product or service protect, promote, or maintain health? YES NO
2. Could interrupting delivery of the product or provision of services immediately endanger an individual’s life, health or safety?

  • In making the determination, consider other risks, for example if a person cannot hear a fire alarm or safety instructions because their hearing aids aren’t working, their life, health or safety could be endangered.
YES NO
3. Is the product or service listed on the essential services list available at https://www.alberta.ca/essential-services.aspx? YES NO
4. Is there some other consideration that makes provision of the product or service “urgent”? (ACLSPA members must be able to justify the basis for their decision that the product or service was urgent based on the specifics of the situation) YES NO

Interpretation

Answer to ANY (1), (2), or (3) is “NO”

The service is not essential and should not be provided as an in-person service UNLESS the answer to (4) is “YES”. Products or services which should not be delivered in person may be provided by telepractice, virtual care, or curbside pick-up/drop-off service if this is possible.

  • Provide information to clients and the public about the decision to discontinue services.
  • Refer clients and the public to relevant public health resources if they need critical or urgent care.

Answer to ALL (1), (2), and (3) is “YES”, or the answer to (4) is “YES”

The service may be provided as an in-person service if the following conditions can be met by the provider:

  • Be familiar with and follow all public health requirements for the type of product or service being provided.
  • Perform a detailed pre-appointment screening to determine if there is a risk of COVID-19 transmission. Do not continue with planned services if the person is symptomatic and refer them to appropriate public health resources.
  • Do not permit sick coworkers to show up for work. Anyone with symptoms must stay home and should be referred to appropriate public health resources.
  • Provide as much up-front assessment, screening, or prework as possible by phone, email, or virtual presence so that in-person time and contact are minimized.
  • Perform constant screening of co-workers and clients, send people home immediately and refer them to public health resources if they develop symptoms at any time.
  • Always maintain careful social distancing protocols (2 metres). Protocols must consider appropriate social distancing between co-workers, between co-workers and patients, and between patients.
  • Have detailed plans for effective infection prevention and control (IPC) for any interactions that require close contact (within 2 meters) of co-workers or clients.
  • Maintain rigorous workplace and equipment cleaning and disinfecting protocols.
  • Maintain rigorous co-worker and client personal hygiene protocols, including handwashing, avoiding touching the face, and covering all coughs and sneezes (gloves and face-masks might also be recommended, even for clients).
  • Clients with symptoms or who have tested positive for COVID-19 should not be seen in private practitioner’s clinic setting and should be reminded to stay home and be directed to the self-isolation requirements currently in place.

Click here for examples

March 30, 2020