Advocacy Updates

TRO is launching a letter-writing campaign in response to the recent 2024-25 Long-Term Care Increase Funding Policy. Our letter advocates for government to be aware of the support, abilities and skill set that Recreation Therapists provide and urges them to keep Therapeutic Recreation Professionals in mind for future policies and funding opportunities.

Click here to view and download our letter.

Recently, TRO’s Executive Team provided feedback to Ontario Health on their draft Model of Care Recommendations for Adults in Hospital Settings. The recommendations provide guidance to healthcare providers and administrators on optimal palliative care service delivery for patients and family/caregivers across the province. They also highlight considerations for the implementation of the recommendations. In TRO’s review, we advocated for the inclusion of Recreation Therapists in the list of extended service providers, when identified, throughout the document.

On Monday, March 20, 2023 the TRO team went to Queen’s Park to advocate for the TR profession. The TRO team comprised 3 members of TRO’s leadership team, two TR students, one TR researcher and two TR professionals. We were well received by and had engaging discussions with the various Ministers, including Dr. Adil Shamji, France Gelinas, Monique Taylor, Mike Schreiner, Jamie West and our Minister of Health, Sylvia Jones. Our conversations centred around TRs’ valuable contributions to our health care system, providing preventive, holistic care, as well as leveraging TRs such that they are a solution to the current health care staffing shortage. We shared some of the existing challenges and barriers, and several of our Ministers advised us about and agreed to assist us with title protection as a concrete next step. We subsequently reached out to each of our Ministers to thank them for meeting with us and to arrange to continue the dialogue. We also extended the invitation for them to attend our upcoming conference in June. We will continue share progress updates with you about our advocacy efforts, and we encourage you to reach out to your local MPPs to advocate as well.

February 23, 2022 – The TRO advocacy committee held a letter-writing campaign webinar to kick-start communications between MPPs and TR professionals. The goal was e to get in contact for the June 2022 provincial elections. Check it out here.

February 7, 2022 – The Ontario Ministry of Health has stated, “It’s a time to recognize the critical work Therapeutic Recreationists & TR Assistants do to support patient recovery through physical, social & activity-based interventions” in a tweet that they shared for TR Awareness Month. Check it out here. 

December 15, 2021 – The Patient Ombudsman, Craig Thompson, was interviewed on Metro Morning this morning about the “Honouring Voices and Experiences, Long-Term Care Home Survey“, and which was released today. The report addresses the isolation and loneliness that residents in LTC have experienced as a result of COVID-19 restrictions and proposes strategies to mitigate them. In the interview, he stated that more Recreation Therapists should be hired to offset the impacts of restrictions. Many thanks to the volunteers on the LTC Task Force who helped write the paper, Therapeutic Recreation Ontario: A Blueprint to combat LTC residents’ helplessness, loneliness, and boredom. Click here to view the CBC article. Past president, Katherine Plested and former ED, Rozalyn Werner-Arce, met with the former Patient Ombudsman Fooks on November 23, 2020 where they discussed TRO’s LTC Commission submission and our proposed recommendations: 1. Reduce the ratio of resident to TR ratio 2. Increase resources to TR: allocate more money for meaningful programming, acknowledge the essential value of TR to quality of life in LTC, ensure consistency of care by increasing wages and ensuring full-time, stable employment. 3. Strengthen staffing qualifications- changing staffing qualifications so that staff must have a degree, diploma or post-graduate certificate in LTC. For additional details on our recommendations, you can read the submission by clicking here.

July 7, 2021 – Therapeutic Recreation Ontario wrote to the Hon. Rod Phillips, Minister of Long-Term Care to express outrage that the pandemic wage bump being made permanent for PSWs has not been extended to Therapeutic Recreation professionals working in care homes too. TRO members are encouraged to write a letter expressing their concerns too.

Therapeutic Recreation Ontario is thrilled to share a message of thanks and appreciation from Premier Ford to all Therapeutic Recreation professionals in Ontario! You’ve worked hard remaining committed to your patients/residents/clients this past year. We hope you can feel proud knowing that your passion and commitment to your practice is recognized.

APRIL 26, 2021 – Prompted by articles in two local newspapers, Heidi Slotegraaf, R/TRO, manager of programs and support services at the Ontario Finnish Resthome Association (OFRA) and Rozalyn Werner-Arcé, TRO executive director, sought a meeting with Ross Romano, MPP for Sault Ste Marie and Minister of Colleges and Universities, to discuss TRO’s concerns about the lack of recognition of Therapeutic Recreation (TR) in long term care. Minister Romano agreed to share our concerns with Dr. Merrillee Fullerton, Minister of Long-Term Care. Given his portfolio, Minister Romano was also interested in learning about the education of Therapeutic Recreation professionals, particularly as the provincial government pursues a micro-credentialing strategy to help individuals upskill and employers develop the workforce they need. We provided information on the 12 post-secondary Recreation Therapy programs in Ontario and emphasized the specialized skills required to be a qualified Therapeutic Recreation professional.

MARCH 19, 2021 – As a follow-up to TRO’s meeting earlier this month with the Director of Stakeholder Relations for the Ministry of Long-Term Care, TRO has submitted a proposal to the Ministry which outlines concrete, cost-effective recommendations that demonstrate how TR professionals help improve the quality of life of residents, family members and staff at Ontario’s long term care homes. To support the provincial government in its efforts to transform the Long-Term Care system, TRO’s proposal recommends: • Strengthening staffing qualifications • Improving the TR staff-to-resident ratio • Recognition of the essential value of TR for the overall well-being and quality of life of residents, team members/staff, and family members • Documentation that reflects the impact of Therapeutic Recreation TRO looks forward to future discussion of the proposal with the Ministry.

MARCH 12, 2021 – TRO had the opportunity to meet with Mason Saunders, Director of Stakeholder Relations for Ministry of Long-Term Care, to discuss the role of Therapeutic Recreation professionals in LTC, the role of TR staff during the pandemic, and the specialized skills and training required to ensure residents experience quality of life while living in LTC. Katherine Plested, R/TRO, TRO President, Shannon McCallum, R/TRO, President-Elect and, Rozalyn Werner-Arcé, Executive Director, seized the opportunity to explain how TRs make the difference between existing in LTC and living a life with meaning and purpose, and once again, emphasized the specialized skills required to assess, develop and implement individual and group programs. We discussed our partnerships with 12 post-secondary institutions to standardize curriculum and align it with the TR Standards of Practice and that these schools are a pipeline to a large, skilled talent pool. Finally, we strived to differentiate the difference between the roles and expertise between Resident Support Assistants and Therapeutic Recreation professionals. As we positioned TRO as a collaborative solution-seeker, we were invited to submit a proposal outlining our recommendations that will effectively save government money and improve the quality of life experience of residents. In drafting the response, we will reference our recommendations in our submission to the LTC Commission and TRO’s LTC infographic.

MARCH 12, 2021 – The invitation arrived in TRO’s Executive Director’s inbox the afternoon of Thursday, March 11 and 24 hours later, Rozalyn Werner-Arcé and Leanne Hughes, R/TRO, Chair of TRO’s Long-Term Care Task Force were meeting with LTC Commission team members, Dawn Palin Rokosh, director of operations and Lynn Mahoney, counsel to the commission. We were invited to speak to TRO’s submission and provide any additional comments. Before we launched into our presentation, Ms. Mahoney stated that TRO’s submission was one of the best they received. (TRO proved that the old adage is true, a picture is worth a 1000 words!) She also stated that they had heard about the importance of recreation and quality of life when meeting with residents and other groups and they were pleased to have the opportunity to meet with TRO. After highlighting the role of TR and speaking to the loneliness and isolation residents have experienced during COVID, we provided further explanation of our three recommendations: Improve the staff to resident ratio Recognition of the essential value of TR for the overall well-being and quality of life of residents, team members and family members Increase funding to recreation Protected envelope of funding Improve consistency of care: Full-time permanent positions, and enhanced wages Strengthen current LTC staffing qualifications During the discussion, we once again took the opportunity to emphasize the skilled talent pipeline graduating from the province’s 12 post-secondary education institutions as well as the need to amend the current legislation regarding qualifications of recreation staff: Section 67 – Recreational and Social Activities Qualifications All staff members providing recreational and social activities services at the Home for the first time on or after July 1, 2010 must have a post-secondary diploma or degree in recreation and leisure studies, therapeutic recreation, kinesiology or other related field from a community college or university, or be enrolled in a community college or university diploma or degree program in such a field. The Home must cease to employ a staff member who is hired to provide these services, if the person ceases to be enrolled in the program, or fails to successfully complete the program within three years of being hired. A Therapeutic Recreation professional would never be hired to be a kinesiologist, why is the reverse acceptable? We believe that a qualified Recreation Therapist is someone with education in therapeutic recreation and who is Registered with TRO – the designation represents excellence in the profession. TRO appreciated the opportunity to meet with representatives of the Commission and looks forward to reading the final report.

FEBRUARY 24, 2021 – Therapeutic Recreation repeatedly forgotten in Queen’s Park plans to improve staffing at facilities across the province. A year into the pandemic and many Long-Term Care (LTC) residents are living without the necessary therapeutic recreation programs they need to sustain good quality of life. With February being National Recreation Therapy Month, Therapeutic Recreation Ontario is calling on Queen’s Park to prioritize the wellbeing of residents by recognizing the essential, highly specialized and life-enriching work its members provide. Read TRO’s full press release.

FEBRUARY 5, 2021 – On behalf of its members, Therapeutic Recreation Ontario has once again called upon the Ontario government to recognize the essential value of therapeutic recreation for the overall well-being and quality of life of residents, staff, and family members. Rozalyn Werner-Arcé, Executive Director, attended a virtual session of the Ministry of Finance’s 2021 Budget Consultations. During her remarks to Finance Minister Peter Bethlenfalvy, Werner-Arcé asked the government to consider improving resident-to-staff ratios and strengthening staffing qualifications for recreation therapists as part of Ontario’s strategy to reform the province’s long term care system and focus on ensuring better quality of life for LTC residents. Werner-Arcé made her presentation via videoconference to a panel of four Durham Region MPPs that included Minister Bethlenfalvy, as well as Rod Phillips, Lindsay Park and Lorne Coe. Read TRO’s full message and written submission to the Ontario Ministry of Finance.

In an ongoing effort to provide greater clarity to help TRO members better understand the implications of the controlled act of psychotherapy, TRO’s College of Psychotherapy Working Group has received new insights from the College of Registered Psychotherapists of Ontario (CRPO). The Psychotherapy Act (2007) was created by the Ontario government as a means to regulate several new health professions in Ontario. As of December 2017, the controlled act of psychotherapy came into force, which means it has become law. The Ontario government’s proclamation of the Controlled Act was accompanied by a two-year transition period, from December 31, 2017 to December 31, 2019. During this time, individuals who provide psychotherapy have the opportunity to become registered with an appropriate health regulatory college if they wish to continue to perform the controlled act of psychotherapy or to change their practice (Rosen Sunshine, 2018). In 2015, TRO implemented the College of Psychotherapy Working Group (TRO-CPWG) to research, recommend and act on behalf of the TRO membership, in relation to the designated and Controlled Act of psychotherapy. Throughout this process, the group has been working in collaboration with the CRPO Registrar. In June 2016, the TRO-CPWG reviewed and disseminated information on the CRPO document called “Understanding When Psychotherapy is a Controlled Act.” In October 2018, the TRO-CPWG received and studied the “Controlled Act Task Group Consultation Documents.” This material has served to clarify some questions, which Therapeutic Recreation professionals identified, regarding CRPO. Specifically, CRPO published a self-assessment tool which the working group also spent time studying. While valuable, these documents still did not clearly address all questions from the membership. The TRO-CPWG developed further questions regarding Therapeutic Recreation scope of practice within mental health and addictions settings. These questions were sent to CRPO on November 14, 2018. We are pleased to report a response was received December 4, 2018, and that the TRO-CPWG met December 13, 2018 to discuss the reply. The TRO-CPWG is pleased to share our questions along with the CRPO’s responses in this letter. We are confident the responses bring greater clarity to multiple issues specific to TR scope of practice and psychotherapy.

Earlier this year, the Ontario Palliative Care Network launched the Palliative Care Health Services Delivery Framework, which outlines recommendations for a model of care to improve palliative care in Ontario. While Recreation Therapists are mentioned in the Palliative Care Health Services Delivery Framework as members of the Extended Services Team, they are not acknowledged in the Ontario Palliative Care Competency Framework (a companion resource to the Delivery Framework). TRO’s Advocacy Committee has written a response letter to the co-chairs of the Ontario Palliative Care Network (OPCN) Executive Oversight to express our disappointment that Recreation Therapists have not been recognized in this document for their contributions. Read TRO’s response letter to the OPCN here. 

TRO welcomes the appointment of Merrilee Fullerton as Ontario’s new Minister of Long-Term Care. Fullerton was appointed to the position in June by Ontario Premier Doug Ford. In a letter congratulating her on her new role, TRO President Sue Verrilli, R/TRO, said Fullerton’s leadership “will be vital as your government continues to implement its strategy to add 30,000 new beds through the addition of 15,000 new long-term care beds and the renewal of 15,000 beds. Read TRO’s letter to Minister Fullerton here. 

As many members may recall, TRO conducted a salary survey in 2018 to get a clearer picture of compensation for TR professionals in a variety of settings across the province, and to provide a resource so you can better advocate for yourself and your profession with your employer or union. Following the preliminary report that was released at the 2018 Annual General Meeting at the TRO Conference, we are pleased to announce that [drum roll please] the TRO 2018 Salary Survey Report is now available! This comprehensive, detailed analysis offers a breakdown of salary data by region, work setting, years of experience, and much more. What are the most important factors that determine your level of compensation as a TR professional in Ontario? Is it years of experience? Geographic location? Check out the report to find out! 

As many members may recall, TRO conducted a salary survey in 2018 to get a clearer picture of compensation for TR professionals in a variety of settings across the province, and to provide a resource so you can better advocate for yourself and your profession with your employer or union. Following the preliminary report that was released at the 2018 Annual General Meeting at the TRO Conference, we are pleased to announce that [drum roll please] the TRO 2018 Salary Survey Report is now available! This comprehensive, detailed analysis offers a breakdown of salary data by region, work setting, years of experience, and much more. What are the most important factors that determine your level of compensation as a TR professional in Ontario? Is it years of experience? Geographic location? Check out the report to find out!

TRO President Leanne Hughes, R/TRO, CTRS and Rozalyn Werner-Arcé, Executive Director, met with Jeff Yurek, MPP for Elgin-Middlesex-London and the Health Critic for the Progressive Conservative (PC) party. Mr. Yurek asked great questions to better understand what we were asking for, and was supportive of our messages. He said he would ensure that our information about Therapeutic Recreation would be passed along to whoever formed the next government after June 7, 2018 (the date of the next provincial election). As a reminder, our key messages are: establish a life enrichment protected envelope of funding that supports TR in LTC settings, increase Therapeutic Recreation (TR) programs delivered by qualified practitioners (LTC and in community), establish hiring standards which include consistent education requirements, job titles and appropriate compensation for TRs, and increase the ratio of TR practitioners to residents in Ontario’s Long-Term Care homes (in some homes this can be as high as 1 RT to 150 residents). After receiving our latest Advocacy Alert, TRO past-president, Sue Verrilli, R/TRO wrote to France Gélinas and thanked her for meeting with TRO and reinforced support for the TRO messages. You can do the same. As a voting constituent, your voice matters. Here is the contact and riding information for the MPPs: Hon. Helena Jaczek (MPP for Oak Ridges-Markham and Minister of Health and Long-Term Care), Jeff Yurek (MPP for Elgin-Middlesex-London and PC Health Critic), France Gélinas (MPP for Nickelbelt and NDP Health Critic), John Fraser (MPP for Ottawa South and Parliamentary Assistant to the Minister of Health and Long Term Care).

TRO board director Jackie Frail, R/TRO and executive director, Rozalyn Werner-Arcé met with France Gélinas, MPP for the Nickel Belt riding and NDP Health Critic. They took the opportunity to discuss the role of recreation therapy and its value in long-term care. By taking the opportunity to talk about TR in LTC, TRO was able to educate Ms. Gélinas about the need for hiring standards as well as the need for a consistent and reasonable ratio of TR to residents. Consistent with our previous statements to government, TRO’s key recommendations to Ms. Gélinas were: establish a life enrichment protected envelope of funding that supports TR in LTC settings, increase Therapeutic Recreation (TR) programs delivered by qualified practitioners (LTC and in community), establish hiring standards which include consistent education requirements, job titles and appropriate compensation for TRs, and increase the ratio of TR practitioners to residents in Ontario’s Long-Term Care homes (in some homes this can be as high as 1 RT to 150 residents). Additionally, we asked Ms. Gélinas to be a champion for TR and advocate for the practice. A copy of the discussion presentation can be found here.

TRO had two meetings with officials within the MOHLTC. The first meeting that TRO President Leanne Hughes, R/TRO, CTRS, President-Elect, Katherine Plested, R/TRO and Executive Director, Rozalyn Werner-Arcé had was with Ian Chesney, Senior Policy Advisor to the Minister of Health and Long-Term Care, Helena Jaczek. The second meeting was with Nicole Donaldson, Acting Manager of Programs Unit, Licencing and Policy Branch, Bryan Sarles, Senior Program Consultant and Metoo Mach, Senior Financial Policy Advisor. The purpose of the meetings were two-fold: to create a better understanding of Therapeutic Recreation (TR) and its valued role in LTC and to discuss how TR can be a resource to government in addressing the issues in LTC. During the hour long meetings, we took the opportunity to talk about TRO as the provincial association that represents 1700 members, what Recreation Therapy is and is not, why it is important to hire qualified TR professionals and the role of TR in LTC as well as providing several examples. Discussion included the fact that the government is investing $300 million in LTC and opening 5,000 more beds.  Their first priorities are nursing and personal support, followed by other therapies, which is where TR would fit. Going forward, it will be important to demonstrate how TR intersects with behavioural and dementia supports. At the meeting with Nicole Donaldson and her team, there was a greater focus on how TR fits within the Falls Prevention Strategy and palliative care. We welcome input/comment from TRO members who are working within either of these two areas to help demonstrate the role recreation therapy has within them. A copy of the discussion presentation with Ian Chesney, Senior Policy Advisor to the Minister of Health and Long-Term Care, Helena Jaczek can be found here. A copy of the discussion presentation with Nicole Donaldson, Acting Manager of Programs Unit, Licencing and Policy Branch, Bryan Sarles, Senior Program Consultant and Metoo Mach, Senior Financial Policy Advisor can be found here.

TRO President Leanne Hughes, R/TRO, CTRS, Board Director, Jackie Frail, R/TRO and Executive Director, Rozalyn Werner-Arcé met with Daniel Oettl, Senior Policy Advisor to the Minister of Seniors Affairs, Dipika Damerla to discuss the role of TR within the Aging with Confidence: Ontario’s Action Plan for Seniors. During the half hour meeting, we took the opportunity to talk about TRO as the provincial association that represents 1700 members, what Recreation Therapy is and is not, as well as why it is important to hire qualified TR professionals. We identified ways that TR can fulfil strategies within the Aging with Confidence document and the benefits to seniors in the community. We wrapped up the meeting with the following key recommendations: access to Therapeutic Recreation Programs and Supports Delivered by Qualified TR Professionals, establish hiring standards which include consistent education requirements, job titles and appropriate compensation for TRs, and establish a life enrichment protected envelope of funding that would support TR in LTC settings​. A copy of the discussion presentation can be found here.

Upon receiving an invitation from Ontario’s Ministry of Finance to participate, Rozalyn Werner-Arcé, Executive Director represented TRO at the in pre-budget consultations in Oshawa. Charles Sousa, Minister of Finance and a local MPP, Joe Dickson were in attendance. These public consultations are taking place in several communities around the province. Additionally, the Ministry is conducting telephone town hall meetings and welcoming written submissions.  The consultations, no matter what their format, are an opportunity for members of the public including businesses and the non-profit sector, to provide input to the government as they plan the 2018 budget.  Last year, 71,000 people participated in consultations. All the public consultations are recorded and transcribed and made available to the policy staff at Queen’s Park who cross-reference the presentations to written material they receive.   Presentations are three minutes long – timed by a stopwatch. Click here to see the attached remarks. 

TRO president Leanne Hughes, TRO member Sherry Dupuis, and TRO ED Rozalyn Werner-Arcé met with Member of Provincial Parliament (MPP) John Fraser at Queen’s Park to discuss TR in Long Term Care. TRO requested the meeting in response to the CBC radio show, Ontario Today, upon which Mr. Fraser, who is also Parliamentary Assistant to the Minister of Long-Term Care, was a guest. The topic was long-term care and callers were invited to speak about their concerns. Following the show, TRO requested an opportunity to inform Mr. Fraser about the value and impact of TR in long term care and demonstrate how it can address many of the concerns expressed. We focused our messaging on the following theme: ‘Surviving versus Thriving in LTC: The Importance of Therapeutic Recreation to Quality of Life’. We provided evidence-based research as well as anecdotes about the difference TR can make not only in the lives of residents and their families, but how it can also contribute to changing the culture within the long term care sector. We ended our meeting with the following three asks: ensure Adequate and Protected Resources for TR to support the wellness of residents, families and other staff, value and Include Therapeutic Recreation, and Culture Change: Shift from medical models that focus on body care to person-centred and relational models. A copy of the speaking notes can be found here.  

TRO member Rebecca Cole-Zimmer along with TRO Board Director Jackie Frail, R/TRO presented to the Niagara Catholic District School Board (NCDSB) Special Education Advisory Committee (SEAC) introducing Therapeutic Recreation (TR) as an intervention for their students. Rebecca began this advocacy initiative by discussing the potential role for TR in a school setting with the principal at her children’s school. The principal suggested that Rebecca connect with SEAC to introduce TR as an intervention for their students. After reaching out to her professor at Niagara College Jackie Frail, R/TRO and the TRO office for support she helped to create a professional presentation advocating for TR services within a school setting. The presentation was received enthusiastically by the SEAC committee as they seemed excited to learn about existing services like the Niagara College sensory room, they were open to the idea of TR students completing placements in their schools and were interested in learning how to access services. Learn more about Rebecca’s advocacy journey and their presentation on the TRO Blog.

TRO past-president Sue Verrilli, R/TRO and TRO member, Anne Scanlon presented to members of the Behaviour Supports Ontario (BSO) Provincial Coordinating Office (PCO) Operations Committee focusing on the value and role of Therapeutic Recreation (TR) in long term care and in community. Sue provided an overall understanding of TR and the work TRO has undertaken to advance the profession including our development of the Code of Ethics, Standards of Practice, Essential Competency Framework and Scope of Practice, all of which are put into practice by TRO members across the province. Anne, who worked in Complex Continuing Care and Long Term Care until two years ago when she joined the Community Responsive Behaviour Team in Waterloo-Wellington, spoke to the role of TR as it relates to the BSO and specifically to her role on the Waterloo-Wellington Community Responsive Behaviour Team. The timeliness of their presentation is significant as additional annualized funding of $10 million for BSO will be implemented in 2017-18. Anne and Sue strategically positioned TR as one of the strategies BSO teams around the province should consider as they develop plans to effectively address the increasing need for responsive behaviour supports.

The Ministry of Health and Long Term Care (MOHLTC) hosted the Ontario Summit on Healthy Aging on June 28, 2017 at the MaRS Discovery District.  The day consisted of keynote speakers and a series of panel presentations followed by audience q and a. Topics were very broad ranging including the senior care workforce, the diversity of seniors, age-friendly communities and non-medical transportation systems in communities for seniors. Representing the TRO membership, TRO ED, Rozalyn Werner-Arcé used the opportunity to network with Ministry officials and other health care stakeholders. While some speakers often referred to personal support workers and the health care system, Dr. Isser Dubinsky from the Institute of Health Policy, Management and Evaluation, University of Toronto referred to the entire care team including Recreation Therapists who contribute to enhancing a person’s quality of life during his remarks.

Although the APO-TRO Dementia Joint Working Group was disbanded, TRO’s efforts in ensuring that Therapeutic Recreation is included within Ontario’s Dementia Strategy continue. Below is an update on what has transpired since our joint submission with APO was made to the Ministry in November 2016. Many thanks to Sherry Dupuis and TRO president, Leanne Hughes who organized a presentation at the recent TRO conference. Most notably, Sherry was able to secure Michael Campo and Justin Armstrong, Senior Policy Advisors at MOLHLTC, both of whom have Ontario’s Dementia Strategy in their portfolios, to also present at the conference. The joint presentation focused on our submission and the status of the strategy to date including 10 initiatives of the Ministry (click here to review the submitted document). Sherry has been an amazing advocate for TR at the Ministry level and having Michael Campo at the conference is a feather in our cap. It was a good opportunity for Michael to learn more about TR and engage with the session attendees.   Following the conference, Michael reached out to Leanne, Sue Verrilli, past president, and Rozalyn Werner-Arcé, Executive Director, to organize a telephone meeting to discuss TR and its role in community dementia care. Thanks to Jeanette Sears, R/TRO and Anne Scanlon who provided good insights in preparation for the meeting.  In addition, Michael invited us to attend a Healthy Aging Summit which will take place June 28 in Toronto. We also sent Michael research that was gathered when the joint response was being written. We will continue to seek ways to keep TR top-of-mind for the planners behind Ontario’s dementia strategy.  In the recent provincial budget, $10 million dollars was allocated to Ontario’s Dementia Strategy and thanks to TR advocates like Sherry Dupuis and at the provincial Behaviour Support Organization (BSO), we are hopeful that additional resources will be allocated to the role of TR in dementia community care programs.

As many TRO members will know, in February 2010, TRO submitted a letter of intent to apply for regulation under RHPA.  Unfortunately, the process was stalled because the application for regulation criteria changed.  Professions needed to prove risk of harm to the public before they could move forward with their applications. This requirement, in addition to the financial and administrative challenges, proved to be a significant barrier for TRO.  Since that time, many professions have not been recommended for regulation under RHPA by HPRAC, including paramedics and physician assistants. Today, rumours abound about what is happening with regulation in Ontario including umbrella colleges and public registries. There are many healthcare professions that want to become regulated, but simply do not have the means or size of membership to pursue it, Therapeutic Recreation, of course, being one of those professions. With that in mind, Sue Verrilli, President, Jill Gibson, Board Director and Rozalyn Werner-Arcé, Executive Director met with Denise Cole, Assistant Deputy Minister, Health Workforce Planning & Regulatory Affairs Division, MOHLTC, Allison Henry, Director, Health System Labour Relations and Regulatory Policy, and Letitia Nolasque, Manger, Business Integration Services.  The purpose of the meeting was to inform the Ministry about TRO and TR as a valued component of the health care system and for TRO to get an update on the status of regulation in Ontario.

Working together with the Therapeutic Recreation Provincial Education Steering Committee (TRPESC), TRO learned that the Ministry of Advanced Education and Skills Development (MAESD) Program Standards for the Recreation Therapy diploma and Recreation for Special Populations certificate programs are scheduled for review in their 2016-2019 plan. Our Executive Director wrote a letter on behalf of TRO to the MAESD Evaluation Unit offering to share our Essential Competency Framework (ECF) for Therapeutic Recreation document and provide support to the program standards review team during their 2018-2019 review. We were pleased to receive a response from the MAESD Program Standards and Evaluation Unit just three days later. The Senior Policy Advisor stated that they appreciate our offer to share the ECF to assist in the development of program standards for the college recreation therapy programs and will be inviting TRO to participate in the consultation process for the review and development of program standards slated to take place in 2018-19. Read Letter to MAESD, MAESD Response to TRO

The Alzheimer Society is seeking a fully-funded Ontario Dementia strategy (www.campaignfordementia.ca). On behalf of our membership, Therapeutic Recreation Ontario wrote a letter to Premier Kathleen Wynne, Hon. Charles Sousa, Minister of Finance, Hon. Dr. Eric Hoskins, Minister of Health and the two Health Critics Jeff Yurek (PC) and France Gélinas (NDP) to express our support for a fully-funded dementia strategy and draw their attention to TR as a key care component of that strategy which can help them achieve their goal of a fiscally sustainable health care system. Please feel free to forward this letter to your own local Member of Provincial Parliament (MPP) and ask them to support this vital initiative. 

With the topic of therapeutic recreation practice in mental health settings being a central component in the College of Psychotherapy discussion, the committee felt they would like to pursue advocacy initiatives in this area and discussed the need to develop a proactive document/ position paper on the role of Recreation Therapy in Mental Health, from an Ontario perspective. The intention of this document would be to have a resource ready to use if members should need to advocate for positions etc.  A two-page infographic was created to share with delegates at the 2017 TRO Conference.

An additional Briefing Note was sent to employers of TRO members outlining the Scope of Practice and the benefits of hiring a TR practitioner who is a Registered Professional member of TRO. Read more here.

Interested TR professionals from both TRO and CTRA have been working together to develop a working group in Ontario with the objective to demonstrate the value of TR in community and present this information to the Local Health Integration Networks (LHINs). The group has conducted a comprehensive literature review to identify any gaps and to emphasize the need for TR within the community setting. We have also been working diligently to establish key contacts with the LHINs and other community networks such as Health Links. Our goal is to increase awareness about the value of TR while identifying gaps in the community, and cost savings associated with hiring TR professionals in the community. We will do this by developing a presentation which will be delivered to as many of the LHINs as possible.To help with this process, we need the support the TRO members! LHIN Presentations completed to date: May 2016 Northeast LHIN, December 2016 HNHB LHIN, March 23, 2018 Central West LHIN, SWO LHIN (pending), Champlain LHIN (pending)

This is an update in terms of what has been happening in Ontario with regulation under the Regulated Health Professions Act (RHPA). A number of professional groups have been investigated for recommendation for regulation by the Health Professions Regulatory Advisory Council (HPRAC) this past year or so. The following groups were investigated and denied recommendation for regulation: physician assistants, paramedics and dental assistants. Let’s look at the reasons behind the denials. Physician Assistants – insufficient evidence to meet risk of harm threshold. There are approximately 130 Physician Assistants practicing in Canada. Paramedics – the applicant did not meet risk of harm threshold. There are 7000 paramedics in Ontario, representing three levels of practice. Dental Assistants – insufficient evidence to meet risk of harm threshold. There are an estimated 20,000 dental assistants in Ontario. This information is important for TRO to reflect upon in terms of our change in direction in regarding regulation. Let’s ask ourselves the same questions we reflected on two years ago. Do we feel we have the number of members needed to go forward with regulation under RHPA? Two years ago we had less than 1000 members. We now have over 1300 members. Increasing membership is important for elevating our status in Ontario and we continue to work towards increasing our numbers. Do we feel we have an established risk of harm that is more so than paramedics or physician assistants? Our risk of harm does not include any controlled acts or jobs where we don’t work for someone else (for the most part). Is there a way we can combine with other professions that would make us stronger in numbers? When the government looks at regulation, they want to see that we have considered who else we might align ourselves with, such as Activity Professionals of Ontario or the Occupational Therapists of Ontario. And, if we don’t feel that regulation under RHPA is viable, what other options do we have for seIf-regulation? When reviewing the reports on the professions denied for regulation, there are recommendations TRO might consider for ourselves: title protection, mandatory registry, established scope of practice, etc. All of these areas were touched upon by the consultants two years ago. They are also areas that HPRAC recommended in their reports to the professions listed above. For further details on the reports denying regulation to these groups, please see www.hprac.org 

Some of the work TRO has done to prepare for regulation (for more details please see Next Steps Toward Regulation) include creating a code of ethics, standards of practice, registration (R/TRO) process, restructuring the board to include college like components, creation of new bylaws and procedures for bylaws and ultimately a letter to the Ministry of Health and Long-Term Care proposing regulation for therapeutic recreation in Ontario. Please see the response to Part 2 of the Proposed Initial Draft Regulation on behalf of Therapeutic Recreation Ontario (TRO). With a change in government, they are currently not reviewing regulation letters for any profession.  However, TRO plans to continue to lay the required framework for regulation such as demonstrating a unified profession, creating common education preparation and recognizing different levels of scopes of practice.

TRO members have been interested in pursuing certification prior to its inception in 1999; however, the ultimate goal has always been regulation. Although TRO had voted (2007) to create an Ontario made certification model as a step toward regulation, in 2009 the TRO board recommended using the R/TRO as the minimum credential in pursuit of the ultimate goal of regulation. This decision was not made lightly as the TRO board considered many factors including an extensive review of other Canadian therapeutic recreation associations, advice of consultants and the fact that certification would be an additional voluntary step compared to regulation which would be mandatory -the ultimate goal.  Certification by definition is a voluntary qualification/designation earned by a person to indicate they are qualified for a job. It consists of entry to practice, competency evaluation and a continuing competency program.  Whereas regulation provides a framework for a scope of practice and it includes a general Act, a Procedural Code for all the regulated health professions.  The purpose of regulation is to protect the public. The pursuit of regulation requires for example that we demonstrate a united profession including common education preparation, common competency review, common practice standards, common continuing competency, common job titles and recognizing different levels of scopes of practice.

During the TRO conference in Waterloo June 2009, the TRO Board of Directors did a presentation entitled: TRO’s New Direction from Registration (R/TRO) to Regulation. To download the presentation for this session, click here. The presentation was also videotaped and can be viewed below.  It is broken down into 5 sections as it is over an hour and half in length: Intro, Part1, Part2, Part3, Part4, and Part5.

The Ontario Government’s Ministry of Health and Long Term Care is continuing to move forward in their commitment to developing and implementing an Ontario Dementia Strategy. Public consultations took place in the fall of 2015 followed by the formation of working groups in the winter of 2015. In response to the Government of Ontario’s Dementia Strategy Report, Therapeutic Recreation Ontario (TRO) and Activity Professionals of Ontario (APO) created a working group to collaborate on the development of a Response Paper. The response paper outlined opportunities to enhance quality of life for persons with dementia and their care partners through the recognition and inclusion of professions currently underutilized.  The paper highlights the following 4 areas of discussion: Recreation as Part of the Health Care Sector and Healthy Communities, Enabling Persons with Dementia in Self-Directed Care and in Navigating the Healthcare and Community Support Service Systems, Supporting Care Partners through Leisure, and Creating Informed Societies. Read the submitted document here.

The TRO board of directors embarked on a two-day planning process to strategically advance the TR profession. After listening to subject matter experts, considering trends in TR and healthcare, and debating critical issues, the board fully believes that one of the keys to the future of TR is a scope of practice and as such, the board will undertake to lead this initiative immediately. This is a necessary piece of foundational work integral to creating new opportunities and with a renewed singular focus and increased capacity through our Executive Director, we are convinced it is achievable. In addition to this vital strategic priority, TRO will work with colleges and universities to advocate to the Ontario Ministry of Training for Colleges and Universities for TR curriculum standardization consistent with TRO’s Essential Competency Framework. Furthermore, the board recognizes that support of research in and about TR is essential to our messaging and we will develop strategies to gather and make accessible this information to our members. Another main focus of our discussions was the identification of a number of new and existing partnerships which will be important for advancing the profession. As TRO has communicated over the last two years, regulation is about protection of the public, not about elevating the profession.  The primary criterion threshold for regulation under the Regulated Health Professions Act (RHPA) is risk of harm to the public. At this time, it is difficult for us to demonstrate risk of harm and the public’s self-interest in regulation of Therapeutic Recreation.  But this should not impede TRO – your professional association – and we, as Therapeutic Recreation professionals, from taking control of our profession’s future and leading the way by creating opportunities in the new health care paradigm. Background Information Considered by the Board of Directors: Regulation –Moving Forward, What Does it all Mean? –2013 Presentation by Sue Verrilli, R/TRO, RECognizing our Place in History –2013 Presentation by Sue Verrilli, R/TRO, TRO SWOT and PESTLE Analysis – 2015 Presentation by Marita Kloseck, PhD.

In response to concerns raised by members, the TRO board of directors formed the TRO – College of Psychotherapy Working Group to understand the impact that the new Controlled Act of Psychotherapy will have on Therapeutic Recreation (TR) practitioners and to share that information with our membership. While not applicable to all TRs, this has particular relevance for those who have received additional training in psychotherapy modalities such as Cognitive Behavioural Therapy (CBT) and Dialectical Behavioural Therapy (DBT). There have been many questions about who should register with the College before the grandfathering period is up (March 2017) and what the impacts are if people don’t register. The response was overwhelming to the August 2015 call for volunteers to sit on the Working Group. The terms of reference only allowed for 10 people and so we selected TRO members based on geography (provincial representation), experience, and workplace most likely impacted. Over the course of two meetings, we gathered information about the controlled act, learned more about the College, and attempted to understand the impact in some workplaces and how employers were responding. As there was still a need for greater clarity and because there was such great interest from the membership about the issue, we contacted Joyce Rowlands, Registrar at the College of Registered Psychotherapists of Ontario (CRPO). CRPO is still meeting with the five other Colleges to discuss the meaning of the controlled act of psychotherapy, and therefore cannot address our concerns at this time. However, we are pleased to announce that Ms. Rowlands has agreed to speak at the June 2016 TRO/CTRA joint conference. For further information about the College of Registered Psychotherapist of Ontario, please visit: www.crpo.ca. Read here for more information.

As per TRO’s strategic plan and goals of increasing communication and strengthening the organization, an information letter for employers was mailed out to employers of TRO members across the province of Ontario in 2015. The purpose of this initiative is to educate employers about Therapeutic Recreation Ontario, discuss the Registration (R/TRO and R/TRO DIP) designation, including its purpose and process and share our new and exciting website. A follow-up Briefing Note was sent to employers of TRO members in 2015 announcing R/TRO DIP. Each year, the letter was mailed to human resource departments across the province and a Why Hire R/TRO? brochure was included. Click here to download the initial letter and here to download the briefing note.

The Disability Today Network approached TRO with an opportunity to write an article describing Therapeutic Recreation for this year’s Canadian Association for Prosthetics and Orthotics newsletter “Alignment 2015”. Our very own R/TRO Member Keli Cristofaro provided specific examples of TR interventions such as how she worked together with the team to help a young hockey player return to the rink with his new prosthetic leg. Thank-you also to Kimberly Lopez, Ph.D (C) from the TRPR-Journal of TRO for all your work as co-author on this article! Click here to read the published article.