In December 2020, the Health Statutes Amendment Act, 2020 (No. 2) (“Bill 46”) received Royal Assent. The Act includes several amendments to the Health Professions Act (HPA) including provisions that require regulatory colleges to cease functioning as professional associations and to divest themselves of any professional association functions they currently perform.

On October 1st, 2021, the Lieutenant Governor in Council proclaimed portions of the Health Statutes Amendment Act, 2020 in force, with other portions to come into force on April 1, 2023. The portions proclaimed on October 1st start the clock ticking on the separation of college and association mandating that:

  • By March 31st, 2022, the college must provide the Minister of Health with a plan to divest itself of all professional association functions, and
  • By April 1st, 2023, the college must have executed the plan and divested itself of the functions of, connection to, or affiliation with a professional association.

Alberta physiotherapists have been a self-regulating profession since 1985 when the College of Physical Therapists of Alberta was formed. The Alberta Physiotherapy Association (APA) pre-existed the College and was a branch of the Canadian Physiotherapy Association. Over time, the APA began to have difficulty demonstrating value to its members as most of its funds were spent on operations with a small amount going to member services. The APA eventually concluded that it was no longer financially viable and chose to cease operations.

At that point, the APA approached the College to see if we would take on some of the association functions of the APA. We opted to take on some of the APA’s prior functions that were not incompatible with our primary mandate as a health profession regulatory body. In 2010, the College re-branded as Physiotherapy Alberta – College + Association to reflect this change. You can learn more about the history of Physiotherapy Alberta by listening to the College Conversations Podcast, Episode 23: The Journey to College and Association and Back Again.

For the past decade Physiotherapy Alberta has operated as a dual mandate organization. However, the risk in regulation, and one that we have observed in colleges in different jurisdictions, is that of being perceived to have put the interest of the profession ahead of the interests of the public. In recent years, there has been a trend in the regulatory community to have increased public involvement in regulatory organizations. This ultimately led to the introduction of Health Statutes Amendment Act, 2020 (No. 1) which resulted in increased public representation on college councils and committees with the intent of providing the public with a stronger voice and a greater role in professional oversight.

The legislative changes passed in December 2020 require that all colleges, including dual mandate organizations and those who identify only as a regulatory college, review all their operations, and divest themselves of those functions which serve the interests of the profession regulated.

The mandate of health regulatory colleges is to protect the public interest. Patients and families expect safe and effective quality physiotherapy care. Physiotherapy Alberta works to ensure the right systems and processes are in place to support quality physiotherapy service delivery by:

  • Setting and enforcing practice and professional standards.
  • Registering only qualified and competent physiotherapists.
  • Ensuring registered physiotherapists are of good character and reputation
  • Administering a continuing competence program.
  • Investigating public and patient concerns.
  • Supporting member understanding of and adherence to their regulatory responsibilities.

These core roles are established in the HPA. The HPA also enables regulatory colleges to engage in other activities provided they are consistent with the college role and public interest mandate. However, under the new provisions, colleges must not:

  • Set fees, provide guidelines for fees, or negotiate professional fees
  • Serve as a bargaining unit
  • Act as or set itself out to be association

Professional associations exist to support and provide services to their members through functions such as advocacy, professional development/continuing education, interest groups, member benefits and professional awards of excellence. An association protects the interests of its members and is often the voice the profession.

The table below, provided by the Government of Alberta, helps to define some key differences between colleges and associations.

Regulatory colleges

Professional associations

A college governs its members to serve and protect the interests of the public.

An association represents its members, to serve the mandate of the association.

A college derives its authority and mandate from legislation.

An association derives its authority and mandate from its membership, although it may be established through enabling legislation such as the Societies Act.

 

Physiotherapy Alberta hosted a webinar titled "What Does It Mean To Be A Member Of A Self-Regulating Profession In 2021?" which may be of interest to registered members who wish to increase their understanding regarding the role of regulatory Colleges.

Since 2009, physiotherapists in Alberta have been members of Physiotherapy Alberta – College + Association as part of their annual practice permit.

After this transition, physiotherapists will continue to be required to maintain their registration and an active practice permit with the College if they wish to practice as a physiotherapist. However, physiotherapists will be able to decide if they wish to be members of a professional association of physiotherapists in Alberta which will have the role of promoting the interests of the profession in Alberta.

It is not yet clear what relationship may develop between the future association of physiotherapists in Alberta and the Canadian Physiotherapy Association. The association is currently in the process of establishing itself and its governance structure and completing other key activities that need to occur for the association to begin operations. A Steering Committee has been formed to complete this work.

You can sign up to receive information from the association Steering Committee here.

As an organization that had adopted a formal dual mandate as both College and Association, it is clear that Physiotherapy Alberta must develop plans to divest ourselves of professional association functions.

As part of this process, Physiotherapy Alberta staff and Council have been working through the process of reviewing all our current functions to ensure they are consistent with our role as a single mandate organization.

Our actions to date:

  • Reviewed the legislative amendments and their affects in detail.
  • Collaborated with other health profession regulatory organizations in Alberta to understand the legislative changes and how they are being implemented by comparable organizations.
  • Developed regulatory principles to identify what is or is not within our mandate.
  • Hired a consultant (Halford Consulting) to assist with the preparation for the launch of an independent professional association.
  • Set aside funds for a one-time seed funding in the amount of $300,000 to support the establishment of the independent professional association. This amount represents the monies that were transferred from the APA to the CPTA when the APA ceased operations.
  • Facilitated the identification and recruitment of inaugural Steering Committee members to lead the establishment of the independent professional association.
  • Developed Physiotherapy Alberta’s new strategic plan, in alignment with our newly revised and refocused mandate.
  • Created a space where regulated members of Physiotherapy Alberta could submit questions regarding the separation of College and Association.
  • Published a podcast and provided a webinar to educate regulated members about the history of our organization, the respective roles of College and Association, and background regarding self-regulation.
  • Announced the new name of the single mandate organization will be the College of Physiotherapists of Alberta. The name will become official when Schedule 20 of the Health Professions Act is amended. 

What’s next?

  • Develop the brand identity for the future single mandate College of Physiotherapists of Alberta.
  • Council approval of Physiotherapy Alberta’s Divestment Plan of Association Functions.
  • Obtain Ministerial approval of Physiotherapy Alberta’s Divestment Plan of Association Functions.
  • Redevelop Physiotherapy Alberta’s website.
  • Retire resources that are no longer consistent with our mandate.

Timeline

Date

Action

Summer 2020

Government of Alberta consultation re: regulatory reform.

December 2020

The Health Statutes Amendment Act, 2020 receives Royal Assent.

October 1, 2021

Sections 70, 74, 78, 79, 93 of the Health Statutes Amendment Act are proclaimed by the Lieutenant Governor in Council.

January 1, 2022

The new professional association will officially separate from the College on January 1, 2022. 

Seed funding transferred from Physiotherapy Alberta to new association.

March 31, 2022

Deadline for Physiotherapy Alberta to provide the Minister with a plan to divest itself of its professional functions.

April 1, 2023

Deadline for Physiotherapy Alberta to fully divest itself of association functions, connections, or affiliations with a professional association.

How we decide what we do

One of the challenging aspects of this change has been working through the process of determining which of the activities currently conducted by Physiotherapy Alberta are consistent with our future mandate and which ones need to be discontinued.

While some activities can be identified that are purely in the public interest and others that are purely in the profession’s interest, many more exist in the grey zone of representing the interests of both groups.

In deciding what activities we continue or adopt, one of the first questions we ask ourselves is whether the driver to act is the public interest and whether the impetus and outcome are public first.

Other questions we ask ourselves are represented in this Flow Chart.

Consistent with Physiotherapy Alberta’s new mandate, some resources will be retired from our website in the coming months. Once retired, these resources will no longer be available from Physiotherapy Alberta. The items being retired include:

Physiotherapy Alberta is proud of the resources we have developed over the years and would like to thank our many contributors to this work.

Individuals who wish to have ongoing access to these resources are advised to download the documents prior to January 2022.

Why is the separation of College and Association happening faster than Physiotherapy Alberta is required to make it happen?

Physiotherapy Alberta knew that this change was coming back in the summer of 2020 and started to work in late 2020/2021 to prepare. Physiotherapy Alberta has always been a regulatory body first and foremost; however, we also believe in the importance of a strong association in Alberta, particularly with the rapid pace of change that we have seen within the health-care environment in Alberta in recent years.

How will my Physiotherapy Alberta Fees Change with the Change in Mandate?

Physiotherapists should be aware that Physiotherapy Alberta is a not-for-profit organization which generates 96.15% of its income through registration and renewal fees. The remainder comes from investment income and by applying for and receiving government grants to support special initiatives.

Any changes to annual renewal fees will be discussed by Council at the June 2022 Council meeting. This is consistent with our operating procedures for budgeting and establishing fees. At this time, we are unsure if fees will go down or by how much.

You can learn more about the costs of regulation and how the fee setting/budgeting process is conducted from this podcast.

I remember that my fees went up significantly when the College took on association functions. Doesn’t that mean that there will be a significant reduction when separation occurs?

Physiotherapy Alberta has heard from several physiotherapists who have made this comment. As the table below reflects, individuals who were CPA and APA members at the time when the APA ceased operations experienced a slight fee decrease the following year. Individuals who were not CPA and APA members in 2008, experienced a fee increase in 2009 (when the College took on association functions).

Year

College (Mandatory)

APA/CPA*

(Optional)

COMBINED TOTAL

2008

 

$550

$499 (combined APA and CPA)

$1,049

2009

 

$745

CPA – data not available

 

APA – not applicable

$745 + CPA fee

Current

$805

$297.50 (CPA only)

$1102

 

At approximately the same time as Physiotherapy Alberta became a dual mandate organization, we were also approaching proclamation of the Physical Therapists Profession Regulation (PTPR) under the Health Professions Act. In 2008 the then College of Physical Therapists of Alberta advised regulated physiotherapists that once the PTPR was proclaimed it would become a registration requirement that each individual hold personal professional liability insurance. This registration requirement is unrelated to the change to a dual mandate organization; however, the costs associated with the two changes in 2008 may be temporally associated in the minds of some physiotherapists, and this may explain their perceptions regarding fee changes at the time.

Since 2009, practice permit fees have increased by $60, while the costs of regulation (particularly the costs related to complaint investigations and other conduct processes) have increased considerably.

Regulation is a human resource-intense endeavor. Approximately 45% of Physiotherapy Alberta’s annual operating budget goes towards staff costs. Considerable resources are spent on regulatory functions including registration, investigations, conduct and continuing competence requirements.

What will the new association fees be?

The new association will operate independently of Physiotherapy Alberta and will be responsible for determining its own fee structure based on costs of operations and supporting the profession of physiotherapy in Alberta.

When will the association be up and running?

We anticipate that the new professional association will officially separate from the College on January 1, 2022. Physiotherapy Alberta will transfer seed funding to the new association of physiotherapists and the association will continue to work through the process of developing its own governance structure, bylaws, and establishing its operations through early 2022.

Individuals wanting additional information about the new association and its plans can sign up for updates from the Steering Committee here.   

Will the association be a branch of CPA?

That remains to be seen and will be a decision of the association. Physiotherapy Alberta will have no role in this decision.

Who’s on the steering committee?

In the spring of 2021, Physiotherapy Alberta’s Council put out a call for Expressions of Interest from individuals willing to serve on the Inaugural Steering Committee of an independent association. Physiotherapy Alberta thanks the many physiotherapists who put their names forward to support this work.

Geoff Schneider, Ahmad Qayyum, Janelle Van Heeren, Prajakta Shirolkar, Colleen Kuntze, and Geoff Bostick were appointed to undertake the process of launching the new professional association.

Physiotherapy Alberta had to appoint individuals to the Steering Committee to start this process. Now that the Steering Committee has formed, they are engaging in the process of developing their governance model, bylaws and other foundational documents independent of Physiotherapy Alberta.

We are hopeful this new organization will continue to strengthen the voice of physiotherapy in our province.

How can I get involved in the College?

The next opportunity to become involved with the College will come in early 2022 with the call for nominees for Council elections.

How can I get involved in the Association?

The process of establishing a new professional association of physiotherapists in Alberta is time consuming work. Its success will depend on the willingness of members of the profession to step forward and contribute to this work. Individuals wanting to get involved with the new professional association should contact the steering committee directly. You can sign up for updates from the association Steering Committee here.  

Physiotherapy Alberta has committed to sharing information with our regulated members as we work through this process. The FAQ section of this webpage will have new content added as new information arises or themes emerge from questions we receive. You can submit a question or comment through this form.