Over 20 million Canadian employees, pensioners and their dependents receive health care protection through their employer.
What issues are employers facing that provide
opportunities for occupational therapists?
There is growing recognition that more money has to be spent on ensuring a healthy work force by all of the stakeholders including the government (Negel, K. F., Schmitz, M., & Cutt, J., 1998). Illnesses resulting in short-term disability (STD) and long-term disability (LTD) claims have changed in the past three years, so that they now include more mental health disabilities, such as depression. This combined with an increase in use of antidepressant medications is forcing employers to look at employee stress and wellness programs. Early intervention is critical to the management of depression and in prevention of LTD claims. The most common approaches that appear to be used by businesses to reduce absenteeism and health costs include:
Similarly a comprehensive benefits package that includes non-traditional benefits such as elder care can reduce caregiver stress and mitigate against lost productivity.
Although occupational therapists are involved in all of these four approaches, they face competition from other health professionals. The challenge is to position occupational therapy as the number one choice. Increasing the demand for our services places pressure on the insurance companies to include occupational therapy on their list of available services.
What types of insurance products cover
Disability insurance provides employees with partial replacement of lost income during periods of total disability, complementing workers' compensation benefits by covering injuries and illnesses not related to work. Rehabilitation services may be offered to assist the employee in reducing the duration of disability, and promoting return to work.
Extended health insurance helps employees and their dependents pay for medical expenses that are not covered by the provincial health plan. Extended health care plans vary according to the services that are covered in a core, optional or flex plan, and the amount of coverage for services.
Typically, occupational therapy services are not included in an extended health insurance package. This presents two problems:
There is a shift to placing the responsibility of health care on the individual plan member. Employers are educating employees about what their benefit plan includes and why. In order for employees to request occupational therapy as part of the extended health benefits package they need to be aware of the services we provide. "It is important to educate and provide incentive for residents [employees] to seek the most appropriate service providers within the health care system" (ECHCO, 1995, p. 18).
What can you do to assist in the insurance lobby?
2. Identify major industries and employers in your community to promote occupational therapy messages which may include:
3. Measure outcomes to demonstrate the value of occupational therapy services.
4. Develop case studies that emphasize the benefits of occupational therapy to employee and family wellness.
5. Write success stories that demonstrate the value of occupational therapy that can be promoted to consumer, insurance and human resource publications.
6. Create consumer tips illustrating the role of occupational therapy in different practice areas.
7. Use the CAOT lobby letter with clients to encourage insurance companies to recognize our services. A copy is available on both www.caot.ca and www.otworks.com, as well as in the CAOT Insurance Lobby ToolKit. If you would like a copy faxed to you, please contact email@example.com or 1 (800) 434-2268, ext. 242.
Consumer tips, case studies and success stories can be shared with National Office and compiled as resources for individual occupational therapists and organizations to use in their lobby efforts. Alternatively if you would like assistance in developing these resources that can then be shared nationally, please contact me at 1 (800) 434-2268, ext. 237 or e-mail: dtoalsullivan @caot.ca.
OT Works: Skills for the Job of Living Marketing Brochure includes a description of our unique approach, qualifications and case studies to demonstrate the effectiveness of occupational therapy.
Skills for the Job of Living Pamphlets These are based on the tips found in Occupational Therapy Now or on www.otworks.com. (Contact: firstname.lastname@example.org for the current list or 1 (800) 434-2268, ext. 242.
OT Works: The Canadian Occupational Therapy Resource Site contains not only more skills for the job of living tips but more in depth information regarding occupational therapy outcomes, our qualifications and how to hire us.
Benefits Canada. (1999b). The wellness package. Retrieved May 8, 2000 from the World Wide Web: http://www.benefitscanada.com/Content/1999/01-99/ben019901.html.
Employers Committee on Health Care-Ontario. (1998). Towards integrated delivery systems: An employer view. BCE Place, 161 Bay Street, P.O. Box 501, Toronto, ON M5J 2S5
Employers Committee on Health Care-Ontario. (1995). A perspective on health care. BCE Place, 161 Bay Street, P.O. Box 501, Toronto, ON M5J 2S5
International Foundation of Employee Benefits Plans. (1999). Employee benefits in the future. Retrieved April 19, 2000 from the World Wide Web: http://www.ifebp.org/ichotcnh.html
Negel, K. F., Schmitz, M., & Cutt, J. (1998). Corporate strategies: Reducing absenteeism and health costs. Employee Health and Productivity, 6 (4), 24-41.
Toal-Sullivan, D.(1999). Health insurance lobby. Occupational Therapy Now, 2, 18.
Toal-Sullivan, D.(1999). CAOT's Insurance lobby: Establishing private funding for occupational therapy services. Occupational Therapy Now, 4, 21.
Toal-Sullivan, D. (1999). Insurance lobby update. Occupational Therapy Now, 5, 3-4.
* Members of the Professional Alliance of Canada's project team include: The British Columbia Society of Occupational Therapists (BCSOT), the Ontario Society of Occupational Therapists (OSOT), and l'Ordre des Ergothérapeutes du Quebec (OEQ) and CAOT
This past July, the Publications Division of CAOT was restructured and expanded to accommodate the increase in our publications and communication activities. Lisa Sheehan our former Publications Representative was promoted to Publications Administrator and the following new staff were hired.
Lisa Wallans joined CAOT in the position of Publications Assistant as of July 10, 2000. Lisa works half days at CAOT office. Her primary responsibilities include the sales and distribution of CAOT publications and subscriptions. Lisa came to CAOT from the Child Maltreatment Division of Health Canada. Lisa is bilingual in English and French.
Susan MacEachern joined CAOT in the full time position of Desktop Publishing Administrator as of July 17, 2000. Susan's responsibilities include the layout of CAOT publication and communication products. Susan is a recent graduate of Algonquin College and Acadia University. Susan is bilingual in English and French.
News from the
Canadian Occupational Therapy Foundation
Recent award winners
Pediatric award available
The deadline for applications is September 30, 2000.