Health Professionals

Purpose

This policy provides the criteria used to approve health professionals who deliver services under the Health Care Treatment Benefits Program, the Veterans Independence Program, and the Rehabilitation Program.

Policy

General

1. Veterans Affairs Canada (VAC) pays for the cost of health care benefits and other services provided to eligible individuals by health professionals who are approved by the Minister. In Canada, the regulation of health professionals falls primarily within the jurisdiction of the provinces (including Yukon, the Northwest Territories and Nunavut). In deciding whether a health care practitioner is to be approved as a “health professional”, the Minister may take into account the regulation of that health profession by a province.
2. The regulation of health professions and health professionals is important, as it:
   1. establishes oversight to ensure that members of the profession have the credentials and training needed to provide safe and effective care, and meet professional standards of conduct and competence in practice; and
   2. facilitates the Department’s decision-making as to who can prescribe and/or provide benefits and services.
3. The regulation of health professions and health professionals, whether by a province, or a body granted the authority to regulate by the province, consists of a number of elements relating to the process of managing a profession and the practitioners within that profession. These elements may include:
   1. protecting professional title;
   2. defining scope of practice;
   3. setting qualification standards for entry into the profession;
   4. establishing continuing education requirements;
   5. establishing a licensing process;
   6. taking action against unlicensed individuals
   7. defining and setting standards of practice and ethics; and
   8. establishing a process for dealing with complaints and findings of misconduct and/or incompetence.

Approval of Health Professionals

4. The Benefits Review Committee, acting on behalf of the Minister, is responsible for deciding about inclusions and exclusions of benefits and health professionals groups.
5. VAC may approve a health profession if:
   1. the health care practitioners are licensed by the appropriate regulatory authority of that health profession in the province where those practitioners provide the benefits or services; or
   2. the health care practitioners practise a health profession that is not regulated in the province where those practitioners provide the benefits or services, but:
      1. that health profession is one that is regulated in at least three of the following provinces: Nova Scotia, Quebec, Ontario, Alberta, British Columbia; and
      2. the VAC Benefits Review Committee considers that the benefits or services provided by that health profession are considered to be a safe and effective treatment; and
      3. the health professional meets the “provider” requirements outlined by VAC (see paragraph 6).
6. Where a health profession is approved, a health professional who practises that health profession may apply for VAC’s "provider" status to facilitate approval and payment of the benefits or services which that health professional provides. Health professionals are encouraged to apply for and obtain "provider" status, but it is not required. If the health care practitioners are approved as a health professional, those practitioners may provide benefits or services and be reimbursed for the same.
7. The health professions currently approved by the Minister are as listed in Common health professionals covered by Veterans Affairs Canada. Health professions followed by an asterisk are not authorized by VAC in every province. Please consult the benefit grids for more information on a health professional’s status in a given province.
8. Under section 4(d) of the Veterans Health Care Regulations, a person, other than a physician or dentist, may be authorized to prescribe pharmaceuticals under the laws in force in the province or country where the pharmaceuticals are provided. This authority does not require VAC to approve the person as a health professional for purposes of providing any other benefits or services unrelated to the prescription of pharmaceuticals.

Delivery of Telehealth by Health Professionals

9. A health professional, approved subject to paragraphs 4 through 8 of this policy, may deliver health care services using telehealth, where it is determined by the treating health professional that this approach would be beneficial. Telehealth allows the health professional to use telecommunications technology in lieu of a face-to-face consultation to bring people in different locations together in a secure and private meeting (an example would be videoconferencing to connect with hospitals, clinics, or Veterans). Telehealth may be useful in cases where Veterans are challenged not only by the complexities of their health conditions, but also by the rural and remote areas in which they live.
10. When the Veteran resides in the same province/territory as the approved health professional who is delivering health care services using telehealth, that health professional must comply with the requirements for telehealth, if defined, under the regulatory authority in that province.
11. Where the Veteran and the approved health professional delivering health care services using telehealth reside in different provinces,
    1. the health professional must be licensed by the appropriate regulatory authority of that health profession in the province where he/she resides and practices; and
    2. the health professional must be licensed by the appropriate regulatory authority of that health profession in the province where the Veteran resides (and is receiving the benefit or service); and
    3. the health professional must comply with the requirements for telehealth, if defined, under the regulatory authority in the province where the Veteran resides; or
    4. the health professional must comply with the requirements for telehealth, if defined, under the regulatory authority in the province where he/she resides and practices.
12. In exceptional circumstances, an exemption may be made if the approved health professional, who is licensed in the province where he/she practices and resides, meets the requirements to be licensed by the appropriate regulatory authority of that health profession in the province where the Veteran resides and receives the benefit or service, and no other suitable treatment option exists.

Approval of Collaborative or Multi-Disciplinary Health Care Teams

13. A collaborative or multi-disciplinary health care team approach may be required to address a patient’s physical, mental and/or social health needs. In situations where no single health professional is able to address all of the patient’s needs, the skills of various health professionals from different disciplines may be required to deliver a comprehensive range of benefits or services to the patient.

Approval of Inter-Disciplinary Health Care Teams

14. There are circumstances where a health professional, approved subject to paragraphs 4 through 8 of this policy, may approve benefits or services for a patient and then delegate or oversee the provision or delivery by another person who is not a “health professional”. In such cases, the health professional has the responsibility to ensure that the benefits or services are provided in a safe, effective manner, consistent with the applicable professional standards. Veterans Affairs Canada is not responsible for approving each person that a health professional chooses as part of a specific inter-disciplinary team, as such a team functions under the guidance and instructions of the health professional.

Canadian Armed Forces Personnel at Release

15. VAC may continue coverage of an existing treatment plan for Canadian Armed Forces personnel at release who are transitioning to coverage under VAC, even if the health provider is not on the approved list of health professions. The treatment plan may be continued as long as needed to accomplish established outcomes.

References

Veterans Well-being Act, sections 8 - 17

Veterans Well-being Regulations, sections 6, 8, 9, 10, 11, 12, and 14

Veterans Health Care Regulations, sections 2 and 4

Common health professionals covered by Veterans Affairs