To fight COVID-19, remove barriers for Ontario’s physician assistants

Dear Minister Elliott and Deputy Minister Angus,

On behalf of physician assistants (PAs) across our province, we thank you for your tireless dedication to the wellbeing of Ontarians and your tremendous support of all frontline health care professionals throughout the COVID-19 pandemic. Your efforts are greatly appreciated.

We are writing today to propose policy solutions that will allow Ontario to strengthen our health workforce capacity, mitigate the loss of health care professionals to self-isolation, and meet the demand for skilled health care professionals during a surge in COVID-19 cases.

We would be pleased to discuss these issues with your officials and are requesting the opportunity to speak by phone at the earliest opportunity.

The attached briefing note describes our proposals in full, but they include:

  • A temporary order by the CPSO to allow PA oversight and the delegation of acts to be determined at the practice level by supervising physicians, in consultation with hospital medical leadership where necessary, without penalty.
  • The creation of temporary new fee codes or modifiers that would allow physicians to bill at a discounted rate for services and procedures rendered by PAs.

CAPA is not alone in proposing solutions to mobilize the PA workforce during this pandemic. Last month, the state of New York issued an executive order to modify laws governing PAs. Elsewhere in the United States, two other states issued executive orders related to PA oversight and COVID-19, and 14 states had previously updated their laws to relax these requirements in emergencies or disasters.

Here at home, we have seen your Ministry act quickly to address the crisis, from introducing new fee codes to support virtual care to launching efforts to recall retired health care workers back to service. With officials projecting that Ontario could be dealing with the effects of COVID-19 for up two years, now is the time to consider additional policy measures that will effectively strengthen our health system over the long term.

Today, CAPA submits our recommendations in the spirit of collaboration and innovation. We strongly believe that by enacting our proposed measures now, doctors, hospitals, and other health care organizations can improve coverage, efficiently use skilled and flexible resources, and increase capacity during a surge in COVID-19 cases.

Thank you in advance for your consideration. And, more importantly, on behalf of our members we thank you again for your leadership, commitment, and compassion during this very difficult period.


Leslie St. Jacques, CCPA

Sahand Ensafi, CCPA
Provincial Director, Ontario

Patrick Nelson
Executive Director

c.c.       Mr. Anthony Dale, President and CEO, Ontario Hospital Association

Dr. Sohail Gandhi, President, Ontario Medical Association

Mr. Allan O’Dette, Chief Executive Officer, Ontario Medical Association

Dr. Nancy Whitmore, Registrar and CEO, College of Physicians and Surgeons of Ontario

Dr. Brenda Copps, President, College of Physicians and Surgeons of Ontario

Mr. Patrick Dicerni, Assistant Deputy Minister and General Manager, OHIP

Ms. Rana Shamoon, Director, Health Policy, Office of the Premier of Ontario