College of Chiropodists of Ontario
180 Dundas Street West, Suite 1901 M5G 1Z8 Toronto, ON, Canada

In October, College Council approved amendments to the Records Standard and approved a new Discontinuation of Services Advisory. For the full announcement, visit our website here: https://cocoo.on.ca//Ema/Dec/members_email_2020_Dec_16.pdf

A reminder to Members that you can access all communications sent to the membership anytime via the College's website here: https://cocoo.on.ca/members/member-communications/

The College has been made aware that some Members are not receiving e-mail communications from the College. We have looked into this matter, and have confirmed this is not an issue from our outgoing e-mail source. The College advises Members to please check their spam/junk folders as some communications may end up marked as spam or junk. Please check your e-mail account settings or contact your e-mail provider if you continue to experience issues receiving College e-mails. Please also ensure that your most current e-mail address is on file with the College, by updating your contact information via the Member Login page: https://members.cocoo.on.ca/

Recently, College Council approved amendments to the Orthotics Standard and Fees By-Law. For the full announcement, visit our website here: https://www.cocoo.on.ca//Orthotics_and_Fees_Bylaw_05Nov202

An important announcement to Members regarding the Spousal Exception Regulation... for full details visit our website: http://cocoo.on.ca/pdf/Email/Oct/spousal_exemption_reg.pdf

Last week, we prepared an FAQ regarding best practice for dealing with patient coats and other belongings during COVID-19. This FAQ and others (as they arise) will be added to the COVID-19 FAQ page on our website: http://cocoo.on.ca/covid-19-faqs/

The College congratulates the following successful candidates in the recent election: District 3 - Matthew Doyle who was elected for a second three year term. District 4 Melanie Atkinson who was acclaimed.... Districts 3 & 4 combined/District 2 Irving Luftig, Podiatrist, who was acclaimed. The bi-election in District 5 is ongoing.

Practice Advisory Services are now available at COCOO. Visit our website for more information: http://cocoo.on.ca/members/practice-advisory-services/

Coming Soon: Practice Advice at COCOO! Beginning September 8th, the College will have a Practice Advisor available to answer members’ questions about professional services in Ontario. Stay tuned to the College's Twitter and Facebook feeds for more information.

COCOO Council Member Sasha Kozera will be reviewing the College Pandemic Directive at a webinar on Thursday https://www.facebook.com/205684512803012/posts/3105549222816512/?sfnsn=mo

ATTENTION: IMPORTANT NEWS - A REVISED DIRECTIVE #2 FROM THE CHIEF MEDICAL OFFICER OF HEALTH OF ONTARIO HAS REPLACED THE DIRECTIVE ISSUED ON MARCH 19th, 2020. The CMOH directive reflects a gradual restart of services. Where possible, Members are encouraged to limit the number of in-person visits for the safety of their patients, staff, and themselves. It remains important for Members to continue to monitor COVID-19 spread in their community and to restart services carefully a...Continue reading

The Ontario Government announced today that Directive #2 has been amended to permit health care professions to return to practice. Those returning to practice must follow the government guidelines in conjunction with those issued by their regulatory College. Members should monitor their email and the College website for additional information that will be released today.

New Advisories Please follow the link to find an advisory on: 1. Long Term Care Facilities (http://cocoo.on.ca/covid-19-faqs/#LTCFs); and 2. Home visits (http://cocoo.on.ca/covid-19-faqs/#InHomeCare)... The College is also working on updating practice issues relating to orthotics based on the many questions we have received. As well, the College is developing guidance to assist members in preparing for the eventual return to practice. We are working with the government and the CMOH to clarify timing, guidelines and access to personal protective equipment. Please watch your e-mail for these updates. And presently The provincial government has extended all emergency orders, including those that call for the closure of non-essential workplaces, until at least May 19. This direction may change in the coming weeks, however, there is currently no set date for a return to practice for chiropodists and podiatrists and other health care providers. Our members should avoid scheduling non-urgent appointments until a restart date has been released as the existing directive from the Chief Medical Officer of Health (CMOH) remains in place. We know chiropodists and podiatrists are very eager to prepare for the return to practice and we will share our guidance as soon as it is available.

At 12:01 am on May 19, 2020, the Regulation passed under the Emergency Management and Civil Protection Act which closed all non-essential businesses was amended such that the limitation on members only being able to provide urgent care has been removed https://www.ontario.ca/laws/regulation/200082. As a result, members can see patients in their offices provided that the member complies with the directives of Ontario’s Chief Medical Officer of Health. The existing directive ...may be found at http://www.health.gov.on.ca//direct/RHPA_professionals.pdf. Members may see patients in their offices provided the member determines that the patient requires essential service. The decision as to whether the service is essential must be made by the clinician. The College cannot provide a definitive list of what is and what is not essential. However, the College would consider services which are needed to prevent negative outcomes for patients to be essential. Members who open their offices to provide essential services must follow the standards of practice of the profession, including any standards related to infection control and prevention. They must also have available the personal protective equipment, system, and administrative controls necessary to minimize the risk of spreading the Covid-19 virus. Resources to assist you in this, including the Technical Brief V2 and the COCOO Pandemic Directive, are found at http://cocoo.on.ca/covid-19-novel-coronavirus These are unprecedented times and the information we are receiving from Government sources may well change without notice. This includes the potential for the amendment of Directive No. 2. As new information becomes available, we will advise members of it. See more

The College and other members of Health Profession Regulators of Ontario (HPRO) have identified access to PPE as a major issue to regulated health professions. The College and HPRO have communicated to the Minister of Health and the EOC of the Ministry of Health about concerns and the need to provide timely access to PPE for members (particularly in the community). The College has been informed that PPE allocation continues to be focused on critical need at this time and allocation for non-urgent sectors is still at a very early stage. However, as the situation in Ontario evolves and as the work on easing restrictions progresses, there will be more information to communicate regarding PPE allocation for other sectors. http://cocoo.on.ca//up/2020/04/PPE-Survey-Infographic.pdf

In response to the extended period that the Chief Medical Officer of Health Directive # 2 has been in place, the College has reviewed and modified its advice in relation to Prescription Custom Foot Orthoses. Please follow the link to the modified advisory for the provision of Prescription Custom Foot Orthoses during the COVID-19 Pandemic, http://cocoo.on.ca//Modified-PCFO-Advisory-13th-May-2020.p In addition the College is working quickly to develop a Return to Practice Directive that will be ready for release to members once the Government and CMHO allows this to occur.

New Advisories Please follow the link to find an advisory on: 1. Long Term Care Facilities (http://cocoo.on.ca/covid-19-faqs/#LTCFs); and 2. Home visits (http://cocoo.on.ca/covid-19-faqs/#InHomeCare)... The College is also working on updating practice issues relating to orthotics based on the many questions we have received. As well, the College is developing guidance to assist members in preparing for the eventual return to practice. We are working with the government and the CMOH to clarify timing, guidelines and access to personal protective equipment. Please watch your e-mail for these updates. And presently The provincial government has extended all emergency orders, including those that call for the closure of non-essential workplaces, until at least May 19. This direction may change in the coming weeks, however, there is currently no set date for a return to practice for chiropodists and podiatrists and other health care providers. Our members should avoid scheduling non-urgent appointments until a restart date has been released as the existing directive from the Chief Medical Officer of Health (CMOH) remains in place. We know chiropodists and podiatrists are very eager to prepare for the return to practice and we will share our guidance as soon as it is available.

The College and other members of Health Profession Regulators of Ontario (HPRO) have identified access to PPE as a major issue to regulated health professions. The College and HPRO have communicated to the Minister of Health and the EOC of the Ministry of Health about concerns and the need to provide timely access to PPE for members (particularly in the community). The College has been informed that PPE allocation continues to be focused on critical need at this time and allocation for non-urgent sectors is still at a very early stage. However, as the situation in Ontario evolves and as the work on easing restrictions progresses, there will be more information to communicate regarding PPE allocation for other sectors. http://cocoo.on.ca//up/2020/04/PPE-Survey-Infographic.pdf

ADVISORY FAQ Q: I UNDERSTAND SOME MEMBERS HAVE BUILT ‘ISOLATION ROOMS’ IN THEIR CLINIC TREATMENT ROOM FROM PLASTIC SHEETS TO SEE PATIENTS DURING THE COVID-19 CRISIS. IS THIS SOMETHING I SHOULD CONSIDER DOING IN MY OFFICE? A: No, the addition of extra items such as plastic sheeting into clinic treatment rooms can increase the amount of surfaces that will need disinfecting between patients. This does not meet current College IPAC standards of Practice or any advice provided by the College PHO, CDC or WHO related to care of patients during the COVID 19 crisis

The Standards and Guideline committee is meeting and working to understand and provide best practice guidelines and standards for our members during the COVID-19 crisis. As an example the College is currently developing an advisory to help guide members performing home visits and care in Long-Term Care facilities. . Once available it will be circulated & posted on the website. Be sure to check the website on a frequent basis to remain current on FAQ and other information.

ADVISORY FAQ Q: I UNDERSTAND SOME MEMBERS HAVE BUILT ‘ISOLATION ROOMS’ IN THEIR CLINIC TREATMENT ROOM FROM PLASTIC SHEETS TO SEE PATIENTS DURING THE COVID-19 CRISIS. IS THIS SOMETHING I SHOULD CONSIDER DOING IN MY OFFICE? A: No, the addition of extra items such as plastic sheeting into clinic treatment rooms can increase the amount of surfaces that will need disinfecting between patients. This does not meet current College IPAC standards of Practice or any advice provided by the College PHO, CDC or WHO related to care of patients during the COVID 19 crisis

ADVISORY: Important College updates and advice on PPE protocols have just been released to Members Check your emails or go to:http://cocoo.on.ca/members/member-communications/

Make sure to complete the member PPE availability survey by Wednesday if you haven't already done so. Your input is important ! https://www.surveymonkey.com/r/COCOO_PPE_SURVEY

Due to the COVID-19 outbreak, Personal Protective Equipment (PPE) for all healthcare workers is in high demand. The College has designed a survey to understand how much PPE is available and whether PPE is reaching members. The results of this survey will be very helpful to The College of Chiropodists of Ontario as we work with Government to speed up the supply of PPE to those who need it. All responses are voluntary and completely anonymous You can only take the survey once, but you can edit your responses until the survey is closed on April 22nd, 2020. Questions marked with an asterisk (*) are required. If you have any questions about the survey, please email us: [email protected] Please follow the SURVEY LINK here : https://www.surveymonkey.com/r/COCOO_PPE_SURVEY We really appreciate your input.

https://news.ontario.ca//ontario-takes-further-action-to-s

To help members navigates to important documents sent during the crisis, an IMPORTANT REFERENCE DOCUMENTATION button has now been added under the COVID-19 (Novel Coronavirus) section. http://cocoo.on.ca/covid-19-novel-coronavirus/

The College is continually updating its FAQs for both Members and the Public. Be sure to visit the College website http://cocoo.on.ca/covid-19-faqs/ frequently to keep current and to see if the question you have has already been asked. Here is a recent example: Q:AS YOU ARE AWARE IT IS ALMOST IMPOSSIBLE TO OBTAIN PPE. I WAS HOPING YOU COULD ANSWER A FEW QUESTIONS FOR ME? AS I LOOK THROUGH CATALOGS. I FIND REUSABLE ISOLATION GOWN ARE LISTED, HOWEVER ARE ALSO NOT AVAILABLE. IS ...A LONG LAB COAT THAT CAN BE LAUNDERED CONSIDERED ADEQUATE? CAN WE HAVE A WASHABLE GOWN MADE BY A SEAMSTRESS AND WOULD THAT BE CONSIDERED ADEQUATE? A: The College understands that PPE and infection control products are in short supply but currently it does strongly recommend the use of Droplet and Contact precautions. The College advises members that they should consult Routine Practices and Additional Precautions In All Health Care Settings, 3rd edition Provincial Infectious Diseases Advisory Committee (PIDAC). In particular you will note it states ‘Clinical and laboratory coats or jackets are not a substitute for gowns where a gown is indicated’ In regards to isolation gowns, you should refer to Important regulatory considerations for the supply of medical gowns Guidance to Industry In particular you will note it states ‘In Canada, all medical gowns are Class I medical devices Class I devices can be manufactured by companies that hold a Medical Device Establishment Licence (MDEL). Medical gown manufacturers authorized in Canada are listed in the Medical Devices Establishment Licence Listing database.’