IBSIG Members, Are you Adequately Insured?

As an RPN in independent practice, it is important that you are aware of the need for, and protect yourself and your business with, professional liability and general (commercial) liability insurance.

The KW Insurance Brokers would be happy to discuss your insurance requirements. Areas of insurance to consider include:

  • Commercial Contents Insurance: Theft of your business tools/equipment (ie laptop). Can cover equipment on a floater form for contents travelling with you to other locations.
  • Commercial General Liability Coverage: For actions or occurrences that are not “Professional” related, (ie. slip and fall at your place of business/ clinic or trip and fall over your equipment left on the floor and will cover operations at other people’s premises.
  • Liability is not tied to your premises, but to your operations.
  • Commercial Automobile Insurance: for business use of your vehicle.
    Disability Insurance Coverage/ Critical Illness: If you are injured or become ill and can’t complete normal duties.

For more information, please contact:

Louise Engler, KW Insurance Brokers
112-501 Krug St, Kitchener, ON. N2B 1L3
(p) 519-744-4190 | (f) 519-744-7664
lengler@kwbroker.ca |  http://www.kwbroker.ca/nurses-commercial-insurance-program

What is IB SIG doing on the public’s behalf?

IB SIG is working to get recognition of RPNs in independent business by insurance companies. This starts with raising the public’s awareness of who we are, what we do and how you can help us. We hope to get further assistance from our professional nursing associations as needed. We are advocating and working on raising awareness [in conjunction with RPNAO and its ‘role-clarity’ exercise] with government representatives and CNO of the discrepancy between RPNs in the public and private sectors and discussing ways of having better integration of nurses in independent business.

Also, we are in the process of informing health insurance companies of who RPNs in independent business are and how they can integrate with a 21st-century-model of nursing and scope of nursing practice into their health plans and policies. Through this effort we hope health insurance companies update their definitions, as currently they do not serve their policy holders as well as they could.

IB SIG prepared this new paper: “RPNs in Independent Business: IB SIG Request for Action”which is meant to provide:

  • a high-level background on the issues that face Registered Practical Nurses (RPNs) in Independent Business, and
  • some proposed actions that the Independent Business Specialty Interest Group (IB SIG) believes are foundational in alleviating the issues at hand.

Help us raise awareness by sharing this document with your Member of Parliament. Visit the Request for Action page, and download the report.

What is an RPN?

According to the Nursing Act, 1991, “The practice of nursing is the promotion of health and the assessment of, the provision of care for, and the treatment of health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function.”

"In Ontario, nursing is one profession with two categories of care providers — registered nurses (RNs) and registered practical nurses (RPNs). In most ways, the two categories are subject to the same regulatory requirements." (Office of the Fairness Commissioner, 2007).

RPN stands for “Registered Practical Nurse” and is a designated title as first defined in 1993 by the Regulated Health Professions Act and is protected by the College of Nurses of Ontario (CNO). The Registered Practical Nurses Association of Ontario (RPNAO) is a support organization, educational resource and advocacy body for RPNs.

RPNs receive their foundational education through a College of Applied Arts and Technology and often take additional courses in specialty interest areas. In order to practice as a nurse in Ontario, RPNs must successfully complete an exam administered by the College of Nurses of Ontario, renew their registration annually and keep up to date on current practices. The CNO operates in accordance with the Regulated Health Professions Act, 1991 and the Nursing Act, 1991.

More information:

For full details about the RPNs and Ontario regulators, visit these links:

What do RPNs in independent business do?

RPNs who are in independent business (IB) are regulated healthcare professionals who use their nursing skills, knowledge and judgment, and work in a variety of healthcare practice settings. For example, RPNs may work at an independent business location, or attend in long-term care homes, community settings, healthcare agencies and educational institutions.

RPNs in independent business have additional training in nursing specialties such as: foot care, health promotion (nutrition), naturopathy, aromatherapy, reflexology, colon hydrotherapy, and EMS training/education. They are also mandated by the College of Nurses of Ontario (CNO) to continue their studies through continuing education and practice review to ensure that nursing practice is current.

More information:

Are Independent Business RPN services covered under OHIP?

Independent Business RPN services are notcurrently covered under OHIP.

Nursing services provided by RPNs running their own business who offer health promotion and disease prevention-focused care, are not considered 'medically necessary' services. The Canada Health Act deems nursing care medically necessary if it is provided by nurses working within the publically funded healthcare system. Nurses in independent business are outside of this funding model.

More information:

http://laws-lois.justice.gc.ca/eng/acts/C-6/FullText.html

Does my employer’s Extended Health Insurance cover the services of IB RPNs?

In some cases your employer’s Extended Health Insurance will cover IB RPN services, but in other cases it will not. Health Insurance Plans are a continuation of where the publicly funded healthcare system leaves off. Plans customarily cover in-home nursing services when deemed 'medically necessary'.

As many RPNs in independent business provide services that are oriented towards health promotion and disease prevention, they do not fit into medically necessary definition. Furthermore, an RPN in independent business may be providing services outside of a client's home. For these reasons, health insurers are not often aware of the expanded depth, breadth and scope of nursing practice provided by RPNs who run an independent business.

The result of this lack of awareness amongst health insurers is that benefits are only extended to cover paramedical or allied healthcare professionals providing services in the area of health promotion and disease prevention while RPNs in independent business working to provide similar services are not covered.

We believe the addition of nurses in independent businesses -- like other regulated health providers who are covered under health plans -- should be included. Therefore IB SIG executive are working with other associations and advocating towards recognition of nurses in independent business. Individuals with private health plan coverage would benefit from the flexibility to choose an RPN in independent business for their healthcare needs. We believe it is time to discuss this with the appropriate people and that is why our executive and specifically, public relations person is involved in this endeavour.

What can I do to help RPNs in IB SIG gain recognition?

You can help us by lobbying your insurance company, the Ontario Ministry of Health and the Federal/Provincial Governments to demand recognition in this 21st century to recognize nurses of all levels in independent business. Please send a copy of your correspondence to our public relations officeror president so we are aware of your efforts.

Please know that there is a lack of recognition by insurance companies for coverage of client-initiated health promotion/disease prevention care provided by an RPN in independent business. This lack of recognition disempowers your ability to choose RPNs in independent business as your healthcare practitioner of choice, should you wish benefits be paid by your health insurance plan. You can help us by contacting our public relations officer or president. We would be happy to speak with you and arrange a presentation at your workplace/association/union affiliation, etc. for those who would like to understand more about what we do and how you can help us gain recognition.

As OHIP continues to trim spending, some nursing services are falling outside of public funding and in turn being provided by nurses in independent business. If you have health insurance benefits you will need to ask for inclusion of RPNs in independent business under your policy and we can explain the details on how to go about this.