The Canadian Forces Spectrum of Care: Implications for Occupational Therapist

Purpose of the Canadian Forces Spectrum of Care

Canadian Force (CF) members are entitled to receive health benefits and services through Canadian Forces Health Services Group (CF H SVCS GP) in accordance with specific regulations (Queen’s Regulations and Orders Chapters 34 and 35 found here).

The benefits and services are comparable to those provided to other Canadians through their respective provincial health care plans.

The CF Spectrum of Care (SoC) provides direction to CF health care providers, Base/Wing Surgeons, Clinic Managers and Dental Detachment Commanders. QR&O 34.07 Entitlement to Medical Care are the authority for utilization of public funds to ensure CF members have access to a range of medical benefits and services similar to those Canadians receive through provincial health care plans.

What is placed in the SoC health services and benefits for CF members?

Recommendations for inclusion of health benefits and services in the CF SoC are based on the following principles:

  1. The benefit/service is necessary for the purpose of maintaining health and mental well-being or preventing disease; diagnosing or treating an injury; illness or disability;
  2. The benefit/service sustains or restores a serving member to an operationally effective and deployable member of the CF;
  3. The benefit/service adheres to the scientific principle of evidence-based medicine. (This principle would eliminate any new procedures or remedies that have not been thoroughly and scientifically investigated (e.g. homeopathic remedies); and
  4. The benefit/service is not for purely experimental, research or cosmetic purposes.

The benefit/service is funded by at least one provincial health care plan or federal Agency (this principle is in keeping with Public Service Health Care Plan criteria).

Implications for occupational therapists working with CF members:

  1. Occupational therapy referrals: Canadian Forces Health Services (CFHS) will make referrals regarding a number of different CF member issues. Most often CFHS are interested in assessment and treatment of injuries that are causing issues living in the home and community; however, more recently CFHS are referring specifically to OT assess and treat in the area of return to duty and return to work. The idea of assessment and treatment in the area of return to duty draws on processes and concepts regarding “operational effectiveness”, “universality of service” and “deployability” often not seen in other industries. These CF process and concepts will be explored in-depth in a later post.
  2. Occupational therapy and military duty: For OTs working with CF members who are not transitioning out of the CF, an understanding of the member’s return to duty plan should be considered within the OTs approach. In dialogue and partnership with the CFHS team, OTs will want to consider the members current function and their work status and position. If the CFHS team plan intents to send the member back to full time military duty, consider your role to assist and, if you have the skills and experience, speak with the CFHS team. If the CF member has a long term disability, is still in the military but transitioning slowly to civilian work / community, the member still has expectations to engage in work or health work. It is critical to understand what the CFHS expectations are for the member and integrate these expectations within the OT rehabilitation plan and recommendations.
  3. Occupational therapy CF recommendations: When an OT assesses a CF member an OT report (either  must be written and provided to the CFHS team. The recommendations within in the report are recommendations for the CFHS to consider in light of the CF funding criteria, the medical needs of the member and over arching rehabilitation and health care plan for the member. Each recommendation is reviewed in light of the SoC #3 and #4 criteria above. Because of this OTs must communicate to the CF member that their recommendations are not “set in stone” but are reviewed by the CFHS care team first. Further, OT recommendations must (a) be based on assessment findings / medical needs (outcome measures, assessments, expert observations rounded out with member’s subjective, voiced concerns) and (b) treatment recommendations are are to have evidence of effectiveness.

Have you had to work with CFHS at any point? What great experiences have you had with the CFHS team?

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About HBrownDNDOT

Helen Brown MOT., OT Reg., (Ont.) Rehabilitation Occupational Therapy Coordinator | Coordonnatrice des services d'ergothérapie en réadaptation physique des Forces canadiennes CF H SVCS GP HQ | QG GP SVC S FC National Defence | Défense Nationale
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