ACOTRO Notice about Cross Jurisdiction Telehealth Services

ACOTRO Notice about Cross Jurisdiction Telehealth Services

ACOTRO Memorandum of Understanding

ACOTRO is working on implementing a Memorandum of Understanding (MOU) for cross jurisdictional virtual/telehealth services.

It should be clarified that the MOU addresses how each of the OT regulators relate to each other on regulatory matters that arise when an OT provides cross jurisdiction virtual/telehealth services. The existence of the MOU does not directly address the obligations or options available to individual OTs providing virtual/telehealth services to clients in other jurisdictions.  Each regulator through collective conversations, coordinated by ACOTRO, is determining if it can establish regulatory processes to address the unique issues regarding these service delivery methods; methods that were not contemplated when each of our respective legislation was enacted.

It is essential to remember that each province and territory in Canada has autonomy for health delivery legislation, including how governments create the legislation to regulate health professions.

Guidance for Occupational Therapists

If you are an OT planning to offer virtual/telehealth services in other jurisdictions, you will need to contact the regulator in the jurisdiction in which the client(s) resides. You are encouraged to first determine if there is information on the applicable regulator’s website; that may answer this question regarding the requirements for providing such services.

To assist in this process, we offer the following links:

Nova Scotia
Virtual Care Update – College of Occupational Therapists of Nova Scotia (

New: Information on Virtual Services (

FACTS-Telepractice (

Practice Across Jurisdictions – Alberta College of Occupational Therapists (ACOT)

Practice Guidance

Here are some practical considerations:

If a provincial OT regulator does not require you to be registered to provide virtual/telehealth services to their citizens, then this regulator views your practice to be occurring in your jurisdiction of registration. The regulator in your jurisdiction of registration will accept complaints from clients who reside outside of your “home” jurisdiction.

Even if you are not registered in the jurisdiction where the client resides you must still determine what jurisdictional rules apply, such as personal information privacy protection obligations, child protection reporting, mature minor rules, registration requirements for controlled acts or restricted activities, record keeping, knowledge of local emergency services, etc.  Most regulators provide significant practice resources, you need to avail yourselves of these as well as recognize that it is your obligation to know what is relevant for that client’s context with or without registration in their province.

Beyond the jurisdictional issues, you must determine the value of this service to your potential clients including considering alternatives in their own communities.