Common use of FULL SERVICE FAMILY PRACTICE FUNDING Clause in Contracts

FULL SERVICE FAMILY PRACTICE FUNDING. 5.1 The General Practice Services Committee will be used to further collaborate with General Practitioners to encourage and enhance full service family practice and benefit patients through increases to the existing $ 275.9 million annual funding level for full service family practitioners, as follows: (a) an additional $0.85 million per year effective April 1, 2019. The funds identified in this section 5.1 are to be allocated by the General Practice Services Committee to support its work in maintaining, enhancing and expanding the programs that support the delivery of primary care services to British Columbians by, among other things, offsetting utilization pressures on its programs, supporting integrated and collaborative initiatives including change management, identifying and treating patients and communities with unmet needs, providing incentives for General Practitioners to provide full service family practice, enhancing risk assessment and reduction, improving capacity in primary care, enhancing comprehensive and continuous care and improving coordination and quality of care to family practice patients in British Columbia, with allocations to include, but not be limited to, the areas identified in section 5.2. 5.2 The General Practice Services Committee will use the funds available to it pursuant to section 5.1 for the following purposes, among others: (a) to fund financial incentive programs for the support of full service family practice, including: (i) improved identification and management of: (A) mental health conditions; (B) chronic disease; (C) complex co-morbidities; (D) maternity care; (E) the frail elderly; (F) the co-ordination of care of patients in hospital or residential care; and (G) patients requiring end of life care; and (ii) increased multi-disciplinary care between General Practitioners and other healthcare providers; (b) to fund, in whole or in part, full service family practice support programs such as Divisions of Family Practice and the Practice Support Program; and (c) to improve disease prevention. 5.3 In addition to the funds identified in section 5.1, the Government will provide the following funding to be allocated by the General Practice Services Committee to the development of new fees or compensation to support full service family practice: (a) an additional $12.75 million per year effective April 1, 2019; (b) an additional $18.00 million per year effective April 1, 2020; and (c) an additional $18.00 million per year effective April 1, 2021. 5.4 The General Practice Services Committee will design all new fees funded under section 5.3 in such a way that will allow their transfer to the Payment Schedule in accordance with Appendix I to the 2019 Physician Master Agreement (hereinafter referred to as Appendix I), and the Government and the Doctors of BC confirm their intent to transfer any fee developed and funded under section 5.3 to the Payment Schedule as soon as it is feasible to do so. The Government and the Doctors of BC will meet before December 31, 2021 to review and assess the readiness of transferring to the Payment Schedule fees developed and funded under section 5.3. 5.5 The General Practice Services Committee will establish a process to review, potentially modify and transfer to the Payment Schedule the GPSC fee items identified in section 1(a)(i) of Appendix I in accordance with the processes described in Appendix I. Upon the transfer to the Payment Schedule of the fees developed and funded under section 5.3 and the GPSC fee items identified in section 1(a)(i) of Appendix I, those amounts determined in accordance with Appendix I will be taken out of the appropriate General Practice Services Committee ongoing annual budget and transferred into the Available Amount. 5.6 On an ongoing basis, the General Practice Services Committee will review and propose amendments to those GPSC fee items that have been transferred to the Available Amount. 5.7 In addition to the funds identified in sections 5.1 and 5.3, the Government will provide the following funding to be allocated by the General Practice Services Committee to: (a) support other non-fee enhancements to full service family practice including physician practice support, physician engagement and change management with respect to the implementation of Patient Medical Homes/Primary Care Networks: (i) an additional $3.1 million per year effective April 1, 2019; and (ii) an additional $2.0 million per year effective April 1, 2020. (b) fund the Pathways initiative: (i) an additional $1.4 million per year effective April 1, 2019. 5.8 In addition to the funds identified in sections 5.1, 5.3, and 5.7, the Government will provide an additional $12.0 million per year effective April 1, 2019 to the General Practice Services Committee to support its Residential Care Initiative. 5.9 The following funding will be made available on a one-time basis for the purposes set out in the Memorandum of Understanding on Physical/Psychological Safety between the Government, the Doctors of BC and the Health Authorities from existing unexpended General Practice Services Committee funds from the 2014 General Practitioners Subsidiary Agreement or those funds set out at section 5.11: (a) $150,000 effective April 1, 2019; (b) $150,000 effective April 1, 2020; and (c) $150,000 effective April 1, 2021. 5.10 $25 million will be made available on a one-time basis to fund a portion of the one-time lump sum payment to eligible physicians in accordance with section 1.1 of Appendix F to the 2019 Physician Master Agreement from existing unexpended General Practice Services Committee funds from the 2014 General Practitioners Subsidiary Agreement. 5.11 Any funds described in sections 5.1, 5.3, 5.7, and 5.8 that remain unexpended at the end of any Fiscal Year will be available to the General Practice Services Committee for use as one time allocations to improve the quality of care. 5.12 If the General Practice Services Committee needs to reduce expenditures in order to meet its budget targets, the General Practice Service Committee will first address such budget pressures through a reduction of expenditures on its programs that do not have accompanying fees before considering adjustments to any of its established fees. Any such fee adjustments will be by mutual agreement. For clarity, this section 5.12 does not restrict the General Practice Service Committee from adjusting its fees in order to meet its mandate. 5.13 The General Practice Services Committee will continue to review and recommend approaches that support General Practitioners’ continued role in providing hospital care, including the relationship between that role and the role of hospitalists. The General Practice Services Committee will determine the key elements or models of care with indicators that demonstrate and support optimum patient outcomes. The recommendations will propose how best to utilize existing allocations for primary care support of hospitalized patients.

FULL SERVICE FAMILY PRACTICE FUNDING. 5.1 The General Family Practice Services Committee will be used to further collaborate with General Family Practitioners to encourage and enhance full service family practice and benefit patients through increases to the existing $ 275.9 $157.347 million annual funding level for full service family practitioners, as follows: (a) an additional $0.85 million per year effective April 1, 2019. The funds identified in this section 5.1 are to be allocated by the General Family Practice Services Committee to support its work in maintaining, enhancing and expanding the programs that support the delivery of primary care services to British Columbians by, among other things, offsetting utilization pressures on its programs, supporting integrated and collaborative initiatives including change management, identifying and treating patients and communities with unmet needs, providing incentives for General Practitioners Family Physicians to provide full service family practice, enhancing risk assessment and reduction, improving capacity in primary care, enhancing comprehensive and continuous care and improving coordination and quality of care to family practice patients in British Columbia, with allocations to include, but not be limited to, the areas identified in section 5.2. 5.2 The General Family Practice Services Committee will use the funds available to it pursuant to section 5.1 for the following purposes, among others: (a) to fund financial incentive programs for the support of full service family practice, including: (i) improved identification and management of: (A) mental health conditions; (B) chronic disease; (C) complex co-morbidities; (D) maternity care; (E) the frail elderly; (F) the co-ordination of care of patients in hospital or residential long term care; and (G) patients requiring end of life care; and (ii) increased multi-disciplinary care between General Practitioners Family Physicians and other healthcare providers; (b) to fund, in whole or in part, full service family practice support programs such as Divisions of Family Practice and Practice, the Practice Support ProgramProgram and the Long Term Care Initiative; and (c) to improve disease prevention. 5.3 In addition to the funds identified in section 5.1, the Government will provide the following funding to be allocated by the General Family Practice Services Committee to the development of maintain or increase existing compensation programs or develop new fees or compensation programs to support full full-service family practice: (a) an additional $12.75 18.3 million per year effective April 1, 20192022; (b) an additional $18.00 10.7 million per year effective April 1, 20202023; and (c) an additional $18.00 1.0 million per year effective April 1, 20212024. 5.4 The General Practice Services Committee will design all new fees funded under A priority for the funding in section 5.3 in such a way that will allow their transfer is to continue and expand upon the Payment Schedule in accordance with Appendix I existing (Fiscal Year 2022/23) funding to support in-patient services to medium-sized communities under the 2019 In-Patient Initiative for the term of the 2022 Physician Master Agreement (hereinafter referred to as Appendix I), and the Government and the Doctors of BC confirm their intent to transfer any fee developed and funded under section 5.3 to the Payment Schedule as soon as it is feasible to do so. The Government and the Doctors of BC will meet before December 31, 2021 to review and assess the readiness of transferring to the Payment Schedule fees developed and funded under section 5.3Agreement. 5.5 The General Practice Services Committee will establish a process to review, potentially modify and transfer to the Payment Schedule the GPSC fee items identified in section 1(a)(i) of Appendix I in accordance with the processes described in Appendix I. Upon the transfer to the Payment Schedule of the fees developed and funded under section 5.3 and the GPSC fee items identified in section 1(a)(i) of Appendix I, those amounts determined in accordance with Appendix I will be taken out of the appropriate General Practice Services Committee ongoing annual budget and transferred into the Available Amount. 5.6 On an ongoing basis, the General Practice Services Committee will review and propose amendments to those GPSC fee items that have been transferred to the Available Amount. 5.7 In addition to the funds identified in sections 5.1 and 5.3, the Government will provide the following funding to be allocated by the General Family Practice Services Committee to: (a) support other non-fee enhancements to full service family practice compensation initiatives including physician practice support, physician engagement and change management with respect to the implementation of Patient Medical Homes/Primary Care Networks: (i) an additional $3.1 3.0 million per year effective April 1, 20192022; and (ii) an additional $2.0 3.0 million per year effective April 1, 20202023. (b) fund the Pathways initiative: (i) an additional $1.4 million per year effective April 1, 2019. 5.8 In addition to the funds identified in sections 5.1, 5.3, and 5.7, the Government will provide an additional $12.0 million per year effective April 1, 2019 to the General Practice Services Committee to support its Residential Care Initiative. 5.9 The following funding will be made available on a one-time basis for the purposes set out in the Memorandum of Understanding on Physical/Psychological Safety between the Government, the Doctors of BC and the Health Authorities from existing unexpended General Practice Services Committee funds from the 2014 General Practitioners Subsidiary Agreement or those funds set out at section 5.11: (a) $150,000 effective April 1, 2019; (b) $150,000 effective April 1, 2020; and (c) $150,000 effective April 1, 2021. 5.10 $25 million will be made available on a one-time basis to fund a portion of the one-time lump sum payment to eligible physicians in accordance with section 1.1 of Appendix F to the 2019 Physician Master Agreement from existing unexpended General Practice Services Committee funds from the 2014 General Practitioners Subsidiary Agreement. 5.11 5.6 Any funds described in sections 5.1, 5.3, 5.7, 5.3 and 5.8 5.5 that remain unexpended at the end of any Fiscal Year will be available to the General Family Practice Services Committee for use as one one-time allocations to improve the quality of care. 5.12 5.7 The Government and the Doctors of BC agree that the total annual amount of new and existing designated funding provided to the Family Practice Services Committee for compensation programs or fees, less the amount of such funding for compensation that will continue to be available to physicians who move to the New Longitudinal Family Physician Payment Model, will be reduced to account for the expected payments to those physicians who have claimed a Community Longitudinal Family Physician (CLFP) Payment amount, and who move to the New Longitudinal Family Physician Payment Model.‌‌ 5.8 The Government and Doctors of BC will develop a mechanism to address the details of the revisions to the funding provided to the Family Practice Services Committee in accordance with 5.7 above. 5.9 If the General Family Practice Services Committee needs to reduce expenditures in order to meet its budget targets, the General Family Practice Service Committee will first address such budget pressures through a reduction of expenditures on its programs that do not have accompanying fees before considering adjustments to any of its established fees. Any such fee adjustments will be by mutual agreement. For clarity, this section 5.12 5.9 does not restrict the General Family Practice Service Committee from adjusting its fees in order to meet its mandate. 5.13 5.10 The General Family Practice Services Committee will continue to review and recommend approaches that support General PractitionersFamily Physicians’ continued role in providing hospital care, including the relationship between that role and the role of hospitalists. The General Family Practice Services Committee will determine the key elements or models of care with indicators that demonstrate and support optimum patient outcomes. The recommendations will propose how best to utilize existing allocations for primary care support of hospitalized patients.

FULL SERVICE FAMILY PRACTICE FUNDING. 5.1 The General Practice Services Committee will be used to further collaborate with General Practitioners to encourage and enhance full service family practice and benefit patients through increases to the existing $ 275.9 $208.5 million annual funding level for full service family practitioners, as follows: (a) an additional $0.85 5.5 million per year effective April 1, 20192016; (b) an additional $9.1 million per year effective April 1, 2017; and (c) an additional $7.5 million per year effective April 1, 2018. The funds identified in this section 5.1 are to be allocated by the General Practice Services Committee to support its work in maintaining, enhancing and expanding the programs that support the delivery of primary care services to British Columbians by, among other things, offsetting utilization pressures on its programs, supporting integrated and collaborative initiatives including change management, identifying and treating patients and communities with unmet needs, providing incentives for General Practitioners to provide full service family practice, enhancing risk assessment and reduction, improving capacity in primary care, enhancing comprehensive and continuous care and improving coordination and quality of care to family practice patients in British Columbia, with allocations to include, but not be limited to, the areas identified in section 5.2. 5.2 The General Practice Services Committee will use the funds available to it pursuant to section 5.1 for the following purposes, among others: (a) to fund financial incentive programs for the support of full service family practice, including: (i) improved identification and management of: (A) mental health conditions; (B) chronic disease; (C) complex co-morbidities; (D) maternity care; (E) the frail elderly; (F) the co-ordination of care of patients in hospital or residential care; and (G) patients requiring end of life care; and (ii) increased multi-disciplinary care between General Practitioners and other healthcare providers; (b) to fund, in whole or in part, full service family practice support programs such as Divisions of Family Practice and the Practice Support Program; and (c) to improve disease prevention. 5.3 In addition to the funds identified in section 5.1, the Government will provide the following funding to be allocated by the General Practice Services Committee to support its work in maintaining, enhancing and expanding the development programs that support the delivery of new fees or compensation primary care services to support full service family practiceBritish Columbians: (a) an additional $12.75 15.3 million per year effective April 1, 20192016; (b) an additional $18.00 14.0 million per year effective April 1, 20202017; and (c) an additional $18.00 16.0 million per year effective April 1, 20212018. 5.4 The General Practice Services Committee will design all new fees funded under section 5.3 in such a way that will allow their transfer to the Payment Schedule in accordance with Appendix I to the 2019 Physician Master Agreement (hereinafter referred to as Appendix I), and the Government and the Doctors of BC confirm their intent to transfer any fee developed and funded under section 5.3 to the Payment Schedule as soon as it is feasible to do so. The Government and the Doctors of BC will meet before December 31, 2021 to review and assess the readiness of transferring to the Payment Schedule fees developed and funded under section 5.3. 5.5 The General Practice Services Committee will establish a process to review, potentially modify and transfer to the Payment Schedule the GPSC fee items identified in section 1(a)(i) of Appendix I in accordance with the processes described in Appendix I. Upon the transfer to the Payment Schedule of the fees developed and funded under section 5.3 and the GPSC fee items identified in section 1(a)(i) of Appendix I, those amounts determined in accordance with Appendix I following funds will be taken out of the appropriate General Practice Services Committee ongoing annual budget and transferred into the Available Amount. 5.6 On an ongoing basis, the General Practice Services Committee will review and propose amendments to those GPSC fee items that have been transferred to the Available Amount. 5.7 In addition to the funds identified in sections 5.1 and 5.3, the Government will provide the following funding to be allocated by the General Practice Services Committee to: (a) support other non-fee enhancements to full service family practice including physician practice support, physician engagement and change management with respect to the implementation of Patient Medical Homes/Primary Care Networks: (i) an additional $3.1 million per year effective April 1, 2019; and (ii) an additional $2.0 million per year effective April 1, 2020. (b) fund the Pathways initiative: (i) an additional $1.4 million per year effective April 1, 2019. 5.8 In addition to the funds identified in sections 5.1, 5.3, and 5.7, the Government will provide an additional $12.0 million per year effective April 1, 2019 available to the General Practice Services Committee to support its Residential Care Initiative: (a) up to $12 million in each of Fiscal Years 2016/2017, 2017/2018 and 2018/2019 from any existing unexpended General Practice Services Committee funds from the 2012 General Practice Subsidiary Agreement, to be applied on a one time basis in each of those Fiscal Years; and (b) an additional $12 million per year to be added by the Government to the annual funding for the General Practice Services Committee, effective April 1, 2019. 5.9 5.5 The following funding will be made available on a one-one time basis for the purposes set out in the Memorandum of Understanding on Physical/Psychological Safety between the Government, the Doctors of BC and the Health Authorities CMPA Rebate Program from existing unexpended General Practice Services Committee funds from the 2014 2012 General Practitioners Subsidiary Agreement or those and from existing unexpended Specialist Services Committee funds set out at from the 2012 Specialists Subsidiary Agreement, or, if existing unexpended funds are not sufficient for this purpose, from General Practice Services Committee funding described in section 5.115.1 and from Specialist Services Committee funding described in the 2014 Specialist Services Subsidiary Agreement: (a) up to $150,000 effective April 1, 2019;7.3 million for Fiscal Year 2014/2015 as required to mitigate CMPA costs increases to physicians; and (b) up to $150,000 effective April 1, 2020; and (c) $150,000 effective April 1, 202124.3 million for Fiscal Year 2015/2016 as required to mitigate CMPA costs increases to physicians. For each of Fiscal Years 2014/2015 and 2015/2016 the contribution of these funds shall be apportioned between the General Practices Services Committee funds and the Specialist Services Committee funds based on the increased CMPA costs distribution between General Practitioners and Specialists in accordance with the applicable CMPA Fee Schedule for those years. 5.10 $25 million 5.6 In Fiscal Year 2016/2017, the Government will be made available transfer on a one-one time basis to fund a portion the Doctors of BC $3 million from unexpended funds available to the General Practice Service Committee to be allocated by the Specialist Services Committee per Article 8 of the oneSpecialist Services Subsidiary Agreement to support the engagement of facility-time lump sum payment to eligible physicians based General Practitioners with Health Authorities in accordance with section 1.1 of Appendix F to the 2019 Physician Master Agreement from existing unexpended General Practice Services Committee funds from objectives described in the 2014 General Practitioners Subsidiary Regional and Local Engagement Memorandum of Agreement. 5.11 5.7 Any funds described in sections 5.1, 5.3, 5.7, 5.3 and 5.8 5.4 (b) that remain unexpended at the end of any Fiscal Year will be available to the General Practice Services Committee for use as one time allocations to improve the quality of care. 5.12 5.8 If the General Practice Services Committee needs to reduce expenditures in order to meet its budget targets, the General Practice Service Committee will first address such budget pressures through a reduction of expenditures on its programs that do not have accompanying fees before considering adjustments to any of its established fees. Any such fee adjustments will be by mutual agreement. For clarity, this section 5.12 5.8 does not restrict the General Practice Service Committee from adjusting its fees in order to meet its mandate. 5.13 5.9 The General Practice Services Committee will continue to review and recommend approaches that support General Practitioners’ continued role in providing hospital care, including the relationship between that role and the role of hospitalists. The General Practice Services Committee will determine the key elements or models of care with indicators that demonstrate and support optimum patient outcomes. The recommendations will propose how best to utilize existing allocations for primary care support of hospitalized patients.