Common use of THE JOINT STANDING COMMITTEE ON RURAL ISSUES Clause in Contracts

THE JOINT STANDING COMMITTEE ON RURAL ISSUES. 5.1 The Joint Standing Committee on Rural Issues (the “JSC”) will continue under this Agreement and will continue to work to enhance the delivery of rural healthcare in accordance with the duties imposed and the powers conferred by this Agreement. In addition to administering the Rural Programs as described in this Agreement, the JSC may consider and make recommendations on matters that support the following objectives: (a) increasing relativities between Rural Communities; (b) supporting hospital based core services; (c) supporting new physicians moving into Rural Communities; (d) enhancing support for rural emergency departments; (e) developing a response to Rural Communities in crisis; and (f) supporting the use of physician extenders in Rural Communities. 5.2 The JSC is composed of five members appointed by the Doctors of BC and five members appointed by the Government. In addition, each party may designate up to three alternates. Each party pays for the expenses of its own members. 5.3 The JSC must meet a minimum of six days per year and will be co-chaired by a member chosen by the Government members and a member chosen by the Doctors of BC Board of Directors. The JSC must establish, before March 31 each year, a schedule of meetings for the next 12 months. 5.4 The time for any JSC meeting may be changed but only by mutual agreement of the co- chairs. Either co-chair may call additional meetings. Any such additional meetings must take place within two weeks of the call, unless otherwise agreed. 5.5 The JSC must adopt appropriate procedural rules to ensure the fair and timely resolution of matters before it. The JSC will make all decisions by consensus decision, whether or not a consensus decision is expressly called for by any other provisions of this Agreement. 5.6 The JSC may make recommendations to the Physician Services Committee on the use of innovative and emerging technologies. 5.7 The JSC must review Appendix A annually in accordance with section 5.8. In addition to amendments made to Appendix A as a result of that annual review, Appendix A may be amended periodically to reflect any changes determined by the JSC to be appropriate and consistent with this Agreement, provided however that any community listed on Appendix A must have at least 0.5 Isolation Points. 5.8 Commencing in December of each year, the JSC must review the Isolation Points assigned to each community in Appendix A by applying Appendix C to each such community. This annual review must be completed by the end of February of the subsequent calendar year. By no later than April 1 of the same year, the JSC must amend the Isolation Points assigned to each of the communities in Appendix A, to reflect the results of the annual review. 5.9 Where, as a result of a review pursuant to section 5.7 or section 5.8, the JSC assigns a community: (a) less than 6 Isolation Points then, in the year to which that assignment applies, (i) eligible physicians, who received a Flat Premium the immediately preceding year, will be entitled to receive a Flat Premium in the amount of 50% of their Flat Premium entitlement from the immediately preceding year. (ii) eligible physicians who received a Percentage Fee Premium for medical services performed in such community in the immediately preceding year will be entitled to receive a Percentage Fee Premium on medical services performed in such community in the amount of 50% of their Percentage Fee Premium for such community from the immediately preceding year. (b) between 0.5 and 5.99 Isolation Points, it will be deemed to be a “D” community and physicians residing and practising in such community will only be eligible for the RCME, the RGPLP, the RSLP, the RGPALP, the RIF, the RCF and the REAP, all in accordance with the specific terms, conditions, rules and eligibility criteria applicable to each of those programs as established by the JSC from time to time; and (c) less than 0.5 Isolation Points, it will be deleted from Appendix “A” and, if prior to such review it was listed in Appendix B, it will be deleted from Appendix B and physicians residing and/or providing services in such community will be ineligible for Rural Programs. 5.10 Where a community has been recommended for inclusion in Appendix A in accordance with section 4.4, the JSC must evaluate the community by application of Appendix C. If the evaluation results in a rating for the community of at least 0.5 Isolation Points, the JSC must add the community to Appendix A. 5.11 The JSC will periodically review Appendix B and may, by consensus decision, add or delete communities to it if the JSC determines such changes are required to reflect the criteria set out in section 4.5. 5.12 The JSC will periodically review Appendix C and may, by consensus decision, make any changes determined by the JSC to be appropriate. 5.13 In the event the JSC is unable to reach a consensus decision with regard to any matter that it is required by this Agreement to decide, the Government and/or the Doctors of BC may refer the matter in dispute for in accordance with section 21.2 of the 2019 Physician Master Agreement. 5.14 The JSC must establish practices and procedures appropriate to decisions with respect to the disbursement of public funds, including conflict of interest guidelines. The practices and procedures adopted by the JSC must include provisions that promote accountability, transparency and, consistent with section 5.3 of the 2019 Physician Master Agreement, confidentiality. 5.15 On an annual basis, the JSC will develop a work plan, ensure that evaluations to measure outcomes are an integral part of the work plan, and report to the Physician Services Committee in the manner outlined in section 6.3(a) of the 2019 Physician Master Agreement. 5.16 The JSC must follow any communication protocol developed by the Physician Services Committee, and in any event must ensure that the co-chairs of the JSC pre-approve any communication about the business and/or affairs of the JSC.

THE JOINT STANDING COMMITTEE ON RURAL ISSUES. 5.1 The Joint Standing Committee on Rural Issues (the “JSC”) will continue under this Agreement and will continue to work to enhance the delivery of rural healthcare in accordance with the duties imposed and the powers conferred by this Agreement. In addition to administering the Rural Programs as described in this Agreement, the JSC may consider and make recommendations on matters that support the following objectives: (a) increasing relativities between Rural Communities; (b) supporting hospital based core services; (c) supporting new physicians moving into Rural Communities; (d) enhancing support for rural emergency departments; (e) developing a response to Rural Communities in crisis; and (f) supporting the use of physician extenders in Rural Communities. 5.2 The JSC is composed of five members appointed by the Doctors of BC BCMA and five members appointed by the Government. In addition, each party may designate up to three alternates. Each party pays for the expenses of its own members. 5.3 The JSC must meet a minimum of six days per year and will be co-chaired by a member chosen by the Government members and a member chosen by the Doctors of BC Board of DirectorsBCMA members. The JSC must establish, before March 31 each year, a schedule of meetings for the next 12 months. 5.4 The time for any JSC meeting may be changed but only by mutual agreement of the co- chairs. Either co-chair may call additional meetings. Any such additional meetings must take place within two weeks of the call, unless otherwise agreed. 5.5 The JSC must adopt appropriate procedural rules to ensure the fair and timely resolution of matters before it. The JSC will make all decisions by consensus decision, whether or not a consensus decision is expressly called for by any other provisions of this Agreement. 5.6 The JSC may make recommendations to the Physician Services Committee on the use of innovative and emerging technologies. 5.7 The JSC must review Appendix A annually in accordance with section 5.8. In addition to amendments made to Appendix A as a result of that annual review, Appendix A may be amended periodically to reflect any changes determined by the JSC to be appropriate and consistent with this Agreement, provided however that any community listed on Appendix A must have at least 0.5 Isolation Points. 5.8 Commencing in December of each year, the JSC must review the Isolation Points assigned to each community in Appendix A by applying Appendix C to each such community. This annual review must be completed by the end of February of the subsequent calendar year. By no later than April 1 of the same year, the JSC must amend the Isolation Points assigned to each of the communities in Appendix A, to reflect the results of the annual review. 5.9 Where, as a result of a review pursuant to section 5.7 or section 5.8, the JSC assigns a community: (a) less than 6 Isolation Points then, in the year to which that assignment applies, (i) eligible physicians, who received a Flat Premium the immediately preceding year, will be entitled to receive a Flat Premium in the amount of 50% of their Flat Premium entitlement from the immediately preceding year. (ii) eligible physicians who received a Percentage Fee Premium for medical services performed in such community in the immediately preceding year will be entitled to receive a Percentage Fee Premium on medical services performed in such community in the amount of 50% of their Percentage Fee Premium for such community from the immediately preceding year. (b) between 0.5 and 5.99 Isolation Points, it will be deemed to be a “D” community and physicians residing and practising in such community will only be eligible for the RCME, the RGPLP, the RSLP, the RGPALP, the RIF, the RCF and the REAP, all in accordance with the specific terms, conditions, rules and eligibility criteria applicable to each of those programs as established by the JSC from time to time; and (c) less than 0.5 Isolation Points, it will be deleted from Appendix “A” and, if prior to such review it was listed in Appendix B, it will be deleted from Appendix B and physicians residing and/or providing services in such community will be ineligible for Rural Programs. 5.10 Where a community has been recommended for inclusion in Appendix A in accordance with section 4.4, the JSC must evaluate the community by application of Appendix C. If the evaluation results in a rating for the community of at least 0.5 Isolation Points, the JSC must add the community to Appendix A. 5.11 The JSC will periodically review Appendix B and may, by consensus decision, add or delete communities to it if the JSC determines such changes are required to reflect the criteria set out in section 4.5. 5.12 The JSC will periodically review Appendix C and may, by consensus decision, make any changes determined by the JSC to be appropriate. 5.13 In the event the JSC is unable to reach a consensus decision with regard to any matter that it is required by this Agreement to decide, the Government and/or the Doctors of BC BCMA may refer the matter in dispute for adjudication by the Adjudication Committee in accordance with section 21.2 of the 2019 Physician Master Agreement. 5.14 The JSC must establish practices and procedures appropriate to decisions with respect to the disbursement of public funds, including conflict of interest guidelines. The practices and procedures adopted by the JSC must include provisions that promote accountability, transparency and, consistent with section 5.3 of the 2019 Physician Master Agreement, confidentiality. 5.15 On an annual basis, the JSC will develop a work plan, ensure that evaluations to measure outcomes are an integral part of the work plan, and report to the Physician Services Committee in the manner outlined in section 6.3(a) of the 2019 2012 Physician Master Agreement. 5.16 The JSC must follow any communication protocol developed by the Physician Services Committee, and in any event must ensure that the co-chairs of the JSC pre-approve any communication about the business and/or affairs of the JSC.

THE JOINT STANDING COMMITTEE ON RURAL ISSUES. 5.1 The Joint Standing Committee on Rural Issues (the “JSC”) will continue under this Agreement and will continue to work to enhance the delivery of rural healthcare in accordance with the duties imposed and the powers conferred by this Agreement. In addition to administering the Rural Programs as described in this Agreement, the JSC may consider and make recommendations on matters that support the following objectives: (a) increasing relativities between Rural Communities; (b) supporting hospital based core services; (c) supporting new physicians moving into Rural Communities; (d) enhancing support for rural emergency departments; (e) developing a response to Rural Communities in crisis; and (f) supporting the use of physician extenders in Rural Communities. 5.2 The JSC is composed of five members appointed by the Doctors of BC BCMA and five members appointed by the Government. In addition, each party may designate up to three alternates. Each party pays for the expenses of its own members. 5.3 The JSC must meet a minimum of six days per times a year and will be co-chaired by a member chosen by the Government members and a member chosen by the Doctors of BC Board of DirectorsBCMA members. The JSC must establish, before March 31 each year, a schedule of meetings for the next 12 months. 5.4 The time for any JSC meeting may be changed but only by mutual agreement of the co- chairs. Either co-chair may call additional meetings. Any such additional meetings must take place within two weeks of the call, unless otherwise agreed. 5.5 The JSC must adopt appropriate procedural rules to ensure the fair and timely resolution of matters before it. The JSC will make all decisions by consensus decision, whether or not a consensus decision is expressly called for by any other provisions of this Agreement. 5.6 The JSC may make recommendations to the Physician Services Committee on the use of innovative and emerging technologies. 5.7 The JSC must review Appendix A annually in accordance with section 5.8. In addition to amendments made to Appendix A as a result of that annual review, Appendix A may be amended periodically to reflect any changes determined by the JSC to be appropriate and consistent with this Agreement, provided however that any community listed on Appendix A must have at least 0.5 Isolation Points. 5.8 Commencing in December of each year, the JSC must review the Isolation Points assigned to each community in Appendix A by applying Appendix C to each such community. This annual review must be completed by the end of February of the subsequent calendar year. By no later than April 1 of the same year, the JSC must amend the Isolation Points assigned to each of the communities in Appendix A, to reflect the results of the annual review. 5.9 Where, as a result of a review pursuant to section 5.7 or section 5.8, the JSC assigns a community: (a) less than 6 Isolation Points then, in the year to which that assignment applies, (i) subject to section 5.10, eligible physicians, who received a Flat Premium the immediately preceding year, will be entitled to receive a Flat Premium in the amount of 50% of their Flat Premium entitlement from the immediately preceding year. (ii) subject to section 5.10, eligible physicians who received a Percentage Fee Premium for medical services performed in such community in the immediately preceding year will be entitled to receive a Percentage Fee Premium on medical services performed in such community in the amount of 50% of their Percentage Fee Premium for such community from the immediately preceding year. (b) between 0.5 and 5.99 Isolation Points, it will be deemed to be a “D” community and physicians residing and practising in such community will only be eligible for the RCME, the RGPLP, the RSLP, the RGPALP, the RIF, the RCF and the REAP, all in accordance with the specific terms, conditions, rules and eligibility criteria applicable to each of those programs as established by the JSC from time to time; and (c) less than 0.5 Isolation Points, it will be deleted from Appendix “A” and, if prior to such review it was listed in Appendix B, it will be deleted from Appendix B and physicians residing and/or providing services in such community will be ineligible for Rural Programs. 5.10 Notwithstanding the assigning of Isolation Points by the JSC for the Fiscal Year 2006/2007 pursuant to the annual review referred to in section 5.8: (a) no Rural Community that was entitled to Percentage Fee Premiums during the Fiscal Year 2005/2006, will experience a reduction in the Percentage Fee Premium in the Fiscal Year 2006/2007 of greater than two percentage points; and (b) no Rural Community that was entitled to Flat Premiums during the Fiscal Year 2005/2006, will experience a reduction in the Flat Premium in the Fiscal Year 2006/2007 of greater than two percent. 5.11 Where a community has been recommended for inclusion in Appendix A in accordance with section 4.4, the JSC must evaluate the community by application of Appendix C. If the evaluation results in a rating for the community of at least 0.5 Isolation Points, the JSC must add the community to Appendix A. 5.11 5.12 The JSC will periodically review Appendix B and may, by consensus decision, add or delete communities to it if the JSC determines such changes are required to reflect the criteria set out in section 4.5. 5.12 5.13 The JSC will periodically review Appendix C and may, by consensus decision, make any changes determined by the JSC to be appropriate. 5.13 5.14 In the event the JSC is unable to reach a consensus decision with regard to any matter that it is required by this Agreement to decide, the Government and/or the Doctors of BC BCMA may refer the matter in dispute for adjudication by the Adjudication Committee in accordance with section 21.2 22.2 of the 2019 Physician Master Agreement. 5.14 5.15 The JSC must establish practices and procedures appropriate to decisions with respect to the disbursement of public funds, including conflict of interest guidelines. The practices and procedures adopted by the JSC must include provisions that promote accountability, transparency and, consistent with section 5.3 of the 2019 Physician Master Agreement, confidentiality. 5.15 5.16 On an annual basis, the JSC will develop a work plan, ensure plan that includes evaluations to measure outcomes are an integral part of the work plan, and will report on progress and outcomes to the Physician Services Committee in the manner outlined in section 6.3(a) of the 2019 Physician Master AgreementCommittee. 5.16 The JSC must follow any communication protocol developed by the Physician Services Committee, and in any event must ensure that the co-chairs of the JSC pre-approve any communication about the business and/or affairs of the JSC.

THE JOINT STANDING COMMITTEE ON RURAL ISSUES. 5.1 The Joint Standing Committee on Rural Issues (the “JSC”) will continue under this Agreement and will continue to work to enhance the delivery of rural healthcare in accordance with the duties imposed and the powers conferred by this Agreement. In addition to administering the Rural Programs as described in this Agreement, the JSC may consider and make recommendations on matters that support the following objectives: (a) increasing relativities between Rural Communities; (b) supporting hospital based core services; (c) supporting new physicians moving into Rural Communities; (d) enhancing support for rural emergency departments; (e) developing a response to Rural Communities in crisis; and (f) supporting the use of physician extenders in Rural Communities. 5.2 The JSC is composed of five members appointed by the Doctors of BC and five members appointed by the Government. In addition, each party may designate up to three alternates. Each party pays for the expenses of its own members. 5.3 The JSC must meet a minimum of six days per year and will be co-chaired by a member chosen by the Government members and a member chosen by the Doctors of BC Board of Directorsmembers. The JSC must establish, before March 31 each year, a schedule of meetings for the next 12 months. 5.4 The time for any JSC meeting may be changed but only by mutual agreement of the co- chairs. Either co-chair may call additional meetings. Any such additional meetings must take place within two weeks of the call, unless otherwise agreed. 5.5 The JSC must adopt appropriate procedural rules to ensure the fair and timely resolution of matters before it. The JSC will make all decisions by consensus decision, whether or not a consensus decision is expressly called for by any other provisions of this Agreement. 5.6 The JSC may make recommendations to the Physician Services Committee on the use of innovative and emerging technologies. 5.7 The JSC must review Appendix A annually in accordance with section 5.8. In addition to amendments made to Appendix A as a result of that annual review, Appendix A may be amended periodically to reflect any changes determined by the JSC to be appropriate and consistent with this Agreement, provided however that any community listed on Appendix A must have at least 0.5 Isolation Points. 5.8 Commencing in December of each year, the JSC must review the Isolation Points assigned to each community in Appendix A by applying Appendix C to each such community. This annual review must be completed by the end of February of the subsequent calendar year. By no later than April 1 of the same year, the JSC must amend the Isolation Points assigned to each of the communities in Appendix A, to reflect the results of the annual review. 5.9 Where, as a result of a review pursuant to section 5.7 or section 5.8, the JSC assigns a community: (a) less than 6 Isolation Points then, in the year to which that assignment applies, (i) eligible physicians, who received a Flat Premium the immediately preceding year, will be entitled to receive a Flat Premium in the amount of 50% of their Flat Premium entitlement from the immediately preceding year. (ii) eligible physicians who received a Percentage Fee Premium for medical services performed in such community in the immediately preceding year will be entitled to receive a Percentage Fee Premium on medical services performed in such community in the amount of 50% of their Percentage Fee Premium for such community from the immediately preceding year. (b) between 0.5 and 5.99 Isolation Points, it will be deemed to be a “D” community and physicians residing and practising in such community will only be eligible for the RCME, the RGPLP, the RSLP, the RGPALP, the RIF, the RCF and the REAP, all in accordance with the specific terms, conditions, rules and eligibility criteria applicable to each of those programs as established by the JSC from time to time; and (c) less than 0.5 Isolation Points, it will be deleted from Appendix “A” and, if prior to such review it was listed in Appendix B, it will be deleted from Appendix B and physicians residing and/or providing services in such community will be ineligible for Rural Programs. 5.10 Where a community has been recommended for inclusion in Appendix A in accordance with section 4.4, the JSC must evaluate the community by application of Appendix C. If the evaluation results in a rating for the community of at least 0.5 Isolation Points, the JSC must add the community to Appendix A. 5.11 The JSC will periodically review Appendix B and may, by consensus decision, add or delete communities to it if the JSC determines such changes are required to reflect the criteria set out in section 4.5. 5.12 The JSC will periodically review Appendix C and may, by consensus decision, make any changes determined by the JSC to be appropriate. 5.13 In the event the JSC is unable to reach a consensus decision with regard to any matter that it is required by this Agreement to decide, the Government and/or the Doctors of BC may refer the matter in dispute for in accordance with section 21.2 of the 2019 2014 Physician Master Agreement. 5.14 The JSC must establish practices and procedures appropriate to decisions with respect to the disbursement of public funds, including conflict of interest guidelines. The practices and procedures adopted by the JSC must include provisions that promote accountability, transparency and, consistent with section 5.3 of the 2019 Physician Master Agreement, confidentiality. 5.15 On an annual basis, the JSC will develop a work plan, ensure that evaluations to measure outcomes are an integral part of the work plan, and report to the Physician Services Committee in the manner outlined in section 6.3(a) of the 2019 2014 Physician Master Agreement. 5.16 The JSC must follow any communication protocol developed by the Physician Services Committee, and in any event must ensure that the co-chairs of the JSC pre-approve any communication about the business and/or affairs of the JSC.