Ultimate Blogging Championship

Year: 2011

  • FHT Funding Agreements – concerns about “Requirement that all funded positions be employees”

    The cover letter for all of the funding agreements MOHLTC has sent to FHTs contains a paragraph called “Requirement that all funded positions be employees”.  This post: ·         Summarizes specific issues AFHTO has collected to date, from e-mails and phone calls with EDs & lead physicians over March 24-25, 2011. ·         Reports on outcome of an initial conversation with Phil Graham, Manager of the FHT Unit (i.e. this requirement results from a government-wide directive) ·         Asks you to complete a brief survey so AFHTO can identify the depth and breadth of these issues, found at http://www.surveymonkey.com/s/MCCLLMZ . ·         Asks for potential volunteers who can be called on to form an AFHTO working group to find workable solutions on behalf of all FHTs, if needed. Requirement, as stated in the letter: 3 Requirement that all funded positions be employees To ensure consistency and alignment with enhanced accountability requirements, the following clause has been incorporated into the new Funding Agreement: “The Recipient acknowledges and agrees that all positions funded pursuant to this Agreement shall be employees of the Recipient unless the Ministry has provided its written consent for the use of an independent contractor. In no case, shall any portion of the Funds be transferred by the Recipient to any other person, corporation or entity for the purpose of paying for a position Funded pursuant to this Agreement, unless otherwise agreed to in writing by the Ministry.” Why has this requirement been introduced? This is to meet an Ontario government-wide directive implemented last September that applies to all government-funded transfer payment agencies. I requested a copy to get clarity on the scope and intent of this directive, and the criteria for the Ministry to determine exceptions. Apparently the document cannot be shared, but further background may be forthcoming in another week. Key problem areas identified by FHT leaders: ·         Barriers to recruiting community pharmacists, psychologists, dieticians who generally working in private practice and are contracted to work x hours per week in the FHT. Prescribed pay rates are below what they earn in their other roles. They appear to meet Canada Revenue Agency’s test for “independent contractor”. Conversion to an employment contract means payroll taxes will reduce their income further. ·         Contracts with outside agencies to provide services, e.g. mental health: in a number of communities, this was found to be the most cost-effective way to provide quality services to FHT patients. ·         Contracts for physician staff to fill part-time roles: where some roles are less than .5 FTE, some FHTs have found it more efficient to combine the role with one in the physician organization to create a full FTE position. Other issues raised by FHTs regarding the Funding Agreements: ·         The specific content of the schedules. These are unique to each FHT – each FHT will need to make sure they are accurate and negotiate the content with your MOHLTC consultant individually.  Keep in mind that this is your FHT’s “base” funding and activity for the next 5 years. Each year your FHT can apply for additions to your base or for one-time funding required to meet specific objectives in your annual operating plan. ·         Amount of time needed for full review with board and legal counsel. MOHLTC’s letter says “This Agreement must be signed and returned to the ministry by March 31, 2011 in order for the ministry to process the April 2011 payment.” Some FHTs received their Funding Agreements yesterday. ·         Time needed to implement changes to comply with the agreement. MOHLTC consultants have said FHTs would be allowed 6 – 8 months to transition to the new requirements (e.g. ensuring equal access to IHPs, implementing public complaints process, ensuring the FHT comprises all physicians contracted under a Physician Services Agreement). Next steps: Please click here to complete the brief survey – http://www.surveymonkey.com/s/MCCLLMZ . AFHTO’s Executive Director will continue to work on getting clarity regarding the scope and criteria for granting exceptions to the employee requirement. Your response to the survey will help in this matter. AFHTO will continue to keep you informed, and we appreciate your help in keeping the AFHTO board and me informed of developments as well.

  • Applying for and using HST rebates

    Family Health Teams may apply to the Canada Revenue Agency for a ruling to confirm whether your FHT qualifies as a “facility operator” and therefore could claim a rebate 83% of the federal part of the HST and 87% of the provincial part of the HST.  FHTs are not obligated to apply for the HST credit.  Recommended practice but not required. FHTs that do are required to follow the following direction which is provided to them in their financial reporting guidelines: HST Rebates: Public Service Bodies (charities, municipalities, universities, public colleges, school authorities, hospital authorities and non-profit organizations) are eligible to claim rebates for the provincial and federal components of the HST paid or payable on most inputs used to provide exempt supplies.  FHTs are qualifying non-profit organizations since FHTs receive at least 40% of their funding from the provincial government.  FHTs should report actual costs net of the rebate and book the projected rebate as a receivable.  This way, financial statements reflect actual expenditures.  FHT should contact the Canada Revenue Agency for information and forms.  At the end of the fiscal year, the ministry will recover any HST rebate that the ministry did not approve for use by the FHT. For more information and to access the application form, click here to go to the “Facility Operator” page on the Canada Revenue Agency website.

  • Improving access to care in the academic family health team

    The big challenge in family practices within academic settings is, how do you match a naturally variable demand to a highly artificially variable supply. How do you connect the patients to that ever moving supply? The connection could be called or labeled continuity.  So do you want continuity to a group (and no delays) or continuity to individuals with guaranteed delays? If you choose the second alternative how can you maximize continuity and minimize delays? It’s all in how you design the system. Here are links to a few published articles on access in academic settings:

  • Governance and the New Ontario Not-for-Profit Corporations Act

    Click here to access a slide presentation from Karima Kanani of Miller Thomson LLP on “Governance Changes on the Horizon – the New Ontario Not-for-Profit Corporations Act”. The presentation highlights: *        The new Ontario Not-Profit-Corporations Act – What is it and when will it be effective? *        Changes on the horizon – key concepts and differences in the new Act *        Implementation rules and requirements *        Action Plan – getting ready

  • Respiratory Health Resources from the Ontario Lung Association

    BreathWorks™ Helpline – 1-888-344-LUNG (5864)

    BreathWorks™ is The Lung Association’s national COPD program that offers practical information and support for people with COPD and for their families and caregivers. The BreathWorks™ Helpline is available 8:30 am – 4:30 pm Monday to Friday and is staffed with Certified Respiratory Educators, health care professionals with special training in COPD. They provide counselling on COPD symptoms, diagnosis, management and smoking cessation. To access COPD resources, click here: https://lung.healthdiary.ca/Guest/SearchResults.aspx?C=24&M=0&K=&N=&S=1&P=

    Asthma Action™ Helpline – 1-888-344-LUNG (5864)

    Available for Ontario residents, this free helpline is available 8:30 am – 4:30 pm Monday to Friday and is staffed with Certified Respiratory and Asthma Educators. They provide counselling on asthma control, treatment options and the importance of trigger avoidance. To access asthma resources, click here: https://lung.healthdiary.ca//Guest/SearchResults.aspx?C=27&M=0&K=&N=&S=1&P Free fact sheets and other resources Call the Helpline 1-888-344-LUNG (5864) or go to www.on.lung.ca to order The Lung Association’s free educational materials. Resources include asthma handbooks, asthma fact sheets for adults and children, a variety of fact sheets on managing COPD, breathlessness, energy management, pulmonary rehabilitation and exercise.  Also available are resources on air quality, smoking cessation and the effects of second hand smoke exposure, tuberculosis, pulmonary fibrosis, and sleep apnea.

    Other Resources

    The Lung Association websites offers information on asthma, COPD and other respiratory diseases  www.on.lung.ca or www.lung.ca Ontario Thoracic Society’s Provider Education Program (PEP) develops, implements and evaluates continuing medical education (CME) programs and materials that promote the implementation of the Canadian Asthma Consensus Guidelines (CACG) and CTS COPD Guidelines for physicians and allied healthcare professionals in Ontario. Visit http://olapep.ca/ for continuing education on COPD, Asthma and Spirometry. Funded by the MoHLTC, the Primary Care Asthma Program (PCAP) facilitates and enhances effective implementation and coordination of best practices and outcomes to participating sites. It uses specific tools designed to guide practitioners and clients through effective management of asthma, as well as developing and evaluating resources needed to effectively provide asthma care in the primary care setting. http://www.on.lung.ca/Page.aspx?pid=513 Sign up for Asthma Action and BreathWorks Newsletters to learn the latest news about lung health and Lung Association initiatives.  To sign up for The Lung Association’s asthma and COPD newsletters, go to www.on.lung.ca. The Lung Association’s National Database provides a list of asthma education centers, respiratory rehabilitation programs and COPD support groups across the country.  To access it, go to www.lung.ca. The Canadian Lung Association (CLA) has also released videos on exercise and COPD to help the public and patients understand the importance of exercise in managing COPD.  Please visit: http://www.youtube.com/watch?v=DFemC5giG1Y Copies of all the current respiratory guidelines, including asthma and COPD,  are found on Canadian Thoracic Society’s (CTS) website: http://www.respiratoryguidelines.ca/ Living Well with COPDTM is a self-management education program developed to help patients with COPD and their family in managing their disease.  It contains references guides for health care professionals as well as many patient education tools  www.livingwellwithcopd.com password “copd” Smokers’ Helpline – 1 877 513-5333 is run by The Canadian Cancer Society and is a free, confidential telephone service that people can call for easy access to a trained quit coach.

     Additional links

  • Keep the voice for FHTs strong – Renew your AFHTO membership for 2011-12

    AFHTO’s membership year begins on April 1. Notices and registration forms were e-mailed to all FHT leaders on March 3. Why join? – click here. What are AFHTO’s plans? – click here to see the AFHTO Strategic Plan 2011-2013. What are the fees? – click here. Need a registration form? – click here. AFHTO is the only group that advocates on behalf of ALL family health teams. It is led by, representative of, and accountable to all member FHTs, and provides a focal point for FHTs to learn, share concerns and speak with a common voice. For more information, contact info@afhto.ca.

  • New resources for FHTs on www.afhto.ca

    The most recent posts include: ·         Ideas and resources for FHT planning ·         The Progress of FHTs in Ontario, recently published in Annals of Family Medicine ·         AFHTO Strategic Plan 2011-13 and FHT Survey Results ·         Updated information on learning events On our Members Only website, you’ll find new posts on the following pages: ·         Members Only News:  AFHTO’s notes from the March 11, 2011 ministry teleconferences on NP-SERT, and a copy of the ministry’s February 2011 FHT Newsletter ·         Finance: information on applying for and using HST rebates ·         Human Resources: learning modules on Progressive Discipline and Termination of Employment ·         Health and Safety: learning modules on Respect in the Workplace and Investigations in the Workplace, and information on meeting the training requirements regarding Workplace Violence, link to resources from the Public Services Health & Safety Association ·         Chronic Disease Prevention and Management: links from the Ontario Lung Association’s Respiratory Health Forum ·         Improving Access to Care: a set of published articles on advanced access in academic family medicine settings ·         Governance: a presentation on changes arising from the new Ontario Not-for-Profit Corporations Act, and a a generic template for practice-sharing agreements To receive a username and password to enter the Members Only site, your FHT must become a member. Each member FHT shares one username and password among its board and staff members. If you’ve misplaced yours, please send an e-mail to info@afhto.ca and we’ll respond the next day.   Join AFHTO or renew your membership today For more information, click here. Why join AFHTO? By joining the two-thirds of FHTs who are already members your FHT will: ·         Strengthen the voice of all FHTs in Ontario ·         Receive updates on issues and other information pertinent to FHTs ·         Be invited to participate in consultation or problem-solving processes with the Ministry ·         Have access to news and resources on AFHTO’s Members Only website ·         Be able to register staff members for the AFHTO annual conference at a reduced rate ·         Be able to vote for AFHTO’s board and on motions presented at the Annual General Meeting

  • Chiropractic Collaboration in Centre for Family Medicine FHT

    The Ontario Chiropractic Association has extended the offer to provide further information on how a tailored model of chiropractic collaboration could fit into your FHT. Click here to see a case study of successful collaboration in Kitchener’s Centre for Family Medicine FHT. o        Contact Andrea Endicott at 416-860-7188 or by e-mail at aendicott@chiropractic.on.ca .

  • Ideas and resources for FHT planning

    FHTs are currently in the process of developing plans and budget submissions for the 2011-12 fiscal year.  In the past few days AFHTO has received ideas, resources and offers of assistance that may be useful to you as you develop your plans.  These include:

    • Occupational Therapy:

    o        For FHTs that may have a new or first opportunity to propose programs and services that may engage the addition of an occupational therapist to their complement of IHPs, the Ontario Society of Occupational Therapists (OSOT) has offered to assist FHTs with their proposals and provides a variety of useful resources on their website.

    o        Click here for further information. Contact Anne Murphy-Turliuk, OSOT’s FHT Project Lead at 416-322-3011/877-676-6768 ext 233 or by e-mail at amurphy-turliuk@osot.on.ca .

    • Enhanced 18-month Well-Baby Visit:

    o       Now province-wide in Ontario, this program introduces a process using standardized tools to facilitate health professionals to have a broader discussion with parents on child development, parenting, literacy, and connection to local community programs and services that promote healthy child development.  The visit also provides an opportunity to identify those children who will require referral to specialized services.  The standardized tools include a parent checklist (such as the Nipissing District Developmental Screen (NDDS)) and an evidence-based guide for health care professionals (such as the Rourke Baby Record (RBR)).

    o       The website www.18monthvisit.ca is an excellent resource for information and resources relating to the visit for both health care professionals and families.

    o       The billing code for the enhanced 18-month visit for family physicians is A002 and the current billable amount is $62.20.  The fee is outside the basket of services for FHTs and it has come to the program’s attention that optimal billing is not occurring; please ensure that your finance person is aware of the fee code for this visit.

    o       Project Coordinator is Julie Gross, who can be reached at grossj@mcmaster.ca if you require any information or support

    • Chiropractic Collaboration:

    o        The Ontario Chiropractic Association has extended the offer to provide further information on how a tailored model of chiropractic collaboration could fit into your FHT. Click here to see a case study of successful collaboration in Kitchener’s Centre for Family Medicine FHT.

    o        Contact Andrea Endicott at 416-860-7188 or by e-mail at aendicott@chiropractic.on.ca .

  • NP-SERT implementation

    Click here to access AFHTO’s notes on the questions and answers discussed during the two teleconferences on NP-SERT hosted by MOHLTC on March 11, 2011. Click here to to access the Q&A document e-mailed by MOHLTC on February 1, 2011.