To: Family Health Group (FHG) Family Health Network (FHN) Family Health Organization (FHO) Published By: Primary Health Care Branch Date Issued: September 30, 2014 Bulletin #:11114 Re: Exemption Criteria for Enhanced After-Hours Requirement This communication is in follow up to INFOBulletin #11099 http://www.health.gov.on.ca/en/pro/programs/ohip/bulletins/11000/bul11099.pdf which outlined the exemption criteria for enhanced after-hours requirements for affected primary care groups consisting of 10 or more physicians. As a reminder, groups that meet the following conditions are not required to provide Enhanced After-Hours: Groups exempt from pre-existing after-hours requirements (up to 5 blocks) i.e. Groups with more than 50% of its physicians that provide one or more of the following: a) Public hospital emergency room, b) public hospital anaesthesia services on a regular, ongoing basis, c) obstetrical deliveries outside of regular office hours. Northern and Rural FHN/FHO groups with 50% of its physicians maintaining active inpatient hospital privileges. Groups of 9 or fewer physicians. Eligible physician groups interested in applying for a ministry exemption from enhanced after hours-requirement must complete the enclosed form titled Request for Exemption from Enhanced After-Hours Requirement. Groups are encouraged to submit supporting documentation with their application if required. Further a signature from the designated group Lead Physician certifying group details is required to facilitate a proper ministry review. In completing the form, please ensure that you fill in Section(s) A and C. Section B should only be completed if applicable to your group. Posted Electronically Only 1 of 6
Important note: Exemptions are not automatic. Only groups that submit a completed form will be considered for an exemption. The Primary Health Care Subcomittee (PHCS) may use its discretion to request additional information to faciliate a proper review. Further all exemptions are temporary (for up to one year) and must be renewed each calendar year (or earlier) based on group circumstances. Completed forms should be mailed to the following Ministry address: Blended Models Unit 1075 Bay St., 9th Floor Toronto ON M5S 2B1 Questions regarding this process can be directed to either the Ministry at 1-866-766-0266 or the Ontario Medical Association at 1-800-268-7215/psc@oma.org Posted Electronically Only 2 of 6
REQUEST FOR EXEMPTION FROM ENHANCED AFTER-HOURS REQUIREMENT PLEASE COMPLETE SECTIONS A and C. SECTION B is optional and dependent on group circumstances. The physicians of the Family Health Group (FHG)/ Family Health Network (FHN)/ Family Health Organization (FHO) request exemption from the obligation to provide enhanced after-hours services due to: SECTION A: 50% or more of the group s physicians provide one or more of the following: (a) regular care of hospital in-patients (b) hospital on-call (c) care to patients in nursing homes / LTC, including on call (d) are coroners (e) care to patients in hospices or a palliative care unit, including on call. SECTION A, INSRUCTIONS: Please list each group physician and place an X to indicate the service(s) that (s) he is currently providing in the table below. If more lines are needed, please attach a separate sheet to this form. Name of Physician OHIP Billing Number Regular care of hospital inpatients Hospital on-call in nursing homes / LTC, including on call Coroner in hospices or a palliative care unit, including on call Posted Electronically Only 3 of 6
Name of Physician OHIP Billing Number Regular care of hospital inpatients Hospital on-call in nursing homes / LTC, including on call Coroner in hospices or a palliative care unit, including on call Posted Electronically Only 4 of 6
SECTION B Physicians who are on leave (i.e. maternity/paternity, disability, sabbatical) and are unable to secure locum shall not count towards the group membership total for the purposes of enhanced after hours requirements. The physician and/or group must be able to demonstrate recruitment efforts made to secure a locum for continuity of comprehensive care to the patient roster of the departed group member. SECTION B INSTRUCTIONS: List each group physician currently on leave and place an X to indicate the nature of the leave as well as applicable start/end dates. If more lines are needed, please attach a separate sheet to this form. Name of Physician OHIP Billing Number Maternity/ Paternity Disability Sabbatical Start date of leave (mm/dd/yy) End date of leave (mm/dd/yy) Recruitment efforts were made for above listed physicians but were not successful? (Check one.) Yes No Posted Electronically Only 5 of 6
SECTION C: TO BE COMPLETED BY LEAD PHYSICIAN This submission is sent for (please check): Commencement In-year change Annual renewal Lead Physician Name: Lead Physician Signature: For Ministry of Health and Long-Term Care Use Only Total Number Physicians # Physicians Providing Services % Physicians Providing Services Exemption Approved & Letter Sent (Y/N) Posted Electronically Only 6 of 6