Farewell to Kristie Lamirande!

Kristie has been the Oceanside PCN Manager for Central Island Division of Family Practice since 2022.
She has worked hard to make a difference in the Oceanside community.
Thank you for your enthusiasm and dedication to this work, Kristie. We appreciate all you have done during your time with us.

We wish you fulfillment, growth, and continued success with your future endeavors.

Port Alberni PCN Update

It's important to celebrate the small wins! Since we hired our first RN in practice in last spring, the Port Alberni PCN has allocated nursing resources to 6 family medicine practitioners, 2 nurse practitioners, and included one family physician on a new to practice PCN contract - that's 9 practitioners in total taking part in the Port Alberni PCN. With one of the aims of PCNs to be increased patient attachment, our latest attachment report from January 2024 indicates that of the 9 practitioners taking part in the Port Alberni PCN, all 9 have attached new patients! Kudos to our resource allocation team for their great work in identifying practices that could best make use of new community resources, and most of all, kudos to the practitioners that are finding success and capacity in their practices to care for new patients. Whether it is one patient or 100, in year one, since we started allocating resources in March last year, we are now 858 patients closer to reaching out goal of attaching 5400 patients in Port Alberni. That's terrific!

With more nurses coming in 2024, the latest addition of our Pharmacist in practice, and movement on the upcoming Indigenous Community Health Centre, the Port Alberni PCN is really making a difference in our community.

LFP Payment Model: Your feedback in action

April 25, 2024
LFP Payment Model: Your feedback in action
Doctors of BC and BC Family Doctors continue to work with the Ministry of Health to refine and improve the Longitudinal Family Physician (LFP) Payment Model. We continue to listen to your feedback and adjust the payment model to address your concerns. To submit questions or feedback, please email FP.Billing@doctorsofbc.ca.

In this newsletter, we are providing information on the following:

• Expanded eligibility for longitudinal family physicians not billing under the LFP Payment Model
• Listening to your feedback about facility-based care codes
• Limits for facility-based time and interaction codes
• Upcoming billing education and support
• Billing tip: LFP Locums

Expanded eligibility for facility-based care billing
We have reached agreement that eligibility for billing LFP facility-based care codes will be expanded beyond longitudinal family physicians who bill the LFP Payment Model in their clinic.

Longitudinal family physicians who are remunerated under the following payment models for their clinic-based care will also be eligible:

• Fee-for-Service physicians who meet the eligibility criteria of the CLFP Payment.
• New-to-Practice Contract
• APSA GP Full Scope contracts (provided that facility-based care is not already covered by their contract)
• General Practice – Full Scope (Rural) – Area A, B, C
• General Practice – Full Scope (Non-JSC Community)

We are working to determine the start date for billing the LFP facility-based codes for this expanded group of physicians. We will share this information in an upcoming LFP newsletter.

In addition, discussions are also underway regarding blended capitation models that may require some adjustments prior to being included in this expanded eligibility.

Listening to your feedback about facility-based care codes
Some physicians have written to us to share ideas for improvement about LFP billing for facility-based care:

• Physicians who provide labour and birth care have asked us to revisit the value of the LFP birth code. As a result, we are currently working with the Ministry of Health to review the billing codes for labour and birth care.
• Physicians who provide long-term care (LTC) have expressed their desire for an expanded group of LTC physicians to be eligible for the LFP Payment Model, including those without a clinic-based practice. We are discussing this with the Ministry as well.
• Physicians who provide inpatient care, particularly those in mid-sized hospitals, are asking for additional support from the FPSC to maintain service levels once the FPSC bridge and stabilization funding ends.

We are tracking all feedback received about facility-based care, the LFP Payment Model, and associated FPSC support.

We are currently clarifying and finalizing details of LFP billing codes, as well as FPSC funding and support. We are working with the Ministry through this next stage of detail, including making adjustments to help ensure the success of the facility-based billing.

Thank you for helping us to improve the payment model. Your insights are essential as we work to ensure it meets the needs of physicians and patients in BC. Please continue to share your feedback by emailing FP.Billing@doctorsofbc.ca.

Time and interaction code limits
We have received many questions about the limits that will apply to billing for facility-based care. We are now able to share the limits that will apply to time codes and interaction codes.

The limits for long-term care and palliative care facilities align with clinic-based care; however, each setting has its own limits. Limits are not applied across settings.

Limits have not been applied to interaction codes for inpatient care and maternity care in hospitals. This is because the daily volume of patients seen for these areas of care is not within the control of the physician.

As with all billing claims, billing for time codes and interaction codes that significantly exceed typical numbers are more likely to result in a review and/or audit.

For more information about current limits on clinic-based care, please review the Billing Question Library on the BC Family Doctors website.

Upcoming billing education on facility-based care
We have begun planning for billing education webinars and other billing support for facility-based care. We expect to have specific dates and registration information in an upcoming LFP newsletter.

Billing tip: LFP Locums
Effective January 1, 2024, there is a simplified enrolment process for LFP Locums. Locums only need to submit locum registration code 98005. They do not need to also submit 98000.

If you are a locum physician who does not meet the requirements of 98000 and you have submitted both 98005 and 98000 in 2024, please complete a LFP Withdrawal Form. Ensure that you tick only the 98000 box on the withdrawal form if you intend to continue providing LFP Locum Services.

Please see the LFP Payment Schedule for full details about the eligibility, requirements, and enrolment process for locum billing under the LFP Payment Model.

Need more information?
Write us
Email: FP.Billing@doctorsofbc.ca

View our information online (member login required)
Doctors of BC: doctorsofbc.ca/new-payment-model
BC Family Doctors: https://bcfamilydocs.ca/lfp-payment-model/
BC Government website: gov.bc.ca/MSP/LFP (login not required)

Upcoming PAS Changes to Enhance Patient Attachment

Upcoming PAS changes to enhance patient attachment
On April 17, the Ministry of Health will launch enhancements to the Provincial Attachment System (PAS) and the Health Connect Registry (HCR) to help improve and accelerate patient attachment while reducing the burden on physicians. The new ‘end to end’ approach starts from when the patient registers with the Health Connect Registry until attachment is complete. This process has been developed based on feedback and engagement with communities since the start of the PAS last year.  

The objective of the PAS has always been to better support patients and FPs/NPs by establishing a clear, consistent, and digitally enabled approach to attachment coordination across the province. This is one of the next steps in the process.

What does this mean?

For patients: Health Connect Registry

Patients registered with the Health Connect Registry will begin to receive regular communications (every 90 days) updating them on their status and seeking information about changes in their health to assist with re-prioritization as needed. The system will also help to link them with advice and information about available services while they wait for attachment.
This new approach will prioritize patient attachment based on:

• Complexity of health care needs (high, medium, low);
• Changes in health status (new questions will be added asking patients to identify new diagnoses or changes in their health); and
• Length of time on the registry

For physicians: Coordination through the PAS

Attachment Coordinators will use the new data to recommend a list of patients for possible attachment with physicians who have capacity to expand their panels, taking into account complexity, any recent changes, and length of time on the HCR. Physicians will be able to build a panel with varying degrees of complexity and health care needs. For the first time, physicians will be able to receive, select, and attach patients entirely through the PAS.

How it will work?

Once physicians meet the patient and the attachment is confirmed, the patient will be considered attached within the system. If the patient is not selected, they will remain on the HCR until a suitable match is found. Later this spring, the Ministry will start directing complex, high needs patients to interim, virtual supports while waiting for attachment.

More information is available in a Ministry of Health memo, and the FAQs on the Doctors of BC website under the section on “Accelerated attachment through the PAS”.

LFP Payment Model: Your feedback makes us stronger

Doctors of BC and BC Family Doctors continue to work with the Ministry of Health to improve the Longitudinal Family Physician (LFP) Payment Model. We continue to listen to your feedback and make payment model changes to address your concerns. To submit questions or feedback, please email FP.Billing@doctorsofbc.ca.

In this newsletter, we are providing information on the following:

• Thank you for your feedback about the LFP Payment Model
• LFP Payment Model billing tip: Transition Code

Your feedback makes the LFP Payment Model stronger
Thank you for sharing your feedback, concerns, and insights about billing for facility-based care in the LFP Payment Model. We have received many emails and letters from physicians around the province, and this has been very helpful in understanding the practice circumstances in different communities.

We are currently crafting the time and interaction codes as well as the details of the LFP Payment Schedule for facility-based care. We are similarly clarifying and finalizing specific details for FPSC funding and supports for long-term care and inpatient care. We are considering all the feedback received and are working with the Ministry of Health through this next stage of detail.

Some adjustments can be made prior to the launch of facility-based codes in June. Other issues will require more discussion and refinement after that time. For clinic-based care, over 100 changes have been made to the LFP Payment Model in response to physician feedback since the launch in February 2023. The significant ones are summarized here. For facility-based care, the model and associated supports will continue to evolve and improve based on your feedback.

Please continue to reach out and share your thoughts. Your insights are essential as we work to ensure that this payment model meets the needs of physicians and patients in BC. Please continue to share your feedback by emailing FP.Billing@doctorsofbc.ca.

Billing tip: Reminder to submit Transition Code
A Transition Code (98001) is required if a physician needs time to meet the LFP requirement that Non-panel Services are no more than 30% of the total of LFP Practice Services and Non-panel Services provided in one calendar year. (See section 6(g) of the LFP Payment Schedule.) In the most recent LFP Payment Schedule, the end date for the Transition Code was extended to September 30, 2024, to give physicians more time to meet this requirement, if needed. Transition Codes are not required for physicians in rural communities.

If a physician is enrolled in the LFP Payment Model and provides care at more than one location, this requirement must be met at each location or a Transition Code must be submitted for each location. It’s not necessary to submit the Transition Code for a single LFP Clinic more than once.

More information on the Transition Code can be found in the BC Family Doctors' Simplified LFP Guide.

Need more information?
Write us
Email: FP.Billing@doctorsofbc.ca

View our information online (member login required)
Doctors of BC: doctorsofbc.ca/new-payment-model
BC Family Doctors: bcfamilydocs.ca/lfp-payment-model/
BC Government website: gov.bc.ca/MSP/LFP (login not required)

Central Island Parkinson's and Movement Disorders Clinic - Speech-Language Pathology

Island Health is pleased to offer regional Speech-Language Pathology (SLP) services for Central and Northern Vancouver Island through the Parkinson’s and Movement Disorders Clinic based at Nanaimo Regional General Hospital (NRGH).
Purpose
People with Parkinson Disease and related movement disorders living on mid- and northern Vancouver Island were previously provided outpatient SLP services exclusively at NRGH or RJH. Through the PMDC program, these individuals will now be able to receive in-person SLP services nearer to their home communities, as well as virtual SLP services for intensive treatment.
The purpose of the PMDC is to provide assessment, treatment and longitudinal support of speech, voice and swallowing disorders for people with diagnoses in the Parkinson family: Parkinson Disease, Progressive Supranuclear Palsy, Multiple System Atrophy, Corticobasal Degeneration, Spinocerebellar Ataxia and NYD movement disorders.
Services offered include:

• speech and voice therapy (in-person and virtual, one-to-one and groups)
• swallowing assessment and treatment, including imaging (Video Fluoroscopic Swallow Study, available at regional sites: CDH, WCGH, CVH, CRH)
• ongoing assessment and monitoring of speech, voice and swallowing
• saliva management strategies
• augmentative and alternative communication support, including voice amplification devices

The PMDC SLP provides scheduled monthly in-person services at each site listed below, as well as on-going virtual care for appropriate services (e.g., intensive speech treatment, voice maintenance groups). Intensive treatment includes 3-4x weekly 1 hour therapy sessions for 3-4 weeks.
Admission Criteria
While individuals can be referred to the PMDC by their GP or other healthcare provider, a recent neurology consult (within 2 years of date of referral) is required to access PMDC clinical services (the person may be an active patient with any BC-based neurologist, e.g., UBC MDC). If an individual has not previously received neurological assessment, their GP may refer them for consultation.
Please find our referral form HERE, which includes pre-approval for instrumental swallowing assessment; GP, neurologist or geriatrician signature required for imaging.
Parkinson’s and Movement Disorders Clinic
Island Health – Central Island
Speech Language Pathology
Tel: (250) 713-7040 // Fax: (250) 755-7684
Catchment
In-person assessment and/or treatment will be provided at the site corresponding to the individual’s catchment. Catchment areas for Central and North Island PMDC SLP services are outlined below:

• Cowichan District Hospital (CDH): people living Duncan – Ladysmith (including Thetis and Penelakut Islands)
• Nanaimo Regional General Hospital (NRGH): people living Cassidy – Qualicum Beach (including Gabriola Island)
• West Coast General Hospital (WCGH): people living Coombs/Errington – Tofino
• Comox Valley Hospital (CVH): people living Bowser – Merville (including Hornby and Denman Islands)
• Campbell River Hospital (CRH): people living Black Creek – Port Hardy (including Gold River, Tahsis, Cormorant and Malcolm Islands)

(Note: Individuals with Parkinson Disease living between Victoria and Cowichan Bay may be eligible for South Island PMDC SLP services at Royal Jubilee Hospital)
Community Outreach
PMDC SLP may provide community outreach where appropriate, e.g., presentations to community PD groups, in-service education for caregivers in residential settings.
Contact Information
Health professionals interested in further information or consultation for potential referral are welcome to contact the Parkinson and Movement Disorders Clinic SLP:
Matt Law, MSc, RSLP
matthew.law@islandhealth.ca
telephone: (250) 713-7040
fax: (250) 755-7684

Virtual Psychiatric Consult Clinic

I am very pleased to advise you of our enhanced virtual psychiatry service available to Island Health children, youth and their families. Given that our Telehealth Psychiatry Program was available to some communities in the Island Health region but not all, we have consolidated our services and expanded them to ensure access for children and youth in all communities who meet the referral criteria.

This service is intended as a one-time psychiatry consult for youth ranging in age from five to 18 years of age. We are accepting referrals from family physicians, pediatricians and nurse practitioners.

Intakes are received by fax and reviewed by our intake nurse. Once accepted, referring clinicians and families will be contacted with next steps and follow up. If a referral is declined or redirected, referring clinicians will be notified, with rationale and suggested alternative options provided.

Please click the following links for more information:

• Introduction letter
• Service brochure
• Referral form
• Psychiatry access document

If you have any questions, please contact us at: 250-519-3050.

UBC Rural Scholars Program

Looking for rural clinicians with an interest in research/scholarship. If you are interested in gaining more experience in research/scholarship and are looking for mentorship and support, consider the UBC Rural Scholars program.

Please click here for more information.

This program provides two rural clinicians with $35,000 each (0.2 FTE) for two years of support. For additional information contact: Denise.jaworsky@ubc.ca

BC PAD academic detailing - new topics

I am the Island Health academic detailing pharmacist who meets with physicians in the Oceanside and Port Alberni areas. We are an evidence-based, continuing-education service, independent from the pharmaceutical industry, supported by Island Health and the BC Ministry of Health and accredited by the College of Family Physicians of Canada.

We have some new medication education topics available for physicians: Medications for Weight Loss, Medications for Osteoporosis, Medications for ADHD.

Physicians can book a meeting time (Zoom or in person) that works for them using the online calendar in the invitation.

Please click here for more information.

Dr Cait O’Sullivan, PharmD
Island Health, Clinical Pharmacy Programs
BC Provincial Academic Detailing (PAD) Service
Phone, Text | 250.202.0829

Point of Care Clinical Pathway for Possible or Confirmed Eating Disorder in BC Children and Youth

BC Children’s Hospital, in association with Shared Care (a joint collaborative committee representing a partnership between Doctors of BC and the Government of BC) have been working to develop a “Point of Care Clinical Pathway for Possible or Confirmed Eating Disorder in BC Children and Youth”. This pathway tool is aimed at supporting BC primary care and specialist physicians, and nurse practitioners, who provide care to children and youth, who may present with possible or confirmed eating disorders. The pathway is now live on the Pathways BC website. Please click here.

At this time, BC Children’s Hospital is seeking feedback from primary care and specialist physicians, and nurse practitioners who are interested in testing the pathway in their clinical practice, and in providing feedback on its functionality and usefulness in clinical care. All participants will receive honoraria for their involvement in improving this tool. Please note that you are eligible to take part in this pilot, even if you do not see children or youth with possible or confirmed eating disorders very often as part of your practice.

If you would like to learn more or are interested in being involved, please click here.  

We appreciate your time and consideration. If you have any questions, please reach out to the Project Manager, Erica Roberts

Oceanside Hospice Society

The Oceanside Hospice Society serves individuals and families experiencing end-of-life, care-giving and bereavement in the area stretching from Deep Bay to Nanoose, and west to Errington and Whiskey Creek
We strive to provide links in the continuum of care by supporting care giving at home, in hospital or the palliative care unit at Trillium and at community care facilities.
Please contact us at 250.752.6227 or visit www.oceansidehospice.com for further information.

Divisions Dispatch

The latest news from the provincial team and complementary organizations.

Please click here for updates including:

• LFP Payment Model updates
• Updated BC Cancer screening report titles
• Divisions invited to meet with BC Cancer Cervix Screening Program to prepare for transition from cytology to HPV primary screening
• East Kootenay family doctor develops guide to reducing environmental impact of health care
• July 19 webinar | Antidepressants and substance use
• July 20 webinar | Updates on risks and harms of alcohol use
• Opioid use disorder training for doctors and their clinical teams: LOUD in PC Collaborative
   

Divisions in the News

Divisions in the News
See what is going on in other divisions around BC:

https://divisionsbc.ca/provincial/news-and-events