DRAFT AHSC AFP FRAMEWORK TEMPLATE

							   DRAFT AHSC AFP
FRAMEWORK TEMPLATE

AHSC AFP Provincial Steering Committee
        September 23, 2002
AHSC AFP Framework

» The challenge - Transition from the Provincial
  Working Group report vision to a legal document that
  parties would sign
» A draft framework agreement is being developed to
  capture the deliberations of the parties and to meet
  government, institutional and physician
  accountability requirements
» The following slides describe, in brief, the developing
  framework agreement
Background

» Provides a conceptual definition of an AHSC and
  some background on the process


Article 1 - Definitions
» Provides working definitions of terms included in the
  Agreement e.g. clinical services, department, provider
  party funding, on-call coverage etc.
Article 2 - Governance, Representations,
Warranties and Covenants
» Provides for the establishment of a governance
  structure, and describes what constitutes the
  governance structure - including the parties to the
  Agreement, their rights and obligations

» Examples of activities/responsibilities include:
    -ensuring decision-making mechanisms
    - ensuring prudent distribution of funds
    -ensuring dispute resolutions processes etc.
Article 3 - Provision of In-Scope Services

» Sets out requirements for provision of in-scope
  services by the provider party in each funding year
    -In-scope services are described in appendices to the
    Agreement to allow tailoring to specific AHSC and/or
    institutional programs and goals. Such services are
    described in a general manner in one appendix (e.g. clinical
    services at the hospital; related teaching and research and
    administrative activities at the hospital), and are then listed
    more specifically in a subsequent appendix that ties in-scope
    services to specific departments and activity or program
    targets
Article 3 - Provision of In-Scope Services
cont’d.
» States the responsibilities of the Provider Party in
  provision of these in-scope services

» For example:
    -preparing encounter reports for insured services
    -ensuring an average number of physicians providing an
    average number of hours of clinical services, teaching,
    research and administration
    -ensuring accessibility and quality of care
Article 4 - Funding

» Sets out the funds that form the base funding for the
  Agreement and confirms the Minister’s obligation to
  provide such funding for provision of in-scope services
» Sets out the basis by which the funds will flow e.g. EFT
» Describes the responsibility of the Provider Party to use
  funds for the purpose of providing in-scope services; the
  process for using best efforts to discuss and resolve non-
  conformance issues related to the Agreement; and potential
  corresponding recovery of funds
» Sets out funding provisions if/as Agreement is terminated or
  expires
Article 5 - Ontario Medical Association (OMA)
Dues
» Describes the requirement for Department physicians
  providing in-scope services to pay OMA dues and the
  responsibilities of the Provider Party to ensure
  payment in accordance with the 2000
  OMA/MOHLTC Agreement
Article 6 - Review by Parties
» The parties shall meet as necessary to discuss issues
  related to the Agreement (e.g. activity targets,
  complement issues etc.)
Article 7 - Reports

» Outlines the obligation of the Provider Party to
  submit reports and other documents that will be
  required to ensure appropriate accountability
» The reports are specified in a subsequent appendix
  and are to be determined during negotiations but are
  likely to include the hospital’s business planning
  brief, physician human resources plan, audited
  financial statements etc.
Article 8 - Records

» Describes the obligations of the Provider Party to establish
  and maintain records
» Ensures protection of personal health information and
  records

Article 9 - Billing
» Sets out the Provider Party’s obligations with respect to
  physicians remunerated for in-scope services under the
  Agreement as these services relate to the Ontario Health
  Insurance Plan -OHIP - (i.e. ensuring no OHIP claims or
  payments for in-scope services)
Article 10 - Relationship Among the Parties

» Describes the provisions that ensure an independent
  relationship among the parties and the responsibility
  of each party for its own actions
Article 11- Limitation of Liability, Indemnification and
Insurance
» Clarifies liability and indemnity issues
» Sets out the the requirement for the Hospital,
  University and any Related Facility to maintain
  insurance
Article 12 - Term and Termination


» Sets out the term of the Agreement, as well as
  procedures and timelines for various termination
  scenarios (e.g. by Provider Party, by the Minister)
» Provides for notification of the Provider Party and the
  opportunity to remedy a material breach
Article 13 - General Provisions


» Describes the obligations of the parties when
  providing notices/required communication
» States standard legal provisions for contract
  interpretation
» Provides assurance that parties will not assign or
  transfer rights and obligations under the Agreement
  without written consent of the other parties
Article 13 - General Provisions cont’d.


» Sets out provision of appropriate protection if any
  party fails to perform any obligation under the
  Agreement resulting from matters beyond the control
  of such party