Memorandum of Agreement Re: Redesign of current payment model for On-call/Callback

The Employer and PAR-BC agree to work together to implement a new payment model for on-call responsibilities effective July 1, 2013 to replace the provisions of Article 20.01 through 20.03 of the Agreement on the following terms and conditions:

A.    DEFINITIONS, PAYMENT ELIGIBILITY AND SCHEDULING

“Total Expenditure” means the total payments made for on-call pursuant to Article 20.01 in the 2012/2013 Academic Year.

“Actual Expenditures” means the expenditure on payments for on-call responsibilities and the costs incurred in B. 2. d. below for the 2013/2014 Academic Year and subsequent Academic Years.

1. The two types of on-call responsibility are:
   1. In-Hospital:  where the Resident is scheduled to be immediately available to provide clinical services and is required to remain in the hospital for the scheduled on-call time period.  In-Hospital call does not include “day call” during regular working hours of service.
   2. Out-of-Hospital:  where the Resident is scheduled to be available, but not required to remain on site for the scheduled on-call time period. If on site attendance is needed, the Resident shall be required to come in.  Out-of Hospital call does not include “day call” during regular working hours of service.
2. Payment eligibility for either “In-Hospital” or “Out-of-Hospital” call will be based on the following:
   1. A unit of “In-Hospital” call is eligible for payment when the Resident is scheduled for, and provides, a period of coverage lasting twelve (12) hours or more on-site, of which one full hour is after 12:00 a.m. midnight and before 6:00 a.m.
   2. A unit of “Out-of-Hospital” call is eligible for payment when the Resident is scheduled for, and provides, a period of coverage lasting twelve (12) hours or more, of which one full hour is after 12:00 a.m. midnight and before 6:00 a.m.
   3. A Resident who is scheduled for “Out-of-Hospital” call but who is required to work more than four (4) consecutive hours on-site during the call period, of which more than one (1) hour is past 12:00 a.m. midnight and before 6:00 a.m., will receive payment for a unit of  “In-Hospital” call instead of a payment for a unit of “Out-of-Hospital” call.
      1. In-Hospital call that is scheduled to start on Saturday 8:00 a.m. and end on Monday 8:00 a.m. and provided, will be considered to be two units of In-Hospital call. Out-of- Hospital call that is scheduled to start on Saturday 8:00 a.m. and end on Monday 8:00 a.m. and provided, will be considered to be two units of Out-of-Hospital call.
      2. The rate of payment for a unit of In-Hospital call will be $100.00 and the rate of payment for a unit of Out-of Hospital call will be $50.00.
3. The Memorandum of Understanding Re: On-Call Provisions continues to apply.
4. Determination of call requirements and scheduling of call within Residency Programs are Academic matters.

B.    IMPLEMENTATION

1. The protocols and administrative processes, including necessary forms and documents required for implementation will be determined by a Joint Implementation Committee (JIC) of HEABC/Employer and PAR-BC to be established within thirty (30) days of ratification of the Agreement.
2. The JIC protocols and administrative processes will ensure that capturing of a Residents’   In-Hospital and Out-of-Hospital scheduled and actual call includes the following:
   1. Submission of a monthly reimbursement form to be submitted to the PAR-BC office by each Resident claiming payment with provision for signed verification by the Resident of the accuracy of the call information and claim for payment.
   2. Compilation of all claims for payment and submission of call payment information by the PAR-BC office to the paying agency in a manner acceptable to the paying agency so it can process payments to Residents on a timely basis.
   3. How call schedule data can be collected and processed to efficiently enable implementation of the model set out above.
   4. Reasonable labour costs for the administrative responsibilities provided by PAR-BC to implement and administer this new payment model.

C.    EXPENDITURE MANAGEMENT AND TRANSITION PROVISIONS

1. Actual Expenditures will not exceed the Total Expenditure.
2. If, at the end of the 2013/2014 Academic Year, the Actual Expenditures are less than the Total Expenditure, then the balance of the Total Expenditure may, at the direction of PAR-BC, be distributed as a lump sum payment to each Resident for that Academic Year towards partial reimbursement of CMPA premiums paid by Residents or a one-time additional payment for call in that Academic Year.
3. If at the end of the 2013/14 Academic Year, the Actual Expenditures exceed the Total Expenditure, the Employer can recover the over-expenditure by either:
   1. Sending an invoice to PAR-BC for the over-expenditure, in which case PAR-BC will promptly remit payment as specified in the invoice; or,
   2. Reduction of the unit payment rates set out above for the Academic Year commencing 2014, in a manner that covers the over-expenditure and will cause the Total Expenditure for the next Academic Year not to be exceeded.
4. After two complete Academic Years of experience with the new payment model, the unit payment rates will be adjusted to a level that will not cause the Total Expenditure to be exceeded by application of the established annual volume of call units.  Those payment rates may be adjusted for future Academic Years through collective bargaining.
5. The JIC will be the forum to deal with changes arising under C. 2, 3, and 4 above and may recommend to the parties that the unit prices for call increase prior to March 31, 2014 based on Actual Expenditures trends.
6. The Employer has the right to audit the call data at the level of individual Resident and/or administrative processes for which PAR-BC has responsibility.