Creating Opportunities to
Further Promote the (Integration) of
Nurse Practitioner Roles
in British Columbia
Call for Proposals
Guide and Application
January 15, 2013
INTRODUCTION
This new funding initiative for Nurse Practitioner (NP) services is aligned with the Ministry of Health’s (the Ministry) strategic agenda of maintaining the health system on a sustainable path and ensuring quality health care for future generations. Funding supports the Ministry of Health 2012/13-2014/15 Service Plan Goal #2: “British Columbians will have the majority of their health needs met by high quality primary and community based health care and support services. It supports the optimized utilization of NPs and recognizes their primary health care skills and competencies by providing opportunities to practice in collaborative inter-professional relationships with physicians and other health care providers.
Integrating NP roles through health authorities or other qualified health service providers supports increased access to primary health care services for high need priority populations. NPs can address local gaps in care for target patient groups such as the frail elderly, those with chronic co-morbid conditions, individuals with mental health and substance use issues, those in need of maternity care, and patients currently unattached to a general practitioner (GP).
ELIGIBILITY
To support the integration of NPs into the system, the Ministry will fund up to 135 new health authority salaried positions over the next three years. Funding for the positions will be awarded through a Provincial Call for Proposals process. This application is for the initial round of funding for up to 45 full time equivalent NP positions for a service commencement within the 2012/13 fiscal calendar.
Eligible Applicants include:
1. Qualified non-profit health service providers (i.e. Divisions of Family Practice, Community Health Co-ops)
2. Health Authorities
3. Primary health care teams
4. Others, including interim First Nations Health Authority (NPs will be hired as employees of the health authority but can work in a number of settings, including fee for service doctor’s offices, residential care settings, etc).
All submissions must be supported and signed off by the Health Authority Chief Nursing Officer and Primary Health Care Lead and by health care provider(s) collaborating with the NP.
Health Authorities are to only submit their allotted number of applications plus a maximum of TWO additional applications if they choose. The allotted number of applications (plus a maximum of two additional applications) will be reviewed and evaluated by the evaluation committee in no priority order or rank.
PRINCIPLES
1. NPs will practice to full scope as independent practitioners, but must be part of a multi-disciplinary team. Funding will not be extended to NPs working in isolation.
2. Targeted services must align with published MOH and/or health authority (HA) identified strategic needs.
3. Services must meet identified gaps within the service area and focus on longitudinal care and attachment i.e. NPs shall work across the system, in collaborative practice with GPs and other health professionals to integrate care and increase access and continuity of care for high need priority clients.
4. The proposed service must ensure that clients are able to establish a continuous relationship with health care providers for comprehensive, family health care close to home.
5. All applications for funding for an NP position(s) must include the responsibility to support the NP through the start-up phase and after full implementation.
6. Funded organizations will be required to provide reporting, including patient encounters, to MOH as per the funding agreement.
7. Proposals for the funding of NP services in acute care practice settings will not be considered in this initial call for proposals.
8. All submissions must be supported and signed off by the Health Authority Chief Nursing Officer and Primary Health Care Lead and by health care provider(s) collaborating with the NP.
9. A selection for funding by the funding committee under this process is a signal to the HA that a funding contract between it and the MOH can be completed using the information contained in the application. Any additional information sought during the contracting process shall be for clarity only and may not result in any material change to the proposed service. A material change shall be considered a new application and may be submitted under a subsequent Call for Proposals.
OUTCOMES MEASUREMENT
Significant consideration shall be given to how well the expected results of the implemented service can be measured and evaluated, with an emphasis on Triple Aim results. Expected outcomes may include, but are not limited to;
1. Improved patient, caregiver, and family experience;
2. Improved provider experience;
3. Increased attachment rates to primary care for target populations;
4. Reduced hospitalizations, use of emergency departments, and delayed admissions to residential care facilities for target populations; and
5. Reduced per capita costs for target populations.
TIMELINE
SUBMISSION REQUIREMENTS & NOTES
i. Health Authorities are to only submit their allotted number of applications plus a maximum of TWO additional applications if they choose. The allotted number of applications (plus a maximum of two additional applications) will be reviewed and evaluated by the evaluation committee in no priority order or rank.
ii. Application package available on NPs for BC website on January 15, 2013 must be filled out electronically (http://www.primaryhealthcarebc.ca/NPapplication)
iii. Completed and signed PDF applications must be submitted by e-mail to .
iv. Deadline for Ministry of Health submission is Noon (12pm) on March 15, 2013. Late or incomplete submissions will be not accepted. Please note health authorities will require time to review and sign off on applications – please check with the local health authority re: deadline date (or something that reflects the deadline will actually be about 10 -14 days before this to allow HA time to review).
v. It is the applicant’s responsibility to ensure that all information provided is up-to-date and correct to the best knowledge of the applicant, and that the completed application and supporting documents are received by the MoH before the deadline. The MoH is not responsible for applications that are lost, delayed, misplaced or misdirected.
vi. The selection panel will review all applications using a predetermined scoring process to rank and recommend proposals for funding.
vii. The MoH will notify all health authorities of the results of the review process by email no later than April 30, 2013.
viii. All applicant names and information submitted shall be held in confidence by the MoH and the selection panel. Successful applicants and a brief description of the service will be posted on the MoH’s NP4BC website.
Consent: Consistent with the MoH’s desire to protect the privacy rights of applicants, contact information will not be released to the public during the application stage. By submitting this application form, applicants consent to the release of the information contained in the “Applicant Identification” section of the application form to requesting individuals or organizations, in the event the group’s application is successful. This consent includes permission to post such information on a MoH website.
Nurse Practitioner Funding Applicant Identification
APPLICANT NAMEAUTHORIZED REPRESENTATIVE / POSITION / TITLE
TELEPHONE NUMBER
() - / FAX NUMBER
() -
MAILING ADDRESS
/ POSTAL CODE
E MAIL
SIGNATURE OF AUTHORIZED REPRESENTATIVE
HEALTH AUTHORITY SPONSOR (if applicant is not the health authority) *Please ensure this application clearly aligns with government priorities and strategic alignment and clearly identifies community gaps and needs.
AUTHORIZED REPRESENTATIVE / POSITION / TITLE
TELEPHONE NUMBER
() - / FAX NUMBER
() -
MAILING ADDRESS
/ POSTAL CODE
E MAIL
SIGNATURE OF AUTHORIZED REPRESENTATIVE
Application Contents
The application is laid out in the following sections as noted below. There are several questions for each section. Please complete the following sections and answer all questions fully. If necessary, attach additional pages where needed:
A. Service Description Summary and Appropriateness of NP Role
B. Alignment with Strategic Objectives
C. Description of Current Primary Care Practice Setting and the Impact of Integrating an NP Service
D. Non-practice Supports and Operational Readiness
A. Service Description Summary and Appropriateness of NP Role
1. Please provide a brief summary of the primary care service gap that has been identified and the nature of the NP service proposal that will address it (max. 1000 characters, not including spaces).
2. Explain the role, function and scope of practice of the NP and how this NP will be working to full scope.
3. Identify primary care service gap and indicate the target patient group(s) addressed through the integration of this NP.
4. Why do you think this is a desirable opportunity for an NP? What external contacts/supports will the NP service have? Please attach any additional evidence of community support for this proposal (beyond the HA signatory or collaborating provider on this proposal) i.e. letters of support from community groups, etc.
B. Alignment with Strategic Objectives
1. Please include each published MoH and HA strategic primary care objective your proposal is aligned with. Under each objective, briefly describe why your proposal meets this objective. [1]
a. Objective #1
b. Objective #2
c. Objective #3
2. Geographically identify the community where the NP services will be provided, including all relevant population demographics.
3. Identify the population health characteristics (i.e. age, gender) of the target patient groups for the NP services.
4. Describe the target patient group’s existing access to primary health care services in the community.
5. Describe the target patient group’s health care needs and describe the barriers and challenges that the patients experience in securing care. How was the target patient group identified (i.e. needs analysis, wait lists, comparable standards of service in other areas of the Province, quality indicators)?
6. What are the expected population health impacts of integration of an NP in your community? What are the expected population health impacts in your community? Identify additional programs that will become available to the community with the integration of this NP?
C. Description of Current Primary Care Practice Setting and the Impact of Integrating an NP Service.
1. Please describe your current primary care practice including volume and types of clients, all healthcare providers, their current degree of integration, and how the public accesses your services (location and hours).
2. What are the short and long term impacts of maintaining the current service level without integrating this additional NP role?
3. What stakeholders have you consulted with to substantiate this service need and the appropriateness of integrating an NP into this setting to address this need (i.e. why is it necessary to hire an NP as opposed to another health care provider)?
4. What alternative community healthcare sources have you considered to meet the target patients’ needs?
5. Why is your practice best suited for the integration of an NP into the service delivery model? How long will it take to reach full implementation of the NP into this practice?
6. Please explain how the NP service will be integrated into your current practice. How will the existing roles change? How will the integration of the NP role improve the other providers’ experiences in your practice?
7. Please provide an explanation which will eliminate the risk of overlapping payments for services from this NP role and from different sources.
8. What will be the incremental service volume to the target patient group once this proposal is fully implemented? Please provide the estimated number of patients rostered to the NP once fully implemented.
9. How will you measure the activity and outcomes of this new service? What baselines have you developed to measure against? Please be specific (i.e. attach statistics, surveys, reduced hospitalization rates, etc.).
10. Is there any additional information beyond that generated in your practice that would be of assistance in evaluating the effects of the new service? If yes, please note any instances where you believe a data sharing agreement may be required.
D. Non-practice supports and operational readiness
1. Is this proposal reliant on any funding supports other than those provided through this proposal or the practice itself?
Please provide a detailed non wage budget for this proposed position (required). List and quantify all expenditures that must take place prior to the commencement of services (i.e. physical office modifications, additional support staff, equipment).
Clearly identify how these specific expenditures are being funded and how long will it take to secure them, who is the party(ies) and demonstrate how that commitment has been secured (i.e. attach written agreement/commitment). Describe the nature and amount of funding (i.e. one-time, on-going, capital, operating).
I UNDERSTAND AND AGREE THAT:
I hereby certify that to the best of my knowledge all information contained in this application is true and complete.
______
Signature of Applicant Name (please print)
______
Position Date
HEALTH AUTHORITY:
______Signature of Health Authority Signing Officer Name (please print)
______
Health Authority
______
Position Date
HEALTH CARE PROVIDER(S):[2]
______Signature of Health Care Provider Name (please print)
______
Position Date
______
Signature of Health Care Provider (Optional) Name (please print)
______
Health Authority
[1] Please attach additional pages if more than 3 primary care objectives are met by the proposal
[2] Signature of health care provider(s) collaborating with the NP. Attach additional signatures if necessary.