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Health Bulletin

Communiqué to Emergency Department Chiefs, Hospital Chief Executive Officers & Chiefs of Staff

2012 Summer Initiative For Emergency Departments


Summer Incentive

The Ministry of Health and Long-Term Care recognizes the challenges of staffing emergency departments (EDs), especially in the summer months.With a focus on assisting Ontario's hospitals in averting unplanned ED closures during the summer of 2012, this incentive is directed primarily to the smaller, single-coverage sites that are generally at the highest risk of closure. Funding is available to support local physicians to provide additional coverage, minimizing the use of locum physicians, and keeping the ED open.

Who is eligible?

In order to be eligible an ED must :

Is partial funding an option?

No. If a designated ED is unable to maintain 24/7 coverage during the incentive period, it will not receive any Summer Incentive funding.

What is the amount of funding for each ED?

Type of ED1 Funding
EDCDP Regional Referral Centers $40,000, -$50 hourly reduction based on EDCDP usage (maximum reduction $20,000)
All other EDCDP participants $25,000, -$50 hourly reduction based on EDCDP usage (maximum reduction $20,000)
(ED AFAs with ≤30hrs coverage/day or
FFS sites with ≤30,000 visits per year)
EDs covered through an RNPGA $10,000

1 The Summer Incentive for Designated Emergency Departments (EDs) is only available to EDs maintaining 24/7 coverage, and as such Urgent Care Centres would not be considered eligible under the initiative.

Do I have to apply?

No. In summer 2012, hospitals with eligible EDs will receive a letter from the Ministry of Health and Long-Term Care outlining the funding amount and accountability requirements. Summer Incentive funding must be utilized in a manner that demonstrably supports keeping EDs open during the specified time period.

How does the funding flow?

Subject to fulfillment of accountability requirements, and all other program conditions being met, funds will flow to hospitals in late fall 2012.

What can the incentive be used for?

This is up to the hospital and ED physician group. There are no restrictions provided the funding is used in a manner that demonstrably supports keeping the ED open between June 1, 2012 and September 16, 2012 (inclusive).

Where can I go to get or offer advice or ideas on how to best utilize the funding?

The Ministry encourages physician groups to collaborate with their peers (i.e. neighbouring ED physician groups) to discuss common challenges and potential best practices. Speak to your ED LHIN lead, ED Chiefs from nearby communities or the Emergency Department Coverage Demonstration Project (EDCDP) Team ( ).

You may also wish to consider the following suggestions :

What happens if an ED group needs the EDCDP to fill shifts over the summer?

Groups that are eligible for EDCDP support will still be able to call on EDCDP for assistance. sEvery hour of EDCDP assistance that is used from June 1 to
September 16, 2012 (inclusive) will reduce the Summer Incentive by $50, with a maximum reduction of $20,000.

What happens if an eligible ED is unable to maintain 24/7 ED coverage for any period between June 1 - September 16, 2012 (inclusive)?

The hospital will not be eligible to receive any Summer Incentive funding.

Who is the contact for questions about the Summer Incentive?

EDCDP Hospitals

Jessica Chisolm-Nelson
Senior Operations Coordinator
Emergency Department Coverage Demonstration Project
HealthForceOntario Marketing and Recruitment Agency

All Other Hospitals

John Amodeo
Health Sector Labour Market Policy Branch
Ministry of Health and Long-Term Care


Existing Initiatives

Holiday Long-Weekend Premiums Payments

A 25% service encounter reporting premium payment on the shadow billing service encounters will be paid on summer long weekends in addition to the existing premiums of either 38% or 10% depending on whether the ED AFA physician group has selected Billing Option # 1 (Low base-higher premium) or Option #2 (High base-lower premium) respectively.

The holiday "H" schedule of benefit codes may be billed on statutory holiday dates as shown in the chart below for 2012.


Start Date

End Date

# of Days

Victoria Day

May 19

May 21


Canada Day

June 29

July 1


Civic Day

Aug 4

Aug 6


Labour Day

Sept 1

Sept 3


ED AFAs with fewer than 30,000 unscheduled visits per year

Physicians at hospitals with annual ED volumes of fewer than 30,000 visits receive an additional 25% shadow-billing premium payment during July and August, excluding the statutory holidays that are already eligible for this shadow billing premium. This premium is designed to assist smaller hospitals in attracting physician coverage over the summer months, and means that groups are eligible to receive premium payments (based on their billing option selection) of either 63% (Billing Option # 1) or 35% (Billing Option # 2) during the months of July and August.

Hours of coverage for workload ED AFAs

Workload hospitals with scheduling issues during the July 1- October 14 period may reduce total hours scheduled without being subject to recovery at the end of the year as long as the hospital stays open 24/7 and the hours of coverage do not fall below the minimum number of hours required for a Workload hospital (40% of the hours over 24). The physician group determines the use of these additional funds, which may be used to provide an incentive to physicians who pick up extra shifts over the summer or who work unsociable hours.

Off-Site Flexibility for 24hr ED AFAs

To provide additional flexibility at the local level during the July 1 to October 14 period, for Emergency Groups within funding levels 3A, 4A, and 4B, hospitals with scheduling issues may agree, together with the Emergency Group and with volumes permitting, that the on-duty ED physician may be on-call from outside the ED, provided that the on-duty physician is available to provide emergency services within 15 minutes of a call or within a time frame agreed upon by the hospital and the Emergency Group.

Who is the contact for questions about the existing initiatives?

Barbara Roston
Program Manager
Specialist Physician Contracts
Ministry of Health and Long-Term Care

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