Updated January 31, 2020

Primary Care Network Steering Committee

Terms of Reference (TOR)

Template and Sample Text

Contents PageIntroduction 2Sample Organizational Charts 3Terms of Reference Template 5Sample Text 9

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Introduction

Provincial partners are committed to an inclusive collaborative approach to implementing Primary Care Networks (PCNs) and interdisciplinary team- based care. Collaborative local partnerships, co-governance and transparency through the Collaborative Services Committee (CSC) and PCN Steering Committee will be integral to our success in shifting the way primary and community care is delivered for British Columbians.

The CSC should provide PCN strategic leadership for the establishment of a local PCN Steering Committee, PCN design and implementation, Specialized Community Services Programs (SCSPs) alignment, and analysis of data to help identify community care needs and outcomes. The PCN Steering Committee should provide oversight to operationalize the PCN clinical services, as defined in the PCN service plan and as part of the local network of primary care services.

This document aims to support PCN communities through the process of developing and refining their local PCN Steering Committees. The content has been based on existing PCN Steering Committee Terms of References which have been developed by communities that are currently implementing PCNs. This template can be completed by making use of the sample text provided, and adapted to meet the needs of your community.

Your GPSC and Ministry liaison can provide further support and guidance to help strengthen your local governance structures and partnerships. Additional information and guidance can also be found in the following documents which are available on the PCN toolkit:

GPSC PCN Governance diagram PCN Implementation Guide PCN Collaborative Governance - Roles and responsibilities document

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Sample Organizational Charts

Model 1

CSC with one PCN Steering Committee – Centralized decision-making

Local community committees advise the PCN Steering Committee, which then advises the CSC. CSC makes the final decisions based on Terms of Reference.

Model 2

CSC with one PCN Steering Committee – Delegated decision-making

CSC delegates decision-making authority to the PCN Steering Committee, and monitors PCN Steering Committee to ensure alignment with mandates and service plan. May also engage in dispute resolution.

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CSC

PCN Steering

Committee

Local Community Committee

Local Community Committee

Local Community Committee

Makes recommendations/Advises CSC

Advises PCN SC

Makes final decisions

CSC PCN Steering Committee

Final decisions (informs

CSC)

Monitoring/ Strategic

input/ Dispute

resolution

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Model 3

CSC with multiple PCN Steering Committee – Delegated Authority

CSC delegates decision-making authority to the PCN Steering Committees, and monitors PCN Steering Committees to ensure alignment with mandates and service plan. May also engage in dispute resolution as needed.

Model 4

CSC and PCN Steering Committee are combined

CSC is the PCN Steering Committee and meets the requirements of included members for a PCN Steering Committee. This model is used in rural/small communities with a small number of stakeholders.

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csc

PCN Steering Committee 1

PCN Steering Committee 2

PCN Steering Committee 3

CSCPCN Steering Committee

Updated January 31, 2020

PCN Steering Committee Terms of Reference Template

Background (optional)This section provides context for the formation of the PCN Steering Committee. Recommended to reference the GPSC PCN Governance diagram , PCN collaborative governance: roles and responsibilities document, PCN Implementation Guide , and Letter of Intent that established the CSCs, for context.

Purpose (required)This section sets out the overall function of the PCN Steering Committee. This is not the place to identify the purpose of the PCN itself, but rather of the Steering Committee that will oversee the development, implementation, and ongoing operations of the PCN.

Guiding Principles or Ground Rules (recommended)Some CSCs have chosen to include a statement of guiding principles by which the PCN will operate. This section is optional but may be useful as a way to establish a common understanding of the common values that all parties have agreed to.

Responsibilities of the Steering Committee (required)This section outlines what the Steering Committee is expected to do and the scope of their duties. Some groups have called this section “Scope of Responsibilities” or “Expectations”. The title is flexible, but a section about what this committee is expected to do is important to include. Some groups include governance and operational responsibilities in this section, while others divided these functions into separate sections.

Governance and Decision-Making (required)This section outlines how decisions will be made by the PCN Steering Committee. The title of this section may be “governance” or “decision-making” or both. Some CSCs have chosen to include the reporting structure in this section, i.e., the relationship of the PCN Steering Committee to the CSC.

The CSC oversees PCN Steering Committees as they are known as the collaborative table at the community level. The CSC may give mandate and authority to the PCN Steering Committee (if desired) or may function as the PCN Steering Committee.

Note that PCN Steering Committees are not legal entities governed under the Societies Act. Therefore, they do not need to establish quorum. Nonetheless, the committee may wish to establish principles or agreements about who should be present for a decision to be made (such as a representative from each of the partners). This is generally understood as a principle of ‘inclusion’ which is foundational for consensus decision-making.

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Decision-making should follow a consensus model. Consensus refers to agreement on decisions by all members of a group, rather than a majority or a select group of representatives. This is the standard practice of the GPSC and most CSCs in the province.

It is important to indicate what is meant by consensus in the Terms of Reference. For example, consensus may mean:

All parties agree with the decision and are willing to carry it out. Everyone supports a decision and understands how it was made. Everyone is able to live with the decision and no one will block its

implementation. ‘Straw polling’ or using a show of hands to ask if everyone agrees with or can live with a decision can be used, but this is to identify whether consensus has been achieved rather than as a vote by majority.

A ‘Consensus minus One’ model may also be used for PCN Steering Committee decisions. This means is that it takes more than one dissenting member to block consensus. One voice at odds with the rest is considered a workable way to go forward, but more than one is a sign that the decision should be rethought.

It is a good idea to include guidelines for dispute resolution or how to address disagreements and divergences of views within the committee. For example, will a mediator or facilitator be brought in? Will disputes be taken to the CSC for a decision?

TIP: LEVELS OF CONSENSUS

• I can say an unqualified “yes!”.• I can accept the decision. • I can live with the decision. • I do not fully agree with the decision; however, I will not block it and will support it.

TIP

Successful consensus processes follow several guiding principles. You may wish to include a version of these principles in the TORs for PCN Steering Committees.

• Inclusiveness– To the extent possible, all necessary interests are represented or, at a minimum, approve of the decision. • Accountability– Participants usually represent stakeholder groups or interests. They are accountable both to their constituents and to the process. • Facilitation– An impartial facilitator accountable to all participants manages the process, ensures the ground rules are followed, and helps to maintain a productive climate for communication and problem solving. • Flexibility– Participants design a process and address the issues in a manner they determine most suitable to the situation.

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• Shared Control/Ground Rules– Participants share with the facilitator responsibility for setting and maintaining the ground rules for a process and for creating outcomes. • Commitment to Implementation– All stakeholders commit to carrying out their agreement.

Membership (required)This section lays out the rules around membership on the PCN Steering Committee and the committee structure, including:

Composition (representation from all PCN Partners) – required. How members are appointed – optional but recommended. Term of membership – how long members serve – optional but

recommended. Change of membership – how people can step off or onto the Committee. Advisory/ad hoc members who do not participate in formal decision-making

but can participate in the Committee discussions. Roles and responsibilities of members – if desired.

Information about Composition:

Required Members: Co-Chairs – A Health Authority representative, a physician representative from local Divisions of Family Practice and a local First Nations representative will be invited to chair.

Required Members: Local Partners, including representative local physicians and NPs from local primary care practices, Divisions, Health Authority, First Nations Health Authority, local First Nations representatives (if they choose to engage). These are the members who participate in decision-making.

Optional: Additional decision-making partners, if appropriate, such as patients, allied health providers, alternative service providers, community agencies, community specialist, midwives, municipal officials (e.g., mayor).

Optional: Other non-decision-making members may be included in an advisory/ad hoc role, such as a GPSC rep, an MOH Liaison, a PCN Manager, RST Leads, etc. These members may speak at meetings and provide input for consideration by the committee; however, these members do not participate in final decisions that are made by the committee.

Meetings (required)Indicate the frequency of meetings, who will create the agenda and chair/facilitate the meetings, and if minutes will be maintained and to whom they will be distributed.

Dispute Resolution (recommended)It is recommended to have a section on what will happen in the case of a dispute within the Steering Committee that cannot be resolved by the members. This

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information could be included as a section on its own or under the “Decision-Making” section.

Reporting (required)This section outlines the reporting relationship of the PCN Committee vis-à-vis their CSC and the Ministry of Health (who they report to, what kinds of reports they provide, and with what frequency). Reporting is a joint responsibility of the Division and Health Authority.

Objectives (optional)Some CSCs have decided to include the expected outcomes or deliverables of the PCN Steering Committee(s). This can support accountability of the PCN Steering Committee(s). On the other hand, some groups may prefer to include this kind of information in an annual operations plan rather than in the TORs.

Confidentiality (recommended)This section includes a statement about the confidential nature of information shared within the PCN Committee or to their CSC.

Amendments (recommended)This section outlines the process of how the PCN Steering Committee will review their Terms of Reference.

Accountability (recommended)Guidelines for accountability of the PCN Steering Committee(s) are recommended, and could be a section on their own or could be included under “Responsibilities” or “Reporting”.

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PCN Steering Committee Terms of Reference Sample Text

Contents Page1. Background 102. Purpose 103. Guiding Principles or Ground Rules 114. Responsibilities of the Steering Committee 125. G overnance and D ecision-Making 136. M embership 157. Meetings 188. Dispute Resolution 199. Reporting 1910. Objectives/Desired Outcomes/Deliverables 2011. Confidentiality 2012. Amendments 2013. Accountability 21

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1. Background (optional) Sample Text 1 The Name Division of Family Practice (the Division), Name Health Authority, First Nations Health Authority, Doctors of BC, the Ministry of Health (the Ministry) and the General Practice Services Committee (GPSC) (collectively referred to as “the Partners”) recognize a shared responsibility for the health of the community. To support the Ministry’s priority of implementing Primary Care Networks across the province of British Columbia, the Name Collaborative Services Committee (CSC) has established the Name Primary Care Network Steering Committee (the “Steering Committee”) for the purpose described in these Terms of Reference. Sample Text 2 To support the priority of the partners to implement Primary Care Networks across the province of British Columbia to enhance attachment, capacity and patient access through team based primary care services, the Name (CSC) has established this local primary care network steering committee for the purpose described in these Terms of Reference. Sample Text 3 Name Health Authority, Name Division of Family Practice (“Division”), First Nations Health Authority and Name First Nation (collectively, the “PCN Members”) have jointly established the Name Primary Care Network (“PCN”) under the guidance of the Name Collaborative Services Committee (“CSC”). The PCN will be overseen by the PCN Steering Committee. In consideration for establishing the PCN and for Name Health and Division acting as PCN fund administrators under funding agreements with the Ministry of Health (the “Ministry”) and Doctors of BC, the PCN Members have agreed to enter into these terms of reference to establish the PCN Steering Committee and their commitments to the PCN. 

2. Purpose (required)Sample Text 1 The purpose of the PCN Steering Committee is to oversee the establishment, implementation and operations of the Name PCN (PCN) in accordance with the Service Plan for (name of community) approved by the Ministry of Health (the Service Plan). Sample Text 2 The Name Primary Care Network (PCN) Steering Committee (SC), in consultation with local PCN members, will oversee the establishment and ongoing operation of the Name PCN in accordance with the approved Name PCN service plan, and will liaise with the Name CSC to ensure ongoing health system coordination and partnership. 

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3. Guiding Principles or Ground Rules (recommended)  Sample Text 1

Guiding Principles Embed principles of collaboration and engagement throughout the planning,

implementation, and operations of the PCN. Ensure cultural safety throughout the implementation of the PCN. Embed the principles of a collaborative learning environment in all aspects of the

work: openness, curiosity, commitment to learning, together with creativity, collaboration, innovation and connection.

Take the Lessons Learned from our collective CSC work as the foundation for the PCN roll-out (e.g. Relationship-based care, self-management of care teams, local governance, QI, collaboration and consensus, coaching, readiness and agreements).  

Sample Text 2

Quadruple AimSteering Committee members will reference the Quadruple Aim when discussing and making decisions with respect to matters within the Steering Committee’s mandate. The Quadruple Aim focuses on four things:

An improved patient experience of care.  An improved provider experience of care. An improvement in population health. The financial sustainability of the system.

Sample Text 3

Ground Rules Create clarity about the work and commitment. Define short-term (SMART) objectives and longer-term vision and measures of

success. Be open and willing to explore a range of options - Create a safe learning

environment. Agree to work collaboratively. Establish trust and relationships - Define and practice effective communication. Embrace evidence in decision-making - Undertake baseline assessment.

Determine what data is needed to make effective decisions and secure it. Embrace a QI-driven processes – Undertake the work in a spirit of constant self

and group reflection and improvement.

Sample Text 4

Guiding Principles (Our values) We communicate by listening to and encouraging all voices. We ask questions

when something is said that we don’t understand.  We learn from the cultures and worldviews of others and embrace a perspective

of oneness.

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We believe that each of us is coming from a place of good intent, even when our words or actions may be off.

We embrace difficult tasks and conversations rather than avoid them. We choose to do what is right over what is fast, easy or comfortable. We understand that this work is an iterative process that will require us to be

flexible.   We seek evidence-based solutions and recognize the need for innovation.

4. Responsibilities of the Steering Committee (required)

Sample Text 1

Responsibilities of the Steering Committee include the following: Ensuring that the PCN adheres to the principles for Primary Care Networks set

out by the Ministry and GPSC. Overseeing the strategy, implementation and operations of the PCN in

accordance with the Service Plan. The allocation of funds and other resources for the PCN through the Partners

acting as PCN fund administrators in accordance with the Service Plan. Ensuring that the financial and other reporting relating to the PCN and

required by the Ministry is prepared, approved and submitted. To provide oversight and direction to the PCN Manager and the PCN

Administrator, or such other management and administrative staff that are retained to support the PCN from time to time.

Sample Text 2

The Name PCN Steering Committee will: Share reciprocal accountability for implementation and operationalization of

the Name PCN as per the approved Service Plan and Growth Plans. Be accountable for expenditure of PCN funds as per the approved Service Plan

and Growth Plans. Make decisions by consensus. Establish advisory committees or other consultative methods for other

providers including nursing and allied health members, community members, patients, family and community partners to be involved.

Establish a process for the hiring of all PCN contracted GPs and Nurse Practitioners that involves all partners in the decision-making, including representatives from the participating Patient Medical Home.

Establish a process for the hiring of all PCN Allied Health and Nursing positions that involves all partners in the decision-making, within the expectations of the respective collective agreements.

Establish guidelines for Patient Medical Home participation in PCN; Hire a PCN Manager who will not have or otherwise be delegated voting rights

or decision-making. Share information with, and be responsive to, the Name Collaborative

Services Committee.

Sample Text 3

The responsibilities of the PCN Steering Committee are to: Page 12 of 21

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Administer the PCN in accordance with PCN Service Plan Approval. Provide oversight over the PCN by reviewing reports, evaluating the PCN,

being responsible for quality improvement, and overseeing risks and liabilities.

Provide regular high-level reporting to the CSC. Provide CSC with regular PCN oversight progress updates. Bring any recommended changes to the PCN vision to CSC for approval as

required. Determined and approve PCN strategic changes and direction based on

recommendations from Strategic Planning Working Groups (“SPWGs”) an/or PCN and/or CSC leadership. Report changes to CSC.

Provide financial oversight for the PCN, including approve monthly financial statements prepared by Name Health Authority and Division and regular budgets.

Ensure periodic and quarterly reporting is provided to the Ministry and CSC in accordance with the Implementation Schedule approved by the Ministry.

Submit an Implementation Plan to the Ministry and CSC for each fiscal year. Ensure an Annual Progress Report is updated and submitted to the Ministry

and CSC annually by July 1st of each year. Manage Patient Attachment to applicable PCN Members from the Provincial

Health Connect Registry once available. Provide notification to the CSC and Ministry and GPSC liaisons as soon as it is

aware of any event that could materially impact the ability of the local PCN to meet its goals or obligations under the PCN Service Plan Approval.

Dialogue quarterly or as needed with Ministry and GPSC representatives and CSC to mitigate the following for the benefit of the patient population served:

o a pending retirement or resignation of a primary care provider within the PCN; or loss of a provider or employee or contractor funded through local PCN funding or a position critical to operations of a local PCN service.

5. Governance and Decision-Making (required)Sample Text 1

Governance and Decision-Making The Name PCN Steering Committee reports to the CSC and will provide

updates to the Name Collaborative Services Committee to ensure ongoing community coordination and partnership.

The Name PCN shall aim to operate by consensus. Consensus is achieved when everyone accepts and supports a decision and understands how it was reached. In meetings where significant decisions are to be made, all partners will be notified and encouraged to attend.

Members are responsible for raising issues of concern prior to committing final decisions.

If the event of disagreement or divergences of views, members will at all times make best efforts to conduct themselves in a respectful manner.

Sample Text 2

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Decision-Making and Dispute Resolution A minimum number of 6 Steering Committee members are required to be

present at a meeting to make a decision or implement a course of action. Representatives must include at least 2 representatives from each of the Division and Name Health Authority, and at least 2 of the Indigenous representatives; where all members have been identified.

Decisions will be made by a modified consensus approach called Consensus-Minus-One. A majority of members present at a meeting will be required to approve a decision, with the minority agreeing to go along with the decision.

Consensus-based decision-making is committed to finding solutions that members actively support, or at least can live with. This ensures that all opinions, ideas and concerns are taken into account.

No decision is made against the will of a minority of members. If significant concerns remain unresolved, a proposal can be blocked and prevented from going ahead. The Consensus-Minus-One approach requires more than one dissenting member to block consensus.

In dispute resolution, a mediator will be appointed by the members.

Sample Text 3

Decision-MakingDecisions will be made by consensus. Consensus is achieved when everyone accepts and supports a decision and understands how it was reached. In meetings where significant decisions are to occur, all partners will be notified and encouraged to attend. Sample Text 4

Decision-Making and DisputesThe following rules will apply with respect to decision-making and disputes:

All decisions of the PCN Steering Committee will be made by consensus amongst the voting members.

If the voting members fail to reach consensus, then the decision will be referred to the CSC for resolution.

A decision by the CSC is binding on the PCN Steering Committee and its members.

6. Membership (required)Sample Text 1 CompositionMembers will be individuals consisting of the following:

(a) Division Representation: 3 representatives from the Division.

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(b) Indigenous Representation: 3 members including 1 representative from First Nations Health Authority, 1 representative appointed by Name First Nation and 1 additional Indigenous representative.

(c) Health Authority Representation: 3 representatives from Name Health Authority.

(d) Local Patient Representation: 2 local patient members.(e) Local NP representative if not already included in (a)

Appointment of Individual Members and Changes in MembershipIndividual representatives from the Health Authority, the Division and Indigenous representatives will be designated as members by their organization and may be replaced from time to time at the organization’s discretion. Changes in these individual members may be considered and approved by the Steering Committee.

Orientation of New MembersThe orientation of new members is the responsibility of the organization that they represent and the PCN Manager.

Sample Text 2

Decision-Making Members “Division” representatives: 3 Division Board Members and up to 3 GP PCN

leads appointed by Division. “Name Health Authority” representatives: up to 4 Health Authority

representatives appointed by the Health Authority. “Indigenous representatives” – if they choose to participate. “Nurse Practitioner” representatives: 2 NP representatives.

All voting members can attend meetings, speak at meetings and participate in decision-making.

Advisory Members APP GP – nominated by APP GPs and approved by PCN Steering Committee. APP NP – nominated by APP NPs and approved by PCN Steering Committee. Division Executive Director. Division PCN Manager Lead. Co-Chair of Partner and Patient Advisory Committee. Co-Chair of Indigenous Advisory Committee. PCN Manager.

All advisory members can attend and speak at meetings. Advisory members do not have the right to participate in decision-making.

Ad Hoc MembersThe PCN Steering Committee will consider and approve the following ad hoc members:

Public Health Allied Health Representative

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Additional ad hoc members may be approved by the PCN Steering Committee from time to time. All ad hoc members can attend and speak at meetings. Ad hoc members do not have the right to participate in decision-making.

Sample Text 3

The local PCN Steering Committee will be minimally comprised of local patient representatives, local First Nations representatives, physician representatives from local primary care practices, local NP representatives, the Division, and the Health Authority. Other local partners may be invited to participate as members of the PCN Steering Committee at the discretion of the CSC.

Members: HA Manager. HA Community Engagement. GP #1 (member of CSC and Division board). Physician #2 - GP from PCN clinic. Physician #3 - GP from PCN clinic. Division ED. First Nation representative. NP representative. Patient Partner #2. Patient Partner #2.

Advisors: Medical Health Officer. Practice Support Program (RST Leads). HA leadership (local and central) and staff. HA SCSP leads. Division board and members. Ministry of Health Liaison. GPSC/Division liaisons. GPSC representatives.

Sample Text 4

Patient and Family MembersQualifications:

A patient or family member of a patient in (name of community) in past 2 years.

Respects diversity and differing opinions. Works collaboratively with staff and other members of the public. Respects privacy and confidentiality. Provides constructive advice. Can represent families as a well-informed participant.

General Requirements: Attend a screening interview, Sign a confidentiality agreement and volunteer

contract, Attend meetings

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Patient and family members of the committee are asked to participate for two (2) years. Members can serve for three (3) terms maximum.

Sample Text 5

Member Responsibilities Members will be responsible for endeavouring to attend all meetings of the

Steering Committee and contributing to discussions in a collaborative and effective manner; and

Members who will be presenting information at a meeting will ensure that any resources and materials are prepared and available at the time of the meeting. If detailed information will be presented at the meeting, those materials should be provided to the chair of the meeting to ensure it is distributed in advance.  

Sample Text 6

Member Responsibilities Be present at all meetings, prepared for informed discussion around agenda

items Share ideas and insights to establish planning of the PCN strategy in (name of

community) Promote the interests and vision of Name PCN Members of the committee are accountable to their home agency but agree

to fully participate in efforts to improve primary care access, patient experience and health outcomes for (name of community) residents through the formation of PCNs, which consist of Patient Medical Homes (PMH) networked together, linkages to local health authority, community and Indigenous social and health services.

Sample Text 7

Co-Chairs and SecretaryCo-Chairs: A representative from each of the Division, the First Nations Health Authority and Name Health Authority will act as co-chairs for the Steering Committee with one representative acting as chair of a meeting at a time and chairs for each meeting rotating among the three co-chairs.

Secretary: The Secretary of a meeting may be appointed by the Steering Committee for each meeting and will be responsible for taking minutes of the meeting.

Sample Text 8

Working Groups and SubcommitteesThe Steering Committee may establish subcommittees or/working groups (Subcommittees) from time to time for the purpose of making recommendations to the Steering Committee on specific matters. The Subcommittees will be responsible for making recommendation to the Steering Committee on those matters within the Subcommittee’s mandate for decisions to be made at the Steering Committee in accordance with these Terms of Reference.

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7. Meetings (required)Sample Text 1

FrequencyMeetings will be held as deemed necessary or requested by the members, with a minimum of quarterly meetings. Any member can request a meeting of the Steering Committee. Meetings may take place in person or via telephone conferencing.

Agenda, Minutes and MaterialsAn agenda, minutes of the previous meeting and any other materials required for information to be considered at the meeting will be sent to the Steering Committee members in advance of the meeting. Meeting InviteesThe Steering Committee may invite guests to attend meetings from time to time to provide information that is needed or valuable to enable the Steering Committee to be fully informed with respect to its areas of responsibility in accordance with these Terms of Reference. Invited guests may include PCN staff, representatives from the Division, Health Authority, the Ministry, GPSC, Doctors of BC and the local medical community.

Sample Text 2

The PCN Steering Committee will hold regular meetings on a monthly basis. The PCN Steering Committee will participate in CSC meetings. Regular meetings of the PCN Steering Committee will be scheduled to

commence immediately after the CSC meetings. No decisions will occur at a CSC meeting. All decisions arising out of matters

discussed at a CSC meeting will be made during the PCN Steering Committee meeting.

The meeting agenda, minutes and reporting package will be sent out to the PCN Steering Committee members 7 days in advance of a meeting.

All meetings will be co-chaired by the Director of Clinical Operations and one of the GP PCN leads. The GP PCN lead that co-chairs may change from meeting to meeting, to permit flexibility in the schedules of the GP PCN leads.

The majority of both Division representatives and Health Authority representatives must be present in order for the PCN Steering Committee to make decisions.

A PCN staff member will be present to provide support to the PCN Steering Committee, take minutes and record a decision/action log.

Sample Text 3

Frequency: The committee will meet monthly. Decision-Making: Will strive for consensus and will use voting when there is no

clear agreement. A historical decision-making log will be maintained by the PCN Manager.

Quorum: At least 51% of the decision-making members must be present for a decision to take place.

Voting (if needed): Show of hands or secret ballot if requested. Page 18 of 21

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The Name Division staff liaison will send the minutes out within 2 days of each meeting. Minutes will be sent by email to all voting and non-voting members of the committee.

8. Dispute Resolution (recommended)Sample Text

Disputes within the PCN Steering Committee will be resolved by involvement of an outside facilitator as agreed to by the Steering Committee Members. Failure to resolve an issue will result in involvement of an arbitrator as agreed by the Members.

Disputes within PCN Patient Medical Homes will be resolved as follows:o Problem solving among the service providers in a clinic, supported by

PCN change management staff and health authority PCN managers.o If the dispute remains unresolved within the clinic, despite efforts

towards resolution, the issue will be considered by the PCN Steering Committee and a plan of action recommended.

o If the PCN Steering Committee cannot resolve the issue, a remedy will be recommended to the clinic providers and the contract holder.

9. Reporting (required)Sample Text 1

At the CSC, the PCN Steering Committee will receive reports from the Indigenous Advisory Committee, Partner and Patient Committee, Operation Leadership and the SPWGs.

The PCN Steering Committee will provide the following reports:

At CSC meetings, reports to the CSC members on decisions made by the PCN Steering Committee.

Regular high-level reporting and PCN oversight progress updates to CSC for each CSC meeting.

Period reporting, quarterly reporting, and annual reporting provided to the Ministry and CSC as required by the funding agreements.

The PCN steering committee is accountable to and reports to the CSC.

Sample Text 2

Follow MoH reporting requirements.

10. Objectives/Desired Outcomes/Deliverables (optional)Sample Text 1

DeliverablesThe Committee will provide the BC Ministry of Health, with a PCN Service Plan that integrates, aligns, and coordinates health services that meet the health needs of the identified population.

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Sample Text 2

Deliverables Implementation of the PCN according to the PCN work plan. Ongoing effective management of the Name PCN.

Sample Text 3

Expected Outcomes1. Attachment to Primary Care provider for all people living in Name PCN.2. Improved Access to Primary Care.3. Improved Population Health for people living in Name PCN.

11. Confidentiality (recommended)Sample Text

All materials produced and presented to the Steering Committee are the property of the Primary Care Network and confidential to this committee within their stated purpose. All members of the Steering Committee are required to maintain the confidentiality of all materials, documents and discussions. Any communications that are of a public nature will be clearly identified as such and must be approved by the B.C. Ministry of Health in accordance with stated communications policies.

12. Amendments (recommended)Sample Text

These Terms of Reference will be reviewed on an annual basis and/or at the discretion of the Steering Committee. Any proposed revisions will require approval of the Steering Committee.

13. Accountability (recommended)Sample Text

The partnership is accountable for the results achieved or not achieved. Partners should commit to ongoing improvement of co-designing programs to ensure the best possible results for patients, providers and the community.

All Partners are accountable to any funding Partner or outside funding agency to ensure funds provided for change management activities are used effectively

Members will communicate matters of importance between their own organizations and the Committee.

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