British Columbia Order in Council — Order under Medicare Protection, s (O.C. 183/2022)

O.C. 183/2022

British Columbia — Orders in Council

183 April 4, 2022 PROVINCE OF BRITISH COLUMBIA ORDER OF THE LIEUTENANT GOVERNOR IN COUNCIL Order in Council No . , Approved and Ordered Executive Council Chambers, Victoria On the recommendation of the undersigned , the Lieutenant Governor, by and with the advice and consent of the Executive Council, orders that approval is given for the Medical Services Commission to enter into an information-sharing agreement, substantially in the attached proposed form, with the Ministry of Health, the Provincial Health Services Authority and British Columbia Emergency Health Services. Presiding Member of the Executive Council (Thi s

part is for ad mini stra/i,,e p11111oses univ and is nut part of th e Order .) Authority under which Order is made: Act and

section : Medicare Protection Act, R.S .B .C. 1996 , c. 286, s. 5 (5) and (6) Other: Page 1 with attachment (22 pages total) 020579743

Minbtrv of lk.1hh .

Information Sharing Agreement Effective Date: Term Date: THIS AGREEMENT is made effective the _______ (the "Effective Date") and expires BETWEEN: HER MAJESTY THE QUEEN IN RIGHT OF THE PROVINCE OF BRITISH COLUMBIA, as represented by the Minister of Health ("MOH") AND: AND: AND: Ministry of Health Data Management & Stewardship Branch Health Sector Information, Analysis & Reporting Division 2nd Floor - 1515 Blanshard Street Victoria BC V8W 3C8 Email: HealthDataCentral@gov.bc.ca Medical Services Commission ("MSC") 1515 Blanshard Street Box 9649 Victoria BC V8W 9P4 British Columbia Emergency Health Services ("BCEHS") Ambulance Billing Services Block D - 2261 Keating Cross Rd Victoria, BC V8M 2A5 Email: Billing@bcehs .ca Provincial Health Services Authority ("PHSA") 200-1333 West Broadway Vancouver, BC V6H 4C1 (Each a "Party" and collectively the "Parties") ISA: 19-095 Page 1 of21

WHEREAS: Ministry of llt:.ilrh . Information Sharing Agreement A. BCE HS is a corporation continued under the Emergency Health Services Act (EHSA), which operates as a part of PHSA. BCEHS provides pre-hospital emergency services and inter-facility patient transfers throughout British Columbia, and it oversees the BC Ambulance Service, the BC Patient Transfer Services , and the Community Paramedics program. BCEHS air and ground services are provided to BC MSP beneficiaries and non-MSP beneficiaries on a fee for service basis. B.

PHSA operates under the Societies Act and is accountable to the Minister of Health through a Board of Directors , which is appointed by the Minister of Health. PHSA has a unique role in BC's health authority system: to ensure that BC residents have access to a coordinated provincial network of high-quality specialized health-care services, which includes ambulance services delivered by BCEHS.

To this end and to support BCEHS focus on delivering ambulance services, in 2010 PHSA assumed full management of BCEHS, and in 2014 the entire Ambulance Billing Services Department , including its staff members, were transferred from BCEHS to PHSA resulting in the staff members becoming employees of PHSA.

The Ambu lance Billing Services Department is responsible for adjudicating patient care records created by BCEHS paramedics by reviewing the PCR; ensuring names, addresses and other information are accurate and complete; and determining the appropriate bill type to arrive at the amount of the invoice to be issued to patients. Meanwhile, the IMIT Department at BCEHS has continued managing the system applications that the Ambulance Billing Services Department uses to process ambulance service fees. C.

Ambulance service fees are determined in part by the patient's Medical Services Plan (MSP) coverage for supplemental services under the Medicare Protection Act (MPA), which is income-based coverage at the time the ambulance services were provided in accordance with the Emergency Health Services Regulation under the EHSA. Funds from ambulance billings are received by Revenue Management Services (RMS) of the Ministry of Finance on behalf of the Province of British Columbia. D.

The MSC is responsible for administering MSP in accordance with the MPA and Regulations, and MOH fulfils policy and operations roles on its behalf . Further, MOH under the Minister of Health's direction, has a general stewardship mandate for health information pursuant to the Ministry of Health Act. E. For PHSA and BCEHS to determine a patient's health insurance coverage for their ambulance billing purposes, PHSA and BCEHS requires information contained in the RAPID system in relation to MSP Enrolment.

The RAPID system is the underlying technical system for the MSP Enrolment and card qualification steps of the BC Services Card (BCSC) , and for other MSP functions outside of the BCSC. F. The MOH prepared a Privacy Impact Assessment (PIA; HLTH13018) that speaks to the RAPID system. The RAPID system that is the subject of the PIA is the MOH's technica l underpinning for the BCSC MSP Enrolment and identity proofing processes. G. The BCEHS Gateway System is the system used by PHSA and BCEHS to verify MSP ISA: 19-095 Page 2 of 21

1\-1 in isrrv of I lcalrh , Information Sharing Agreement eligibility to ensure the correct billing rate is applied before the invoice is issued, Invoicing data is forwarded to RMS (Revenue Management Services - Ministry of Finance) (which uses a suite of Systems Applications and Products applications hosted by Revenue Services of British Columbia (RSBC)) to produce the invoice, Read only access to the RAPID system enables PHSA and BCEHS staff to assist clients in understanding their ambulance bills and indicates eligibility for a reduction of ambulance billing charges. H. The purposes of this Agreement are: (

i) to enable information sharing of MSP enrolment information; (ii) to identify persons who receive supplemental services under MSP (including due to receiving assistance under the Employment and Assistance Act or the Employment and Assistance for Persons with Disabilities Act); (iii) to establish that these persons will not be charged for ambulance services; and (iv) to assist PHSA and BCEHS to evaluate the Ambulance Billing program and identify quality improvement strategies.

NOW THEREFORE in consideration of the mutual promises contained herein, the Parties hereby agree as follows:

Article 1.

Definitions See Appendix A for a description of

definitions pertaining to this Agreement.

Article 2. Description of Systems and Data Flows See Appendix B for descriptions of the relevant information systems and data flows under the Agreement.

Article 3. Legal Authorities for Collection, Use and Disclosure The Parties agree that they will collect, use, disclose and retain Personal Information in accordance with Applicable Law, including the legislation authorities as set out in "Legislation Authorities" of "Appendix D: Data Narrative" and, insofar as the MSC is concerned,

Section 5.5 of the MPA.

Article 4. Data Transfer Method 4.01 The Parties agree they will disclose and collect Personal Information only by secure electronic file transfer that meets or exceeds BC Government standards, including encryption of files at both ends, at rest, and while in transit, where only individuals authorized to access the Data can do so. ISA: 19-095 Page 3 of 21

Mini~try of I k .tlth , Information Sharing Agreement 4.02 The Data will be transmitted by PHSA, BCEHS and MOH using the MOH Secure File Transfer Protocol (SFTP). Please see Appendix E: Batch File Transmission Processes for additional details. Additional details regarding the File layout are set out in Appendix B.

Article 5. Authorized Personnel The following table sets out the PHSA and BCE HS positions of Authorized Personnel, their roles, the data elements that will be accessed, and the reason(

s) for data access.

Data Elements Containing Personal Reason for Data Position Role Organization Information Access that will be Accessed by Users Oversees the PHSA Ambulance Billing Services Director, Financial Department Services (Manager , Supervisors and Ambulance Billing Specialists) Manages the PHSA READ ONLY -Ambulance Billing Personal Health Assist clients to Manager , Services Number, Name, understand the Department legislated rate Ambulance Billing (Supervisors and Birthdate, applied to their Ambulance Billing MSP eligibility, ambulance Specialists) or service invoice, Oversees the PHSA supplementary and/or adjust rate benefits Ambulance Billing Ambulance Billing entitlement, if eligibility Administrator Specfalists in the Ambulance call coverage has (Supervisor) Ambulance Billing #, changed since Services invoice was Department Date of created.

Confirming PHSA ambulance call appropriate bill type and rate are applied Ambulance Billing to ambulance billing data Specialist Confirming and tracking status of invoices, addressing client concerns ISA: 19-095 Page 4 of 21

~1iniml · of Health· Position Role about invoices, updating information in billing system if RAPID Data is more current Responsible for managing the systems that are IMIT Department used by the Ambulance Billing Services Department Information Sharing Agreement Data Elements Containing Personal Reason for Data Organization Information Access that will be Accessed by Users BCEHS Managing the systems to support Ambulance Billing Services Department. The systems include PCIS, PC-DES, and Gateway. In order to gain access to RAPID, PHSA and BCEHS personnel must fill out form HLTH 7077 using their IDIR access.

Once filled out, the form must be sent to HIBC/Maximus Service desk, which will then provide the access to RAPID . HTLH 7077 form: https://logon7 .gov.bc.ca/clp- cgi/int/logon .cgi?flags=1000 : 1 ,O& TAR GET =$SM$https%3a%2f%2fgww%2ehealth%2egov%2eb c%2eca%2four -tools%2fforms%2finformation-management%2fhlth-7077-hibc-data-access request

Article 6. MOH Obligations 6.01 MOH will provide PHSA and BCEHS access to the Data as soon as reasonably practical for the nature of the Data being shared after this Agreement is signed.

Article 7. PHSA and BCEHS Obligations 7 .01 PHSA and BCEHS will only use the information for the purposes of Ambulance Billing Services. 7.02 PHSA and BCEHS must obtain prior written approval from the MSC before compiling any Personal Information into other databases. For further clarity, PHSA and BCEHS will not link, copy or incorporate any Personal Information into any other databases, holdings or systems unless the MSC provides written approval to PHSA and BCEHS, as applicable. ISA: 19-095 Page 5 of 21

M ini\lrv of I kahh , Information Sharing Agreement 7.03 PHSA and BCEHS will not sell or exchange Personal Information for valuable consideration. 7.04 Each of PHSA and BCE HS shall be responsible for the actions of its Service Provider with respect to the collection, use, disclosure and disposal of the Personal Information.

Article 8. Privacy and Security 8.01 Each Party will make reasonable arrangements to maintain the security of the Personal Information in its custody, by protecting it against such risks as unauthorized access, collection, use, disclosure or disposal. 8.02 Each Party will implement this Agreement in conformity with the Government of British Columbia's Information Security Policy. 8.03 Each Party will advise the other Parties immediately of any circumstances, incidents or events which to its knowledge have jeopardized or may in future jeopardize: (

a) the privacy of individuals; or (

b) the security of any computer system in its custody that is used to access the Personal Information.

Article 9. Compliance, Monitoring, and Investigations 9.01 Each of PHSA and BCEHS will assign its Authorized Personnel one or more access role(

s) that correspond to their duties (each an "access role") to be assigned in accordance with the Least Privilege and Need to Know principles. At any given time, during the term of this Agreement, PHSA and BCEHS, jointly, will have no more than thirty

(30) Authorized Personnel. 9.02 PHSA and BCE HS will authenticate the identity of all Authorized Personnel in a manner acceptable to MOH and MSC. 9.03 PHSA and BCEHS will ensure that the access role(

s) assigned to Authorized Personnel are approved by the appropriate individual(

s) responsible for PHSA's and BCEHS's obligations under this Agreement before the Authorized Personnel in question are permitted access to Personal Information. 9.04 During the term of this Agreement, PHSA and BCEHS will ensure that they will keep appropriate and up-to-date records identifying all Authorized Personnel and the access role(

s) to which they have been assigned. Each of PHSA and BCEHS will maintain these records in a manner acceptable to MOH and the MSC and provide them to the MSC upon signing this Agreement, and in the event of any changes to these records, PHSA and BCEHS will send an updated record to MOH and the MSC as soon as reasonably possible via the following form: http://www2.gov. bc.ca/assets/gov/health/forms/551 0fil. pdf ISA: 19-095 Page 6 of 21

Mini~try of lfoalth. Information Sharing Agreement 9.05 Each of PHSA and BCEHS will ensure that its Authorized Personnel: (

a) only access Personal Information in accordance with PHSA's and BCEHS's obligations under this Agreement and Applicable Law; (

b) only access Personal Information to the extent necessary to fulfill their duties, in accordance with the Need to Know principle; (

c) upon having reason to believe that a Privacy or Security Incident has or may have occurred, promptly convey that belief to the appropriate individual(

s) responsible for the Party's obligations under this Agreement; (

d) are reasonably informed, through ongoing education and training, of their obligations under this Agreement and Applicable Law on an ongoing basis during the term of this Agreement; and (

e) for greater certainty and without limiting the foregoing, each of PHSA and BCEHS acknowledges that material failure of any Authorized Personnel to comply with (

a) or (

b) above constitutes a material breach of this Agreement by PHSA and BCEHS. 9.06 During the term of this Agreement, each of PHSA and BCEHS will reasonably monitor the use of Personal Information by its Authorized Personnel to ensure ongoing compliance with Applicable Law and the terms of this Agreement. 9.07 PHSA and BCEHS will promptly comply with any direction given by MOH or the MSC under this Article.

Article 10. Dispute Resolution 10.01 Any issue, matter of general concern or dispute arising from this Agreement will be first directed to the Parties' designated representatives for resolution, and if not then resolved within thirty (30) days it will be a matter of consultation and resolution between the Parties' senior executive in such manner as they see fit. The Parties will identify to the other their representative for the purpose of this Article.

Article 11. Term 11.01 Notwithstanding the date of execution and delivery of this Agreement, this Agreement will become effective on the Effective Date and will continue until _____ , unless earlier terminated in accordance with

Article

Article 12. Modification or Termination of Agreement - General 12.01 This Agreement may be modified or terminated any time by agreement, in writing, of all Parties. 12.02 This Agreement may be terminated at any time by any Party for any reason (or no reason) by providing at least 30 days advanced written notice to the other Parties. ISA: 19-095 Page 7 of21

Mini~try of I kalth

Article 13. General Information Sharing Agreemen t 13.01 Any notice contemplated by this Agreement can be delivered by email to the addressee's email address specified on the first page of this Agreement , in which case it will be deemed to be received on the day of transmittal unless transmitted after the normal business hours of the addressee or on a day that is not a business day, in which cases it will be deemed to be received on the next following business day.

Any Party may from time to time give written notice to the other Parties of a substitute email address, which from the date such notice is given will supersede any previous email address specified for the Party giving the notice. 13.02 No partnership, joint venture.or agency will be created or will be deemed to be created by this Agreement or any action of the Parties under this Agreement. 13.03 If any provision of this Agreement is found to be invalid, illegal, or unenforceable, it will be severable from this Agreement and the remaining provisions will not be affected thereby and will be valid, legal, and enforceable. 13.04 A waiver of any breach by a Party of this Agreement is effective only if it is in writing and signed by the non-breaching party and is not a waiver of any other breach. 13.05 If for any reason and Party does not comply, or anticipates that it will be unable to comply, with a provision in this Agreement in any respect, that Party will promptly notify the MSC of the particulars of the non-compliance or anticipated non compliance. 13.06 The following Articles: Authorized Personnel, Privacy and Security Incidents, Dispute Resolution, General , and any other provision of this Agreement that expressly or by its nature continues after termination , shall survive the termination of this Agreement.

ISA: 19-095 Page 8 of 21

Ministrv of H alch .

Article 14. Appendices Information Sharing Agreement 14.01 Any appendices to this Agreement are part of the Agreement. If there is a conflict between a provision in an appendix and any provision of this Agreement , the provision in the appendix is inoperati ve to the extent of the conflict unless it states that it operates despite a conflicting provision of this Agreement.

IN WITNESS WHEREOF this Agreement has been signed and delivered on behalf of the Parties by their duly authorized representatives.

BC Emergency Health Services Ministry of Health By: By: (Signature of Authorized Signatory) (Signature of Authorized Signatory) Name: Leanne Heppell Name: Andrew Elderfield (Printed) (Printed) Title: Interim Executive Vice President Title : Executive Director BC Emergency Health Serv ices & Data Management & Stewardship Chief Ambulance Officer Ministry of Health Date: Date: Provincial Health Services Authority Medical Services Commission By: By: (Signature of Authorized Signatory) (Signature of Authorized Signatory) Name: Le Thuy Mai Name: Dr.

Robert Halpenny (Printed) (Printed) Title: Chief Financial Officer Title: Chair Provincial Health Services Authority Medical Services Commission Date: Date: ISA: 19-095 Pa~e 9 of 21

Definitions Minim\'of I k .1l[h . Information Sharing Agreement Appendix A -

Definitions In addition to the terms defined throughout this Agreement and the recitals hereto, in this Agreement: (a) "Agreement" means this information sharing agreement including its Appendices . (b) "Applicable Law" means all applicable laws that are binding on the Parties (or on one Party as applicable) and in effect from time to time, including without limitation: (

i) the Freedom of Information and Protection of Privacy Act ("FOIPPA"), RSBC 1996 c. 165, as amended from time to time, including any regulations made thereunder; (ii) the Medicare Protection Act ("MPA"), RSBC 1996, c. 286, as amended from time to time, including any regulations made thereunder; · (iii) the Information Management Act, S.B.C. 2015, c. 27, and (iv) any other statutes, regulations, by-laws or orders that may apply to the Data, but does not include any law, statute, regulation or by-law, treaty , order, directive, policy having the force of law, judgment, injunction , award or decree of a foreign jurisdiction outside of Canada or any Service Provider agreements, including contracts, memorandum of understanding, research engagements or partnerships; (c) "Authorized Person nel" means the individuals authorized to access, retain, use or disclose the Data, as listed in the Health Data Request relating to this Agreement (as such list may be amended from time); (d) "Contact Information" means information to enable an individual at a place of business to be contacted and includes the name, position name or title, business telephone number, business address, business email or business fax number of the individual; (e) "Data" means the information disclosed under this Agreement, including the data elements described in Appendix A; (f) "Effective Date " means the date on which all of the Parties have signed this Agreement; (g) "Least Privilege" means a principle requiring that personnel be granted the most restrictive set of privileges (or lowest clearance) needed for the performance of authorized tasks; Least Privilege implements the Need to Know principle; (h) "Need to Know" means a principle where Authorized Personnel may access only the information required for the performance of their respective duties, and are not entitled to access merely based on status, rank or office; ISA: 19-095 Page 10 of 21

M inistry of l lealth . Information Sharing Agreement (i) "Personal Information" means 'personal information' as defined in FOIPPA and includes only information shared under this Agreement; U) "Privacy Impact Assessment" means an assessment that is conducted by a public body under

section 69 of FOIPPA to determine if a current or proposed enactment , system, project, program or activity meets or will meet the requirements of FOIPPA

Part 3; (k) "Privacy or Security Incident" means a single or a series of unwanted or unexpected events that threaten privacy or information security. Information incidents include the collection, use, disclosure, access, disposal, or storage of information, whether accidental or deliberate, that is not authorized by the business owner of that information; (I) "Term" has the meaning ascribed thereto in

section 11; and (m) "Service Provider" means, as defined in FOIPPA, a person, including an associate, retained under a contract to perform services for a public body. ISA: 19-095 Page 11 of 21

Miniscry of I frahh ISA: 19-095 Information Sharing Agreement Append ix B - Data Flow ttPCR~ (Siren lc:11.Jlcl <Wla) Adjud ication Slaff Manage EKcept ions (patient or response info) Manage Exceptions (pa 11en1 1nfonnaoon) Man39e Exc:eptioos billing addresses) Manogc Excep tions (returned invoicc!l, poymonts, rcl).lls otc) I : l PCIS Pre Sorts BIH typ o Processes Silting RtAes l dem,nes Exceptions Eligibility Ch ecks (BC Medical Services Plan) PC-DES Chec k CRS fOI' Death Data (R03 Reassig n B il type Check CRS for Patient Information 1 1 Processes Billing Rules t Eltgl::,llty CheckS (BC M~Jectl Sttrvic.:~s Pfijll) Identifies Exceptions Gateway Sends dato to RM S 1 RMS (Revenue Management System) Current State Adju dication a nd Billing Processes Apr,I 202 1 h nd candci a1es H CIM Nightly Vcrific:alion ► l LegacyCRS/ NHR/ RAPID (future) Legacy CRS Verficialion Inte rface Invoices (RMS ) Page 12 of 21

1ini -crv Clf Hc-J_hh . Information Sharing Agreement Description of Information Technology Systems and Processes There are four systems involved in creating ambulance billing data: 1) PCIS: A Patient Care Information System, which captures the following information from the paramedic's electronic patient care record (ePCR) entered on a Siren Tablet: a. Patient demographics, b. Patient medical history , c. Care provided by paramedics, d. Confirmation of whether patient was transported as well as treated, e. Other indicators : Work Safe BC (WSBC), Insurance Corporation of BC (ICBC) etc.

Based on the information provided in a, d and e above, PCIS pre-sorts the service into a potential "bill type" to help determine rates to be applied. 2) PC-DES (in conjunction with PCIS) determines bill types and rates and creates the files to be sent to RAPID to validate what level of, if any, of MSP coverage is in place at the time of the service.

Once bill types are assigned and the appropriate fee for service applied, PC-DES generates a file to be sent to Gateway . 3) Gateway : A suite of components and modules to process encounters, adjudicate, calculate rates and prepare invoice data . 4) RMS: Ambulance billing invoice data is sent to RMS to generate invoices for ambulance service, and allows the tracking of invoice status (i.e. paid/outstanding) . In order to ensure correct invoice recipients and amounts, PHSA and BCEHS must acquire two key pieces of information from the MSC: 1.

Whether or not the patient had MSP coverage on the date of service; and 2. If the patient was eligible for MSP coverage, whether or not the patient was entitled to supplementary benefits on the date of service. The acquisit ion of these two key pieces of information is managed by three applications of which staff at PHSA's Ambulance Billing Services Department and BCEHS staff are the primary users: PCIS, PC-DES and Gateway. • PCIS calls the HCIM system for either find Candidates or Get Demographics with a request for information about the patient. PCIS also creates a nightly file to request the following .

Whether or not the patient had MSP coverage on the date of service. This information is contained in the Report of Eligibility Flag field, which reports either "Y" indicating that the patient had MSP coverage on the date of service or "N" indicating that the patient did not have MSP coverage on the date of service. ISA: 19-095 Page 13 of 21

~1inim v of I lcalth . Information Sharing Agreement • PC-DES identifies patients who were eligible for MSP coverage on the date of service and who are entitled to supplementary benefits on the date of service using the MoH Rapid . This information is contained in the Adjustment Description field which reports either "PVC" and "Y" indicating that the patient was entitled on the date of service, or "PVC" and "N" indicating that the patient was not entitled on the date of service.

As the Adjustment Description field may contain other information, some parsing of the returned value is required to extract the "PVC" text and the "Y" or "N" from the field. • Gateway creates a batch file (known as the WVJ file) containing those patients ' information. The batch file is sent via the BCEHS SFTP server to the MOH server (using Secure File Transfer Protocol) where it is processed overnight and the next day a file is returned indicating the type of supplementary benefits for which each patient may qualify for.

The possible indicator values are: • "D" -- Health Canada; • "P" -- On Premium Assistance/Supplementary Benefits & Mental Health & Extended Care; • "I" -- Ministry of Social Development & Poverty Reduction; • "N" -- Corrections & Refugees & all others that do not meet PHSA and BCEHS requ irements . • Blank - Indicating the PHN is not in the RAPID system . • · Gateway adjust the bill type, invoice recipient or suppresses the invoice .. A data file is sent to RMS to generate invoices for services rendered .

Description of Data Flows 1) An initial patient record is created and includes the patient's demographics, billing status (MSP, ICBC , WSBC etc.), the treatment the patient received from paramedics, transport information and dispatch data (event number, service date and location etc.).

This information is entered into Siren through the electronic form of the Patient Care Record (ePCR) by the paramedics using a tablet. 2) PCIS then begins to process the data and does a check of the patient demographics with HCIM (Healthc are Client Identity Management System) to ensure the right person is identified/found. 3) HCIM collects data from PCIS . 4) HCIM discloses data to PCIS . 5) PCIS receives a data feed from HCIM. ISA: 19-095 Page 14 of 21

M inistr y of lkahh . Information Sharing Agreement 6) Once the ePCR is deemed ready by PCIS to proceed for invoice processing, PCIS creates a feed. A subset of this feed is sent to RAPID (HIBC database on the mainframe) to confirm if the person is eligible for MSP coverage at the time of the ambulance service event. 7) RAPID receives a data feed from PCIS. 8) RAPID discloses a data feed to PC-DES. 9) When the file returns from RAPID indicating the person is covered by MSP, the record is batched with other similar records. All records are then processed in PC-DES for invoicing.

PC-DES accesses RAPID through an MOH server to determine eligibility. 10)Once the person is confirmed as being covered and before the invoice is issued , a final check with Client Registry is made to ensure the person is not deceased. 11) Once PC-DES finishes the invoicing process, a rate is assigned to the bill and the bill type may be reassigned and then exported to Gateway. 12) Gateway receives the data from PC-DES. Gateway sends a file to RAPID again, to confirm if the person is covered by subsidy (Supplementary Benefits). If the file returns a response of I or P to the question, the invoice is suppressed.

If the file returns a D the invoice is redirected to Health Canada. Gateway uses encrypted SFTP to securely transport the files. Gateway creates a data file with account receivable line items to be sent to the RMS system. The invoices are batched and sent to BC Mail to be printed and mailed. ISA: 19-095 Page 15 of 21

M ini try of I leJlth Information Sharing Agreement Appendix C - Data File Layout Eligibility Batch Request File Body Fields from BCEHS Field Name Descriotlon Data Tvoe Lenath Comments BCEHS_ID Unique identifier of Numeric 17 Values less than 17 the record in the (Unsigned Long digits in length will BCEHS system Integer) be padded with leading zeros (date of service resides in columns 10 to 17) Run Sequence Identifier used to Numeric 1 Used internally by denote type of run BCEHS (Pre/Post 1 - if Pre run verification) 2 - if Post run Not used 10 Blanks PHN The patient's BC Numeric 10 Personal Health (Unsigned Long Number lnteqer) Not used 27 Blanks Subsidy or Placeholder to Character 1 Blank Supplementary denote possible or Benefits supplementary Indicator benefits indicator Not used 18 Blanks Not used 9 Blanks Not used 10 Blanks Not used 9 Blank s Page 16 of 21

Mi nis1ry of l k~1hh ' Information Sharing Agreement For the Subsidy or supplementary benefits request/response file, the items returned by RAPID are in RED.

Unique identifier of the Numeric Values less than 17 record in the BCEHS (Unsigned digits in length will be system Long padded with leading lnte er zeros Run Sequence Identifier used to denote Numeric 1 Used internally by type of run (Pre/Post BCEHS verification) 1 - if Pre run 2 - if Post run Not used 10 Blanks PHN The patient's BC Personal Numeric 10 Health Number (Unsigned Long lnte er Not used 27 Blanks Supplementary The type of supplementary Character 1 Allowable values are Benefits benefits for which the "I", "P", "D", Blank, or Indicator patient was eligible on the "N".

If the patient was date of service . not eligible for supplementary benefits on the Date of Service the PA TYPE field will contain a 'N'. A blank value indicates the Personal Health Number is not in the RAPID s stem. Not used 18 Blanks Not used 9 Zeros Not used 10 Blanks Not used 9 Zeros Page 17 of 21

Ministry of Health . A.1:m.endix D - Data Narrative Number Description Collection, Use, (Follows Appendix 8) Disclosure 1 An initial patient record is created and includes the patient's Collection by demograp hics, billing status (MSP, ICBC, WSBC etc.), the PHSA and BCEHS trea tment the patient received from paramedics, transport information and dispatch data (event number , service date and location etc.).

This information is entered into Siren through the electronic form of the Patient Care Record (ePCR) by the paramedics using a tablet. 2 PCIS then begins to process the data and does a check of the Use and patient demograph ics with HCIM to ensure the right perso n is Disclosure by identified/found. PHSA and BCEHS 3 HCIM collects data from PCIS. Collection by MOH 4 HCIM discloses data to PCIS. Disclosur e by MOH 5 PCIS receives a data feed from HCIM.

Collect ion by PHSA and BCEHS Information Sharing Agreement Purpose Authority the relevant pu rpose in FOIPPA s. 26(c) - the informa t ion relates th is context is for billing , directly to and is necessary for a program or which is included as a activ ity of a public body. purpose in the BCEHS Notice of Collection FOIPPA s. 26(a) - Expressly authorized unde r (compliant with FOIPPA

an Act, in accorda nce with the Client Registry 27 (2)) System/Enterpr ise Master Pat ient Index Designation Order purs uant to t he E-Heo/th Act. to ensure the right FOIPPA s. 33.2 -A public body may disclose perso n is identified / found information referred to in

section 33 inside Canada as follows : (

a) for the pu rpose for which it was obtained or compi led or for a consistent purpose . to ensure the right FOIPPA s. 26(a) - Expressly authorized under person is identified / found

an Act, in accorda nce with the Client Registry System/Enterprise Master Pat ient Index Designat ion Order pu rsuant to the E-Heolth Act. to ensure the right FOIPPA s. 33.l(

c) of FOIPPA- Expressly perso n is identified/found autho rized under

an Act, in accorda nce the Client Registry System/Enter prise Maste r Patient Index Designation Order pursuant to the £-Health Act. to ensure the right FOIPPA s. 26(a) - Expressly authorized under person is identified

an Act, in accordance the Client Registry System/E nterprise Master Patient Index Designation Orde r purs uant to t he £-Health Act. FOIPPA s. 26(c) - the info rmation relate s direct ly to and is necessary for a prog ram or activity of the public body . Page 18 of 21

Number MiniMrv of Health, Descript ion (Follows Appendix B) 6 Once the ePCR is deemed ready by PCIS to proceed for invoice processing, PCIS creates a feed. A subset of this feed is sent to RAPID (HIBC database on the mainframe) to confirm if the person is eligible for MSP coverage at the time of the ambulance service event. 7 RAPID receives a data feed from PCIS. 8 RAPID discloses a data feed to PC-DES. 9 When the file returns from RAPID indica ting the person is covered by MSP, the record is batched with other similar records. All records are then processed in PC-DES for invoicing.

PC-DES accesses RAPID through an MOH server to determine eligibility. 10 Once the person is confirmed as being covered and before the invoice is issued, a fina l check with Client Registry is made to ensure the person is not deceased.

Collection, Use, Disclosure Disclosure by PHSA and BCEHS Collect ion by MOH Disclosure by MOH Collection by PHSA and BCEHS Use by PHSA and BCEHS Information Sharing Agreement Purpose Autho rity FOIPPA s. 27(1){a)( iii)- indirect collection authorized by another enactment. to confirm if the person is FOIPPA s. 33.2 - A publ ic body may disclose eligible for MSP cpverage informat ion referred to in sect ion 33 inside at the t ime of the Canada as follows : ambulance service provision (

a) for the purpose for which it was obtained or compiled or for a consistent purpose . to confirm if the person is FOIPPA s. 26 (

c) the information relates eligible for MSP coverage direct ly to and is necessary fo r a program or at the time of the activity of the pub lic body. ambulance service provis ion to confirm if the person is FOIPPA s. 33.2 - A public body may disclose eligible for MSP coverage informat ion referred to in

section 33 inside at the time of the Canada as fol lows: ambulance service provision (

a) for the purpose for which it was obtained or compiled or for a consisten t purpose. to determine if a bill ing FOIPPA s. 26(c) - the informat ion relates subsidy is available directly to and is necessary for a program or activity of a public body. to dete rm ine if the FOIPPA s. 32 (c) - for a purpose for which person is now deceased that information may be disclosed to a public and their estate must be body under sections 33 to 36. billed 33.1 (1) (

i) If: (

i) The disclosur e if for the purposes of collection amounts owing to the government of Britis h Columbia or a publ ic body. Page 19 of 21

Number Ministrv of H.:alth . Description (Follows Appendix B) 11 Once PC-DES finishes t he invoicing process, a rate is assigned to the bill and the bill type may be reassigned and then exported to Gateway. 12 Gateway receives the data from PC-DES. Gateway sends a file to RAPID again, to confirm if the person is covered by subsidy (Supplementary Benefits). If the file returns a response of " I" or "P" to the question, the invo ice is suppressed. If the file returns a "D", the invoice is redirected to Health Canada. Gateway uses encrypted SFTP to securely transport the files.

Gateway creates a data file with account receivab le line items to be sent to the RMS system . The invoices are batched and sent to BC Mail to be prin ted and mailed . Collection, Use, Disclosure Use by PHSA and BCEHS Use by PHSA and BCEHS Information Sharing Agreement Purpose Aut hority assigning a bill rate FOIPPA s. 32 (c) - for a purpose for whic h t hat information may be disclosed to a pub lic body under sect ions 33 to 36. 33.1 (1) (

i) If: (

i) The disclosure if for t he purposes of collection amounts owin g to t he government of Brit ish Columb ia or a public body . to comp ile the final billing FOIPPA s. 32(c) -for a purpose for wh ich that info rmation infor mation may be disclosed t o a public body under sections 33 to 36. 33.1 (1) (

i) If: (

i) The disclosure is for t he purposes of collect ion amou nts owing to the government of British Columbia or a public body. Page 20 of 21

Ministn- of I k1!1h .

Information Sharing Agreement Appendix E - Batch File Transmission Processes MSP Claim5 Reque st Batch File Transmi ssion Process I Moly 20111 BCEHS MSP C ~ll'h •.tlll.H!~I l,al\.11 t~ : 1:smm•HL'••J lv Mo H Sr1P St-Mr •'Ii ~t:-:Uf._. f:"TP B MoH SFTP Sorvcr R'lti P•)n ~ fill!!- 1s o ul'-ild hO!'ll :hi! llo'i S F TP '3t.-i.·e.r M~'OfflJ C. (!l'\(...,t)'$ ff'lt M,b1m11& o ur.-. rM ti.IA irom lh& ,'-Oc.pr-.nr-.,: hie :,,tt ML>tt S Fi P 9Ch'tt IO lM u~'<totH u a ,~ (-S J :fl~• )J-3;_ 1•.u4.- fl~ SC1vt1 bt,,J I~ :o the MoH Sf TP de<:' )t.:!l ,: !!:C'h'[f Moxlmus Malnframo r.1;un•1:ir.Ul p ull~ MSF C:l;;-rnt.

File Tran sfer Server , '.;"1.,;~,: • t-.,:::h rie- , ~ p,o:~t!ll~ 110m 1h1: t,Mi,;11111.:,- r.) :u --i~re, ,a:r•~ r Rapid . FIio Transfor applic ation M ~ tnfl' r>fNt 1>ueior. ' M t •.'9~ 1'.,1',~ lilt 10 lhotl M~)IOlfJ 'J: r 1.e Tr:a:l'rle r ~ ,,..er Page 21 of 21

Document details

Collection	British Columbia — Orders in Council
Citation	O.C. 183/2022
Type	order_in_council
Volume / chapter	arc oic 0183 2022
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	f94f1ede2aefab20b77e08272f80e7c8d3d63459

Source file is stored in the law ingest library (pdf).