MLA Meeting Guide

Note: This document was developed to help support you and your loved ones in having conversations with your MLAs about getting the MSP virtual group medical visit cap raised. It includes answers to the questions that MLAs are commonly asking. While this document focuses on the BC-CLMF and complex chronic disease, much of the general information will work for patients of all clinics.

Don't rely on this document alone! We have been supporting people before, during, and after meeting with their MLAs for the last half-year. Contact us to arrange a coaching call ahead of your meeting. We can also arrange for a LifeLineBC representative or a physician to attend the meeting with you.

Summary of the Issue:

The BC Centre for Long COVID, ME/CFS, and Fibromyalgia (BC-CLMF) provides an innovative, cost-effective, multidisciplinary chronic disease care model for individuals with ME/CFS, fibromyalgia, and Long COVID. This model offers a reduced cost to the system by using only MSP billing and leveraging group medical visit fee codes.

MSP Telehealth Group Medical Visit (TGMV) attendance caps, scheduled to take effect in the first quarter of 2026, will collapse the clinic model, leaving over 5,000 British Columbians living with ME/CFS, Fibromyalgia, and Long COVID without specialized care. This loss of desperately needed specialist care will increase the burden on primary care providers, specialists, and emergency medicine, overburdening an already strained health system. 

In order to save this innovative and deeply needed care model, we are asking for your support in telling Minister Osbourne that the cap on virtual group medical visits must be raised from 20 to 50, or other funding streams established, to maintain and expand this vitally important care. 

Why is this care so important?

As of 2019, an estimated 902,800 Canadians (2.4%) were living with ME/CFS and/or fibromyalgia. The COVID-19 pandemic exacerbated the situation, with over 3 million Canadians currently affected by Long COVID, which has significant overlap with ME/CFS and fibromyalgia. Individuals with ME/CFS, fibromyalgia, and Long COVID are high consumers of health care, but often report unmet needs and face challenges in accessing appropriate care. Thus, this patient population often ends up seeking care from overburdened primary care providers or at urgent care and emergency departments that are not equipped to manage complex chronic conditions.

Patients with ME/CFS are:

• 3x more likely to have 10+ GP visits

• 1.5x more likely to have seen specialists

• 2x more likely to have received overnight hospitalization

• 2x more likely to have to have used mental health services

• 2x more likely to report unmet health needs

How does the model work?

The BC-CLMF provides an innovative, multidisciplinary complex chronic disease care model that offers immediate access to all aspects of the program upon referral, preventing bottlenecks and reducing wait times to access care. Each patient receives a 1:1 consultation with an internal medicine specialist. Follow-up visits are primarily group-based and include medical visits, medication visits, patient education groups, and special lecture series run by physicians and multidisciplinary allied health such as physiotherapists, occupational therapists, and registered dietitians. 

This model:

• Allows for high-quality, individualized physician care

• Facilitates access for hundreds of patients each week

• Allows for rapid access to specialist expertise and allied health treatment options 

• Eases the burden on other specialist referrals like cardiac, rheumatology, and neurology

• Provides a shared care model with general practitioners to best meet patient needs

What is unique about this model?

The model provides access to specialist care immediately, offering a holistic approach that incorporates evidence-based medication, lifestyle, and psychosocial interventions. This model allows patients to access resources at any time during their illness or remission, preventing the need for repeat referrals and wait lists for conditions that are frequently relapsing and remitting. The group model allows for shared learning among and between patients in a way that is lost in programs that consist only of 1:1 treatment. Patients often praise the sense of community this clinic gives them while they deal with incredibly isolating diseases. 

The virtual-first model supports patients from all over the province, many of whom reside in communities with no specialists who can manage their care, and most of whom are housebound due to the severity of their illness. Patient data from the clinic shows that 43% of patients live over one hour away from St. Paul’s Hospital, a site where the clinicians deliver some in-person services, and almost 1 in 5 patients lives in a rural or remote community.

What is the impact on the healthcare system?

Losing access to this care will increase overall costs to the system, as patients with these conditions have much higher healthcare utilization when not appropriately treated. Complex chronic disease patients being forced to leave specialized care will overload an already overburdened system. Access to this clinic reduces ER visits, specialist referrals, and hospitalizations. 

Existing Telehealth Group Medical Visits are frequently filled and have waitlists. Wait times for 1:1 intakes with the clinic’s physicians are steadily increasing, with the current wait period for 1:1 intake projected at up to 3.7 years and many new referrals received daily. Without access to virtual group medical visits, these patients will seek care from their primary care providers, other specialists, and urgent and emergency care.

The BC-CLMF is supportive of a cap that ensures high-quality care across the province. However, limiting the cap to 20 creates significant unintended consequences, greatly extending wait times for patients and rendering this clinic model not feasible without additional funding. This would slow access for patients, increasing prescription waits from 6 weeks to over 6 months and specialist expertise from weeks to years. If the clinic has to discontinue group visits and revert to 1:1 appointments, it would increase cost per visit for MSP, as 1:1 telehealth sessions are generally 7 times more expensive on average.

What does this mean for referring providers?

Over 2,300 health care practitioners have made referrals to the BC-CLMF. Reducing the cap from 50 to 20 patients per TGMV will cut access to direct patient care by 60% at the BC-CLMF.

If this cap is not lifted, over 6,000 patients will be forced to shift the majority of their health care needs back to primary care providers and emergency departments who lack the training to effectively manage these conditions and care for them properly. 

Does the new MSP cap cause equity issues?

Reducing the cap from 50 to 20 patients per TGMV will cut access to direct patient care by 60% at the BC-CLMF. Notably, this cap only pertains to TGMVs, while in-person GMVs continues to have no cap. This presents a significant equity issue, as most patients of BC-CLMF are not able to access in-person care due to a lack of specialists in their area, living outside the Lower Mainland, and/or being house- or bedbound due to the severity of their conditions. Patient data from the clinic shows that 43% of patients live over one hour away from St. Paul’s Hospital, a site where the clinicians deliver some in-person services, and almost 1 in 5 patients lives in a rural or remote community. Furthermore, the patient population is overwhelmingly female (84%), with many living at or below the poverty line due to disability.

Can group care provide the level of care required for these patients?

The BC-CLMF recognizes the importance of balancing access to care and ensures each patient always has the opportunity for a private 1:1 with the interacting physician as well as follow ups as needed. In addition, the clinic provides 1:1 interaction with patients in its TGMVs. 

This model has significant strengths for effective patient treatment. It greatly increases the number of patients seen by specialist physicians while maintaining a high standard of individual care. In a standard model, the clinic would see 80 follow-up specialist visits weekly. In the group visit model this doubles to 160 follow-ups, while also taking on new patient consultations each week. This provides timely access to specialist care, reducing wait times, and ensuring timely and equitable access to care for this patient population. 

What can I do to support this model?

Write in support of raising the TGMV cap to 50 to Minister of Health Josie Osborne at HLTH.Minister@gov.bc.ca, and cc info@lifelinebc.ca. Please make sure to ask that they lift the Telehealth Group Medical Visit from 20 to 50. 

Do you want more help preparing for your MLA meeting? Reach out to us! We have been supporting people with MLA meetings about this issue since Summer 2025, and we're happy to share our experience with you to help you be the most effective advocate for your health care you can be! We may also be able to attend the meeting with you, or arrange for a physician to attend with you as well. Contact us today to find out more!