Details of Transfer Payment Programs (TPPs)


Name of Transfer Payment Program:
Grant for the Territorial Medical Travel Fund - Nunavut

Start date: April 2005

End date: March 2010

Description: To support the medical travel fund
(Voted)

Strategic Outcome: Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:

  • Address the significant and immediate pressures facing the Nunavut in the area of medical travel expenditures
  • Offset a portion of the territories' medical travel costs; and
  • Enable the territories to redirect resources to alternative sustainable health reform initiatives.
Program Activity: First Nations and Inuit Health Programming and Services - Nunavut

($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 10.2 10.2 10.2 10.2 10.2 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 10.2 10.2 10.2 10.2 10.2 0.0

Comment(s) on Variance(s):

Audit completed or planned:

Evaluation completed or planned:



Name of Transfer Payment Program:
Grant for the Territorial Health Access Fund and Operational Secretariat - Yukon

Start date: September 2005

End date: March 2010

Description: Grant for the territorial Health Access Fund and Operational Secretariat.
(Voted)

Strategic Outcome: Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:

Program Activity:

  • Strengthened, integrated sustainable health promotion and illness prevention strategies;
  • Enhanced alcohol and drug services, programs, and treatment options;
  • Improved public health services and emergency preparedness and response measures and oral health;
  • Reduced frequency of acute care facilities utilization;
  • Enhanced application of e-health and telehealth solutions;
  • Increased out-reach services to outlying communities;
  • Improved health professional recruitment and retention strategies;
  • Improved access to specialized physician and diagnostic services;
  • Supported territorial-based education and training for health professionals and para-professionals
  • Improved in-territory services to population groups with special needs; and
  • Enhanced medical travel information collection and collation capacity.
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 6.3 6.3 6.3 6.3 6.3 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 6.3 6.3 6.3 6.3 6.3 0.0

Comment(s) on Variance(s):
Completed in 2010

Audit completed or planned:

Evaluation completed or planned:



Name of Transfer Payment Program:
Payments to First Nations and Inuit Health Services Transfer

Start date: April 2007

End date: March 2012

Description:
To increase responsibility and control by First Nations and Inuit for their own health programs and services to improve health conditions for First Nations and Inuit people.

Strategic Outcome:
Better Health outcomes and reduction of Health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Increased control or accountability by First Nations and Inuit for their own of health care programs and services.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 0 213.7 243.6 266.4 266.4 (22.8)
Total Other types of transfer payments            
Total Program Activity(ies) 0 213.7 243.6 266.4 266.4 (22.8)

Comment(s) on Variance(s):
Additional resources were required to stabilize primary care services. It is also expected that this class grows over time as it supports the increasing desire of First Nations and Inuit to assume management of health programs and services and the opportunity to redesign these programs and services so that they are more suited to local priorities.

Audit completed or planned:

Evaluation completed or planned:
Planned as part of the funding models evaluation in 2011-12



Name of Transfer Payment Program:
Contributions for First Nations and Inuit Health Governance and Infrastructure Support

Start date: April 2005

End date: March 2010

Description:
Health Governance and Infrastructure Support aims to increase First Nations and Inuit control over health programs and services. Activities include: health planning and management; health research, knowledge and information management; health consultation and liaison; health delivery and infrastructure; integration and adaptation of health services; and health human resources.
(Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Improved health status of First Nations and Inuit through strengthened governance and infrastructure.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 124.3 148.6 216.2 164.2 164.2 52.0
Total Other types of transfer payments            
Total Program Activity(ies) 124.3 148.6 216.2 164.2 164.2 52.0

Comment(s) on Variance(s):
The original resources allocated to this program exceeded needs in 2009-2010. A realignment of resources to other programs will be requested in future years. When comparing actual spending (11) to total authorities (10), there is no variance.

Audit completed or planned:

Evaluation completed or planned:
Evaluation of the funding models planned in 2011-12



Name of Transfer Payment Program:
Contributions for First Nations and Inuit Community Programs

Start date: April 2005

End date: March 2010

Description:
Community programs support child and maternal-child health; mental health promotion; addictions prevention and treatment; chronic disease prevention and health promotion services.
(Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Increased participation of First Nations and Inuit individuals, families, and communities in programs and supports Improved continuum of programs and services in First Nations and Inuit communities.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 315.3 285.1 240.9 265.9 265.9 (25.0)
Total Other types of transfer payments            
Total Program Activity(ies) 315.3 285.1 240.9 265.9 265.9 (25.0)

Comment(s) on Variance(s):
The needs of the community programs were higher than expected.

Audit completed or planned:

Evaluation completed or planned:
Children and Youth Cluster completed in 2010; Evaluations planned for Mental Health and Addictions and Chronic Disease and Injury Prevention Clusters in 2010-11.



Name of Transfer Payment Program:
Contributions for First Nations and Inuit Health Facilities and Capital Program

Start date: April 2005

End date: March 2010

Description:
Provides funding to eligible recipients for the construction acquisition, leasing, operation and maintenance of nursing stations, health centres, health stations, health offices, treatment centres, staff residences, and operational support buildings.
(Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Increase availability of health facilities, equipment and other moveable assets in First Nations and Inuit communities that support the provision of health services.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 55.7 66.1 47.3 98.7 98.7 (51.4)
Total Other types of transfer payments            
Total Program Activity(ies) 55.7 66.1 47.3 98.7 98.7 (51.4)

Comment(s) on Variance(s):
Additional resources were required for construction and renovation of infrastructure for First Nations and Inuit health services.

Audit completed or planned:
Audit of Health Facilities and Capital Program planned in 2010-2011.

Evaluation completed or planned:
Planned in 2010-11



Name of Transfer Payment Program:
Contributions for First Nations and Inuit Health Benefits

Start date: April 2005

End date: March 2010

Description:
A limited range of medically necessary health-related goods and services which supplement those provided through other private or provincial/territorial health insurance plans is provided to registered Indians and recognized Inuit. Benefits include drugs, dental care, vision care, medical supplies and equipment, short-term crisis intervention mental health services, and transportation to access medical services not available on reserve or in the community of residence.
(Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Access by eligible clients to Non-Insured Health benefits.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 148.1 150.0 139.8 167.1 166.7 (26.9)
Total Other types of transfer payments            
Total Program Activity(ies) 148.1 150.0 139.8 167.1 166.7 (26.9)

Comment(s) on Variance(s):
Additional resources were required to stabilize the Non-Insured health Benefits Program. Growth in spending for this program was higher than anticipated.

Audit completed or planned:
Audit of Non-Insured Health Benefits - Medical Transportation planned in 2010-2011.

Evaluation completed or planned:
Planned in 2010-11



Name of Transfer Payment Program:
Contributions for First Nations and Inuit Health Protection

Start date: April 2005

End date: March 2010

Description:
Communicable Disease and Environmental Health and Research programs facilitate prepardness to implement measures in the control, management and containment of outbreaks of preventable diseases and improve management and control of environmental hazards.
(Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:

  • Environmental health risk management contributes to improved health status of First Nations individuals, families and communities
  • Improved access to quality well-coordinated communicable disease prevention and control programs for First Nations and Inuit individuals, families, and communities.
Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 30.9 24.4 18.6 29.4 27.4 (8.8)
Total Other types of transfer payments            
Total Program Activity(ies) 30.9 24.4 18.6 29.4 27.4 (8.8)

Comment(s) on Variance(s):
Additional resources were received through Supplementary Estimates (B) for H1N1 influenza pandemic.

Audit completed or planned:

Evaluation completed or planned:
Communicable Disease Control and Environmental Health an Environmental Research Clusters planned in 2010-2011.



Name of Transfer Payment Program:
Contributions for First Nations and Inuit Primary Health Care

Start date: April 2005

End date: March 2010

Description:
Primary Health Care services include emergency and acute care health services, Community primary health care services which include illness and injury prevention and health promotion activities. These programs also include: the First Nations and Inuit Home and Community Care; and the Oral Health Strategy.
(Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Improved access to quality well-coordinated culturally appropriate primary health care programs and services for First Nations and Inuit individuals, families and communities.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 92.6 147.9 124.1 144.6 144.6 (20.5)
Total Other types of transfer payments            
Total Program Activity(ies) 92.6 147.9 124.1 144.6 144.6 (20.5)

Comment(s) on Variance(s):
Nursing costs continue to increase beyond planned spending. Additional resources were required to stabilize primary care services.

Audit completed or planned:
Audit of Primary Care
Nursing Services planned in 2010-2011.

Evaluation completed or planned:
Planned in 2011-12



Name of Transfer Payment Program:
Contributions for Bigstone Non-Insured Health Benefits Pilot Project

Start date: April 2005

End date: March 2010

Description:
Administration and delivery of benefits with Bigstone Health Commission to registered Indians and recognized Inuit.
(Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Improved access to quality well-coordinated culturally appropriate primary health care programs and services for First Nations and Inuit individuals, families and communities.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 9.5 10.0 8.8 10.4 10.4 (1.6)
Total Other types of transfer payments            
Total Program Activity(ies) 9.5 10.0 8.8 10.4 10.4 (1.6)

Comment(s) on Variance(s):

Audit completed or planned:

Evaluation completed or planned:



Name of Transfer Payment Program:
Contributions to the Organization for the Advancement of Aboriginal People=s Health (OAAPH)

Start date: April 2005

End date: March 2010

Description:
To support the Organization for the Advancement of Aboriginal People's Health
(Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Continued empowerment of Aboriginal peoples through advancements in knowledge and sharing of knowledge on Aboriginal health.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 5.0 5.0 5.0 5.0 5.0 0.0
Total Other types of transfer payments            
Total Program Activity(ies) 5.0 5.0 5.0 5.0 5.0 0.0

Comment(s) on Variance(s):

Audit completed or planned:

Evaluation completed or planned:
Completed in 2009



Name of Transfer Payment Program:

Start date: November 2006

End date: March 2013

Description:
This program is to support the mental wellness of former Indian Residential School students, their families and communities by providing:

  • resolution health support services, delivered by Resolution Health Support Workers;
  • Elder support;
  • support during truth and reconciliation and commemoration events;
  • research and communication activities in support of the mental wellness of former IRS students, and an overall increased awareness of and demand for mental health services available to former IRS students and their families during the resolution process.
    (Voted)

Strategic Outcome:
Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results Achieved:
Services which are culturally sensitive, holistic, comprehensive, effective and efficient, ultimately improving emotional and mental wellness of former Indian Residential School students. Services allow former IRS students to disclose accounts of childhood sexual and physical abuses in a safe and effective manner.

Program Activity:
First Nations and Inuit Health Programming and Services
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 8.2 18.8 7.2 24.1 24.0 (16.8)
Total Other types of transfer payments            
Total Program Activity(ies) 8.2 18.8 7.2 24.1 24.0 (16.8)

Comment(s) on Variance(s):
Additional resources were received through Supplementary Estimates (C) to face increased demand for this program.

Audit completed or planned:

Evaluation completed or planned:
Completed in 2006



Name of Transfer Payment Program:
Contributions in support of the Federal Tobacco Control Strategy

Start date: July 1, 2007

End date: March 31, 20112 (T&Cs expire March 31, 2012)

Description:
The purpose of the Federal Tobacco Control Strategy (FTCS) Contribution Program is to contribute to the achievement of FTCS objectives through assistance to provinces, non governmental organizations, researchers and other tobacco control stakeholders. In 2007, the Government of Canada announced new goals and objectives for the Federal Tobacco Control Strategy until 2011. These are:

Goal:
Reducing the overall smoking prevalence from 19% (2005) to 12% by 2011.

The new objectives are to:

  • Reduce the prevalence of Canadian youth (15 17) who smoke from 15% to 9%;
  • Increase the number of adult Canadians who quit smoking by 1.5 million;
  • Reduce the prevalence of Canadians exposed daily to second hand smoke from 28% to 20%;
  • Examine the next generation of tobacco control policy in Canada;
  • Contribute to the global implementation of the World Health Organization's Framework Convention on Tobacco Control; and
  • Monitor and assess contraband tobacco activities and enhance compliance.

Strategic Outcome:
Reduced health and environmental risks from products and substances and healthy, sustainable living and working environments

Results Achieved:
With over 70 projects in place, the following results are some highlights:
Support for the coordination of a practice based research project which facilitates the development, testing, and implementation of hospital based smoking cessation programs within New Brunswick and British Columbia. The expected results of this project include improved institutional policies and systems related to the systematic identification and treatment of tobacco users at hospitals in Canada.

  • Continued support to organizations to facilitate knowledge transfer and exchange and networking in tobacco control, including support for the 65th National Conference on Tobacco or Health, held in Montréal and Edmonton, November 2007.
  • Support for the to community health centres in the four Inuit regions across Canada for which expectant and new mothers to help and support them quit smoking, including the training of 52 community health worker. A smoke-free awareness campaign is also being delivered in northern communities as part of this project.
  • Support for the implementation of a comprehensive smoking cessation program in 21 out-patient clinics in Ontario, New Brunswick and British Columbia. The expected results include the treatment of 15,000 smokers; the training of more than 2,000 health care providers on tobacco addiction treatment and the adoption in clinics across the country of best practices established through this project.
  • Established a national practice based research network to facilitate research and knowledge exchange
  • to inform on the development of tobacco cessation guidelines for use in clinical practice, as well as in population based strategies.
  • Support of four grants to international multi-lateral and non-governmental organisations. This funding supports two grants related to the program of work of the WHO Framework Convention on Tobacco Control - Convention Secretariat as well as two capacity building and implementation projects in Latin America.
Program Activity:
Substance Use and Abuse
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 2.8 7.4 15.8 12.7 12.7 3.1
Total Other types of transfer payments            
Total Program Activity(ies) 2.8 7.4 15.8 12.7 12.7 3.1

Comment(s) on Variance(s):
Delays in projects resulted in the variance.

Audit completed or planned:

Evaluation completed or planned:
The Federal Tobacco Control Strategy incorporates a full summative evaluation which includes process and impact evaluations. A preliminary impact evaluation report is due in October 2010 and final deliverables are expected in March 2011.



Name of Transfer Payment Program:
Drug Treatment Funding Program

Start date:
October 2007 - Services component
April 2008 - Systems component

End date:
March 31, 2012 (Services component)
March 31, 2013(systems component)

Description:
Drug Treatment Funding Program (DTFP), under the National Anti Drug Strategy, provides $111 million in financial support over five years to provincial and territorial governments to support illicit drug treatment services for at risk youth, and to assist in strengthening the quality of drug treatment services. An additional $10M over five years is designated support for a project in Vancouver's Downtown Eastside.

Strategic Outcome:
Reduced health and environmental risks from products and substances and healthy, sustainable living and working environments

Results Achieved:

  • The DTFP approved funding for 7 system projects (Nfld, PEI, NB, ON, MB, YK, and BC), bringing the total number of approved projects to 13. Contribution agreements were signed for two projects bringing the total number of contribution agreements to 5 with a cumulative funding value of $15.2M. It is anticipated that the remaining contribution agreements will be signed in 2010/11. Funded projects focus on all 3 DTFP investment areas (implementation of best practices, enhancing knowledge exchange, and strengthening performance measurement and evaluation).
  • As of March 31, 2010, 6 contribution agreements were signed for treatment services projects bringing the total to 8 with a cumulative funding value of $24.8M.
  • While treatment projects are in the early stages of implementation, evidence to date indicates significant progress in establishing community partnerships and linkages in support of new and enhanced treatment services, and enhanced collaboration amongst P/Ts on national level activities such as the development, collection and reporting of national treatment indicators.
  • In 2009/10, 8 projects invested in new staff hires, orientation and training activities in order to deliver new treatment services.
  • Funded projects have already helped to produce a wider range of services by developing partnerships within the community, expanding hours of service, offering different locations when working with clients and offering a range of activities to help attract youth to their services.
Program Activity:
Substance Use and Abuse
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions n/a 1.4 26 6 5.9 20.1
Total Other types of transfer payments            
Total Program Activity(ies) n/a 1.4 26 6 5.9 20.1

Comment(s) on Variance(s):
Delays in projects resulted in the variance. When comparing actual spending (11) against total authorities (10), there is a variance of $0.1 million.

Audit completed or planned:
No audits were completed in 2009-10.

Evaluation completed or planned:
DTFP has invested significant resources (financial and human) in the development of project-level performance measurement and evaluation plans. Of the 24 approved projects, 13 plans are completed or near completion and the remaining plans are under development. DTFP has a contract in place to complete two synthesis reports which will be available in 2010-11. These reports will highlight common themes and areas of focus from the systems and services proposals. In addition, DTFP will be conducting an interim evaluation in 2010-11, which will include an in-depth review of five projects to determine the extent to which progress is being made towards Program outcomes. Standardized reporting templates were developed and are currently being used by funded projects.



Name of Transfer Payment Program:
Drug Strategy Community Initiatives Fund (voted contribution dollars)

Start date: April 2004

End date: Ts & Cs renewed effective April 1, 2010

Description:
The Drug Strategy Community Initiatives Fund will contribute to reducing drug use among Canadians, particularly among vulnerable populations such as youth, by focussing on health promotion and prevention approaches to address drug abuse before it happens. The objectives of the Fund are to facilitate the development of local, provincial, territorial, national and community based solutions to drug use among youth and to promote public awareness of illicit drug use among youth. The Program is delivered through Health Canada's regional and national offices.

Strategic Outcome: Reduced health and environmental risks from products and substances and healthy, sustainable living and working environments

Results Achieved:

  • Received and reviewed a total of 184 applications for funding as part of a staggered Call for Proposals (CFP) in 2009-10 across the regions.
  • As of March 31, 2010, under the recent CFP, 1 new project in Manitoba/ Saskatchewan was funded in 2009-10 and a total of 22 new projects have been approved for funding starting in fiscal 2010-11 under the National Anti Drug Strategy: British Columbia 3; Alberta 2; Manitoba/Saskatchewan 5; Atlantic 5, and Ontario 7.
  • CCSA=s "A Drug Prevention Strategy for Canada's Youth." focused on developing Canadian standards for the design and delivery of prevention programs, sustainable partnerships, and a media/youth consortium. Their website Xperiment.ca continues to attract new visitors and 657 partnerships have been included in the Compendium of Organizations. CCSA has conducted baseline Stakeholders and Youth awareness surveys.
  • During 2009 2010, DSCIF met with NCPC to discuss a potential joint strategic national project. Instead of providing funding support NCPC participated on the Review Committee to assess a national strategic project.
Program Activity:
Substance Use and Abuse
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 8.7 4.9 11.5 9 9 2.5
Total Other types of transfer payments            
Total Program Activity(ies) 8.7 4.9 11.5 9 9 2.5

Comment(s) on Variance(s):
Delays in projects resulted in the variance.

Audit completed or planned:
No project audits were completed in 2009-10.
4-6 six audits will be carried out in 2010-11 subject to RAPB Branch plans.

Evaluation completed or planned:

  • The DSCIF Formative evaluation of the 2008-09 CFP was suspended in April 2009, in order to include results from the new 2009-10 CFP. A Preliminary Findings report on the first CFP was submitted in early 2009-10. A new contract to complete the formative evaluation on the two DSCIF CFPS began in March 2010.
  • A cluster evaluation plan has been developed to capture project level outcomes as contributors to the objectives/outcomes of the overall program. In 2009-10, the external contractor was hired to begin the implementation of this evaluation.
  • In an effort to enhance evaluation and reporting capacity of funding recipients, new evaluation training workshops were planned and implemented. 7 workshops were carried out to accommodate funded projects in all Health Canada regions.


Name of Transfer Payment Program:
Assessed Contribution to the Pan-American Health Organization (PAHO)

Start date: April 15, 2008

End date: March 31, 2013

Description:
To support Canada=s membership in PAHO

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Canada receives direct and indirect benefits from its membership in PAHO. Attendance at meetings of the governing bodies and at expert consultations provides a forum for the wider dissemination of Canadian based values related to health and the provision of health care services and public health approaches. Participation by Canadian health experts ensures bilateral linkages are created and maintained with key countries in Latin America and the Caribbean.

The Director of PAHO annually reports the Organization's accomplishments and how it has spent its resources to meet stated objectives. Health Canada provides a website link to PAHO's website: (http://www.paho.org/English/gov/govbodies index.htm).

Program Activity:
International Health Affairs
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions n/a 12.0 12.5 13 13 -0.5
Total Other types of transfer payments            
Total Program Activity(ies) n/a 12 12.5 13 13 -0.5

Comment(s) on Variance(s):
The payment to PAHO is to be made in US currency. With the exchange rates fluctuating, the equivalent in Cdn dollars at the time of payment was higher than expected.

Audit completed or planned:
No audit was completed nor is planned. International organizations have their own audit activities, the results of which are shared with member states of PAHO. As a member state, Canada participates and influences this work through active involvement in budgetary discussions.

Evaluation completed or planned:
A DFAIT initiative provides the opportunity to review Canadian membership in international organisations every five years. In the context of this initiative, Health Canada will likely review its participation in PAHO in 2011. In addition, PAHO is funded under the International Health Grants Program (IHGP) for which a mid-point review was undertaken in 2010. An IHGP summative evaluation will also be completed by December 2012. Both of these exercises under IHGP include PAHO as one of the program=s annual contributions.



Name of Transfer Payment Program:
Grant to Canadian Blood Services

Start date: April 2000

End date: Ongoing

Description:
To support basic, applied and clinical research on blood safety and effectiveness issues through the auspices of Canadian Blood Services.

Strategic Outcome:
Access to safe and effective health products and food information for healthy choices

Results Achieved:
Continued improvements to basic applied and clinical research on blood safety and effectiveness.

Program Activity:
Health Products
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 5 5 5 5 5 0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 5 5 5 5 5 0

Comment(s) on Variance(s):

Audit completed or planned:

Evaluation completed or planned:
October, 2012



Name of Transfer Payment Program:
Official Languages Health Contribution Program
[replaces: Contribution Program to Improve Access to Health Services for Official Language Minority Communities 2003-2004 to 2008-2009]

Start date: April 1, 2009

End date: March 31, 2013

Description:

In December 2008, the Government of Canada approved the Official Languages Health Contribution Program, for the 2008-2009 to 2012-2013 periods. In addition to ongoing funding of $23M from the former Contribution program to improve access to health services for official language minority communities, additional funds totalling $59.3M were provided over the five-year period. The total commitment of $174.3M comprises $170 M which is dedicated to program contributions and $4.3 M is for Health Canada operations. The new funds are pursuant to the government's Roadmap for Canada's Linguistic Duality 2008-2013: Acting for the Future, which was announced on June 18, 2008 by the Honourable Josée Verner, Minister of Canadian Heritage, Status of Women and Official Languages and Minister for La Francophonie.

The new program has two principal objectives:

  • improved access to health services for English speaking communities in Quebec and French speaking communities in other provinces and territories;
  • increased use of both official languages in the provision of health services in Canada.

These objectives are realized through the following three mutually reinforcing program components.

a) Health Networking ($22M over 2008 2009 to 2012 2013):
The approach used for improving access to services for the French speaking and English speaking communities is based on community partnership networks as a focal point for activities and initiatives to engage communities and health stakeholders in improving their health care. The approach enables communities to engage various stakeholders as partners in initiatives for improving access to health care services for official language minority communities (OLMCs) that are integrated within provincial and territorial health systems. Primary funding recipients are the Société Santé en français (SSF) for the promotion of Francophone networks and the Community Health and Social Services Network (CHSSN) for the Anglophone networks in Quebec.

b) Training and Retention of Health Professionals ($114.5M over 2008 2009 to 2012 2013):
This component provides funding for post secondary training of Francophone health professionals in OLMCs outside Quebec, and promotes the recruitment of students into francophone post secondary health training programs and their re integration into OLMCs upon graduation. It also funds cultural and French language training to bilingual health professionals to improve their ability to provide health services to Francophone minority language communities. In Anglophone minority communities in Quebec, funding is targeted to language training and retention initiatives to ensure that health professionals have opportunities to improve their ability to work in both official languages and to practice where they can meet the needs of OLMCs. Finally, this component also promotes research and information sharing. Funding recipients include the member institutions of the Consortium national de formation en santé (CNFS) and McGill University's Training and Human Resources Development Project. The SSF and the Consortium are the recipients for the cultural and French language training activity.

c) Official Languages Health Projects ($33.5M over 2009 2010 to 2012 2013):
This component aims to improve the health of OLMCs and especially their most vulnerable members such as seniors, youth and infants. Funding is provided for several projects, including strategies to develop, retain and mobilize health human resources within French OLMCs; development of sustained health information products and tools to facilitate access to health services within networks; provision of improved front line health service expertise in the minority official language; support to regional and local health and social service agencies and community organizations in implementing new programs and best practices for access to health services in the minority official language; development of volunteer health and social support services for OLMCs within local networks, institutions and health organizations and; evidence based assessment and dissemination of the effectiveness of initiatives to improve access to health services in the minority language. Funding recipients will include the SSF for the coordination of health services projects in Francophone communities and the CHSSN for the English speaking minority language communities.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:

23 contribution agreements were launched with educational institutions and community-based organisations for the engagement of new program activities to address program objectives.

965 students new student registrations were accepted in 2009-2010 into training programs sponsored through the ten post-secondary institutions and one provincial government agency (New Brunswick) funded under the coordination of the Consortium national de formation en santé.

McGill University coordinated language training activities in 2009-2010 for some 1000 health professionals in Quebec to improve their ability to service English-speaking minority communities.

New projects aimed at improving the health and health access of official language minority communities were implemented in 2009-2010. For example, a new French-language telehealth site was launched in Manitoba under the sponsorship of the Société Santé en français and an initiative to improve access to health and social services in English in the Estrie region of Quebec was launched through the Community Health and Social Services Network.

Further information regarding these projects is available from the websites of Program recipients:

  • Société Santé en français [http://santefrancais.ca/]
  • Community Health and Social Services Network [http://www.chssn.org/]
  • Consortium national de formation en santé [http://www.cnfs.net/]
  • McGill University [http://www.mcgill.ca/hssaccess/]
Program Activity:

($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 30.6 27.9 34 35.5 35.5 -1.5
Total Other types of transfer payments            
Total Program Activity(ies) 30.6 27.9 34 35.5 35.5 -1.5

Comment(s) on Variance(s):
In 2009 2010, $2M in additional funding wase provided to the 11 member institutions making up the Consortium national de formation en santé to promote its activities/programs and recruit students, to expand the scope of distance learning, to strengthen clinical training through the purchase of medical equipment and to strengthen continuous learning by recruiting teaching personnel. In addition, some program recipients did not spend the entire contribution to which they were entitled in 2009-2010, which brought the actual spending to $35.5M.

Audit completed or planned:

Evaluation completed or planned:



Name of Transfer Payment Program:
Health Care Policy Contribution Program (Voted)

Start date: September 24, 2002

End date: March 31, 2013

Description:
The Program provides policy analysis and advice to support the First Ministers' commitment to a more accessible, high-quality, sustainable and accountable health system that will be adaptable to the needs of Canadians. The Program was established to support research to identify, assess and promote new approaches, models and best practices that respond to health care system priorities, both emerging and on-going, and to foster strategic and evidence-based decision-making for quality health care. The Program has continued to evolve in response to health care system priorities in a changing environment and currently manages agreements within the Health Care System Innovation Component, the Canadian Medication Incident Reporting and Prevention System, the Pan-Canadian Health Human Resources Strategy, and the Internationally Educated Health Professionals Initiative.

The Health Care System Innovation Component aims to support projects to broaden the base of evidence to inform policy decisions leading to improvements in the accessibility, quality, sustainability and accountability of the health care system in Canada.

The Canadian Medication Incident Reporting and Prevention System (CMIRPS) aims to reduce harm caused by preventable medication incidents through activities such as the collection and analysis of standardized incident data and the development and dissemination of information including best practices in safe medication use systems.

The goal of the Health Human Resources Strategy (HHRS) is to aid in the establishment and maintenance of a stable and optimal health workforce. The federal government commits $20 million annually to the HHRS. The HHRS is pursuing four key strategic directions: More health care providers; Using human resources skills effectively; Creating healthy, supportive, learning workplaces; and More effective planning and forecasting

The Internationally Educated Health Professionals Initiative (IEHPI) is designed to facilitate the integration of internationally educated health professionals by assisting them in obtaining licensure and reducing barriers to practice within the Canadian health care workforce. The ultimate goal is to increase the number of internationally educated health professionals in the health care workforce. In the spring 2005 budget, the Canadian government committed $75 million to support IEHPI over its first five years and $18M annually thereafter. The IEHPI is complementary to the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications announced by the Forum of Labour Market Ministers in 2009.

The Patient Wait Times Guarantee (PWTG) Pilot Project Fund is a three-year initiative (2007-08 through 2009-10) to assist provinces and territories to develop and test innovative approaches to inform the establishment of guarantees, including options for alternate care (recourse) when set time frames for specific health services have been exceeded.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
The Health Care System Innovation Component directed funding toward research and knowledge transfer activities to support innovation and implementation of best practices in key policy areas such as wait times, aging and end of life care.

CMIRPS projects continued to contribute to system level changes to improve the safety of medication use in Canada. For example, through ISMP Canada's individual practitioner incident report analyses, discussions continued with pharmaceutical manufacturers to inform enhancements to labelling and packaging. Over 30 improvements have been made by manufacturers since the inception of CMIRPS. In addition, project results have led Accreditation Canada to include three additional areas of requirements related to medication safety in its 2009 Required Organizational Practices (ROPs): i) dangerous abbreviations, symbols and dose designations, ii) Heparin storage and availability, and iii) Narcotic (opioid) storage and availability. To date, more than 50 recommended system-based safeguards from medication incident analysis learning have been incorporated into Accreditation Canada standards.

The Pan-Canadian Health Human Resource Strategy and the Internationally Educated Health Professionals Initiative enable Health Canada to maintain a leadership role in priority areas of HHR. Some examples include:

  • Investments in new or innovative programs across the country that help: to increase the number of qualified providers entering the health workforce; to increase productivity of health care providers by making full use of their skills; and to improve access to health care services for all Canadians, particularly in underserved areas. In FY 2009-10, there were 25 projects focused on this investment with activities such as: identifying interventions that were effective in improving workforce utilization; addressing access in rural and remote settings; and modernizing health education.
  • Continued work with provinces and territories, professional organizations and other key stakeholders to enable more effective health human resources planning and forecasting for an affordable, sustainable health care system. In FY 2009-10, eight projects supported this priority through activities such as the development of tools, models and research.

Notable accomplishments through the IEHPI include substantial gains in areas such as the development of assessment, bridging, path-finding, orientation and workplace oriented language and communication programs for specific groups of internationally educated health professionals. For example, new assessment programs for internationally educated nurses are now operating in Western and Atlantic provinces and self-assessment tools have been developed for internationally educated midwives and occupational therapists. A central website has been developed for international medical graduates and a Faculty Development Program was implemented at 17 medical schools. To address orientation needs, an interdisciplinary orientation program to the Canadian health care system is now available in-person and online.

The PWTG Pilot Project Fund funded 12 pilot projects in 6 provinces and 2 territories, covering a range of clinical areas and approaches to improve wait times management and inform the development of wait times guarantees. Those projects ended as of March 31, 2010, with final project evaluation reports to be completed by June 2010, and have supported provincial/territorial commitments to implement guarantees by 2010.

Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 43.4 40.6 46.1 41.5 40.9 5.2
Total Other types of transfer payments            
Total Program Activity(ies) 43.4 40.6 46.1 41.5 40.9 5.2

Comment(s) on Variance(s):
Estimates of planned spending can be impacted by a variety of factors throughout the year, many beyond the control of Health Canada or the contribution recipient. Projects can be delayed, rescheduled or withdrawn altogether. Projects are monitored closely and potential surpluses are identified as early as possible.

Audit completed or planned:
In 2009/10, the Program completed three recipient audits that were initiated in 2008/09. Two recipient audits were initiated in 2009/10 and are expected to be completed in 2010/11.

Evaluation completed or planned:
Health Canada will complete an evaluation of the PWTG Pilot Project Fund in late 2010. The summative evaluation of the Program is scheduled to take place in 2011/12.



Name of Transfer Payment Program:
Named Grant to the Canadian Patient Safety Institute (CPSI)

Start date: December 10, 2003

End date: March 31, 2013

Description:
CPSI is an independent not-for-profit corporation mandated to provide leadership and coordinate the work necessary to build a culture of patient safety and quality improvement throughout the Canadian health system. CPSI promotes leading ideas and best practices, raises awareness and provides advice on effective strategies to improve patient safety.

This named grant provides financial assistance to support CPSI's efforts to implement the provisions in the 2003 First Ministers' Accord on Health Care Renewal towards improving health care quality by strengthening system co-ordination and national collaboration related to patient safety. CPSI's grant agreement was renewed in 2008 for a five-year period, beginning April 1, 2008 and ending March 31, 2013.

Strategic Outcome:
Strategic Outcome(s)
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
To fulfill its mandate, CPSI continues to: lead and coordinate campaigns, programs and interventions to improve safety in targeted areas; adapt international, evidence-based practices to the Canadian context; support local teams and leaders in implementing initiatives and sustaining momentum; promote public awareness of patient safety issues and support patients and families to participate in the safety improvement processes; and develop and support partnerships with provinces and territories, health regions, and health care organizations. For example:

  • The Safer Healthcare Now! campaign now includes over 1100 teams that are active throughout the country implementing 10 evidence-based interventions and contributing to significant reductions in areas like in-hospital death rates from heart attacks, central line blood stream infections, ventilator-associated pneumonia infection rates and surgical site infections;
  • Canadian Patient Safety Week 2009 focused on "Ask. Listen. Talk.", using 10,000 posters, 20,000 table tents, and 100,000 newspapers across the country;
  • Training was delivered to increase capacity in local organizations through the Executive Patient Safety Series, the Canadian Patient Safety Officer Course, and Root Cause Analysis, Safe Surgery Saves Lives, Human Factors, and Hand Hygiene workshops, as well as through the opportunities provided to participants with the hosting the Canadian Healthcare Safety Symposium (Halifax Series) and Canada's Forum on Patient Safety and Quality Improvement;
  • Broadened scope of research was funded, collaborating with partners to develop a greater understanding of patient safety issues related to home care and emergency medical services, in addition to ongoing funding of its patient safety research program;

In addition, as set out in its Strategic Plan, CPSI continued to provide leadership and coordination of efforts to prevent and reduce harm to patients, with an emphasis on four key areas: education; interventions and programs; research; and tools and resources.

Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 7.6 8.0 8.0 8.0 8.0 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 7.6 8.0 8.0 8.0 8.0 0.0

Comment(s) on Variance(s):

Audit completed or planned:
The Institute's financial records are reviewed and audited annually by independent external accountants.

Evaluation completed or planned:
As per their Funding Agreement, CPSI is required to submit a final evaluation report to the Minister by March 31, 2012, and to make that report public.



Name of Transfer Payment Program:
Grant to the Canadian Partnership Against Cancer (Voted)

Start date: April 1, 2007

End date: March 31, 2012

Description:
The Canadian Partnership Against Cancer is responsible for implementing the Canadian Strategy for Cancer Control, a five-year plan with the following objectives: (1) to reduce the expected number of new cases of cancer among Canadians; (2) to enhance the quality of life of those living with cancer; and (3) to lessen the likelihood of Canadians dying from cancer.

The mandate of the Canadian Partnership Against Cancer corporation (CPACC) is to provide a leadership role with respect to cancer control in Canada, through the management of knowledge and the coordination of efforts among provinces and territories, cancer experts, stakeholder groups and Aboriginal organizations to champion change and improve health outcomes related to cancer. The Canadian Partnership Against Cancer will act as a pan-Canadian resource to provide the most up-to-date knowledge across strategic priority areas including prevention, screening/early detection, re-balancing the focus towards patient-centred care, clinical practice guidelines, health human resources, standards, as well as supporting key research activities and facilitating the development of a pan-Canadian surveillance system.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Over the past year, the Partnership has made some significant gains, for example:

  • a National Colorectal Cancer Screening Network is now in place;
  • colorectal, HPV and cervical screening initiatives are accelerating the development of quality screening programs for colorectal and cervical cancers by encouraging interprovincial sharing of methods, quality initiatives and outreach programs;
  • work to develop tools, resources and knowledge necessary to improve the journey in the cancer system for patients and their families (e.g. distress screening and survivorship initiatives) has begun;
  • Cancer View Canada, a bilingual online resource to facilitate data sharing and collaboration within the cancer system, has been launched;
  • the CAREX Canada project, which aims to identify and map the presence and prevalence of workplace and environmental carcinogens across the country, is well underway;
  • in June, 2008, CPACC, in collaboration with several provincial partners, launched The Canadian Partnership for Tomorrow Project - a landmark cancer cohort study of 300,000 Canadians that explores how genetics, environment, lifestyle and behaviour contribute to the development of cancer. Data collection has begun and recruitment of participants is continuing;
  • The Canadian Platform To Increase Usage of Real-World Evidence (CAPTURE) initiative has been launched and aims to establish a platform for developing, validating and enabling the use of common indicators and tools to evaluate primary prevention policies and programs. To date an environmental scan of nutrition, physical activity and alcohol policies and programs has been completed and a review of these policies is underway; and
  • The Coalitions Linking Action & Science for Prevention (CLASP) initiative has been launched and works to promote the integration of cancer control activities with other chronic disease prevention initiatives. To date environmental scans have been completed to identify existing primary prevention activities in Canada, so that what's happening in the field can be better understood.
Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 28.8 58.2 57.5 57.5 57.5 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 28.8 58.2 57.5 57.5 57.5 0.0

Comment(s) on Variance(s):

Audit completed or planned:
An Audit of the Partnership is planned for fiscal year 2011-2012.

Evaluation completed or planned:
An evaluation has been completed and is awaiting formal approval by the Department.



Name of Transfer Payment Program:
Named Grant for the Mental Health Commission of Canada (Voted)

Start date: April 1, 2008

End date: March 31, 2017

Description:
As part of Budget 2007, the Government of Canada announced funding for the establishment of a Mental Health Commission of Canada, an independent, arm's length organization, tasked with a mandate to conduct an anti-stigma campaign, build a pan-Canadian Knowledge Exchange Centre, and facilitate/animate a process to elaborate a national mental health strategy for Canada. The structure and role of the Commission is based on the recommendations of the Standing Senate Committee on Social Affairs, Science and Technology, in its comprehensive report on mental health, mental illness and addiction in Canada, entitled "Out of the Shadows at Last".

In serving as a national focal point for addressing mental health and mental illness, the Commission will undertake a more targeted approach to addressing these issues in Canada; foster improved coordination and information sharing among mental health stakeholders and the public health community; and encourage a better public understanding of mental health and mental illness nationally.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
The Commission has made significant headway since its inception in 2007, in its ability to build partnerships and bring national awareness to the challenges of mental health and illness. Progress has been made on many of its mandated activities, specifically:

  • Mental Health Strategy for Canada - The framework for the national strategy was publicly released in November 2009. The document, which reflects input from broad consultations in early 2009, sets out the vision and seven high-level goals for a mental health system transformation. Now in the second phase, the Commission is focusing on 'how' to achieve the vision and seven goals in diverse sectors and population groups. Seven roundtables with diverse stakeholders will have been held between March and July 2010, and the Commission is considering a mix of roundtables, policy papers, research projects, and online consultations to further develop the strategy. The MHCC will continue to engage all levels of government and members of the mental health community throughout this process. A final strategy document is targeted for 2012.
  • Anti-stigma / Anti-discrimination Initiative - The initiative, now entitled Opening Minds, was launched on October 2, 2009, in Calgary. The launch also coincided with public awareness campaign on mental health, funded by the MHCC and involving the media consortium CTV/Globe Media. The target audience for the initiative, which has focussed on children and youth, and healthcare providers, has just recently been expanded to include the workplace.
Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 0 7.5 12.0 12.0 12.0 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 0 7.5 12.0 12.0 12.0 0.0

Comment(s) on Variance(s):

Audit completed or planned:
As outlined in the Grant funding agreement, the Commission must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2009-10 audited financial statements have now been completed and were presented to the Board of Directors for approval during their meeting on June 6, 2010.

Evaluation completed or planned:
As a requirement of the funding agreement with Health Canada, the Commission must undertake an initial independent evaluation during 2010/2011. A request for proposals was released by the Commission in early May 2010 to engage a third party. Health Canada continues to work closely with the Commission throughout this process and is participating as a member of an advisory committee to oversee the evaluation.



Name of Transfer Payment Program:
Grant to the Canadian Agency for Drugs and Technologies in Health (CADTH) (Voted)

Start date: April 1, 2005

End date: March 31, 2013

Description:
CADTH is an independent not-for-profit corporation funded by federal, provincial, and territorial governments to provide credible, impartial advice and evidence-based information about the effectiveness of drugs and other health technologies to Canadian health care decision-makers. The Named Grant's purpose is to provide financial assistance to support CADTH's core business activities, namely: the Common Drug Review (CDR), Health Technology Assessment (HTA), and the Canadian Optimal Medication Prescribing and Utilization Service (COMPUS).

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Evidence-based information that supports informed decisions on the effectiveness of drugs and health technologies, in terms of health outcomes and cost.

Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 17.2 16.9 16.9 16.9 16.9 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 17.2 16.9 16.9 16.9 16.9 0.0

Comment(s) on Variance(s):

Audit completed or planned:
Per Audit Plan approved by the Senior Management Board (SMB) to be reviewed by the Departmental Audit Committee (DAC), CADTH audit has moved to 2011-12.

Evaluation completed or planned:
An independent evaluation of CADTH's core business activities is required as part of Health Canada's 2008-13 funding agreement with CADTH. The funding agreement stipulates that this evaluation cover April 1, 2007 - March 31, 2011, and be submitted to the Minister by December 31, 2011. The evaluation is intended to assess CADTH's performance in achieving the purpose of the Grant, including CADTH's value-for-money.



Name of Transfer Payment Program:
Grant to the Health Council of Canada

Start date: September 1, 2004

End date: March 31, 2015

Description:
The Health Council was established by First Ministers in the 2003 Accord on Health Care Renewal with the mandate to report on jurisdictional progress in meeting Accord commitments. The Health Council's mandate was expanded by First Ministers in the 2004 Health Accord to report on health outcomes and the health status of Canadians.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Along with on-going work to support its mandate, in 2009/10 the Council:

  • Released two reports on primary health care: Teams in Action: Primary Health Care Teams in Canada and Getting it Right: Case Studies of Effective Management of Chronic Disease Using Primary Health Care Teams.
  • Released a report on governments' progress towards the 2004 Accord commitments related to pharmaceuticals management: A Prescription Unfilled: A Status Report on the National Pharmaceuticals Strategy
  • Collaborated with McMaster University on a expert forum to identify barriers and potential opportunities for advancing primary health care in Canada.

Analysed data from the 2008 Canadian Survey of Experiences with Primary Health Care, and the 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults to create two electronic news bulletins about Canadians with chronic health conditions, and the care they receive: Safer Care for "Sicker" Canadians, and Helping Patients Help Themselves.

Program Activity:
Health Policy, Planning & Information
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 6.4 6.2 10.0 10.0 4.8 5.2
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 6.4 6.2 10.0 10.0 4.8 5.2

Comment(s) on Variance(s):
The annual operating budget of the Health Council can be up to $10M per year. The Health Council's 2009-10 work plan, approved by Corporate Members, requested $6.3M. Actual spending was less than planned due to delays in the implementation of projects under the Council's approved workplan.

Audit completed or planned:
The Council's financial records are reviewed and audited annually by independent external accountants. Audited financial statements can be found on the Council's website: http://www.healthcouncilcanada.ca

Evaluation completed or planned:
As per their Funding Agreement, the Council is required to submit a final evaluation framework to the Minister by March 31, 2010, and a final evaluation report by March 31, 2014.



Name of Transfer Payment Program:
Health Care Policy Contribution Program (Voted)

Start date: September 24, 2002

End date: March 31, 2013

Description:
The Program provides policy analysis and advice to support the First Ministers' commitment to a more accessible, high-quality, sustainable and accountable health system that will be adaptable to the needs of Canadians. The Program was established to support research to identify, assess and promote new approaches, models and best practices that respond to health care system priorities, both emerging and on-going, and to foster strategic and evidence-based decision-making for quality health care. The Program has continued to evolve in response to health care system priorities in a changing environment and currently manages agreements within the Health Care System Innovation Component, the Canadian Medication Incident Reporting and Prevention System, the Pan-Canadian Health Human Resources Strategy, and the Internationally Educated Health Professionals Initiative.

The Health Care System Innovation Component aims to support projects to broaden the base of evidence to inform policy decisions leading to improvements in the accessibility, quality, sustainability and accountability of the health care system in Canada.

The Canadian Medication Incident Reporting and Prevention System (CMIRPS) aims to reduce harm caused by preventable medication incidents through activities such as the collection and analysis of standardized incident data and the development and dissemination of information including best practices in safe medication use systems.

The goal of the Health Human Resources Strategy (HHRS) is to aid in the establishment and maintenance of a stable and optimal health workforce. The federal government commits $20 million annually to the HHRS. The HHRS is pursuing four key strategic directions: More health care providers; Using human resources skills effectively; Creating healthy, supportive, learning workplaces; and More effective planning and forecasting.

The Internationally Educated Health Professionals Initiative (IEHPI) is designed to facilitate the integration of internationally educated health professionals by assisting them in obtaining licensure and reducing barriers to practice within the Canadian health care workforce. The ultimate goal is to increase the number of internationally educated health professionals in the health care workforce. In the spring 2005 budget, the Canadian government committed $75 million to support IEHPI over its first five years and $18M annually thereafter. The IEHPI is complementary to the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications announced by the Forum of Labour Market Ministers in 2009.

The Patient Wait Times Guarantee (PWTG) Pilot Project Fund is a three-year initiative (2007-08 through 2009-10) to assist provinces and territories to develop and test innovative approaches to inform the establishment of guarantees, including options for alternate care (recourse) when set time frames for specific health services have been exceeded.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
The Health Care System Innovation Component directed funding toward research and knowledge transfer activities to support innovation and implementation of best practices in key policy areas such as wait times, aging and end of life care.

CMIRPS projects continued to contribute to system level changes to improve the safety of medication use in Canada. For example, through ISMP Canada's individual practitioner incident report analyses, discussions continued with pharmaceutical manufacturers to inform enhancements to labelling and packaging. Over 30 improvements have been made by manufacturers since the inception of CMIRPS. In addition, project results have led Accreditation Canada to include three additional areas of requirements related to medication safety in its 2009 Required Organizational Practices (ROPs): i) dangerous abbreviations, symbols and dose designations, ii) Heparin storage and availability, and iii) Narcotic (opioid) storage and availability. To date, more than 50 recommended system-based safeguards from medication incident analysis learning have been incorporated into Accreditation Canada standards.

The Pan-Canadian Health Human Resource Strategy and the Internationally Educated Health Professionals Initiative enable Health Canada to maintain a leadership role in priority areas of HHR. Some examples include:

  • Investments in new or innovative programs across the country that help: to increase the number of qualified providers entering the health workforce; to increase productivity of health care providers by making full use of their skills; and to improve access to health care services for all Canadians, particularly in underserved areas. In FY 2009-10, there were 25 projects focused on this investment with activities such as: identifying interventions that were effective in improving workforce utilization; addressing access in rural and remote settings; and modernizing health education.

  • Continued work with provinces and territories, professional organizations and other key stakeholders to enable more effective health human resources planning and forecasting for an affordable, sustainable health care system. In FY 2009-10, eight projects supported this priority through activities such as the development of tools, models and research.

Notable accomplishments through the IEHPI include substantial gains in areas such as the development of assessment, bridging, path-finding, orientation and workplace oriented language and communication programs for specific groups of internationally educated health professionals. For example, new assessment programs for internationally educated nurses are now operating in Western and Atlantic provinces and self-assessment tools have been developed for internationally educated midwives and occupational therapists. A central website has been developed for international medical graduates and a Faculty Development Program was implemented at 17 medical schools. To address orientation needs, an interdisciplinary orientation program to the Canadian health care system is now available in-person and online.

The PWTG Pilot Project Fund funded 12 pilot projects in 6 provinces and 2 territories, covering a range of clinical areas and approaches to improve wait times management and inform the development of wait times guarantees. Those projects ended as of March 31, 2010, with final project evaluation reports to be completed by June 2010, and have supported provincial/territorial commitments to implement guarantees by 2010.

Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants            
Total Contributions 43.4 40.6 46.1 41.5 40.9 5.2
Total Other types of transfer payments            
Total Program Activity(ies) 43.4 40.6 46.1 41.5 40.9 5.2

Comment(s) on Variance(s):
Estimates of planned spending can be impacted by a variety of factors throughout the year, many beyond the control of Health Canada or the contribution recipient. Projects can be delayed, rescheduled or withdrawn altogether. Projects are monitored closely and potential surpluses are identified as early as possible.

Audit completed or planned:
In 2009/10, the Program completed three recipient audits that were initiated in 2008/09. Two recipient audits were initiated in 2009/10 and are expected to be completed in 2010/11.

Evaluation completed or planned:
Health Canada will complete an evaluation of the PWTG Pilot Project Fund in late 2010. The summative evaluation of the Program is scheduled to take place in 2011/12.



Name of Transfer Payment Program:
Named Grant to the Canadian Patient Safety Institute (CPSI)

Start date: December 10, 2003

End date: March 31, 2013

Description:
CPSI is an independent not-for-profit corporation mandated to provide leadership and coordinate the work necessary to build a culture of patient safety and quality improvement throughout the Canadian health system. CPSI promotes leading ideas and best practices, raises awareness and provides advice on effective strategies to improve patient safety.

This named grant provides financial assistance to support CPSI's efforts to implement the provisions in the 2003 First Ministers' Accord on Health Care Renewal towards improving health care quality by strengthening system co-ordination and national collaboration related to patient safety. CPSI's grant agreement was renewed in 2008 for a five-year period, beginning April 1, 2008 and ending March 31, 2013.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
To fulfill its mandate, CPSI continues to: lead and coordinate campaigns, programs and interventions to improve safety in targeted areas; adapt international, evidence-based practices to the Canadian context; support local teams and leaders in implementing initiatives and sustaining momentum; promote public awareness of patient safety issues and support patients and families to participate in the safety improvement processes; and develop and support partnerships with provinces and territories, health regions, and health care organizations. For example:

  • The Safer Healthcare Now! campaign now includes over 1100 teams that are active throughout the country implementing 10 evidence-based interventions and contributing to significant reductions in areas like in-hospital death rates from heart attacks, central line blood stream infections, ventilator-associated pneumonia infection rates and surgical site infections;

  • Canadian Patient Safety Week 2009 focused on "Ask. Listen. Talk.", using 10,000 posters, 20,000 table tents, and 100,000 newspapers across the country;

  • Training was delivered to increase capacity in local organizations through the Executive Patient Safety Series, the Canadian Patient Safety Officer Course, and Root Cause Analysis, Safe Surgery Saves Lives, Human Factors, and Hand Hygiene workshops, as well as through the opportunities provided to participants with the hosting the Canadian Healthcare Safety Symposium (Halifax Series) and Canada's Forum on Patient Safety and Quality Improvement;

  • Broadened scope of research was funded, collaborating with partners to develop a greater understanding of patient safety issues related to home care and emergency medical services, in addition to ongoing funding of its patient safety research program;

In addition, as set out in its Strategic Plan, CPSI continued to provide leadership and coordination of efforts to prevent and reduce harm to patients, with an emphasis on four key areas: education; interventions and programs; research; and tools and resources.

Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 7.6 8.0 8.0 8.0 8.0 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 7.6 8.0 8.0 8.0 8.0 0.0

Comment(s) on Variance(s):

Audit completed or planned:
The Institute's financial records are reviewed and audited annually by independent external accountants.

Evaluation completed or planned:
As per their Funding Agreement, CPSI is required to submit a final evaluation report to the Minister by March 31, 2012, and to make that report public.



Name of Transfer Payment Program:
Grant to the Canadian Partnership Against Cancer (Voted)

Start date: April 1, 2007

End date: March 31, 2012

Description:
The Canadian Partnership Against Cancer is responsible for implementing the Canadian Strategy for Cancer Control, a five-year plan with the following objectives: (1) to reduce the expected number of new cases of cancer among Canadians; (2) to enhance the quality of life of those living with cancer; and (3) to lessen the likelihood of Canadians dying from cancer.

The mandate of the Canadian Partnership Against Cancer corporation (CPACC) is to provide a leadership role with respect to cancer control in Canada, through the management of knowledge and the coordination of efforts among provinces and territories, cancer experts, stakeholder groups and Aboriginal organizations to champion change and improve health outcomes related to cancer. The Canadian Partnership Against Cancer will act as a pan-Canadian resource to provide the most up-to-date knowledge across strategic priority areas including prevention, screening/early detection, re-balancing the focus towards patient-centred care, clinical practice guidelines, health human resources, standards, as well as supporting key research activities and facilitating the development of a pan-Canadian surveillance system.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Over the past year, the Partnership has made some significant gains, for example:

  • a National Colorectal Cancer Screening Network is now in place;

  • colorectal, HPV and cervical screening initiatives are accelerating the development of quality screening programs for colorectal and cervical cancers by encouraging interprovincial sharing of methods, quality initiatives and outreach programs;

  • work to develop tools, resources and knowledge necessary to improve the journey in the cancer system for patients and their families (e.g. distress screening and survivorship initiatives) has begun;

  • Cancer View Canada, a bilingual online resource to facilitate data sharing and collaboration within the cancer system, has been launched;

  • the CAREX Canada project, which aims to identify and map the presence and prevalence of workplace and environmental carcinogens across the country, is well underway;

  • in June, 2008, CPACC, in collaboration with several provincial partners, launched The Canadian Partnership for Tomorrow Project - a landmark cancer cohort study of 300,000 Canadians that explores how genetics, environment, lifestyle and behaviour contribute to the development of cancer. Data collection has begun and recruitment of participants is continuing;

  • The Canadian Platform To Increase Usage of Real-World Evidence (CAPTURE) initiative has been launched and aims to establish a platform for developing, validating and enabling the use of common indicators and tools to evaluate primary prevention policies and programs. To date an environmental scan of nutrition, physical activity and alcohol policies and programs has been completed and a review of these policies is underway; and

  • The Coalitions Linking Action & Science for Prevention (CLASP) initiative has been launched and works to promote the integration of cancer control activities with other chronic disease prevention initiatives. To date environmental scans have been completed to identify existing primary prevention activities in Canada, so that what's happening in the field can be better understood.
Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 28.8 58.2 57.5 57.5 57.5 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 28.8 58.2 57.5 57.5 57.5 0.0

Comment(s) on Variance(s):

Audit completed or planned:
An Audit of the Partnership is planned for fiscal year 2011-2012.

Evaluation completed or planned:
An evaluation has been completed and is awaiting formal approval by the Department.



Name of Transfer Payment Program:
Named Grant for the Mental Health Commission of Canada (Voted)

Start date: April 1, 2008

End date: March 31, 2017

Description:
As part of Budget 2007, the Government of Canada announced funding for the establishment of a Mental Health Commission of Canada, an independent, arm's length organization, tasked with a mandate to conduct an anti-stigma campaign, build a pan-Canadian Knowledge Exchange Centre, and facilitate/animate a process to elaborate a national mental health strategy for Canada. The structure and role of the Commission is based on the recommendations of the Standing Senate Committee on Social Affairs, Science and Technology, in its comprehensive report on mental health, mental illness and addiction in Canada, entitled "Out of the Shadows at Last".

In serving as a national focal point for addressing mental health and mental illness, the Commission will undertake a more targeted approach to addressing these issues in Canada; foster improved coordination and information sharing among mental health stakeholders and the public health community; and encourage a better public understanding of mental health and mental illness nationally.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
The Commission has made significant headway since its inception in 2007, in its ability to build partnerships and bring national awareness to the challenges of mental health and illness. Progress has been made on many of its mandated activities, specifically:

  • Mental Health Strategy for Canada - The framework for the national strategy was publicly released in November 2009. The document, which reflects input from broad consultations in early 2009, sets out the vision and seven high-level goals for a mental health system transformation. Now in the second phase, the Commission is focusing on 'how' to achieve the vision and seven goals in diverse sectors and population groups. Seven roundtables with diverse stakeholders will have been held between March and July 2010, and the Commission is considering a mix of roundtables, policy papers, research projects, and online consultations to further develop the strategy. The MHCC will continue to engage all levels of government and members of the mental health community throughout this process. A final strategy document is targeted for 2012.

  • Anti-stigma / Anti-discrimination Initiative - The initiative, now entitled Opening Minds, was launched on October 2, 2009, in Calgary. The launch also coincided with public awareness campaign on mental health, funded by the MHCC and involving the media consortium CTV/Globe Media. The target audience for the initiative, which has focussed on children and youth, and healthcare providers, has just recently been expanded to include the workplace.
Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 0 7.5 12.0 12.0 12.0 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 0 7.5 12.0 12.0 12.0 0.0

Comment(s) on Variance(s):

Audit completed or planned:
As outlined in the Grant funding agreement, the Commission must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2009-10 audited financial statements have now been completed and were presented to the Board of Directors for approval during their meeting on June 6, 2010.

Evaluation completed or planned:
As a requirement of the funding agreement with Health Canada, the Commission must undertake an initial independent evaluation during 2010/2011. A request for proposals was released by the Commission in early May 2010 to engage a third party. Health Canada continues to work closely with the Commission throughout this process and is participating as a member of an advisory committee to oversee the evaluation.



Name of Transfer Payment Program:
Grant to the Canadian Agency for Drugs and Technologies in Health (CADTH) (Voted)

Start date:April 1, 2005

End date: March 31, 2013

Description:
CADTH is an independent not-for-profit corporation funded by federal, provincial, and territorial governments to provide credible, impartial advice and evidence-based information about the effectiveness of drugs and other health technologies to Canadian health care decision-makers. The Named Grant's purpose is to provide financial assistance to support CADTH's core business activities, namely: the Common Drug Review (CDR), Health Technology Assessment (HTA), and the Canadian Optimal Medication Prescribing and Utilization Service (COMPUS).

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Evidence-based information that supports informed decisions on the effectiveness of drugs and health technologies, in terms of health outcomes and cost.

Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 17.2 16.9 16.9 16.9 16.9 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 17.2 16.9 16.9 16.9 16.9 0.0

Comment(s) on Variance(s):

Audit completed or planned:
Per Audit Plan approved by the Senior Management Board (SMB) to be reviewed by the Departmental Audit Committee (DAC), CADTH audit has moved to 2011-12.

Evaluation completed or planned:
An independent evaluation of CADTH's core business activities is required as part of Health Canada's 2008-13 funding agreement with CADTH. The funding agreement stipulates that this evaluation cover April 1, 2007 - March 31, 2011, and be submitted to the Minister by December 31, 2011. The evaluation is intended to assess CADTH's performance in achieving the purpose of the Grant, including CADTH's value-for-money.



Name of Transfer Payment Program:
Grant to the Health Council of Canada

Start date: September 1, 2004

End date: March 31, 2015

Description:
The Health Council was established by First Ministers in the 2003 Accord on Health Care Renewal with the mandate to report on jurisdictional progress in meeting Accord commitments. The Health Council's mandate was expanded by First Ministers in the 2004 Health Accord to report on health outcomes and the health status of Canadians.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Along with on-going work to support its mandate, in 2009/10 the Council:

  • Released two reports on primary health care: Teams in Action: Primary Health Care Teams in Canada and Getting it Right: Case Studies of Effective Management of Chronic Disease Using Primary Health Care Teams.

  • Released a report on governments' progress towards the 2004 Accord commitments related to pharmaceuticals management: A Prescription Unfilled: A Status Report on the National Pharmaceuticals Strategy

  • Collaborated with McMaster University on a expert forum to identify barriers and potential opportunities for advancing primary health care in Canada.

Analysed data from the 2008 Canadian Survey of Experiences with Primary Health Care, and the 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults to create two electronic news bulletins about Canadians with chronic health conditions, and the care they receive: Safer Care for "Sicker" Canadians, and Helping Patients Help Themselves.

Program Activity:
Health Policy, Planning & Information
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 6.4 6.2 10.0 10.0 4.8 5.2
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 6.4 6.2 10.0 10.0 4.8 5.2

Comment(s) on Variance(s):
The annual operating budget of the Health Council can be up to $10M per year. The Health Council's 2009-10 work plan, approved by Corporate Members, requested $6.3M. Actual spending was less than planned due to delays in the implementation of projects under the Council's approved workplan.

Audit completed or planned:
The Council's financial records are reviewed and audited annually by independent external accountants. Audited financial statements can be found on the Council's website: http://www.healthcouncilcanada.ca

Evaluation completed or planned:
As per their Funding Agreement, the Council is required to submit a final evaluation framework to the Minister by March 31, 2010, and a final evaluation report by March 31, 2014.



Name of Transfer Payment Program:
Grant to the Canadian Institute for Health Information (voted)

Start date: April 1, 1999

End date: March 31, 2012

Description:
CIHI is an independent, not-for-profit organization supported by federal, provincial and territorial governments that provides essential data and analysis on Canada's health system and the health of Canadians. CIHI was created in 1991 by the F/P/T Ministers of Health to address significant gaps in health information. CIHI's data and its reports inform health policies, support the effective delivery of health services and raise awareness among Canadians about the factors that contribute to good health.

Since 1999, the federal government has provided funding to CIHI through a series of grants and conditional grants, known as the Roadmap Initiative. More recently CIHI's funding has been consolidated through the Health Information Initiative.

Through the past Roadmap Initiatives I, II and II Plus, CIHI had been provided with approximately $260 million since 1999. Budget 2005 allocated an additional $110 million over five years (2005-2006 to 2009-2010) to CIHI through Roadmap III. This has allowed CIHI to provide quality and timely health information, including the delivery of data on a variety of important health indicators and other health publications to support health sector decision-making and improve accountability.

Beginning in 2007/2008, the Health Information Initiative provides grant funding to CIHI, replacing the previous Roadmap II, II Plus, III funding and also provides additional funds for new initiatives. This funding allows CIHI to continue important work under the Roadmap Initiative and to further enhance the coverage of health data systems so Canadians get information on their health care system, including information on wait times, and continued development of comparable health indicators. The funding will also enable CIHI to respond effectively to emerging priorities. Under this initiative, up to $406.49 million will be delivered to CIHI over five years (2007/2008 to 2011/2012).

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Many of CIHI's activities undertaken in 2009-2010 focused on building on successes achieved in previous years to accomplish the major goals set out in the strategic plan, including:

  • implementing strategies to further expand jurisdictional adoption and implementation of key reporting systems, such as the National Prescription Drug Utilization Information System (NPDUIS), the National Ambulatory Care Reporting System (NACRS) (with a particular focus on emergency visit data), and the Home and Continuing Care reporting systems (HCRS and CCRS);

  • addressing emerging issues through the provision of analytical products related to H1N1 and medical isotopes in a timely and effective manner;

  • initiating a pilot of comparable Pan-Canadian facility-level reports on hospital performance, including measures that reflect clinical outcomes, financial health and other factors; and

  • the continued enhancement of the CIHI Portal tool, including the addition of new data marts.

A large-scale client satisfaction survey was completed this year, providing CIHI with valuable information on where the organization is doing well and where it could do better. Overall, the survey showed that CIHI provides high quality products and services which are valuable to stakeholders, however it could focus on responding to high value customer needs and preferences, in addition to taking its web services to the next maturity level. In response to this, CIHI: is redeveloping its website, with a phased approach to implementation; enhancing and expanding its e-reporting capabilities; initiating the development of a comprehensive education strategy; and has implemented a rapid response service, as well as service standards for external data requests.

More and Better Data

  • Jurisdictional uptake of the National Ambulatory Care Reporting System (NACRS) has increased significantly in the last year, mainly due to the introduction of a new level of reporting to the database. This new level of reporting provides stakeholders with timelier access to wait time reporting, receiving reports on a monthly basis. Participation in the database increased this year allowing improved reporting comparability.

  • Significant progress was made in expanding jurisdictional uptake of the home and continuing care reporting systems, with 5 jurisdictions submitting data to the Home Care Reporting System (HCRS), and approximately 800 facilities, from 6 jurisdictions, submitting data to the Continuing Care Reporting System (CCRS), nearly doubling the number of facilities submitting from the previous year.

  • On the pharmaceutical front, a total of 6 jurisdictions submitted claim-level data to the NPDUIS National Prescription Drug Utilization Information System (NPDUIS). In fiscal 2009/2010, CIHI worked closely with jurisdictions to establish data sharing agreements to facilitate the submission of drug claims data to the NPDUIS Database. Also, CIHI reached a milestone with over 2,000 incidents now having been reported through its National System for Incident Reporting (NSIR). The live system will be fully implemented in the spring of 2010.

  • With the increasing interest in comparable cost data, CIHI enhanced its Canadian MIS Database (CMDB) to allow for more frequent data submissions, thus providing jurisdictions with access to more useful and timely data for analysis. CIHI also developed a patient-specific estimator which was launched on the web site, providing meaningful data on the costs of inpatient and ambulatory health services.

  • In the area of health human resources, CIHI released data for the first time from two new HHR databases on medical laboratory technologists and medical radiation technologists. This completed the development of the five new HHR databases, with the others including occupational therapists, physiotherapists and pharmacists.

  • In fiscal 2009/2010, CIHI continued working on its multi-pronged approach to strengthen primary health care (PHC) information in Canada. This included releasing the program's first reports, one using data from the Canadian Survey of Experiences with Primary Health Care and the second report, Diabetes Care Gaps and Disparities in Canada. It also included continuing to build on work from last year, mainly developing standards for electronic medical records (EMRs), reporting on PHC indicators and analysis, and developing a voluntary PHC reporting system.

  • Finally, CIHI continued to enhance the quality of its data and information products through continued implementation of its comprehensive data quality program, including production of an enhanced set of data quality reports for Deputy Ministers, which were released one month earlier this year, and its ongoing program of re-abstraction studies. In 2009/2010, CIHI's Data Quality Framework was extensively revised and is now posted on CIHI's external web site. The Framework includes a data holding assessment tool, which is the model adopted by many Canadian and international organizations.

Relevant and Actionable Analysis

  • Over the last year, CIHI developed and released 38 analytical products. These included special analytical reports relevant to priority themes (e.g. access and quality of care, wait times, health outcomes, and continuity of care) and special studies related to priority health services themes (e.g. costs, patient safety).

  • CIHI identified a series of cross-cutting analytical themes, representing priority areas of information needs among key CIHI stakeholders. These themes include patient safety, aboriginal health information, cancer, mental health and seniors.

  • In order to respond to priority analytical needs, CIHI was able to release timely reports in several areas, including a report on H1N1. Other priority work including an initiative related to Medical Isotopes which included an electronic survey and focus groups to gather data to help shed light on the impact of the supply disruption of Tc-99m to patients, with a focus on measures of throughput.

  • Given the increasing jurisdictional interest measuring and comparing hospital performance, CIHI initiated a very successful pilot project aimed at producing pan-Canadian hospital performance reports based on a core set of indicators in areas such as clinical care and outcomes, and financial performance.

  • CIHI continues to explore opportunities for collecting First Nations, Inuit and Métis health information. In 2009/2010, efforts focused on building collaborative relationships, enhancing data, and developing analytical opportunities.

Improved Use and Understanding

  • In order to improve access and use of its data, CIHI continued to actively promote the adoption and use of its Portal, which provides access to facility-identifiable data on the delivery of services by hospitals across the country. Uptake of the Portal increased significantly this year to include four ministries of health, two territories, 23 regional health authorities and 15 facilities, with a total of over 230 regional users.

  • CIHI initiated the development of a comprehensive Education Strategy to help focus and refine CIHI's services to clients, with a greater emphasis on helping stakeholders use and understand data and information. CIHI also hosted/co-sponsored a number of health information-related conferences including the eHealth Conference and the Data User's Conference 2009.
Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 51.1 81.7 81.7 81.7 81.7 0.0
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 51.1 81.7 81.7 81.7 81.7 0.0

Comment(s) on Variance(s):

Audit completed or planned:
In 2007, an audit was conducted by Health Canada internal auditors on the Health Information Contribution Program. Auditors concluded that, in general, the internal controls in place at CIHI to manage the Contribution Agreement were sufficient to meet the terms and conditions of the Agreement with minor exceptions. Risk exposure was not serious.

Evaluation completed or planned:
An evaluation on the first phase of the Health Information Initiative is presently being performed and will be completed in Fiscal Year 2010/2011. The last evaluation on the second phase of Roadmap II and II Plus was completed in Fiscal Year 2006/2007. The summary is available at: http://www.cihi.ca/cihiweb/en/downloads/Executive_Summary_EN.pdf.



Name of Transfer Payment Program:
Grant to provincial and territorial health ministries for the disbursement of excess revenue monies collected by the Patented Medicine Prices Review Board (PMPRB), pursuant to the authority of the Minister of Health as described under S.103 of the Patent Act.

Start date:
Ministerial responsibility for the disbursement of excess revenues collected by the PMPRB was introduced through the 1993 Patent Act amendments.

End date:
Disbursement agreements represent an ongoing program requirement.

Description:
The PMPRB is a federal quasi-judicial tribunal with a regulatory responsibility to ensure prices of patented medicines sold in Canada are non-excessive. Where the Board finds a price to be excessive, remedial measures are ordered, including the repayment of excess revenues. The excess revenues collected by the Board are deposited into the Consolidated Revenue Fund, and S.103 of the Patent Act defines the responsibility of the Minister of Health for entering into agreements with provinces for the purposes of disbursement of the monies.

Strategic Outcome:
Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved:
Monies disbursed to provincial and territorial health ministries.

Program Activity:
Canadian Health System
($ millions) Actual
Spending
2007-08
Actual
Spending
2008-09
Planned
Spending
2009-10
Total
Authorities
2009-10
Actual
Spending
2009-10
Variance(s)
Total Grants 0 0 0 9.3 9.3 (9.3)
Total Contributions            
Total Other types of transfer payments            
Total Program Activity(ies) 0 0 0 9.3 9.3 (9.3)

Comment(s) on Variance(s):
Disbursement amounts reflect the outcomes of legal proceedings and therefore can not be anticipated. In addition, disbursement agreements do not follow a fixed timeframe, making it very difficult to anticipate when one will be initiated/finished.

Audit completed or planned:

Evaluation completed or planned:


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