DPR 2011-2012 Supplementary Tables

Table of Contents

1. Details on Transfer Payment Programs
   
2. Up-Front Multiple Year Funding
   • Canada Health Infoway
   • Canadian Health Services Research Foundation
   • Mental Health Commission of Canada - Conditional Grant to Support Research Demonstration Projects in Mental Health and Homelessness
   • Rick Hansen Man in Motion Foundation
     
3. Greening Government Operations
   
4. Horizontal Initiatives (where Health Canada is the lead Department)
   • Federal Tobacco Control Strategy
   • Defence of Canada Against Third-Party Claims in Tobacco Legislation
   • Action Plan to Protect Human Health from Environmental Contaminants
   • Early Childhood Development and Early Learning and Child Care
   • Food and Consumer Safety Action Plan
     
5. Internal Audits and Evaluations
   • Internal Audits
   • Evaluations
     
6. Sources of Spendable and Non-Respendable Revenue
   
7. Summary of Capital Spending by Program Activity
   
8. User Fees

Details on Transfer Payment Programs Tables

Introductory Note:

As a result of a reorganization of the First Nations and Inuit programs that took effect on fiscal year 2011-12, the 10 previous First Nations and Inuit programs were renewed and streamlined into 3.

The main objectives of this transition are up-to-date information classification and reporting of the First Nations and Inuit programs.

Below, is the actual spending for the previous fiscal years 2009-10 and 2010-11 reported under the renewed 2011-12 programs authority structure, according to the crosswalk:

Name of transfer payment program:
Contributions for First Nations and Inuit Primary Health Care

Start date: April 2011

End date: Ongoing

Description:

The Primary Health Care Authority funds a suite of programs, services and strategies provided primarily to First Nations and Inuit individuals, families, and communities living on-reserve or in Inuit communities.  It encompasses health promotion and disease prevention programs to improve health outcomes and reduce health risks; public health protection, including surveillance, to prevent and /or mitigate human health risks associated with communicable diseases and exposure to environmental hazards; and primary care where individuals are provided diagnostic, curative, rehabilitative, supportive, palliative/end-of-life care, and referral services.
(Voted)

Strategic outcome(s):

First Nations and Inuit communities and individuals receive health services and benefits that are responsive to their needs so as to improve their health status.

Results achieved:

Improved ongoing access to health promotion/disease prevention programs and services

Increased community capacity to deliver community-based health promotion and disease prevention programs and services

Increased community capacity to manage and administer communicable disease control programs

Increased program and community capacity to address and mitigate environmental public health risks

Increased appropriate primary care services based on assessed need

Improved coordinated and seamless responses to primary care needs

Program Activity:

Comments on variance(s):

The Planned Spending was increased by $23.3M of approved authorities through Supplementary Estimates B & C and reduced by $8.9M of transferred authorities to other programs resulting in a Total Authorities of $698.9M for TPP Contributions for First Nations and Inuit Primary Health Care.

Actual Spending was less than anticipated

Audits completed or planned:

N/A

Evaluation completed or planned:

This new TP include the Health Promotion and Disease Prevention Programs; Public Health Protection Programs and Primary Care:

Completed evaluations are:   FNI Communicable Disease Control and FNI Children & Youth - Cluster Evaluations completed in 2010-11; FNI Communicable Disease and Injury Prevention and FNI Environmental Health and Environmental Research - Cluster evaluations completed in FY 2011-12 as well as the Mental Health and Addictions was also evaluated in FY 2011-12

Evaluations currently underway are: Clinical and Client Care and Home and Community Care.

Engagement of applicants and recipients:

Discussed the Ts & Cs with recipients at the time of renewal of their contribution agreement and as necessary, work with them to ensure they comply with these Ts & Cs.

Name of transfer payment program:
Contributions for First Nations and Inuit Supplementary Health Benefits

Start date: April 2011

End date: Ongoing

Description:

The Supplementary Health Benefits Program is a national program that provides, to registered First Nations and recognized Inuit in Canada regardless of residency, a limited range of medically necessary health-related goods and services not provided through other private or provincial/ territorial programs. 

The benefits include the following: pharmacy benefits (prescription drugs and some over-the-counter medication), medical supplies and equipment, dental care, vision care, short term crisis intervention mental health counselling, and medical transportation benefits to access medically required health services not available on reserve or in the community of residence.

The Program also pays provincial health premiums on behalf of eligible clients in British Columbia.
(Voted)

Strategic outcome(s):

First Nations and Inuit communities and individuals receive health services and benefits that are responsive to their needs so as to improve their health status.

Results achieved:

Improved access to non-insured health benefits appropriate to the unique health needs of First Nations people and Inuit

Efficient and cost-effective management of access to non-insured health benefits

Program Activity:

Comments on variance(s):

The Planned Spending was increased by $32.7M of approved authorities through Supplementary Estimates B & C and reduced by $0.8M of transferred authorities to other programs resulting in a Total Authorities of $191.4M for TPP Contributions for First Nations and Inuit Supplementary Health Benefits.

Actual Spending was less than anticipated due to the fact that this is a demand driven program.

Audit completed or planned:

Audit done on FNIHB Contributions for First Nations and Inuit Supplementary Health Benefits for FY 2011-12.

Audit of NIHB - Pharmacy completed by AAB on June 2011.

Evaluation completed or planned: 

NIHB Cluster Evaluation was completed in November 2010.

Engagement of applicants and recipients:

Discussed the Ts & Cs with recipients at the time of renewal of their contribution agreement and as necessary, work with them to ensure they comply with these Ts & Cs.

Name of transfer payment program:
Contributions for First Nations and Inuit Health Infrastructure Support

Start date: April 2011

End date: Ongoing

Description:

The Health Infrastructure Support Authority underpins the long-term vision of an integrated health system with greater First Nations and Inuit control by enhancing their capacity to design, manage, deliver and evaluate quality health programs and services. It provides the foundation to support the delivery of programs and services in First Nations communities and for individuals, and to promote innovation and partnerships in health care delivery to better meet the unique health needs of First Nations and Inuit.

The funds are used for: planning and management for the delivery of quality health services; construction and maintenance of health facilities; research activities; encouraging Aboriginal people to pursue health careers; investments in technologies to modernize health services; and integrate and realign the governance of existing health services.
(Voted)

Strategic outcome(s):

First Nations and Inuit communities and individuals receive health services and benefits that are responsive to their needs so as to improve their health status.

Results achieved:

Improved quality in the delivery of programs and services

Provide safe health facilities that support health program delivery

Promote engagement of key stakeholders in Aboriginal health in the integration of health services

Improved access to health information

Program Activity:

Comments on variance(s):

The Planned Spending was increased by $21.8M of approved authorities through Supplementary Estimates B & C and by $13.8M of transferred authorities from other programs resulting in a Total Authorities of $263.4M for TPP Contributions for First Nations and Inuit Health Infrastructure Support.

Actual Spending was as anticipated

Audit completed or planned:

N/A

Evaluation completed or planned:

The following evaluations were completed in FY 2011-12: FNI eHealth Infostructure Program (eHIP); FNI Health Facilities and Capital Program and FNI Health Planning, Consultation and Research Projects - Synthesis.

Evaluations currently underway are: BC Tripartite; FNI Health and Human Resources and FNI Nursing Innovation

Engagement of applicants and recipients:   

Discussed the Ts & Cs with recipients at the time of renewal of their contribution agreement and as necessary, work with them to ensure they comply with these Ts & Cs.

Name of transfer payment program:
Contributions in support of the Federal Tobacco Control Strategy

Start date: July 1, 2007

End date: March 31, 2012 (Ts&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(s):

Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating.

Results achieved:

With 126 projects funded since 2007, the following results are some highlights:

• National Cessation Guidelines: Development of evidence-based national cessation guidelines.
• Hospital Based Smoking Cessation: Helping recipient organizations implement a systematic approach to the treatment of tobacco dependant patients in hospital based settings.
• Smoking Cessation Counselling: Helping recipient organizations adapt and create tailored cessation programs for specific populations. Population sectors include First Nations and Inuit, pregnant women, persons with mental health issues, and reaching smokers in workplaces.
• Policy and Training: Assisting recipient organizations in exploring new policy options, developing capacity building and training initiatives.
• Social Media: Assisting recipient organizations in exploring the use of social media to deliver cessation programs for young adults.
• First Nations and Inuit: Supporting recipient organizations to tailor and deliver prevention and cessation programs for First Nations and Inuit communities as well as educate and train service providers in tobacco use prevention and cessation.

Program Activity:

Comments on variance(s):

Difference between planned spending and actual spending is minimal and is related to minor lapses from committed projects due to condensed project timelines.

Audit completed or planned:

Audits of three projects were conducted in 2011-12: Centre for Addiction and Mental Health: Canadian Action Network for the Advancement, Dissemination and Adoption of Practice-Informed Tobacco Treatment (CAN-ADAPTT) Practice-Based Research Network; Kenora Chiefs Advisory: Youth & Elders Tobacco Control Project; University of Ottawa Heart Institute Prevention and Rehabilitaton Centre: Expansion of Evidence-Based Smoking Cessation Interventions in Hospitals Across Canada.

Evaluation completed or planned:

A full summative evaluation of the Federal Tobacco Control Strategy was conducted which included process and impact evaluations of the contribution funding program. Final reports of the process and impact evaluations were submitted in 2011-12 and results were incorporated into the Federal Tobacco Control Strategy 2001-11 Horizontal Evaluation.

Engagement of applicants and recipients:

Through the Contributions in Support of the Federal Tobacco Control Strategy, Health Canada works closely with recipients to monitor contribution agreements. Applicants and recipients are engaged in knowledge sharing and exchange activities which have included face-to-face meetings and teleconferences. Applicants also provide input to potential funding priorities. Stakeholder groups have regular opportunities to engage with Health Canada on tobacco funding priorities through mechanisms such as the Federal/Provincial and Territorial Tobacco Control Liaison Committee and the Canadian Coalition Against Tobacco which is comprised of non-governmental organizations

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(s):

Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating.

Results achieved:

• The DTFP has 26 signed contribution agreements for 27 projects in 2011-12.
• Funded "Systems" projects have made significant progress in achieving results in the investment areas: implementation of best practices, enhancing knowledge exchange, and strengthening performance measurement and evaluation.
• Funded "Services" projects support new and enhanced treatment services for at-risk youth and for those living in Vancouver's Downtown Eastside, and significant progress is being made.
• Treatment systems, programs and services are better able to address illicit drug dependency due to sharing of knowledge and best practices within and among health sectors, more availability of critically needed services, improved needs-based planning, and understanding of lessons learned through increased evaluation activities.

Program Activity:

Comments on variance(s):

The 2011-12 Total Authorities (10) and the 2011-12 Planned Spending (9) should be at $31.8M. A $1.9M yearly permanent transfer from Health Canada to Justice Canada in Annual Reference Level Update (ARLU) 2008-09, was mistakenly taken from DTFP reference levels instead of DSCIF reference levels. This will be corrected as an item in the 2013-14 ARLU. Hence the correct variance (12) for DTFP should have been at $4.1M.

The variance is due to late implementation of planned activities.

Audit completed or planned:

No audit planned.

Evaluation completed or planned:

A final impact evaluation for DTFP is underway and will be completed by November 2012.

Engagement of applicants and recipients:

DTFP works closely with recipients to monitor contribution agreements. DTFP also engages applicants and recipients (mainly P/Ts) in knowledge sharing and exchange activities which have included face to face meetings and teleconferences.

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 (DSCIF) will contribute to reducing illicit 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 DSCIF 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(s):

Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating.

Results achieved:

During 2011-12, no new contribution agreements were signed.

DSCIF continues to work closely with recipients to aid in performance reporting including implementing standardized instruments and ongoing data collection as part of the cluster evaluation.

The roll out of the standardized cluster tools was completed as planned. Now all DSCIF projects (except those funded in 2008) are using standardized survey tools to measure the impact of their programming on youth.

The interim report on the DSCIF cluster evaluation was completed this year. This interim report indicates that one third of all projects funded in the 2008 call for proposals (cohort 1) have reported back final numbers on results. Some of the most promising results include: a 96% reduction in likelihood to take risks after attending programming; 76% of youth in one project reported an increase in leadership skills as a result of participating in programming; the number of youth reporting not using drugs increased from 10% at pre-test to 31% at post-test in another project.

This year the program has developed an online pilot of the integrated planning and performance reporting system (IPPRS) to improve the ability to roll-up project information. As well, the program established a performance measurement working group to improve performance measurement and evaluation capacity among program officers.

Program Activity:

Comments on variance(s):

The 2011-12 Total Authorities (10) and the 2011-12 Planned Spending (9) should be at $9.6M. A $1.9M yearly permanent transfer from Health Canada to Justice Canada in 2008-09 Annual Reference Level Update (ARLU), was mistakenly taken from Drug Treatment Funding Program (DTFP) reference levels instead of DSCIF reference levels. This will be corrected as an item in the 2013-14 ARLU.

Hence the correct variance (12) for DSCIF should have been at ($0.5M). Note there was an in-year transfer of $0.5M from DTFP to DSCIF to cover this shortfall.

Audit completed or planned:

One audit for a DSCIF project in the Ontario region was conducted in fiscal 2011-12. One audit for a different DSCIF project in the Ontario region is anticipated for fiscal 2012-13.

Evaluation completed or planned:

The DSCIF program outcome evaluation "Cluster Evaluation" is ongoing. The interim outcome evaluation was completed in December 2011. The final outcome evaluation is expected towards the end of fiscal year 2012-13.

Engagement of applicants and recipients:

DSCIF engages applicants and recipients at many stages in the delivery of Gs & Cs. Applicants are engaged in order to get feedback on Call for Proposals processes (priorities, tools, communication, and rejections) and thereby contribute to DSCIF process evaluation. Recipients provide feedback on the entire Call for Proposal and approval process, they then provide feedback both formally and informally on program tools including application tools, reporting tools, and evaluation tools. Recipients feed into both process and outcome evaluation. Furthermore recipients are engaged for knowledge sharing exercises both over the phone and face to face.

Name of transfer payment program:
Assessed Contribution to the Pan-American Health Organization

Start date: April 15, 2008

End date: March 31, 2013

Description:

To support Canada's membership in the Pan-American Health Organization (PAHO).

Strategic Outcome:

A health system responsive to the 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. Link to  PAHO's website.

Program Activity:

Comments on variance(s):

Variance due foreign exchange rate fluctuation.

Audit completed or planned:

None. As per the program's terms and conditions, Health Canada relies upon the Pan-American Health Organization's internal and external audit regimes to monitor accountability.

Evaluation completed or planned:

The evaluation completion date will be March 2013, as identified in the Departmental Evaluation Plan.

Engagement of applicants and recipients:

As a member of PAHO, Canada sits of the Directing Council of the organization as a voting member, thereby influencing the direction of the organization's work as well as the use of its budgets.

Name of transfer payment program:
Grant to the Canadian Blood Services: Blood Safety and Effectiveness Research and Development

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(s):

Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating.

Results achieved:

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

Program Activity:

Comments on variance(s):

No variance.

Audit completed or planned:

None.

Evaluation completed or planned:

The evaluation completion date will be December 2012, as identified in the Departmental Evaluation Plan.

Engagement of applicants and recipients:

The Department convened a knowledge transfer event with Canadian Blood Services for Health Canada personnel with responsibility for federal oversight of blood safety event, in order to disseminate highlights and results achieved by the grant.

Name of transfer payment program:
Official Languages Health Contribution Program

Start date: April 1, 2009

End date: March 31, 2013

Description:

The Official Languages Health Contribution Program has the following 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:

1. The operation of Health Networks to support English and French linguistic minority communities across Canada by enabling linkages between health sector stakeholders to maintain and improve the health services available to these communities;
2. Activities for the Training and Retention of Health Professionals to provide an increased supply of health professionals who are able to provide health-related services to English and French linguistic minority communities across Canada; and
3. Official Languages Health Projects comprising specific time-limited initiatives of one to four years in each province, territory and region that aim to have lasting effects on improving the health services situations for English and French linguistic minority communities across Canada.

Strategic outcome(s):

A health system responsive to the needs of Canadians

Results achieved:

There are 26 active contribution agreements signed with educational institutions and community-based organizations for the engagement of new program activities to address program objectives.

1,040 new student registrations were accepted in 2011-12 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. There were 596 graduates from these same programs for the academic year ending in May/June 2011. A follow-up survey of training graduates from 2008-09, which was released in 2010-11, revealed that 86% of graduates surveyed were employed in health professions serving official language minority communities.

McGill University coordinated language training activities in 2011-12 for some 1,534 health professionals in Quebec to improve their ability to service English-speaking minority communities.

Approximately 70 projects are being launched during 2010-13 in French-speaking minority communities outside Quebec. Examples of projects launched in 2010-11:

• A three-year project (2010-13) to facilitate the delivery of health care services in French in retirement homes and to provide support to family caregivers in three French-speaking communities of three regions of Newfoundland and Labrador: Avalon, Port-au-Port and Labrador City.
• Another three-year project (2010-13) to create and distribute public health education and awareness tools for French-speaking and Acadian preschool children in Nova Scotia.

A total of 38 projects have been launched in English-speaking minority communities in Quebec over 2010-13. Examples of projects launched in 2010-11:

• A project designed to co-ordinate recruiting efforts of regional stakeholders in order to fill the need for bilingual workers in the Gaspésie-Îles-de-la-Madeleine region.
• English translation of health information documents in Saguenay-Lac-Saint-Jean

New projects aimed at improving the health and health access of official language minority communities were implemented in 2009-10. 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
• Community Health and Social Services Network
• Consortium national de formation en santé
• McGill University

Program Activity:

Comments on variance(s):

Variance is minimal.

Audit completed or planned:

Completed in 2011-12 for fiscal 2009-10: Société Santé en français National Secretariat; Community Health and Social Services Network Secretariat; Consortium national de formation en santé National Secretariat.

Planned: McGill University to be conducted in 2012-13 for fiscal 2011-12

Evaluation completed or planned:

The summative evaluation of the Health Canada initiative under the Roadmap for Canada's Linguistic Duality has been underway since September 2011. The evaluation is managed by Health Canada's Departmental Performance Measurement and Evaluation Directorate through a contract with Prairie Research Associates Inc.

As of May 31 2012, data collection is in the process of being completed, with interviews conducted by telephone with a select number of key informants representing the following groups:

• the health networks funded by the Health Canada initiative;
• health professionals;
• representatives of provincial and territorial health authorities at the local level and at the headquarters level;
• representatives from health professional training institutions (universities and colleges) in receipt of funding under the initiative; and
• Health Canada operational and management staff.

The key informant interviews addressed the following key issues or questions:

1. Need for the Health Canada Initiative
2. Alignment with Government of Canada priority and Health Canada strategic outcomes
3. Alignment with federal and Health Canada legislated roles and responsibilities
4. Achievement of expected outcomes
5. Extent to which the Initiative was implemented efficiently and economically

Engagement of applicants and recipients:

In 2011-2012, achievements in recipient engagement include:

• Officials with Health Canada, including the official languages champion and coordinators, took part in various forums and board meetings, as well as annual general meetings held by organizations active in the health sector in official language minority communities:
  • Meetings of the Joint Research Committee of the Société Santé en français and the Consortium national de formation en santé.
  • Meetings of the Joint HR Committee of the Société Santé en français and the Consortium national de formation en santé.
  • Committee on organizing services of the Société Santé en français, composed of members from the health and association sectors, which is proposing directions on planning French-language services in minority communities.
  • A number of symposia and workshops organized by OLMCs in which the regional Official Languages Coordinators participated.

Specifically, Health Canada's engagement with recipients can be witnessed through these initiatives:

• Health Canada supported program recipients in developing national public opinion survey tools with regard to the health challenges facing the communities, including a population survey on the health of minority Francophones.
• In addition, Health Canada helped organize formal and informal consultations with stakeholders from the official language minority communities and recipients of the Official Languages Health Contribution Program:
  • Consultations with Quebec minority Anglophone communities as part of focus groups from February to August 2011 by the Quebec Community Groups Network on behalf of Health Canada to determine the communities' health needs and priorities in the coming five years.
  • Multiple follow-up meetings between representatives of Health Canada and recipients of the Program, including meetings with the Department's senior management and site visits by program officers and regional OL coordinators.
  • Preparatory meetings to inform recipients of the Official Languages Health Contribution Program of the summative evaluation process for the Program and to learn their expectations.
  • Participation by Manitoba regional Director General and departmental OL champion for Part VII as a representative of Health Canada during three meetings and three teleconferences held by the Société Santé en français.

All of these meetings with representatives of English- and French-speaking minority communities enabled Health Canada officials to keep apprised of these communities' health needs and priorities, both in the immediate term and over the next five years.

In addition:

• Health Canada funded 37 health networking organizations established across all provinces and territories to engage community partnerships in improving health services, through such means as, informing provincial/territorial and regional health authorities of their needs and implementing various projects to promote health and healthy lifestyles within their communities. There were 99 active projects in 2011-12. The health networks, through their ability to develop partnerships and leverage the joint commitments of partners, all contributed to improving the organization of health services for English-speaking and French-speaking official language minority communities.
• Health Canada, in partnership with program recipients, organized a workshop on the state of health research for official language minority communities. The workshop looked at what has been done, what can be done, and what should be done to understand the emerging and developing health needs of official language minority communities. The main message coming from this workshop was the importance for research activities to be collaborative, as alliances formed between researchers and organizations can be more successful at improving health care than stand-alone research activities.

Name of transfer payment program:
Grant for Territorial Health System Sustainability Initiative

Start date: April 1, 2010

End date: March 31, 2012

Description:

The Territorial Health System Sustainability Initiative (THSSI) is divided into the following three funds:

• The Territorial Health Access Fund intended to: reduce reliance over time on the health care system; strengthen community level services; and build self-reliant capacity to provide services in-territory. Territorial governments each receive $8.6 million, over two years, to support the implementation of these activities.
• The Operational Secretariat Fund which: supports the functioning of the Federal / Territorial Assistant Deputy Minister's Working Group (F/T ADM Working Group) which oversees the implementation of the THSSI; provides capacity support to territorial governments to administer THSSI; and, supports pan-territorial initiatives that address common territorial health priorities. Territorial governments share $4 million, over two years, to support these activities.
• The Medical Travel Fund which offset the costs of medical transportation in each territory. Nunavut is allotted $20.4 million, NWT $6.4 million and Yukon $3.2 million over the two years of the initiative.

Strategic outcome(s):

A health system responsive to the needs of Canadians

Results achieved:

The overriding goal of the two-year extended THSSI is to assist the three territories to consolidate progress made under the THSSI in reducing the reliance on outside health care systems and medical travel. For territories, consolidating projects that have achieved their goals and integrating projects with an ongoing mandate into territorial core business.

Program Activity:

Comments on variance(s):

N/A

Audit completed or planned:

N/A

Evaluation completed or planned:

N/A

Engagement of applicants and recipients:

N/A

Name of transfer payment program:
Health Care Policy Contribution Program (Voted)

Start date: September 24, 2002

End date: Ongoing

Description:

The Health Care Policy Contribution Program (HCPCP) provides contribution funding for projects that address the challenges facing Canada's health care system. The Program fosters strategic and evidence-based decision-making for quality health care, and promotes innovation through pilot projects, evaluation, research, and policy development on current and emerging health care system issues. The Program has continued to evolve in response to changing health care system priorities and currently consists of three components: the Health Care System Innovation Fund; the Health Human Resource Strategy; and the Internationally Educated Health Professionals Initiative.

The Health Care System Innovation Fund (HCSIF) is designed to be flexible and support projects that address a wide range of health care policy issues to encourage innovation. 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 support of safer medication use systems.

The goal of the Health Human Resource Strategy (HHRS) is to aid in the establishment and maintenance of a stable and optimal health workforce. Through the HHRS, Health Canada supports provincial and territorial governments, educational institutions and key health-related organizations, to address health human resource issues, such as the distribution of physicians, particularly in underserved locations; effective use of skills; healthy and supportive workplaces; provision of quality health care; and effective planning and forecasting.

By working with the provinces and territories, and stakeholder organizations, 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 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.

Strategic outcome(s):

A health system responsive to the needs of Canadians

Results achieved:

The Health Care System Innovation Fund 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 labeling and packaging. Over 30 improvements have been made by manufacturers since the inception of CMIRPS and more than 50 recommended system-based safeguards from medication incident analysis learning have been incorporated into Accreditation Canada standards.

The Health Human Resource Strategy and the Internationally Educated Health Professionals Initiativehave supported projects which have contributed to: increasing the number of qualified providers entering the health workforce; increasing productivity of health care providers by making full and appropriate use of their skills; and improving access to health care services for all Canadians, particularly in underserved areas. Specific examples include:

• In 2011-12 under the HHRS, 34 innovative projects were funded, with activities such as: improving health human resources planning and forecasting; promoting interprofessional practice; supporting more effective uses of health provider skills; developing learning opportunities to improve the quality of health care; and modernizing medical education.
• In addition, the Family Medicine Residencies Initiative, announced in 2011, provides $39.5M in funding to provinces and territories with the goal of training approximately 100 family medicine residents in rural and remote areas. In 2011-12, Health Canada signed agreements with British Columbia, Ontario, Nunavut, New Brunswick and Newfoundland. Agreements were also signed with Prince Edward Island and Quebec for medical residency related initiatives. These initiatives build on a project with the University of Manitoba, which began in 2010.
• 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 internationally educated health professionals. For example, funding enabled the development of an orientation program on Canada's health care system and programs to address skills gaps for occupational therapists, physiotherapists, pharmacists, nurses, medical laboratory technologists and medical radiation technologists. Progress toward pan-Canadian approaches to assessing internationally educated physicians and nurses has also been made with the assistance of IEHPI funding.

Program Activity:

Comments on variance(s):

The time required to develop, review and approve proposals as well as to negotiate contribution agreements resulted in under-expenditure in 2011-12. The Program transferred $7.3 to the department to cover priorities during 2011-12.

Audit completed or planned:

The Health Care Policy Contribution Program was reviewed under the Audit of the Management Control Framework for Contribution Programs, completed by the Audit and Accountability Bureau of Health Canada in June 2011. The Program has actively participated in the development and implementation of the Management Response and Action Plan resulting from this audit.

Evaluation completed or planned:

The summative evaluation for the Program is now underway. The final evaluation report is expected by December 21, 2012.

Engagement of applicants and recipients:

The HCPCP engages recipients, potential recipients, and the public in various ways, for example, through stakeholder meetings and project site visits; by providing opportunities for stakeholder input in the development of program tools and templates; and through dissemination of program information on the Departmental web site.

Name of transfer payment program:
Grant to the Canadian Patient Safety Institute

Start date: December 10, 2003

End date: March 31, 2013

Description:

The Canadian Patient Safety Institute (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 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(s):

A health system responsive to the needs of Canadians

Results achieved:

To continue to fulfill its mandate, CPSI is focusing on its strategic priorities of: improving the safety of patient care in Canada through learning, sharing and implementing interventions that are known to reduce avoidable harm; building governance capability; supporting networks; and increasing capacity through evidence-informed resources and tools. For example:

• The Safer Healthcare Now! campaign now has nearly 700 organizations throughout the country implementing evidence-based interventions known to reduce risk for patient harm in areas such as medication reconciliation, infection prevention and control, and surgical safety.
• Over 1,100 participants registered to participate in Canadian Patient Safety Week 2011, a national annual campaign started in 2005 to inspire improvement in patient safety and quality by highlighting patient safety issues, sharing information about best practices, and expanding patient safety and quality initiatives.
• Training was delivered to increase capacity in local organizations through the Effective Governance for Quality and Patient Safety educational program for health care leaders, the Patient Safety Education Project-Canada, and the Canadian Patient Safety Officer Course, and through the opportunities provided to the more than 2,000 participants in Canada's Virtual Forum on Patient Safety and Quality Improvement.
• Targeted patient safety research was funded, including collaborations with partners to support and coordinate research to ensure relevant patient safety evidence moves into action across the health care continuum.
• An updated version of the Canadian Disclosure Guidelines, which promotes a clear and consistent approach to disclosure, emphasizes the importance of inter-professional teamwork, and supports learning from patient safety incidents, was released.
• Initiated the development of Global Patient Safety Alerts, to provide an ongoing resource of actionable information on specific patient safety incidents; and launched the Improving Care Search Centre, which brings patient safety and quality improvement information together in one easy to access manner.

Program Activity:

Comments on variances:

N/A

Audits completed or planned:

The Institute's financial records are reviewed and audited annually by independent external accountants

Evaluations completed or planned:

As per its funding agreement, CPSI conducted an independent evaluation during the 2011-12 Fiscal Year, which will be finalized in 2012-13.

Engagement of applicants and recipients:

To ensure the CPSI funding agreement is managed in an appropriate and efficient manner, Health Canada officials regularly engage with CPSI. In addition, Health Canada appoints one representative to CPSI's Board of Directors, and participates as a Voting Member.

Name of transfer payment program:
Grant to the Canadian Partnership Against Cancer (Voted)

Start date: April 1, 2007

End date: March 31, 2012; renewed as a Named Contribution Agreement for 2012-2017

Description:

The Canadian Partnership Against Cancer (CPAC) is responsible for implementing the Canadian Strategy for Cancer Control 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 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 CPAC will act as a pan-Canadian resource to provide the most up-to-date knowledge across strategic priority areas including prevention, screening/early detection, patient-centred care, guidelines, health human resources, standards, as well as supporting key research activities and facilitating the development of a pan-Canadian surveillance system.

Strategic outcome(s):

A health system responsive to the needs of Canadians

Results achieved:

Since it began operating in April 2007, the CPAC has:

• Armed cancer patients and physicians across Canada with state of the art knowledge about what works best to prevent, diagnose and treat cancer;
• Improved the quality of our national cancer system by monitoring its performance and identifying gaps;
• Provided online cancer training for over 700 medical providers serving more than 215 First Nations communities and organizations with the @YourSide Colleague® Cancer Care Course;
• Improved the quality of life for cancer victims by providing information that addressed their social, emotional and financial needs;
• Implemented a large-scale effort to raise awareness of the common risk factors for cancer and other chronic diseases;
• Initiated the country's largest population health study of risk factors - the Canadian Partnership for Tomorrow Project - which will enrol 300,000 Canadians to explore why some people develop cancer and others do not;
• Expanded cancer screening programs in all provinces and encouraged hard-to-reach populations, such as women living with cervical cancer, to undergo screening - which helped doctors catch cancer earlier; and
• Developed programs to help survivors through the tremendous uncertainty following treatment.

Program Activity:

Comments on variances:

N/A

Audits completed or planned:

Health Canada completed an audit of the grant to the CPAC in 2011. The objectives of the audit were to provide assurance that aManagement Control Framework is in place within Health Canada for monitoring and administration of the funding agreement with CPAC, and that the CPAC is incompliance with the terms and conditions of the funding agreement. The audit concluded that an effective framework is in place, and that the CPAC is compliant.

Evaluations completed or planed:

The CPAC is preparing to perform an evaluation of its relevance and performance in the achievement of it mandate. A performance measurement strategy and evaluation framework will be completed in 2012-13, and an independent evaluation performed in 2015-16.

Engagement of applicants and recipients:

The CPAC works to engage stakeholders through communications activities that include media and online vehicles to both the broader public and the cancer and health communities, and targeted outreach and partnership building. In 2011-12 CPAC's communications activities focused on expanding engagement with and outreach to stakeholders to sustain support for the national cancer control strategy and generating awareness about initiatives and outcomes

Name of transfer payment program:
Grant to the Health Council of Canada (Voted)

Start date: September 1, 2004

End date: March 31, 2015

Description:

The Health Council of Canada (the 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 Council's mandate was expanded by First Ministers in the 2004 Health Accord to report on health outcomes and the health status of Canadians. In 2010, the Council's mandate was reconfirmed through Future Directions for the Health Council of Canada by participating federal, provincial and territorial Ministers of Health in their role as Corporate Members of the Council.

Strategic outcome(s):

A Health System Responsive to the Needs of Canadians

Results achieved: 

To continue to fulfill its mandate, the Council undertook a wide variety of projects, released associated public reports and undertook supporting promotional activities. For example, in 2011-12 the Council:

• Released Progress Report 2011: Health Care Renewal in Canada examining progress made in five Accord priority areas (wait times, pharmaceuticals management, electronic health records, teletriage, and health innovation) in consultation with experts, stakeholders and federal, provincial and territorial officials.
• Released Health Council of Canada: Strategic Plan 2011, outlining the Council's strategic priorities the Council will pursue to achieve the goals outlined by the First Ministers.
• Released the corporate annual report, Health Council of Canada Annual Report 2010-11: Setting the Course.
• Released a report on Aboriginal health issues entitled, Understanding and Improving Aboriginal Maternal and Child Health in Canada: Conversations about Promising Practices across Canada.
• Conducted the National Patient Engagement Symposium in October 2011. Following the symposium, a proceedings report and Turning what we know into action: A commentary on the National Symposium on Patient Engagement were released.
• Developed and released two reports on primary health care, including: How Engaged Are Canadians in their Primary Care? Results from the 2010 Commonwealth Fund International Health Policy Survey, and, How Do Sicker Canadians with Chronic Disease Rate the Health Care System: Results from the 2011 Commonwealth Fund International Health Policy Survey of Sicker Adults.
• Conducted regional consultation sessions with aboriginal leaders, groups and health care providers to identify best and promising practices in health and community-based programming that are designed to address current health disparities, leading to a report scheduled for release in fall 2012.

Program Activity:

Comments on variance(s):

The annual operating budget of the Health Council of Canada can be up to $10M per year. The Health Council of Canada's 2011-12 work plan, approved by Corporate Members, requested funding in the amount of $5.1M. Payments were made accordingly.

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 the Funding Agreement, the Council is required to submit a final evaluation framework to the Minister by March 31, 2013, and a final evaluation report by March 31, 2014.

Engagement of applicants and recipients: 

The Health Council of Canada engages with participating F/P/T jurisdictions (all, with the exception of Québec), on a regular basis. As Council's Corporate Members, the Ministers of Health of the participating jurisdictions are engaged throughout the planning and implementation of the Council's activities, including the review and approval of the annual workplan and budget. Further, the Council engages with F/P/T officials and consults with them, on an on-going basis, in reviewing and providing comments on project charters, draft Council reports, and other materials as appropriate.

Name of transfer payment program:
Grant to the Canadian Agency for Drugs and Technologies in Health (Voted)

Start date: April 1, 2008

End date: March 31, 2013

Description:

The Canadian Agency for Drugs and Technologies in Health (CADTH) is an independent, not-for-profit agency funded by Canadian 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.

Strategic outcome(s):

A Health System Responsive to the Needs of Canadians

Results achieved:

The purpose of the Named Grant 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). Results include: creation and dissemination of evidence-based information that supports informed decisions on the adoption and appropriate utilization of drugs and non-drug technologies, in terms of both effectiveness and cost.

Program Activity:

Comments on variances:

N/A

Audits completed or planned:

Audits are conducted each year, including budgetary items.

Evaluations completed or planned:

CADTHs independent evaluation is being conducted in two phases. Phase I was submitted in December 2011 and Phase II will be completed at the end of October 2012.

Engagement of applicants and recipients:

• Policy Forum
• Health Technology Analysis Exchange
• CDR recommendations and Optimal Use working groups
• HTA analyses and rapid responses

Name of transfer payment program:
Grant to support 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 (MHCC), an independent, arm's length organization, designed to focus national attention on mental health issues and to work to improve the health and social outcomes for people living with mental illness. To fulfill its mandate, the Commission has been tasked with:

• facilitating the development of a National Mental Health Strategy;
• undertaking an anti-stigma campaign to reduce the stigma associated with mental illness; and
• building a national Knowledge Exchange Centre to facilitate access to reliable information on mental health and mental illness.

In serving as a national focal point for addressing mental health and mental illness, the MHCC 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(s):

A health system responsive to the needs of Canadians

Results achieved:

The MHCC 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. Over the past year, progress has been made on several fronts:

• The release of the first-ever Mental Health Strategy for Canada which builds on the significant work already carried out by the provinces and territories.
• Canada's largest anti-stigma and anti-discrimination initiative, Opening Minds, began replicating best practice programs from its evaluation projects. More than 70 projects are being evaluated or developed into resource material and toolkits across four target groups: healthcare providers, youth, media and the workforce.
• A Knowledge Exchange Centre was launched and began accelerating the sharing of knowledge and best practices across the country. The KEC also initiated three projects: a training institute, a systems performance initiative and a pan-Canadian program to identify and disseminate best practices to improve primary mental health care delivery.
• Mental Health First Aid (MHFA), an initiative of the MHCC, has trained approximately 600 instructors in all provinces and territories, which have provided MHFA training to approximately 50,000 Canadians across the country. The program is working on adapting its curriculum for sub-populations such as First Nations, Northerners and Seniors.
• Partnering with the Canadian Standards Association and the Bureau de normalisation du Québec, the development of the first National Standard of Canada for Psychological Health and Safety in the Workplace is progressing and will be launched in the fall of 2012.

Program Activity:

Comments on variances:

N/A

Audits completed or planned:

An audit of the MHCC was conducted by Health Canada in 2011 and found: that the Department has in place an effective Management Control Framework to manage and monitor the funding agreements; that the MHCC is in compliance with terms and conditions of the funding agreements; and identified four areas for improvement. All recommendations in the audit have been addressed by the Department and the MHCC.

Evaluations completed or planned:

An independent (formative) evaluation was done in 2011 and found the work of the MHCC was aligned with its mandate. The evaluation also proposed some findings to help the Commission improve its approaches and initiatives to ultimately meet their objectives.

Engagement of applicants and recipients:

MHCC is the sole recipient of the grant. Health Canada monitors the recipient's compliance with the funding agreement through the analysis of corporate documents and has regular correspondence with senior management of the organization.

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:

The Canadian Institute for Health Information (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 toaddress 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 was provided with about $260 million since 1999. Budget 2005 allocated an additional $110 million over five years (2005-06 to 2009-10) 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.

Since 2007-08, the Health Information Initiative has been providing grant funding to CIHI, replacing the previous Roadmap II, II Plus, III funding and also providing additional funds for new initiatives. This funding allows CIHI to continue 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 (2007-08 to 2011-12).

Strategic outcome:

A health system responsive to the needs of Canadians.

Results achieved:

In 2010-11 CIHI continued to make progress in producing more and better data, more relevant and actionable analysis, and improved client understanding and use of CIHI data and information products. The following are selected highlights from the Corporate Performance Reporting 2010-11.

More and Better Data

There has been solid progress in data collection for National Ambulatory Care Reporting System (NACRS) Emergency Department data holdings as a result of focused effort on improving comprehensiveness.

• NACRS Emergency Department (ED) data holdings:
  • There has been progress in data collection for British Columbia and Quebec.
  • Alberta is now submitting complete data.
  • Saskatchewan is submitting partial data.
• NACRS Day Surgery and Ambulatory Clinics data holdings - Alberta is now submitting complete data.
• Continuing Care Reporting System (CCRS):
  • There has been progress in the number of Alberta facilities submitting data.
  • Ontario is now submitting complete data.
  • NWT is in discussions regarding data submission.
• Home Care Reporting System (HCRS):
  • There has been progress in the number of British Columbia and Alberta facilities submitting data.
  • Plans are being developed regarding PEI data submission.
• Hospital Mental Health Database (HMHDB) - Quebec is now submitting full data.
• National Physicians Database (NPDB) - The payments data in the NPDB is predominantly Fee-for Service (FFS) payments, by physician. FFS has been a declining portion of total physician remuneration and now stands at about 73% of total physician payments. CIHI is working with the jurisdictions to mitigate this situation. CIHI is starting to probe select jurisdictions for physician billing data at the patient level, rather than at the physician level. This is important in the attempt to link this data to other CIHI datasets and enrich our analytic capabilities. CIHI has patient level data for Saskatchewan and are also in the process of accessing Ontario's data. As well, they have had early discussions with Alberta. The Yukon has not sent CIHI any NPDB data this year.
• National Prescription Drug Utilization Information System (NPDUIS) - Ontario and FNIHB are now submitting complete data
• National System for Incident Reporting (NSIR) Medication Incidents data holding - four new jurisdictions - Saskatchewan, Ontario, Nova Scotia and Nunavut are now submitting partial data.
• Physiotherapists Database (PTDB) - Nova Scotia is now submitting full data.
• Progress has been made in the currency (timeliness) of data in the Hospital Morbidity (HMDB), Hospital Mental Health (HMHDB), Joint Replacement (CJRR) and Medical Imaging Technology (MIT) data holdings. In the case of HMDB the currency improved from 4-year-old data to 1-year-old data and from 4-year to 2-year old data for HMHDB.

Relevant and Actionable Analysis

Over the last year, CIHI continued to increase the overall depth and breadth of analysis and reporting across all data holdings, developing and releasing 34 analytic products. These included special analytic reports relevant to ongoing themes (e.g. access and quality of care, wait times, continuity of care) and special studies related to priority health services themes (e.g. costs, patient safety). CIHI also developed and released a number of annual reports and various other policy-relevant analytic outputs relating to health services, health expenditures, pharmaceuticals, and health human resources.

Improved Understanding and Use

CIHI completed 380 requests for data in 2010-11, the majority of which (91%) were completed within 90 days, a higher proportion than was achieved in the previous fiscal year. An area of focus for the organization is improving access to CIHI's data and reports for our clients and stakeholders through the development of better access tools. The Data Request Tracking Tool (DaRT) is a system launched early in 2008-09 that captures information on all custom data requests from external clients. In 2010-11, CIHI staff handled a total of 523 customized data requests, which is a 29% increase from 405 in the previous year. The vast majority (79%) of the data requests were from third-parties, with the remaining 21% being requests from data suppliers themselves or Ministries of Health. Effective April 1st, 2011, an automated process tool replaced the DaRT excel spreadsheets to track and report on CIHI data requests. This system is expected to improve monitoring of data requests and administrative processes related to data requests.

Media Coverage

A concerted effort was made this year to focus on quality over quantity in media products. As a result, this fiscal year saw 23 media products (16 releases, 7 advisories), compared to 28 (17 releases, 11 advisories) in 2009-10:

• While there were fewer releases, the results suggest that they were more relevant. The number of solicited (media release) mentions was slightly higher this year than last year, and 54% higher than it was two years ago.
• Broadcast coverage was up significantly when compared to the previous two fiscal years. Broadcast coverage is considered an important indicator, as audiences tend to be more "captive" and engaged in what they are hearing.
• Print mentions declined. There are two factors that may explain this:
• newspapers are shrinking in size and market share overall across Canada, as more people turn to the web for news
• two embargo breaches this fiscal year for La Presse and the Sun newspaper chain, both had their embargo privileges revoked for three-month periods. As a result, they stopped covering CIHI data for the period and a significant number of mentions with wide circulation were lost.

Tools to capture mentions and audience reach are constantly evolving - for web metrics in particular - making year-over-year comparisons challenging. The large discrepancy in total reach between this year and last year is largely driven by web reach numbers which are still being honed for greater accuracy.

Program Activity:

Comments on variance(s):

N/A

Audit completed or planned:

Completed Audit:

Performance Audit

In 2010, KPMG completed a performance audit on the Health Information Initiative (HII) as required by the 2007-2012 Funding Agreement between Health Canada and CIHI. The performance audit provided an independent assessment of CIHI's operations to assess the economy, efficiency, and effectiveness of HII funds used.

Overall, KPMG found that CIHI had designed and implemented practices and processes that promoted economy and efficiency in the use of resources and that were effective in supporting the achievement of the HII objectives and expected results.

The audit identified a number of positive practices in place at CIHI, for example: privacy program, data quality management, information security, engagement of stakeholders, process improvements, and communications. Some areas for improvement were also identified. Based on these findings, KPMG issued seven recommendations:

• that CIHI management should continue to develop an overarching stakeholder management framework in conjunction with CIHI's customer strategy project, to better address the needs of CIHI's clientele.
• that CIHI management should formally report on progress against cross cutting theme strategies on a regular (e.g. quarterly) basis to a central committee charged with overall oversight of the cross cutting themes;
• that CIHI revise its performance measurement framework and approach to include more outcomes-based measures and to reduce the number of performance measures being formally monitored and reported on at the senior management and Board levels to only critical performance measures, such as through a dashboard approach;
• that password and authentication mechanisms be strengthened for web-based applications used to load data to data holdings, and that the process for removal of Client Services access be reviewed to mitigate the gap observed;
• that regular user access revalidations be conducted and formally documented;
• that the responsibility for reviewing and following up on third party service provider performance be formally defined and assigned, and a structured process be implemented; and,
• that consideration be given to further strengthening the Privacy Audit Program by modifying procedures over action item logging and monitoring and reporting to the Privacy Data Protection Committee as described above.

As of December 31, 2010 CIHI had implemented all of the above recommendations.

Planned Audits:

The Deputy Minister is accountable for all resources assigned to the Department. As such, internal audit activities relating to the Health Information Initiative (HII) will be considered in the context of the annual risk-based departmental audit plans and any requirements of the Office of the Comptroller General pursuant to horizontal or sectorial audits.

Each year, CIHI is required to provide audited financial statements that comply with GAAP principles. The Funding Agreement also sets out the rights of the Auditor General as per section 7.1 of the Auditor General Act.

Evaluations Completed or Planned:

Completed Evaluations :

In 2010, CIHI commissioned KPMG to conduct an independent evaluation of the Health Information Initiative (HII) as was required by the 2007-2012 Funding Agreement between Health Canada and CIHI. The evaluation assessed a series of issues related to the relevance and performance of the HII in a manner that was not fully consistent with the requirements and standards of the Treasury Board Policy on Evaluation. Performance was examined in the context of the HII's objectives, whereas efficiency and economy were assessed in the performance audit.

Overall, the evaluation demonstrated that the HII objectives were achieved and that CIHI had been successful in realizing its mandate while playing an increasingly critical role in the coordination and delivery of trusted, high-quality information products to governments, hospitals and regions, researchers, and other Canadians. A few notable findings included:

• Evaluations noted the unique role of CIHI and its need within the Canadian landscape of health and health services. In fact, there is no one organization that could contribute the expertise, data and knowledge to healthcare reporting that CIHI can.
• CIHI has made major contributions to improving the quality, integrity and comparability of healthcare data in Canada.
• CIHI has also played an important role in increasing the ability of healthcare organizations to track and report on their own performance, as well as producing a number of significant reports dealing with the overall performance of the Canadian health care system.
• CIHI data is used regularly across the country and many CIHI products are well recognized by its stakeholders. There are several examples where CIHI's work has had an instrumental impact in the health care system. For example, CIHI's National Ambulatory Care Reporting System was used by Ontario hospitals to set targets to reduce wait times in emergency departments.

The evaluation also identified some areas requiring closer examination. The following were identified as key strategic issues that require future focus in order to improve the relevance of CIHI and its products:

• Information for making decisions about the management of the health care system: while stakeholders find CIHI's products and services to be very useful, CIHI's work has only partially met the information needs related to decision-making for the management of the healthcare system.
• Responsiveness to emerging health information needs: although healthcare stakeholders say CIHI's products and services have met their needs, CIHI's work could be even more responsive to emerging needs and produced within shorter timelines.
• Awareness of factors affecting good health: while CIHI's work has had a major impact on increasing awareness of health care system performance, it has had less of an impact on increasing the awareness on factors affecting good health, although there are few notable examples of this type of impact. For example, a study released by the National Prescription Drug Utilization Information System database on drug use in seniors had an impact on increasing the knowledge of the risks of hormone replacement therapy and drug use in seniors.

These evaluation findings were used to inform CIHI's 2012-2015 Strategic Directions, which were approved by the CIHI Board of Directors in November 2011. Specifically, CIHI intends to become more responsive to emerging data needs, as well as to produce the information necessary to improve the health of Canadians, the Canadian health system, and to inform Canadians and policy debates.

Planned Evaluations :

Building on the PMF developed by CIHI, Health Canada's Departmental Performance Measurement and Evaluation Directorate (DPMED) will develop an evaluation framework within six months of the approval of this submission. Evaluation timelines and resources will also be confirmed in the evaluation framework. The development of the evaluation framework will contribute to supporting quality evaluations as well as support enhancement of performance measurement. Enhancements to performance measurement will be implemented and monitored by the Program to support future evaluations and decision-making.

In accordance with the Treasury Board Policy on Evaluation (2009) and Health Canada's Evaluation Policy (2010), Health Canada will complete and send to the Treasury Board Secretariat a supplementary evaluation of the HII by March 31, 2013. This evaluation will address the gaps between the CIHI evaluation conducted by KPMG in 2010 and the requirements and standards of the Treasury Board Policy on Evaluation. In addition, Health Canada will complete a full evaluation of the Health Information Initiative by March 31, 2015 and every five years thereafter to comply with Section 42.1 of the Financial Administration Act. These evaluations will be reflected in the Health Canada Five-Year Departmental Evaluation Plan.

Engagement of applicants and recipients:

• CIHI is the sole recipient of HII funding; therefore there are no initiatives to engage applicants and recipients.

Name of transfer payment program:
Multi-Year Contribution Agreement for Brain Canada Foundation to establish the Canada Brain Research Fund (Voted)

Start date: April 1, 2011

End date: March 31, 2017

Description:

Set up as a dollar-for-dollar matched funding program, the Canada Brain Research Fund represents a total of up to $200M ($100M from the federal government and $100M from non governmental donations) in funding over 6 years for cutting-edge brain research. The Fund will be managed by Brain Canada, whose proposed research program is grounded in a transformative approach that looks at the brain as one system and seeks commonalities across what was previously thought of as unrelated diseases. The purpose of the Canada Brain Research Fund research program is to bring together teams of scientists specializing in different disciplines to identify common mechanisms for repair, restructuring, remodeling and recovery of brain functions, and to translate this knowledge into brain repair and recovery that can apply to many different diseases and disorders of the brain and nervous system.

The Canada Brain Research Fund will serve two functions: as a focal point for private investment in brain research, and will attract this investment by matching private donations with Government of Canada funding, and through grants to researchers. The Fund will also support research that advances knowledge of the brain and that promises developments in diagnostics and therapies for Canadians who live with, or will develop neurological disorders.

Through open competition and rigorous Canadian and international peer review, Brain Canada will fund three types of grants aimed at collaboration and accelerating the pace of discovery: (a) transformative multi-investigator grants in brain research; (b) national neuroscience technology platforms; and (c) fellowships to train the next generation of researchers.

Strategic outcome(s):

A Health System Responsive to the Needs of Canadians

Results achieved:

N/A

Program Activity:

Comments on variances:

This amount was not included as planned spending in the 2011-12 RPP.  As per the Contribution Agreement, Brain Canada was advanced $10M for fiscal year 2011-12. As the funds flowed only at the very end of that fiscal year, Brain Canada did not have time to finance any research projects. That amount, in accordance with the Contribution Agreement, may be carried forward.

Audits completed or planned:

While audits have not yet been undertaken or planned, the Agreement provides for audit rights for the Minister. The Agreement provides that the Minister may conduct performance (value-for-money) and compliance audits with respect to the use of funding. The audits would be conducted by Health Canada, in accordance with its multi-year risk-based Departmental audit plan.

Evaluations completed or planned:

As per the Contribution Agreement, Brain Canada will develop an evaluation framework, in conjunction with Health Canada, no later than March 31, 2013. Brain Canada will then, conduct an Independent Evaluation of the activities of the Canada Brain Research Fund that will measure relevance and performance (effectiveness, efficiency, economy) in achieving immediate, intermediate, and long-term outcomes identified in the evaluation framework. Brain Canada will make the evaluation report available to the Minister no later than September 30, 2016.

Engagement of applicants and recipients: 

Brain Canada is the sole recipient of the contribution. Health Canada monitors the recipient's compliance with the contribution agreement through the analysis of corporate documents and has regular correspondence with senior management of the organization.

Up-Front Multi-Year Funding

All departments responsible for administering such Up-Front Multi-Year Funding, former conditional grant agreements, must complete one template for each recipient, each year, for the duration of the funding agreement.

Name of recipient: Canada Health Infoway (Infoway)

Start date: March 9, 2001

End date: N/A

Total funding: $2.1B*

*Infoway received $1.2B as lump-sum grants between 2001 and 2004. The $400M allocated in 2007 was subject to new conditions - these funds flow to Infoway on an as-needed basis based on cash flow requests. An additional $500M for Infoway was announced in Budget 2009 and confirmed in Budget 2010. In March 2010, Health Canada and Infoway signed a related funding agreement. The $500M funds flow to Infoway on an as-needed basis based on cash flow requests.

Description:

Canada Health Infoway Inc. (Infoway) is an independent, not-for-profit corporation established in 2001 to accelerate the development of health information and communication technologies such as electronic health records (EHRs), telehealth and public health surveillance systems on a pan-Canadian basis. Its Corporate Members are the 14 federal, provincial and territorial Deputy Ministers of Health.

Since 2001, the federal government has committed the following funding allocations: $500 million in 2001 in support of the September 2000 First Ministers' Action Plan for Health System Renewal to strengthen a Canada-wide health infostructure (with the EHR as a priority); $600 million in the First Ministers' Health Accord of February 2003, to accelerate implementation of the EHR and Telehealth; $100 million as part of Budget 2004 to support development of a pan-Canadian health surveillance system; and $400 million as part of Budget 2007 to support continued work on EHRs and wait times reductions. Also, as part of the Economic Action Plan, and as indicated in Budget 2009, the Government of Canada announced an additional investment of $500 million in Infoway, to support continued implementation of EHRs, implementation of electronic medical records (EMRs) in physicians' offices, and integration of points of service with the EHR system. Following a due diligence process, Budget 2010 announced the government's intention to move forward with the transfer of the funds. In March 2010, Health Canada and Infoway signed a related funding agreement, which includes enhanced accountability provisions.

It is anticipated that Infoway's approach, where federal, provincial and territorial (F/P/T) governments participate as equals, toward a goal of modernizing the health information system, will reduce costs and improve the quality of health care and patient safety through coordination of effort and avoidance of duplication.

Strategic outcome(s):

A health system responsive to the needs of Canadians

Summary of results achieved by the recipient:

Investment Strategy: Infoway is a strategic investor, with a funding formula covering up to 100% of territorial and 75% of provincial project development and implementation costs. Infoway provides a portion of system development costs and supports project oversight while province/territory (P/T) partners are responsible for actual system development, implementation and overall funding, including ongoing operational costs. In 2011-2012, Infoway approved $75.1 million in new projects (56 projects), bringing its cumulative allocation of investments to $2.073 billion (371 projects since Infoway's inception).

Electronic Health Records (EHRs): Infoway's goal for EHRs, endorsed by all jurisdictions is that: "by 2010, every P/T and the populations they serve will benefit from new health information systems that will help transform their health care delivery system. Further, by 2010, the electronic health records of 50 per cent of Canadians and by 2016, those of 100 per cent of Canadians, will be available to their authorized health care professionals." As of March 31, 2012, the core components of an EHR were in place for 52.2% of Canadians.

In 2011-2012, Infoway and the P/T s continued to make significant progress on the various components of the EHR - client and provider registries, laboratory information and diagnostic imaging systems, drug information systems and clinical reports.

Results achieved in 2011-2012 include:

• Diagnostic Imaging Systems: As of March 2012 an estimated 49,000 health care professionals are using diagnostic imaging system technology. 98% of exams performed in public hospitals are filmless, stored digitally and available to physicians. Researchers estimate that this has increased productivity by more than 25%, enabling as many as 11 million more exams each year.
• Drug Information Systems - 30,000 health care professionals are estimated to be using second generation drug information systems that enable authorized care providers to securely view a patient's medication profile online, allow for enhanced medication reconciliation and drug interaction alert checking.  It is estimated that the current annual savings with the systems already in place is $436 million.
• Registries - Registries needed to identify patients and health care providers have been established in every province. Some work is still required to complete the registries in the territories.
• Laboratory Test Results - Systems to electronically capture and share laboratory tests are now available in most jurisdictions, while others are in various stages of implementation. There are currently an estimated 35,000 users of lab systems in Canada.
• Clinical reports/immunizations - Most jurisdictions have made clinical reports or immunizations available in a shared repository, while others are at various stages of implementation.

Telehealth: Every province in Canada is now using telehealth to bring care closer to people in their communities, and sometimes in their homes. In 2010, Infoway conducted an independent pan-Canadian study to describe telehealth use in Canada and the benefits achieved to date. The report released in May 2011 reported that in Canada there are more than 5,700 telehealth systems in at least 1,175 communities. This study also found that over the past five years, across the country, telehealth has grown 35% annually. In 2011, it is estimated over 350,000 telehealth events occurred. These events included remote care, education for health care providers, and administrative meetings.

Electronic Medical Records (EMRs): Infoway has allocated part of the 2010 funding towards investment in EMR systems in community based practices and outpatient settings. On March 31, 2012, Infoway reported that more than 11,000 physicians were enrolled in EMR programs across six jurisdictions with a physician office program, surpassing the original target of 8,000 to 9,000. In addition to EMR deployment in physicians' offices, 18 new projects were launched for ambulatory care that will support 25,000 users.

In 2011-2012, Infoway conducted a series of benefits studies on EMR use. Overall, EMR-enabled clinics were much faster than paper-based clinics at completing such tasks as sorting and retrieving lab reports, and were more confident in their results.

Consumer Health Solutions: As an emerging area of interest and investment for Infoway, this program will educate and empower Canadians by providing electronic access to their medical record. Progress was made during the past fiscal year with Alberta launching the first phase of its provincial patient portal (MyHealthAlberta.ca) in May, 2011. Work also began on the next phase of the portal that includes access to a Personal Health Record (the first in Canada) that will provide Albertans secure access to their personal health information through the province's EHR system. Patients will be able to track their own personal health data such as blood pressure readings, insulin levels, weight, and immunizations.

Innovation and Adoption: In the past fiscal year, Infoway has focused on accelerating the extent to which clinicians and Canadians receive tangible value from the use of information and communication technology. Investments were made to engage and support clinicians on EMRs through clinician peer networks and reference groups, focus groups, and clinician-in-training projects with the national associations of faculties of medicine, nursing and pharmacy. Infoway has also funded projects intended to stimulate clinical innovation, through challenge awards and demonstration projects.

Comments on variance(s):

N/A

Significant evaluation findings by the recipient during the reporting year and future plans: 

No evaluation activity was undertaken in the 2011-2012 fiscal year.

In March 2013, Infoway is expected to release an independent evaluation to measure its performance in achieving the objectives of the 2010 funding agreement.

Significant audit findings by the recipient during the reporting year and future plan:

No audit activity was undertaken in the 2011-2012 fiscal year.

In March 2013, Infoway is expected to submit an independent performance (value-for-money) audit report, relating to use of funds under all funding agreements.

Link to recipient's website:  Canada Health Infoway

¹ Some information included in this document is based on a draft of Infoway's 2011-2012 Annual Report. The full report will be released July 31, 2012.

Name of recipient: Canadian Health Services Research Foundation (CHSRF)

Start date: 1996-1997

End date: N/A

Total funding: $151.5M

Description:

1996 - $66.5 M endowment (received over five years) to establish the CHSRF;

1999 - $25 M one-time grant to support a ten-year program to develop capacity for research on nursing recruitment, retention, management, leadership and the issues emerging from health system restructuring (Nursing Research Fund or NRF); and a $35 M one-time grant to support the CHSRF's participation in the Canadian Institutes of Health Research (CIHR); and

2003 - $25 M one-time grant to develop a program to equip health service professionals and their organizations with the skills to find, assess, interpret and use research to better manage the Canadian health care system (Executive Training for Research Application or EXTRA) over a thirteen-year period.

CHSRF's mission is to improve the health of Canadians by:

• Capturing the best evidence about how healthcare and other services can do more to improve the health of Canadians;
• Filling critical gaps in evidence about how to improve the health of Canadians, by funding research and evaluation; and
• Supporting policy makers and managers to develop the skills needed to apply the best evidence about services to improve the health of Canadians.

CHSRF's work contributes to Health Canada's aim of strengthening the knowledge base to address health and healthcare priorities. The foundation collaborates with decision-makers to tackle difficult questions about how to organize, finance, manage and deliver high-quality, affordable, patient-centered healthcare for Canadians. Working at the nexus of health policy and delivery, CHSRF enables leaders to tackle thorny and systemic barriers to change. The foundation brings together expert teams who provide the analysis, processes, tools, learning systems and leadership development needed to create breakthroughs with evidence driven policy and implementation solutions."

Strategic outcome(s):

A health system responsive to the needs of Canadians

Summary of results achieved by the recipient:

Engaging and Supporting Citizens:

As part of its ongoing Patient Engagement Projects (PEP) program, CHSRF funded seven additional healthcare organization-based teams from across Canada to engage patients in the design, delivery and evaluation of health services with the objective of improving the overall effectiveness and efficiency of services. Participating organizations now include five province-wide initiatives, four mental health initiatives, two acute care settings, two regional health authorities, two rehabilitation centres, and two community care centres. CHSRF also hosted a number of training and networking events for PEP teams, and profiled the PEP program at over five national events, including:

• convening a panel (that included three PEP teams) at the annual National Healthcare Leadership Conference; and
• hosting a session on patient engagement in transforming health systems at the annual Taming of the Queue conference.

CHSRF wound up the program it had initiated with the Canadian Institute for Patient Safety (CPSI) to support effective governance by healthcare boards. From 2010 to 2011, CHSRF and CPSI jointly delivered the governance education program over 12 sessions. The sessions took place in Ontario, Manitoba and Saskatchewan, involving roughly 550 board members and the leadership teams they work with from 150 organizations.

Accelerating Evidence-Informed Change:

CHSRF implemented a training initiative in partnership with the Department of Health and Social Services (DHSS) of the Government of the Northwest Territories to improve the way chronic disease is managed in the territory. Through four workshops, more than 40 health system executives, managers, policy makers and frontline healthcare providers increased their capacity to use evidence as they design and plan for health system improvement and sustainability. Participants subsequently developed plans for improving the management of three areas of chronic diseases: diabetes, mental health and renal care. By the end of 2011, the plans were ready for implementation across the territory to inform the development of a territory-wide chronic disease management strategy.

In 2011 26 Fellows graduated from the two-year training stream of the Executive Training for Research Application (EXTRA) program. Each Fellow also undertook an intervention project - a change-management project conducted at the Fellow's home organization. The EXTRA program, which selects 24 to 28 Fellows each year, launched a shorter, more team-focused, 14-month version in 2011. (Competition results will be available in Spring 2012.) Over the course of the fellowship, participants acquire skills for using research-based evidence that will bring about organizational change; skills for improving the use of research evidence across their organizations; and skills for collaborating with other professionals as an evidence-based decision maker.

CHSRF's annual CEO Forum was attended by 150 delegates from across Canada. The theme in 2011 was "Leadership Accountability in Canadian Healthcare: Creating the momentum to improve quality".  First held in 2007, this annual event provides a venue for healthcare leaders from organizations of all sizes to share insights and best practices on the most effective ways to transform healthcare for the well-being of Canadians. CHSRF's 2011 Excellence Through Evidence Award, which celebrates leaders who have accelerated change and strengthened healthcare in Canada, was awarded at the CEO Forum.

2011 marked the end of the majority of the CADRE (Capacity for Applied and Developmental Research and Evaluation in Health Services and Nursing) program awards. The CADRE program was designed to build capacity in applied health services and policy research, including nursing. A key goal was to build and sustain solid partnerships between researchers and the decision- making community.

Promoting Policy Dialogue:

Under the umbrella of Healthcare Financing, Innovation and Transformation, CHSRF commissioned a series of 20 research synthesis papers that addressed the themes of financing, cost drivers and health system efficiencies, and healthcare innovation and transformation. Findings were disseminated via our website, webinars and conference presentations (e.g., session at the Canadian Association of Health Services and Policy Research annual conference, and at a CHSRF-sponsored symposium on healthcare financial sustainability held as part of the International Health Economics Association conference). In addition, CHSRF held 13 meetings with deputy ministers and other senior policy makers who work in health, finance, and intergovernmental affairs, and hosted a series of policy dialogues across the country for stakeholders (e.g., policy and decision makers in government and regional health authorities) to discuss specific topics in healthcare transformation and determine which of the recommendations from the syntheses were worth further exploration and consideration.

CHSRF hosted 1,000 attendees during six targeted "CHSRF on Call" webinars. The topics were:

• Well-coordinated care: Addressing cracks in the system,
• Innovation and pharmaceutical spending,
• Exploring options for physician payment in Canada;
• Patients as partners;
• Key elements toward health system transformation; and
• Exploring activity based funding: Hospitals and post-acute care facilities.

In 2011, CHSRF released three new Mythbusters articles:

• Myth: Medicare covers all necessary health services
• Myth: C-sections are on the rise because more mothers are asking for them
• Myth: The aging population is to blame for uncontrollable healthcare cost (released in conjunction with the annual health policy conference of the Centre for Health Services and Policy Research)

CHSRF also launched its new Mythbusters Award competition in partnership with the Mental Health Commission of Canada. (The awards are decided in early 2012 and conferred later in the year.)

The Commonwealth Fund's International Program in Health Policy and Practice granted full fellowship status to the Canadian recipients of this prestigious award this year. Prior to 2010, Canadian recipients held the title of Harkness Associates. The selection committee, led by the Commonwealth Fund, and including CHSRF's President, chose the two Canadian Fellows for 2011-2012. CHSRF organized and hosted the 2011 Canadian Harkness Health Policy Briefing Tour in Montreal and Toronto. The tour was attended by 14 fellows (from the 2010-2011 Harkness cohort), with 13 briefings delivered by 20 experts in interactive sessions.

Partnerships:

In 2011, CHSRF entered into 31 new agreements with 22 partner organizations involving $0.78 million in cash commitments by CHSRF and $1.93 million by its partners for disbursement in 2011 or later (depending on the terms of the agreements).

CHSRF's six largest partners, listed below, accounted for 71 percent of CHSRF's total direct funding commitments to joint CHSRF-partner activities:

• Health Canada--Health system transformation papers ($500,000)
• Canadian Partnership Against Cancer (two agreements)--Knowledge exchange meetings for Patient Engagement Project teams and 2012 CEO Forum sponsor ($275,000)
• The Saskatchewan Ministry of Health--Initiative to advance transformation through prospective analysis and facilitated exchange ($218,500)
• The Ontario Ministry of Health and Long-Term Care--Delivery of governance education sessions in Ontario ($160,700)
• Fraser Health Authority and Institute for Health System Sustainability--Health system transformation in the Fraser Health Authority Project ($214,000)

CHSRF also has multi-year partnership funding commitments that carry over from prior years. Fifteen such agreements involving 18 different partner organizations were still in progress during 2011. Total commitments under these agreements, of which only part was disbursed in 2011, were $2.79 million by CHSRF and $3.88 million by partners. The most significant partner organizations in these carryover agreements were:

• Canadian Institutes for Health Research--funding for a CIHR Primary Healthcare Chair and funding for an additional 2008 post-doctoral award ($562,500)
• Alberta Innovates--Health Solutions (formerly Alberta Heritage Foundation for Medical Research)--REISS (Research, Exchange, and Impact for System Support) program ($499,531)
• Health Council of Canada--Patient Engagement Projects ($166,667)
• Max Bell Foundation--Patient Engagement Projects ($198,299)

Additional information is available in  CHSRF's 2011 Annual Performance Report which was submitted to Health Canada on 16 April 2012.

Comments on variance(s):

N/A

Significant evaluation findings by the recipient during the reporting year and future plans:

Evaluations completed in 2011 included:

• Listening for Direction (LFD) Evaluation
• Two evaluations of the Executive Training for Research Application (EXTRA) program (on impact of intervention projects on the health system; and on the EXTRA 'team' model)
• Effective Governance
• Patient Engagement Project Outcome Synthesis
• CEO Forum evaluation
• Aging Roundtable evaluation
• Survey of CHSRF- International Health Economics Association pre-conference symposium

Significant audit findings by the recipient during the reporting year and future plan:

The 2011 external financial and pension plan audits showed no major concerns, with the auditors reporting clean audits with no evidence of fraud or illegal acts.

Link to recipient's website:  Canadian Health Services Research Foundation,  La Fondation canadienne de la recherche sur les services de santé

Name of recipient: Mental Health Commission of Canada - Conditional Grant to support Research Demonstration Projects in Mental Health and Homelessness

Start date: April 1, 2008

End date: March 31, 2013

Total funding: $110M

Description:

As part of Budget 2008, the federal government committed $110 million in funding to the Mental Health Commission of Canada (MHCC) to support a research demonstration project in mental health and homelessness in five Canadian cities (Moncton, Montreal, Toronto, Winnipeg and Vancouver). The research demonstration project, known as At Home / Chez Soi, focuses on developing best practices and a broader knowledge base in the areas of mental health and homelessness, supporting future interventions and long-term improvements to the lives of Canada's most vulnerable.

The initiative uses a Housing First approach, which provides people with housing along with support services tailored to meet their needs, and compares this with traditional care. A total of 2234 homeless people living with a mental illness are participating in the project. Currently, 980 people have housing along with support services to assist them over the course of the initiative. The remaining participants will receive the regular services that are currently available in their cities. This research will provide evidence about what housing-related service and system interventions best support recovery within the context of a Housing First approach.

Strategic outcome(s):

A health system responsive to the needs of Canadians.

Summary of results achieved by the recipient: 

• 100% of project participants have been enrolled in the study. Approximately 1,200 individuals have now been housed at least once.
• Established partnerships with more than 265 landlords and property managers across the five sites.
• MHCC and the National Film Board of Canada have established a partnership to develop an interactive website on At Home/Chez Soi.
• At Home/Chez Soi hosted its largest annual training event on Housing First implementation and recovery with 239 individuals in Vancouver in May 2011.
• A total of eight papers are either in print, in press, or have been submitted to peer-reviewed journals for publication.
• Shared and disseminated knowledge and early findings at several national and international conferences including the International Initiative for Mental Health Leadership, American Evaluation Association, and the Canadian Mental Health Association National conference.
• In December 2011, the project completed the second of three planned early findings reports.
• Focusing the Frame, a unique knowledge exchange initiative involving project participants taking pictures to tell stories about their recovery, was implemented in Winnipeg as a pilot.
• The At Home/Chez Soi team worked with the government of France to provide training and technical support as well as consultation and advice around the Housing First model and the Commission's approach and lessons learned. In July 2011, France launched its own research demonstration project, modeled on MHCC's At Home/Chez Soi project.

Comments on variance(s):

The full $110M was provided to the recipient upon signing of the agreement in 2008.

Significant evaluation findings by the recipient during the reporting year and future plans:

An Independent Evaluation of the Mental Health Commission of Canada was completed in FY 2011-2012. That evaluation, which included the homelessness initiative, set out to assess the Commission's progress between July 2007 and December 2010 in the areas of:

• ability to meet its mandate
• effectiveness of policy and/or programs;
• intended and unintended impacts across the mental health system; and
• alternative ways to achieve expected results.

The evaluation demonstrated the organization's positive efforts to strengthen its accountability, and performance management processes and practices, and is making progress on most of its initiatives including the Homelessness initiative. Findings were based on a review of project documents, an online survey, focus groups, and a series of interviews with key informants.

Significant audit findings by the recipient during the reporting year and future plan: 

As outlined in the funding agreement, the Commission must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2011-12 audited financial statements have now been completed and were presented to the Board of Directors for approval on June 11, 2012.

An audit of the MHCC was conducted by Health Canada in 2011 and found that the Department: has in place an effective Management Control Framework to manage and monitor the funding agreements; the MHCC is in compliance with terms and conditions of the funding agreements; and identified four areas for improvement. All recommendations in the audit have been addressed by the Department and the MHCC.

Link to recipient's website:  Mental Health Commission of Canada

Name of recipient: Rick Hansen Man in Motion Foundation

Start date: April 1, 2007

End date: March 31, 2013*

*In February 2012, the Funding Agreement, originally scheduled to end on March 31, 2012, was amended to extend the term of the agreement by one year to March 31, 2013, to allow the RHI to fully expend the original investment.

Total funding: $30M

Description:

The Rick Hansen Man in Motion Foundation (RHF) is an independent, not-for-profit organization founded by Rick Hansen in 1988 to create solutions to improve the lives of Canadians with spinal cord injury (SCI) and to drive advances in SCI research.

Funding is used to implement a Strategy being carried out by the Rick Hansen Institute (RHI). The Strategy has the following objectives:

• Reduce the incidence and severity of permanent paralysis resulting from SCI;
• Increase the recovery of function following SCI;
• Reduce the incidence and severity of secondary complications associated with SCI;
• Increase the level of satisfaction with quality of life among Canadians with SCI;
• Enhance the customized response to the priority unmet needs of Canadians with SCI; and,
• Establish a world class Canadian SCI registry and data management platform.

Strategic outcome(s):

A health system responsive to the needs of Canadians.

Summary of results achieved by the recipient:

Key accomplishments of the RHI for 2011-2012 include:

• The Rick Hansen Spinal Cord Injury Registry (RHSCIR), a database to track the experiences and outcomes of people with SCI through acute care, rehabilitation and community reintegration, was successfully migrated onto an RHI-developed, web-based platform called the Global Research Platform (GRP) in all 31 sites across Canada. The platform is helping to decrease data entry-related workload, resulting in a concomitant improvement in data quality. RHSCIR data is now being analyzed and prepared for publication by members of the RHSCIR national network.
• Continuing RHI's partnership with Accreditation Canada to develop Acute and Rehabilitation Spinal Cord Injury Standards that will be soon be piloted in four Canadian Spinal Cord Injury centres.
• Building on the release of the SCI Physical Activity Guidelines last year, the Get Fit Toolkit was released this year and supported by a major, nation-wide campaign to help adults with SCI to meet the physical activity guidelines.
• Development of a computer simulation model (referred to as the ACT model) to enable clinicians, researchers and administrators to understand the impact of changes (e.g., increase or decrease in secondary complications such as pressure ulcers, adding more hospital beds in a Spinal Cord Injury centre, impact of an aging population) and to evaluate both health care system and patient outcomes. This model has generated interest among decision-makers and a national workshop is being planned to discuss how the ACT model can inform SCI care in Canada.
• A national collaboration of six rehab centres was established in partnership with Ontario Neurotrauma Foundation and the Alberta Paraplegic Foundation. This collaboration aims to establish best practices in the area of pressure ulcer, bladder functioning and pain management. Initial implementation of the pressure ulcer guidelines was achieved at all six sites.

Comments on variance(s):

None noted for 2011-2012 (the full $30M was provided to the recipient upon signing of the agreement in 2007).

Significant evaluation findings by the recipient during the reporting year and future plans:

A summative performance evaluation for the RHI is scheduled to be submitted to Health Canada by July 31, 2012. The summative evaluation will:

• Focus on the fundamental issues of relevance and performance;
• Assess whether the initiative continues to address a need;
• Assess consistency with federal government priorities;
• Provide evidence regarding the cost-effectiveness of the Spinal Cord Injury Solutions Network model.

Significant audit findings by the recipient during the reporting year and future plan:

On March 30, 2012, the RHI submitted the report of its Independent Performance Audit, which did not identify any significant deficiencies in the design and effectiveness of RHI's financial and management controls and practices to achieve economy, efficiency and effectiveness in the use of HC funds.

Link to recipient's website:  Rick Hansen Foundation,  Rick Hansen Institute

Greening Government Operations

Overview

The Greening Government Operations (GGO) supplementary table applies to departments and agencies bound by the Federal Sustainable Development Act, the Policy on Green Procurement, or the Policy Framework for Offsetting Greenhouse Gas Emissions from Major International Events.

Please note:

• RPP refers to Reports on Plans and Priorities and represents planned / expected results.
• DPR refers to Departmental Performance Reports and represents actual results.

Green Building Targets

Strategies and/or Comments

1. Minimum level of environmental performance: LEED New Construction (NC) Gold (new construction and build-to-lease projects); and Green Globes Design three Globes or LEED Core and Shell/Commercial Interiors (CS/CI) Silver (major renovation projects valued over $1M).
2. Appropriate threshold (dollar value or floor area): 1000m², project budget 50%+ value of building replacement cost, significantly affects the building envelope and heating, ventilation and air conditioning systems.
3. Applicable building types: temperature controlled office and lab space where benchmark data is available.
4. Rationale for target status: Health Canada is on track to achieve the target, as per departmental strategic framework.

Green Building Targets

Strategies and/or Comments

1. Minimum level of assessment: BOMA BESt
2. Appropriate threshold (dollar value or floor area): 1000m²
3. Applicable building types: All temperature controlled facilities where Health Canada has full access and control over utilities monitoring and usage.
4. Industry recognized assessment and verification tool used: BOMA BESt
5. Assessment level achieved: BOMA BESt Level 1 for targeted buildings; remaining facilities to be assessed using BOMA BESt tool and may seek certification at the department's discretion.
6. Targeted buildings for which certification will be sought: Occupational Health Unit; Laboratory Centre for Disease Control Building; and Radiation Protection Building (2012-13).
7. Rationale for target status: Health Canada is on track to assess 100% of its facilities as per the departmental strategic framework. Four of the seven facilities have been assessed while the rest are scheduled for assessment in 2012-13.

Green Building Targets

Strategies and/or Comments

1. This target is not directly applicable to Health Canada since Public Works and Government Services Canada (PWGSC) negotiates leases on behalf of Health Canada. As the client, Health Canada can only request inclusion of this target in its lease requirements. Adherence to FSDS green building targets is in accordance with PWGSC's Strategic Framework and Departmental Sustainable Development Strategy.

Green Building Targets

Strategies and/or Comments

1. Minimum level of environmental performance: Green Globes Design three Globes or LEED CI Silver.
2. Appropriate threshold (dollar value or floor area): $1M and 1000m².
3. Applicable building types: temperature controlled facilities where Health Canada has full access and control over utilities monitoring and usage.
4. Rationale for target status: Health Canada is on track to achieve the target, as per the departmental strategic framework.

Greenhouse Gas Emissions Target

Strategies and/or Comments

1. Scope: targeted GHG emissions sources include only on-road fleet operations, no incremental funding is being made available.
2. Implementation Plan to reduce GHG emissions includes:
   Interim target: Health Canada's annual interim target is 1% absolute reduction in GHG emissions annually (until 2020-21), relative to baseline 2005-06. This represents 30% of the department's overall GHG reduction target by 2014. Therefore, by the end of the first DSDS, the department should have achieved a 3% reduction of GHG emissions.
   
   
   • Key Activities include:replacement of old vehicles; policy adherence; and communications and raising employee awareness.
     
   • An action plan has been developed to encourage adherence with Health Canada's fleet standards, which includes "greening" the fleet.
     
   • HC will also:
     
     
     • Provide stronger direction, guidance and a challenge function to fleet operators.
     • Use best practices already established from the more successful Regions/Programs.
     • Investigate practices of other government departments facing similar fleet challenges.
     • Ramp up communications (Goods News, Health Canada Broadcast News, National Materiel and Assets Advisory Committee meetings, etc.)
     • Health Canada will investigate opportunities to support a modernization strategy which includes using rental vehicles and/or carpooling, where applicable.
3. Rationale for traffic light indicator selected: GHG emissions have decreased by 20% from 2005-06. This can be explained due to an increase in the purchase of ethanol blended fuel (Regular/E10/E85) for more efficient vehicles. This reduction has been realized despite operational needs for cars to be driven more frequently and an increase in the number of alternative fuel vehicles procured over previous years.
4. Roles and Responsibilities: Director of Materiel and Asset Management Directorate (MAMD) is overseeing this target. Input and support for this target comes from Health Canada fleet managers and cost centre managers.
5. Reporting Requirements: Annual GHG emissions will be assessed with the Federal Greenhouse Gas Tracking Protocol - A Common Standard for Federal Operations, which is provided by PWGSC. Health Canada uses the Automotive Resources International data base to monitor and manage fleet operations.
6. Tools and Resources: Federal Greenhouse Gas Tracking Protocol - A Common Standard for Federal Operations; the Automotive Resources International database which manages fleet operations; and the Fleet GHG Inventory Accounting Template provided by PWGSC.

Surplus Electronic and Electrical Equipment Target

Strategies and/or Comments

1. Definition of location: The department has defined location as a region, of which there are nine (9): National Capital Region (NCR); Atlantic; Quebec; Ontario; Manitoba; Saskatchewan; Alberta; British Columbia; and the Northern region.
2. Health Canada's EEE implementation plan for the NCR includes all the required elements, as per the mandatory implementation strategies listed in the GGO targets table. This plan will be used to develop similar programs in remaining locations by the required timeline.
3. Rationale for target status: Health Canada is on track to achieve 100% of locations with a fully implemented EEE implementation plan.
4. Adjustments: The target reported for 2011-12 has been updated to reflect the fact that the number of regions in the department increased from eight to nine.

Printing Unit Reduction Target

Strategies and/or Comments

1. Definition: desktop printers, network printers and multi-functional devices.
2. Scope: Applies to all employees with the exception of: those who frequently deal with confidential or secret documents; those working in a space with a maximum of 15 employees or less; and employees requiring personal printers due to a disability.
3. Method used for determining the number of printing units: Network printing units have been determined using OpenView; a network discovery service. Personal printing units were determined by a walk-through exercise and an analysis of asset management databases and tools.
4. Method used for determining # of employees: Treasury Board Secretariat (TBS) Population Affiliation Report and departmental human resource statistics.
5. Number of employees subject to this target: 11,392.
6. Rationale for target status: While the overall printer ratio increased during 2010-11 due to increased data refinement, Health Canada is confident in its ability to meet an 8:1 ratio by end of 2012-13 by implementing its Printer Reduction Strategy.
7. Roles and responsibilities: ADM, Corporate Services Branch is the target lead. Other Branch Assistant Deputy Ministers (ADMs) are responsible for meeting the 8:1 ratio within their respective work units.

Paper Consumption Target

Strategies and/or Comments

1. Scope: Health Canada elected to include all departmental employees, instead of just office employees.
2. Method used for determining paper consumption: PWGSC standing offer data usage.
3. Method used for determining number of employees: TBS Population Affiliation Report and departmental human resource statistics.
4. Number of employees subject to this target: 11,392.
5. Rationale for target status: Health Canada is working to establish a concrete strategy to meet the 20% target by 2013-14. Strategies have been developed and are set to be implemented.
6. Roles and responsibilities: ADM of Corporate Services Branch is the target lead.

Green Meetings Target

Strategies and/or Comments

1. Scope: All meetings held at Health Canada offices.
2. Rationale for target status: Health Canada has adopted a green meeting guide.

Green Procurement Targets

8.10 As of April 1, 2011, each department will establish at least three SMART green procurement targets to reduce environmental impacts.

Strategies and/or Comments

1. Scope:
   • N7010 Automatic Data Processing (ADP) equipment
   • N7020 ADP CPU
   • N7021 ADP CPU
   • N7022 ADP CPU
   • N7025 ADP Input-Output
   • N7035 ADP support equipment
   • N7042 Mini and microcomputer control devices
2. Exclusions: laboratory or field equipment and purchases using acquisition cards
3. Departmental policy mandates the use of PWGSC standing offers (which include IT hardware purchases).
4. IT hardware purchases represent approximately 50% of assets.
5. Rationale for traffic light indicator selected:
   1. Volume/percentage of "unknown" responses from the baseline year has decreased from 34.7% to 6.7% in the given 2011-12.
   2. Health Canada has exceeded the self-selected target of 60% [March 31, 2014] by 28% in the given 2011-2012.
6. Other: Health Canada will use its green procurement field in SAP to assess the environmental friendliness of IT hardware. To decrease confusion on what is "green", SAP users have been given six specific options to choose from with extensive documentation on each:
   • Unknown (included to increase data reliability and assess the level of user awareness);
   • Environmental Attributes of Supplier;
   • Uncertified Environmental Attribute;
   • Certified Environmental Attribute(s);
   • Recycled Content; and
   • No Environmental Attribute.
7. A communication strategy was developed to encourage procurement officers and/or cost centre managers to comply in purchasing "green" IT hardware and utilize the SAP system to identify the greenness of procured items.
8. Investigate whether IT hardware providers (standing offers) can be limited to offering environmental preferred products only.

Green Procurement Targets

Strategies and/or Comments

1. Scope:
   • N7045 ADP supplies
   • N7510 Office supplies
   • N7520 Office devices and accessories
   • N7530 Stationary
   • N7540 Standard forms
   • N7035 ADP support equipment
   • N7042 Mini- and microcomputer control devices
   • Exclusions: purchases using acquisition cards
     
2. Other: Health Canada will use its green procurement field in SAP to identify "office supplies" with environmental features. To decrease confusion on what is "green", SAP users have been given six specific options to choose from, and extensive documentation on each:
   • Unknown (included to increase data reliability and assess the level of user awareness);
   • Environmental Attributes of Supplier;
   • Uncertified Environmental Attribute(s);
   • Certified Environmental Attribute(s);
   • Recycled Content; and
   • No Environmental Attribute.
3. Rationale for traffic light indicator selected :
   In 2011-12, Health Canada has exceeded the baseline of 30% in 2009-2010 by 28% which surpasses the progress against measure by 10%. Therefore, Health Canada is on track to achieve the self-selected target of 60%.
   
4. A communication strategy will be developed to encourage procurement officers and/or cost centre managers to comply with purchasing "green" office supplies and use the SAP system to identify the "greenness" of procured items.
5. Investigate whether office supply providers (standing offers) can be limited to offering environmental preferred products only.

Green Procurement Targets

Strategies and/or Comments

1. Semi-annual reports will be obtained through SAP and/or ARI to identify new fleet acquisitions. These will be individually assessed against the existing fleet standard matrices to determine compliance. 
2. The Health Canada Fleet Standard was developed in 2008 and will be updated annually.
3. A communication strategy was developed to encourage compliance with the standard.
4. Rationale for the traffic light indicator selected:
   A baseline of 45% has been determined. For 2011-12, 48% of vehicles purchased were right-sized for operational needs; deemed to be the most fuel efficient vehicle in their class (as per Health Canada Fleet Standard), and/or are an alternative fuel vehicle. In 2011-12, of the 75 fleet purchases 36 were compliant with Health Canada's Fleet Standard.

Green Procurement Targets

8.11 As of April 1, 2011, each department will establish SMART targets for training, employee performance evaluations, and management processes and controls, as they pertain to procurement decision making.

Strategies and/or Comments

1. Green Procurement Policy supports all designated employees (PG group) to take green procurement training.
2. An annual human resources report identifying PG group employees will be compared to MAMD's listing of participants who have taken thegreen procurement training (course C215 or in-house equivalent) through the CSPS.
3. Due to constant changes in the total number of PG positions at Health Canada, a percentage will be used to annually report the number of procurement and materiel management staff with formal green procurement training versus the total number of procurement and materiel management staff identified with such responsibilities in any given year.
4. PGs that have not taken the course(s) will be followed up with to encourage compliance.
5. Rationale: As of April 1, 2012, five out of 56 PGs had not completed the green procurement training course (C215) several of which are scheduled to do so in the coming months. Health Canada is on track to achieve its departmental training target by March 31, 2014.

Green Procurement Targets

Strategies and/or Comments

1. Rationale: Phase 1a - By April 1, 2011, all Health Canada materiel and asset management managers and functional heads within MAMD (1 director, 3 PG-6 senior managers and 7 PG-5 managers) had GGO clauses embedded into their employee performance evaluations.
2. Rationale: Phase 1b - By April 1, 2012, Health Canada developed strategies to have GGO embedded into the Corporate Commitments for Executives; including identifying applicable EX positions and matching them to appropriate clauses. Ultimately, a performance measure under the Leadership Results Commitment was included in the final version of the Corporate Commitments for Executives.
3. Rationale: Phase 2 - Health Canada has completed the assessment of the scope of program and regional managers [RSFOs and fleet managers] with procurement responsibilities/authorities related to GGO during 2011-12. Development and implementation strategies to incorporate environmental clauses into their employee performance evaluations will be completed by the end of the 2012-13. 

Green Procurement Targets

Strategies and/or Comments

1. During 2011-12 an internal assessment of the management processes and controls that pertain to Health Canada procurement decision-making was conducted. Governance, policies, processes, procedures, tools and templates, management information systems, risk management, results and performance, change management and information and communication were all examined.
2. 2011-12 was spent analyzing possible actions against impact on behavior, planning and reporting. Similarly, management processes and controls were assessed for their potential to impact on procurement objectives.
3. Based on the above analysis, the baseline type and number of processes and controls that accommodate green procurement has been narrowed down to the following:
   Policies , Processes and Procedures:
   1. CRCC Communiqué for NCR;
   2. CRCC Communiqué for Regions;
   3. Fleet Management Policy; and
   4. Fleet Management Standard.
4. Based on the above analysis, there are 13 procurement processes and controls in total, of which nine still require a "greening" process:
   1. Health Canada Assets Management Policy;
   2. Assets Management Standard;
   3. A contracting Guide for Cost Centre Managers and Administrators;
   4. Assets Inventory Instruction Guide (2010-11);
   5. Health Canada Materiel Management Policy;
   6. Procurement Planning Summary;
   7. Risk Management Policy;
   8. Annual Fleet Report; and
   9. Systems: SAP
5. The methodology for designating those management processes and controls that should include green procurement was based on version 2.0 of Setting Green Procurement Management Framework Targets.
6. A phased approach focusing on a subset of processes and controls in each fiscal year will be established. This represents a continuous improvement best practice.
7. A schedule for revising five identified management processes and controls each year has been established.

Horizontal Initiatives

Name of horizontal initiative 1: Federal Tobacco Control Strategy (FTCS)

Name of lead department(s):

Health Canada (HC)

Lead department program activity:

Substance Use and Abuse

Start date of the horizontal initiative: 2001

Funding for the initiative is ongoing but however the current policy approval ended March 31, 2012. Policy approval for a re-focussed FTCS was received in the Spring of 2012.

End date of the horizontal initiative:

Funding for the initiative is ongoing but however the current policy approval ended March 31, 2012. Policy approval for a re-focussed FTCS was received in the Spring of 2012.

Total federal funding allocation:

Total allocation for 2007-08 to 2011-12 was $326.6M (second phase of FTCS - renewal of Terms & Conditions was in 2007-08)

Description of the horizontal initiative (including funding agreement):

The FTCS establishes a framework for a comprehensive, fully-integrated, and multi-faceted approach to tobacco control. It is driven by the longstanding commitment of the Government of Canada to reduce the serious and adverse health effects of tobacco for Canadians. It focuses on four mutually reinforcing components: prevention, cessation, protection, and product regulation.

Shared outcome(s):

The long-term outcome of the FTCS is to reduce tobacco-related disease and death in Canada.

Governance structure(s):

Health Canada is the lead department in the FTCS and is responsible for the coordination and implementation of the FTCS, including delivering the contribution program component and undertaking activities related to our components and objectives. The role of federal partners will remain to: monitor and assess tobacco contraband activities; identify and prosecute offenders; impose and collect fines; and collect taxes under the Excise Act.

The partner departments and agencies are:

• Public Safety Canada - monitors increases in contraband tobacco activity and related crime;
• Office of the Director of Public Prosecutions - monitors federal fines imposed in relation to tobacco and other types of offences in order to enforce and recover outstanding fines;
• The Royal Canadian Mounted Police - works with federal partners to identify criminal activities and to coordinate information on national and international contraband tobacco issues;
• The Canada Revenue Agency - administers the Excise Act 2001, which governs federal taxation of tobacco products and regulates activities involving the manufacture, possession and sale of tobacco products in Canada; and
• The Canada Border Services Agency - increases knowledge of contraband domestically and internationally by liaising with tobacco authorities at all levels and by monitoring and providing regular reports on both national and global contraband tobacco.  The CBSA provides reports, information and guidance to the Department of Finance Canada on matters that will impact the future tax structure of tobacco.

Planning Highlights:

Funding for the initiative is ongoing but the current policy approval ends March 31, 2012. Further information is not available at this time.

Performance highlights:

Performance highlights:

Performance highlights:

Performance highlights:

Performance highlights:

Performance highlights:

Comments on variances:

* FTCS was in the renewal stage and surplus funds were reallocated within Controlled Substances and Tobacco Directorate. HC allocation figures include EBP and PWGSC Accommodations costs. HC total allocation figures are final budget allocations, which factors in all permanent reductions by the end of each fiscal year.

** Approximately $2M was deducted from the total allocation to date as well as the ongoing total since 2011-12, as a result of Strategic Review reductions. Also, of the $6.9M in yearly funding received by CBSA, $4.3M is related to compensation for revenue lost (loss of Duty Free Licensing) and is allocated to other Agency activities.

Results to be achieved by non-federal partners (if applicable):

The Akwesasne Mohawk Police (AMP) has been able to increase their surveillance and monitoring in regards to tobacco smuggling. The AMP has reported participating in joint forces operations that have led to charges and seizures, including tobacco. All tobacco seizures made by the AMP are turned over to the RCMP for prosecutions and reported through the RCMP Cornwall Detachment.

The Akwesasne Mohawk Police have enhanced their capacity in intelligence development and specialized criminal investigation techniques through their work with Canadian and U.S. law enforcement partners in the context of the Integrated Border Enforcement Team in the Cornwall area. In addition, they have had an opportunity to lead and participate in Joint Forces Operations related to cross-border criminal activities and organized crime.

An evaluation has been conducted by Consulting and Audit Canada under contract to PS. Annual reports is provided by the Akwesasne Mohawk Police, relating specifically to the Joint Investigation Team. These reports detail on-going efforts by the Joint Investigation Team to combat illicit tobacco activities in the Akwesasne Community, including breakdowns of significant seizures of contraband tobacco.

Contact information:

Cathy A. Sabiston, Director General
Controlled Substance and Tobacco Directorate
Healthy Environments and Consumer Safety Branch
Health Canada
Telephone: (613) 941-1977

Name of horizontal initiative 2: Defence of Canada Against Third-Party Claims in Tobacco Litigation

Name of lead department(s):

Health Canada (HC)

Lead department program activity:

Substance Use and Abuse

Start date of the horizontal initiative:

2010-2011

End date of the horizontal initiative:

2012-2013

Total federal funding allocation:

$45,738,000

Description of the horizontal initiative (including funding agreement):

The purpose of this horizontal initiative is to defend Canada against third party claims in tobacco litigation. The sources of funding for this initiative are:

• $34,878,000 over three fiscal years from the fiscal framework in Budget 2010;
• Up to $9,000,000 from Health Canada's existing reference levels ($3,000,000 in 2010-11, $3,000,000 in 2012-12, and $3,000,000 in 2012-13); and
• Up to $1,860,000 from Agriculture and Agri-Food Canada's existing reference levels ($1,100,000 in 2010-11, $380,000 in 2011-12, and $380,000 in 2012-13).

Shared outcome(s):

Canada is defended against third-party claims in tobacco litigation.

Governance structure(s):

The Interdepartmental Assistant Deputy Minister Steering Committee on Tobacco Litigation co-ordinates the defence efforts. The committee is co-chaired by Health Canada, Agriculture and Agri-Food Canada and Justice Canada. The responsibilities of the Steering Committee include:

• Ensuring a clear and consistent understanding of the collective and individual obligations of departments and agencies in all aspects of the defence;
• Providing high-level strategic instruction and policy advice as to significant aspects of the litigation or its financial administration;
• Monitoring expenditures;
• Monitoring the evolution of the defence and related resource allocations and needs; and
• Identifying and sharing lessons learned for any future large-scale document production or litigation actions.

Performance highlights:

Performance highlights:

Comments on variances:

• *1 FTCS was in the renewal stage and surplus funds were reallocated within Controlled Substances and Tobacco Directorate. HC allocation figures include EBP and PWGSC Accommodations costs. HC total allocation figures are final budget allocations, which factors in all permanent reductions by the end of each fiscal year.
• * 2 Approximately $2M was deducted from the total allocation to date as well as the ongoing total since 2011-12, as a result of Strategic Review reductions. Also, of the $6.9M in yearly funding received by CBSA, $4.3M is related to compensation for revenue lost (loss of Duty Free Licensing) and is allocated to other Agency activities.

Results to be achieved by non-federal partners (if applicable):

The Akwesasne Mohawk Police (AMP) has been able to increase their surveillance and monitoring in regards to tobacco smuggling. The AMP has reported participating in joint forces operations that have led to charges and seizures, including tobacco. All tobacco seizures made by the AMP are turned over to the RCMP for prosecutions and reported through the RCMP Cornwall Detachment.

The Akwesasne Mohawk Police have enhanced their capacity in intelligence development and specialized criminal investigation techniques through their work with Canadian and U.S. law enforcement partners in the context of the Integrated Border Enforcement Team in the Cornwall area. In addition, they have had an opportunity to lead and participate in Joint Forces Operations related to cross-border criminal activities and organized crime.

An evaluation has been conducted by Consulting and Audit Canada under contract to PS. Annual reports is provided by the Akwesasne Mohawk Police, relating specifically to the Joint Investigation Team. These reports detail on-going efforts by the Joint Investigation Team to combat illicit tobacco activities in the Akwesasne Community, including breakdowns of significant seizures of contraband tobacco.

Contact information:

Cathy A. Sabiston, Director General
Controlled Substance and Tobacco Directorate
Healthy Environments and Consumer Safety Branch
Health Canada
Telephone: (613) 941-1977

Name of horizontal initiative 3: Implementation of an Action Plan to Protect Human Health from Environmental Contaminants

Name of lead department(s):

Health Canada (HC)

Lead department program activity:

Sustainable Environmental Health

Start date of the horizontal initiative:

2008-2009

End date of the horizontal initiative:

2012-2013

Total federal funding allocation:

$84.6 million

Description of the horizontal initiative (including funding agreement):

Recent surveys show that Canadians are concerned about environmental contaminants and their effect on human health. There is a clear need to ensure that Canadians have credible information on the health impact of chemicals in their environment and the steps that they should take to protect themselves from potential harm.

The Government has already taken steps to address contaminants through the Chemicals Management Plan and the Clean Air Agenda, focusing on substances which have known potential for harming human health and the environment. Both industry and other stakeholders have been supportive of these initiatives but continue to insist that decisions be made based on scientific evidence and the precautionary principle. Monitoring, surveillance and ongoing research is needed to ensure that the effectiveness of interventions to address known potential risks can be assessed and that emerging risks can be detected.

The Action Plan to Protect Human Health from Environmental Contaminants is designed to further protect the health of Canadians from environmental contaminants while increasing the knowledge-base of contaminant levels and potential impacts on health, in particular:

• to foster awareness and provide information for Canadians to take action;
• to identify and monitor trends in exposures to contaminants and potential association with health problems such as asthma, congenital anomalies and developmental disorders; and
• to better understand the association between contaminants and illness.

$13.1M has been allocated to Health Canada from 2008-2009 to 2012-2013 to develop and disseminate an Environmental Health Guide for Canadians as part of the Hazardcheck campaign, as well as tailored guides for First Nations and Inuit communities. The objective of the guide is to help make Canadians aware of the risks that harmful environmental contaminants may pose to their health along with direct actions that they can take to reduce these risks and improve their health.

$54.5M has been allocated to Statistics Canada from 2008-2009 to 2012-2013 towards conducting the Canadian Health Measures Survey (CHMS) and $5.6M has been allocated to Health Canada from 2008-2009 to 2012-2013 to conduct the First Nations Biomonitoring Initiative (FNBI). The CHMS is used to collect information from Canadians about their general health and lifestyles and includes the collection of blood and urine specimens to be tested for environmental contaminants among other things. The CHMS will not provide data on First Nations on-reserve or Inuit communities. The FNBI will focus on these communities.

From 2008-2009 to 2012-2013, the Public Health Agency of Canada has been allocated funding in the amounts of $5.9M to enhance surveillance of congenital anomalies and $5.5M to conduct surveillance of developmental disorders.

Shared outcome(s):

Reduce health risks to Canadians (particularly vulnerable populations) from environmental contaminants.

Governance structure(s):

All action plan initiatives take advantage of governance and management structures already established for ongoing government programs such as: the Canadian Population Health Statistics Program, the Chemicals Management Plan, the Healthy Living and Chronic Disease initiative of the Public Health Agency of Canada, as well as components of existing national surveillance systems developed by the Public Health Agency of Canada in partnership with stakeholders.

Each program within Health Canada, the Public Health Agency of Canada and Statistics Canada is fully responsible for the management of initiatives they are leading within the action plan. Consultations and stakeholder involvement are governed through consultative structures and interdepartmental committees already established.

A tripartite governance structure with Health Canada, the Public Health Agency of Canada and Statistics Canada is used to oversee the implementation of the Canadian Health Measures Survey (CHMS). The CHMS will use the existing Canadian Population Health Statistics Program as a governance structure, which includes senior officials from all three federal organizations.

Performance highlights:

Expected results:

• Distribution of The Environmental Health Guides
• Increased online discussion of the link between health and home environments
• Tailored Guide for Inuit Youth and Outdoor activities are developed and distributed for review with Aboriginal partners.
• Tailored Guides for First Nations Fall/Winter Outdoor activities are developed and distributed to aboriginal communities.
• Continuation of the Environmental Health marketing campaign (mainstream and First Nations components).

Results Achieved:

HECSB/PACCB/FNIHB

Continuation of the Environmental Health marketing campaign / Distribution of The Environmental Health Guides

The 2011-12 Environmental Health Marketing campaign focused primarily on providing information and promoting awareness about common indoor environmental hazards (radon, carbon monoxide, mould, lead) via retail engagement/outreach events. The events were complemented by the continuation of advertising tactics and on-line information sources, as well as the introduction of public service announcements.

• Engagement events were held at 121 Home Depot locations across Canada during 2 consecutive weekends in October and November 2011. Through these events, consumers were educated on the potential environmental risks that may impact their health and how to mitigate them. The events included:
  • The distribution of 9,907 Hazardcheck guides and 36,063 Hazardcheck checklists (a new "take-away" product)
  • More than 30,000 face-to-face conversations and over 17,300 more people reached through subsequent consumer generated conversations
  • The combined sale of 127% more CO monitors, radon test kits and bath fans compared to the previous year in those locations where the campaign was held
  • The distribution to 3.76 M households of Home Depot flyer promoting the events
  • Respondents to the post-events survey indicated they found the Health Canada materials (Guides and Checklists) and their conversations with the event representative helpful
• A Google Ad word buy was again very successful, driving 46,000 visits to the Hazardcheck web pages
• Polybag insertion of 180, 000 copies of the Hazardcheck guides in the Parents Canada magazines with Expecting and C'est pour quand from November 2011 to April 2012.
• Online Outreach returned as a minor yet still important component of the campaign, in order to continue to leverage the Hazardcheck web pages/interactive information sources. Tactics and tools included the virtual house tour and quiz (developed in the last campaign year), as well as Twitter and Facebook posts, Blogger content and outreach and QR Codes.
• Public service announcements (PSA) were introduced to the campaign this year, which included the development of radio spots promoting Hazardcheck within the Health Canada Parent Report, and News Canada print, online and radio content that was distributed nationally. News Canada results indicate that 69 stories have been published to date, providing a reach of over 5.4 million. (Note: The final results eport for the Parent Report PSAs will be finalized in mid June 2012.)

FNIHB

First Nations Biomonitoring Initiative

In 2011-12, the focus for the First Nations Biomonitoring Initiative (FNBI) was on the implementation phase. This involved conducting the health survey in all First Nation communities who were randomly selected as part of the full-scale survey.

• FNIHB and the Assembly of First Nations (AFN) obtained Health Canada's Research Ethics Board approval to conduct the full survey across Canada.
• The health survey (comprising collection of blood and urine samples, taking direct physical measurements from participants, and completion of household questionnaire) was conducted for the FNBI full survey which included 13 First Nation communities across Canada (in partnership with the AFN). Over 500 First Nation peoples participated as part of the full survey.
• A working group was established which included federal, provincial, academia, and chemical specialists to address elevated exposure levels to chemicals of concern.
• Work with individuals and communities to decrease exposure to chemicals of concern.

FNIHB/PACCB

In 2011-12, the First Nations and Inuit Environmental Health Marketing campaign focused on providing and promoting tailored information directly in communities and online as recent research indicates that First Nations and Inuit community members prefer to receive information related to the environment through these channels.

• 9,000 copies of the Inuit Environmental Health Home Guide were distributed to Inuit households and an additional 6,000 were distributed to community health centres. The distribution plan for these guides in English, French and Inuktitut was completed in collaboration with ITK and NICoH.
• 4,000 copies of the First Nations Environmental Health guide were ordered online. This guide was distributed to households and community health centres last fiscal year.
• 44,000 copies of the First Nations Youth Guide and 21,000 copies of the Inuit Youth Guide were distributed to schools in First Nations and Inuit communities. 81,000 copies of the First Nations Kids and Teens Activity Booklets were distributed to schools. The Inuit Kids and Teens Activity Booklets have been developed and will be distributed to schools in the fall of 2012.
• The First Nations Outdoor Guides have been developed. The Spring/Summer versions are being distributed this spring (2012) to First Nations communities. The Fall/Winter versions will be distributed in the fall of 2012. The Inuit Ice Season Guide will be finalized and distributed to Inuit communities in the fall of 2012 and the Inuit Open Water Season Guide will be finalized and distributed in March 2013.
• Content of the First Nation and Inuit Home and Youth Guides, as well as the First Nations Spring and Summer Outdoor Guide and Youth Activity booklets are available on the HC website. The total number of website visits was over 44,000, compared with 3,700 website visits in 2010-2011.
• A four-module video on food safety was developed and made available online at the end of March, 2012. A DVD version along with complementary fact sheets were also produced and will be sent to EHOs for use and distribution in communities this spring (2012).
• The four video modules on mould were viewed over 46,000 times on YouTube (over 66,000 total views since posting in 2010).
• Online advertising generated over 62,000 clicks, including Facebook (33,000+ clicks), Google Adwords (17,000+ clicks) and YouTube (12,000+ clicks).
• Radio advertising on First Nations and Inuit radio stations generated approximately 3.5M impressions. Radio PSAs were also sent out to 159 First Nations and Inuit community radio stations. Print PSAs were sent out to 210 First Nations and Inuit community print publications.
• The advertising drove a 1,636% increase in web traffic.
• A Youth Art Contest was launched on March 26, 2012 with NAHO. The deadline for submissions was May 14, 2012, and a total of 70 submissions were received.
• A pilot project with the Aboriginal Peoples Television Network was started and will be completed by July 2013. It includes a TV PSA contest for Aboriginal film and broadcasting students, an exhibit at APTN's National Aboriginal Day Live event, and a community voice video (series video clips.

Performance highlights:

Expected results:

1. Enhanced Congenital Anomalies Surveillance:
   • increased capacity in the provinces and territories for surveillance of congenital anomalies in their urisdictions and
   • strengthened networks across Canada for surveillance and research into prevention of congenital anomalies.
2. Surveillance of Developmental Disorders:
   • develop a network for surveillance of autism in Canada and
   • increased public health scientific capacity on autism within the federal government.

Results Achieved:

Enhanced Congenital Anomalies Surveillance

• Increased capacity in the provinces and territories for surveillance of congenital anomalies in their jurisdictions
  • PHAC put in place Memoranda of Agreements to support 8 P/Ts across Canada to establish and enhance surveillance systems for congenital anomalies. Key P/T surveillance activities included consulting with local stakeholders, conducting needs assessments, developing databases, planning and implementing Privacy Impact Assessments, developing data sharing agreements, integrating data sources, collecting data, creating secured file transfer protocols, communicating with health care professionals and developing surveillance tools.
• Strengthened networks across Canada for surveillance and research into prevention of congenital anomalies
  • PHAC's Canadian Congenital Anomalies Surveillance Network (CCASN) provides an ongoing forum to engage P/T jurisdictions on the Agency's activities to improve congenital anomalies nationally, as well as a platform to move the initiative forward.
  • The CCASN successfully hosted its 9th Scientific Meeting on November 16-18, 2011 in Ottawa focussing on "Musculoskeletal Congenital Anomalies". Among other topics, participants discussed maternal and environmental risk factors associated with musculoskeletal congenital anomalies and ways to integrate congenital anomalies surveillance and research into current public health initiatives. This Meeting, held in conjunction with the CCASN Advisory Group meeting, provided a forum for exchange of knowledge and best practices that enable the Agency and its P/T counterparts in enhancing congenital anomalies surveillance nationally.

Surveillance of Developmental Disorders (including Autism Spectrum Disorders (ASDs))

• Develop a network for surveillance of ASDs in Canada
  • In 2011/12, the Agency put in place an Expert Advisory Committee, comprised of national experts in the fields of health, education, treatment/services, government/policy, as well as representatives from non-government organizations and professional associations. The Committee, which met for the first time in March 2012, will provide advice to the Public Health Agency regarding the creation of an ASD surveillance network in Canada.
• Increased public health scientific capacity in autism within the federal government
  • In 2011/12, the Agency completed staffing the new PHAC Developmental Disorders Surveillance Unit.
  • The Unit has been consulting with provincial and territorial partners to characterize how data is collected on individuals living with ASDs in Canada. The goal of these consultations is to better understand existing programs, data sources, needs and gaps to inform the development of a new surveillance system.

Performance highlights:

Expected results:

• CHMS Cycle 1: All data from Cycle 1 will be in the public domain and the CHMS biobank will be available for access by researchers according to published protocols. Access to the data by users and researchers, use of the data files in the Research Data Centres, publications in journals, media and other channels will be tracked and monitored.
• CHMS Cycle 2: Data collection response rates are monitored regularly to ensure adequate representation of the Canadian population by age group and sex. Ongoing data quality control and data quality assurance activities, including observation of the data collection procedures by health experts, are performed to ensure a high data quality level.
• CHMS Cycle 3: Specifications for data collection and processing applications, operations manuals and lab and clinic manuals will be developed in collaboration with health experts, through working groups and advisory committees, and federal partners through the tripartite governance structure between Health Canada, the Public Health Agency of Canada and Statistics Canada. Pilot testing and feasibility studies will determine appropriate operational processes to ensure high response rates and quality data while ensuring adherence to planned resources.

Results Achieved:

Canadian Health Measures Survey (CHMS)

Cycle 3 (2012-2013) Data collection began in January 2012 in Montreal QC, the first of 16 national sites. Data collection response rates are monitored regularly to ensure adequate representation of the Canadian population by age group and sex.

Several new measures in support of environmental contaminants include testing of household tap water for volatile organic compounds (VOCs) and fluoride; hearing tests to support examination of hearing loss and its association with noise exposure/noise pollution; and a Fractional exhaled Nitric Oxide (FeNO) measurement that directly measures airway inflammation. Also included in cycle 3 is an objective test of skin pigmentation. New laboratory measures in blood or urine include VOCs, acrylamide and glycidamide, methyl mercury, some additional organophosphate insecticides such as acephate and malathion, parabens, Triclosan, total immunoglobulin E, vitamin C, fatty acids, reproductive hormones and thyroid status.

Cycle 2 (2009-2011) Data processing and validation began in February 2012, with the first data files planned for release and dissemination in the fall, 2012. A series of analytical articles and fact sheets will be prepared in conjunction with the data release with a specific focus on indoor air data to be released in April 2013.

Cycle 1 (2007-2009) Six applications for studies using stored samples from the CHMS biobank are in technical and methodological review according to published protocols. Several studies using Cycle 1 data have been published and 65 studies have applied to use CHMS data through Statistics Canada Research Data Centre Network in Canadian universities.

Comments on variances:

HECSB: Expenditures were reduced through the continuation of alternate cost effective delivery approaches, other cost efficiencies (i.e. existing approved campaign content and products were used, no significant requirements to develop new materials), and partnerships. As well, a planned evaluation was delayed to 2012/13 and, therefore, these funds were not expended in 2011/12.

FNIHB: Travel costs were the primary result of unspent funds for the First Nations Biomonitoring Initiative (FNBI). Efficiencies were realized by travelling back-to-back to communities so as to avoid shipping costs for laboratory supplies and equipment as well as return flights for FNBI team.

PHAC: For Developmental Disorders surveillance, variances are the result of delays related to staffing of the new specialized Public Health Agency of Canada unit and in finalizing the establishment of a national advisory committee to oversee the developmental disorders surveillance network. For Congenital Anomalies surveillance, variances are related to delays in ongoing detailed negotiations for provision of data from key partners.

Results to be achieved by non-federal partners (if applicable):

Health Canada: Partnerships in the First Nations Biomonitoring Initiative involved the Environmental Stewardship Unit of the Assembly of First Nations.

• Obtained HC's Research Ethics Board approval for the full survey in collaboration with FNIHB.
• Returned individual results to participants in the pilot study.
• Conducted health survey (comprising collection of blood and urine samples, taking direct physical measurements from participants, and completion of household questionnaire) for the FNBI full survey which included 13 First Nation communities across Canada (in partnership with FNIHB).

Published article on the First Nations Biomonitoring Initiative with the "International Journal of Hygiene and Environmental Health

Contact information:

Suzanne Leppinen
Director, Chemicals Policy Bureau
Safe Environments Directorate, Healthy Environments and Consumer Product Safety Branch, Health Canada
613-941-8071
Suzanne.Leppinen @hc-sc.gc.ca

Name of horizontal initiative 4: Early Childhood Development (ECD) Strategy for First Nations and Other Aboriginal Children.

Name of lead department(s):

Health Canada (HC)

Lead department program activity:

First Nations and Inuit Health Primary Health Care

Start date of the horizontal initiative:

• ECD component - October 2002.
• Early Learning and Child Care (ELCC) component - December 2004.

End date of the horizontal initiative:

• ECD component - ongoing.
• ELCC component - ongoing.

Total federal funding allocation:

• ECD: $320 million 2002-03 to 2006-07 ($60 million in 2002-03 and $65 million thereafter). Ongoing: $65 million per year.
• ELCC: $45 million 2005-06 to 2007-08 ($14.5 million in 2005-06; $15.3 million in 2006-07; $15.2 million in 2007-08). Ongoing: $14 million per year.

Description of the horizontal initiative (including funding agreement):

The goal of the Federal Strategy on Early Childhood Development for First Nations and Other Aboriginal Children, announced in October 2002, is to address the gap in life chances between Aboriginal and non-Aboriginal children. This initiative allocated $320 million over first five years which was shared by Health Canada, Human Resources and Skills Development Canada, Aboriginal Affairs and Northern Development Canada, and the Public Health Agency of Canada.

In December 2004, an additional $45 million was approved (beginning fiscal year 2005-06) with $14 million ongoing, to increase access to and improve the quality of ELCC programming for First Nations children on reserve.

The objectives of these funds are to increase access to and improve the quality of ELCC programming for First Nations children on reserve, and improve integration and coordination between the two programs through joint planning, joint training and co-location.

Shared outcome(s):

The ECD component complements the September 2000 First Ministers F/P/T ECD Agreement. It seeks to address the gap in life chances between Aboriginal and non-Aboriginal children by improving the developmental opportunities to which Aboriginal children (and their families) are exposed at an early age (0-6 years).

The ELCC component complements funding released to provinces and territories under the March 2003 Multilateral Framework for Early Learning and Childcare (ELCC) to improve access to ELCC programs and services.

Governance structure(s):

• Interdepartmental ECD ADM Steering Committee;
• Interdepartmental ECD Working Group.

Performance highlights:

Performance highlights:

Performance highlights:

(*) Based on current HRSDC Program Activity Architecture

Performance highlights:

Comments on variances:

HECSB: Expenditures were reduced through the continuation of alternate cost effective delivery approaches, other cost efficiencies (i.e. existing approved campaign content and products were used, no significant requirements to develop new materials), and partnerships. As well, a planned evaluation was delayed to 2012/13 and, therefore, these funds were not expended in 2011/12.

FNIHB: Travel costs were the primary result of unspent funds for the First Nations Biomonitoring Initiative (FNBI). Efficiencies were realized by travelling back-to-back to communities so as to avoid shipping costs for laboratory supplies and equipment as well as return flights for FNBI team.

PHAC: For Developmental Disorders surveillance, variances are the result of delays related to staffing of the new specialized Public Health Agency of Canada unit and in finalizing the establishment of a national advisory committee to oversee the developmental disorders surveillance network. For Congenital Anomalies surveillance, variances are related to delays in ongoing detailed negotiations for provision of data from key partners.

Results to be achieved by non-federal partners (if applicable):

Human Resources and Skills Development Canada: When completing the RPP in November 2010, HRSDC was planning to spend $1.5M for the surveys data and $0.8M for the Aboriginal component of "Understanding the Early Years" (AUEY) (total amount of $2.3M). The AUEY is a sunset initiative. As for the Aboriginal children data, it was decided to partner with AANDC and HC and collect information on young Aboriginal children living on-reserve.

Contact information:

Halina Cyr, Director
Health Promotion and Disease Prevention,
Inter-professional, Advisory and Program Support Directorate
First Nations and Inuit Health Branch, Health Canada
Postal Locator 1920A Tunney's Pasture, Ottawa
Telephone: (613) 948-6412
Email: halina.cyr@hc-sc.gc.ca

Name of horizontal initiative 5: Food and Consumer Safety Action Plan (Action Plan).

Name of lead department(s):

• Health Canada (HC)
• Canadian Food Inspection Agency (CFIA)
• Public Health Agency of Canada (PHAC),
• Canadian Institutes of Health Research (CIHR).

Lead department program activity:

• HC: Health Products, Consumer Products Safety, Pesticide Safety and Food Safety and Nutrition;
• CFIA: Food Safety Program;
• PHAC: Health Promotion, Chronic Disease Prevention and Control, and Infectious Disease Prevention and Control;
• CIHR: Health and Health Services Advances.

Start date of the horizontal initiative:

2008-2009

End date of the horizontal initiative:

2012-2013 (and ongoing)

Total federal funding allocation:

$489.4 million over five years ending in Fiscal Year 2012-2013 (and $126.7 million ongoing)

Description of the horizontal initiative (including funding agreement):

The federal government is responsible for promoting the health and safety of Canadians. A key part of this role is ensuring that the food, health and consumer products used by Canadians are safe. Adverse consequences associated with unsafe products impact not only the Canadian public, but also the Canadian economy. The Action Plan is a horizontal initiative aimed at modernizing and strengthening Canada's safety system for food, health and consumer products. A number of high-profile incidents, such as lead and ingestible magnets in children's toys, foodborne illness outbreaks, and the global withdrawal of some prescription medicines, have underscored the need for government action.

The Action Plan modernizes Canada's regulatory system to enable it to better protect Canadians from unsafe consumer products in the face of current realities and future pressures. The Action Plan bolsters Canada's regulatory system by committing to amending or replacing outdated health and safety legislation with new legislative regimes that respond to modern realities, and by enhancing safety programs in areas where modern legislative tools already exist. The Action Plan helps to ensure that Canadians have the information they need to assess the risks and benefits associated with the consumer and health products they choose to use, and to minimize risks associated with food safety.

The Action Plan is an integrated, risk-based plan and includes a series of initiatives that are premised on three key areas of action: active prevention, targeted oversight and rapid response. We focus on active prevention to avoid as many incidents as possible and work closely with industry to promote awareness, provide regulatory guidance, and help identify safety concerns at an early stage. Targeted oversight provides for early detection of safety problems and further safety verification at the appropriate stage in a product's life cycle. To improve rapid response capabilities and ensure the government has the ability to act quickly and effectively when needed, we work to enhance health and safety risk assessments, strengthen recall capacity, and increase the efficiency in responding and communicating clearly with consumers and stakeholders.

Shared outcome(s):

• Increased knowledge of food risks and product safety (scientific and surveillance/monitoring);
• Increased industry awareness and understanding of regulatory requirements;
• Increased industry compliance with safety standards;
• Increased consumer awareness and understanding of safety risks associated with health and consumer products and food;
• Strengthened oversight and response to safety incidents;
• Increased consumer confidence in health and consumer products and food;
• Increased trade-partner confidence in Canadian controls, which meet international standards;
• Increased availability of safe and effective products; and
• Level playing field where imports can be demonstrated to meet Canadian requirements.

Governance structure(s):

The Minister of Health and the Minister of Agriculture and Agri-Food Canada have joint responsibility and accountability for results, and for providing information on progress achieved by the Action Plan.

A Governance Framework has been established and endorsed by all of the partner departments/agencies. To facilitate horizontal coordination, the following Director General (DG)/Executive Director (ED) level Task Forces have been established:

• Legislative and Regulatory Task Force;
• Health Products Task Force;
• Consumer Products Task Force;
• Food Task Force; and the
• Communications Task Force.

These Task Forces report to a DG/ED level Coordinating Committee. An Assistant Deputy Minister (ADM)/Vice President (VP) level Steering Committee provides direction to the Coordinating Committee. An Oversight Committee of Deputy Heads facilitates the provision of high level guidance to the Steering Committee.

Health Canada's Strategic Policy Branch (SPB) provided the Secretariat function for the Action Plan until April 2012 when it was transferred to Health Products and Food Branch (HPFB). The Secretariat provides the oversight and integration of performance against commitments, and providing advice to senior management.

Health Canada's Health Products and Food Branch (HPFB) has primary responsibility for implementing Action Plan activities related to health products with support from Health Canada's Strategic Policy Branch (SPB) and the Canadian Institutes of Health Research (CIHR) on one initiative (increased knowledge of post-market drug safety and effectiveness).

Health Canada's Healthy Environments and Consumer Safety Branch (HECSB) and the Pest Management Regulatory Agency (PMRA), along with the Public Health Agency of Canada (PHAC), work together to implement Action Plan activities related to consumer products. The Canadian Food Inspection Agency (CFIA), HPFB and the Public Health Agency of Canada (PHAC) work together to implement Action Plan activities related to food safety.

The Public Affairs, Consultation and Communications Branch (PACCB) provide communications support for all of the above activities and will coordinate or lead many of the horizontal Departmental activities under the Consumer Information Strategy.

Performance highlights:

Active Prevention

Expected results for Health Products 2011-12

The Health Products program will initiate regulatory change to include regulatory oversight of the manufacturing of active pharmaceutical ingredients to improve the safety, quality and efficacy of health products. To increase awareness and compliance with regulatory requirements, Health Canada continues to engage in pre-submission meetings with industry, including the ability to better document, track, and monitor and evaluate the exchange of information. These meetings provide an opportunity for the drug submission sponsor to obtain feedback regarding areas of concern prior to filing a submission. In addition, as part of the lifecycle approach, and in the absence of enabling legislation, Health Canada continues to implement an interim strategy for development and review of Pharmacovigilance Plans (PvP) and Risk Management Plans (RMP) with the aim of generating better and new information concerning health products during the pre or post-market phases. A PvP, which can be requested by Health Canada or submitted voluntarily by the manufacturer, identifies and characterizes known or potential safety concerns. RMP, which include a PvP component plus additional risk minimization activities, provide proposals on how to mitigate any identified or potential safety risk by providing additional assurance that the manufacturer has measures in place to react and act quickly if new information concerning the product emerges once on the market. To improve and augment patient and consumer participation in Health Product and Food Branch (HPFB) consultations, a Patient and Consumer Pool will be launched. Efforts in 2011-12 will focus on the establishment of a governance body, the implementation of a recruitment strategy, and the development and delivery of training material. The Active Pharmaceutical Ingredient (API) Inspection Program is dependent on the introduction of the API regulations; therefore, API inspections are not possible at this time and targets cannot be set. Preparatory work on inspection training, compliance and promotion work continue while these regulations are pending.

Expected results: Enhance knowledge of post-market health products safety risks and oversight of risk management and mitigation strategies to inform decisions and to increase ability to monitor and identify safety concerns before or as they arise.

Results Achieved for Health Products 2011-12

Risk Management Plans/Risk Management and Mitigation Plans

There has been a consistent annual increase in industry submitted Risk Management Plans (RMP) and Risk Management and Mitigation Plans (RMMP) to Health Canada. In 2011-12, there were 95 RMPs and 28 RMMPs submitted by industry. This represents an increase of one third for each category from the previous year. Health Canada completed 85 RMPs and 37 RMMPs in 2011-2012, of which 97% were completed within the 90 day performance standard. This represents an increase over the 69 RMPs and 19 RMMPs completed in 2010-2011. (Note: The term "Pharmacovigilance Plan" (PvP) is no longer current, and has been replaced with Risk Management Plans and Risk Management and Mitigation Plans).

Pre-Submission Meetings

In 2011/12, Health Canada organized a total of 71 face to face pre-submission meetings with industry to discuss biologics, radiopharmaceuticals and genetic therapies. Multiple teleconferences were also held dealing with submissions in review. In addition, the regulatory staff responded to phone calls/ e-mails from sponsors on regulatory matters on a daily basis. The 71 pre-submission meetings with sponsors led to the following submissions being filed for review: 11 clinical trial applications (CTA), 2 New Drug Submissions (NDS), 7 Supplemental New Drug Submissions (SNDS), and 1 Abbreviated New Drug Submission (ANDS) for a radiopharmaceutical for a total of 20 new submissions filed.

Pharmaceutical Drugs received 129 meeting requests of which 78 meetings were held face-to-face, through teleconference, or through written correspondence to address the items raised by sponsors in their meeting requests. Thirty-eight meetings were scheduled and are pending and 13 were cancelled. Specific to the Oncology candidate submissions pilot, in 2011-12, 27 oncology pre-submission meeting requests were received, an increase from last year's 17. Eighteen meetings were held and 4 were cancelled.

Following up on the 17 Oncology meetings held in 2010-11, due to the large number of variables and complexity involved in scientific-based decision making, it is not feasible to attribute an increased efficiency or different review outcome to the fact that a pre-submission meeting was held. Pre-submission meetings do, however, allow for earlier scoping of key issues that could arise during review. For example, they facilitate earlier discussion in the review process of the submission or of possible scientific issues by the review team, such as at a review team's "kick-off meeting". Pre- submission meetings also provide an opportunity for Health Canada to hear from Canadian clinical experts during the meetings and to pose questions directly to them.

In addition to the above, industry was engaged to enable Health Canada to obtain feedback on the use of and value of pre-submission meetings. The results of this survey are pending and are expected by mid-2012.

Patient and Consumer Pool

The Patient and Consumer Participation Pool initiative was launched and 87 stakeholders were recruited. There were 60 calls made to Pool participants to match them appropriately to consultation activities. In the latter part of the year, members of the Pool's External and Internal Advisory Groups were appointed. Completed portions of the on-line training module for Pool participants were piloted.

Expert Advisory Committees

Health Canada continued to participate in both the HPFB Secretariat Manager's Network and the Departmental Reference Group by providing input into the development of the Health Canada Policy on External Advisory Bodies. A departmental guidance on Advisory Committees was finalised and posted on the website.

Furthermore, advice or recommendations received from external experts through our scientific advisory bodies, which Health Canada considers when making regulatory decisions, was made available to the public on the Health Canada website. Proceedings of this year's meetings can be found at http://www.hc-sc.gc.ca/dhp-mps/prodpharma/activit/sci-com/index-eng.php

A protocol was developed to allow observers to attend certain agenda items of Advisory Committees. This protocol will be piloted in the 2012/2013 fiscal year.

In addition, all therapeutic product committees are now in compliance with Departmental guidance on declaration of conflicts of interest and affiliations. These declarations are posted on Health Canada's website for all members of our committees and panels.

Social Media and Web Development

Health Canada encouraged social networking and conversations among consumers through Facebook posts on the Healthy Canadians page and Twitter. These platforms were used to promote the Recalls and Safety Alerts mobile application for BlackBerry, Android and iPhone smart phones and to inform consumers whether recalls had been issued for products that they were about to purchase or had already bought. Health Canada also supported the development of a web based version of the Recalls and Safety Alerts mobile application. This web tool will be promoted in 2012-13 as part of the Healthy Canadians campaign, which is a merger of the Safe and Informed Consumers campaign and the Children's Health and Safety campaign.

Health Canada's websites were redeveloped with a new look, feel and functionality for Healthy Canadians (a consumer focused website), as well as hundreds of pages of new and renewed content.

Health Canada staff were trained in web and clear writing workshops, and improvements were made to Health Canada's distribution and contact centres, ensuring better and more timely access to health information for Canadians.

Drug Approvals (Interim funding)

In 2011-12, Health Canada was successful in maintaining 90% of decisions issued within theperformance target for brand name new drug submissions when combined. When reported separately, performance for New Drug Submissions (NDS) was 89% (88) and for Supplemental New Drugs (SNDS) 97% (131). For Generic Drug submissions, 17% (104) met target for Abbreviated New Drugs Submissions (ANDS) and 51% (70) for Supplemental Abbreviated New Drug Submissions (SANDS). We continue to make progress, but a performance backlog still exists.

With respect to Health Canada's contribution toward enabling timely access of safe drugs for Canadians, in 2011-12, 87% (38) New Active Substance (NAS) approvals were made within performance targets. Of the 28 products approved by Health Canada, 27 are now marketed in Canada.

(Note these figures include 1st and 2nd decisions for FY 2011-12. All numbers are subject to change pending the official annual TPD submission performance report.)

Consumer Information Strategy for Health Products

Health Canada developed and published a draft guidance document entitled, Product Monograph - Part III: Consumer Information. (Product Monographs are factual, scientific documents on a drug product that, devoid of promotional material, describes the properties, claims, indications, and conditions of use for the drug, and that contains any other information that may be required for optimal, safe, and effective use of the drug.)

A stakeholder workshop on the Plain Language Labelling Project was held and stakeholders were provided with an overview of the project. They had an opportunity to ask questions about and provide general feedback, verbally and written, on how to improve the clarity, readability, and ease of use of the Product Monograph Part III: Consumer Information (for pharmaceuticals and biologics), as well as the Instructions for Use (for medical devices intended for use by consumers). The meeting was attended by a broad cross-section of patient and consumer groups, industry, health literacy groups and health professional associations.

Additionally, Health Canada continued to process and publish 2,396 product monographs to the Health Canada website this year.

Summary Basis of Decision Project

Summary Basis of Decision (SBD) documents explain why Health Canada authorized certain drugs and medical devices for sale in Canada. The documents include regulatory, safety, effectiveness and quality (chemistry and manufacturing) considerations. Notice of Decisions (ND) documents, posted before SBDs, inform the public of the authorization and provide some general information about the decision and product itself

Health Canada consulted externally on plans for Phase II of the Summary Basis of Decision Project, in order to obtain feedback from stakeholders on proposed changes to the initiative. External consultation included a face-to-face meeting with key stakeholders and an online consultation via the Health Canada website. A consultation report was posted in early 2012.

Additionally, Health Canada published on its website, 29 Notices of Decision and 26 Summary Basis of Decision documents (for pharmaceutical drugs, biologics and medical devices).

The Active Pharmaceutical Inspection Program

The Active Pharmaceutical Inspection (API) Program is dependent on the regulatory amendments, which are in the process for approval. Health Canada's Inspection Program has initiated a voluntary API Program.

Performance indicator:

Year over year increase in PvP/RMP submitted by industry. Number of pre-submission meetings per year.

Expected results for Consumer Products Safety 2011-12

The Consumer Products Safety program will provide information to consumers and work closely with industry to promote awareness, provide regulatory guidance, help identify and systematically assess safety risks at early and ongoing stages of product development, develop standards and share best practices.

Expected results:

Increased consumer/industry awareness of health risks and regulatory requirements related to consumer products.

Results Achieved for Consumer Products Safety 2011-12

Industry Awareness

The new, modernized legislation - the Canada Consumer Product Safety Act (CCPSA), which replaces Part I and Schedule I of the Hazardous Products Act (HPA), is designed to address risks associated with consumer products available in the Canadian marketplace. With the coming-into-force of the CCPSA on June 20, 2011, Health Canada adopted modern tools and techniques to strengthen protection of health and safety, and bring Canada's consumer product safety system in line with key trading partners.

To increase industry awareness of their product safety obligations, a stakeholder outreach plan for the CCPSA was implemented. It outlined a number of regional outreach activities, the production and development of various guidance materials, a public notice campaign, and electronic newsletters ― including the creation of a subscription service for industry to receive regular updates ― and modifications to industry and consumer sections on Health Canada's website to improve access to guidance and consultation documents.

Highlights include:

• Web posting of a comprehensive set of Frequently Asked Questions, CCPSA presentation, webinars, and guidance material for Industry
• 1800 views/downloads of the online education video and 450 attendees for the educational webinars.
• Approximately 130 industry presentations across the country, reaching over 1,500 people. Of these participants, 448 completed an awareness survey. The survey asked participants to rate their awareness levels before the information session and after.
  • Prior to the information sessions 15% of participants indicated that they were "Very Aware" of their obligations under the new CCPS and 43% indicated that they were "Somewhat Aware".
  • Post information sessions awareness increased amongst participants to 60% indicating they were now "Very Aware" and 39% indicating they had become "Somewhat Aware".
  • 96% of industry respondents found the sessions to be helpful.
  • 28% became aware of information sessions through Industry Associations, 24% from the Health Canada Website, 15% from the Internet, 14% from Consumer Product Safety Staff, 7% from Public Notices and 11% identified "Other".
• Developed and distributed a suite of CCPSA publications (disseminated about 10,000 copies of each):
  • Canada Consumer Product Safety Act ― Quick Reference Guide
  • Canada Consumer Product Safety Act ― Information for Retailers
  • Canada Consumer Product Safety Act ― Preparing and Maintaining Documents
  • Canada Consumer Product Safety Act ― Protecting Consumers through Product Safety
  • Guidance on Mandatory Incident Reporting under the Canada Consumer Product Safety Act ― Section 14 Duties in the Event of an Incident

Moving forward, Health Canada will continue to provide guidance to industry and will place more emphasis on the role consumers have to play in product safety. This involves encouraging consumers to report health and safety related incidents to Health Canada as well as to the manufacturer or supplier of the product.

With respect to consumer and clinical radiation protection activities under the Radiation Emitting Devices Act (REDA), Health Canada responded to 150 inquiries by industry regarding safety obligations under REDA.

Consumer Awareness

To increase consumer awareness of product safety issues, we focused on updating Health Canada's website and participated in the renewal of the Healthy Canadians website. We updated more than 200 consumer pages and changed technical language to plain, consumer-friendly text and developed a writing guide for the Department, to pass along the importance of clear language in all of its publications. New social media tools were developed to give Canadians the option to receive information by way of mobile applications, widgets, social networking and videos were produced and posted.

Highlights include:

• the Healthy Canadians Facebook page and Twitter was used to promote the Recalls and Safety Alerts mobile application for BlackBerry, Android and iPhone smart phones that allows buyers to find out if a product they are about to purchase or have already bought has been recalled.
• a web based version of the Recalls and Safety Alerts mobile application was developed. This web tool will be promoted inn 2012-13 as part of the Healthy Canadians campaign, which is a merger of the Safe and Informed Consumers campaign and the Canadian Health and Safety campaign.

Public Opinion Research was completed in 2011 to explore consumer awareness, attitudes and knowledge as they relate to Consumer Products. The research consisted of two elements: a telephone survey, and a set of focus groups. 1,357 adult Canadians (general public) were interviewed. The total number of parents/ guardians of children 12 or younger in the sample that is available for analysis is 545. The focus groups followed the survey and were designed to obtain supplementary information on key issues identified from the survey results, as well as to help interpret some of the quantitative findings.

Levels of awareness with respect to Consumer Products:

• 54% of the general public and 70% of parents stated that they were aware that the Government of Canada posts safety information, such as advisories, warnings or recalls.
• 53% of the general public and 57% of parents are aware Health Canada posts on the Internet advisory, warning and recall notices to inform Canadians about potential health risks associated with the unsafe use of certain products.
• 72% of the general public and parents identified the Internet as an effective method of receiving product safety information. Other effective methods were:
  • 71% Family and friends
  • 65% Health Canada publications
  • 64% manufacturer product information
  • 63% newspapers
  • 62% Health Canada's website
  • 61% consumer watchdog publications
  • 60% television
  • 53% Retailers.
• 70% of the general public and parents read labels before purchasing a product. Of this group:
  • 17% identified reading labels for cosmetics,
  • 13% of the general public and 41% of parents for children's products.
• 94% of the general public and 39% of parents do not currently subscribe to any of the Government of Canada RSS feeds for safety information.
• 52% of the general public and 55% of parents said they did not know that they can report an incident or injury involving consumer products among respondents aware of this, 5% of the general public and parents have done it.

Health Canada will use the results of this survey to improve its consumer outreach strategies in 2012-13.

To increase consumer awareness of health risks associated with radiation emitting devices, the following documents were published/updated on the Health Canada website:

• It's Your Health - Preventing Skin Cancer
• It's Your Health - Safety of Cell Phones and Cell Phone Towers
• It's Your Health - Safety of Wi-Fi Equipment
• It's Your Health - Smart Meters
• It's Your Health - Sun Safety - Healthy Living Website (in collaboration with PHAC)
• Information Update - Health Canada Offers Practical Advice on Safe Cell Phone Use
• Safe Use of Cell Phones Video
• Cell Phones (CPS Web page)
• Cell Phone Towers
• Health Canada Statement on Radiofrequency Energy and Wi-Fi Equipment (2012)
• Wi-Fi Equipment
• Frequently Asked Questions About Wi-Fi
• Radiofrequency Fields
• Electromagnetic Hypersensitivity
• Laser Advisory

Performance indicators:

% by target population aware of information related to consumer product safety and related to exposure to consumer products by: level of consumer awareness; type of target group and # reached; planned industry outreach activities completed by level of establishment; and product category.

Expected results for PMRA 2011-12

Pest Management Regulatory Agency (PMRA) encourages and facilitates industry development and adoption of quality assurance and stewardship programs for the safe manufacture and subsequent selection and use of pesticides and other consumer products containing pesticides. Retailers of pest control products often rely on their distributors for validation of access to products with lapsed registrations, or which have never been registered. Work under this strategy fosters an increased knowledge of the requirements of the Pest Controls Products Act (PCPA) and an awareness of the tools available to validate the status of the pest control products and their label information. These initiatives are critical in promoting the safe and proper use of pesticides and ensuring risk reduction practices are established along the entire supply chain. In addition, stakeholders are engaged in order to test assumptions about the ability and will to comply with product recall or phase-out requirements. This includes such considerations as whether users can follow through with specific requirements when the financial implications are significant.

Expected results:

Increased awareness and understanding of product safety obligations, standards and regulatory requirements by industry.

Results Achieved for PMRA 2011-12

Outreach Activities

PMRA engaged in targeted safety education efforts on key themes, including personal protective equipment, reading and following product labels, flea/tick products for pets, and rodenticides used in domestic settings. Outreach material was disseminated broadly to public through Pest Management Information Service (1-800 call line and e-mail service; responded to 2,200 public inquiries in 2011). "Generic" articles on responsible pesticide use prepared by Health Canada resulted in widespread exposure in online and print media across the country (450 published articles in 2011). Additionally, all regions were equipped with booths/screens and educational tools in regards to responsible pesticide use for participation at consumer-oriented events (e.g. home/garden shows) throughout Canada.

Compliance and Enforcement Activities

PMRA participated and delivered compliance and enforcement presentations at various fora (annual F/P/T meeting, annual Association of American Pesticide Control Officials meeting, Canadian Consumer Specialty Products Association, and Pest Management Advisory Council meetings.) These activities provided awareness of PMRA regulatory requirements and improved stakeholder knowledge as it relates to the regulation of consumer pesticides.

Additionally, 128 stakeholders were engaged through activity specific presentations, print material, interviews and meetings of pesticide regulation and responsibilities. Other consultation activity included the delivery of the second phase of a consultation program with rental property associations (13 consultations) toward increasing their level of knowledge related to the safe use of pesticide products and associated regulatory requirements. During inspections of 310 consumer pesticide vendors, importers and distributors, provided information in support of raising awareness of regulatory requirements.

Seven compliance and enforcement projects/programs were developed and delivered, as well the contribution to the development of a Health Canada policy for articles treated with pesticides.

Performance indicators:

% of the target population aware/engaged/confident regarding risks and regulatory activities; # of complaints and/or incidents; # of industry situations noted and self-corrected; # violations where absence of knowledge of requirements is the cause; and # of stakeholder partnerships formed.

Expected results for Food Safety and Nutrition 2011-12

The Food Safety and Nutrition program activity will continue to support the Government as it develops and seeks Parliamentary approval for amendments to the Food and Drugs Act (FDA) to strengthen and modernize food safety provisions. The program will continue to conduct risk mapping exercises, engage industry to address food safety risks, develop strategic partnerships for work sharing opportunities in standard setting with international food regulators, consult with consumers and industry on updated food standards and will update its health risk assessment standard operating procedures to respond to new service standards.

Expected results:

Increased industry and public understanding/engagement in food safety risks and mitigation processes, improved international collaboration in establishing global standards and establishment of the appropriate instrument or mix of instruments, including regulatory and non-regulatory measures (policies, standards, etc), to address immediate areas of concern.

Results Achieved for Food Safety and Nutrition 2011-12

Regulatory Modernization

Health Canada developed targeted amendments to the Food and Drugs Act that would support the modernization of food safety frameworks. These amendments will provide more nimble and flexible tools to enable updated policies, so that frameworks are more aligned internationally and support risk-based approaches. The changes will continue to put the health and safety of Canadians first, providing more rapid implementation of decisions in consultative and transparent approaches.

The Food Safety Program of Health Canada has developed information materials on the new Food Allergen Labelling Regulation. The new regulation has been presented to consumer associations including: Anaphylaxis Canada, Association Quebecoise des allergies alimentaires (QC), and Asthme et Allergies Association (QC), as well various industry associations. A webcast entitled "Food Allergen Labelling: "Updated Canadian Regulations" was also staged in collaboration with Agriculture and Agri-Foods Canada.

Health Canada continued to review the current policy on food allergen precautionary statements. To address the potential risks associated with the misuse or misinterpretation of food allergen statements, Health Canada and the CFIA recommended that food manufacturers and importers begin to use only one precautionary statement of food labels: "may contain (x)" where x is the name by with the allergen is commonly known.

Health Canada posted a joint risk assessment with its Canadian and International counterparts on the potential risks from norovirus contamination in bivalve molluscan shellfish (i.e., oysters, clams, mussels). Health Canada is collaborating with these groups to gain a better understanding and interpretation of the risks associated with viral contamination in bivalve shellfish. 

A consultation was held on the guidance document entitled "Guidance for Industry on Reducing the Risk of Salmonella Enteritidis in Canadian Shell Eggs". This guidance document was developed to provide industry with recommendations on ways to reduce the risk of foodborne illness due to Salmonella Enteritidis in Canadian Shell Eggs.

Health Canada posted an"Updated Approach for Managing Dietary Exposure to Lead" along with a new "Lead in Food" information page. The strategy focuses on the continued assessment of dietary intake of lead, revising the health risk assessment of lead in foods, identifying and controlling point sources of lead contamination of foods, and developing risk management recommendations regarding lead.

An information page on "Lectins in Dry Legumes" was posted on Health Canada's website. Lectins are naturally-occurring plant proteins that are found at low levels in the edible parts of commonly consumed fruits and vegetables such as apples, bananas, cucumbers and sweet peppers, and in varying levels in many types of legumes including soybeans, lentils, lima beans and kidney beans. Lectins, also called haemagglutinins, are toxic to humans if consumed in large amounts. Uncooked and improperly cooked red kidney beans can contain elevated levels of a certain lectin, phytohaemagglutinin, relative to other types of legumes.

A consultation document entitled "Health Canada's proposed Standard (Maximum Level) for the presence of the Mycotoxin Patulin in Apple Juice and Unfermented Apple Cider" was developed with the intention of outlining the evidence used by Health Canada's scientists in support of this action and to seek comments from stakeholders on the proposal.

A risk/exposure assessment and consultation of the natural toxin Deoxynivalenol (DON) has been completed and will assist in the development of a Canadian guideline for the presence of DON in Canadian foods.

Health Canada participated in the evaluation of options for risk profiling tools and exchanged information on the use of such tools with our international counterparts. Health Canada, in collaboration with the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO), and additional support from the Government of Japan, hosted two Expert consultations on Vibrio vulnificus in Seafoods and Salmonella in Bivalve Molluscs. The expert consultation on Vibrio parahaemolyticus and Vibrio vulnificus in Seafood produced expert recommendations for presentations to the Codex Committee on Food Hygiene and will inform continuing microbial risk assessments of pathogenic vibrios in seafood.

Performance indicators: # of engagement opportunities with industry, international collaborations; # of guidance/educational tools developed; # of standards, frameworks and policies developed or modified; and # of consultations/engagement activities with Canadians and target populations.

Targeted Oversight

Expected results for Health Products 2011-12

The Health Products program's ability to make and support admissibility decisions at the border as they relate to health products will be strengthened through the establishment of a national border integrity program, which will include among other initiatives: a national standardized process for the handling of health products at the border; establishment of service standards between Canada Border Services Agency (CBSA) and Health Canada; and, undertaking public education activities to inform Canadians of risk associated with the importation of non-compliant health products. In addition, Health Canada will continue to enhance the post-market surveillance elements of the program through increased efforts focused on review of Periodic Safety Update Reports (PSURs) - documents that summarize the worldwide safety experience of a health product at pre-established post-authorization times. The Department will continue to work with its partners to increase reporting of adverse drug reactions through the Hospital-Based Mandatory Reporting project for Adverse Drug Reactions. Implementation of mandatory reporting is however dependent upon passing of relevant enabling legislation. If new legislation is not passed, Health Canada will continue requesting the reports from the hospitals on a voluntary basis, and will continue to coordinate efforts with provincial and territorial agencies to promote voluntary reporting.

In partnership with the Canadian Institutes of Health Research (CIHR), Health Canada has established the Drug Safety and Effectiveness Network (DSEN) (a pan-Canadian network of centres of excellence in post-market pharmaceutical research) in order to fund studies that will inform pharmaceutical decision-making across the health care system. Please refer to Federal Partner #4 CIHR for DSEN's Expected Results and Performance Indicators.

Expected results:

The TB submission anticipated annual doubling of PSUR volumes (baseline was 125/year in 2007-08), presuming that relevant legislation would be passed in 2010-11. Given that Adverse Reactions are not predictable, it is not possible to set targets related to the volume of reports expected in any given year. Since the Border Integrity Program is reactive, there are no set targets; however, admissibility decisions are tracked and reported quarterly.

Results Achieved for Health Products 2011-12

Periodic Safety Update Reports (PSURs)

Health Canada performed 178 Level 1 Periodic Safety Update Reports (PSUR- L1) and 70 Level 2 Periodic Safety Update Reports (PSUR- L2) in 2011-2012. This represents a slight increase over the previous year when 172 PSUR L-1 and 52 PSUR L-2 were completed, and a significant increase over the 125 total PSURs completed in 2007-2008. PSUR reviews resulted in a number of safety recommendations including 30 labelling recommendations (both major and minor), the identification of 5 signals, and a recommendation of enhanced monitoring in 59 cases.

Border Integrity Program

The Border Integrity Program assesses the compliance of imported health products with the Food and Drugs Act and its Regulations, and provides admissibility recommendations to the Canada Border Services Agency.

Post Market Reporting Compliance Inspection Program

The Post Market Reporting Compliance (PMRC) Inspection Program continues to seek opportunities to expand and enhance the inspection program through a review of international best practices. One hundred inspections were conducted in 2011-12.

Drug Safety and Effectiveness Network (DSEN)
Also see: DSEN, Canadian Institutes of Health Research, Targeted Oversight for CIHR results and total allocation (from start to end).

Expected results:

Increased knowledge of post-market drug safety and effectiveness to inform decisions; Increased capacity in Canada to address priority research on post-market drug safety and effectiveness.

The partner organizations (CIHR and Health Canada (Strategic Policy Branch and Health Products and Food Branch) continued to collaborate on a number of DSEN processes:

• Participation in the development and approval of the DSEN Prioritization Framework to support national prioritization of DSEN research queries (SPB)
• Coordination of the DSEN Operational and DSEN Executive Working Group meetings to maintain and strengthen the working partnership (SPB)
• Exchange of DSEN information with the Federal Provincial Relations Division to circulate via the Health Support Committee (SPB)
• Facilitation of communication with Provincial and Territorial government representatives to identify opportunities for collaboration -Pharmaceutical Directors Forum, Expert Working Groups etc. (SPB)
• Participation and contribution to the HPFB-led, DSEN Health Canada Implementation Team meetings to maintain awareness of the DSEN policy objectives (SPB)
• Collation, review and forwarding of research queries from Health Canada (HPFB) staff to the DSEN Coordinating Office (within CIHR) for consideration as part of the Network's prioritized national research agenda. Since 2009, Health Canada (HPFB) Team has forwarded 23 proposed research queries for the DSEN to investigate. The Health Canada DSEN Implementation Project Team was established by HPFB in 2009, with representatives from HPFB and FNIHB
• Ongoing discussions sessions between Health Canada staff and DSEN researchers to reframe query wording and discuss methodologies. This engagement is fostering communication and understanding between both parties on DSEN capability and the needs of the regulator. Ultimately this will improve how the Health Canada can leverage DSEN capacity (HPFB)
• Exchange of information on DSEN development and Health Canada research queries with various groups within European Medicines Agency (HPFB)
• Engagement with international partners implementing related initiatives (e.g., EnCepp in EU; Sentinel in U.S) to share best practices and explore opportunities for data sharing (HPFB)
• Support of DSEN Steering Committee representatives [i.e., preparation of briefing material, etc.] (SPB and HPFB)
• Active participant in CIHR led DSEN activities (SPB and HPFB)
• Active participation in the biannual DSEN Network operational meetings, which brings together DSEN decision makers and researchers to advance their working relationships (SPB and HPFB)

Performance indicators:

Year over year increase in PSUR submitted by industry and year over year increase in AR Reports submitted by Institutions. Also tracked are # of patients/consumers recruited; # of patients/consumers trained, # of patients/consumers who have taken part in consultations, patient/consumer satisfaction; and client (HPFB) satisfaction.

Expected results for Consumer Products Safety 2011-12

Through targeted oversight actions, the Consumer Product Safety program activity works to detect safety problems as early as possible and at all stages in a product's life cycle. Under the new Consumer Product Safety Act, Consumer Products Safety program has improved authorities to ensure investigative actions are being taken to determine the safety profile of products and to verify that preventative measures are being implemented.

Expected results:

Improved Information and reporting of consumer product safety related incidents (by industry and consumers).

Results Achieved for Consumer Products Safety 2011-12

With the coming into force of the CCPSA on June 20, 2011, we introduced new requirements for industry to report product safety incidents to Health Canada. To improve access to timely information with respect to consumer product related incidents, we developed and implemented an on-line incident reporting service, which was operational for the coming into force of the CCPSA. Under the Act, this innovative early-warning system requires industry to provide Health Canada with information about product-related safety issues that could harm consumers. The first report was submitted within hours of this program becoming operational. It was reviewed the same day, prioritized based on level of risk and routed to a regional product safety office for action.

The incident reporting service's simplified, efficient system for industry to report consumer product safety issues means reduced burden while ensuring the health and safety of Canadians.

Between June 20, 2011 and March 31, 2012, Health Canada received 2202 incident reports regarding consumer products and cosmetics: 1688 (77%) were mandatory incident reports from industry (retailers, distributors, importers and manufacturers) regarding unique incidents and 514 (23%) were voluntary reports from consumers, coroners, police, etc.

Electrical and electronic products accounted for the vast majority, 69%, of mandatory reports while household products accounted for 11% and children's products accounted for 10%. A lower number of mandatory reports were received for products in the outdoor and recreational category (7%), chemicals (2%) and cosmetics* (1%).
*note that cosmetics are regulated under the Food and Drugs Act and therefore are not subject to the mandatory incident reporting requirements under the CCPSA.

Performance indicators:

# of health-related consumer product incidents reported including type of injury/illness and product category examined (i.e., Consumer Products, Cosmetics) that cause illness/risk; # complaints received; # advisories and warnings issued; and # product recalls issued/recall monitoring/recall effectiveness.

The Food Safety & Nutrition program activity has no targeted oversight funding under this initiative.

Rapid Response

Expected results for Consumer Product Safety 2011-12

The Government is equipped to respond rapidly to remove unsafe consumer products from shelves, preventing them from reaching consumers. While the Department continues to operate with a step-wise approach to compliance and enforcement by working with industry to voluntarily take corrective actions the Canada Consumer Product Safety Act (CCPSA) offers new measures to protect Canadians from unsafe consumer products. This includes a general prohibition against products that pose an unreasonable danger, the authority to order industry to recall* and/or take other corrective measures and in the case of industry's failure to act in a timely manner, Health Canada's ability to initiate a recall and/or corrective measures to ensure the health and safety of Canadians.

* Recall is a process by which the responsible establishment in Canada notifies consumers of the danger associated with a product and this notice should be accompanied by all of the following steps:

• Stopping distribution of product by upper levels of trade;
• Stopping sale of product by lower levels of trade;
• Determining accounts/producing distribution lists and gathering necessary information pertaining to the recall;
• Notifying accounts of the recall, with instructions to take specified measures (correct, return product/accept returns of products, disposal);
• Removing product throughout supply chain; and,
• Completing recall effectiveness form(s) and reporting on any reconciled product from accounts.

(The recall may also include other corrective measures in a separate order.)

Expected results:

Improved industry compliance with product safety obligations.

Results Achieved for Consumer Product Safety 2011-12

The regulatory regime for the Consumer Product Safety Program is based on Post-Market Surveillance. Under the Cyclical Enforcement Cycle, the sampling for compliance is targeted to those regulated product categories where there is a reasonable assumption of non-compliance (i.e. higher risk). Therefore, high rates of non-compliance are expected. This is an indicator that the risk-based sampling is effective.

In preparation for the new CCPSA, the cyclical enforcement cycle was placed on hold during the first and second quarter of 2011 while inspectors and lab personnel focused their systems, processes and operations on the new program requirements in order to meet the June 20, 2011 coming into force date.

Completed in 2011-12, the cycle targeting six regulated product categories with identified hazards and baseline data:

• Children's Jewellery: 50 samples - 74% non-compliant - 14 recall notices issued;
• Matches: 15 samples - 73% non-compliant- One recall notice issued;
• Phthalates: 81 samples - 9% non-compliant - Six recall notices issued;
• Second Hand Children's Product: 589 visits - 10% non-compliant;
• Toys-Chemistry: 35 samples - 6% non-compliant;
• And Toys-Small Components: 22 samples - 27% non-compliant - Five recall notices issued.

Corrective action was taken on 100% of non-compliant cases. Corrective actions are selected to be appropriate to the risks identified, and can range from the correction of future products to full recalls.

When there is a concern with a product, consumers are informed quickly through risk communications posted on the Health Canada website, such as consumer product recalls and advisories. Recalls are used when industry and Health Canada become aware of a danger associated with a consumer product, and consumers need to be made aware so that they can stop using the product in its current form. Some recalls involve consumers disposing of the product or returning it to the place of purchase for a refund. Other recalls involve consumers contacting the manufacturer for a repair kit, replacement, or updated user instructions. In all cases, a recall involves some action being taken by both industry (remove the unsafe product from the market and/or correct it, if possible) and consumers (stop using the unsafe product in its current form). Advisories are generally used to help educate consumers about potential health risks associated with the unsafe use of a consumer product. For example, in December 2011, Health Canada advised Canadians of the dangers of button batteries and how to use them safely. During 2011-12, Health Canada used social media to quickly inform Canadians of the 20 advisories and 249recalls issued related to consumer products. Specifically, a market survey on children's jewellery was conducted between October and December 2011 and high levels of lead and cadmium found (up to 80% total concentration). As a result, 14 Recalls were issued in December 2011. As part of Health Canada's Cadmium Action Plan, we published a draft guideline in July 2011 proposing a limit for total cadmium in children's jewellery of 130ppm. The Department is currently considering whether a regulatory limit for cadmium is required (a regulatory limit is already in place for lead).

In support of modernizing the implementation of the Radiation Emitting Devices Act (REDA), the administrative function of REDA was improved through enhanced compliance and enforcement activities. In collaboration with the Canadian Border Services Agency, 2 seizures occurred resulting in 309 radiation emitting devices being seized due to non-compliance with safety requirements.

New mandatory reporting requirements guidelines were developed and implemented for marketed medical devices. Industry must notify HC of non-compliance, as per REDA.
Guidance Document for Mandatory Problem Reporting for Medical Devices

Performance indicators:

% and # of inspected registrants/firms/users that are compliant** ('C') / non-compliant ('NC') with standards/acts/regulations /guidelines including Consumer Product Safety Regulations and cyclical enforcement (Product Category).
**Compliance is measured by a monitoring approach. Compliance results are determined by monitoring activities following initial inspection. Due to the non-license (post-market) nature of the consumer products industry, compliance verification is limited to primary level establishments and targeted to the highest levels of trade.

Expected results for PMRA 2011-12

PMRA enhances compliance targeting and enforcement capacity in support of expanded regulatory authority under the PCPA, and maintains public confidence in pesticide product safety. In conjunction with other federal and provincial regulators, Health Canada continues the development and implementation of an evidence and risk-based approach to identify and act on situations of higher risk associated with non-compliance. Activities continue to include the enhancement of current information/intelligence networks, analysis and an updated targeting strategy to verify the presence of compliance and the reasons that non-compliance was found to exist. Activities also include an updated strategy to address the importation of unregistered consumer pesticides where the safety would be unknown.

Expected results:

Improved risk-based monitoring of products.

Results Achieved for PMRA 2011-12

Compliance and Enforcement Activities

Targeted inspections were conducted with manufacturers and vendors of consumer products. Sixty-five follow-up inspections were conducted in establishments (vendors, distributors and importers) found to be previously non-compliant. These activities confirmed that 45 (nearly 70%) of the establishments returned to compliance and 19 (29%) remained non-compliant. The original 2010 inspection program targeted establishments suspected of selling unregistered pest control products (e.g. insecticidal chalk, mothballs).

An inspection program of home and garden product vendors (188 inspections) was conducted, that included follow-up actions on non-compliance included letters to registrants. This program included the delivery of questionnaires to assess vendor's knowledge of regulatory requirements as well as physical inspection of products, including label statements and symbols. Appropriate fact sheets were distributed to vendors explaining regulatory requirements with respect to consumer pesticides.

Two Health Canada Consumer Advisories were issued related to imported unregistered and potentially harmful consumer pesticides (e.g. "Miraculous Insecticide Chalk" and an ant bait product containing Mirex). Letters were sent to warn consumers of the dangers of Mirex and to increase awareness of the risks related to unregistered pesticides and illegal importations. HC worked with the Canada Border Services Agency (CBSA) to strengthen oversight at the border, including signing a Letter of Intent between Health Canada and CBSA. As part of the Single Window Initiative, PMRA is receiving and analysing pesticide importation data collected by CBSA at the border. The data allow compliance risk analysis and intelligence-based enforcement actions in order to reduce the importation of illegal PCPs and their presence in the marketplace.

Performance indicators:

# monitoring reports; #, % of targeted inspections on products/industries/sector of high risk to health; # follow-up inspections; and # and/or % pest management products monitored.

Expected results for Food Safety and Nutrition 2011-12

Under the rapid response pillar the Food Safety and Nutrition program activity will continue its participation in the Partnership for Consumer Food Safety Education with the goal of promoting the "Be Food Safe" campaign and will continue to develop new education materials for consumers to promote food safety in an effort to reduce foodborne disease outbreaks in Canada. In addition, it will develop a strategy for addressing the findings of a Public Opinion Research in February 2010 that measured the percentage of population aware of and engaged in food safety risks, alert systems and safety systems.

Expected results:

Increased public understanding of food safety risks, alerts systems and safety systems.

Results Achieved for Food Safety and Nutrition 2011-12

Be Food Safe Campaign

Health Canada provided expertise, financial support, and developed new education materials for the "Be Food Safe Campaign". The Department continued to improve the consolidation and tracking of data through the public enquiries centre and manage a central contact centre for consumer phone and e-mail requests for information on food and product safety issues. A regular communications calendar is maintained and food safety tips sheets are created and updated on a regular basis (i.e. Shellfish Food Safety Tip Sheet, Thanksgiving Food Safety Tip Sheet, Home Canning Tips Sheet and Halloween Food Safety Tips Sheet). A total of 189,167 food safety web pages were viewed in 2011-12.

Performance indicators: % of targeted population aware, engaged in food safety risks, alert systems and safety systems; and # of web hits of consumer oriented web pages.

Performance highlights:

Active Prevention

Expected Results for 2011-12:

The Canadian Food Inspection Agency's (CFIA) food safety initiatives aimed at ensuring active prevention include measures to enable government to better understand and identify food safety risks and to work with industry to implement effective food safety risk mitigation strategies. The CFIA, along with its federal partners, will strive to strengthen food safety standards and regulations and will engage Canadians in making decisions with respect to food safety.

In 2011-12, the CFIA will continue to work with Health Canada on data collection and risk mapping towards identification and characterization of areas of concern, including imported food ingredients, produce, mycotoxins in cereals and undeclared allergens. Risk maps will identify gaps in standard-setting and policy development and will assist in focusing operational efforts on areas of greatest risk.

A proposed regulatory scheme intended to minimize the risk of unsafe products entering the Canadian marketplace will be introduced. The proposed scheme would enable identification of importers bringing food products and ingredients into Canada and verification of industry's compliance with minimum food safety requirements.

The CFIA will publish guidance for industry on preventative food safety systems and will promote the implementation of these systems in high-risk areas.
Compliance activities and marketplace monitoring for the correct application of the revised "Product of Canada/Made in Canada" policy will continue.
Discussions with key trading partners on approaches to managing high-risk source countries will be ongoing, as well as collaboration with specific high-risk countries on managing food safety risks.

Expected results:

Increased understanding of food safety risks by HC, PHAC & CFIA; Establishment of the appropriate instrument or mix of instruments, including regulatory and non-regulatory measures (standards, policies, etc.) to address immediate areas of concern; Increased industry understanding of and engagement in the development and implementation of food safety risk mitigation processes; Improved international collaboration in addressing common import risks; Increased engagement by Canadians in the regulatory system; Increased industry knowledge regarding food labelling.

Results Achieved in 2011-12

Development of the Food Safety Risk Prioritization process was furthered through expanding the list of food hazard combinations to be included for risk ranking. One risk profile, which is a compilation of scientific information on a specific food hazard combination, was completed for Ochratoxin-A in cereals and cereal products. A new risk profiling process was developed with templates for two different risk profiling documents: Two-Pager Risk Profile and Full Risk Profile.

Development of novel platforms for testing and detection of pathogens such as of food bourne hazards including the procurement and method validation of the VIDAS platform in six (6) CFIA microbiology laboratories for enhanced rapid detection of various pathogens including Salmonella, Listeria, E.coli, etc; the validation of a rapid kit for E.coli 0157 in shelled nuts; enhanced allergen capacity to respond to nuts (cashews, macadamia, pistachio); evaluation of an allergen rapid kit for mustard species to support enforcement of Allergen Regulations; enhanced capacity as a result of validation of method to quantify coumarin in foods by HPLC; and enhanced laboratory capacity for Phthalates testing.

Conducted 81 targeted surveys for the following microbiological and chemical hazards groups: allergens (6), bacteriology (37), chemistry (21), parasitology (5), and virology (12), for which 30,734 samples were collected resulting in approximately 75,000 different microbiological and chemical tests being performed.

The analysis of results for compliance of thirty-two (32) microbial targeted surveys conducted in 2010-11 were completed and compiled into ten (10) commodity groups for reporting: Bacteria Pathogens & generic E.coli in Leafy Green Vegetables in the Canadian Market; Bacteria Pathogens & generic E.coli in Cantaloupes in the Canadian Market; Bacteria Pathogens & generic E.coli in Fresh Leafy Herbs in the Canadian Market; Bacteria Pathogens & generic E.coli  in Green Onion in the Canadian Market; Bacteria Pathogens & generic E.coli in Fresh Berries in the Canadian Market; Bacteria Pathogens & generic E.coli in Dry Fruits and Dry Mixes in the Canadian Market; Bacteria Pathogens & generic E.coli in Tahini in the Canadian Market; Bacteria Pathogens & generic E.coli in Spices in the Canadian Market; Viruses in Fresh Fruits and Vegetables in the Canadian Market; and Parasites in Fresh Fruits and Vegetables in the Canadian Market.

The analysis of results for compliance of twenty-six (26) chemistry targeted surveys conducted in 2010-11 were completed: Undeclared Allergens in Flavour Packets; Microcystin in Bottled Water; Bromate in Bottled Water; Mercury in Foods; Aflatoxins in Food; Undeclared Gluten in Spices; Undeclared Sulphites in Jams and Fruit Spreads; Glycoalkaloids in Potatoes; Dioxins in Intra-Provincial Cheese and Vegetable Oils; Ochratoxin A and Deoxynivalenol; Fumonisins in Corn-based Products; Undeclared Allergens in Sauces; Propylene Oxide in Foods; Pesticides in Beverages; Antimony in Selected Foods; Acrylamide in Food; Arsenic Speciation in Food and Mineral Water; Bisphenol-A in Infant Food and Infant Formula; Cadmium in Rice Products; Food Colours; Melamine in Milk and Soy-based Products; Perchlorate in Foods; Pesticides in Vegetables; Progesterone in Dairy Products; Undeclared Sulphites in Fresh Grapes; and Undeclared Fining Agents in Beer.

Significant progress was made on a draft of the proposed Imported Food Sector regulations and associated policies, and on the requirements and design for the licence management system and associated IT infrastructure.

Published the General Principles of Food Hygiene, Composition and Labelling Guidelines. In response to the March 11, 2011 Japan nuclear crisis, the CFIA implemented enhanced border controls. Collaboration within the Agency and with other federal departments, along with constant sharing of information with Japan and other foreign governments informed responses in regards to enhanced border controls.

Continued to advance relationship building on food safety with trading partners through meetings with Indian, Mexican, Guatemalan regulatory authorities.

Continued to engage with QUAD governments (US, Australia, & New Zealand) on produce and food safety issues to advance regulatory cooperation initiatives and enhance information exchange.

In follow-up to consultations undertaken in 2010-11, the CFIA responded to public and industry feedback on the proposed licensing regime for imported food sector products by posting the "Overview of Public Feedback Received on the Imported Food Sector Regulatory Proposal" report in October 2011. Feedback submitted during the pre-consultation will be considered during the final drafting of the proposed regulatory package. Significant industry outreach efforts were initiated.

The Product of Canada guidelines provide consumers with information that would help them make informed purchasing decisions, help industry comply with the requirements for making truthful and accurate claims, and provide the CFIA with the tools necessary to promote compliance in the market place. In this regard, the CFIA conducted 21 labelling investigations related to Product of Canada, while continuing to monitor compliance with the guidelines through its inspection and label verification activities and responding to inquiries, complaints and referrals related to the interpretation and implementation of the revised policy.

Performance indicators:

Performance indicators for the food portion of the Action Plan are presently under review and will be reported on in the following performance report.

Targeted Oversight

Expected Results for 2011-12

Targeted oversight initiatives include enhanced inspection of identified high-risk food sectors and targeted import control measures such as border blitzes to intercept non-compliant food products before they are distributed, thus preventing contaminated products from reaching consumers. The CFIA will continue to adapt its food safety inspection practices for high-risk sectors. The bulk of inspection capacity will be dedicated to evaluation and verification of industry's control systems in both the domestic and imported food sectors. Method development and testing in targeted areas will continue, and front-line capacity will continue to increase. Border blitz plans will be reviewed and revised in light of the experience gained from the first three years of the Action Plan, and IM/IT business solutions for supporting enhanced tracking of imported food products will be further developed.

Expected results:

Increased verification of industry food safety measures; Improved ability to monitor and control importation of food.

Performance indicators:

Performance indicators for CFIA's activities under the food portion of the Action Plan are presently under review and will be reported on in the following performance report.

Results achieved in 2011-12

Training sessions on Fresh Produce Safety and Allergen Labelling Regulations were delivered to a total of 816 inspection staff and the Canadian adaptation of thirteen (13) USFDA e-learning modules on microbiological growth and control was completed.

The FFV Establishment Inspection Pilot Project for Packer and Re-packers of Fresh Leafy Greens, Green Onions & Herbs continued during which 15 inspection were completed.

In the non-federally registered sector, a total of 709 inspections were conducted in the four identified priority areas of greatest risk (produce, mycotoxins in cereal, imported ingredients, undeclared allergens): 85 related to undeclared allergens and Salmonella spp. in chocolate and chocolate products; 361 related to microbial pathogens, allergens and chemical hazards for all domestic NFRS products; 41 related to microbial pathogens in minimally processed RTE fresh-cut fruits and vegetables; 9 related to deoxynivalenol (DON), ochratoxin A (OTA), and undeclared allergens in grain-based infant and toddler foods; 66 related to microbial pathogens, patulin, undeclared allergens in juice and juice products that fall under the jurisdiction of the Imported and Manufactured Food Program;

39 related to Salmonella and aflatoxin in imported peanuts, domestic and imported peanut butter, and domestic and imported tree nuts that fall under the jurisdiction of the Imported and Manufactured Food Program; 68 related to pathogens in spices, spice blends and seasoning mixes that fall under the jurisdiction of the Imported and Manufactured Food Program; and 40 related to microbial pathogens for sprouted seeds.

Continued increasing the capacity to identify imported food products entering Canada by completing Phase 7 & and 8 of the ten phase initiative for improvements to the Automated Import Reference System database.

Import control measures were implemented to determine if implicated produce entered Canada in response to various fresh produce issues that arose in the summer of 2011, including but not limited to the E.coli outbreak due to fenugreek seeds in Europe and contaminated cantaloupe and papayas from the US and Mexico respectively. The CFIA worked with other governments departments such as the CBSA, to verify that fresh fruit and vegetables implicated in these outbreaks were not imported into Canada and when necessary, the CFIA implemented enhanced border and surveillance controls to track shipments destined for Canada. In addition to the enhanced border surveillance during the Salmonella outbreak associated in Papayas imported from Mexico, targeted sampling and testing was conducted by Operations, Programmes and Science branches.  

Border lookouts and enhanced import controls were put in place to mitigate the risk of Japanese products contaminated with radionuclides from entering the Canadian market. In concert with Health Canada, this enabled the identification and targeted testing of over 600 shipments which came in during the border lookouts (March 24 to June 11, 2011).

74 Border Blitz inspections and 267 import surveillance activities were conducted.

Rapid Response

Expected Results for 2011-12

Towards ensuring rapid response to food safety issues and emergencies, enhanced recall capacity will enable the Government of Canada to effectively respond to and conduct investigations for an anticipated increased number of food recalls resulting from targeted oversight activities. Targeted consumer risk communication activities and products will also improve Canadian's awareness of food safety issues and recalls and will help consumers better protect their health.

In 2011-12, the CFIA will continue to increase human resource capacity to address identified food safety issues. Enhancements to food safety recall and investigation methodology will continue.

Expected results:

Timely and efficient recall capacity; Increased public understanding of food safety risks, alert systems and safety systems;

Results achieved in 2011-12

By the end of 2011-12, the CFIA managed 421 food recall incidents related to non-federally registered (398) and fresh fruit and vegetable (23) products, and conducted 2752 food safety investigations.

Regarding recalls, the CFIA responded to over 12,000 web-based and 16,000 telephone requests for information.

Science Advice and support including laboratory testing and analysis was provided to numerous follow up and investigations, including: non-0157 VTEC outbreak in Europe, DEHP from Taiwan imported products, undeclared food colours in various imported products, and E.coli 0157 in walnuts.  

A communication strategy was implemented to increase awareness of the food recall e-mail notification service for consumers and industry.

National distribution to Canadian public health units of the "10 Least Wanted Pathogens" brochures, to better inform Canadians on the nature of micro-organisms which can cause foodborne illness.

Continued meetings of the Consumer Association Roundtable to ensure that consumers have a voice in the food safety continuum.

Posting on the CFIA website of four targeted surveys reports. These reports present information on the findings of CFIA's targeted surveys regarding the occurrence of contaminants in the food supply. The reports covered: Pesticide Residues in Fresh Fruit and Vegetables, Melamine Residues, Arsenic Speciation, and Food Colours.

Past food safety issues have highlighted the importance of gathering regular feedback from Canadians on food safety, food recalls and confidence in Canada's food safety system. Results have helped inform outreach initiatives and policies related to food safety. Results also provide the Agency with a better understanding of consumers' awareness, attitudes and behaviours in terms of food safety, and helps ensure communications material is consistent with the needs of Canadians.

Targeted POR conducted in the Fall of 2011 revealed that the percentage of Canadians that gave Canada's food safety system a favourable to strong confidence rating remains steady from last year at 68 percent. That is up from 60 percent in 2008. In fact, 93 percent of Canadians express some degree of confidence in Canada's food safety system. The POR report shows that Canadians are increasingly likely to feel more confident in the system when there is a food recall, because it shows the system is working. However Canadians have an increased appetite for more information on food safety, particularly food recalls. Results also indicate that Canadians hold a favourable opinion of the work done by the CFIA.

Performance indicators: Performance indicators for CFIA activities under the food portion of the Action Plan are presently under review and will be reported on in the following performance report.

Performance highlights:

Active Prevention

Expected Results for 2011-12

The Public Health Agency of Canada (PHAC) will modernize and strengthen Canada's food safety systems by use of molecular typing, by expanding the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) integrated surveillance systems and C-EnterNet surveillance infrastructure, and use of decision making models in priority areas.

Expected results:

Increased understanding of food safety risks by HC, PHAC and CFIA.

Results Achieved in 2011-12

In order to better identify and understand food safety risks, PHAC is engaged in several activities, including surveillance, sharing of outbreak information, detection technologies, and development of risk assessment tools. Significant achievements to date include the following:

Surveillance

FCSAP funding has maintained and enhanced the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) and the National Integrated Pathogen Surveillance Program (C-EnterNet) surveillance programs. These programs consistently contribute valuable population-based information not available from any other sources on food-borne and gastrointestinal pathogens, and antimicrobial resistance in the food chain.

C-EnterNet operated in two sentinel sites in 2011-12. Key achievements included:

• C-EnterNet data have been accessed on multiple occasions to look for potential sources in provincial and national food-borne illness outbreaks (e.g., epidemiologists working on a recent Salmonella investigation in one province accessed C-EnterNet data on food consumption as part of their investigation);
• an analysis of public health inspectors' opinions on the most likely source of infection in enteric illness cases was published, which is an important analysis for source attribution work;
• identification of key differences in pathogen prevalence between chicken nuggets and ground chicken, as compared with chicken breasts;
• new information on the occurrence of enteric pathogens, such as Listeria, Giardia and Cryptosporidium, in imported produce was generated;
• herb sampling was initiated in 2012, and replaces the testing of fruit conducted in 2011;
• analysis of travel-related food-borne disease data was continued as a follow-up to an earlier analysis which identified key differences in domestic versus travel-related gastrointestinal disease in Canada; and
• C-EnterNet held its first Strategic Planning Meeting, which was valuable in identifying the needs and interests of partners, collaborative opportunities, and potential future directions.

CIPARS specific achievements in 2011-12 included the following:

• retail sampling expansion was undertaken, including expansion from three to seven provinces, including imported seafood and produce, and regular sampling of turkey meat in all sampling sites;
• a comprehensive analysis was conducted of the genetic basis of resistance from bacteria from across the CIPARS program from 2010, which provided critical information in understanding the impacts of antimicrobial use in the food chain on the emergence and spread of resistance;
• through retail chicken meat testing, CIPARS continued to monitor the impact of partial reintroduction of ceftiofur in the meat chicken hatching eggs;
• CIPARS similarly continued monitoring increases in the prevalence of Campylobacter resistant to fluroquinolones;
• The results of a meta-analysis on antimicrobial use and resistance in aquaculture and ornamental fish was completed and prepared for publication, and will inform surveillance in aquaculture in Canada and with respect to imported seafood. This is the first initiative of its kind globally.

Outbreak Summaries Application

PHAC has led the development of a new platform for summarizing outbreak information. The Outbreak Summaries Application is a secure, web-based application for documenting and disseminating outbreak data in a standardized manner, which can then be used for monitoring trends in sources and risk factors, evaluating public health interventions, and informing risk assessments. The application has been implemented in five provinces, as well as at PHAC, and discussions are ongoing to have additional provinces and territories implement the application. To date, there are over 1900 outbreak summaries in the system.

Detection

PHAC has increased the capacity for molecular fingerprinting (Pulsed Field Gel Electrophoresis (PFGE)) of Salmonella spp. and E. coli O157:H7 isolated by surveillance programs. In addition, work has commenced on the molecular fingerprinting of non-O157:H7 VTEC using the same technique. PHAC has also optimized and evaluated the effectiveness of next generation molecular typing methodology (Multilocus Variable Number Tandem Repeat Analysis (MLVA)) for further characterization of Salmonella Typhimurium, Salmonella Enteritidis and E. coli O157:H7 strains. These modern laboratory fingerprinting methodologies have been successfully implemented into PHAC outbreak detection and response programs (PulseNet Canada: MLVA subtyping of E. coli O157), and 29% of the E. coli samples submitted for testing in 2011-12 were tested with the newly offered MLVA test. In addition, genomics (DNA sequencing and genetic mapping) has been used to develop novel laboratory fingerprinting methods for Salmonella Enteritidis and Campylobacter. Testing for Campylobacter using these methods now occurs at two sentinel sites, and further technology development and evaluation occurred for new tools to investigate Salmonella. Work will continue to fully implement this new technology into surveillance and outbreak programs, leading to better support and more rapid identification of contaminated food sources.

Risk Assessment

PHAC has developed a risk model to determine risks to Canadians from consumption of E. coli O157:H7 in ground beef and beef cuts, and to evaluate the relative effects of on-farm and processing-level interventions to support a preventative approach. In addition, more accurate estimates of risks to Canadians can be undertaken through the addition of demographic and susceptibility information to risk assessment databases. Finally, PHAC has developed a rapid risk model to quickly determine potential risks to Canadians, including susceptible subpopulations, in the event of contamination of RTE deli meats or hotdogs with Listeria monocytogenes.

In relation to these activities, in 2011-12 PHAC published 33 reports, six short summaries, and 16 peer-reviewed publications. Four issue papers were also provided to departmental colleagues and stakeholders. These documents covered surveillance data and information on the occurrence of food-borne pathogens and antimicrobial resistance in the food chain, as well as comparison and validation of molecular typing methods.

Performance indicators: % of reports tracked, # of peer-reviewed publications, # of issue papers provided to departmental colleagues and stakeholders.

Targeted Oversight

Expected Results for 2011-12

Through ongoing and expanded data collection, analysis and reporting on the rates, patterns and circumstances of unintentional injury of Canadians, focusing on children and seniors, PHAC will contribute to the evidence base for policies, practices and programs for injury prevention and control.

Expected results:

More and better data on accidents, injuries, illnesses and deaths due to consumer products. Engagement of risk assessment stakeholders

Results Achieved in 2011-12:

More and better data on injuries, illnesses and deaths due to consumer products has been achieved through:

• Expansion of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) to two more hospitals and initiation of the CHIRRP modernization project (e-CHIRPP) to improve the timeliness, capacity and quality of data collection for reporting.
• Preparation of the second edition of the Injury in Review report: Spotlight on Road and Traffic Safety, to be released in July 2012. Report was produced in collaboration with Transport Injury Research Foundation, and Safe Kids Canada and aims to provide more data on road and traffic injuries to Canadians.
• PHAC collaborated with Health Canada, Statistics Canada and P/T Chief Coroners and Chief Medical Examiners to improve understanding of consumer product-related deaths in Canada, by conducting data quality assessment of the Canadian Coroner and Medical Examiner Database for deaths related to consumer products and by analyzing recently received CCMED data from 2006-2009.

Engagement and ongoing risk assessment of consumer product related injury with a focus on vulnerable populations has been achieved through:

• As risk assessment data are now available, the Agency engaged key stakeholders, including P/T representatives, to develop a risk assessment plan at the Consumer Product Safety Initiative Sentinel Centre Meeting and the Consumer Product Related Senior Injury Risk Assessment PHAC/Canadian Longitudinal Study on Aging Initiative Consultative Meeting in November 2011.
• Key stakeholders, such as injury epidemiologists and provincial injury organizations, were engaged with PHAC researchers to develop journal articles in order to raise awareness of injuries in Canada related to consumer product risks.

Performance indicators: # and type of databases created/improved against plan; # of cases of product- related injuries; risk assessments of consumer-related injuries; and # and type of data/reports from key stakeholders.

Performance highlights:

Targeted Oversight

Expected Results for 2011-12

The Canadian Institutes of Health Research will make investments and focus efforts in advancing the Drug Safety and Effectiveness Network to increase the available evidence on drug safety and effectiveness to regulators, policy-makers, health care providers and patients and to increase capacity within Canada to undertake high-quality post-market research in this area.

Work will continue on engaging interested parties during the development of the Network, delivering on peer reviewed funding opportunities for the initiative and responding to strategic direction received from the DSEN Steering Committee.

Expected results:

Increased knowledge of post-market drug safety and effectiveness to inform decisions and increased capacity in Canada to address priority research on post-market drug safety and effectiveness.

Results achieved in 2011/12
Also see: DSEN, Health Canada, Health Products, Targeted Oversight
DSEN has built a functioning national network, comprised of more than 150 researchers across Canada focused on five distinct methodological areas, to support the development of new research evidence to fill knowledge gaps identified by decision makers within the Canadian health care system. In 2011/12 the network grew to encompass researchers working in eight provinces (BC, AB, SK, MB, ON, QC, NS, NFL) along with international collaborators (UK, USA, EU). Furthermore, DSEN established standard processes to support the network's function and the activities of the DSEN Steering Committee (DSEN SC), which is comprised of senior executives from federal and provincial governments and non-governmental organizations, and the practitioner and public communities.

• DSEN launched funding opportunities to meet its principal objectives to both increase the availability to decision makers of new evidence on drugs' safety and effectiveness and the capacity in Canada to conduct this research.
  • Team Grants - six grants, awarded through two competitions, identified the majority of the DSEN research teams, comprising 55% of the current complement of DSEN collaborating researchers. The funding for these teams totals $6.28 million over three years starting in 2011/12. The six new research teams create two new Collaborating Centres, one for Prospective Studies and a second for Network Meta-Analysis, bringing the total number of Collaborating Centres to three (the Collaborating Centre for Observational Studies was established in 2010/11).
  • Catalyst Grants - 15 grants were funded for a total of $1.43 million.
  • New Investigator Awards - funding was committed for the career development of six new investigators starting in 2012/13, totaling $1.8 over five years

• The DSEN Coordinating Office (CO) established a calendar of semi-annual network meetings to engender the collaboration necessary for optimal network operations. A fall 2011 meeting aimed to further develop the common DSEN vision and identify activities where inter-team synergies exist, while a spring 2012 meeting brought teams together with decision makers submitting queries to DSEN in order to broaden the understanding and expectations between knowledge creators and users.

• DSEN struck a federal / provincial Working Group on the Prioritization of DSEN Queries to develop a multi-criteria decision analytical (MCDA) framework to inform the advice of the DSEN SC. The MCDA process allows for the ranking of individual queries against standard criteria covering an array of issues pertinent to the expected value of the new research evidence in responding to decision makers information needs within the Canadian health care system.

• To strengthen DSENs commitment to transparency in operations the DSEN CO created a framework document for management of DSEN Queries describing the criteria and process for prioritization by the DSEN SC for received DSEN Queries. An accompanying guidance document was created specifically to target the information needs of Query submitters.

• The DSEN SC met three times in 2011-12. On their advice, the DSEN prioritized research agenda was revisited in November 2011 to acknowledge the value to decision makers of the team projects identified within their applications for CIHR/DSEN funding, and in January 2012, when new queries were advanced to the research agenda under the established DSEN prioritization processes. The agenda currently identifies 24 priority research projects.

• Collaborating DSEN researchers initiated work responding to priorities on the DSEN research agenda and results are starting to be disseminated.
  • Five DSEN Query responses were forwarded to decision makers for use.
  • At year end 13 DSEN Queries were under research by the Collaborating Centres, and six other DSEN Queries proposed by decision-makers within the federal regulator or the federal/provincial/territorial drug plans were pending decisions on methodology approaches.
• The DSEN identified an opportunity to assume a leadership role in the career development of a new generation of drug safety and effectiveness researchers by supporting discussions aiming to develop a National Curriculum for training future generations of researchers in the area.

Performance indicators:

Evidence of the dissemination of research knowledge to the target audience, evidence of knowledge translation to target audience, number and value of projects funded to address priority areas, number of funded research projects completed, number of centres/partners participating in DSEN.

Comments on variances:

HC (Health Products) - The variance observed for the "Active Prevention" pillar under the "Health Products" program activity is mainly the result of two things. First, the program was not able to staff all positions in FY 2011-12. Second, the API Inspection program was unable to proceed with some activities because the regulatory amendments had not yet been approved (in the process of approval).

The variance shown for the "Targeted Oversight" pillar under the "Health Products" program activity is mostly due to the inability to proceed with some activities under the "Mandatory Reporting" project in the absence of the legislative amendment. In addition, the program was not able to staff some positions in FY 2011-12, which also contributed to the variance for this pillar.

HC (Food Safety and Nutrition) - There were no variances for both the "Active Prevention" pillar and the "Rapid Response" pillar of the "Food Safety and Nutrition" program activity in FY 2011-12.

HC (DSEN) - There is a variance of $35,465 between the planned and actual spends as a result of planned expenditures on contract research projects that were not issued.

CIHR - As outlined in the FCSAP DPR 2010/11, the priority for roll out of the DSEN grants program has focused strategically on first developing the DSEN network of collaborating researchers through 2010-2012. CIHR/DSEN first focused efforts on the establishment of the key pan-Canadian network of research centres to establish a core research capacity for the DSEN initiative. To reach the desired outcomes in the long term, DSEN has managed funding between the implementation years to align the DSEN grants budget with the DSEN mandate and objectives. In 2011/12, $1.2 million has been re-profiled within the DSEN budget for dispersion between 2012 and 2016.

CFIA - In the fourth year of implementation of the Food and Consumer Safety Action Plan, the CFIA experienced a delay in obtaining Treasury Board approval to proceed with the IM/IT project to support initiatives falling under both Active Prevention and Targeted Oversight. Further contributing to the lapse under Targeted Oversight, is the stage of development of the importer licensing program. Specific details require refinement before training and delivery can commence, thus delaying the hiring of inspection staff to deliver the program. The over expenditure in Rapid Response is attributed to the misalignment of the originally anticipated required funding to deliver the rapid response initiatives and the actual costs. Funds lapsed are being carried forward.

Results achieved by non-federal partners (if applicable):

Contact information:

Kendal Weber,
Director General,
Policy, Planning and International Affairs Directorate, Health Products and Food Branch, Health Canada
Telephone: 613-952-8149
E-mail: Kendal.Weber@hc-sc.gc.ca

Internal Audits and Evaluation

Evaluations

Electronic Link to Reports

Sources of Respendable and Non-Respendable Revenue

Reflected in this table is the collection of respendable revenues by program activity and of non-respendable revenues by classification and source.

Respendable revenues refers to funds collected for user fees or for the recovery of the cost of departmental services. These revenues include those both external and internal to the government, the majority being external. A variety of respendable revenues are collected which include Medical Devices, Radiation Dosimetry, Drug Submission Evaluation, Veterinary Drugs, Pest Management Regulation, Product Safety, hospital revenues resulting from payments for services provided to First Nations and Inuit Health hospitals, which are covered under provincial or territorial plans, and for the sale of drugs and health services for First Nations communities.

Non-respendable revenues are shown by source in order to reflect the information in a useful format. The Department is not allowed to respend these revenues.

Summary of Capital Spending by Program Activity

Note: Details may not add to totals due to rounding.

User Fees

User Fee: Right to Sell Drugs Fees

Fee Type: R

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: April 1, 2011

Performance Standards: 120 calendar days to update the Drug Product Database following notification

Performance Results: 100% within 120 calendar days. Average number of days: 9.1 Days.

User Fee: Drug Establishment Licensing Fees

Fee Type: R

Fee-setting Authority: Financial Administration  Act (FAA)

Date Last Modified: April 1, 2011

Performance Standards: 250 calendar days to issue / renew licence

Performance Results: Average number of days: 121 Days.

User Fee: Drug Submission Evaluation Fees (Pharmaceuticals & Biologic Products)

Fee Type: R

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: April 1, 2011

Performance Standards: Old User Fees - Received* prior to April 1, 2011

Review 1 (average time in calendar days)

Pharmaceuticals

• NDS: Priority NAS = 180
• NDS: NAS = 300
• NDS: Clin only = 300
• NDS: Clin/C&M = 300
• NDS: Priority Clin/C&M = 180
• NDS: Labelling only = 60
• NDS: Comp/C&M = 180
• NDS: C&M = 300
• NDS Admin = 45
• ANDS: C&M = 180
• ANDS: Comp/C&M = 180
• ANDS Admin = 45
• SNDS: Clin/C&M = 300
• SNDS: Clin only = 300
• SNDS: Comp/C&M = 180
• SNDS: C&M = 180
• SNDS: C&M/Labelling = 180
• SNDS: Rx to OTC New INDIC = 300
• SNDS: Rx to OTC No New Indication =180
• SNDS: Labelling only = 60
• SNDS NOC-C Clin = 200
• SNDS NOC-C Clin C&M = 200
• SNDS Admin = 45
• SANDS: Clin only = 300
• SANDS: Comp/C&M = 180
• SANDS: C&M = 180
• SANDS: Labelling only = 60
• SANDS Admin = 45
• DIN A with data = 210
• DIN A form only = 180
• DIN A Label Standard = 45
• DIN A Admin = 45
• DIN D with data = 210
• DIN D form only = 180
• DIN D Label Standard = 45
• DIN D Admin = 45
• DIN F Label Standard = 45

Biologics

• NDS: NAS = 300
• NDS: Clin/C&M = 300
• SNDS: Priority Clin only = 180
• SNDS: Clin/C&M = 300
• SNDS: Clin only = 300
• SNDS: Comp/C&M = 180
• SNDS: C&M/Labelling = 180
• DIN B with data = 210
• DIN B form only = 180

New User Fees – Received* post April 1, 2011

Review 1 (average time in calendar days)

Pharmaceuticals

• NAS: NDS = 300
• CLIN C&M: NDS = 300
• CLIN C&M: SNDS = 300
• CLIN: SNDS = 300
• CLIN: DIN A = 210
• COMP C&M: ANDS = 180
• COMP C&M: NDS = 180
• COMP C&M: SANDS = 180
• COMP C&M: SNDS = 180
• COMP C&M: DIN A = 210
• C&M: ANDS = 180
• C&M: SANDS = 180
• C&M: SNDS = 180
• C&M: DIN A = 210
• Published Data: SNDS=300
• Published Data: DIN A=210
• Rx to OTC Switch: SNDS = 180
• Disinfectant: NDS-D = 300
• Disinfectant: DIN D = 210
• Disinfectant: DIN D = 180
• Labelling only: NDS=60
• Labelling only: SNDS=60
• Labelling only: SANDS=60
• Labelling only: DIN A=180
• Label Standard: DIN A=45
• Label Standard: DIN D=45
• Label Standard: DIN F=45
• Administrative: ANDS = 45
• Administrative: NDS = 45
• Administrative: SNDS = 45
• Administrative: SANDS = 45
• Administrative: DIN A = 45
• Administrative: DIN D = 45

Biologics

• CLIN C&M: NDS = 300
• CLIN C&M: SNDS = 300
• CLIN: SNDS = 300
• C&M: SNDS = 180
• C&M: DINB = 210
• COMP C&M: SNDS = 180
• Labelling only: SNDS = 60
• Published Data: SNDS = 300
• Administrative: NDS = 45
• Administrative: DINB = 45

Performance Results: Old User Fees – Received* prior to April 1, 2011

Review 1 (average time in calendar days)

Pharmaceuticals

• NDS: Priority NAS = 245
• NDS: NAS = 309
• NDS: Clin only = 234
• NDS: Clin/C&M = 288
• NDS: Priority Clin/C&M = n/a
• NDS: Labelling only = n/a
• NDS: Comp/C&M = n/a
• NDS: C&M = 179
• NDS Admin = 49
• ANDS: C&M = 483
• ANDS: Comp/C&M = 454
• ANDS Admin = 39
• SNDS: Clin/C&M = 295
• SNDS: Clin only = 266
• SNDS: Comp/C&M = 157
• SNDS: C&M = 169
• SNDS: C&M/Labelling = n/a
• SNDS: Rx to OTC New INDIC = NA
• SNDS: Rx to OTC No New Indication =NA
• SNDS: Labelling only = 70
• SNDS NOC-C Clin = 298
• SNDS NOC-C Clin C&M = 200
• SNDS Admin = 34
• SANDS: Clin only = n/a
• SANDS: Comp/C&M = 428
• SANDS: C&M = 444
• SANDS: Labelling only = 66
• SANDS Admin = n/a
• DIN A with data = 343
• DIN A form only = 203
• DIN A Label Standard = 95
• DIN A Admin = 76
• DIN D with data = 134
• DIN D form only = 124
• DIN D Label Standard = n/a
• DIN D Admin = 31
• DIN F Label Standard = 80

Biologics

• NDS: NAS = 299
• NDS: Clin/C&M = 289
• SNDS: Priority Clin only = 174
• SNDS: Clin/C&M = 292
• SNDS: Clin only = 235
• SNDS: Comp/C&M = 145
• SNDS: C&M/Labelling = 159
• DIN B with data = 159
• DIN B form only = 130

**includes SNDS-C

New User Fees - Received* post April 1, 2011

Review 1 (average time in calendar days)

Pharmaceuticals

• NAS: NDS = 220
• CLIN C&M: NDS = 236
• CLIN C&M: SNDS = 235
• CLIN: SNDS = 226
• CLIN: DIN A = 188
• COMP C&M: ANDS = 172
• COMP C&M: NDS = 175
• COMP C&M: SANDS = 177
• COMP C&M: SNDS = 159
• COMP C&M: DIN A = n/a
• C&M: ANDS = 121
• C&M: SANDS = 132
• C&M: SNDS = 115
• C&M: DIN A = 201
• Published Data: SNDS=243
• Published Data: DIN A=n/a
• Rx to OTC Switch: SNDS = n/a
• Disinfectant: NDS-D = n/a
• Disinfectant: DIN D = 181
• Disinfectant: DIN D = 7
• Labelling Only: NDS=47
• Labelling Only: SNDS=46
• Labelling Only: SANDS=27
• Labelling Only: DIN A=103
• Label Standard: DIN A=32
• Label Standard: DIN D=22
• Label Standard: DIN F=32
• Administrative: ANDS = 30
• Administrative: NDS = 31
• Administrative: SNDS = 33
• Administrative: SANDS = 30
• Administrative: DIN A = 16
• Administrative: DIN D = 17

Biologics

• CLIN C&M: NDS = 244
• CLIN C&M: SNDS = 291
• CLIN: SNDS = 233
• C&M: SNDS = 146
• C&M: DINB = 153
• COMP C&M: SNDS = 179
• Labelling Only: SNDS = 33
• Published Data: SNDS = 177
• Administrative: NDS = 38
• Administrative: DINB = 36

User Fee: Medical Device Licence Application Fees

Fee Type: R

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: April 1, 2011

Performance Standards: Old User Fees – Received* prior to April 1, 2011

Review 1 (average time in calendar days)

• Class II = 15
• Class II amendment = 15
• Class II Private Label = 15
• Class II Private Label amendment = 15
• Class III = 60
• Class III amendment = 60
• Class IV = 75
• Class IV amendment = 75

New User Fees – Received* post April 1, 2011

Review 1 (average time in calendar days)

• Class II New = 15
• Class III New = 60
• Class III Near Patient =60
• Class III Manufacturing Amendment = 60
• Class III Significant Amendment = 60
• Class IV New = 75
• Class IV Human-Animal Tissue =75
• Class IV Manufacturing Amendment = 75
• Class IV Significant Amendment = 75

Performance Results: Old User Fees – Received* prior to April 1, 2011

Review 1 (average time in calendar days)

• Class II = 28.31
• Class II amendment = 17.55
• Class II Private Label = 14
• Class II Private Label amendment = 18.5
• Class III = 90.39
• Class III amendment = 79.24
• Class IV = 85.00
• Class IV amendment = 69.38

New User Fees – Received* post April 1, 2011

Review 1 (average time in calendar days)

• Class II New = 10.49
• Class III New = 45.02
• Class III Near Patient = 40.86
• Class III Manufacturing Amendment = 25.92
• Class III Significant Amendment = 43.25
• Class IV New = 67.33
• Class IV Human-Animal Tissue= 70
• Class IV Manufacturing Amendment = 32.72
• Class IV Significant Amendment= 52.14

User Fee: Fees for Right to Sell a Licensed Medical Device

Fee Type: R

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: April 1, 2011

Performance Standards: 20 calendar days from deadline for receipt of annual notification to update the Medical Devices Active License Listing (MDALL) database

Performance Results: 99.8% within 20 calendar days

User Fee: Medical Device Establishment Licensing Fees

Fee Type: R

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: April 1, 2011

Performance Standards: 120 calendar days to issue / renew licence

Performance Results: Average number of days: 77 Days

User Fee: Veterinary Drug Evaluation Fees

Fee Type: R

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: March 1996

Performance Standards:

Review 1 (average time in calendar days)

• NDS (including Priority Review) = 300
• ANDS = 300
• SNDS = 240
• SANDS = 240
• Admin = 90
• DIN (including changes to DINs) = 120
• NC = 90
• ESC = 60
• Labels = 45
• Emergency Drug Release = 2

Performance Results:

Review 1 (average time in calendar days)

• NDS (including Priority Review) = 346
• ANDS = 275
• SNDS = 252
• SANDS = 213
• Admin = 127
• DIN (including changes to DINs) = 155
• NC = 138
• ESC = 59
• Labels = 86
• Emergency Drug Release = 2

User Fee: Fees to be paid for Pest Control Product Application Examination Service

Fee Type: R

Fee-setting Authority: Pest Control Products Act (PCPA)

Date Last Modified: April 1997

Performance Standards: Target is 90% of submissions in all categories to be processed within the applicable review time http://www.hc-sc.gc.ca/cps-spc/pest/part/consultations/_pro2010-05/pro2010-05-eng.php

• Category A – e.g.,
  Standard - 550 days User Request Minor Use Registration (URMUR) - 365 days
• Category B – e.g.,
  Standard/priority - 365 days
• Category C – e.g.,
  Standard - 180 or 225 days
• Category D – e.g.,
  IMEP – 32 days OUI – 56 days URMULE – 247 days and Master Copy – 21 days
• Category E  - e.g.,
  New Active – Food – 152 days New Active – Non-food – 152 days

Performance Results:

• Category A = 100% overall were completed with established international standards.
• Category B = 96% overall for the fiscal year.
• Category C = 92%
• Category D = 84%  (note1)
• Category E = 37% (note 2)

User Fee: Fees to be paid for the right or privilege to manufacture or sell a pest control product in Canada and for establishing a Maximum Residue Limit in relation to a pest control product.

Fee Type: R

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: April 1997

Performance Standards: 100% of all fees for the right or privilege to manufacture or sell a pest control product in Canada are invoiced by April 30th of each fiscal year.

Performance Results: 100% of all invoices were issued by April 30, 2011

User Fee: Fees charged for the processing of access requests filed under the Access to Information Act (ATIA)

Fee Type: Other products and services (O)

Fee-setting Authority: Access to Information Act

Date Last Modified: 1992

Performance Standards: Response provided within 30 days following receipt of request; the response time may be extended pursuant to section 9 of the ATIA. Notice of extension to be sent within 30 days after receipt of request. The  Access to Information Act provides fuller details: http://laws-lois.justice.gc.ca/eng/acts/A-1/index.html

Performance Results: During fiscal year 2011-2012, Health Canada completed processing 1763 requests and reviewed 775,079 pages. Health Canada closed 1866 requests and released 356,061 pages. In 2011-12 the Compliance Rate increased to 91.6%.

Health Canada was able to reduce the deemed refusal rate (late files) to 11.1%. which enabled us to complete 97.5 % of backlog;

Health Canada minimized OIC complaints from 5% to 3.5 % reduction that equals to 30 % overall in the reduction of the OIC Complaints received.

The Act authorizes fees for certain aspects of processing formal requests under the Act (the fee structure is prescribed in ATI Regulations). However, Health Canada cannot charge fees for reviewing records, overhead or shipping, nor does it charge for the first five hours needed to search for a record or prepare any part of it for disclosure (required by section 11 of the Act).

During the year, Health Canada collected $7,115.00 in application fees and $4,703.00 in search fees. In total the Receiver General collected $11,818.00 in fees. In addition, Health Canada waived $6,539.00 in fees for 404 requests in accordance to its duty to assist applicants.

On June 29, 2012 an Order-in-Council was signed to formalize our shared services partnership between Health Canada and Public Health Agency of Canada. By sharing services, we have the opportunity to bring together resources and expertise and adopt each other's best practices.

User Fees Totals

Please note that according to prevailing legal opinion, where the corresponding fee introduction or most recent modification occurred prior to March 31, 2004:

• the performance standard, if provided, may not have received parliamentary review; and
• the performance standard, if provided, may not respect all establishment requirements under the UFA (e.g. international comparison; independent complaint address).
• the performance result, if provided, is not legally subject to section 5.1 of the UFA regarding fee reductions for unachieved performance.