Page 3: Health Canada – 2014–2015 – Supplementary Information Tables – Departmental Performance Report - Details on Transfer Payment Programs of $5 Milion or More

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Details on Transfer Payment Programs of $5 Milion or More

• Anti-Drug Strategy Initiatives (Voted)
• Canada Brain Research Fund to Advance Knowledge for the Treatment of Brain Disorders (Voted)
• Canadian Blood Services: Blood Research and Development Program (Voted)
• Contributions for First Nations and Inuit Health Infrastructure Support (Voted)
• Contributions for First Nations and Inuit Primary Health Care (Voted)
• Contributions for First Nations and Inuit Supplementary Health Benefits (Voted)
• Contribution to the Canadian Agency for Drugs and Technologies in Health (Voted)
• Contribution to the Canadian Institute for Health Information (Voted)
• Contribution to the Canadian Partnership Against Cancer (Voted)
• Contribution to the Canadian Patient Safety Institute (Voted)
• Grant to support the Mental Health Commission of Canada (Voted)
• Health Care Policy Contribution Program (Voted)
• Official Languages Health Contribution Program (Voted)
• Territorial Health Investment Fund (Voted)

Anti-Drug Strategy Initiatives (Voted)

General Information

Start date

December 4, 2014

End date

Ongoing

Fiscal year for terms and conditions

2014-15

Strategic outcome(s)

Health risks and benefits associated with food, products, substances, and environmental factors are appropriately managed and communicated to Canadians.

Link to department's Program Alignment Architecture

• Program 2.5: Substance Use and Abuse
  • Sub-Program 2.5.2: Controlled Substances

Description

In December 2014, the Anti-Drug Strategy Initiatives (ADSI) was created, which consolidated two previous Health Canada contribution funding programs - the Drug Strategy Community Initiatives Fund (DSCIF) and the Drug Treatment Funding Program (DTFP), into one joint fund. ADSI will continue to deliver the National Anti-Drug Strategy (NADS) Prevention and Treatment Action Plan mandates. Reporting on ADSI will commence in 2015-16.

The DSCIF contribute to reducing illicit drug use and prescription drug use among Canadians, particularly among vulnerable populations such as youth, by focusing on health promotion and prevention approaches to address substance abuse before it happens. The objectives of the DSCIF is to facilitate the development of local, provincial, territorial, national and community-based solutions to drug use among youth and to promote public awareness of substance use among youth. The Program is nationally delivered.

The DTFP, under the NADS, provides financial support annually to provincial and territorial governments and non-government organizations to strengthen drug treatment systems.

In 2014-15, $8,259,353 were spent under the DSCIF and $4,637,561 were spent under the DTFP.

Drug Strategy Community Initiatives Fund

Results achieved

In 2014-15, DSCIF projects reported reaching over 116,000 youth, parents, teachers and other community organizations and individuals through the production and dissemination of various products including publications, knowledge exchange mechanisms, multi-media products, promotional materials, direct services and events and various training opportunities. An evaluation of DSCIF completed in 2014-15 concluded that DSCIF was successful at achieving most of its outcomes including enhancing capacity among targeted populations to make informed decisions about substance use, reducing risk-taking behaviors associated with substance use among youth, increasing the uptake of health promotion and prevention knowledge and resources and increasing community engagement in order to prevent substance use among youth. Key findings from the evaluation include:

• Youth improved their capacity (knowledge and skills) to avoid illicit drug uses. 69% of projects reporting on this outcome perceived there was an increase in the level of youth knowledge about how to avoid illicit drug use including increased confidence, awareness of triggers to substance use, development of skills to respond to peer pressure, increased ability to communicate, greater comfort to refuse drugs and development of leadership skills. In addition, 83% of relevant projects reported positive changes in the level and nature of coping, avoidance and resistance skills such as coping skills, relationship building skills, positive attitude shifts and improvements in family change variables. Finally, 91% of relevant projects perceived an increase in the level and nature of participant resilience, including self-efficacy and access to support;
• Capacity changes positively influenced decision-making among youth. 78% of youth assessed against this indicator reported a positive change in intention to use drugs including first use, frequency and nature of use. There was also a statistically significant change, from pre to post projects, in the likelihood that youth would use various strategies to avoid or resist drug use. Finally, there was a statistically significant decrease in the likelihood of youth both trying and regularly using marijuana and other illicit drugs over the next 12 months. The number of youth who responded they were very unlikely or unlikely to regularly use marijuana increased from 84% at baseline to 93% post intervention;
• There has been a reduction in the frequency of the use of illicit drugs in some projects as well as improvements in healthy lifestyle behaviours such as class attendance and school involvement;
• At the community level there is evidence of uptake of health promotion and prevention resources generated through DSCIF projects. Information and resources produced by DSCIF projects are being used in classrooms and, more broadly in schools and communities. They are also being used in youth worker's daily work, incorporated into municipal and organizations' strategic plans and program planning, and integrated into organization's ongoing work; and
• Community engagement is an integral aspect of the DSCIF program and working collaboratively with existing and new partners is inherent to the implementation of DSCIF projects. All projects reporting on this outcome were able to provide strong evidence of engagement of community partners and networks in efforts to prevent illicit drug use and there was a statistically significant change from baseline to post intervention on all dimensions of community capacity. The types of benefits derived from community engagement and the contributions of partners included knowledge/expertise, coordination and linkages with networks of existing services and support for delivery, communications, strategic planning and involvement in strategy and resource creation and dissemination.

Current DSCIF projects continue to report against these outcomes and have started reporting positive findings, especially related to enhancing youth capacity and community engagement. As projects progress in their implementation, it is anticipated the program will gain further evidence to support the achievement of program outcomes.

Audits completed or planned

No audits were planned or completed.

Evaluations completed or planned

A departmental evaluation assessing relevance and performance was finalized in 2014-15. The program is leading a cluster evaluation, which uses standardized tools across projects to assess specific program outcomes. Baseline data collection for the cluster evaluation started in 2014-15. Post test data will be collected at the end of projects so results will not be available until after current project agreements ends. An evaluation of the NADS will commence in 2015-16 which DSCIF will participate in. The next departmental evaluation of the ADSI, in which DSCIF participates, is currently scheduled for completion in 2017-18.

Engagement of applicants and recipients

DSCIF continued to engage recipients through various channels. Recipients participated in the collection of data related to the core program outcomes and program consultants worked regularly with recipients to monitor contribution agreements and obtain required performance and evaluation reports. Recipients were also encouraged to use Prevention Hub Canada as a web platform to promote collaboration and knowledge sharing.

Drug Treatment Funding Program

Results achieved

Limited performance data was available in 2014-15 to support reporting against program outcomes due to the majority of contribution agreements not being signed until late in the fiscal year. However, those projects who were able to provide information on progress towards outcomes reported positive findings, particularly around improving collaboration and knowledge exchange and access to evidence-informed information. To date, projects have reported involving over 2,100 individuals in consultations and have reached over 41,600 individual through the production and distribution of knowledge exchange mechanisms, multi-media products, publications, performance/evaluation tools and reports, standards/guidelines and training/education. Examples of project success include:

• Nova Scotia launched a collaborative process with district health authorities and other key stakeholders to design a provincial in-patient withdrawal management service delivery model that is client-centred, safe, cost-effective and compliant with all applicable legislation. This has resulted in the development of triage and admission criteria, clinical pathway, policy and process for nurse-led discharge, development of roles and responsibilities for withdrawal management staff and definitions for required competencies for staff; and
• In British Columbia, collaborative activities across health authorities have increased in nature, scope and depth to support collective efforts to enhance awareness, knowledge and capacity at the individual, group and organizational levels. For example all Health Authorities are participating in the co-creation of knowledge exchange tools and resources to support Trauma-Informed practice, Indigenous cultural safety, and compassionate, inclusive, and engaging service responses. Additionally, trauma-informed practice implementation has begun to shift from a procedural approach to one of relational practice and understanding. Dialogues between and among service providers, self-described trauma champions, leadership and people with lived experience and their families have begun to focus on practice changes that are required to ultimately change the relationship of staff with the people they serve, their families and to their work.

Audits completed or planned

No audits were planned or completed.

Evaluations completed or planned

No evaluations were planned or completed in 2014-15. An evaluation of the NADS will commence in 2015-16 which DTFP will participate in. The next departmental evaluation of the ADSI, in which DTFP participates, is currently scheduled for completion in 2017-18.

Engagement of applicants and recipients

DTFP continued to engage recipients through various channels. Program consultants worked regularly with recipients to negotiate and monitor contribution agreements and obtain required performance and evaluation reports. Teleconferences and e-mail contact was used to engage and inform applicants about funding for 2014-15.

Performance Information (dollars)

Consolidation of the Drug Strategy Community Initiatives Fund and Drug Treatment Funding Program as of December 2014 into a single contribution program entitled Anti-Drug Strategy Initiatives (ADSI).

Canada Brain Research Fund to Advance Knowledge for the Treatment of Brain Disorders (Voted)

General Information

Start date

April 1, 2011

(Actual funding received Supplementary Estimates C 2011-12)

End date

March 31, 2017

Fiscal year for terms and conditions

2011-12

(No standalone terms and conditions (Ts & Cs) were developed, Ts & Cs are included within the Agreement).

Strategic outcome(s)

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

• Program 1.1: Canadian Health System Policy
  • Sub-Program 1.1.1: Health System Priorities

Description

The Canada Brain Research Fund (CBRF) is managed by Brain Canada, an organization dedicated to advancing cutting-edge brain research. Announced in Budget 2011, the Government of Canada is providing up to $100 million in funding to match non-governmental donations over six years. The purpose of the CBRF 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.

Specifically, the CBRF serves two functions: it is a focal point for private investment in brain research, and attracts investment by matching private donations with Government of Canada funding 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 funds 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.

Results achieved

Brain Canada continued to build on its activities and progress from the first year. Highlights include:

• Announced the first project under the Chagnon Family - Brain Canada Multi-investigator Research Initiative (MIRI) Interventions for Prevention of Alzheimer Disease and Related Disorders and four projects under the Azrieli Neurodevelopmental Research Program focused on Autism Spectrum Disorders and Fragile X syndrome.
• Announced 32 projects under the 2014 MIRI and the Platform Support Grants (PSGs).
• Announced six projects on brain and mental health with the Hotchkiss Brain Institute under the 2014 MIRI and PSG Sponsored Opportunity programs.
• Announced the first research grant under a partnership with Amyotrophic lateral sclerosis (ALS) Canada to match funds raised from the Ice Bucket challenge.
• Announced five team grants under the British Columbia Alzheimer's Research Award Program involving a partnership between Brain Canada, the Michael Smith Foundation for Health Research, Genome British Columbia, and The Pacific Alzheimer Research Foundation.
• Announced four research grants on brain cancer in partnership with the Canadian Cancer Society.
• Launched the Focus on Brain program in partnership with CQDM (Consortium Québécois sur la Découverte du Médicament) to fund breakthrough technologies to accelerate drug discovery.
• Launched Requests for Applications for the 2015 MIRI, the 2015 PSG, and the Azrieli Neurodevelopmental Research Program Phase 2.
• Increased Brain Canada's outreach and visibility to donors, partners and media, both domestically and internationally.

Audits completed or planned

As specified in the funding agreement, Brain Canada must submit independently audited financial statements to Health Canada each calendar year. Also required is an annual report detailing activities conducted and outcomes achieved. These reports are due to Health Canada no later than February 28 of the year following the calendar year being reported on.

Evaluations completed or planned

As per the funding agreement Brain Canada will conduct an independent evaluation of the activities of the CBRF 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.

Performance Information (dollars)

Canadian Blood Services: Blood Research and Development Program (Voted)

General Information

Start date

April 1, 2000

End date

Ongoing

Fiscal year for terms and conditions

Terms and conditions (Ts & Cs) for this contribution program became effective April 1, 2013.

Strategic outcome(s)

Health risks and benefits associated with food, products, substances, and environmental factors are appropriately managed and communicated to Canadians.

Link to department's Program Alignment Architecture

• Program 2.1: Health Products
  • Sub-Program 2.1.2: Biologics and Radiopharmaceuticals

Description

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

Results achieved

The CBS Research and Development (R&D) Program helps maintain and increase the safety, supply and efficiency of the Canadian blood system by advancing innovation and maintaining Canadian capacity in transfusion science and medicine. The CBS R&D Program has generated numerous outputs, specifically knowledge products such as journal articles, learning events, and the development of highly qualified people in the important areas of basic and applied research that support the mission of CBS. The Program has shown a good level of achievement across its immediate and intermediate outcomes. In particular, the Program has played a key role in building and maintaining research capacity in transfusion science and medicine. At the immediate level, more than 1,700 healthcare professionals and researchers attending learning events and most reported enhanced knowledge. At the intermediate level, CBS has reported that key stakeholders in the transfusion and transplantation community are applying the knowledge created by R&D projects, such as updating standard operating procedures and license amendments.

Audits completed or planned

None

Evaluations completed or planned

An evaluation assessing relevance and performance was completed in 2013-14. The next planned evaluation will be 2017-18.

Engagement of applicants and recipients

CBS was engaged to sit as an advisory committee member and be a recipient participant testing a new automated system for the collection of performance information

Health Canada officials undertook numerous exchanges (meetings, phone calls, e-mails) with CBS to discuss program progress and revisions to the performance measurement strategy.

Performance Information (dollars)

Contributions for First Nations and Inuit Health Infrastructure Support (Voted)

General Information

Start date

April 1, 2011

End date

Ongoing

Fiscal year for terms and conditions

2013-14

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.

Link to department's Program Alignment Architecture

• Program 3.3: Health Infrastructure Support for First Nations and Inuit
  • Sub-Program 3.3.1: First Nations and Inuit Health System Capacity
    • Sub-Sub Program 3.3.1.1: Health Planning and Quality Management
    • Sub-Sub Program 3.3.1.2: Health Human Resources
    • Sub-Sub Program 3.3.1.3: Health Facilities
  • Sub-Program 3.3.2: First Nations and Inuit Health System Transformation
    • Sub-Sub Program 3.3.2.2: e-Health Infostructure
  • Sub-Program 3.3.3: Tripartite Health Governance

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.

Results achieved

• Improved quality in the delivery of programs and services;
• Provided safe health facilities that supported health program delivery;
• Promoted engagement of key stakeholders in Aboriginal health in the integration of health services; and
• Improved access to health information.

Audits completed or planned

• Portfolio Audit and Accountability Bureau (PAAB) Audit of Capital Programs: 2015-16.
• Audit of the Management of Grants and Contributions-Health Canada.
  (includes the Grants and Contribution Information Management System (GCIMS)) : 2016-17.
• PAAB Audit of First Nations and Inuit Health System Capacity: 2017-18.

Evaluations completed or planned

• Health Planning and Quality Management: 2011-12.
• Health Planning and Quality Management: 2016-17.
• British Columbia Tripartite Initiative 2017-18.
• Health Human Resources: 2013-14.
• Health Facilities: 2011-12.
• Health Facilities: 2016-17.
• Health Services Integration Fund: 2015-16.
• e-Health Infostructure: 2011-12.
• e-Health Infostructure: 2016-17.
• Nursing Innovation: 2013-14.

Engagement of applicants and recipients

Health Canada's First Nations and Inuit Health Strategic Plan provides overall guidance on where efforts need to be focused in the short-, medium-, and long-term to improve First Nations and Inuit health outcomes over time. This Plan was developed collaboratively with First Nations and Inuit, provinces and territories (P/T), other federal departments and health and social organizations to outline how Health Canada plans to move forward in fulfilling its core mandate of providing quality health services while strengthening its focus with key partners to advance mutual priorities for improved health. More specifically, the Strategic Goal 2: Collaborative Planning and Relationships will include better mechanisms for First Nations and Inuit to feed into branch's planning and decision-making including contribution programs management and delivery. The Goal 2 includes two key elements:

• 2.1 Identify and advance shared priorities with First Nations, Inuit, other federal departments, P/T, and other partners through culturally-appropriate collaborative planning and coordinated initiatives to improve health outcomes; and
• 2.2 Support First Nations and Inuit in their aim to influence, manage and/or control health programs and services that affect them.

The First Nations and Inuit Health Infrastructure funding is provided mainly to First Nations and Inuit organizations through multi-year funding agreements. The level of flexibility in the management of health funding is determined by the interest and capacity of the funding recipient in assuming greater control over their health programming and planning.

As part of the Strategic Plan, Regional Transition Plans (RTP) (initiated in 2012-13) will be implemented, which specifically set out how regions will organize themselves to better respond to local health needs/priorities. In addition, RTP will set out mechanisms to engage with local First Nations and Inuit and provincial and territorial partners (e. g., regional advisory bodies).

In order to streamline and reduce reporting and administrative burden associated with grants and contributions, the First Nations and Inuit Health Branch will continue efforts to standardize recipient reporting, multi-departmental contribution agreements, and standardization of processes, procedures requirements, and tools for transfer payment programs such as the joint GCIMS project initiative between Health Canada, the Public Health Agency Canada and Aboriginal Affairs and Northern Development Canada.

Performance Information (dollars)

Contributions for First Nations and Inuit Primary Health Care (Voted)

General Information

Start date

April 1, 2011

End date

Ongoing

Fiscal year for terms and conditions

2010-11

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.

Link to department's Program Alignment Architecture

• Program 3.1: First Nations and Inuit Primary Health Care
  • Sub-Program 3.1.1: First Nations and Inuit Health Promotion and Disease Prevention
    • Sub-Sub Program 3.1.1.1: Healthy Child Development
    • Sub-Sub Program 3.1.1.2: Mental Wellness
    • Sub-Sub Program 3.1.1.3: Healthy Living
  • Sub-Program 3.1.2: First Nations and Inuit Public Health Protection
    • Sub-Sub Program 3.1.2.1: Communicable Disease Control and Management
    • Sub-Sub Program 3.1.2.2: Environmental Public Health
  • Sub-Program 3.1.3: First Nations and Inuit Primary Care
    • Sub-Sub Program 3.1.3.1: Clinical and Client Care
    • Sub-Sub Program 3.1.3.2: Home and Community Care

Description

The Primary Health Care (PHC) 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.

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.

Audits completed or planned

• Portfolio Audit and Accountability Bureau (PAAB) Audit of Transfer Payment for Public Health Protection: 2013-14.
• Office of the Auditor General (OAG) Audit of Federal Programs for Diabetes: 2012-13.
• OAG Audit of Emergency Management on Reserves: 2013-14.
• PAAB Audit of the Transfer Payments for First Nation and Inuit (FNI) Health Promotion & Disease Prevention: 2015-16.
• PAAB Audit of Transfer Payments for Home and Community Care: 2014-15.
• PAAB Audit of British Columbia Tripartite Agreement: 2016-17.
• PAAB Joint Health Canada/Public Works Government Services Canada Audit of Nursing Services Contracts in Northern Manitoba: 2013-14.
• OAG Performance audit on Access to Health Services for Remote First Nations Communities: 2014-15.

Evaluations completed or planned

• Healthy Child Development: 2009-10.
• Healthy Child Development: 2014-15.
• Mental Wellness: 2012-13.
• Mental Wellness: 2015-16.
• Chronic Disease and Injury Prevention: 2011-12.
• Healthy Living: 2014-15.
• Communicable Disease Control and Management: 2010-11.
• Communicable Disease Control and Management: 2014-15.
• Environmental Health: 2010-11.
• Environmental Health: 2016-17.
• Clinical and Client Care: 2013-14.
• Clinical and Client Care: 2017-18.
• Home and Community Care: 2013-14.
• Home and Community Care: 2017-18.

Engagement of applicants and recipients

Health Canada's First Nations and Inuit Health Strategic Plan provides overall guidance on where efforts need to be focused in the short, medium, and long term to improve First Nations and Inuit health outcomes over time. This Plan was developed collaboratively with First Nations and Inuit, provinces and territories, other federal departments and health and social organizations to outline how Health Canada plans to move forward in fulfilling its core mandate of providing quality health services while strengthening its focus with key partners to advance mutual priorities for improved health. More specifically, the Strategic Goal 2: Collaborative Planning and Relationships will include better mechanisms for First Nations and Inuit to feed into branch's planning and decision-making including contribution programs management and delivery. The Goal 2 includes two key elements:

• 2.1 Identify and advance shared priorities with First Nations, Inuit, other federal departments, P/T, and other partners through culturally-appropriate collaborative planning and coordinated initiatives to improve health outcomes.
• 2.2 Support First Nations and Inuit in their aim to influence, manage and/or control health programs and services that affect them.

The PHC funding is provided mainly to First Nations and Inuit organizations through multi-year funding agreements. The level of flexibility in the management of health funding is determined by the interest and capacity of the funding recipient in assuming greater control over their health programming and planning.

As part of the Strategic Plan, Regional Transition Plans (RTP) (initiated in 2012-13) will be implemented, which specifically set out how regions will organize themselves to better respond to local health needs/priorities. In addition, RTP will set out mechanisms to engage with local First Nations and Inuit and provincial and territorial partners (e. g., regional advisory bodies).

In order to streamline and reduce reporting and administrative burden associated with grants and contributions, the First Nations and Inuit Health Branch will continue efforts to standardize recipient reporting, multi-departmental contribution agreements, processes, procedures requirements, and tools for transfer payment programs such as the joint Grants and Contributions Information Management System (GCIMS) project initiative between Health Canada, the Public Health Agency of Canada and Aboriginal Affairs and Northern Development Canada.

Performance Information (dollars)

Contributions for First Nations and Inuit Supplementary Health Benefits (Voted)

General Information

Start date

April 1, 2011

End date

Ongoing

Fiscal year for terms and conditions

2010-11

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.

Link to department's Program Alignment Architecture

Program 3.2: Supplementary Health Benefits for First Nations and Inuit

Description

The Non-Insured Health Benefits (NIHB) program provides coverage for a specified range of medically necessary health-related goods and services to registered Indians (according to the Indian Act) and Inuit (recognized by one of the Inuit Land Claim Organizations) regardless of residency in Canada where not otherwise covered under a separate agreement (e.g. a self-government agreement) with federal, provincial or territorial governments. The benefits under the NIHB Program include the following, where not otherwise provided to eligible clients through other private or provincial/territorial programs: 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.

Results achieved

• Improved access to non-insured health benefits appropriate to the unique health needs of First Nations people and Inuit.
• Efficiently managed access to NIHB.

Audits completed or planned

• Portfolio Audit and Accountability Bureau (PAAB) Audit of NIHB Pharmacy: 2011-12.
• PAAB Follow-up Audit of NIHB Medical Transportation: 2012-13.
• PAAB Audit of First Nations and Inuit Health Branch - Vision Care, Medical Supplies, Mental Health: 2013-14.
• OAG Follow up to the Management of Federal Drug Benefit Programs: 2015-16.

Evaluations completed or planned

• Supplementary Health Benefits for First Nations and Inuit: 2010-11.
• Supplementary Health Benefits for First Nations and Inuit: 2015-16.

Engagement of applicants and recipients

Health Canada's First Nations and Inuit Health Strategic Plan provides overall guidance on where efforts need to be focused in the short-, medium-, and long-term to improve First Nations and Inuit health outcomes over time. This Plan was developed collaboratively with First Nations and Inuit, P/T, other federal departments and health and social organizations to outline how Health Canada plans to move forward in fulfilling its core mandate of providing quality health services while strengthening its focus with key partners to advance mutual priorities for improved health. More specifically, the Strategic Goal 1: High Quality Health Services will emphasize quality improvement, strengthen access to services and adapt programs to ensure access to health services. Of the four key elements outlined in Goal 1, the following is directly related to Supplementary Health Benefits:

• 1.2 Support access to a comprehensive range of quality services and medically necessary health products and benefits.

Additionally, the Strategic Goal 3: Effective and Efficient Performance will improve availability of, and access to, high quality data, manage cost-effective and evidence-based supplementary health benefits, streamline and harmonize administrative processes and leverage work with other government departments. Of the four key elements outlined in Goal 3, the following is directly related to Supplementary Health Benefits:

• 3.2 Efficient management of cost-effective and evidence-based supplementary health benefits that contribute to improving the health status of First Nations and Inuit in Canada.

As part of the Strategic Plan, Regional Transition Plans (RTP) (initiated in 2012-13) will be implemented, which specifically set out how regions will organize themselves to better respond to local health needs/priorities. In addition, RTP will set out mechanisms to engage with local First Nations and Inuit and provincial and territorial partners (e. g., regional advisory bodies).

Contribution to the Canadian Agency for Drugs and Technologies in Health (Voted)

General Information

Start date

April 1, 2008

End date

March 31, 2018

Fiscal year for terms and conditions

Terms and Conditions as approved for the Contribution Agreement will apply to future Canadian Agency for Drugs and Technologies in Health (CADTH) agreements until such time as they are superseded. The fiscal year for those Terms and Conditions follows the traditional fiscal year calendar, from April 1 through March 31 of the following calendar year.

Effective April 1, 2013, the CADTH funding was transitioned to a Contribution Agreement from a Named Grant. The change allows Health Canada to augment monitoring and managements of the funds. Prior to March 31, 2018 CADTH will need to request a renewal of funding.

The previous Named Grant covered the period of 2008 to 2013.

Strategic outcome(s)

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

• Program 1.1: Canadian Health System Policy
  • Sub-Program 1.1.1: Health System Priorities

Description

The CADTHis an independent, not-for-profit agency funded by Canadian federal, provincial, and territorial governments to provide credible, impartial and evidence-based information about the clinical/cost-effectiveness and optimal use of drugs and other health technologies to Canadian health care decision makers.

Results achieved

The purpose of the Contribution Agreement is to provide financial assistance to support CADTH's core business activities, namely, the Common Drug Review, Health Technology Assessments and Optimal Use Projects. 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.

Audits completed or planned

An audit was completed by the Portfolio Audit and Accountability Bureau in November 2012. The objectives of the audit were to determine whether the Strategic Policy Branch has put in place an effective management control framework for the oversight and management of the funding agreement; and whether CADTH has complied with the terms and conditions of the funding agreement.

Evaluations completed or planned

In 2011, CADTH underwent a two-phased independent evaluation to determine the performance to date of CADTH's three core activities and other program areas; the current state of CADTH's multi-phase organizational transformation; and the findings to make supporting recommendations to improve the impact of CADTH's customer offerings. Health Canada also conducted a synthesis evaluation involving this program that was completed in 2013-14. CADTH will be evaluated in 2015-16 as per the terms of the contribution agreement. A recipient-led evaluation will start in September 2015 and the report will be available in December 2016. Health Canada and CADTH officials are working collaboratively to make certain the evaluation will provide information on the value of CADTH's existing products and services and information to support how these could be refined in future to enhance the value proposition of CADTH. The next departmental evaluation is scheduled to be completed in March 2017.

Engagement of applicants and recipients

CADTH has produced numerous products and services including health technology reports, optimal use projects, environmental scans, therapeutic reviews and formulary listing recommendations. These deliverables provide guidance and evidence-based information to health care decision-makers regarding the cost-effectiveness and optimal use of health technologies. In particular, the formulary listing recommendations increases transparency across jurisdictions and provides consistency to pharmaceutical reimbursement decisions made by the participating public drug plans.

Performance Information (dollars)

Contribution to the Canadian Institute for Health Information (Voted)

General Information

Start date

April 1, 1999

The current contribution agreement began in 2012-2013 and was recently amended to be extended by one year; the amended agreement will expire on March 31, 2016. Negotiations for a new agreement are underway.

End date

Ongoing

Fiscal year for terms and conditions

A Treasury Board Submission to establish new terms and conditions (Ts & Cs) for the Health Information Initiative (HII) was approved by Treasury Board on March 29, 2012. These new Ts & Cs provide the Federal Minister of Health the authority to renew funding agreements with the recipient without returning to Treasury Board Secretariat. The contribution agreement with CIHI is governed by the HII Ts & Cs, for which there is no expiry date.

Strategic outcome

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

• Program 1.1: Canadian Health System Policy
  • Sub-Program 1.1.1: Health System Priorities

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 1994 by the federal/provincial/territorial Ministers of Health to address significant gaps in health information. CIHI's data and its analyses respond to questions about Canada's health systems and assist a variety of stakeholders, including funders, policy makers, health system managers, analysts, clinicians and researchers, in making informed decisions.

Since 1999, the federal government has provided funding to CIHI through a series of grants and conditional grants, known as the Roadmap Initiatives. More recently CIHI's funding has been consolidated through the HII, and is currently delivered through a contribution agreement. This combined funding has allowed CIHI to produce quality and timely health information ranging from health care system capacity, wait times data to the development of pan-Canadian health indicators.

The HII extended funding to CIHI for their 2012-15 Plan: "Better data. Better decisions. Healthier Canadians". This contribution agreement, which began in fiscal year 2012-13, was recently amended to be extended by one year to include additional funds for activities to reduce Prescription Drug Abuse (PDA). The amended agreement spans over fiscal years 2012-13 to 2015-16 and provides $317,308,157 million to CIHI over four years, with annual funding as follows:

Remaining PDA funds for years three, four and five ($3.33 million) will be included in a new contribution agreement that will be prepared for April 1, 2016; $1,090,000 will be provided in 2016-17 and 2017-18 and the remaining funds ($1,150,000) will be provided in 2018-19. Thus, $4.28 million of PDA funding will be provided over fiscal year 2014-15 to 2018-19.

Results achieved

In 2014-15, 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 President's Quarterly Reports, and are accurate as of June 20, 2015. More detailed information on results achieved for 2014-15 is available in the CIHI Annual Report released in mid-July 2015.

Improving the Comprehensiveness, Quality and Availability of Data

There has been solid progress in data collection, especially surrounding the comprehensiveness and availability of CIHI data holdings. Progress has been made most notably in:

New or amended Data Sharing Agreements were finalized with:

• Ontario Ministry of Health and Long-Term Care - Data Privacy Agreement to allow CIHI to obtain patient-level physician billing and eligible persons for healthcare data for the Population Risk Adjustment Grouper project.
• Ontario Renal Network and Trillium Gift of Life Network - to facilitate the flow of Ontario dialysis and organ donation/transplantation data to CIHI.
• British Columbia Ministry of Health - to add pediatric rehabilitation and patient-level physician billing data.
• Medical Laboratory Technologists and Medical Radiology Technologists - to facilitate the flow of health workforce data from professional colleges, associations and/or societies.
• Collège des Médecins du Québec - to facilitate disclosure of list of its members to CIHI.
• Transplant Québec - to facilitate the disclosure of organ transplant and donor data to CIHI.
• Cancer Care Ontario (CCO) - replacing the 2010 DSA (Data Sharing Agreements) to facilitate the disclosure of renal-related personal health information to CIHI; and to facilitate the flow of personal health information from DAD, NACRS and CORR (Canadian Organ Replacement Registry) to CCO.
• Canadian Medical Protective Association (CMPA) - to facilitate the flow of de-identified DAD and NACRS data to the CMPA.
• Statistics Canada - amendment to extend the terms of the agreement for the Data Liberation Initiative to March 31, 2016.
• First Nations and Inuit Health Branch - amendment to extend the terms of the agreement for data submission to NPDUIS to March 31, 2017.

Canadian Multiple Sclerosis Monitoring System:

• Three proposals were approved for participation in the Phase 2 feasibility pilot and launch meetings were held with the three new MS (multiple sclerosis) clinics. A separate meeting was held with a fourth clinic to assess the feasibility of submitting a streamlined set of CMSMS data elements via NACRS, which could lower the burden of data collection for many MS clinics.
• CMSMS recruited and approved a proposal to assess the feasibility of submitting a priority set of CMSMS data elements via NACRS Clinic Lite. This option has the potential to greatly reduce the burden of data collection for sites and also improve efficiencies in the long-term.

Canadian Organ Replacement Registry:

• CIHI met with Canadian Blood Services (CBS) in preparation for transitioning transplant and donor data collection from CIHI to the CBS. It was agreed that representatives from CIHI will be part of a transition steering committee and working group. The kickoff meeting for this transition project took place in January 2015.
• The CORR Web-Based Data Entry Tool was deployed in February 2015. Sixteen new web-based data forms were developed and released in English and French. The forms eliminate the need for paper-based data submission, reduce the burden of manual data entry for CIHI and minimize security risks.

CIHI - CIHR Collaborative Project: Dynamic High System Users Cohort for the PICHI SPOR:

• Canadian Institutes of Health Research (CIHR) approached CIHI in the fall 2014 to assist with the development of a dynamic pan-Canadian cohort of complex needs/high system users to support one of their projects related to Canada's Strategy for Patient-Oriented Research (SPOR). Three pan-Canadian networks have been identified to deliver on the SPOR objectives. One of these, the Primary and Integrated Health Care Innovations (PICHI) network, will initially focus on individuals with complex health needs. CIHR is launching quick-strike projects starting in September 2015 as a means of gaining early wins to show the value of the PICHI network and to build the case for increasing the funding of a national data platform as a learning health system. Researchers will have the ability to use CIHI's dynamic cohort of complex needs/high system users' data set for their quick-strike projects, where their project requires.
• CIHI is working in collaboration with CIHR, the PICHI network and lead researchers to develop the methodology for the creation of the cohort. The resulting cohort, a linked dataset containing a representative sample of high users across health care settings, will be de-identified in accordance with CIHI standards and policies, and made available to specific CIHR-approved researchers as part of our well-established Third Party Data Request Service. Under this service, researchers requesting the data will be required to justify the specific data elements requested and sign an agreement that outlines their requirements around storage and use of the data, publication of results, data destruction and other aspects. Only data we are authorized to disclose through our DAS with provinces and territories, and that is required to support the research, will be included.

In addition, CIHI has improved the timeliness of data holdings. With a few exceptions, the majority of their data is between one and two years old.

Support population health and health system decision-making

Health System Performance Measurement:

• The new Your Health System: In Depth website was launched on September 18, 2014. This new section of the website (previously known as OurHealthSystem.ca) provides easy access to an expanded set of aligned indicators and contextual measures that reflect health system results at both the population and facility levels. Key features include peer group comparisons, benchmarking and top results, trend information, enhanced mapping functionality and exporting capability.
• Your Health System Insight, a new secure e-tool was launched on March 26, 2015 to over 100 external users. The tool includes five indicators to start; with five more planned in a June 2015 update;
• CIHI was among a group of healthcare organizations recognized for their outstanding websites and digital communications in November 5, 2014 during the Eighteenth Annual Healthcare Internet Conference. CIHI's Your Health System web tool is placed in the Best Interactive Site category.
• A Chart review study for the Hospital Harm Indicator (HHI) was completed with a review of 1,200 hospital charts from two hospitals in Ontario and two from Alberta. A coding culture study to identify and provide input and recommendations regarding how to incorporate coding culture into the HHI calculation was completed.

Partnerships:

• CIHI hosted a knowledge exchange on patient-reported outcome measures with representatives from the Bureau of Health Information in Sydney, Australia.
• CIHI presented recommendations on a composite indicator for potentially preventable hospitalizations to the international Working Group with representatives from Ireland, Israel, Italy, Netherlands, New Zealand, Singapore and the United Kingdom.
• The annual meeting of the World Health Organization (WHO) Family of International Classifications Network was held in Barcelona, Spain from October 11-17, 2014. Major updates for International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) will be released in 2016 and 2019 and possibly 2022. WHO is building a common foundation among ICD-11, International Classification of Functioning and Systematized Nomenclature of Medicine Clinical Terms to enable linkages and comparability among clinical data standards, and it will take 3 to 5 years to implement ICD-11 after its release to the World Health Assembly in 2017.

International Comparisons and Benchmarking:

• Survey data for the 2014 Commonwealth Fund (CF) reporting was collected and preliminary findings were reviewed. Coordination of Canadian input for the 2015 CF survey on primary health care physicians was initiated.
• How Canada Compares: Results From the CF 2014 International Health Policy Survey of Older Adults was released on January 29, 2015. Older Canadians report having longer waits and more difficulties seeing a doctor or nurse when they need medical attention than older people in 10 comparator countries.
• The Organisation for Economic Cooperation and Development (OECD) 2014-15 Health Care Quality Indicator data collection was completed and submitted on March 20, 2015. The international comparison tool will be released in November 2015, and will include an additional 30 indicators with provincial results. The accompanying analysis in brief will examine Canada's performance on risk factors for diabetes.

Deliver organizational excellence

Some notable achievements from the last year include:

• A Lean initiative recommended new timelines for external data submission, which resulted in the receipt of CMDB data almost four months earlier than previous years.
• CIHI received International Organization for Standardization ISO 27001:2005 certification. The project to upgrade to ISO 27001:2013 was initiated, with plans to complete the upgrade by September 2015.
• Online training and references for LEADS leadership (Harvard ManageMentor^®) and instructional videos in software skills development, learning technology tools, and professional business practices (Lynda.com) were implemented across the organization.

Audits completed or planned

Under the terms of its agreement with Health Canada, CIHI was required to have a performance audit completed and reported on by March 31, 2015. KPMG completed the audit in September 2014. Overall, they found that CIHI had designed and implemented practices and processes that promote economy, efficiency, and effectiveness of funding received from Health Canada. The audit identified a number of positive practices currently in place within CIHI. Four areas of improvement were also identified through the audit to further support CIHI's continued evolution as a mature organization and its achievement of expected results and objectives:

• CIHI would benefit from more clearly defined specific areas of focus, aligned with its strategic objectives, to further strengthen its stakeholder and partnership engagement activities.
• Opportunities exist to further clarify and formalize the current process and guidelines to reflect expected practices and promote greater consistency in the documentation retained to support investment decisions.
• As CIHI continues to mature as an organization, management is encouraged to explore cost-effective means of obtaining more complete information on product costing to help inform future decision-making.
• While it is noted that CIHI has a strong security program in place, minor areas were identified in which security settings and security event monitoring could be enhanced to further strengthen security over data holdings.

Evaluations Completed or Planned

The Office of Evaluation evaluated the relevance and performance of the HII for the period of 2012-15, as required by the contribution agreement. The evaluation was completed in December 2014 in anticipation of a new funding agreement to come into effect on April 1, 2016. It confirmed that HII objectives, mandate and activities were aligned and consistent with Health Canada objectives, federal government priorities and the federal role in the development of pan-Canadian health data. The next departmental evaluation is planned for fiscal year 2019-20.

Engagement of applicants and recipients

None needed. CIHI is the sole recipient of HII funding as per the terms and conditions of the HII, which stipulates that CIHI is the only recipient of HII funding.

Performance Information (dollars)

Contribution to the Canadian Partnership Against Cancer (Voted)

General Information

Start date

April 1, 2007

End date

Ongoing

Fiscal year for terms and conditions

Terms and Conditions are embedded in the funding agreement.

Strategic outcome(s)

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

• Program 1.1: Canadian Health System Policy
  • Sub-Program 1.1.1: Health System Priorities

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 CPAC 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-centered care, guidelines, standards, as well as supporting key research activities and facilitating the development of a pan-Canadian surveillance system.

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 on-line 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.
• Implemented the country's largest population health study of risk factors - the Canadian Partnership for Tomorrow Project - which has enrolled 300,000 Canadians to explore why some people develop cancer and others do not.
• Launched a First Nations, Inuit and Métis Action Plan on Cancer Control, in collaboration with First Peoples.
• Expanded cancer screening programs in all provinces and encouraged hard-to-reach populations, such as women living with cervical cancer, to undergo screening - which helps doctors catch cancer earlier.
• Developed programs to help survivors through the tremendous uncertainty following treatment.

Audits completed or planned

N/A

Evaluations completed or planned

An evaluation of CPAC was completed in 2010-11 and another one is planned for 2015-16. A performance measurement strategy and an evaluation framework were completed in 2012-13.

Engagement of applicants and recipients

The CPACworks to engage stakeholders through communications activities that include media and on-line vehicles to both the broader public and the cancer and health communities, and targeted outreach and partnership building. In 2014-15, CPAC: drove uptake of evidence-informed programs and policies in other jurisdictions through Coalitions Linking Action and Science for Prevention (CLASP) initiatives; implemented synoptic pathology reporting best-practice sharing through KTE and enhanced uptake and use of electronic synoptic surgical reporting templates and standards through a new pan-Canadian network; convened a pan-Canadian steering committee to report on patient experience; began development of a national research infrastructure, including the bio- and data- repository and access management portal for the Canadian Partnership for Tomorrow Project; invested in development of multi-jurisdictional networks to support knowledge exchange in rural, remote and isolated communities; and focused on expanding public engagement through digital and social media channels and deepening engagement with the patient community.

Contribution to the Canadian Patient Safety Institute (Voted)

General Information

Start date

December 10, 2003

End date

Ongoing

Fiscal year for terms and conditions

2012-13

Strategic outcome(s)

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

Program 1.1: Canadian Health System Policy
Sub-Program 1.1.1: Health System Priorities

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.

CPSI's first two grant agreements provided financial assistance to help it support implementation of the commitments governments made under the 2003 First Ministers' Accord on Health Care Renewal related to improving health care quality by strengthening system co-ordination and improving national collaboration related to patient safety. Funding is now delivered through a five-year contribution agreement, covering April 1, 2013 to March 31, 2018. For 2013-2018, CPSI will focus and align its activities with a new emphasis on the strategic goals that are most likely to drive further system-level transformation over the five-year period, and beyond.

Results achieved

To continue to fulfill its mandate, CPSI focused on its strategic goals of: inspiring and sustaining patient safety knowledge within the system, and through innovation, enabling transformational change; building and influencing patient safety capability at organizational and systems levels; engaging all audiences across the health system in the national patient safety agenda; and providing leadership on the establishment of a National Integrated Patient Safety Strategy (NIPSS). In 2013-14, key results achieved included:

• Significant work continued on the development and implementation of a National Integrated Patient Safety Action Plan that will identify the priority patient safety areas most likely to lead to system-wide change and find ways to increase the pace of safety improvements. To develop and implement the action plan, CPSI convened the National Patient Safety Consortium, a group of more than 40 key organizations in Canadian healthcare who are working collaboratively to advance the action plan work. A draft action plan has been developed that includes measures to address some of the biggest patient safety challenges in the areas of surgical care safety, medication safety, infection prevention and control and home care safety, with an additional focus on patient safety education.
• The Safer Healthcare Now! campaign now has over 950 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 2,000 participants registered for Canadian Patient Safety Week 2013, 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 programs such as the Effective Governance for Quality and Patient Safety educational program for health care leaders, the Patient Safety Education Program-Canada, the Advancing Safety for Patients in Residency Education program and through the opportunities provided to the more than 1,900 sites and 5,800 viewers of Canada's Virtual Forum on Patient Safety and Quality Improvement.
• Targeted patient safety research was funded, including collaborations with partners to support research in the area of patient safety in the home care sector.
• Continued implementation of a Global Patient Safety Alerts system, which provides an ongoing resource of actionable information on specific patient safety incidents, and release of an application to allow mobile access to the system.
• Work began to develop a NIPSS, which will include a framework for identifying patient safety priorities and aligning CPSI's work with the activities of other organizations working to achieve patient safety improvement in Canada. The NIPSS will initially target the four clinical priority areas of surgical care safety, medication safety, infection prevention and control, and home care safety.

Audits completed or planned

CPSI's financial records are reviewed and audited annually by independent external accountants.

Evaluations completed or planned

Health Canada conducted a synthesis evaluation involving this program that was completed in 2013-14.

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, the Department nominates one representative to CPSI's Board of Directors, and participates as a voting member of the corporation.

Grant to support the Mental Health Commission of Canada (Voted)

General Information

Start date

April 1, 2008

End date

March 31, 2017

Budget 2015 announced the renewal of the Mental Health Commission of Canada's (MHCC) mandate for another 10 years beginning in 2017. A new funding agreement is in development.

Fiscal year for terms and conditions

2008-09 to 2016-17

Strategic outcome(s)

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

• Program 1.1: Canadian Health System Policy
  • Sub-Program 1.1.1: Health System Priorities

Description

As part of Budget 2007, the Government of Canada announced funding for the establishment of a MHCC, an independent, arm's length organization, with a mandate to act as a catalyst for improving the mental health system and changing the attitudes and behaviors of Canadians around mental health issues.

Results achieved

The MHCC has made significant progress since 2007, and has become a valuable source of expertise, advice, programs and policies in the mental health field. In 2014-15, priority areas and achievements of the MHCC included:

Health system improvement:

• Continued work with all levels of government, health professionals and other stakeholders to encourage uptake of the recommendations and priorities of "Changing Directions, Changing Lives", Canada's first national mental health strategy (released by the MHCC in May 2012).

Mental health education and mental illness anti-stigma:

• Released a youth friendly version of the national mental health strategy "Changing Directions, Changing Lives".
• Continued to advance HEADSTRONG, the MHCC's youth anti-stigma campaign, including hosting a national summit in November 2014, involving more than 130 high school students from across Canada, as well as supporting those students in organizing regional summits to bring mental health awareness and the anti-stigma message to their local schools and communities across Canada.
• Supported the development of Mindset: Reporting on Mental Health, by the Canadian Journalism Forum on Violence and Trauma. Launched in April 2014, Mindset is a media resource guide for journalists reporting on mental illness and aims to reduce stigmatizing collateral damage that can be inflicted by journalists without detailed knowledge in the mental health area.

Information Sharing:

• Launched phase one of "Informing the Future: Mental Health Indicators for Canada"; the first-ever national-level set of indicators that identifies and reports on the mental health of Canadians.
• Collaborated with the Graham Boeckh Foundation and the Canadian Institutes for Health Research to conduct a "Best Brains Exchange" on e-Mental Health in Montréal, Québec in November 2014. The Best Brains Exchange provided the opportunity for participants to discuss the current state of knowledge on the development and use of e-Mental health policies, services and technologies.
• Hosted, as part of the Knowledge Exchange Centre, the third Supporting the Promotion of Activated Research and Knowledge (SPARK) Training Workshop in June 2014. SPARK workshops are designed to help participants learn techniques for moving evidence-informed research and knowledge from the fields of mental health, substance use and addictions more quickly into practice.
• Released reports including "State of Police Learning Concerning Interactions with Persons with a Mental Illness and e-Mental Health in Canada: Transforming the Mental Health System Using Technology".

Suicide prevention:

• Launched #308conversations, a national grassroots suicide prevention campaign that invites each of Canada's 308 Members of Parliament to lead a conversation with their constituents about suicide prevention.
• Hosted monthly webinars on a variety of issues related to suicide prevention. The webinars were often created in partnership with members of the Collaborative on Suicide Prevention among other stakeholders and featured best and promising practices across Canada.
• Continued to support the Government of Canada's Federal Framework for Suicide Prevention by providing guidance and advice on implementation.

Workplace mental health:

• Implemented the National Standard for Psychological Health and Safety in the Workplace ("the Standard"). Since its launch in 2013, the Standard has been downloaded over 21,000 times and is being implemented in major organizations across Canada including Bell Canada and several federal departments.
• Expanded awareness and uptake of the Standard by Canadian public and private organizations.
• In partnership with Canadian Standards Association, MHCC developed a comprehensive, user-friendly Implementation Guide to support organizations adopting the Standard. Developed and delivered workplace mental health programs - The Working Mind (TWM) and Road to Mental Readiness (R2MR) - to first responders and employees across the country. More than 20 police services and about 15 public and private sector employers are partnering with the MHCC to deliver these programs.
• Continued to provide Mental Health First Aid training to staff in multiple sectors and across multiple private sector industries. As of March 31, 2015, approximately 120,000 people had been trained in Canada.

Mental health and homelessness:

• Since completing the "At Home/Chez Soi" research project, which was successful in identifying effective health and social interventions for homeless persons with mental illness, the MHCC is now focused on the delivery of Housing First Training and Technical Assistance. In 2014-15, the MHCC:
  • Implemented "Housing First" Consultation and Technical Assistance in 18 communities involving approximately 2,000 participants.
  • Conducted broad dissemination of the "Canadian Housing First Toolkit" to assist communities in the development and implementation of Housing First programs and initiatives.
• This work contributes to the Government of Canada's "Homelessness Partnering Strategy" which was renewed in Budget 2013 based on the findings from the "At Home/Chez Soi" research project and the Housing First model.

Further information on these initiatives can be found on the MHCC's website at www.mentalhealthcommission.ca

Audits completed or planned

As specified in the funding agreement, the MHCC must submit independently audited financial statements to Health Canada each fiscal year. Also required is an annual report detailing activities conducted and outcomes achieved. These reports are due to Health Canada no later than 120 days after the end of the fiscal year (i.e., July 29, 2016).

Evaluations completed or planned

An independent evaluation of the MHCC was completed in fiscal year 2011-12.

A synthesis evaluation identifying common findings and recommendations from previous reviews of several Health Canada funding agreements, including the MHCC's 2011-12 evaluation, was completed in fiscal year 2013-14. This synthesis evaluation is being used to better align departmental funding practices, processes and strategies across the funding recipients examined.

The MHCC is currently being evaluated as part of a broader evaluation on Health Canada and Public Health Agency of Canada mental health and mental illness activities. The final report is expected to be released in March 2016.

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.

Health Care Policy Contribution Program (Voted)

General Information

Start date

September 24, 2002

End date

Ongoing

Fiscal year for terms and conditions

2010-11

Strategic outcome(s)

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

• Program 1.1: Canadian Health System Policy
  • Sub-Program 1.1.1: Health System Priorities

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 (HHRS); and, the Internationally Educated Health Professionals Initiative (IEHPI).

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 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; provision of quality health care; and, effective planning and forecasting.

By working with the provinces, territories and stakeholder organizations, the 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 complements the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications announced by the Forum of Labour Market Ministers in 2009.

Results achieved

The HCSIF directed funding toward knowledge development, translation and exchange activities to support innovation and implementation of best practices in key policy areas such as unnecessary tests, treatments and procedures; care for aging populations; and, palliative and end-of-life care.

The CMIRPS has achieved significant results with a positive impact on the broader healthcare system, such as: high rate of adoption in hospitals of the CMIRPS medication safety self-assessment program and tool; integration of CMIRPS safety bulletins into health care practice; improved packaging and labeling of medications to reduce confusion in products; and improved medical safety organization practices, as required by Accreditation Canada. The HHRS and the IEHP Initiative have supported projects which have contributed to: increasing the number of qualified providers entering the health workforce; increasing productivity of health care providers; and improving access to health care services for all Canadians, particularly in underserved areas. Specific examples include:

• In 2014-15, the HHRS contributed to the Future of Medical Education Post-Graduate Implementation project, which focused on collaboratively improving the medial education system to better meet the healthcare needs of the Canadian population.
• In addition, the Family Medicine Residencies Initiative (FMRI), announced in 2011, provided $39.5 million to support the provinces and territories in providing family medicine residency positions and advanced training in rural and remote areas across the country. For example, the project with New Brunswick has supported the province in training six residents as of 2014-15.
• In 2014-15, the Alberta Internationally Educated Physical Therapists Bridging Program's first cohort of 16 students all completed their academic training. Fourteen of these students passed their clinic placement and five are now working in Alberta as provisionally registered physiotherapists. Progress has also been made toward pan-Canadian approaches to alternative careers. For example, the Canadian Society for Medical Laboratory Sciences has created an area on their website specifically for internationally educated medical laboratory technicians to provide them, early in the assessment process, with eleven potential alternate career paths that make better use of their skill sets in an effort to decrease levels of unemployment and underemployment among applicants.

Audits completed or planned

Under the Health Care Policy Contribution Program in 2014-15, an audit of one contribution agreement with Manitoba Health was completed.

Evaluations completed or planned

The evaluation report and Management Response and Action Plan for the Program were approved in October 2013. This evaluation covered fiscal years 2008-09 to 2012-13. The next evaluation is scheduled for fiscal year 2018-19.

Engagement of applicants and recipients

Funding recipients continue to be engaged through site visits, and regular communication regarding the progress of funded projects.

Performance Information (dollars)

Official Languages Health Contribution Program (Voted)

General Information

Start date

June 18, 2003

End date

Ongoing

Fiscal year for terms and conditions

Terms and conditions for this contribution program became effective April 1, 2013

Strategic outcome(s)

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

Program 1.3: Official Language Minority Community Development

Description

The Official Languages Health Contribution Program (OLHCP) was renewed by Treasury Board on November 28, 2013 with total funding of $174.3 million over five years (2013-14 to 2017-18 fiscal years) under the Government of Canada's Roadmap for Canada's Official Languages 2013-2018: Education, Immigration, Communities initiative.

The OLHCP Program has the following objectives:

• To increase access to bilingual health professionals and intake staff in English and French linguistic minority communities in Canada.
• To increase the active offer of health services for English and French linguistic minority communities within health institutions and communities.

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

• Integrating health professionals within official language minority communities through French-language academic health programs in 11 colleges and universities outside of Québec, and language training for health professionals and health system intake personnel in all administrative regions of Québec.
• Strengthening and improving local health networking capacity through the 38 existing community-based health networks across Canada through the development of health strategies by health authorities for English and French linguistic minority communities.
• Through Health Services Access and Retention Projects, encouraging bilingual health professionals to practice in English and French linguistic minority communities. This includes the engagement of front-line health service providers in providing services in the second official language, supporting English and French linguistic minority communities' specific health human resource retention strategies and addressing specific health needs.
• To improve access to health services in English and French linguistic minority communities, health professionals need to be proficient in the language of the patient. This initiative continues to fund 98 French-language academic health programs in 11 colleges and universities outside of Québec to generate additional health professionals in French minority language communities. The funding supports student and teacher recruitment, the development of French-language training tools, purchasing teaching equipment, and, the availability of bursaries and internships for professors and students. For the province of Québec and its administrative regions, funding is provided to McGill University to coordinate English and French language training courses geared to health professionals and intake personnel.

Results achieved

Contribution Agreements: Under the OLHCP, 13 contribution agreements were signed with targeted recipients for the 2014-15 to 2017-18 fiscal year periods to train additional French speaking health professionals outside Québec. This also includes the provision of language training and retention opportunities for health professionals in Québec in order to better serve the English speaking minority communities.

An additional seven contribution agreements were signed with new recipients for the 2014-15 to 2016-17 fiscal year to support innovative projects that aim to increase access to a range of health care services for Francophone people living outside of Québec and Anglophone people living in Québec.

Health Professionals: A total of 150 health professionals from Québec regions completed language training funded by Health Canada in 2014. In addition, 870 additional French speaking students graduated in health disciplines in 98 postsecondary programs funded by Health Canada in 11 colleges and universities located outside of Québec.

These graduates have increased the pool of health human resources available to meet the needs of official language minority communities in Canada. A 2015 evaluation of incentive bursaries provided to Québec English speaking health system graduates over 2011-14 to encourage them to practice in regions outside of Montréal found that 88% were currently still practicing in those regions well after having completed the one-year period for which they had agreed to practice in those regions.

Health Networks: 38 community-based health networking partnerships were maintained in all provinces and territories, and in 14 health administrative regions of Québec. These networks collaborate with various health sector stakeholders to improve access to health services for English and French speaking minorities.

For instance, specific results in Québec include the:

• Release of the Baseline Data Reports for 2013-14 presenting socio-demographic profiles of Québec's English-speaking population within distinct health and social services regions based on the 2011 National Household Survey and the 2011 Census of Canada.
• Publication of a booklet entitled "Partnering for the well-being of Minority English-Language Youth, Schools & Communities" which "identifies some of the unique challenges, strengths and aspirations of English-speaking youth in Québec and provides a school and community-based framework for action intended to have a positive impact on their well-being and educational success".
• Initiation of two partnership agreements between the Community Health and Social Services Network and the Ministère de la Santé et des Services sociaux to introduce accreditation procedures for English language health and social services and to develop recommendations for the use of English language interpreters in Québec's health and social services facilities.

Results outside of Québec include:

• A collaborative initiative with the Société Santé en français and Accreditation Canada to develop or enrich standards for culturally and linguistically adapted care and services for hospitals, long-term care centres and other health care organizations. This initiative is available to all official language minority communities, including Anglophones residing in Québec, and Francophone people living outside Québec.
• Société Santé en français launched new mental health first aid training sessions fully adapted to the French speaking minority communities. The training sessions are provided by the Mental Health Commission of Canada and the first course, geared to trainers took place in March 2015.

Audits completed or planned

One audit was conducted in 2014-15 and two are planned for 2015-16.

Evaluations completed or planned

• Summative Evaluation of the Contribution Program to Improve Access to Health Services for Official Language Minority Communities (2003-08): November 12, 2008.
• Evaluation of the Official Languages Health Contribution Program 2008-12: March 31, 2013.
• Evaluation of the Official Languages Health Contribution Program 2013-17: March 31, 2017.

Engagement of applicants and recipients

Representatives of the Official Language Community Development Bureau (OLCDB) and departmental senior management attended annual general meetings and meetings of Boards of Directors of official language minority community organizations, and were in frequent contact with beneficiaries of the Program.

Health Canada's regional official languages coordinators also attended meetings with official language minority community organizations in various parts of the country, and shared information about Health Canada programs and initiatives.

Staff from OLCDB also undertook the following site visits and consultations with recipient organizations in order to ensure the achievement of expected results:

• Université de Moncton, Collège communautaire du Nouveau-Brunswick, Government of New Brunswick, and Société Santé et mieux-être en français du Nouveau-Brunswick.
• Three member networks of the Community Health and Social Services Network (Agape, 4Korners, Reisa), and AMI-Québec.
• Collège Boréal, Laurentian University, and Réseau du mieux-être francophone du Nord de l'Ontario.

Performance Information (dollars)

Territorial Health Investment Fund (Voted)

General Information

Start date

April 1, 2014

End date

March 31, 2017

Fiscal year for terms and conditions

2014 to 2017

Strategic outcome(s)

A Health System Responsive to the Needs of Canadians.

Link to department's Program Alignment Architecture

• Program 1.1: Canadian Health System
  • Sub-Program 1.1.1: Health System Priorities

Description

The Territorial Health Investment Fund (THIF) is a three-year investment of $70 million to support territorial health systems, starting in 2014.

The THIF targets priority health areas (children's oral health, mental health and chronic disease) and is intended to strengthen territorial capacity to manage and deliver health services in those targeted areas, which in turn can lead to a reduced reliance on medical travel. Its design features three streams: Territorial, Pan-Territorial and Medical travel.

The Territorial stream ($13 million per fiscal year, $4.33 million per territory) funds projects to strengthen health services in-territory in the targeted areas that have persistent challenges and poor health outcomes. The Pan-Territorial stream provides $2 million per fiscal year for collaboratively developed projects that offer innovative solutions to health systems problems. The territories may also leverage Pan-Territorial Stream investments to reform medical travel. The Medical Travel Stream ($12 million in 2014-15, $8 million in 2015-16, $5 million in 2016-17) is a declining subsidy to offset territories eligible medical transportation costs in the short term, incenting immediate measures to reform medical travel programs and protocols and increase service capacity in-territory.

Results achieved

In 2014-15, Health Canada entered into three new multi-year funding agreements with territorial governments and flowed over $26 million under the three streams of THIF.

Territorial governments are currently undertaking territorial and pan-territorial projects under in the targeted areas. Funding under the Medical Travel stream helped territorial governments offset medical transportation costs associated with accessing health services out-of territory.

Audits completed or planned

No audits are underway nor planned.

Evaluations completed or planned

Health Canada will undertake an evaluation in 2017-18.

Engagement of applicants and recipients

The implementation of the THIF was done in partnership with territorial recipients. Health Canada worked with territorial governments to set out THIF eligibility criteria, review and approve territorial proposals, develop territorial specific funding agreements and provide implementation support to ensure recipient received funding and could begin projects in the first year.

Performance Information (dollars)

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