Canada-British Columbia Agreement 2004 - Annex H: Immigration Health

Annex H:
Immigration Health


Preamble

Recognizing the multiple aspects of increasing diversity resulting from immigration and appreciating the many differences between health care systems in Canada and the rest of the world, Canada and British Columbia have agreed to joint activities designed to better understand some of the health challenges faced by new arrivals. Through this improved understanding, the management of some of the health issues related to immigration will be facilitated.

This process will better serve new arrivals with special needs and allow for more effective and efficient immigration health practices at the provincial and national level.

1.0 Purpose and Objectives

1.1 The purpose of this Annex is:

  1. to establish the mechanisms for continued communication and co-operation on joint policy and program areas related to health and medical services pertaining to immigration; and
  2. to establish the terms and conditions under which Canada and British Columbia will develop and implement general policy principles and proceed to initiate pilot projects related to the subject matter outlined in section 1.1 (a) that are of a mutual interest to both Parties.

1.2 Objectives include:

  1. establishing a Canada-British Columbia forum to discuss and make recommendations to the Program Management Committee (PMC) as outlined in Annex A, and act upon immigration related health matters;
  2. ensuring mechanisms exist for effective information exchange and are in accordance with applicable federal and provincial legislation;
  3. establishing clear delineation of fiscal responsibilities regarding health care costs;
  4. ensuring the safeguarding of public health; and
  5. establishing a forum to develop and oversee pilot projects.

2.0 Consultations

2.1 A joint Immigration Health Sub-Committee of the PMC will be established, comprising CIC and provincial officials. The sub-committee will meet to review issues of common interest, to request more detailed studies or analysis and to identify areas where policy decisions and/or operational actions are required.

2.2 The sub-committee will review existing health and medical services, report on their effectiveness and make recommendations for change.

2.3 The sub-committee will oversee and report to PMC on immigration health related pilot projects.

3.0 General Immigration Health Issues

The sub-committee will be responsible for matters including:

3.1 Analysis and review of the medical care services required by refugees and refugee claimants to allow for positive feedback and improvement to Canada’s medical screening program that would benefit the province.

3.2 Development of joint strategies and sharing of information in order to improve the integration of refugees and refugee claimants into local health care systems.

3.3 Development of contingency plans for the management of health concerns in large-scale arrivals of undocumented migrants.

3.4 Analysis and interpretation of the long-term health impact of migrants arriving with health characteristics different from Canadian norms.

3.5 Future planning for anticipated health service needs that will be driven by immigration.

4.0 Consideration of Health Care Costs

4.1 The sub-committee will review the immigration-related costs of medical and health services, including but not limited to:

  1. the nature and function of the Interim Federal Health (IFH) program, with consideration given to a review of fees allowed, adequacy of the scope of services covered and reimbursement of provincial costs incurred by providing services to refugee claimants;
  2. the impact on services and provincial costs incurred for immigrants deemed to be medically inadmissible who are allowed to proceed to Canada under new legislation (excessive demand);
  3. the responsibility for health care costs of people admitted with serious health problems during the three (3) month waiting period for British Columbia’s Medical Services Plan coverage. (Applicable family class sponsored individuals without private insurance and who would have been medically inadmissible before IRPA); and
  4. options for mitigating healthcare costs attributed to visitors.

5.0 Public Health Safeguards and Medical Surveillance and Information Exchange

5.1 The sub-committee will address public health issues related to immigration such as:

  1. liaison with provincial public health authorities;
  2. development of programs and processes that integrate immigration medical activities with provincial public health programs (e.g. tuberculosis, HIV and hepatitis testing);
  3. analysis and review of the epidemiological impact of immigration on provincial disease patterns; and
  4. development of improved strategies for public health surveillance that would support the:
    1. provision of effective notification to provincial public health authorities of landings of people who have diseases identified as being of particular concern;
    2. provision of information to refugee claimants who test positive for tuberculosis, syphilis and HIV about their condition without delay;
    3. effective notification of provincial public health authorities and consistent tracking of refugee claimants who test positive for tuberculosis, syphilis and HIV;
    4. provision of appropriate services for those individuals for whom surveillance is required;
    5. compliance with medical surveillance requirements, including consideration of enforcement activities; and
    6. monitoring and reporting of medical surveillance compliance.

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