ARCHIVED – Operational Bulletin 504 (Expired) – March 25, 2013

This section contains policy, procedures and guidance used by Immigration, Refugees and Citizenship Canada staff. It is posted on the Department’s website as a courtesy to stakeholders.

Excessive Demand Cost Threshold

This Operational Bulletin has expired.

Summary

The purpose of this Operational Bulletin (OB) is to advise that a new Excessive Demand Cost Threshold took effect February 28, 2013 for use by Health Branch (HB) officers undertaking the Immigration Medical Assessment, ensuring that it is fully compliant with the legislation. This OB also establishes a process for regular updating of the Excessive Demand Cost Threshold.

Issue

Updating the Excessive Demand Cost Threshold.

Background

Under subsection 38(1) of the Immigration and Refugee Protection Act: “A foreign national is inadmissible on health grounds if their health condition…might reasonably be expected to cause excessive demand on health or social services.” Part 1, Division 1 of the Immigration and Refugee Protection Regulations defines “excessive demand” as:

1. (1)(a) a demand on health services or social services for which the anticipated costs would likely exceed average Canadian per capita health services and social services costs over a period of five consecutive years immediately following the most recent medical examination required under paragraph 16(2)(b) of the Act, unless there is evidence that significant costs are likely to be incurred beyond that period, in which case the period is no more than 10 consecutive years; or

(b) a demand on health services or social services that would add to existing waiting lists and would increase the rate of mortality and morbidity in Canada as a result of an inability to provide timely services to Canadian citizens or permanent residents.

The threshold figure used was the Canadian Institute for Health Information (CIHI) aggregate that represented average Canadian per capita health expenditure.

In January 2003, HB implemented a modified approach. Having identified that the CIHI figure did not completely cover expenditures for certain social services, a supplementary amount was identified to account for the missing per capita expenditures. Instructions were issued that this new supplementary amount should be added to the aggregate CIHI figure to arrive at the Excessive Demand Cost Threshold.

This updated threshold of $6,285 is usually multiplied by five (unless there is evidence that significant costs are likely to be incurred beyond that period, in which case the period is no more than 10 consecutive years). This results in the legislated threshold of $31,425 taking effect as of February 28, 2013.

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