Public Health Agency of Canada 2012–13 Departmental Performance Report

Minister’s Message

I am pleased to present the Public Health Agency of Canada’s Departmental Performance Report for fiscal year 2012–13. The report highlights the Agency’s ongoing commitment to protect Canadians and empower them to improve their health.

In an increasingly interconnected world where public health issues know no borders, collaboration is essential to promoting the health, well-being and quality of life of Canadians. As a result, the Agency works regularly with its provincial and territorial partners on a wide range of nationally important public health issues, including food-borne illness investigations, immunization, healthy living and mental health. Internationally, the Agency works with key partners such as the World Health Organization to advance important global issues, including disease threats and health security.

To help Canadians prevent chronic diseases, the Agency supported collaborations among the public, private and voluntary sectors. The Agency partnered with AIR MILES for Social Change and the YMCA to encourage physical activity, and with the Boys and Girls Clubs of Canada and Sun Life Financial to expand the Get BUSY program. All sectors of society have a role to play in improving health, and the Agency’s approach is leveraging expertise and resources to increase the impact and reach of programs and to test results for Canadians.

While encouraging Canadians to be active and to live healthy lifestyles, it is important that they do so safely. The Agency’s Active and Safe initiative focused on preventing injuries among Canadian children and youth. In addition, a four-year initiative was launched with the Heart and Stroke Foundation of Canada to place automated external defibrillators in community hockey arenas across Canada.

Progress continued in preventing and controlling outbreaks of infectious diseases. Through its public health notices, surveillance data and various publications, the Agency informed Canadians and provided public health experts with tools to prepare and respond. The Agency extended its partnership with the Canadian Institutes of Health Research on the Influenza Research Network, to bring together leading influenza researchers from across Canada to identify new research and accelerate vaccine development. Agency laboratories continued to undertake world-class science and provide national leadership and co-ordination.

The results presented in this Departmental Performance Report demonstrate that the Agency, in collaboration with its partners, continues to be a world leader in public health and is helping to build a healthier Canada.


The Honourable Rona Ambrose, P.C., M.P.
Minister of Health

Section I: Organizational Overview

Raison d’être

Public health involves the organized efforts of society to keep people healthy and to prevent injury, illness and premature death. It includes programs, services and policies that protect and promote the health of all Canadians. In Canada, public health is a responsibility that is shared by the three levels of government in collaboration with the private sector, non-governmental organizations, health professionals and the public.

In September 2004, the Public Health Agency of Canada (the Agency) was created within the federal Health Portfolio to deliver on the Government of Canada’s (GC) commitment to increase its focus on public health in order to help protect and improve the health and safety of all Canadians and to contribute to strengthening the health care system.

Responsibilities

The Agency has the responsibility to:

  • Contribute to the prevention of disease and injury, and to the promotion of health;
  • Enhance the quality and quantity of surveillance data and expand the knowledge of disease and injury in Canada;
  • Provide federal leadership and accountability in managing national public health events;
  • Strengthen intergovernmental collaboration on public health and facilitate national approaches to public health policy and planning; and
  • Serve as a central point for sharing Canada’s public health expertise with international partners, and to translate international knowledge and approaches to inform and support Canada’s public health priorities and programs—for example, by participating in international working groups to develop new public health tools to protect, mitigate and respond to emerging public health threats.

Strategic Outcome and Program Alignment Architecture (PAA)

The Agency restructured its Program Alignment Architecture (PAA) during the 2013–14 Management, Resources and Results Structure (MRRS) Amendment Process. Changes to the Strategic Outcome and PAA were approved by Treasury Board on February 22, 2013. For the purposes of this Departmental Performance Report, the Agency is reporting on its performance based on the 2013–14 MRRS.

Strategic Outcome Program Sub-Program Sub-Sub-Program



Protecting Canadians and empowering them to improve their health
1.1 Public Health Infrastructure 1.1.1 Public Health Capacity Building
1.1.2 Public Health Information and Networks
1.1.3 Public Health Laboratory Systems
1.2 Health Promotion and Disease Prevention 1.2.1 Infectious Disease Prevention and Control 1.2.1.1 Immunization
1.2.1.2 Infectious and Communicable Diseases
1.2.1.3 Food-borne, Environmental and Zoonotic Infectious Diseases
1.2.2 Conditions for Healthy Living 1.2.2.1 Healthy Child Development
1.2.2.2 Healthy Communities
1.2.3 Chronic (non-communicable) Disease and Injury Prevention
1.3 Health Security 1.3.1 Emergency Preparedness and Response
1.3.2 Border Health Security
1.3.3 Biosecurity
2.1 Internal Services 2.1.1 Governance and Management Support 2.1.1.1 Management and Oversight
2.1.1.2 Communications
2.1.1.3 Legal
2.1.2 Resource Management Services 2.1.2.1 Human Resource Management
2.1.2.2 Financial Management
2.1.2.3 Information Management
2.1.2.4 Information Technology
2.1.2.5 Travel and Other Administrative Services
2.1.3 Asset Management Services 2.1.3.1 Real Property
2.1.3.2 Material
2.1.3.3 Acquisitions

Strategic Outcome and PAA Crosswalk

Below is a table depicting the 2012–13 PAA and the 2013–14 PAA.

Financial Crosswalk to the 2012–13 Main Estimates ($M)
From 2012–13 PAA (columns) 1.1
Science and Technology for Public Health
1.2 Surveillance and Population
Health Assessment
1.3
Public Health Preparedness and Capacity
1.4
Health Promotion
1.5
Disease and Injury Prevention and Mitigation
1.6 Regulatory Enforcement and Emergency Response 2.1 Internal Services Total
Note: All figures are rounded.
To 2013–14 PAA (rows)
1.1 Public Health Infrastructure 65.4 17.8 38.5 0.2 2.6 0.8   125.3
1.2 Health Promotion and Disease Prevention   43.2 10.9 181.2 97.9     333.2
1.3 Health Security   3.6 35.7     23.3   62.6
2.1 Internal Services             95.4 95.4
Total 65.4 64.6 85.1 181.4 100.5 24.1 95.4 616.5

Organizational Priorities

Priority Type Program(s)
1. Managing Public Health Risks to Canadians Ongoing 1.1, 1.2, 1.3

Summary of Progress

Through the management of the Global Health Security Action Group, an international partnership of experts tasked with developing concrete actions to improve global health security, the Agency maintained the capacity to foster cooperative relationships for sharing information on emergencies/events of national and international significance.

Canada’s preparedness for epidemics and the capacity to detect and respond to food-borne illness and outbreaks was improved. Following recommendations in the Evaluation of Food-borne Enteric Illness Prevention, Detection and Response Activities, the Agency collaborated with its federal, provincial, and territorial (F/P/T) stakeholders to enhance linkages during national outbreaks, including ongoing invitations to the Chief Medical Officers of Health (CMOH) to participate in the Outbreak Investigation Coordinating Committees and engagement of the Inter-departmental Committee on Food Safety.

Provincial public health laboratories were provided with protocols and methods to reliably test for emerging pathogens (e.g., influenza viruses). This information enabled provincial public health laboratories to augment testing capacities and increase Canada’s preparedness to identify and respond to these emerging pathogens.

Work continued with the Committee of Chief Veterinarians [composed of Chief Veterinary Officers from the provinces and territories (P/T)]) through participation on the Antimicrobial Resistance (AMR) sub-committee to establish mechanisms to collect information on antimicrobial use, and to assist with the development of enhanced surveillance capacity at the P/T level.

Legislation and regulations related to the use and manipulation of human and animal pathogens and toxins were administered and enforced.  Regulations are being developed to support the implementation of the Human Pathogens and Toxins Act (HPTA). As well, processes and mechanisms were streamlined to facilitate regulatory compliance for biosecurity in Canada.

The Agency and its federal/provincial/territorial (F/P/T) partners undertook a review of the National Immunization Strategy (NIS) to propose areas of strengthened F/P/T collaboration for a more cohesive and consistent approach to immunization across the country.

Priority Type Program(s)
2. Promoting Health and Reducing Health Inequalities in Canada Ongoing 1.1, 1.2

Summary of Progress

Through programs such as the Aboriginal Head Start in Urban and Northern Communities (AHSUNC), the Canada Prenatal Nutrition Program (CPNP), and the Community Action Program for Children (CAPC), the Agency continued to support community-based groups and coalitions to deliver prevention and early intervention programs that promote the health and social development of vulnerable populations, which can include certain pregnant women, infants, children, and their familiesFootnote 1. To address the public health priority of overweight and obesity, particularly in children, the Agency launched a new, multi-sectoral approach to healthy living and chronic disease prevention to support provinces and territories, the private sector and not-for-profit sector to work together, maximizing resources and promoting innovation. In addition, the Agency supported over 50 Innovation Strategy-funded projects in more than 300 communities to develop, test, and assess interventions designed to address evidence gaps and community needs in mental health promotion and in achieving healthy weights.

Emergency preparedness was enhanced among seniors and other at-risk populations by working with partners to complete Enhancing Resilience Among High Risk Populations to Maximize Disaster Preparedness, Response and Recovery, which developed tools for community action and intervention. In addition, the Agency welcomed Saskatchewan into the Pan-Canadian Age-Friendly Communities Initiative, bringing the number of jurisdictions involved to nine.

Priority Type Program(s)
3. Enhanced Public Health Capacity Ongoing 1.1, 1.2, 1.3

Summary of Progress

Public health officers and field epidemiologists were placed in jurisdictions across Canada in order to respond to both routine and emerging public health needs. As well, the deployment of field placement staff was supported to fill public health capacity gaps in areas such as epidemiology in all three territories to support their governments and regional health authorities on a time-limited basis. Training was provided via a number of channels including the Skills Online program for public health practitioners, and Principles of Laboratory Biosafety for researchers working with human pathogens and toxins.

Financial support was provided to six National Collaborating Centres for Public Health which produced a wide range of products and best practices in knowledge transfer, including an online registry of methods and tools as well as training modules for evidence-based decision making. The National Collaborating Centre on Environmental Health created a continuing education directory consisting of available courses, workshops, seminars, and conferences of value to public health professionals across North America. This directory included accredited courses recognized by the Canadian Institute of Public Health Inspectors, the Royal College of Physicians and Surgeons of Canada, and the College of Family Physicians of Canada.

The PHAC Surveillance Strategic Plan 2013-2016 was launched, which serves as a roadmap to renew the planning, alignment, and delivery of the Agency's public health surveillance activities. This will better position the Agency and its partners to continue to provide credible and timely public health surveillance intelligence to inform public health policy, decision making, and action.

In collaboration with provinces and territories, an Operational Framework for Mutual Aid Response was developed to coordinate surge requests for health care professionals to deploy during national and international emergencies.

Priority Type Program(s)
4. Achieving Excellence in Governance and Management Previously committed 2.1

Summary of Progress

In June 2012, the Deputy Heads of HC and the Agency signed a Shared Services Partnership (SSP) Framework Agreement in which each organization retains responsibility for a different set of internal services and corporate functions. As a result:

  • Agency and HC corporate policies, procedures and governance processes for the internal services functions were aligned and approaches standardized to promote service excellence, facilitate and accelerate decisions, and foster efficiencies and innovation.
  • A significant amount of planning was done to support the implementation of the Common Human Resources Business Process (CHRBP). This included the analysis of all the various human resources processes and the identification and prioritization of the business enhancements opportunities to be implemented in order to comply with CHRBP by March 2014.
  • Security governance structures, operating procedures, policies and frameworks were updated; a Departmental Security Plan was implemented; and a Business Impact Assessment tool with organization-wide coordinator training was developed to enhance business continuity planning. (SSP-HC-CSB)
  • Initiatives fostering engagement and well-being were implemented which included a new process for managing harassment complaints, and training and awareness sessions for managers on the prevention and resolution of harassment.
  • A cross-cutting branch committee was created to help senior management share results of the 2011 Public Service Employee Survey and to engage employees in the development of a corporate action plan, which was approved in the 2012–13.

An internal realignment of functions was undertaken by the Agency to provide more strategic and tactical advice to support the Minister in advancing key federal public health priorities.

Treasury Board approval was received for the Agency’s Investment Plan (IP) and a new, streamlined MRRS was implemented as the basis for its 2013–14 Report on Plans and Priorities and its operational planning process.

In support of workplace wellbeing, a new Policy on Prevention of Violence in the Work Place was approved. As well, two mental health online tools were launched to equip managers and supervisors with the knowledge and skills to identify mental health issues/behaviours in the workplace.

Risk Analysis

Risk Risk Response Link to PAA Link to Priority
Infectious Disease.
There is a risk that emerging and re-emerging infectious diseases will continue to create the potential for epidemics and pandemics that will result in considerable health, social and economic impacts.
The Agency helped protect Canadians from risk factors associated with emerging/re-emerging infectious diseases by:
  • leading, and working collaboratively with provinces and territories to strengthen vaccine supply and address supply shortages;
  • strengthening infectious disease surveillance and applied public health research capacity;
  • working with partners to update the Canadian Pandemic Influenza Plan for the Health Sector (CPIP) based on H1N1 lessons learned and “all-hazards” risk management principles; and
  • conducting laboratory-based research, developing new laboratory tests, and investing in behavioural research to identify means by which to increase vaccine uptake among target populations.
1.2 1, 2, 3
Emergency Preparedness and Response.
There is a risk that the Agency may not be able to respond effectively to new or unanticipated emergencies of high impact or high complexity.
The Agency strengthened its ability to respond to public health emergencies by:
  • using an all-hazards approach to complete the Health Portfolio Strategic Emergency Management Plan which clarified governance, decision-making mechanisms, and coordination within the Health Portfolio;
  • strengthening co-ordination of multi-jurisdictional public health events through the implementation of the Food-borne Illness Outbreak Response Protocol (FIORP), the CPIP, and International Health Regulations (IHR); and
  • strengthening inter-jurisdictional surge capacity and contributing to the resiliency of the public health system through the modernization of the National Emergency Stockpile System and development of the Operational Framework for Mutual Aid Response.
1.3 1, 3
Food-borne Illness.
With current global trends in food production, preparation and distribution there is a continuing risk that food-borne illness will adversely impact the Canadian population with the potential for significant health, social and economic consequences.
To enhance the GC’s ability to prevent, detect and respond to multi-jurisdictional outbreaks of food-borne illness, the Agency undertook a range of actions to enable transparent and timely information sharing and decision making, including:
  • strengthening collaboration with partners during national outbreaks, including ongoing invitations to the F/P/T Chief Medical Officers of Health to participate in Outbreak Investigation Coordinating Committees; and
  • developing a Web-based outbreak communications database, “Outbreak Central”, which serves as a secure platform for information sharing among F/P/T food safety and public health partners during outbreak investigations.
1.2 1, 3
Chronic Disease and Health Promotion.
There is a risk that overweight and obesity rates among children, youth and adults in Canada will continue to rise, therefore increasing the rate of chronic disease such as cancer, diabetes and cardiovascular disease.
In support of Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights, the Agency advanced a number of initiatives, including:
  • implementing new partnership arrangements and a new funding model for its grants and contributions investments in this area, with greater accountability, and improved reach and sustainability. Effectively addressing childhood obesity requires a sustained, multi-sectoral response involving the public, private, health professional, and non-governmental sectors. The new funding model requires that non-governmental organizations obtain matched funding from the private sector or charitable sectors to leverage additional reach and resources, thereby increasing effectiveness and “pay for performance” agreements ensure that payments are tied to tangible outputs; and
  • enhancing the Agency’s surveillance capacity by establishing indicators for childhood, overweight and obesity trends and determinants impacting healthy weights.
1.2 1, 2, 3

Risk Narrative

The Agency operates within a dynamic and complex environment where domestic and international public health challenges continually evolve, highlighting the importance of ongoing planning and preparedness for public health emergencies. The multi-jurisdictional nature of public health also means that the Agency must work closely with domestic and international partners to respond and collaboratively build on lessons learned.

As set out in the table above, the Agency has identified four of its ten key risks, which were reported in its 2012–13 Report on Plans and Priorities and 2012–13 Corporate Risk Profile (CRP). These four risks were selected because they were ranked as having the highest likelihood of significant impacts on program delivery and the potential for consequences for Canadians. In addition, failure of any risk response strategy could impact the Agency’s ability to protect and improve the health and safety of all Canadians.

The risk responses for these four risk areas, as identified in the 2012–13 CRP, were not modified or adjusted during the reporting period. Adjustments will be made to the Agency’s CRP in 2013–14, including its risk response strategies, as part of an annual renewal process. In 2013, the Agency’s Risk Management Oversight Committee completed a review of the risks identified in the 2012–13 CRP. The performance results reported during this review demonstrated that the management of these four risks were appropriate. Factored into this assessment were: the overall program performance against the performance indicators in which risk response strategies are embedded; Risk Lead assessment against key questions; and the integration of risk treatment strategies into the Agency’s operational planning and other accountability processes. Collectively, these approaches enabled the Agency to assess the appropriateness and effectiveness of its management of the risks. Emphasis continued to be placed on enhanced disease prevention through surveillance and detection as key risk treatment strategies that were integral to success, primarily because of the role these activities play in enabling upstream interventions. The successful management of recent multi-player public health events, such as food-borne illness outbreaks and infectious disease prevention, illustrates the effectiveness of these upstream strategies.

Summary of Performance

Financial Resources – Total ($M)
Total Budgetary Expenditures (Main Estimates)
2012–13
Planned Spending
2012–13
Total Authorities (available for use)
2012–13
Actual Spending
(authorities used)
2012–13
Difference
(Planned vs. Actual Spending)
2012–13
616.5 616.5 664.4 619.7 (3.2)

Total Authorities are higher than Planned Spending by $47.9M mainly due to inclusion of additional authorities for the operating and capital budget carry forward; authorities related to the SSP; and additional funding received for the liquidation of severance pay due to revisions to specific collective agreements.

Actual Spending was less than Total Authorities mainly due to lower spending for the pandemic vaccine fill-line; lower orders received from provinces and territories for the National Antiviral Stockpile (NAS); and expenditure reductions achieved through streamlined administration.

Human Resources (Full-Time Equivalents — FTEs)
Planned
2012–13
Actual
2012–13
Difference
2012–13
2,668 2,218 450

The variance between Planned and Actual FTE utilization is 450 FTEs, which is mainly due to the transfer of various programs between HC and the Agency as part of the SSP; and the implementation of business transformation initiatives and streamlined administration.

Performance Summary Table for Strategic Outcome and Programs ($M)

Strategic Outcome: Protecting Canadians and empowering them to improve their health
Program Total Budgetary Expenditures (Main Estimates)
2012–13
Planned Spending Total Authorities (available for use)
2012–13
Actual Spending
(authorities used)
Alignment to Government of Canada Outcomes
2012–13 2013–14 2014–15 2012–13 2011–12 2010–11
1.1 Public Health Infrastructure 125.3 125.3 135.1 124.5 147.8 137.4 142.1 148.1 Healthy Canadians
1.2 Health Promotion and Disease Prevention 333.2 333.2 311.7 350.4 330.6 315.7 330.1 319.4
1.3 Health Security 62.6 62.6 48.9 43.2 76.6 60.1 45.2 37.8 A Safe and Secure Canada
Sub-Total 521.1 521.1 495.7 518.1 555.0 513.2 517.4 505.3

Performance Summary Table for Internal Services ($M)
Internal Services Total Budgetary Expenditures (Main Estimates)
2012–13
Planned Spending Total Authorities (available for use)
2012–13
Actual Spending
(authorities used)
2012–13 2013–14 2014–15 2012–13 2011–12 2010–11
Sub-Total 95.4 95.4 90.9 79.8 109.4 106.5 119.1 112.8

Total Performance Summary Table ($M)
Strategic Outcome and Internal Services Total Budgetary Expenditures (Main Estimates)
2012–13)
Planned Spending Total Authorities (available for use)
2012–13
Actual Spending
(authorities used)
2012–13 2013–14 2014–15 2012–13 2011–12 2010–11
Total 616.5 616.5 586.6 597.9 664.4 619.7 636.5 618.1

In 2011–12, the Agency’s Actual Spending was higher than in the previous year primarily due to severance payouts as a result of revisions to specific collective agreements and increases in spending on transfer payments. 2012–13 Actual Spending and 2013–14 Planned Spending reflect lower levels of spending due to savings measures achieved through streamlined administration. In 2014–15, Planned Spending increases slightly over the previous year as the Agency makes the final payment of $49.7M under the Hepatitis C Health Care Services Program.

Expenditure Profile

Line Graph: Expenditure Profile
Text Equivalent - Expenditure Profile

Expenditure Profile

Spending Trend ($ millions)
Fiscal Year 2009–10 2010–11 2011–12 2012–13 2013–14 2014-15 2015-16
Total Spending 944.2 618.1 636.5 619.7 586.6 597.9 545.6
Total Spending + Sunset programs 944.2 618.1 636.5 619.7 590.6 604.3 556.7

Canada experienced an H1N1 Pandemic Influenza in 2009–10 which accounted for approximately $310M of additional spending in that year. The Agency also spent $49.7M in the same year on the Hepatitis C Health Care Services Program which provides funding to the provinces to compensate for the care of individuals infected with hepatitis C. This program provides payments every five years and the final payment will occur in 2014–15.

The decrease in planned spending from 2011–12 through 2014–15 is primarily due to expenditure reductions achieved through reduced spending on management and administration, travel, and professional services, as well as administrative efficiencies in delivering grants and contributions programs. Planned spending will increase in 2014–15 and subsequently decrease in 2015–16 as the Agency makes the final payment of $49.7M under the Hepatitis C Health Care Services Program in 2014–15.

Estimates by Vote

For information on the Agency’s organizational Votes and/or statutory expenditures, please refer to the Public Accounts of Canada 2013 (Volume II). An electronic version of the Public Accounts 2013 is available on the Public Works and Government Services Canada’s Web site.

Contribution to the Federal Sustainable Development Strategy (FSDS)

The Federal Sustainable Development Strategy (FSDS) outlines the GC’s commitment to improving the transparency of environmental decision making by articulating its key strategic environmental goals and targets.

The Agency includes the consideration of these outcomes as an integral part of its decision-making processes. The Agency contributes to the following FSDS 2010–2013 themes as denoted by the visual identifiers and associated programs below.

Theme I:
Addressing Climate Change and Air Quality

Sub-Program 1.2.1: Infectious Disease Prevention and Control

Theme IV:
Shrinking the Environmental Footprint – Beginning with Government

Program 2.1: Internal Services

During 2012–13, the Agency was compliant with the Cabinet Directive on the Environmental Assessment of Policy, Plan and Program Proposals.

For additional details, please refer to Section II of the DPR and the Agency’s Sustainable Development Web site. For complete details on the FSDS, please visit the Environment Canada Web site.





 

 

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