Public Health Agency of Canada 2013–14 Departmental Performance Report

Section I: Organizational Overview

Organizational Profile

Minister: The Honourable Rona Ambrose, P.C., M.P.

Institutional Head: Krista Outhwaite, Acting Deputy Head

Ministerial Portfolio: Health

Enabling Instruments: Public Health Agency of Canada Act, Department of Health Act, Emergency Management Act, Quarantine Act, Human Pathogens and Toxins Act, Health of Animals Act, and the International Health Regulations.

Year of Incorporation / Commencement: 2004

Other: In June 2012, the Deputy Heads of Health Canada and the Public Health Agency of Canada signed a Shared Services Partnership Framework Agreement. Under this agreement, each organization retains responsibility for a different set of internal services and corporate functions. These include human resources, real property, information management / information technology, security, internal financial services, communications, emergency management, international affairs, internal audit services, and evaluation services.

The Canadian Food Inspection Agency joined the Health Portfolio in October 2013.

Organizational Context

Raison d'être

Public health involves the organized efforts of society to keep people healthy and to prevent injury, illness and premature death. The Public Health Agency of Canada (the Agency) has put in place programs, services and policies that protect and promote the health of all Canadians which form part of "public health". In Canada, public health is a responsibility that is shared by all three levels of government in collaboration with the private sector, non-governmental organizations, health professionals and the public.

In September 2004, the Agency was created within the federal Health Portfolio to deliver on the Government of Canada's 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/emergencies;
• 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(s) and Program Alignment Architecture (PAA)

For the purposes of this Departmental Performance Report, the Agency is using the 2014–15 Management, Resources and Results Structure (MRRS). This will permit a more accurate performance story and enable better alignment with the 2013–14 Report on Plans and Priorities.

• 1 Strategic Outcome: Protecting Canadians and empowering them to improve their health
  • 1.1 Program: Public Health Infrastructure
    • 1.1.1 Sub-Program: Public Health Capacity Building
    • 1.1.2 Sub-Program: Public Health Information and Networks
    • 1.1.3 Sub-Program: Public Health Laboratory Systems
  • 1.2 Program: Health Promotion and Disease Prevention
    • 1.2.1 Sub-Program: Infectious Disease Prevention and Control
      • 1.2.1.1 Sub-Sub-Program: Immunization
      • 1.2.1.2 Sub-Sub-Program: Infectious and Communicable Disease
      • 1.2.1.3 Sub-Sub-Program: Food-borne, Environmental and Zoonotic Infectious Disease
    • 1.2.2 Sub-Program: Conditions for Healthy Living
      • 1.2.2.1 Sub-Sub-Program: Healthy Child Development
      • 1.2.2.2 Sub-Sub-Program: Healthy Communities
    • 1.2.3 Sub-Program: Chronic (non-communicable) Disease and Injury Prevention
  • 1.3 Program: Health Security
    • 1.3.1 Sub-Program: Emergency Preparedness and Response
    • 1.3.2 Sub-Program: Border Health Security
    • 1.3.3 Sub-Program: Biosecurity
  • Internal Services

Organizational Priorities

Summary of Progress

Why is this a priority?
The Agency provides national leadership to strengthen public health and science to support effective decision making, public health practices and interventions, and an integrated, evidence-based public health system.

What progress has been made toward this priority?
The Agency enhanced the capacity of the Canadian public health workforce by placing public health officers (PHOs) and field epidemiologists across Canada. PHOs are located where there are identified public health capacity gaps, especially in the North, to support provinces and territories (P/Ts) as well as regional health authorities for a period of two years.

The Agency established an office in Iqaluit and a Northern Unit in Whitehorse to strengthen the Agency's presence in the North.

Through the Canadian Best Practices Portal and the Chronic Diseases and Injuries in Canada journal, the Agency increased public health professionals' access to information and best practices in the areas of oral health, seniors' health, mental health, violence prevention, child and maternal health, injuries and injury prevention. The majority of key stakeholders (92%) agreed that the journal contributed to increasing their knowledge related to chronic diseases and injuries.

The Agency provided a two-week bioinformatics workshop to public health partners on working with and analyzing "big data".^{Footnote 2}  Providing training to national public health partners in this highly-specialized and rapidly-evolving field builds national capacity and strengthens Canada's role as a global leader in next- generation sequencing technologies and interpretation.

Summary of Progress

Why is this a priority?
The Agency provides leadership and takes action to address the burden of illness associated with common risk factors, multiple chronic and communicable diseases and an aging population, as well as the social, economic and environmental conditions that affect Canadians' health status and can increase the potential for disease occurrence. By providing a stronger evidence base on important health issues and their determinants, the Agency works to improve population health and well-being and reduce health inequalities.

What progress has been made toward this priority?
The Agency supported health promotion and chronic and communicable disease prevention programs and initiatives that addressed the mental, social, and physical factors affecting the health of Canadians, particularly vulnerable and at-risk populations.^{Footnote 3}

The Agency also supported initiatives such as "Lifestyle Prescriptions" to help rural Canadians reduce their risk of Type II diabetes, and the Breast Health Program in Ontario to help women understand their risk factors. This past year, the National Automated External Defibrillator Program installed 484 defribillators in recreational facilities across Canada to increase the chance of survival from sudden cardiac arrests. Within a short timeframe, one life was saved as a result of this initiative.

In addition, the Agency partnered with the private, charitable, and not-for profit sectors to support interventions aimed at the common risk factors (physical inactivity, unhealthy eating, and tobacco use) that contribute to major chronic diseases.

The Agency launched a renewed Canada Communicable Disease Report (CCDR) that integrates surveillance data, disease trends and outbreak information. The revised CCDR has been welcomed by P/Ts as an important component of collaboration among public health stakeholders.

The Agency disseminated evidence-based surveillance, guidance, and information products including: Questions and Answers: Inclusive Practice in Prevention of Sexually Transmitted Blood-borne Infections (STBBIs) Among Ethnocultural Minorities; and the Population Specific Report on HIV/AIDS and other STBBI among youth in Canada.

The Agency also began implementing integrated approaches to HIV and related STBBIs including engaging stakeholders in the development of a new HIV/AIDS and Hepatitis C Action Fund (to be established by April 2017) and began discussions to expand the mandate of the ministerial advisory council.

Summary of Progress

Why is this a priority?
All governments must continue to collaborate to protect the health and safety of Canadians within a context of globalization, environmental change and scientific discovery. The Agency plays an important role supporting public health security through emergency preparedness and response, border health security, and biosecurity.

What progress has been made toward this priority?
The Agency strengthened emergency preparedness and response capacity through the adoption of a risk and evidence-based approach to managing the National Emergency Strategic Stockpile. In addition, the Public Health Network (PHN) finalized and endorsed the federal, provincial, territorial (F/P/T) Operational Framework for Mutual Aid Requests (OFMAR). The OFMAR provides a consistent and timely pan-Canadian approach to the request, offer, and receipt of resources during public health events/emergencies.

The integration of the Agency's Quarantine Program with Health Canada's (HC) Travelling Public Program helped the Agency create a stronger link with domestic and international partners to enhance border health security and to prevent the introduction and spread of communicable diseases.

The Pathogen Oversight Framework for Canada was enhanced through the Agency's development of risk-based regulations to support the complete implementation of the Human Pathogens and Toxins Act (HPTA). Once implemented, Canada's national program will extend beyond existing import-based controls to include biosafety and biosecurity requirements for domestically-acquired and/or produced human pathogens and toxins.

Summary of Progress

Why is this a priority?
Effective management, engagement, collaboration, teamwork and professional development are all essential to a high-performing organization that achieves its intended outcomes. Recognizing this, the Agency is committed to a rigorous pursuit of excellence, innovation and continuous improvement in the design and delivery of programs and services.

What progress has been made toward this priority?
Through the Shared Services Partnership (SSP), the Agency and HC continued to strengthen the delivery of shared services by:

• harmonizing and aligning policies such as the Real Property Management Framework;
• streamlining human resource corporate support and processes through an ongoing review of the Common Human Resources Policy Suite; and
• completing the Common Human Resources (HR) Business Process project in support of the integration of an HR Service Delivery Model with streamlined and standardized HR processes.

The Agency participated in the first-ever Canadian Open Data Event in order to share public health information and encourage new and practical applications in support of the Agency's operations and program delivery. In addition, the Agency developed innovative ways to share snapshots of key chronic disease and injury information with Canadians by producing the Chronic Disease Indicator Framework, data cubes and an infographic on healthy weights.

As well, advances were made by the SSP on government-wide, IT-modernization initiatives such as:

• transitioning to the new government-wide e-mail;
• migrating from a landline phone system to cellular use; and
• responding to Web mail from Canadians in a more timely manner.

Risk Analysis

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 events/emergencies. The multi-jurisdictional nature of public health also means that the Agency must work closely with domestic and international partners to respond to situations and to build on lessons learned.

The risks^{Footnote 5} identified in the table above were drawn from the Agency's 2012–13 Corporate Risk Profile. These risks were ranked as having the highest likelihood of significant impacts on the achievement of the Agency's objectives, and the most significant potential health and safety consequences for Canadians in the event of a failure of any risk response strategy.

Actual Expenditures

Planned Spending was higher than Main Estimates due to the receipt of in-year funding to continue enhancing the ability to prevent, detect and respond to food-borne illness outbreaks, and funding to streamline government import regulations and border processes for commercial trade.

Total Authorities were higher than Planned Spending primarily due to the inclusion of additional authorities for the operating budget carry forward; statutory items; reimbursement of paylist expenditures; payments required by collective agreements; funding received from HC for the Travelling Public Program; and funding re-profiled from previous fiscal years for the pandemic vaccine fill line project as well as the National Antiviral Stockpile (NAS).

Actual Spending was less than Total Authorities mainly due to lower P/T orders of vaccines for the NAS; expenditure reductions achieved through streamlined administration, travel, and; professional services; as well as administrative efficiencies in delivering grants and contributions programs.

The variance is primarily due to the transfer of various programs to HC as part of the Health Portfolio Shared Services Partnership which resulted in the consolidation and streamlining of internal services organizations to create efficiencies.

Budgetary Performance Summary for Strategic Outcome and Programs (dollars)

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.

Alignment of Spending With the Whole-of-Government Framework

Departmental Spending Trend

Departmental Spending Trend Graph

Enlarge Picture - Departmental Spending Trend Graph

The changes in spending are associated primarily with: issuing the final payment for the Hepatitis C Health Care Services Program in 2014–15; sunsetting of some temporary Agency programs; and continued savings measures achieved through streamlined administration, travel, and professional services, as well as administrative efficiencies in delivering grants and contributions programs.

The Agency will continue to examine the level of resources required for priority initiatives and seek renewal as appropriate.

Estimates by Vote

For information on the Agency's Votes and statutory expenditures, consult the Public Accounts of Canada 2014 on the Public Works and Government Services Canada website.