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Expert Advisory Body on the Economic Cost of Illness in Canada: Terms of reference

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Context

The planning, production, and dissemination of the Economic Burden of Illness in Canada program by the Public Health Agency of Canada (PHAC) has been ongoing since 1991. The program, now renamed as the Economic Cost of Illness in Canada (ECIC), has been conducted 5 times (1986, 1993, 1998, 2005-2008, and 2010). The latest report dates to 2010. Therefore, it's essential to update and modernize the ECIC to build a robust and credible analysis that can inform decision making around health strategies and effective allocation of limited health resources. The revitalisation of ECIC will allow for the breakdown of updated costs for all major health illnesses using a consistent methodology. This consistency allows for the comparison of costs for most illnesses in Canada.

PHAC is establishing the Expert Advisory Body (EAB) on the Economic Cost of Illness in Canada. It will be an integral part of the overall governance structure supporting the ECIC modernization work.

Governance

The EAB will provide advice and recommendations related to the ECIC and ensure timely discussions on data and methodological considerations to support the revitalization of the ECIC. The EAB meetings will be chaired by a member of the EAB. Appointment of the Chair will be made by the Secretariat.

Review of these terms of reference will occur (at a minimum) annually for the duration of this EAB. The EAB will approve any changes at the first meeting of each year.

Mandate

The EAB has a mandate to provide advice and recommendations for consideration by PHAC on the modernization of the ECIC.

The mandate of the EAB is to:

Membership

Nomination process and considerations

The EAB will have up to 10 members. Membership will be drawn from those with expertise in:

Diversity and inclusion

When deciding on appointments to the EAB, PHAC will seek a diverse and inclusive membership. For example, PHAC may seek members from different stakeholder groups or experts, in addition to:

To support the Government of Canada's commitment to reconciliation, external advisory bodies should carefully consider how to ensure representation of Indigenous Peoples in ways that are culturally safe and competent.

The EAB should be committed to integrating Sex- and Gender-Based Analysis Plus (SGBA Plus) in their work. This will explore how intersecting identity factors, histories, power relations, distribution of resources and individuals' lived and living realities contribute to differences in health outcomes and accessing health-related resources.

Seeking inputs on appointments

In considering the appointment of members, PHAC may consult with:

Term of membership

Members are appointed by PHAC for up to 2 years or until the updating and modernization of ECIC is complete. Membership will be reviewed by PHAC on an ongoing basis to ensure an appropriate range of expertise, experience, perspectives, and continuity of membership on the EAB.

Members are expected to actively engage in the work of the EAB and to commit to attending meetings and contributing to the mandate of the EAB. If they are unavailable, members may name a designate or alternate to attend meetings. The designate or alternate should have similar expertise and knowledge as the member that they are replacing.

Resignation process

A member may resign from the EAB by providing written notice to the Secretariat and the Chair. It is preferable for a member to provide 14 days notice of the intent to resign. The letter should state the effective date of the resignation.

Reasons for termination

PHAC may end a member's appointment for a variety of reasons including:

PHAC may also end an appointment if a member has not acted in accordance with the terms of reference. Possible examples of this include if a member breaches their confidentiality obligations or misses 3 consecutive meetings without a satisfactory reason. PHAC will notify a member in writing about the termination and provide the reason and the date of termination.

Roles and responsibilities

Members of the EAB have a responsibility to:

The EAB Chair has the responsibility to:

Meetings

Meeting frequency

Meetings will take place once a quarter (at a minimum) or as required. Meetings will last between 90 and 120 minutes. All meetings will be held virtually. In exceptional circumstances, meetings may be held in-person.

Ad hoc meetings

Members may request that additional ad hoc meetings be scheduled to allow for discussion on issues that require immediate attention. Members will be notified of an ad hoc meeting 2 weeks in advance with supporting material.

Quorum for meetings

Quorum for meetings shall be attendance by a simple majority of members.

Official languages

In keeping with the federal Official Languages Act, EAB members have the right to receive documents and participate in discussions in the official language of their choice.

Decision making

The EAB's role is to provide advice and recommendations for consideration by PHAC. The EAB will have no decision-making authority, policy making responsibilities or investigatory responsibilities.

The EAB must have quorum when making recommendations or providing advice. Quorum is a simple majority of EAB members. The EAB is however encouraged to strive to act by consensus when making recommendations or providing advice to PHAC. The participation of all members is encouraged at meetings and through email – to share information, obtain consensus and make recommendations or provide advice.

EAB Secretariat

Meeting support

The Secretariat will be maintained within PHAC.

The Secretariat's roles and responsibilities include:

Items for meeting agendas will be determined by the Chair in concert with technical PHAC leads. Record of decisions will be taken by the technical PHAC leads.

Service standards

Members wishing to bring forward an agenda item for discussion or consideration should aim to distribute the item to the Secretariat at least 10 business days before the scheduled date of the meeting.

To the extent possible, the Secretariat will provide the EAB members with meeting documentation 3 business days before a scheduled meeting.

The Secretariat will inform the EAB of any late additions to the agenda.

Affiliations and conflict of interest

EAB members are expected to conduct themselves in an appropriate manner. That is, the use of their positions cannot be reasonably construed to be for their private gain or that of any other person, company, or organization. Members must refrain from any real or perceived conflict of interest.

As a condition of appointment, EAB members will be required to submit a summary of expertise, experience and affiliations and interests declaration form (the "disclosure form") to the Secretariat before commencing membership on the EAB. They must disclose in the disclosure form any circumstances that may place, or be seen to place the member in a real, apparent or potential conflict of interest. Interests that must be declared include significant financial interests, business and professional interests and intellectual interests.

Members must update the disclosure form in writing whenever their situation changes. PHAC will review disclosure forms before making appointments and on an ongoing basis, at least on an annual basis, as well as any time the external advisory body mandate is changed.

Disclosure should be made at the earliest possible time, and, in any event, prior to any discussion and decision making on the subject matter. In situations where conflict of interest or the appearance thereof arises in the course of the work of the EAB, the member involved must declare the existence of the conflict of interest. They may be required to disqualify themself from participation in the discussions on that subject matter, or from further participation on the EAB, depending on the circumstances.

Any disclosure and measures taken in connection with a real, potential or apparent conflict of interest should be recorded in the record of any meeting in which the disclosure is made or measures taken.

The personal information in a completed disclosure forms is protected under the Privacy Act. PHAC will not make public any information in the form without the member's permission. However, as a condition of membership, EAB members will be asked to permit PHAC to publish on its website a brief biography and a summary of expertise, experience, and affiliations and interests declaration, which will be based on the completed disclosure form. EAB members will be asked to review the content of the summary for accuracy before it is released.

Confidentiality

The Chair and members of the EAB as well as any observers or invitees if applicable will be required to sign confidentiality agreements. EAB members are expected to hold in confidence and not disclose any confidential information obtained as a result of their participation on the EAB, except as permitted under the terms of the confidentiality agreement.

PHAC will mark information according to the level to which it is protected under the Policy on Government Security.

The Chair will ensure that everyone participating in the meeting, telephone discussion, email exchange, or in another form of communication has received clear instructions on the confidentiality of the proceedings.

Legal assistance and indemnification

PHAC undertakes to provide volunteer members with protection against civil liability provided the volunteer member acts in good faith, within the scope of the EAB's mandate, does not act against the interests of the Crown and does not have such protection available.

For an eligible member to receive protection against civil liability, including for legal costs of defending an action as well as any award of damages to them, the volunteer member must notify PHAC within 2 weeks of receipt of a claim, action, suit or proceeding brought against the member. The volunteer member must obtain PHAC's consent, in advance, to the legal counsel selected to represent the volunteer member and any associated costs. PHAC may, at its own expense and discretion, participate in the conduct of the defence of any such claim, action, suit or proceeding, and any negotiations for the settlement of the same. PHAC will indemnify the member for payment of any settlement, provided that the member has obtained PHAC's consent to the settlement.

EAB members act collectively as an advisor to PHAC with respect to the mandate of their external advisory body, but they are not final decision makers. PHAC has the ultimate responsibility and accountability for any decision resulting from the advice received from the EAB.

Travel and expenses

EAB members who travel for authorized EAB purposes will have their travel and accommodation expenses reimbursed according to:

Media and communications

All media requests related to the EAB should be directed to the Secretariat who in turn will engage with the Health Portfolio's Media Relations team. Responses will subsequently be coordinated by PHAC.

When appropriate, PHAC may request the Chair or a member of the EAB to address a question raised by the media. The media request must first be directed to the PHAC's Communications Directorate or the Secretariat, who must decide whether to ask a member of the EAB to respond to the question. As the case may be, PHAC will provide guidance to the member on how to address the question.

If EAB members are asked a question by the media that relates to the mandate of the EAB, they may respond to the question in their personal or professional capacity. For example, an academic professor may speak about their research. EAB members must avoid expressing any opinions on behalf of the EAB or PHAC, or providing information that would be considered confidential under the confidentiality agreement. EAB members may also, in their personal or professional capacity, speak to information that has been published by PHAC. If asked by the media to discuss the EAB or discuss how the EAB has examined certain issues, EAB members should refer the media to the Secretariat.

Social media

Social media content developed by an EAB member, which describes work conducted by the EAB, must be reviewed and approved by PHAC before being disseminated. The Secretariat will review and finalize content with the Health Portfolio's Communications and Public Affairs Branch.

Intellectual property

PHAC must preserve its ability to freely use (for example publish, reproduce, translate) the work authored by members of the EAB. As such, members who have contributed to the formulation of written materials in their role on the EAB will be required to assign the Government of Canada any copyrights they own and to waive any moral rights they have in those materials. Written materials could include any documents, reports, and so on.

Transparency

PHAC is committed to transparency as an operating principle. Transparency of the EAB is served by sharing relevant materials with key stakeholders on a need to know basis. These materials may include the following:

Security clearance

The level of security clearance required for EAB members will be at the discretion of the Secretariat.

Review

PHAC, in discussion with the EAB, will review the mandate, activities, terms of reference, and relevance of EAB annually to ensure that it continues to meet ongoing needs.

Recommendations for improvement will be considered on an ongoing basis.

PHAC retains the prerogative to disband the EAB following any such review.

Deactivation

The work of the EAB is expected to end once the project is completed (2 years minimum).

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