ARCHIVED - Health Canada - Supplementary Tables

User Fee: Authority to Sell Drugs Fees

Fee Type: Regulatory (R)

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: Dec.1994

Performance Standards: 120 calendar days to update the Drug Product Database following notification

Performance Results: 100% within 120 calendar days

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$7,700	$7,615	$47,205 (1)	2011-12	$8,553	$53,095
			2012-13	$8,724	$56,760
			2013-14	$8,899	$57,896

Other Information:

User Fee: Drug Establishment Licensing Fees

Fee Type: Regulatory (R)

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: Dec. 1997

Performance Standards: 250 calendar days to issue / renew licence

Performance Results: 97.4% within 250 calendar days

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$6,000	$7,875	$20,297 (1)	2011-12	$21,901	$26,080
			2012-13	$22,339	$26,601
			2013-14	$22,786	$27,133

Other Information:

User Fee: Drug Submission Evaluation Fees (Pharmaceuticals & Biologic Products)

Fee Type: Regulatory (R)

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: Aug. 1995

Performance Standards: Review 1 (average time in calendar days)

Pharmaceuticals
NDS: Priority NAS = 180
NDS: NAS = 300
NDS: Clin only = 300
NDS: Clin/C&M = 300
NDS: Priority Clin/C&M = 180
NDS: Labelling only = 60
NDS: Comp/C&M = 180
ANDS: C&M/Labelling = 180
ANDS: Comp/C&M = 180
SNDS: Clin/C&M = 300
SNDS: Clin only = 300
SNDS: Comp/C&M = 180
SNDS: C&M/Labelling = 180
SNDS: Rx to OTC New INDIC = 300
SNDS: Rx to OTC No New Indication =180
SNDS: Labelling only = 60
SNDS-C: Clin only =300
SANDS: Clin only = 300
SANDS: Comp/C&M = 180
SANDS: C&M/Labelling = 180
SANDS: Labelling only = 60
DIN A with data = 210
DIN A form only = 180
DIN D with data = 210
DIN D form only = 180

Biologics
NDS: Priority NAS = 180
NDS: NAS = 300
NDS: Clin/C&M = 300
ANDS: Comp/C&M =180
SNDS: Priority Clin only = 180
SNDS: Clin/C&M = 300
SNDS: Clin only = 300
SNDS: Comp/C&M = 180
SNDS: C&M/Labelling = 180
SNDS: Labelling only = 60
SNDS: NOC-C Clin only = 200
DIN B with data = 210
DIN B form only = 180

Performance Results: Review 1 (average time in calendar days)

Pharmaceuticals
NDS: Priority NAS = 169
NDS: NAS = 310
NDS: Clin only = 295
NDS: Clin/C&M = 316
NDS: Priority Clin/C&M = 180
NDS: Labelling only = 50
NDS: Comp/C&M = 325
ANDS: C&M/Labelling = 307
ANDS: Comp/C&M = 385
SNDS: Clin/C&M = 347
SNDS: Clin only = 270
SNDS: Comp/C&M = 233
SNDS: C&M/Labelling = 235
SNDS: Rx to OTC New INDIC = NA
SNDS: Rx to OTC No New Indication =NA
SNDS: Labelling only = 64
SNDS-C: Clin only =277
SANDS: Clin only = 343
SANDS: Comp/C&M = 301
SANDS: C&M/Labelling = 332
SANDS: Labelling only = 53
DIN A with data = 396
DIN A form only = 213
DIN D with data = 147
DIN D form only = 111

Biologics
NDS: Priority NAS = 175
NDS: NAS = 274
NDS: Clin/C&M = 302
ANDS: Comp/C&M = N/A
SNDS: Priority Clin only = 187
SNDS: Clin/C&M = 291
SNDS: Clin only = 257
SNDS: Comp/C&M = 180
SNDS: C&M/Labelling = 167
SNDS: Labelling only = 37
SNDS: NOC-C Clin only = 250
DIN B with data = 94
DIN B form only = 90

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$23,000	$22,657	$79,367 (1)	2011-12	$40,870	$87,157
			2012-13	$50,060	$93,319
			2013-14	$51,061	$95,185

Other Information:

User Fee: Medical Device Licence Application Fees

Fee Type: Regulatory (R)

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: Aug.1998

Performance Standards: Review time to first decision (calendar days)
Review 1 (average time in calendar days)

Class II = 15
Class II amendment = 15
Class II Private Label = 15
Class II Private Label amendment = 15
Class III = 60
Class III amendment = 60
Class IV = 75
Class IV amendment = 75

Performance Results: Average review time to first decision
Review 1 (average time in calendar days)

Class II = 14.7
Class II amendment = 10.25
Class II Private Label = 15.95
Class II Private Label amendment = 13.28
Class III = 69.64
Class III amendment = 66.47
Class IV = 104.84
Class IV amendment = 61.29

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$3,800	$4,025	$11,684 (1)	2011-12	$9,425	$14,864
			2012-13	$9,613	$16,266
			2013-14	$9,805	$16,591

Other Information:

User Fee: Fees for Right to Sell a Licensed Medical Device

Fee Type: Regulatory (R)

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: Aug.1998

Performance Standards: 20 calendar days from deadline for receipt of annual notification to update the Medical Devices Active License Listing (MDALL) database

Performance Results: 100% within 20 calendar days

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$1,800	$2,662	$7,378 (1)	2011-12	$8,377	$10,927
			2012-13	$8,545	$12,408
			2013-14	$8,715	$12,656

Other Information:

User Fee: Medical Device Establishment Licensing Fees

Fee Type: Regulatory (R)

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: Jan. 2000

Performance Standards: 120 calendar days to issue / renew licence

Performance Results: 99.5% issued within 120 calendar days

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$3,000	$4,115	$6,089 (1)	2011-12	$11,992	$13,505
			2012-13	$12,232	$13,775
			2013-14	$12,477	$14,051

Other Information:

User Fee: Veterinary Drug Evaluation Fees

Fee Type: Regulatory (R)

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: Mar. 1996

Performance Standards: Review time to first decision (calendar days)

NDS (including Priority Review) = 300
ABNDS = 300
SNDS = 240
SABNDS = 240
Admin = 90
DIN (including changes to DINs) = 120
NC = 90
ESC = 60
Labels = 45
Emergency Drug Release = 2

Performance Results: Average review time to first decision

NDS (including Priority Review) = 290
ABNDS = 303
SNDS = 261
SABNDS = 242
Admin = 121
DIN (including changes to DINs) = 128
NC = 131
ESC = 67
Labels = 55
Emergency Drug Release = 1

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$650	$719	$9,783 (1)	2011-12	$739	$10,057
			2012-13	$760	$10,338
			2013-14	$781	$10,628

Other Information:

User Fee: Fees to be paid for Pest Control Product Application Examination Service

Fee Type: Regulatory (R)

Fee-setting Authority: Pest Control Products Act (PCPA)

Date Last Modified: April 1997

Performance Standards: Target is 90% of submissions in all categories to be processed within time shown.

www.pmra-arla.gc.ca/english/pdf/pro/pro9601-e.pdf

Category A
Standard - 550 days
User Request Minor Use Registration (URMUR) - 365 days

Category B
Standard/priority - 365 days

Category C
Standard - 180 or 225 days

Category D
IMEP - 32 days
OUI - 56 days
URMULE - 60 days and
Master Copy - 21 days Category E
New Active - Food - 365 days
New Active - Non-food - 165 days

Performance Results:
Category A = 82% overall while100% of joint reviews were completed with established international standards.
Category B = 80% overall for the fiscal year.
Category C = 74%
Category D = 87%
Category E = 31%

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$3,490	$5,073.1	$40,821	2011-12	$3,490	$36,611
			2012-13	$3,490	$36,611
			2013-14	$3,490	$36,611

Other Information:

User Fee: Fees to be paid for the right or privilege to manufacture or sell a pest control product in Canada and for establishing a Maximum Residue Limit in relation to a pest control product.

Fee Type:

Fee-setting Authority: Financial Administration Act (FAA)

Date Last Modified: April 1997

Performance Standards: 100% of all fees for the right or privilege to manufacture or sell a pest control product in Canada are invoiced by April 30th of each fiscal year.

Performance Results: 100% of all invoices were issued by April 30, 2010.

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$4,500	$4,428	$29,318	2011-12	$4,500	$26,294
			2012-13	$4,500	$26,294
			2013-14	$4,500	$26,294

Other Information:

User Fee: Fees charged for the processing of access requests filed under the Access to Information Act (ATIA)

Fee Type: Other products and services (O)

Fee-setting Authority: Access to Information Act

Date Last Modified: 1992

Performance Standards: Response provided within 30 days following receipt of request; response time may be extended pursuant to section 9 of the ATIA. ATIA: http://laws.justice.gc.ca/en/A-1/218072.html

Performance Results: During fiscal year 2010-2011, Health Canada completed processing 1535 (71%) of 2147 active requests.

Health Canada was able to respond within 30 days or less in 700 (45.6%) of completed cases. * The remaining requests were completed within 31 to 60 days in 171 (11.1%) cases, 61 to 120 days in 178 (11.6%) cases and 486 or more days in 486 (31.7%) cases.

*A Notice of Extension is sent to the requester within 30 days of receipt of request.

2010-11 ($ thousands)			Planning Years ($ thousands)
Forecast Revenue	Actual Revenue	Full Cost	Fiscal Year	Forecast Revenue	Estimated Full Cost
$10	$15.5	$2,340	2011-12	$10	$1,800
			2012-13	$10	$1,800
			2013-14	$10	$1,800

Other Information:

Name of Transfer Payment Program:

Payments to First Nations and Inuit Health Services Transfer

Start Date

April 2007

End Date

March 2012

Description

To increase responsibility and control by First Nations and Inuit for their own health programs and services to improve health conditions for First Nations and Inuit people.

Strategic Outcome

Better Health outcomes and reduction of Health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

Increased control or accountability by First Nations and Inuit for their own of health care programs and services.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	213.7	266.4	256.1	448.1	448.1	(192.0)
Total Other Types of Transfer Payments
Total Program Activity(ies)	213.7	266.4	256.1	448.1	448.1	(192.0)

Comment(s) on Variance(s):

* Due to the nature of this program, actual spending includes a total of $191.2M from other classes of contributions, as FN, under this program authority, manage funds previously identified with other classes. This authority allows FN recipients to manage funds under a single consolidated agreement as they assume more responsibility for development and management of their own health programs. As such, funds from other classes are expended under this contribution authority. Correspondingly, those classes affected by spending under Payments to First Nations and Inuit Health Services Transfer will have reference to this spending in their comments.

* It is also expected that this class grows over time as it supports the increasing desire of First Nations and Inuit to assume management of health programs and services and the opportunity to redesign these programs and services so that they are more suited to local priorities.

Audit Completed or Planned:

N/A

Evaluation Completed or Planned:

Planned as part of the funding models evaluation in 2011-12.

Name of Transfer Payment Program

Contributions for First Nations and Inuit Health Governance and Infrastructure Support

Start Date

April 2005

End Date

March 2011

Description

Health Governance and Infrastructure Support aims to increase First Nations and Inuit control over health programs and services. Activities include: health planning and management; health research, knowledge and information management; health consultation and liaison; health delivery and infrastructure; integration and adaptation of health services; and health human resources.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

Improved health status of First Nations and Inuit through strengthened governance and infrastructure.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	148.6	164.2	166.8	84.3	76.9	89.9
Total Other Types of Transfer Payments
Total Program Activity(ies)	148.6	164.2	166.8	84.3	76.9	89.9

Comment(s) on Variance(s):

* Planned spending is reduced by $11.8 for transfer between branches and Supps A & C items.

* $43.6 of the Actual Spending of this contribution class is reported under 'Payments to First Nations and Inuit Health Services Transfer'" due to the desire of First Nations and Inuit to assume management of health programs and services.

* Most of the remaining variance is due to Actual Spending reported under Contribution Class "FNI Community Programs". The amount assigned to this Transfer Payment Program at its establishment in 2005 was overestimated and a realignment towards three other Transfer Payment Programs will be requested for future years.

Audit Completed or Planned:

N/A

Evaluation Completed or Planned:

Evaluation of the funding models planned in 2011-12.

Name of Transfer Payment Program

Contributions for First Nations and Inuit Community Programs

Start Date

April 2005

End Date

March 2011

Description

Community programs support child and maternal-child health; mental health promotion; addictions prevention and treatment; chronic disease prevention and health promotion services.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

Increased participation of First Nations and Inuit individuals, families, and communities in programs and supports.

Improved continuum of programs and services in First Nations and Inuit communities.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	285.1	265.9	170.0	180.7	180.0	(10.0)
Total Other Types of Transfer Payments
Total Program Activity(ies)	285.1	265.9	170.0	180.7	180.0	(10.0)

Comment(s) on Variance(s):

* Planned spending is increased by $73.5 for Supps A, B & C items.

* $89.0 of the Actual Spending of this contribution class is reported under 'Payments to First Nations and Inuit Health Services Transfer'" due to the desire of First Nations and Inuit to assume management of health programs and services.

* Most of the remaining variance is due to Actual Spending that belongs to Contribution Class "Contributions for First Nations and Inuit Health Governance and Infrastructure Support".

Audit Completed or Planned:

N/A

Evaluation Completed or Planned:

Completed for Mental Health and Addictions and Chronic Disease and Injury Prevention Clusters in 2010-11.

Name of Transfer Payment Program

Contributions for First Nations and Inuit Health Facilities and Capital Program

Start Date

April 2005

End Date

March 2011

Description

Provides funding to eligible recipients for the construction acquisition, leasing, operation and maintenance of nursing stations, health centres, health stations, health offices, treatment centres, staff residences, and operational support buildings.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

Increase availability of health facilities, equipment and other moveable assets in First Nations and Inuit communities that support the provision of health services.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	66.1	98.7	112.9	116.3	116.3	(3.4)
Total Other Types of Transfer Payments
Total Program Activity(ies)	66.1	98.7	112.9	116.3	116.3	(3.4)

Comment(s) on Variance(s):

* Actual Spending was higher than forecasted by 3% due to additional Capital pressures.

Audit Completed or Planned:

Audit of Health Facilities and Capital Program completed in 2010-11.

Evaluation Completed or Planned:

Completed in 2010-11.

Name of Transfer Payment Program

Contributions for First Nations and Inuit Health Benefits

Start Date

April 2005

End Date

March 2011

Description

A limited range of medically necessary health-related goods and services which supplement those provided through other private or provincial/territorial health insurance plans is provided to registered Indians and recognized Inuit. Benefits include drugs, dental care, vision care, medical supplies and equipment, short-term crisis intervention mental health services, and transportation to access medical services not available on reserve or in the community of residence.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

Access by eligible clients to Non-Insured Health Benefits.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	150.0	166.7	168.7	168.1	168.1	0.6
Total Other Types of Transfer Payments
Total Program Activity(ies)	150.0	166.7	168.7	168.1	168.1	0.6

Comment(s) on Variance(s):

N/A

Audit Completed or Planned:

Audit of Non-Insured Health Benefits - Medical Transportation completed in 2010-11.

Evaluation Completed or Planned:

N/A

Name of Transfer Payment Program

Contributions for First Nations and Inuit Health Protection

Start Date

April 2005

End Date

March 2011

Description

Communicable Disease and Environmental Health and Research programs facilitate preparedness to implement measures in the control, management and containment of outbreaks of preventable diseases and improve management and control of environmental hazards.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

1. Environmental health risk management contributes to improved health status of First Nations individuals, families and communities.
2. Improved access to quality well-coordinated communicable disease prevention and control programs for First Nations and Inuit individuals, families, and communities.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	24.4	27.4	12.8	21.7	21.7	(8.9)
Total Other Types of Transfer Payments
Total Program Activity(ies)	24.4	27.4	12.8	21.7	21.7	(8.9)

Comment(s) on Variance(s):

* Planned spending is increased by $5.2 for Supps A items.

* $6.8 of the Actual Spending of this contribution class is reported under 'Payments to First Nations and Inuit Health Services Transfer'" due to the desire of First Nations and Inuit to assume management of health programs and services.

* Approximately $4.0 of the variance is due to increased pressure for First Nations Water Monitoring Program.

* Remaining variance of approximately $6.0 is due to increased pressure in other Health Protection Programs.

Audit Completed or Planned:

N/A

Evaluation Completed or Planned:

Communicable Disease Control, Environmental Health and Environmental Research Clusters completed in 2010-11.

Name of Transfer Payment Program

Contributions for First Nations and Inuit Primary Health Care

Start Date

April 2005

End Date

March 2011

Description

Primary Health Care services include emergency and acute care health services, Community primary health care services which include illness and injury prevention and health promotion activities. These programs also include: the First Nations and Inuit Home and Community Care; and the Oral Health Strategy.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

Improved access to quality well-coordinated culturally appropriate primary health care programs and services for First Nations and Inuit individuals, families and communities.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	147.9	144.6	129.5	103.3	103.3	26.2
Total Other Types of Transfer Payments
Total Program Activity(ies)	147.9	144.6	129.5	103.3	103.3	26.2

Comment(s) on Variance(s):

* Planned spending is increased by $6.0 for Supps A items.

* $51.5 of the Actual Spending of this contribution class is reported under 'Payments to First Nations and Inuit Health Services Transfer'" due to the desire of First Nations and Inuit to assume management of health programs and services.

* Most of the variance of $19.3 is explained by a continued increase in Nursing costs.

Audit Completed or Planned:

Audit of Primary Care - Nursing Services completed in 2010-11.

Evaluation Completed or Planned:

Planned in 2011-12

Name of Transfer Payment Program

Contributions for Bigstone Non-Insured Health Benefits (NIHB) Pilot Project

Start Date

April 2005

End Date

March 2011

Description

Administration and delivery of benefits with Bigstone Health Commission to registered Indians and recognized Inuit.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

Improved access to quality well-coordinated culturally appropriate primary health care programs and services for First Nations and Inuit individuals, families and communities.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	10.0	10.4	9.1	10.9	10.9	(1.8)
Total Other Types of Transfer Payments
Total Program Activity(ies)	10.0	10.4	9.1	10.9	10.9	(1.8)

Comment(s) on Variance(s):

* Variance is mainly due to additional spending related to NIHB program growth.

Audit Completed or Planned:

N/A

Evaluation Completed or Planned:

N/A

Name of Transfer Payment Program

Contributions to the Organization for the Advancement of Aboriginal People's Health

Start Date

April 2005

End Date

March 2011

Description

To support the Organization for the Advancement of Aboriginal People's Health.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.

Results Achieved

Continued empowerment of Aboriginal peoples through advancements in knowledge and sharing of knowledge on Aboriginal health.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	5.0	5.0	5.0	4.4	4.4	0.6
Total Other Types of Transfer Payments
Total Program Activity(ies)	5.0	5.0	5.0	4.4	4.4	0.6

Comment(s) on Variance(s):

* Actual Spending was lower than expected by $0.6.

Audit Completed or Planned:

N/A

Evaluation Completed or Planned:

N/A

Name of Transfer Payment Program

Indian Residential Schools Resolution Health Support Program

Start Date

November 2006

End Date

March 2013

Description

This program is to support the mental wellness of former Indian Residential School (IRS) students, their families and communities by providing:

• resolution health support services, delivered by Resolution Health Support Workers;
• Elder support;
• support during truth and reconciliation and commemoration events;
• research and communication activities in support of the mental wellness of former IRS students, and an overall increased awareness of and demand for mental health services available to former IRS students and their families during the resolution process.

(Voted)

Strategic Outcome

Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Results achieved:

Services which are culturally sensitive, holistic, comprehensive, effective and efficient, ultimately improving emotional and mental wellness of former IRS students.

Services allow former IRS students to disclose accounts of childhood sexual and physical abuses in a safe and effective manner.

Program Activity:
First Nations and Inuit Health Programming and Services

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	18.8	24.0	5.4	33.4	33.4	(28.0)
Total Other Types of Transfer Payments
Total Program Activity(ies)	18.8	24.0	5.4	33.4	33.4	(28.0)

Comment(s) on Variance(s):

* Planned spending is increased by $26.9 for Supps B items. The remaining variance is due to a higher than expected demand that results in increased costs for this program.

Audit Completed or Planned:

N/A

Evaluation Completed or Planned:

N/A

Name of Transfer Payment Program

Contributions in support of the Federal Tobacco Control Strategy

Start Date

July 1, 2007

End Date

March 31, 2012 (Ts&Cs expire March 31, 2012)

Description

The purpose of the Federal Tobacco Control Strategy (FTCS) Contribution Program is to contribute to the achievement of FTCS objectives through assistance to provinces, non-governmental organizations, researchers and other tobacco control stakeholders. In 2007, the Government of Canada announced new goals and objectives for the Federal Tobacco Control Strategy until 2011. These are:

Goal:
Reducing the overall smoking prevalence from 19% (2005) to 12% by 2011.

The new objectives are to:

• Reduce the prevalence of Canadian youth (15-17) who smoke from 15% to 9%;
• Increase the number of adult Canadians who quit smoking by 1.5 million;
• Reduce the prevalence of Canadians exposed daily to second-hand smoke from 28% to 20%;
• Examine the next generation of tobacco control policy in Canada;
• Contribute to the global implementation of the World Health Organization's Framework Convention on Tobacco Control; and
• Monitor and assess contraband tobacco activities and enhance compliance.

Strategic Outcome

Reduced health and environmental risks from products and substances and healthy, sustainable living and working environments

Results Achieved

With 104 projects funded since 2007, the following results are some highlights:

• National Cessation Guidelines: Development of evidence-based national cessation guidelines.
• Hospital Based Smoking Cessation: Helping recipient organizations implement a systematic approach to the treatment of tobacco dependant patients in hospital based settings.
• Smoking Cessation Counselling: Helping recipient organizations adapt and create tailored cessation programs for specific populations. Population sectors include First Nations and Inuit, pregnant women, persons with mental health issues, and reaching smokers in workplaces.
• Policy and Training: Assisting recipient organizations in exploring new policy options, developing capacity building and training initiatives.

Program Activity: Substance Use and Abuse

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	7.4	12.7	15.8	15.8	15.7	0.1
Total Other Types of Transfer Payments
Total Program Activity(ies)	7.4	12.7	15.8	15.8	15.7	0.1

Comment(s) on Variance(s):

Differences between planned spending and actual spending is minimal and is related to minor lapses from committed projects.

Audit Completed or Planned:

No audits have been performed, nor are they planned for the Federal Tobacco Control Strategy at this time.

Evaluation Completed or Planned:

The Federal Tobacco Control Strategy incorporates a full summative evaluation which includes process and impact evaluations of the contribution funding program. Final report of the process evaluation is expected in September 2011, and final report of the impact evaluation is expected in July 2011.

Name of Transfer Payment Program

Drug Treatment Funding Program

Start Date

October 2007 - Services component
April 2008 - Systems component

End Date

March 31, 2012 (Services component)
March 31, 2013(Systems component)

Description

Drug Treatment Funding Program (DTFP), under the National Anti-Drug Strategy, provides $111 million in financial support over five years to provincial and territorial governments to support illicit drug treatment services for at-risk youth, and to assist in strengthening the quality of drug treatment services. An additional $10M over five years is designated support for a project in Vancouver's Downtown Eastside.

Strategic Outcome

Reduced health and environmental risks from products and substances and healthy, sustainable living and working environments.

Results Achieved

• The DTFP has signed contribution agreements for 14 projects in 2010-11, bringing the total number of projects being administered to 29. One contribution agreement is under negotiation. The cumulative funding value is $63.4M. Funded projects focus on all three DTFP investment areas: implementation of best practices, enhancing knowledge exchange, and strengthening performance measurement and evaluation.
• While treatment projects are in the early stages of implementation, evidence to date indicates significant progress in establishing community partnerships and linkages in support of new and enhanced treatment services, and enhanced collaboration amongst P/Ts on national level activities such as the development, collection and reporting of national treatment indicators.
• Funded projects have already helped to produce a wider range of services by developing partnerships within the community, expanding hours of service, offering different locations when working with clients and offering a range of activities to help attract youth to their services.

Program Activity: Substance Use and Abuse

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	1.4	5.9	29.9	29.9	16.5	13.4
Total Other Types of Transfer Payments
Total Program Activity(ies)	1.4	5.9	29.9	29.9	16.5	13.4

Comment(s) on Variance(s):

Actual spending of $16.5M versus total authorities and planned spending results in a variance of $13.4M. Of this, $2.2M was reallocated to the National Native Alcohol and Drug Abuse Program and the Drug Strategy Community Initiatives Fund both under the National Anti-Drug Strategy. Health Canada is exploring options to retain the remaining $10.9 M to achieve the desired program objectives.

The Report on Plans and Priorities reported planned spending at the amount of $28M. An adjustment has been made to reflect the correct amount of $29.9M.

Audit Completed or Planned:

No audits have been performed, nor are they planned for the DTFP at this time.

Evaluation Completed or Planned:

An implementation evaluation of the DTFP was conducted in 2010-11 which examined the implementation of the program, relevance of the program to federal priorities, and progress towards achievement of immediate outcomes.

Departmental Performance Measurement and Evaluation Directorate will be overseeing an evaluation of DTFP in 2012.

Name of Transfer Payment Program

Drug Strategy Community Initiatives Fund (voted contribution dollars)

Start Date

April 2004

End Date

Ts&Cs renewed effective April 1, 2010

Description

The Drug Strategy Community Initiatives Fund (DSCIF) will contribute to reducing illicit drug use among Canadians, particularly among vulnerable populations such as youth, by focussing on health promotion and prevention approaches to address drug abuse before it happens. The objectives of the DSCIF are to facilitate the development of local, provincial, territorial, national and community-based solutions to drug use among youth and to promote public awareness of illicit drug use among youth. The Program is delivered through Health Canada's regional and national offices.

Strategic Outcome

Reduced health and environmental risks from products and substances and healthy, sustainable living and working environments

Results Achieved

During 2010-11, 35 new contribution agreements were signed.

DSCIF continues to work closely with recipients to aid in performance reporting including delivering evaluation training (regional evaluation training sessions held for most new projects in 2010-11), development of standardised instruments as part of the cluster evaluation and development of standardised quarterly reporting templates.

In 2010-11, DSCIF worked with the Department Centre of Excellence towards implementing Risk Management Tools.

In 2010-11, British Columbia, Alberta, Manitoba/Saskatchewan and Quebec held regional Showcases or Knowledge Exchange Events where funded projects were brought together to share results, lessons learned and to network.

Program Activity: Substance Use and Abuse

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	4.9	9.0	12.4	12.4	12.7	0.3
Total Other Types of Transfer Payments
Total Program Activity(ies)	4.9	9.0	12.4	12.4	12.7	0.3

Comment(s) on Variance(s):

The $0.3M variance of actual spending in excess of the total authorities and planned spending is the result of the transfer of resources from the Drug Treatment Funding Program to be spent under this program which is also related to the National Anti-Drug Strategy. The planned spending has been adjusted to reflect proper G & C planned spending amounts.

Audit Completed or Planned:

No audits have been performed, nor are they planned for the DSCIF at this time.

Evaluation Completed or Planned:

No evaluations were completed in 2010-11.

Name of Transfer Payment Program

Assessed Contribution to the Pan-American Health Organization

Start Date

April 15, 2008

End Date

March 31, 2013

Description

To support Canada's membership in the Pan-American Health Organization (PAHO).

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians.

Results Achieved

Canada receives direct and indirect benefits from its membership in PAHO. Attendance at meetings of the governing bodies and at expert consultations provides a forum for the wider dissemination of Canadian-based values related to health and the provision of health care services and public health approaches. Participation by Canadian health experts ensures bilateral linkages are created and maintained with key countries in Latin America and the Caribbean.

The Director of PAHO annually reports the Organization's accomplishments and how it has spent its resources to meet stated objectives. Link to PAHO's website: (http://www.paho.org/English/gov/govbodies-index.htm).

Program Activity: International Health Affairs

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	12.0	13.0	12.5	13.2	13.2	-1.7
Total Other Types of Transfer Payments
Total Program Activity(ies)	12.0	13.0	12.5	13.2	13.2	-1.7

Comment(s) on Variance(s):

Variance in spending is due to increases in Canada's assessed contribution to PAHO and fluctuations in foreign exchange rates. The variance was accommodated by using funds from the overall International Health Grants Program budget under which the PAHO payment sits.

Audit Completed or Planned:

None. As per the program Terms and Conditions, Health Canada relies upon the PAHO's internal and external audit regimes to monitoraccountability.

Evaluation Completed or Planned:

None

Name of Transfer Payment Program

Grant to Canadian Blood Services

Start Date

April 2000

End Date

Ongoing

Description

To support basic, applied and clinical research on blood safety and effectiveness issues through the auspices of Canadian Blood Services.

Strategic Outcome

Access to safe and effective health products and food information for healthy choices.

Results Achieved

Continued improvements to basic applied and clinical research on blood safety and effectiveness.

Program Activity:
Health Products

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants	5.0	5.0	5.0	5.0	5.0	0.0
Total Contributions
Total Other Types of Transfer Payments
Total Program Activity(ies)	5.0	5.0	5.0	5.0	5.0	0.0

Comment(s) on Variance(s):

No variance.

Audit Completed or Planned:

None

Evaluation Completed or Planned:

None

Name of Transfer Payment Program

Official Languages Health Contribution Program

[replaces:  Contribution Program to Improve Access to Health Services for Official Language Minority Communities 2003-04 to 2008-09]

Start Date

April 1, 2009

End Date

March 31, 2013

Description

The Official Languages Health Contribution Program has the following objectives:

• improved access to health services for English-speaking communities in Quebec and French-speaking communities in other provinces and territories;
• increased use of both official languages in the provision of health services in Canada.

These objectives are realized through the following three mutually reinforcing program components:

1. The operation of Health Networks to support English and French linguistic minority communities across Canada by enabling linkages between health sector stakeholders to maintain and improve the health services available to these communities;
2. Activities for the Training and Retention of Health Professionals to provide an increased supply of health professionals who are able to provide health-related services to English and French linguistic minority communities across Canada; and
3. Official Languages Health Projects comprising specific time-limited initiatives of one to four years in each province, territory and region that aim to have lasting effects on improving the health services situations for English and French linguistic minority communities across Canada.

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians.

Results Achieved

23 contribution agreements were launched with educational institutions and community-based organisations for the engagement of new program activities to address program objectives.

1,147965 students new student registrations were accepted in 20109-110 into training programs sponsored through the ten post-secondary institutions and one provincial government agency (New Brunswick) funded under the coordination of the Consortium national de formation en santé. There were 518 graduates from these same programs for the academic year ending in May/June 2010. A follow-up survey of training graduates from 2008-09 - which was released in 2010-11 - revealed that 86% of graduates surveyed were employed in health professions serving official language minority communities.

McGill University coordinated language training activities in 20109-110 for some 1,325000 health professionals in Quebec to improve their ability to service English-speaking minority communities.

Approximately 70 projects are being launched during 2010-13 in French-speaking minority communities outside Quebec. Examples of projects launched in 2010-11:

• A three-year project (2010-13) to facilitate the delivery of health care services in French in retirement homes and to provide support to family caregivers in three French-speaking communities of three regions of Newfoundland and Labrador: Avalon, Port-au-Port and Labrador City.
• Another three-year project (2010-13) to create and distribute public health education and awareness tools for French-speaking and Acadian preschool children in Nova Scotia.

A total of 38 projects have been launched in English-speaking minority communities in Quebec over 2010-13. Examples of projects launched in 2010-11:

• A project designed to co-ordinate recruiting efforts of regional stakeholders in order to fill the need for bilingual workers in the Gaspésie-Îles-de-la-Madeleine region.
• English translation of health information documents in Saguenay-Lac-Saint-Jean

New projects aimed at improving the health and health access of official language minority communities were implemented in 2009-2010. For example, a new French-language telehealth site was launched in Manitoba under the sponsorship of the Société Santé en français and an initiative to improve access to health and social services in English in the Estrie region of Quebec was launched through the Community Health and Social Services Network.

Further information regarding these projects is available from the websites of Program recipients:

• Société Santé en français
• Community Health and Social Services Network
• Consortium national de formation en santé
• McGill University

Program Activity:
Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	27.9	35.5	36.7	36.8	36.8	-0.1
Total Other Types of Transfer Payments
Total Program Activity(ies)	27.9	35.5	36.7	36.8	36.8	-0.1

Comment(s) on Variance(s):

Increased spending for 2010-11 was due to $75,000 in funds transferred from Canadian Heritage in support of a community-based public opinion research project directed by the Société Santé en français.

Audit Completed or Planned:

No.Trois bénéficiaires ont fait l'objet d'une vérification financière (déplacements et frais d'accueil) pour l'exercice 2009-2010. Nous avons reçu les ébauches des rapports vers la fin mai. Nous devons maintenant commenter pour finaliser le rapport. Il reste le suivi à faire, donc le tout n'est pas encore complété.

Evaluation Completed or Planned:

A mid-term review of the program that was initiated in 2010-11 is to be completed in 2011-12. The program's summative evaluation will be launched in 2011-12 and completed in 2012-13.

Name of Transfer Payment Program

Grant for Territorial Health System Sustainability Initiative

Start Date

April 1, 2010

End Date

March 31, 2012

Description

The Territorial Health System Sustainability Initiative (THSSI) is divided into the following three funds:

• The Territorial Health Access Fund intended to: reduce reliance over time on the health care system; strengthen community level services; and build self-reliant capacity to provide services in-territory. Territorial governments each receive $8.6 million, over two years, to support the implementation of these activities.
• The Operational Secretariat Fund which: supports the functioning of the Federal / Territorial Assistant Deputy Minister's Working Group (F/T ADM Working Group) which oversees the implementation of the THSSI; provides capacity support to territorial governments to administer THSSI; and, supports pan-territorial initiatives that address common territorial health priorities. Territorial governments share $4 million, over two years, to support these activities.
• The Medical Travel Fund which offset the costs of medical transportation in each territory. Nunavut is allotted $20.4 million, NWT $6.4 million and Yukon $3.2 million over the two years of the initiative.

Strategic Outcome

A health system responsive to the needs of Canadians

Results Achieved

The overriding goal of the two-year extended THSSI is to assist the three territories to consolidate progress made under the THSSI in reducing the reliance on outside health care systems and medical travel. For territories, consolidating projects that have achieved their goals and integrating projects with an ongoing mandate into territorial core business.

Program Activity:Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants	0.0	0.0	30.0	30.0	30.0	0.0
Total Contributions
Total Other Types of TPs
Total Program Activity(ies)	0.0	0.0	30.0	30.0	30.0	0.0

Comment(s) on Variance(s):

No variance. The program was renewed for 2 additional years to the end of fiscal year 2011-12 at the same amounts ($30 million in total per year).

Audit Completed or Planned:

N/A - This program activity is a Grant.

Evaluation Completed or Planned:

N/A - the program has been renewed for an additional 2 years as stated above.

Name of Transfer Payment Program:

Health Care Policy Contribution Program (Voted)

Start Date

September 24, 2002

End Date

Ongoing

Description

The Health Care Policy Contribution Program (HCPCP) provides contribution funding for projects that address the challenges facing Canada's health care system. The Program fosters strategic and evidence-based decision-making for quality health care, and promotes innovation through pilot projects, evaluation, research, and policy development on current and emerging health care system issues. The Program has continued to evolve in response to changing health care system priorities and currently consists of three components: the Health Care System Innovation Fund, which includes the Canadian Medication Incident Reporting and Prevention System; the Health Human Resource Strategy; and the Internationally Educated Health Professionals Initiative. Two components, the National Wait Times Initiative (NWTI) and the Patient Wait Times Guarantee Pilot Project Fund (PWTGPPF), ended on March 31, 2009 and March 31, 2010, respectively.

The Health Care System Innovation Fund (HCSIF) is designed to be flexible and support projects that address a wide range of health care policy issues to encourage innovation and achieve maximum benefit for the health care system and for Canadians. The Canadian Medication Incident Reporting and Prevention System (CMIRPS) aims to reduce harm caused by preventable medication incidents through activities such as the collection and analysis of standardized incident data and the development and dissemination of information including best practices in safe medication use systems.

The goal of the Health Human Resource Strategy (HHRS) is to aid in the establishment and maintenance of a stable and optimal health workforce. The HHRS is pursuing four key strategic directions: more health care providers; using human resources skills effectively; creating healthy, supportive, learning workplaces; and more effective planning and forecasting. The HHRS supports key stakeholders such as provincial/territorial governments, health professional associations, educational institutions and national non-government health care organizations, in their efforts to address health human resource issues that correspond to both federal and stakeholder goals and priorities. Currently, the distribution of physicians, particularly in underserved locations, is a priority health human resource issue for the federal government and stakeholders.

The Internationally Educated Health Professionals Initiative (IEHPI) is designed to facilitate the integration of internationally educated health professionals by assisting them in obtaining licensure and reducing barriers to practice within the Canadian health care workforce. The ultimate goal is to increase the number of internationally educated health professionals in the health care workforce. In the spring 2005 budget, the Canadian government committed $75 million to support IEHPI over its first five years and $18M annually thereafter. The IEHPI is complementary to the Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications announced by the Forum of Labour Market Ministers in 2009.

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians.

Results Achieved

The Health Care System Innovation Component directed funding toward research and knowledge transfer activities to support innovation and implementation of best practices in key policy areas such as wait times, aging and end of life care.

CMIRPS projects continued to contribute to system level changes to improve the safety of medication use in Canada. For example, through ISMP Canada's individual practitioner incident report analyses, discussions continued with pharmaceutical manufacturers to inform enhancements to labeling and packaging. Over 30 improvements have been made by manufacturers since the inception of CMIRPS. In addition, project results have led Accreditation Canada to include three additional areas of requirements related to medication safety in its 2009 Required Organizational Practices (ROPs): i) dangerous abbreviations, symbols and dose designations, ii) Heparin storage and availability, and iii) Narcotic (opioid) storage and availability. To date, more than 50 recommended system-based safeguards from medication incident analysis learning have been incorporated into Accreditation Canada standards

The Health Human Resource Strategy and the Internationally Educated Health Professionals Initiative enable Health Canada to maintain a leadership role in priority areas of HHR. Some examples include:

• Investments in new or innovative programs across the country that help: to increase the number of qualified providers entering the health workforce; to increase productivity of health care providers by making full and appropriate use of their skills; and to improve access to health care services for all Canadians, particularly in underserved areas. In FY 2010-11, there were 23 projects focused on this investment with activities such as: identifying interventions that were effective in improving workforce utilization; addressing access to physicians in underserved settings; and modernizing medical education.
• During FY 2010-11, the Minister announced $39.5M in funding to seven jurisdictions across Canada to support approximately 100 family medicine residents to train in rural and remote areas. These residencies include those slated for rural areas of Manitoba, Nunavut and NWT through a project with the University of Manitoba which began in 2010.
• Continued work with provinces and territories, professional organizations and other key stakeholders to enable more effective health human resources planning and forecasting for an affordable, sustainable health care system. In FY 2010-11, 12 projects supported this priority through activities such as the development of tools, models and research.
• Notable accomplishments through the IEHPI include annual consultations with provincial and territorial partners to coordinate and collaborate on funding initiatives that have contributed to substantial gains in areas such as the development of assessment, bridging, path-finding, orientation and workplace oriented language and communication programs for specific groups of internationally educated health professionals and internationally educated health professionals broadly. For example, funding enabled the development and implementation of a sustainable entry-to-residency assessment tool for international medical graduates. Jurisdictions have agreed, in principle, to implement the tool, pending discussions on a costing model. An online self-assessment tool was also developed to provide internationally educated physiotherapists with information on the competencies, knowledge and skills required for licensure in Canada. Other funds have supported the harmonization of nursing bridging programs across Canada to facilitate the provision of consistent skills upgrading for internationally educated nurses.

Program Activity:Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants
Total Contributions	40.6	40.9	32.7	29.6	29.2	3.5
Total Other Types of Transfer Payments
Total Program Activity(ies)	40.6	40.9	32.7	29.6	29.2	3.5

Comment(s) on Variance(s):

Planned spending estimates were impacted by many factors that are often beyond the control of funded recipients and Health Canada, including delays and/or rescheduling of activities. In some cases, projects may also be withdrawn altogether. Contributions are monitored closely and potential surpluses are identified as early as possible.

Audit Completed or Planned:

In 2008-09, the Program initiated three recipient audits that were completed in 2009-10. Two recipient audits were completed in 2010-11 for projects selected in 2009-10 and three recipient audits are planned for 2011-12. In 2010-11, the Program participated in the Horizontal Audit of the Management Control Framework for Contribution Programs led by the Audit and Accountability Bureau of Health Canada.

Evaluation Completed or Planned:

In May 2011, work began on the summative evaluation for the Program, due for completion by December 2012.

Name of Transfer Payment Program:

Named Grant to the Canadian Patient Safety Institute

Start Date

December 10, 2003

End Date

March 31, 2013

Description

The Canadian Patient Safety Institute (CPSI) is an independent not-for-profit corporation mandated to provide leadership and coordinate the work necessary to build a culture of patient safety and quality improvement throughout the Canadian health system. CPSI promotes leading ideas and best practices, raises awareness and provides advice on effective strategies to improve patient safety.

This named grant provides financial assistance to support CPSI's efforts to implement the provisions in the 2003 First Ministers' Accord on Health Care Renewal towards improving health care quality by strengthening system co-ordination and national collaboration related to patient safety. CPSI's grant agreement was renewed in 2008 for a five-year period, beginning April 1, 2008 and ending March 31, 2013.

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved

To continue to fulfill its mandate, CPSI is focusing on its strategic priorities of: improving the safety of patient care in Canada through learning, sharing and implementing interventions that are known to reduce avoidable harm; building governance capability; supporting networks; and increasing capacity through evidence-informed resources and tools. For example:

• The Safer Healthcare Now! campaign now includes over 1,100 teams that are active throughout the country implementing 10 evidence-based interventions and contributing to significant reductions in areas like in-hospital death rates from heart attacks, central line blood stream infections, ventilator-associated pneumonia infection rates and surgical site infections;
• Over 1,300 participants registered to take part in Canadian Patient Safety Week 2010, a national annual campaign started in 2005 to inspire improvement in patient safety and quality by highlighting patient safety issues, sharing information about best practices, and expanding patient safety and quality initiatives.
• Training was delivered to increase capacity in local organizations through the Effective Governance for Quality and Patient Safety educational program, the Patient Safety Education Project-Canada, and webinars and workshops in areas such as the Safe Surgery Saves Lives checklist and Root Cause Analysis, as well as through the opportunities provided to participants with the hosting the Canadian Healthcare Safety Symposium (Halifax Series) and Canada's Forum on Patient Safety and Quality Improvement;
• Targeted patient safety research was funded, collaborating with partners to develop a greater understanding of patient safety issues in areas related to home care, primary care, and the economics of patient safety.

Program Activity:
Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants	8.0	8.0	8.0	8.0	8.0	0.0
Total Contributions
Total Other Types of Transfer Payments
Total Program Activity(ies)	8.0<</td>	8.0	8.0	8.0	8.0	0.0

Comment(s) on Variance(s):

 

Audit Completed or Planned:

The Institute's financial records are reviewed and audited annually by independent external accountants.

Evaluation Completed or Planned:

As per their Funding Agreement, CPSI is required to submit a final independent evaluation report to the Minister by March 31, 2012, and to make that report public.

Name of Transfer Payment Program:

Grant to the Canadian Partnership Against Cancer (Voted)

Start Date

April 1, 2007

End Date

March 31, 2012

Description

The Canadian Partnership Against Cancer (CPAC) is responsible for implementing the Canadian Strategy for Cancer Control with the following objectives: (1) to reduce the expected number of new cases of cancer among Canadians; (2) to enhance the quality of life of those living with cancer; and (3) to lessen the likelihood of Canadians dying from cancer.

The mandate of the Canadian Partnership Against Cancer corporation is to provide a leadership role with respect to cancer control in Canada, through the management of knowledge and the coordination of efforts among provinces and territories, cancer experts, stakeholder groups and Aboriginal organizations to champion change and improve health outcomes related to cancer. The CPAC will act as a pan-Canadian resource to provide the most up-to-date knowledge across strategic priority areas including prevention, screening/early detection, patient-centred care, guidelines, health human resources, standards, as well as supporting key research activities and facilitating the development of a pan-Canadian surveillance system.

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved

Since it began operating in April 2007, the CPAC has:

• Armed cancer patients and physicians across Canada with state of the art knowledge about what works best to prevent, diagnose and treat cancer;
• Improved the quality of our national cancer system by monitoring its performance and identifying gaps;
• Provided online cancer training for over 700 medical providers serving more than 215 First Nations communities and organizations with the @YourSide Colleague® Cancer Care Course;
• Improved the quality of life for cancer victims by providing information that addressed their social, emotional and financial needs;
• Implemented a large-scale effort to raise awareness of the common risk factors for cancer and other chronic diseases;
• Initiated the country's largest population health study of risk factors - the Canadian Partnership for Tomorrow Project - which will enrol 300,000 Canadians to explore why some people develop cancer and others do not;
• Expanded cancer screening programs in all provinces and encouraged hard-to-reach populations, such as women living with cervical cancer, to undergo screening - which helped doctors catch cancer earlier; and
• Developed programs to help survivors through the tremendous uncertainty following treatment.

Program Activity:
Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants	58.2	57.5	55.0	55.0	55.0	0.0
Total Contributions
Total Other Types of Transfer Payments
Total Program Activity(ies)	58.2	57.5	55.0	55.0	55.0	0.0

Comment(s) on Variance(s):

 

Audit Completed or Planned:

Health Canada's Audit and Accountability Bureau is expected to complete an Audit of the Grant to the Canadian Partnership Against Cancer in fiscal year 2011-12.

Evaluation Completed or Planned:

Health Canada completed an evaluation of the Partnership in July 2010. The results indicate that the Partnership is a relevant organization that has made good progress and has strong stakeholder support and engagement.

Name of Transfer Payment Program

Grant to the Health Council of Canada

Start Date

September 1, 2004

End Date

March 31, 2015

Description

The Health Council of Canada was established by First Ministers in the 2003 Accord on Health Care Renewal with the mandate to report on jurisdictional progress in meeting Accord commitments. The Health Council's mandate was expanded by First Ministers in the 2004 Health Accord to report on health outcomes and the health status of Canadians.

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved

To continue to fulfill its mandate, as reconfirmed in Spring 2010 by participating federal, provincial and territorial Ministers of Health in their role as Corporate Members of the Council, the organization undertook a wide variety of projects, released associated public reports and undertook supporting promotional activities. For example, in 2010-11 the Council:

• Developed and released three reports on primary health care including: Decisions, Decisions: Family Doctors as Gatekeepers to Prescription Drugs and Diagnostic Imaging in Canada, Beyond the Basics: The Importance of Patient-Provider Interactions in Chronic Illness Care, and At the Tipping Point: Health Leaders Share Ideas To Speed Primary Health Care Reform.
• Conducted regional consultation sessions with aboriginal leaders, groups and health care providers to identify best and promising practices in health and community-based programming that are designed to address current health disparities, leading to a report scheduled for release in Summer 2011.
• Analyzed data from the 2010 Commonwealth Fund International Health Policy Survey to create the report How Do Canadians Rate the Health Care System?
• Released two reports on pharmaceuticals: Generic Drug Pricing and Access in Canada: What are the Implications? and Keeping an Eye on Prescription Drugs, Keeping Canadians Safe.
• Reported on indicators and healthy living through A Citizen's Guide to Health Indicators and Stepping it Up: Moving the Focus from Health Care in Canada to a Healthier Canada.
• Developed a report on governments' progress in five Accord priority areas (wait times, pharmaceuticals management, electronic health and medical records, telehealth and health innovation) in consultation with experts, stakeholders and federal, provincial and territorial officials, for release in Spring 2011.

Program Activity:
Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants	6.2	4.8	10.0	10.0	6.4	3.6
Total Contributions
Total Other Types of Transfer Payments
Total Program Activity(ies)	6.2	4.8	10.0	10.0	6.4	3.6

Comment(s) on Variance(s):

The annual operating budget of the Health Council of Canada can be up to $10M per year. The Health Council of Canada's 2009-10 work plan, approved by Corporate Members, requested $6.4M. Payments were made accordingly.

Audit Completed or Planned:

The Health Council of Canada's financial records are reviewed and audited annually by independent external accountants. Audited financial statements can be found on the Health Council's website: http://www.healthcouncilcanada.ca

Evaluation Completed or Planned:

As per their Funding Agreement, the Health Council of Canada is required to submit a final evaluation framework to the Minister by March 31, 2013, and a final evaluation report by March 31, 2014.

Name of Transfer Payment Program:

Grant to the Canadian Agency for Drugs and Technologies in Health (Voted)

Start Date

April 1, 2008

End Date

March 31, 2013

Description

The Canadian Agency for Drugs and Technologies in Health (CADTH) is an independent not-for-profit corporation funded by federal, provincial, and territorial governments to provide credible, impartial advice and evidence-based information about the effectiveness of drugs and other health technologies to Canadian health care decision-makers. The Named Grant's purpose is to provide financial assistance to support CADTH's core business activities, namely: the Common Drug Review (CDR), Health Technology Assessment (HTA), and the Canadian Optimal Medication Prescribing and Utilization Service (COMPUS). Fiscal years 2010-11 and 2011-12 will see CADTH receiving an extra $1M and $2M respectively to complete a 2 year project on Isotope.

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians.

Results Achieved

Evidence-based information that supports informed decisions on the effectiveness of drugs and health technologies, in terms of health outcomes and cost.

Program Activity:
Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants	16.9	16.9	16.9	17.9	17.9	-1.0
Total Contributions
Total Other Types of Transfer Payments
Total Program Activity(ies)	16.9	16.9	16.9	17.9	17.9	-1.0

Comment(s) on Variance(s):

CADTH received a one time increase in funding of $3M ($1M in 2010-2011; $2M in 2011-20121) for a finite project on Isotope, hence the variance.

Audit completed or planned::

Per Audit Plan approved by the Health Canada Executive Committee to be reviewed by the Departmental Audit Committee (DAC), CADTH audit is planned for fiscal year 2011-12.

Evaluation Completed or Planned:

An independent evaluation of CADTH's core business activities and Isotope project is required as part of Health Canada's 2008-13 funding agreement with CADTH. The funding agreement stipulates that this evaluation cover April 1, 2007 - March 31, 2011, and be submitted to the Minister by October 31, 2012. The evaluation is intended to assess CADTH's performance in achieving the purpose of the Grant, including CADTH's value-for-money.

Name of Transfer Payment Program:

Named Grant for the Mental Health Commission of Canada (Voted)

Start Date

April 1, 2008

End Date

March 31, 2017

Description

As part of Budget 2007, the Government of Canada announced funding for the establishment of a Mental Health Commission of Canada (MHCC), an independent, arm's length organization, designed to focus national attention on mental health issues and to work to improve the health and social outcomes for people living with mental illness. To fulfill its mandate, the Commission has been tasked with:

• facilitating the development of a National Mental Health Strategy;
• undertaking an anti-stigma campaign to reduce the stigma associated with mental illness; and
• building a national Knowledge Exchange Centre to facilitate access to reliable information on mental health and mental illness.

In serving as a national focal point for addressing mental health and mental illness, the MHCC will undertake a more targeted approach to addressing these issues in Canada; foster improved coordination and information sharing among mental health stakeholders and the public health community; and encourage a better public understanding of mental health and mental illness nationally.

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians

Results Achieved

The MHCC has made significant headway since its inception in 2007, in its ability to build partnerships and bring national awareness to the challenges of mental health and illness. Over the past year, progress has been made on several fronts:

Progress continues to be made on the anti-stigma initiative Opening Minds which was launched in 2009. The initiative is supporting 49 anti-stigma pilot projects directed at three target groups - youth, health care providers and the workforce. Successful projects are being replicated nationally through the development of toolkits, publication of papers in reputable scientific journals, conferences and the sharing of information through an extensive network of partners.

The Knowledge Exchange Centre (KEC) has completed a scoping exercise and environmental scan to gain a better understanding of knowledge translation and exchange in the mental health field. In addition, the Commission developed the infrastructure for an online portal providing access to the work of the Commission and highlighting best practices around knowledge exchange in mental health. A launch is planned for 2011-12 fiscal year.

The framework document for the National Mental Health Strategy, Toward Recovery & Well-being, which was released in 2009, continues to be disseminated. Consultations to guide the second phase of the development of the strategy took place during summer 2010 which led to a revision of the approach. The approach is now focussing on priorities that will have the highest impact and produce the best possible return on investment. A final strategy document will be released in early 2012.

Program Activity:
Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants	7.5	12.0	15.0	15.0	15.0	0.0
Total Contributions
Total Other Types of Transfer Payments
Total Program Activity(ies)	7.5	12.0	15.0	15.0	15.0	0.0

Comment(s) on Variance(s):

n/a

Audit Completed or Planned:

As outlined in the Grant Funding Agreement, the MHCC must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2010-11 audited financial statements have now been completed and were presented to the Board of Directors for approval during their meeting on June 14, 2011.

An internal audit by Health Canada is planned for 2011-12.

Evaluation Completed or Planned:

As a requirement of the Funding Agreement with Health Canada, an independent evaluation was undertaken during 2010-11. The evaluation set out to assess the MHCC's progress between July 2007 and December 2010 in the following areas: ability to meet its mandate; effectiveness of policy and/or programs; intended and unintended impacts across the mental health system; and alternative ways to achieve expected results.

The evaluation demonstrated the organization's positive efforts to strengthen its accountability, and performance management processes and practices, and is making progress on most of its initiatives. However, the evaluation also found the MHCC needs to strengthen its outreach and establish a leadership presence within the stakeholder community, increase transparency and integration within the MHCC, and advance the Knowledge Exchange and Partners initiatives.

Progress on implementing the evaluation's recommendations will be reported on through various means, including future Business Plans, Annual Reports, and reports to the MHCC Board of Directors.

Name of Transfer Payment Program

Grant to the Canadian Institute for Health Information (Voted)

Start Date

April 1, 1999

End Date

March 31, 2012

Description

The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization supported by federal, provincial and territorial governments that provides essential data and analysis on Canada's health system and the health of Canadians. CIHI was created in 1991 by the F/P/T Ministers of Health toaddress significant gaps in health information. CIHI's data and its reports inform health policies, support the effective delivery of health services and raise awareness among Canadians about the factors that contribute to good health.

Since 1999, the federal government has provided funding to CIHI through a series of grants and conditional grants, known as the Roadmap Initiative. More recently CIHI's funding has been consolidated through the Health Information Initiative.

Through the past Roadmap Initiatives I, II and II Plus, CIHI was provided with about $260 million since 1999. Budget 2005 allocated an additional $110 million over five years (2005-06 to 2009-10) to CIHI through Roadmap III. This has allowed CIHI to provide quality and timely health information, including the delivery of data on a variety of important health indicators and other health publications to support health sector decision-making and improve accountability.

Since 2007/08, the Health Information Initiative has been providing grant funding to CIHI, replacing the previous Roadmap II, II Plus, III funding and also providing additional funds for new initiatives. This funding allows CIHI to continue work under the Roadmap Initiative and to further enhance the coverage of health data systems so Canadians get information on their health care system, including information on wait times, and continued development of comparable health indicators. The funding will also enable CIHI to respond effectively to emerging priorities. Under this initiative, up to $406.49 million will be delivered to CIHI over five years (2007-08 to 2011-12).

Strategic Outcome

Accessible and sustainable health system responsive to the health needs of Canadians.

Results Achieved

In 2010-11 CIHI continued to make progress in producing more and better data, more relevant and actionable analysis, and improved client understanding and use of CIHI data and information products. The following are selected highlights from the Corporate Performance Reporting 2010-11.

More and Better Data

• There has been solid progress in data collection for National Ambulatory Care Reporting System (NACRS) Emergency Department data holdings as a result of focused effort on improving comprehensiveness.
• NACRS Emergency Department (ED) data holdings:
  • There has been progress in data collection for British Columbia and Quebec.
  • Alberta is now submitting complete data.
  • Saskatchewan is submitting partial data.
• NACRS Day Surgery and Ambulatory Clinics data holdings - Alberta is now submitting complete data.
• Continuing Care Reporting System (CCRS):
  • There has been progress in the number of Alberta facilities submitting data.
  • Ontario is now submitting complete data.
  • NWT is in discussions regarding data submission.
• Home Care Reporting System (HCRS):
  • There has been progress in the number of British Columbia and Alberta facilities submitting data.
  • Plans are being developed regarding PEI data submission.
• Hospital Mental Health Database (HMHDB) - Quebec is now submitting full data.
• National Physicians Database (NPDB) - The payments data in the NPDB is predominantly Fee-for Service (FFS) payments, by physician. FFS has been a declining portion of total physician remuneration and now stands at about 73% of total physician payments. CIHI is working with the jurisdictions to mitigate this situation. CIHI is starting to probe select jurisdictions for physician billing data at the patient level, rather than at the physician level. This is important in the attempt to link this data to other CIHI datasets and enrich our analytic capabilities. CIHI has patient level data for Saskatchewan and are also in the process of accessing Ontario's data. As well, they have had early discussions with Alberta. The Yukon has not sent CIHI any NPDB data this year.
• National Prescription Drug Utilization Information System (NPDUIS) - Ontario and FNIHB are now submitting complete data
• National System for Incident Reporting (NSIR) Medication Incidents data holding - four new jurisdictions - Saskatchewan, Ontario, Nova Scotia and Nunavut are now submitting partial data.
• Physiotherapists Database (PTDB) - Nova Scotia is now submitting full data.
• Progress has been made in the currency (timeliness) of data in the Hospital Morbidity (HMDB), Hospital Mental Health
  (HMHDB), Joint Replacement (CJRR) and Medical Imaging Technology (MIT) data holdings. In the case of HMDB the
  currency improved from 4-year-old data to 1-year-old data and from 4-year to 2-year old data for HMHDB.

Relevant and Actionable Analysis
Over the last year, CIHI continued to increase the overall depth and breadth of analysis and reporting across all data holdings, developing and releasing 34 analytic products. These included special analytic reports relevant to ongoing themes (e.g. access and quality of care, wait times, continuity of care) and special studies related to priority health services themes (e.g. costs, patient safety). CIHI also developed and released a number of annual reports and various other policy-relevant analytic outputs relating to health services, health expenditures, pharmaceuticals, and health human resources.

Improved Understanding and Use
CIHI completed 380 requests for data in 2010-11, the majority of which (91%) were completed within 90 days, a higher proportion than was achieved in the previous fiscal year. An area of focus for the organization is improving access to CIHI's data and reports for our clients and stakeholders through the development of better access tools. The Data Request Tracking Tool (DaRT) is a system launched early in 2008-09 that captures information on all custom data requests from external clients. In 2010-11, CIHI staff handled a total of 523 customized data requests, which is a 29% increase from 405 in the previous year. The vast majority (79%) of the data requests were from third-parties, with the remaining 21% being requests from data suppliers themselves or Ministries of Health. Effective April 1st, 2011, an automated process tool replaced the DaRT excel spreadsheets to track and report on CIHI data requests. This system is expected to improve monitoring of data requests and administrative processes related to data requests.

Media Coverage
A concerted effort was made this year to focus on quality over quantity in media products. As a result, this fiscal year saw 23 media products (16 releases, 7 advisories), compared to 28 (17 releases, 11 advisories) in 2009-10:

• While there were fewer releases, the results suggest that they were more relevant. The number of solicited (media release) mentions was slightly higher this year than last year, and 54% higher than it was two years ago.
• Broadcast coverage was up significantly when compared to the previous two fiscal years. Broadcast coverage is considered an important indicator, as audiences tend to be more "captive" and engaged in what they are hearing.
• Print mentions declined. There are two factors that may explain this:
  • newspapers are shrinking in size and market share overall across Canada, as more people turn to the web for news
  • two embargo breaches this fiscal year for La Presse and the Sun newspaper chain, both had their embargo privileges revoked for three-month periods. As a result, they stopped covering CIHI data for the period and a significant number of mentions with wide circulation were lost.

Tools to capture mentions and audience reach are constantly evolving - for web metrics in particular - making

year-over-year comparisons challenging. The large discrepancy in total reach between this year and last year is

largely driven by web reach numbers which are still being honed for greater accuracy.

Program Activity:
Canadian Health System

	2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
Total Grants	81.7	81.7	81.7	81.7	81.7	0.0
Total Contributions
Total Other Types of Transfer Payments
Total Program Activity(ies)	81.7	81.7	81.7	81.7	81.7	0.0

Comment(s) on Variance(s):

Audit Completed or Planned:

In accordance with CIHI's Funding Agreement with Health Canada, a performance audit of the Health Information Initiative (HII) was completed and provided to Health Canada by March 31, 2011. This report presented a summary of the approach followed in planning and conducting the performance audit as well as observations and recommendations for improvement.

Evaluation Completed or Planned:

Third Party Evaluation completed and provided to Health Canada in 2010-11. CIHI undertook an Independent Evaluation, as part of its obligations under the Health Information Initiative (HII) Funding Agreement with Health Canada. The overall conclusion from the evaluation is that CIHI has met the objectives of the Health Information Initiative.

Name of Recipient: Rick Hansen Man in Motion Foundation

Start Date: April 1, 2007

End Date: March 31, 2012

Total Funding: $30M

Description:

The Rick Hansen Man in Motion Foundation (RHF) is an independent, not-for-profit organization founded by Rick Hansen in 1988 to create solutions to improve the lives of Canadians with spinal cord injury (SCI) and to drive advances in SCI research.

Funding is used to implement a Strategy being carried out by the Rick Hansen Institute (RHI). The Strategy has the following objectives:

1. reduce the incidence and severity of permanent paralysis resulting from SCI;
2. increase the recovery of function following SCI;
3. reduce the incidence and severity of secondary complications associated with SCI;
4. increase the level of satisfaction with quality of life among Canadians with SCI;
5. enhance the customized response to the priority unmet needs of Canadians with SCI; and,
6. establish a world class Canadian SCI registry and data management platform.

Strategic Outcome(s): Accessible and sustainable health system responsive to the health needs of Canadians.

Summary of Results Achieved by the Recipient: Key accomplishments of the RHI include:

• The development and expansion of the Rick Hansen Spinal Cord Injury Registry to promote collaborative national research and the collection of longitudinal clinical data of people with traumatic SCI across the health care continuum.
• Partnering with Accreditation Canada to develop comprehensive, evidence-based standards for SCI service delivery in Canada.
• Sponsorship of the ReJoyce (Rehabilitation Joystick for Computerized Exercise) system clinical trial. ReJoyce is a hand and arm rehabilitation system that is now a commercial product being sold in North America and Europe and waiting approval for sale in Asia.
• Creation and dissemination of "Actionable Nuggets" on best practices in SCI care to family physicians in Canada.
• Creation and dissemination of SCI Physical Activity Guidelines.
• Support of translational research (24 projects in 2010-11).

Program Activity: Canadian Health System
($ millions)

2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
$0	$0	$0	$0	$0	$0

Comments on Variance(s): None noted for 2010-2011 (the full $30M was provided to the recipient upon signing of the agreement in 2007).

Significant Evaluation findings by the recipient during the reporting year and future plan:

The RHI conducted an Independent Mid-Point Review to measure its overall performance in achieving the strategic plan as outlined in the funding agreement with Health Canada. The Mid-Point Review, submitted to Health Canada June 18, 2010, confirmed the underlying rationale for HC funding and the need for the continued work of the RHI. Generally, good progress was reported in creating the infrastructure to engage SCI clinicians and researchers, create and manage the translational research program, and expand the Rick Hansen SCI Registry.

Some methodological issues and limitations were noted with the Review and the data collected. In addition, opportunities were identified for improved communication and transparency, establishing linkages with other funding agencies (such as the Canadian Institutes of Health Research), and improving the research grants administration process. The RHF and RHI are working closely with Health Canada to implement improvements outlined in their management response to the Mid-Point Review.

A summative performance evaluation for the RHI is scheduled to be submitted to Health Canada by July 31, 2012.

Significant Audit findings by the recipient during the reporting year and future plan:

As outlined in the funding agreement, the RHI must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2009-2010 annual audit showed no major concerns. The 2010-2011 audited financial statements have now been completed and were submitted to Health Canada July 29, 2011.

The RHI is also required to engage an independent auditor to conduct a performance audit. The performance audit is scheduled to be submitted to Health Canada by March 31, 2012. The performance audit will assess the efficiency, economy and effectiveness with which Health Canada's funds have been used.

Name of Recipient: Canadian Health Services Research Foundation (CHSRF)

Start Date: 1996-1997

End Date: N/A

Total Funding: $151.5M

Description:

1996 - $66.5 M endowment (received over five years) to establish the CHSRF;

1999 - $25 M one-time grant to support a ten-year program to develop capacity for research on nursing recruitment, retention, management, leadership and the issues emerging from health system restructuring (Nursing Research Fund or NRF); and a $35 M one-time grant to support the CHSRF's participation in the Canadian Institutes of Health Research (CIHR); and

2003 - $25 M one-time grant to develop a program to equip health service professionals and their organizations with the skills to find, assess, interpret and use research to better manage the Canadian health care system (Executive Training for Research Application or EXTRA) over a thirteen-year period.

CHSRF's mission is to improve the health of Canadians by:

• Capturing the best evidence about how healthcare and other services can do more to improve the health of Canadians;
• Filling critical gaps in evidence about how to improve the health of Canadians, by funding research and evaluation; and
• Supporting policy makers and managers to develop the skills needed to apply the best evidence about services to improve the health of Canadians.

CHSRF's work contributes to Health Canada's aim of strengthening the knowledge base to address health and healthcare priorities. More specifically, CHSRF's programs further the development of health human resources, provide health managers with tools to improve primary and continuing care, and support nursing research from a health system perspective.

Strategic Outcome(s): Accessible and sustainable health system responsive to the health needs of Canadians.

Summary of Results Achieved by the Recipient:

Effective Governance for Quality and Patient Safety

• The effective governance program (for citizens on healthcare boards) was delivered as a pilot in three Manitoba regional health authorities, and to 15 health organizations in the Hamilton-Niagara-Haldimand-Brant region.
• Following the official launch of the program where 19 health organizations participated, one regional health authority and the Saskatchewan Cancer Agency took part in the program, followed by a session for eight health organizations in Saskatoon.
• After the Manitoba pilot, Manitoba Health, the Regional Health Association of Manitoba and the Manitoba Institute for Patient Safety jointly requested training for the remaining regional health authorities in 2011.
• In Fall 2010, the Ontario Ministry of Health and Long-Term Care and the Ontario Hospital Association entered into discussions around the delivery of effective governance programs across Ontario in 2011.

Patient Engagement

• A call for proposals attracted 74 applications; 11 patient engagement projects (PEP) were selected.
• Twenty-five team members, including representatives from all selected projects met for a learning workshop, following which all PEP teams submitted their project implementation and evaluation plans.

Accelerating Evidence-Informed Change

• Launched new conference series, Picking Up the Pace (PUP), a biennial event showcasing innovation in key areas of the health system. Approximately 300 senior policy-makers, healthcare managers and clinicians participated. Forty-seven effective innovations in primary care from across Canada were featured.

Executive Training for Research Application (EXTRA)

• Ongoing cohort management (fellows participate in four residency sessions over two years during which they study six curriculum modules)
• Twenty-four new fellows were accepted through competition into EXTRA

CEO Forum

• The theme of the 2010 forum was Metrics for Healthcare Quality: The Leader's Role, and focused on ways to measure healthcare in order to support efforts to improve quality and performance. More than 120 CEOs attended.
• CHSRF launched a new, annual survey of leaders' perspectives on the challenges facing the healthcare system to inform the CEO Forum, establish a channel for CHSRF to engage with organizations that are leading improvements and contribute to renewal of the EXTRA curriculum.

Northern Initiatives

• CHSRF and the Northwest Territories Department of Health and Social Services hosted the first of four workshops aimed at developing a model for chronic disease management in the territory.
• Awarded a two-year grant to the Institute for Circumpolar Health Research and the Yellowknife Health and Social Services Authority to explore the use of information technology to improve physician support services in the Northwest Territories.
• Capacity for Applied and Developmental Research in Evaluation in Health Sciences and Nursing (CADRE)
• Much of the effort in 2010 was focused on wind-down, fulfilling accountability and reporting requirements, and evaluation. The formal evaluation, to be completed in 2011 and released in 2012, will assess the extent to which CADRE has influenced health system decision-making and academia.

Nursing

• Published "Clinical Nurse Specialists and Nurse Practitioners in Canada: A decision support synthesis." Based on the recommendations of the report, CHSRF, the Canadian Nurses Association and Health Canada's Office of Nursing Policy are providing direction on a forum on advanced practice nursing to be held in 2011. CHSRF also funded a special issue of the Journal of Nursing Leadership, which will be released in 2011.

Healthcare financing, innovation and transformation

• Five research papers on cost drivers, a paper on healthcare financing, and a policy options paper on hospital funding were completed (for release in 2011). Health Canada contributed $500K in contribution funding to this work.
• Partnered with policy research groups on events across Canada including: the Invitational Symposium on Healthcare Renewal, a healthcare roundtable to discuss the recommendations of the healthcare chapter of the Organisation for Economic Co-operation and Development's Economic Survey of Canada 2010; and a national forum on high-quality, sustainable funding models with the Canadian Institute for Health Information and the Institute of Health Economics.

Planning for the aging population

• Hosted a national and five regional roundtables as part of its series, Better with Age: Health systems planning for the aging population, which brought together more than 200 policy-makers, healthcare executives, researchers and citizens from across Canada. Analysis of the themes that emerged--including integrated care, ageism, choice, patient-centred care and health human resource availability--is underway and CHSRF will release six roundtable reports and one synthesis report in 2011.

Primary healthcare innovation

• Provided funding for and worked with a pan-Canadian primary healthcare working group to help plan the Canadian Institutes of Health Research's primary healthcare summit (+500 attendees in January).
• Published three reports on primary healthcare improvement; released Clinical Nurse Specialists and Nurse Practitioners in Canada: A decision support synthesis; supported five Research, Exchange and Impact for System Support (REISS) projects focusing on the interface between primary healthcare and public health; and provided a one-time grant of $50,000 to the C.T. Lamont Primary Healthcare Research Centre at the University of Ottawa for an economic analysis of the consequences of achieving a high-quality primary healthcare system in Canada.

Publications and programs

• 5 Researcher on Call webinars
• 3 Mythbusters articles
• 2 editions of Pass it on!
• Published Quality of Healthcare in Canada: A Chartbook, undertaken with the Canadian Institute for Health Information, the Canadian Patient Safety Institute and Statistics Canada.

Recognition and capacity development

• Excellence through Evidence Award and Health Services Research Advancement Award Mythbusters Award
• Canadian Harkness Fellowships in Health Care Policy and Practice (worked with The Commonwealth Fund to support the annual selection of up to two Canadian fellows, and hosted the annual Canadian Health Policy Briefing tour)

Additional information is available in CHSRF's 2010 Annual Performance Report which was submitted to Health Canada on 30 May 2010 (available online at www.chsrf.ca).

Program Activity:
($ millions)

2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
$0	$0	$0	$0	$0	$0

Comments on Variance(s): Conditional grants to CHSRF (see list in section 5 above) were all issued prior to the 10-11 reporting period.

Significant Evaluation findings by the recipient during the reporting year and future plan:

• Instituted a new organization-wide Program Performance Management (PPM) evaluation system based on the "outcome mapping" methodology
• Initiated several major evaluations including: a review of the Executive Training for Research Application program; a review of the Capacity for Applied and Developmental Research and Evaluation in Health Services and Nursing program (in wind-down); and an evaluation, in collaboration with Health Canada, of the Listening for Direction national consultation exercise

Significant Audit findings by the recipient during the reporting year and future plan:

The 2010 external financial and pension plan audits showed no major concerns, with the auditors reporting clean audits with no evidence of fraud or illegal acts.

The 2010 internal controls review examined the operational area of investments, insurance and commodity taxes functions. The recommendations from the internal controls review will be implemented in 2011.

Name of Recipient: Canada Health Infoway (Infoway)

Start Date: March 9, 2001

End Date: N/A

Total Funding: $2.1B*
*Infoway received $1.2 B as lump-sum grants between 2001 and 2004. The $400M allocated in 2007 was subject to new conditions - these funds flow to Infoway on an as-needed basis. An additional $500M for Infoway was announced in Budget 2009 and confirmed in Budget 2010. In March 2010, Health Canada and Infoway signed a related funding agreement. The $500M funds will flow to Infoway on an as-needed basis.

Description:

Canada Health Infoway Inc. (Infoway) is an independent, not-for-profit corporation established in 2001 to accelerate the development of health information and communication technologies such as electronic health records, telehealth and public health surveillance systems on a pan-Canadian basis. Its Corporate Members are the 14 federal, provincial and territorial Deputy Ministers of Health.

Since 2001, the federal government has committed the following funding allocations: $500 million in 2001 in support of the September 2000 First Ministers' Action Plan for Health System Renewal to strengthen a Canada-wide health infostructure (with the electronic health record - EHR - as a priority); $600 million in the First Ministers' Health Accord of February 2003, to accelerate implementation of the EHR and Telehealth; $100 million as part of Budget 2004 to support development of a pan-Canadian health surveillance system; and $400 million as part of Budget 2007 to support continued work on EHRs and wait times reductions. Also, as part of the Economic Action Plan, and as indicated in Budget 2009, the Government of Canada announced an additional investment of $500 million in Infoway, to support continued implementation of EHRs, implementation of electronic medical records in physicians' offices, and integration of points of service with the EHR system. Following a due diligence process, Budget 2010 announced the government's intention to move forward with the transfer of the funds. In March 2010, Health Canada and Infoway signed a related funding agreement, which includes enhanced accountability provisions.

It is anticipated that Infoway's approach, where federal, provincial and territorial (F/P/T) governments participate as equals, toward a goal of modernizing the health information system, will reduce costs and improve the quality of health care and patient safety through coordination of effort and avoidance of duplication.

Strategic Outcome(s): Accessible and sustainable health system responsive to the health needs of Canadians.

Summary of Results Achieved by the Recipient:

Investment Strategy - Infoway is a strategic investor, with a funding formula covering up to 100% of territorial and 75% of provincial project development and implementation costs. Infoway provides a portion of system development costs and supports project oversight while P/T partners are responsible for actual system development, implementation and overall funding, including ongoing operational costs. In 2010-2011, Infoway approved $390.5 million in new projects (21 projects), bringing its cumulative allocation of investments to $2.007 billion (315 projects since Infoway's inception).

Electronic Health Records (EHRs) - Infoway's goal for EHRs, endorsed by all jurisdictions is that: "by 2010, every province and territory and the populations they serve will benefit from new health information systems that will help transform their health care delivery system. Further, by 2010, the electronic health records of 50 per cent of Canadians and by 2016, those of 100 per cent of Canadians, will be available to their authorized health care professionals." The first part of this goal has been achieved; as of March 31, 2011, the core components of an EHR were in place for 50.1% of Canadians.

In 2010-2011, Infoway and the P/Ts continued to make significant progress on the various components of the EHR - client and provider registries, laboratory information and diagnostic imaging systems, drug information systems and clinical reports. For example, the following results were achieved in 2010-2011.

Drug Information Systems (DIS): It is estimated that 30,000 health care professionals are using second generation drug information systems. As an example, British Columbia's PharmaNet DIS captures every prescription dispensed in the province's pharmacies and provides alerts to pharmacists. In 2010, more than 60 million prescriptions were reviewed via PharmaNet, resulting in the identification of 32 million potential drug interactions.

Diagnostic Imaging Systems (DI Systems): As of March 2011 an estimated 43,000 health care professionals are using diagnostic imaging system technology. This has improved the turnaround time of receiving the results of these tests by 30-40%, patients are able to get their results faster and start treatment earlier. Infoway's DI system program is available in several provinces.

Telehealth - Infoway is working to implement solutions that facilitate the delivery of health information and services between patients and providers over distance, with a focus on Aboriginal, official language minority, northern and remote communities. Strategic telehealth plans are in place in most jurisdictions.

In 2010, Infoway commissioned an independent pan-Canadian study to describe telehealth use in Canada and the benefits achieved to date. The report was released in May 2011. This report, Telehealth Benefits and Adoption: Connecting People and Providers Across Canada, describes how telehealth has delivered a number of benefits for clinicians, patients and the health care system. The report highlights that telehealth is:

• Growing and on its way to becoming a mainstream way of delivering care
• Reducing travel by patients, families and health care providers
• Making it easier for Canadians in rural and remote areas to access specialized care that they need

Electronic Medical Records (EMR) - As a result of the new funding in 2010, Infoway has allocated funds toward investment in EMR systems in community based practices and outpatient settings. Investments will be used toward clinical peer support networks, innovation projects and consumer health solutions.

In 2010-2011, Infoway worked with jurisdictions and vendors to develop user guides and a set of software solutions to accelerate the interoperability of EHRs, especially with point of service systems such as physicians' office EMRs, hospital information systems and community pharmacy systems.

Consumer Health Solutions - As an emerging area of interest and investment for Infoway, this program will educate and empower Canadians by providing electronic access to their medical record. For example, Infoway is funding Alberta's MyHealth.Alberta.ca initiative. Once complete, Alberta's personal health portal --- the first in Canada -- will provide Albertans secure access to their personal health information through the province's electronic health record system. Patients will be able to track their own personal health data such as blood pressure readings, insulin levels, weight, and immunizations. The portal was launched in May, 2011.

Innovation and Adoption - In the past fiscal year, Infoway launched new investment programs focused on accelerating the extent to which clinicians and Canadians receive tangible value from the use of information and communications technology. Investment is being made in Clinician Peer Support Networks, training and other initiatives to foster innovation in eHealth.

Program Activity: Canadian Health System
($ millions)

2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
$122.9	$64.49	$91.84	$91.84	$91.84	$0

Comments on Variance(s): N/A

Significant Evaluation findings by the recipient during the reporting year and future plan:

In March 2011, Infoway released an independent evaluation of its performance in achieving the objectives of the 2003 funding agreement with the Government of Canada. The report concluded that Infoway has met or made progress on the outcomes specified in the 2003 funding agreement, despite the existing challenges. The evaluation found that the appropriate strategies are in place to achieve the outcomes specified in the funding agreement and projects are managed in a cost effective manner and are achieving the intended results.

In March 2013, Infoway is expected to release an independent evaluation to measure its performance in achieving the objectives of the 2010 funding agreement.

Significant Audit findings by the recipient during the reporting year and future plan:

No audit activity was undertaken in the 2010-2011 fiscal year.

In March 2013, Infoway is expected to submit an independent performance evaluation (value-for-money) audit report, relating to use of funds under all funding agreements.

Name of Recipient: Mental Health Commission of Canada -- Conditional Grant to support Research Demonstration Projects in Mental Health and Homelessness

Start Date: April 1, 2008

End Date: March 31, 2013

Total Funding: $110M

Description: As part of Budget 2008, the federal government committed $110 million in funding to the MHCC to support five research demonstration projects in mental health and homelessness over five years (2008-2013). Among the objectives, these projects will contribute to building knowledge on how to increase access to adequate housing in combination with the provision of necessary support services, and will result in the development of best practices that will support future interventions and long-term improvements to the lives of Canada's most vulnerable.

The initiative uses a 'Housing First' approach, which stresses recovery and consumer/tenant choice, and compares this with traditional care. A total of 2285 homeless people living with a mental illness will participate of which 1,325 people will be given a place to live, and will be offered services to assist them over the course of the initiative. The remaining participants will receive the regular services that are currently available in their cities. The goal is to find out which services provide the best outcomes to homeless people living with mental illness. Expected results include:

• the development of a knowledge-base accessible to all jurisdictions;
• the identification of effective approaches to integrating housing supports and the Basket of Necessary Services or other "prerequisites";
• the development of Best Practices and Lessons Learned; produce data that is reflective of mental health issues among Canada's homeless population;
• the identification of unique problems and solutions for diverse ethno-cultural groups within this population; and
• support improvements at each project site to address fragmentation through improved system integration and support.

Strategic Outcome(s): Accessible and sustainable health system responsive to the health needs of Canadians

Summary of Results Achieved by the Recipient: The project, entitled, At Home /Chez Soi (French)/Niapin (Cree), was launched in November, 2009, in Vancouver, Winnipeg, Toronto, Montreal, and Moncton. Each project focuses on a distinct group of homeless people living with mental illness such as those who also have a substance abuse problem, Aboriginal Canadians and non-English speaking new immigrants. As of May 2011, 95% of the intended participants have been enrolled in the study, of which, 900 have been provided housing. Overall, all sites are well on track in meeting their target enrolment. The initiative continues to gain national and international recognition, with interest from various stakeholders and countries including France and Australia interested in adapting the program. The Commission continues to work collaboratively with provincial and municipal levels of government, researchers, local service providers and people with lived experience of mental illness and homelessness.

Program Activity: Canadian Health System
($ millions)

2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
$110	$0	$0	$0	$0	$0

Comments on Variance(s): N/A

Significant Evaluation findings by the recipient during the reporting year and future plan: As per the terms and conditions of the funding agreement, the Commission is required to carry out an Independent Evaluation within 5 years and 180 days to measure the Commission's overall performance in achieving the purpose of the Grant funding.

The homelessness initiative was also included as part of the overall performance evaluation for the Commission that took place in FY 2010-2011. The evaluation set out to assess the Commission's progress between July 2007 and December 2010 in the areas of:

• ability to meet its mandate
• effectiveness of policy and/or programs;
• intended and unintended impacts across the mental health system; and
• alternative ways to achieve expected results.

The evaluation demonstrated the organization's positive efforts to strengthen its accountability, and performance management processes and practices, and is making progress on most of its initiatives including the Homelessness initiative. Findings were based on a review of project documents, an online survey, focus groups, and a series of interviews with key informants

Significant Audit findings by the recipient during the reporting year and future plan: As outlined in the funding agreement, the Commission must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2010-11 audited financial statements have now been completed and were presented to the Board of Directors for approval on June 14, 2011.

The Homeless project is expected to be part of the internal audit by Health Canada planned for 2011-12.

Name of Horizontal Initiative:

Chemicals Management Plan

Name of Lead department(s):

Health Canada/Environment Canada

Lead Department Program Activity:

Sustainable Environmental Health/ Substances and Waste Management

Start date of the Horizontal Initiative:

FY 2007-2008

End date of the Horizontal Initiative:

FY 2010-2011

Total Federal Funding Allocation (start to end date):

$299.2 M

Description of the Horizontal Initiative (including funding agreement):

The Chemicals Management Plan (CMP) is part of the Government's comprehensive environmental agenda and is managed jointly by Health Canada (HC) and Environment Canada (EC). The activities identified in this plan build on Canada's position as a global leader in the safe management of chemical substances and products, and focus upon timely action on key threats to health and the environment.  It includes risk assessment, risk management, monitoring and surveillance, as well as research on chemicals which may be harmful to human health or the environment.

The CMP also puts more responsibility on industry through realistic and enforceable measures, stimulates innovation, and augments Canadian competitiveness in an international market that is increasingly focused on chemical and product safety.

HC and EC collectively manage the CMP funding and ensure that it is aligned with human health and environmental priorities.

The following program areas were involved in CMP activities in 2010-2011:

In Health Canada:

• Health Products and Food Branch:
  • Food Directorate
  • Biologics and Genetic Therapies Directorate
  • Natural Health Products Directorate
  • Policy, Planning and International Affairs Directorate
  • Therapeutic Products Directorate
  • Veterinary Drugs Directorate
• Healthy Environments and Consumer Safety Branch:
  • Consumer Product Safety Directorate
  • Safe Environments Directorate
  • Environmental and Radiation Health Sciences Directorate
• Pest Management Regulatory Agency

In Environment Canada:

• Environmental Stewardship Branch
  • Chemicals Sector Directorate
  • Legislative and Regulatory Affairs Directorate
  • Public and Resources Sectors Directorate
  • Energy and Transportation Directorate
  • Environmental Protection Operations Directorate
• Science and Technology Branch
  • Science and Risk Assessment Directorate
  • Wildlife and Landscape Sciences Directorate
  • Atmospheric Science and Technology Directorate
  • Water Science and Technology Directorate
• Enforcement Branch
• Strategic Policy Branch
  • Economic Analysis Directorate

For more information, see the Government of Canada's Chemical Substances Website at: http://www.chemicalsubstanceschimiques.gc.ca/

Shared outcome(s):

High-level outcomes for managing the CMP include:

• Canadians and their environment are protected from the harmful effects of chemicals;
• identification, reduction, elimination, prevention or better management of chemicals substances and their use;
• direction, collaboration and coordination of science and management activities;
• understanding of the relative risks of chemical substances and options to mitigate;
• biomonitoring and environmental monitoring of substances;
• risk assessment and risk management; and
• informed stakeholders and the Canadian public.

Governance structure(s):

• HC shares the lead on the CMP with EC. The CMP consists of five inter-related program elements to be planned, delivered and evaluated within an integrated framework, managed jointly by HC and EC.
  
  Governance is assured through a joint HC/EC Assistant Deputy Ministers Committee (CMP ADM Committee) and the Interdepartmental Chemicals Management Executive Committee (CMEC). These Committees were established to maximize the coordination of efforts, while minimizing duplication between the two departments.
• The CMP ADM Committee provides strategic direction, coordination and a challenge function for the overall implementation and review of results and resource utilization on CMP initiatives.  The Committee serves as a high-level forum for making recommendations on chemicals management to respective Deputy Ministers.
• The CMEC is the key management committee at the Director General level to support the development of joint EC-HC strategic directions.  It is also a formal body for joint consultations and cooperation to ensure timely and concerted actions in implementing the CMP work activities in an integrated fashion.  The CMEC reports to the ADM Committee, providing recommendations on program implementation, results and resource utilization.

($ millions)

Federal Partners	Program Activity	Names of Programs	Total Allocation (from Start to End Date)	Planned Spending 2010-11	Actual Spending 2010-11	Expected Results for 2010-2011	Results Achieved in 2010-2011
Health Canada	Sustainable Environmental Health	a. Risk Assessment	$9.9 M	$3.5 M	$3.5 M	Increase level of Canadian public awareness of chemical management issues and actions being taken Risk assessments are conducted and risk management objectives are met for regulations and other control instruments for substances and the products of biotechnology Declining trends in levels of risk, adverse reactions, illnesses and injuries from toxic chemical substances in the environment and their use and/or the risk of exposure to Canadians. Enhanced knowledge of environmental hazards and evidence on which regulatory decisions are based.	A key component of the CMP is taking immediate action on approximately 200 of the highest priority chemicals identified in the Challenge program. Through the "Challenge" Initiative - industry and stakeholders were challenged to provide information on chemicals and on safe management practices for 196 of the highest priority substances found in commerce.  The Government of Canada has now released information on all Challenge substances identifying those that are a potential concern to human health or environment, completed the collection of information under section 71 from industry on all substances, published draft or final screening risk assessments on 192 of the 196 substances in the "Challenge", and initiated risk management action on 45 substances that may pose a risk to our health and/or the environment. The majority of CMP risk assessments that were scheduled for publication during 2010-2011 were completed.  These included the release of the final Screening Assessment Reports for Batches 8 to 10 and draft Screening Assessment Reports for Batches 10 to 12, including additional substances from Batch 1 (CHPD), Batch 6 and Batch 8.  In total, draft risk assessment reports were published for 47 substances, or classes of substances, and final assessment reports were published for 43 substances, or classes of substances. Several reports for non-Challenge substances were also published in the Canada Gazette, Part I (final Screening Assessment Report on Ethylene Glycol and final State of the Science report on DecaBDE; draft Screening Assessment Reports on Quinoline, PFOA, PFCAs and HBCD).  There was also a follow-up Assessment report on Aniline published in 2010-2011. During 2010-2011, three draft Screening Assessment Reports covering approximately 70 petroleum substances that have been identified as being restricted to petroleum refineries and upgrader facilities were published in the Canada Gazette, Part I.  Strategies and methods to assess the remaining substances (or groups of substances) within the Petroleum Stream are currently being developed. As part of the Challenge, risk management approaches were published for nine substances in Batches 8 to 10 that were determined to be harmful to human health or the environment (approaches for Batches 11-12 are planned for 2011-2012) and risk management scopes were published for 13 substances in Batches 8 to 11 that were proposed to meet one or more criteria of section 64 of the Canadian Environmental Protection Act (CEPA, 1999) (Batch 12 scopes are partially complete). Proposed risk management instruments were developed for Batches 1 and 2 and have been published for comment, as per planned timelines. In total, 34 risk management instruments have been applied to CMP Challenge substances during 2010-2011. This year, actions taken or proposed for substances that were determined to be harmful to human health or the environment under the Challenge included final additions to Health Canada's Cosmetic Ingredient Hotlist (16 CMP substances from Batches 3-9 were added to the Health Canada's Cosmetics Ingredient Hotlist on March 2011; to date, 25 CMP substances have been added to the Hotlist from Batches 1-9) targeted dietary surveillance activities for substances of concern where food is the main source of exposure, and proposed listings and delistings of some food additives from the Food and Drug Regulations. As well, 16 proposed CEPA instruments for substances determined to be harmful to human health or the environment in Batches 1 to 3 were published in Canada Gazette, Part I, including Proposed Pollution Prevention Notices for four substances [Bisphenol A, Isoprene, Siloxanes (D4) and TDI]. For substances where current exposure is not of concern, but where there are concerns that new activities or uses  resulting in additional exposure could harm human health or the environment, the Significant New Activity (SNAc) regulatory instrument under CEPA, 1999 provides for information gathering and assessment prior to this new activity or use being initiated. SNAcs were either proposed or implemented for 55Challenge substances concluded to either not meet section 64 of CEPA 1999 or to not be in commerce in Canada. There were also approximately26 proposed or implemented SNAcs for Challenge substances that met one or more criteria of section 64 of CEPA 1999. The Government of Canada continued to seek advice and input from the CMP Stakeholder Advisory Council (members include non-governmental organizations and industry).  HC and EC co-chaired aface-to-face meeting in May 2010 where the Council provided advice and input on CMP related activities.  Advice and input from the CMP Stakeholder Advisory Council, as well as other stakeholders, was also sought at a workshop on selecting the next round of substances for the CMP which was held in November 2010. Environmental monitoring programs have been integrated and augmented under the CMP to provide a truly national program, capable of meeting the government's existing monitoring commitments as well as being responsive to emerging chemicals of concern.  Environmental monitoring and surveillance of chemicals in air, food, water, sediments, fish and birds, as well as releases from wastewater and landfills is coordinated by an EC led working group (including HC representation). The HC CMP Monitoring and Surveillance Initiative supports multi-year projects to advance our knowledge related to the following priorities: national biomonitoring programs, targeted population biomonitoring studies, biomonitoring supportive research, and targeted environmental monitoring. Nineteen multi-year projects were funded under this initiative, with ten initiated in 2010-2011. Projects included: A three year national survey of contaminants in Canadian drinking was completed in 2010-2011. The data is providing updated exposure information to be used in the preparation/update of Guidelines for Canadian Drinking Water Quality. Phase 1 of the multi-year Canadian House Dust Study was completed in 2010-2011.  This project is providing nationally-representative baseline estimates of chemicals found in urban house dust, with the initial determination of bioaccessible lead. A study on dermal absorption of substances being assessed under the CMP.  The study is increasing our understanding of how chemicals are transported from the outer surface of the skin to internal layers and blood circulation, in order to better estimate exposure. A national indoor air survey of chemicals focusing on selected priority chemicals in Canadian residential indoor air.  Indoor air sample collection began in September 2009 and will be completed in December 2011.  Results are expected to be released to the public through Statistics Canada in 2012.  The data will be used to support Health Canada risk assessment and risk management work, as well as indoor air quality guideline development. The CHMS is a national survey carried out by Statistics Canada, in partnership with Health Canada and the Public Health Agency of Canada, to collect information from Canadians about their health.  Health Canada is responsible for the biomonitoring component, in which blood and urine samples are collected to provide nationally representative information on exposure to environmental chemicals. In 2010-2011, Health Canada published the Report on Human Biomonitoring of Environmental Chemicals in Canada which provides full biomonitoring results for chemicals measured during Cycle 1.  Except for lead, these results provide the first ever nationally representative biomonitoring data of all the chemicals measured. The second Cycle (2009 -2011) of CHMS is currently underway and includes children aged 3-5 years, and an indoor air component.  The data is being collected from 18 sites across Canada.  Planning for Cycles 3 and 4 has also been initiated. The Maternal-Infant Research on Environmental Chemicals (MIREC) Study is a national five-year study that is recruiting approximately 2,000 pregnant women during the first trimester of pregnancy, who are then followed through pregnancy and up to eight weeks after birth. This study is measuring the extent to which pregnant women and their babies are exposed to environmental chemicals, assessing what pregnancy health risks, if any, are associated with exposure to heavy metals (lead, mercury, cadmium, arsenic and manganese), and measuring the levels of environmental chemicals and some of the beneficial components (nutritional and immune constituents) of breast milk. Results of the study will inform risk management decisions and identify potential sources of exposure and predictors of exposure to environmental chemicals. To better understand the exposure and effects of a variety of chemicals that were identified as priorities under the CMP, and to ensure the alignment of activities with priorities, a research program with a competitive allocation process has continued. The CMP themes and priorities addressed the following areas: effects, exposure, tool/model development, endocrine disrupting compounds, metals, mixtures, perfluorinated alkyl compounds, brominated flame retardants and the approximately 3000 remaining priority substances.  Other CMP activities undertaken in FY 2010-2011 included: The first phase of the Inventory Update was completed.  550 substances were included, covering approximately 500 chemicals and 50 microorganisms.  The information collected was used in developing strategies to address medium priorities and in initiating screening assessments under section 74 of microorganisms on the Domestic Substances List (DSL). Strategies to address medium priority substances have been developed.  The program further refined priority- setting by grouping these substances by chemical structure, sector, or other strategies. Outreach activities, including the preparation and publication of fact sheets on the CMP and ongoing headquarter and regional activities in support of risk management and risk communication such as workshops for stakeholders, continued on schedule. Industry surveys on two substances of concern where the main source of exposure is food were conducted (DEHA and methyl eugenol) Proposed delisting of three food additives from, and proposed addition of one food additive to, the Food and Drug Regulations as a result of assessments of specific substances under the CMP An enhanced sampling program under the Total Dietary Survey was designed, incorporating several substances of concern where food is expected to be the main source of exposure Health Canada continued to develop and enforce regulations to address risks posed by harmful chemicals in existing consumer products.  In particular, a new national cyclical enforcement project was put in place to determine the compliance level to the prohibition on polycarbonate baby bottles that contain bisphenol A (BPA) and enforcement action was taken on non-compliant products. Early consultations with stakeholders took place on proposed regulatory action for a Batch 3 and 5 substances (DEGME and TCEP) and economic analysis studies were started for both substances.  In FY 2010-11, the Product Safety Lab (PSL) completed method development and analytical testing of 3 CMP substances implicated in consumer products to support risk management actions (incl. BPA and TCEP). In all, the PSL has completed the sampling and testing of nine CMP chemicals. Health Canada also received and assessed nomination packages from industry to support the addition of substances in products regulated under the Food and Drugs Act (F&DA) to the revised In Commerce List (ICL) - a list of substances used in products regulated under the F&DA that were in commerce between January 1987 and September 2001.  A draft framework for the prioritization of substances on the revised ICL was developed as well. Subsequent to prioritization, substances on the revised ICL will undergo health and environmental risk assessments. In consultation with industry and NGO stakeholders, HC developed a regulatory framework to assess the environmental risks of new medicinal ingredients in pharmaceuticals and veterinary drugs. Significant progress has been made on the regulatory framework for non-medicinal substances. HC continued to develop background information on existing Best Management Practices (BMPs) for substances/products regulated under the F&DA for use in a future stakeholder consultation to determine if and where new and/or improved BMPs may be necessary or need to be considered. The re-evaluation of older pesticides, to determine if these pesticides meet today's health and environmental standards was accelerated.  As of March 31, 2011, 373 of the 401 older pesticidal active ingredients have been addressed. Thirtynew pesticide active ingredients were registered, 22 of which were biopesticides. Health Canada has continued to administer a mandatory health and environmental pesticide incidents reporting program (IRP), where trends are assessed and regulatory action is taken when necessary. During the 2010-2011 fiscal year, the IRP posted 11 evaluations of serious incidents. Regulatory action was taken in response to two of these. The incident reports helped identify potential adverse reactions in cats and dogs from the use of flea and tick control products. In response, the Pest Management Regulatory Agency (PMRA) published Regulatory Directive 2010-02 to strengthen the labels of spot-on pesticides used on companion animals for flea and tick control. The Chemical Substances Website, to inform the public and stakeholders on the progress of the CMP, was regularly updated.  Updates included posting information related to all CMP Canada Gazette publications, as well as Challenge Advisory Panel meetings, Stakeholder Advisory Council meetings, and new factsheets. A Subscribe function was launched in 2010 which allows users to sign up to receive copies of the Latest News via email.
		b. Risk Management	$50.1 M	$16.1 M	$12.8 M1
		c. Research	$26.6 M	$6.8 M	$5.0 M2
		d. Monitoring & Surveillance	$34.0 M	$13.8 M	$13.7 M
		e. Program Management	$5.4 M	$1.4 M	$1.3 M3
	Consumer Products	a. Risk Management	$12.6 M	$5.4 M	$4.2 M4
	Pesticide Regulation	a. Risk Assessment	$9.9 M	$3.3 M	$3.3 M
		b. Risk Management	$13.6 M	$4.7 M	$4.7 M
	Health Products	a. Risk Assessment	$3.3 M	$1.5 M	$1.5 M
		b. Risk Management	$12.5 M	$4.3 M	$3.5 M5
		c. Research	$2.5 M	$1.4 M	$1.4 M
		d. Monitoring & Surveillance	$1.1 M	$0.6 M	$0.6 M
		e. Program Management		$0.1 M	$0.1 M3
	Food & Nutrition	a. Risk Assessment	$3.8 M	$1.4 M	$2.1 M
		b. Risk Management	$6.2 M	$2.1 M	$0.5 M
		c. Research	$1.2 M	$0.4 M	$2.1 M
		d. Monitoring & Surveillance			$2.0 M1
Total			$192.7 M	$66.8 M	$62.3 M

($ millions)

Federal Partners	Program Activity	Names of Programs	Total Allocation (from Start to End Date)	Planned Spending 2010-11	Actual Spending 2010-11	Expected Results for 2010-2011	Results Achieved in 2010-2011
Environment Canada	Chemicals Management	a. Risk Assessment	$13.1 M	$4.8 M	$4.8 M	Risks to Canadians and impacts on their environment posed by toxic and other substances of concern are reduced. Direction, collaboration and coordination of science and management activities Increased knowledge of the risks of toxic chemical substances through research and options to mitigate Risk assessments conducted in a timely fashion as required Risk management objectives are met, e.g. effective controls identified and implemented Enhanced knowledge of stakeholders and the Canadian public regarding risk assessment/management activities, including knowledge on the effectiveness of control actions
		b. Risk Management	$64.9 M	$24.4 M	$18.6 M6
		c. Research	$2.1 M	$0 M	$0.0 M
		d. Monitoring & Surveillance	$26.4 M	$7.8 M	$7.8 M
Total			$106.5 M	$37.0 M	$31.2 M

Comments on Variances:

1. $2.0M was transferred from Sustainable Environmental Health (Risk Management) to the Food and Nutrition program.  These funds were intended to increase capacity to perform food related assessment of CMP priority chemicals.
2. $1.8M under Sustainable Environmental Health (Research) was not spent as some research projects were amended to deliver at a later date and some capital expenditures were planned but not purchased in 2010-2011.
3. $100K was transferred from Sustainable Environmental Health (Program Management) to Health Products to support coordination of input into CMP risk assessments.
4. The surplus in Consumer Product Safety was reallocated internally to facilitate mission-critical work to prepare for the coming into force of the Canada Consumer Product Safety Act.
5. The Health Products program under spent by $800K, as there were challenges associated with staffing and procurement.
6. Planned Spending changed from $24.4 M to $20.0 M to include departmental cut reflecting Strategic Review ($3.6M) and Board of Review on Siloxanes ($0.8M).

Results achieved by non-federal partners (if applicable):

N/A

Contact information:

Suzanne Leppinen, Director
Horizontal and International Programs
Safe Environments Directorate
Healthy Environments and Consumer Safety Branch
Health Canada
Ph: (613) 941-8071
suzanne.leppinen@hc-sc.gc.ca

Stewart Lindale, Director
Legislative and Regulatory Affairs
Environmental Stewardship Branch
Environment Canada
Ph: (819) 934-2358
Steward.Lindale@ec.gc.ca

Name of Horizontal Initiative:

Implementation of an Action Plan to Protect Human Health from Environmental Contaminants

Name of Lead department(s):

Health Canada

Lead Department Program Activity:

3.1 Sustainable Environmental Health

Start date of the Horizontal Initiative:

2008-2009

End date of the Horizontal Initiative:

2012-2013

Total Federal Funding Allocation (start to end date):

$84.6M

Description of the Horizontal Initiative:

Recent surveys show that Canadians are concerned about environmental contaminants. There is a clear need to ensure that Canadians have credible information on the impact of chemicals in the environment and the steps that they should take as a result.

The Government has already taken steps to address environmental contaminants through the Chemicals Management Plan and the Clean Air Agenda, focusing on substances which have known potential for harming human health and the environment. Both industry and stakeholders have been supportive of these initiatives but continue to insist that decisions be made based on scientific evidence. This requires mechanisms such as monitoring, surveillance and research to ensure that the effectiveness of interventions to address known potential risks can be assessed and that emerging risks can be detected.

The Action Plan to Protect Human Health from Environmental Contaminants is designed to further protect the health of Canadians from environmental contaminants while increasing the knowledge-base on contaminant levels and potential impacts on health, in particular:

• to foster awareness and provide information for Canadians to take action;
• to identify and monitor trends in exposures to contaminants and potential association with health problems such as asthma, congenital anomalies and developmental disorders; and
• to better understand the association between contaminants and illness.

$13.1M has been allocated to Health Canada from 2008-2009 to 2012-2013 to develop an Environmental Health Guide for Canadians, as well as tailored guides for First Nations and Inuit communities. The objective of the guide is to help make Canadians aware of the risks that harmful environmental contaminants may pose to their health along with direct actions that they can take to reduce these risks and improve their health.

$54.5M has been allocated to Statistics Canada from 2008-2009 to 2012-2013 towards conducting the Canadian Health Measures Survey (CHMS) and $5.6M has been allocated to Health Canada from 2008-2009 to 2012-2013 to conduct the First Nations Biomonitoring Initiative (FNBI).  The CHMS is used to collect information from Canadians about their general health and lifestyles and includes the collection of blood and urine specimens to be tested for environmental contaminants among other things. The CHMS will not provide data on First Nations on-reserve or Inuit communities. The FNBI will focus on these communities.

$5.9M has been allocated to the Public Health Agency of Canada from 2008-2009 to 2012-2013 to enhance surveillance of congenital anomalies.

$5.5M has been allocated to the Public Health Agency of Canada from 2008-2009 to 2012-2013 to conduct surveillance of developmental disorders.

Shared Outcome(s):

• Reduce health risks to Canadians (particularly vulnerable populations) from environmental contaminants

Governance Structure(s):

All action plan initiatives take advantage of governance and management structures already established for ongoing government programs such as: the Canadian Population Health Statistics Program, the Chemicals Management Plan, the Healthy Living and Chronic Disease initiative of the Public Health Agency of Canada, as well as components of existing national surveillance systems developed by the Public Health Agency of Canada in partnership with stakeholders.

Each program within Health Canada, the Public Health Agency of Canada and Statistics Canada is fully responsible for the management of initiatives they are leading within the action plan. Consultations and stakeholder involvement are governed through consultative structures and interdepartmental committees already established.

A tripartite governance structure with Health Canada, the Public Health Agency of Canada and Statistics Canada is used to oversee the implementation of the Canadian Health Measures Survey (CHMS). The CHMS will use the existing Canadian Population Health Statistics Program as a governance structure, which includes senior officials from all three federal organizations.

($ millions)

Federal Partners	Program Activity	Names of Programs	Total Allocation (from Start to End Date)	Planned Spending 2010-11	Actual Spending 2010-11	Expected Results for 2010-2011	Results Achieved in 2010-2011
Health Canada	Sustainable Environmental Health	Environmental Health Guide for Canadians	$13.1M	HECS: $0.385M FNIHB: $0.7M PACCB: $1.6M	HECS: $0.271M FNIHB: $0.392M PACCB: $1.075	Distribution of The Environmental Health Guides and subsequent development of Guides for specific populations A Guide focusing on senior's health as well as fact sheets designed for health care providers and teachers/students will be developed. Tailored guides for First Nations and Inuit for homes and children to be released. Tailored guides for First Nations and Inuit for outdoor activities are to be developed and distributed to aboriginal partners for review. Continuation of the Environmental Health marketing campaign (mainstream and First Nations components). Development of First Nations Biomonitoring Initiative: First Nation priorities will be determined and suitable biomonitoring parameters, sampling protocol, and parameters for an ethics review are to be developed including mechanisms to ensure appropriate comparability of data with the CHMS are in place. Sampling of selected communities is expected to commence.	HECSB/PACCB Continuation of the Environmental Health marketing campaign / Distribution of The Environmental Health Guides The 2010-11 Environmental Health Marketing campaign focused primarily on providing information on-line as recent research indicates that Canadians prefer to receive information related to the environment on-line. An interactive web quiz and a virtual house tour were completed and posted to the website in early March 2011. A Google ad word buy was also very successful and drove 26,000 incremental visits to the website, representing a 245% increase in web traffic with a slightly higher duration of visits. Additionally, four on-line videos were developed and completed on the following topics: radon, carbon monoxide, lead and mould.  Total number of Hazardcheck website visits was 61,623. To complement these on-line tactics, public engagement events were held nationally at 180 Home Depot locations over three consecutive weekends in March 2011.  Through these events, consumers were educated on the potential environmental risks that may impact their health and how to mitigate them. Over 124,000 Environmental Health Guides (Hazardcheck) were distributed and approximately 15,000 one-on-one conversations about home health hazards took place.  These point-of-purchase conversations led to an increase of 32% in sales for air quality devices (i.e. radon test kits and carbon monoxide monitors) vs. sales for the same products in the previous year. Feedback from participants indicated that 91% rated the information that they received at the in-store events as either useful (33%) or very useful (58%). As a further complement to the on-line tactics, 180, 000 copies of the Guide were polybagged and distributed via the Parents Canada national post-natal magazines Best Wishes and Mon Bébé. In addition to these distribution channels in support of the marketing campaign, an average of 13, 000 copies of the Guide are requested and distributed nationally each month through Service Canada, amounting to over 150, 000 per year. In 2010-11, the First Nations and Inuit Environmental Health Marketing campaign focused on providing tailored information directly in communities and on-line as recent research indicates that First Nations and Inuit community members prefer to receive information related to the environment through these channels. 200,000 copies of the First Nation Environmental Health Home Guide were distributed to all First Nation households across the country. An additional 74,000 copies of the guide were ordered on-line. The Inuit Environmental Health Home Guide will be distributed to Inuit communities. Content of both the First Nation and Inuit Home Guide are available on the HC website. Total number of website visits was over 10,000. Tailored guides and activity booklets for First Nations and Inuit youth and children have been developed and will be distributed to schools in First Nations and Inuit communities in the fall. Tailored guides for spring and summer outdoor activities for First Nations and Inuit have been developed and will be distributed to communities. Radio, print and television public service announcements were developed with First Nations and Inuit youth and the Aboriginal Peoples Television Network. Distribution to Aboriginal media outlets is planned for the fall. A pilot project for environmental health community gatherings were held in 4 First Nations and 4 Inuit communities in collaboration with the National Aboriginal Health Organization. A resource for self-run environmental health community gatherings will be distributed to intermediaries in the communities. FNIHB/PACCB The First Nation Environmental Health Home Guide has been distributed to all First Nation household across the country and the Inuit Environmental Health Home Guide will be distributed to Inuit communities. Content of both the First Nation and Inuit Home Guide are available on the HC website. Tailored guides for First Nations and Inuit youth and children have been developed and are in approvals. Environmental Health activity booklets for First Nations and Inuit youth and children have been developed and are available on the HC website and will be distributed to schools in First Nations and Inuit communities. Tailored guides for First Nations spring and summer outdoor activities have been developed and are awaiting approvals. Inuit guides for spring and summer outdoor activities have been developed. Continuation of the Environmental Health marketing campaign (mainstream and First Nations components).
	First Nations and Inuit Health Programming and Services	First Nations Biomonitoring Initiative	$5.6M	FNIHB: $1.17M	FNIHB: $1.126M		First Nations priorities were gauged through Interest Assessment Surveys that were sent by the Assembly of First Nations (AFN) to all FN communities across Canada.   Following the survey, a First Nations Advisory Committee comprising First Nation regional representatives for their eight regions, an Elder, youth, and other technical experts was established to advise the FNBI Steering Committee on the design, conduct, and chemical parameters to be analyzed. The FNBI pilot project (including FNBI sampling protocol and parameters) was submitted to HC/PHAC's Research Ethics Board and received approval in October, 2010. In Jan/Feb 2011, the FNBI pilot project was carried out in two Manitoba communities - a northern, remote, rural community and the other, a southern, non-remote urban community.  The objectives of the pilot project were to determine the operational and logistical requirements, participant response rates, human resources and financial costs associated with this undertaking in a remote vs. non-remote FN community.  Participation rate was very high and the survey was met with much enthusiasm and interest in both communities.  Urine and blood samples sent to same lab as that of CHMS for lab analysis. Results and lessons learned from the pilot project to be applied to the full-scale survey protocol for 2011-12. Environmental parameters chosen for FNBI and the laboratory selected for analysis of chemicals are the same as CHMS.  Statistics Canada statisticians working in consultation with AFN and HC statisticians to ensure comparability to CHMS data.
Public Health Agency of Canada	Surveillance and Population Health Assessment	Enhanced Congenital Anomalies Surveillance	$5.9M	$1.2M	$0.950M	increased capacity in the provinces and territories for surveillance of congenital anomalies in their jurisdictions strengthened networks across Canada for surveillance and research into prevention of congenital anomalies	Increased capacity in the provinces and territories for surveillance of congenital anomalies in their jurisdictions PHAC, through formal agreements (MoA), supported 6 jurisdictions across Canada to establish and develop new surveillance systems for congenital anomalies or to enhance existing ones. Key surveillance activities implemented by jurisdictions to enhance congenital anomalies surveillance included: consultation with local stakeholders; needs assessment; database development; planning and implementation of Privacy Impact Assessments; development of data sharing agreements, data source integration; development of data collection forms; data collection; and, development of surveillance tools. Strengthened networks across Canada for surveillance and research into prevention of congenital anomalies The Canadian Congenital Anomalies Surveillance Network was established and successfully carried out its 2011 Scientific Meeting on "Environmental and Nutritional Vulnerabilities for Congenital Anomalies", held on November 17-19, 2010 in Ottawa.  Participants discussed maternal characteristics and socio-demographic factors affecting fetal development and susceptibility for congenital anomalies; epidemiological studies on nutritional deficiencies and excesses associated with congenital anomalies, focusing on micronutrient intake, including folate; up-to-date information on key environmental exposures/risk factors and their interaction with nutrition in pregnancy; and integrating congenital anomalies surveillance and research into current public health initiatives. The Network continues to provide a forum to inform and engage jurisdictions and programs regarding the Agency's activities to improve congenital anomalies nationally as well as a platform to move the initiative forward.
		Surveillance of Developmental Disorders	$5.5M	$1.4M	$0.183M	a network for surveillance of autism in Canada increased public health scientific capacity in autism within the federal government	A network for surveillance of autism in Canada To develop a network for the surveillance of autism spectrum disorders in Canada, the Public Health Agency of Canada has gathered national and international experts in the fields of health, research, education and treatment/services and national stakeholders in both non-government organizations and professional associations to build a network for the surveillance of autism spectrum disorders in Canada. Over the past few years (2009 to 2011) PHAC supported research on the use of existing administrative data sets to capture information on children living with autism spectrum disorders through the National Epidemiological Database for the Study of Autism in Canada (NEDSAC), Queen's University. Increased public health scientific capacity in autism within the federal government In 2009-2010, PHAC engaged a team of epidemiologists to research surveillance options. The team is working collaboratively with provincial and territorial partners to build upon what has already been achieved to create a national system for the surveillance of autism spectrum disorders and thereby increase public health scientific capacity.  Working with the provinces and territories, PHAC will better understand existing programs, data sources, needs and gaps.
Statistics Canada	Social Statistics	Canadian Health Measures Survey	$54.5M	$14M	13.532M	CHMS cycle 1 data release (including tables, fact sheets and research articles) media coverage will be monitored. In addition, access to the website and requests for information will be tracked. The CHMS micro-data files will be available to external researchers through Statistics Canada Research Data Centres located in Canadian universities. CHMS cycle 2 data collection response rate is monitored regularly to ensure adequate representation of the Canadian population by age group and sex. In addition, ongoing data quality control and data quality assurance activities (including health experts' observations of the data collection procedures) are performed to ensure a high data quality level. CHMS cycle 3 content specifications will be based on extensive consultation with federal partners and health experts through the tripartite governance structure with Health Canada, the Public Health Agency of Canada and Statistics Canada as well as their working committees; and the CHMS advisory committees (Expert, Physician, Laboratory and Quality Assurance and Quality Control). Feasibility studies will be conducted to ensure adherence to existing resources and operations limitations while maintaining a high response rate and quality data.	CHMS cycle 1 data on environmental contaminants was released in August 2010. Media attention was generally interested and positive. The micro-data files in Research Data Centres were updated to include complete cycle 1 information and documentation. Cycle 2 data collection covered 8 sites in 2010-11. Continuous monitoring and rigorous quality assurance activities were applied during the collection period to ensure high quality data. Development of cycle 3 content proceeded during 2010-11 with extensive consultation with federal partners and health experts and the CHMS advisory committees (Expert, Physician, Laboratory and Quality Assurance and Quality Control). New environmental variables measured in biological specimens (participants' blood and urine), tap water and indoor air were identified for cycle 3 collection.
Sub-Total (Health Canada)			$18.7M	$3.855M	1.738M
Sub-Total (PHAC)			$11.4M	$2.6M	1.133M
Sub-Total (Statistics Canada)			$54.5 M	$14M	13.532M
Grand Total:			$84.6 M	$20.455M	16.403M

Comments on Variances:

Health Canada

HECS/PACCB: Expenditures were reduced through alternate delivery approaches, cost efficiencies, and partnerships.

FNIHB/PACCB: The First Nation and Inuit Youth Guides and the First Nations Spring and Summer Guides were delayed; therefore funds that were planned for printing and distribution of these guides were not spent by the end of fiscal year.  Delays in staffing also contributed to the variance.

PHAC: Start-up work took longer than expected.  In 2010-2011 the Public Health Agency of Canada created a new unit to develop and support a national surveillance network and a national advisory committee to oversee the surveillance network.  The Unit has started to lay the ground work and has begun to demonstrate progress towards the objectives of building a network to support national surveillance of developmental disorders (focusing on ASDs) across the country.

Results Achieved by Non-federal Partners:

Heath Canada: Partnerships within the First Nations Biomonitoring Initiative

• Establishment of the First Nations Advisory Committee in May 2010 to provide direction to the FNBI Steering Committee.
• Obtained Resolution in support of the FNBI from Chiefs-in-Assembly in July 2010.
• Obtained consent for selected pilot communities through Band Council Resolutions, Community Research Agreements, and participant consent.
• Established procedures to comply with First Nations OCAP principles (Ownership, Control, Access, and Property)

*NB:  As this is a HC/AFN partnership, many of the results achieved were a collaboration between both Parties.

Contact Information:

Suzanne Leppinen
Director, Chemicals Policy Bureau
Safe Environments Directorate, Healthy Environments and Consumer Product Safety Branch, Health Canada
613-941-8071
Suzanne.Leppinen @hc-sc.gc.ca

Name of Horizontal Initiative:

Early Childhood Development (ECD) Strategy for First Nations and Other Aboriginal Children.

Name of Lead department(s): 

Health Canada (HC)

Lead Department Program Activity:

First Nations and Inuit Health Programming and Services

Start date of the Horizontal Initiative:

ECD component- October 2002.

Early Learning and Child Care (ELCC) component- December 2004

End date of the Horizontal Initiative:

ECD component - ongoing.

ELCC component - ongoing

Total Federal Funding Allocation (start to end date):

ECD: $320 million 2002-03 to 2006-07 ($60 million in 2002-03 and $65 million thereafter). Ongoing: $65 million per year.

ELCC: $45 million 2005-06 to 2007-08 ($14.5 million in 2005-06; $15.3 million in 2006-07; $15.2 million in 2007-08). Ongoing: $14 million per year.

Description of the Horizontal Initiative (including funding agreement):

The ECD Strategy for First Nations and Other Aboriginal Children was announced on October 31, 2002.  The Strategy provides $320 million over five years to: improve and expand existing ECD programs and services for Aboriginal children; expand ECD capacity and networks; introduce new research initiatives to improve understanding of how Aboriginal children are doing; and work towards the development of a "single window" approach to ensure better integration and coordination of federal Aboriginal ECD programming.  In December 2004, as first phase of a "single window", Cabinet approved an additional $45 million over three years (beginning fiscal year 2005-06) and $14 million ongoing to improve integration and coordination of two ECD programs-- Aboriginal Head Start On Reserve (AHSOR) and the First Nations and Inuit Child Care Initiative (FNICCI). The objectives of these funds are to increase access to and improve the quality of ELCC programming for First Nations children on reserve, and improve integration and coordination between the two programs through joint planning, joint training and co-location.  The Strategy also includes Aboriginal Affairs and Northern Development Canada (AANDC)-funded child/day care programs in Alberta and Ontario.

Shared outcome(s):

The ECD component complements the September 2000 First Ministers F/P/T ECD Agreement.  It seeks to address the gap in life chances between Aboriginal and non-Aboriginal children by improving the developmental opportunities to which Aboriginal children (and their families) are exposed at an early age (0-6 years). The ELCC component complements funding released to provinces and territories under the March 2003 Multilateral Framework for Early Learning and Childcare (ELCC) to improve access to ELCC programs and services.

Governance structure(s):

• Interdepartmental ECD ADM Steering Committee;
• Interdepartmental ECD Working Group.

Federal Partners	Federal Partner Program Activity (PA)	Names of Programs for Federal Partners	Total Allocation (from Start to End Date)	Planned Spending for 2010-11	Actual Spending for 2010-11	Expected Results for 2010-11	Results Achieved in 2010-11
1. Health Canada Electronic Link:  http://www.hc-sc.gc.ca/fnihb-dgspni/fnihb/ cp/ahsor/index.htm	First Nations and Inuit Health Programmi-ng and Services	a. Aboriginal Head Start on Reserve (AHSOR)	$107.595 (2002-03 through to 2006-07;  $21.519/year). $21.519/year ongoing. Committed in 2002. ELCC $24.000 (2005-06 through to 2007-08, $7.500 in 2005-06, $8.300 in 2006-07; $8.200 in 2007-08). $7.500 in 2008-09 and ongoing Committed in 2005.	$21.519 $7.500	$27.374 (ECD and ELCC)	Program expansion and enhanceme-nt Increase integration, coordinatio-n,  access, and quality	AHSOR programming was expanded in 15 new First Nations Communities in British Colombia. In partnership with Health Canada's Aboriginal Health Human Resources Initiative, over 200  Early Childhood Education (ECE) workers are working towards their ECE accreditation.Work continues with partner departments to improve integration and coordination among AHSOR, HRSDC FNICCI, and AAND- funded daycares in Alberta and Ontario.
Electronic Link: http://www.hc-sc.gc.ca/fnih-spni/famil/preg-gros/intro_e.html	First Nations and Inuit Health Programmi-ng and Services	b. Fetal Alcohol Spectrum Disorder First Nations and Inuit Component(FASD-FNIC)	$70.000  (2002-03 through to 2006-07; $10.000 in 2002-03 and $15.000 thereafter). $15.000/ year ongoing. Committed in 2002.	$15.000	$12.862	Program expansion and enhancement	Integration between programs that support maternal and child health was increased across First Nation and Inuit communities, resulting in better coordination and collaboration across programs. Programs focused on maintenance and program integrity through training, leading to increased retention of community workers and also the completion of special studies to support evaluation and on-going improvements to FASD activities and programming.
	First Nations and Inuit Health Programmi-ng and Services	c. Capacity Building	$5.075 (2002-03 through to 2006-07; $1.015/year). $1.015/ year ongoing. Committed in 2002.	$1.015	$0.915	Increased capacity	As part of the 2002 Federal Strategy's capacity-building component, Health Canada provides funding to build capacity and expertise relating to early childhood development to National Aboriginal Organizations.  In 2010-11, funds were provided to the Assembly of First Nations (AFN), Inuit Tapiriit Kanatami (ITK), the Native Women's Association of Canada (NWAC) and the Métis National Council (MNC).  As well, Aboriginal Affairs and Northern Development Canada provides funding to Pauktuutit Inuit Women of Canada.   In 2010-11,  funding enabled these organizations to contribute to the development of the Federal Strategy through strategic planning and capacity building in their own organizations.Horizontal training funding was provided to regions to support training for ECD workers in AHSOR and FNICCI sites.  HC is working to develop a training strategy for community based workers, including ECD workers, that will lead to culturally appropriate training and certification of providers of healthy child development programming on reserve.
2. PHAC Electronic Link: http://www.phac-aspc.gc.ca/dca-dea/programs-mes /ahs_main_e.html	PA 1.4 Health Promotion SA 1.4.3 Childhood and Adolescence Programs	a Aboriginal Head Start in Urban and Northern Communities (AHSUNC)	$62.880 (2002-03 through to 2006-07; $12.576/ year and ongoing. Committed in 2002.	$12.576	$10.977	Program expansion and enhancement by increasing number of special needs and parental outreach workers; enhance special needs training; serve another 1000 children	Outreach pilot programs were developed by AHS sites to expand   delivery to   Aboriginal families who may not have access to the program.  Training on  Early Childhood Development (ECD), special needs, and school readiness screening provided to all 128 sites  to improve child outcomes.
	PA 1.4 Health Promotion SA 1.4.3 Childhood and Adolescence Programs	b Capacity Building	$2.500  (2002-03 through to 2006-07; $0.500/year) and ongoing Committed in 2002	$0.500	$0.365	Horizontal coordinatio-n, engagemen-t and developme-nt of tools and resources to build capacity	Monthly conference calls and two annual face-to-face meetings with the Aboriginal advisory council result in improved  capacity, stakeholder engagement and knowledge /tool development (early literacy toolkit) and exchange activities.
3. HRSDC	Lifelong Learning- Health Human Resources (HHR) Lifelong Learning- Health Human Resources (HHR)	a. First Nations  and Inuit  child Care Initiative (FNICCI)	$45.700   (2002-03 through to 2006-07; $9.140/year) and ongoing. Committed in 2002 ELCC $21.000 (2005-06 through to 2007-08; $7.000/year). $6.500/ year ongoing. Committed in 2005	$9.140 $6.500 $4.240 Aboriginal UEY:2010/11 $181,168		Program expansion and enhanceme-nt Increase program integration, coordinatio-n, access and quality.
		b. Research and Knowledge	$21.200 (2002-03 through to 2006-07); $4.240/year and ongoing. Committed in 2002Aboriginal UEY:From 2004/05 to 2010/11, $700,000 per fiscal year		Aboriginal UEY: 2010/11, $208,366	Information on the well-being of Aboriginal children through an Aboriginal Children's Survey (ACS) and the Aboriginal component of "Understanding the Early Years" (UEY)	Aboriginal UEY Results 2010/11:-The UEY Prince Albert Grand Council (PAGC) Project (Aboriginal UEY) has built some capacity in data collection, analysis and dissemination of the project's results; The UEY PAGC outcomes and analysis have had an impact on short-term planning, such as the implementation of full-time kindergarten in five schools. Long-term planning is only beginning with the training of early learning and care staff and the implementation of an oral language program in nursery and kindergarten. More early-years work will take place in the area of strategic planning and community development (in the coming year) with the directors of Education approving a $50,000 project to follow up on the UEY PAGC Project's results. The UEY PAGC Project's Final Report will include PAGC and sector-level data in areas that have never before been examined. The parent interview data and analysis in particular have been of great interest to decision-makers because they highlight many of the family and community strengths, which may act as protective factors against the challenging socio-economic conditions families face. The Better Beginnings Early Childhood Conference and the Talking Partners Initiative are two examples of efforts being made to coordinate resources and provide greater support for Prince Albert Grand Council's children.  Communities, schools and agencies. As well, private-sector donations supported the Better Beginnings Conference and $30,000 will be invested in Talking Partners at the PAGC level, which will enable implementation in four pilot schools. Further investment by the directors of Education in early-childhood initiatives ($180,000) exemplifies the level of awareness of early childhood development and the critical needs to PAGC's children. The Better Beginnings Conference brought together many of the service providers who work with children six months to six years of age.
4. AANDC	The people- social developme-nt	a. Family Capacity Initiatives	$5.050  (total for 2002-03 through to 2006-07; 1.010/year) 2007-2008 and ongoing. Committed in 2002.	$1.010	0.984	Support horizontal work with  ECD partners by funding research and capacity-building.
Total			ECD (2002-03 to 2006-07): $320.000 ($60.000 in 2002-03 and $65.000/year thereafter); $65.000/year ongoing. ELCC (2005-06 to 2007-08): $45.000 ($14.500 in 2005-06; $15.300 in 2006-07; $15.200 in 2007-08); and $14.000/year ongoing.	ECD: $65.000/year ongoing. ELCC: $14.000/year ongoing.

Interdepartmental ECD ADM Steering Committee;

Interdepartmental ECD Working Group.

($ millions)

Comments on Variances:

Aboriginal Component of the Understanding the Early Years Initiative

Aboriginal UEY was allocated $300,000 in Grants and Contribution funding for fiscal year 2010/11 and $400,000 in Non-Salary Funding, for a total of $700,000. The UEY Prince Albert Grand Council Saskatchewan Project, the only Aboriginal UEY project had actual expenses for 2010/11 of $208,366, The variance ($491,634) is a result of the sun-setting of the UEY Initiative, which occurred on March 31, 2011.

PHAC -  The variance between planned and actual spending results from various in-year operational limitations including: delays in staff recruitment; in-year adjustments to grants and contribution agreements resulting in less than full utilization of funds; and, the deferral of a planned National Training Workshop (as officials are exploring more effective and cost-efficient training strategies).

Results achieved by non-federal partners (if applicable):

N/A

Contact information:

Cathy Winters, Senior Policy Coordinator,

Children and Youth Division, Community Programs Directorate, First Nations and Inuit Health Branch, Health Canada Postal Locator 1919A Tunney's Pasture, Ottawa

Telephone: (613) 952-5064  Email: Cathy_winters@hc-sc.gc.ca

Name of Horizontal Initiative:

Food and Consumer Safety Action Plan (the Action Plan)

Name of Lead Department(s):

The lead is shared between Health Canada (HC), the Canadian Food Inspection Agency (CFIA), the Public Health Agency of Canada (PHAC), and the Canadian Institutes of Health Research (CIHR).

Lead Department Program Activity:

• HC: Health Products, Consumer Products, Food Safety, and Pesticide Regulation
• CFIA: Food Safety and Nutrition Risks
• PHAC: Health Promotion, Chronic Disease Prevention and Control, and Infectious Disease Prevention and Control
• CIHR: Strategic Priority Research

Start Date of the Horizontal Initiative:

Fiscal Year 2008-2009

End Date of the Horizontal Initiative:

Fiscal Year 2012-2013 (and ongoing)

Total Federal Funding Allocation (start to end date):

$489.4 million over five years ending in Fiscal Year 2012-2013 (and $126.7 million ongoing)

Description of the Horizontal Initiative (including funding agreement):

The federal government is responsible for promoting the health and safety of Canadians. A key part of this role is ensuring that the products used by Canadians are safe. Adverse consequences associated with unsafe products impact not only the Canadian public, but also the Canadian economy. The Food and Consumer Safety Action Plan (Action Plan) is a horizontal initiative aimed at modernizing and strengthening Canada's safety system for food, health and consumer products. A number of high-profile incidents, such as lead and ingestible magnets in children's toys, contaminants in imported food products, and the global withdrawal of some prescription medicines, have underscored the need for government action.

The Action Plan modernizes Canada's regulatory system to enable it to better protect Canadians from unsafe consumer products in the face of current realities and future pressures. The Action Plan bolsters Canada's regulatory system by amending or replacing outdated health and safety legislation with new legislative regimes that respond to modern realities, and by enhancing safety programs in areas where modern legislative tools already exist. The Action Plan ensures that Canadians have the information they need to assess the risks and benefits associated with the consumer and health products they choose to use, and to minimize risks associated with food safety.

The Action Plan is an integrated, risk-based plan and includes a series of initiatives that are premised on three key pillars: active prevention, targeted oversight and rapid response. We focus on active prevention to avoid as many incidents as possible and work closely with industry to promote awareness, provide regulatory guidance, and help identify safety concerns at an early stage. Targeted oversight provides for early detection of safety problems and further safety verification at the appropriate stage in a product's life cycle. To improve rapid response capabilities and ensure the government has the ability to act quickly and effectively when needed we work to enhance health risk assessments, strengthen recall capacity, and increase the efficiency in responding and communicating clearly with consumers and stakeholders.

Shared Outcome(s):

• Increased knowledge of food risks and product safety (scientific and surveillance/monitoring)
• Increased industry awareness and understanding of regulatory requirements
• Increased industry compliance with safety standards
• Increased consumer awareness and understanding of safety risks associated with health and consumer products and food
• Strengthened oversight and response to safety incidents
• Increased consumer confidence in health and consumer products and food
• Increased trade-partner confidence in Canadian controls, which meet international standards
• Increased availability of safe and effective products
• Level playing field where imports can be demonstrated to meet Canadian requirements

Governance Structure(s):

The Minister of Health and the Minister of Agriculture and Agri-Food Canada have joint responsibility and accountability for results, and for providing information on progress achieved by the Action Plan.

A Governance Framework has been established and endorsed by all of the partner departments/agencies. To facilitate horizontal coordination, the following Director General (DG)/Executive Director (ED) level Task Forces have been established: Health Products Task Force, Consumer Products Task Force, Food Task Force, Communications Task Force, and the Legislative and Regulatory Task Force. The Task Forces report to a DG/ED level Coordinating Committee. An Assistant Deputy Minister (ADM)/Vice President (VP) level Steering Committee provides direction to the Coordinating Committee. An Oversight Committee of Deputy Heads facilitates the provision of high level guidance to the Steering Committee.

Health Canada's Strategic Policy Branch (SPB) provides the Secretariat function for the Action Plan and plays an integral role in supporting the ongoing operation and decision-making of the governance committees, oversight and integration of performance against commitments, and advice to senior management. SPB is also the lead for coordinating the implementation of the legislative and regulatory initiatives.

Health Canada's Healthy Environments and Consumer Safety Branch (HECSB) and the Pest Management Regulatory Agency (PMRA), along with the Public Health Agency of Canada (PHAC), work together to implement Action Plan activities related to consumer products.

Health Canada's Health Products and Food Branch (HPFB) has primary responsibility for implementing Action Plan activities related to health products with support from Health Canada's Strategic Policy Branch (SPB) and the Canadian Institutes of Health Research (CIHR) on one initiative (increased knowledge of post-market drug safety and effectiveness).

The Canadian Food Inspection Agency (CFIA), Health Canada's Health Products and Food Branch (HPFB) and the Public Health Agency of Canada (PHAC) work together to implement Action Plan activities related to food safety.

The Public Affairs, Consultation and Communications Branch (PACCB) provides communications support for all of the above activities and will coordinate or lead many of the horizontal Departmental activities under the Consumer Information Strategy.

Performance Highlights:

Federal Partners	Federal Partner Program Activity	Names of Programs for Federal Partners	Total Allocation (from Start to End Date)	2010-11 ($ millions)
				Planned Spending	Actual Spending	Expected Results	Results Achieved
Health Canada	Health products	Active prevention	$ 57.6	$9.7	$7.0	Increased industry awareness and knowledge of regulatory requirements	Standardized Operating Procedure (SOP)/Guidance Documents Pertinent documents are now in place for pharmaceutical human drugs and include instructions in an external Guidance to Industry on how to request a pre-submission meeting and for submitting a pre-submission meeting information package An internal SOP was developed to track and log pre-submission meetings for biologics and radiopharmaceuticals. Guidance documents/communication pieces are available on the Health Canada website, and sponsors are referred to them during the meetings. Meetings During FY 2010-11, sponsors made 49 requests for pre-submission meetings for biologics and radiopharmaceuticals and all meetings were held. Following the meetings, 18 submissions were filed and accepted into review. Of the 18 submissions accepted into review, 9 have received positive decisions and the remainder are in review or screening. Surveys indicated that 100% of sponsors felt that the pre-submission meetings added value. There were 97 pre-submission meetings held for pharmaceutical drugs. Oncology candidate submissions pilot: 17 oncology pre-submission meetings were held in 2010-11, a slight increase from last year's 11. Of the 17 meetings held, 12 were New Drug Submissions (NDS) and 5 were Supplemental New Drug Submissions (SNDS). Of the NDS, 2 of the 10 have been filed and are in review. Of the SNDS, 4 of 5 have been filed and are in review. Following up on the 11 human pharmaceutical meetings held in FY 2009-10, no specific conclusions can be drawn regarding the effect of pre- submission meetings are having on decisions rendered. The analysis is ongoing and will be concluded at the end of the pilot. Information is, however, being shared between industry and regulators with discussions focussed more on scientific, rather than purely regulatory issues, which are not explicitly addressed in the Regulations. The meetings are allowing for earlier scoping of key issues during review and for Health Canada to hear from Canadian clinical experts and pose questions directly to them. It has not been determined whether an increased efficiency or different review outcome can be attributed to the fact that a meeting was held.
						Increased oversight of the risk management and risk mitigation strategies for health products	100% of Risk Management Plans/Risk Management and Mitigation Plans (RMP/RMMP) were considered satisfactory after clarification was received from Market Authorization Holders (MAH) on any areas of concern. RMMP Received: 18; RMMP Completed: 19 Note - Risk Management Plans (RMP) are provided by MAH and the Risk Management & Mitigation Plan (RMMP) is the MAH follow-up to the initial RMP. The rolled over plans from the previous year account for larger number of completed than assigned.
						Increased awareness and understanding of the safe use of health products by consumers and health care professionals	Stakeholder Engagement Relationships with key stakeholders such as Young Consumers Network and Canadian Public Health Association's Expert Panel on Health Literacy were established/enhanced through seven meetings organized under ADM Stakeholder Meeting Program. Stakeholder input received via surveys and follow-up actions was tracked. In January 2010, a Stakeholder Consultation Workshop on the Plain Language Labelling Project was held in Ottawa. Health Canada will use the results of this consultation to determine how best to improve product information documents for Canadians. Providing information to the consumer in plain language is important for the safe and effective use of therapeutic products and will assist consumers in making informed decisions about their health. Patient and Consumer Pool A proposal was approved to create a Patient and Consumer Pool from which the Branch could draw engaged and informed stakeholders to participate in decision-making. The Operational Plan for the Pool was completed through extensive consultations with external stakeholders and program clients. A Learning Strategy and Curriculum Map were developed for the Pool, including content for two learning modules. Policy Development The HPFB Secretariat Manager's Network and the Health Canada Reference Group collaborated extensively to provide input into the development of the soon to be released Health Canada Policy on External Advisory Bodies. Web Development and Postings: Health Canada led the review of 5000 HPFB outdated web pages and influenced HC information architecture to allow for better information access for stakeholders and the general public. HC also developed new Web pages / sections on health products issues and revised them for a consumer audience as needed. Social Media Provided consumers access to mobile information through the launch of the Recalls and Safety Alerts application for BlackBerry, Android and iPhone smart phones. This tool allows buyers to find out if a product they are about to purchase or have already bought has been recalled. Enhanced the existing Health Canada Recalls and Safety Alerts Widget to include all health and safety risk communications advisories and recall notices across government departments including the Canadian Food Inspections Agency and Transport Canada. Encouraged social networking and conversations among consumers through Facebook posts on the Healthy Canadians Fan page. Promoted risks or other consumer related facts via the @HealthCanada Twitter account. Scientific/expert advisory committees provide ongoing medical/technical/ scientific advice and recommendations on regulatory issues for drugs and medical devices to assist Health Canada in making regulatory decisions. This information was made available to the public on the Health Canada web site. This past year, the following records of proceedings of our meetings were posted: Scientific Advisory Committee on Medical Devices Used in the Cardiovascular System (2010-06-01); Scientific Advisory Committee on Medical Devices Used in the Cardiovascular System (2010-12-10); Scientific Advisory Committee on Oncology Therapies (2010-04-15); Scientific Advisory Panel on Bioequivalence Requirements for Modified-Release Dosage Forms (2010-06-11); Scientific Advisory Panel on Opioid; Analgesic Abuse (2011-03-29) In 2010-11, Health Canada prepared and published 26 Notices of Decision documents (ND) (16 Human Drugs, 9 Biologics, 4 Medical Devices) and 37 Summary Basis of Decision documents (19 Human Drugs, 13 Biologics and 5 Medical Devices). As well, the results from the internal and external evaluation of Phase I of the Summary Basis of Decisions project (period covering Jan 2005-Sept 2008) were released. The evaluation report contains short-term recommendations to be implemented as well as findings that will inform the development of Phase II of the SBD project. A Draft Guidance on Hepatotoxicity of Health Products was posted which contains recommendations from deliberations by the Scientific Advisory Panel on Hepatotoxicity. In 2010-11, 100% or 1,936 product monographs were processed and posted to the Health Canada website within service standards. Of the product monographs processed, 1,641 were pharmaceuticals and 295 were for biological therapies. General Documents Posted on Health Canada Website include: a) Information Gathering, Monitoring and Processing: 138; b) Risk Management and Intervention: 16; d) Other: 95 Risk Communication Advisories/Warnings posted to HC Website (MedEffect Canada): a) Total Issued by HC: 128; b) Total Issued by MAH: 56
Health Canada	Health Products	Targeted Oversight	$34.6	$8.1	$3.3	Enhanced capacity of HC and industry to identify and respond to risk issues	Periodic Safety Update Reports (PSUR) are provided by market authorization holders to Health Canada on health products. Health Canada screens the reports for Level 1 (basic screening) and Level II (more detailed screening of same report). PSURs with conditions involve products with promising evidence of clinical effectiveness that require safety monitoring and periodic provision of safety reports to satisfy the conditions under the Notice of Compliance to enable marketing of the product. Reporting PSUR Conditions - 14 PSUR-C were received and are currently under review. Year-by-year increase in the Periodic Safety Update Reports received PSUR 2010-11 (PAA 2.1) PSUR Level I Assigned: 161; PSUR Level I Completed: 172 (Note: the rolled over submissions from the previous year account for larger number of completed than assigned) PSUR Level II Assigned: 63; PSUR Level II Completed: 52 PSUR 2009-10 (PAA2.1) PSUR Level I Assigned: 180; PSUR Level I Completed: 140 PSUR Level II Assigned: 65; PSUR Level II Completed: 93 (Note: the rolled over submissions from the previous year account for larger number of completed than assigned)
			Included in CIHR DSEN	DSEN $1.1	$1.0	Increased knowledge of post-market drug safety and effectiveness to inform decisions Increased capacity in Canada to address priority research on post-market drug safety and effectiveness	Also see: Canadian Institute for Health Research, Strategic Priority Research, Targeted Oversight Drug Safety and Effectiveness Network(DSEN) The partner organizations (CIHR and Health Canada (SPB and HPFB)) collaborated to prepare the material for the first DSEN Steering committee meeting. The Health Canada DSEN Implementation Project Team (established by HPFB in 2009 and composed of representatives from HPFB and FNIHB) continued to collate research queries from Health Canada staff for consideration as part of the DSEN's prioritized research agenda. This year, nine new research queries were forwarded to the DSEN Coordinating Office within Canadian Institute for Health Research (CIHR) for further consideration. The DSEN measurement and evaluation framework was approved in August 2010. The partners are working to establish appropriate data gathering strategies to support measurement and reporting of DSEN performance in 2012-13 and 2016-17. HC will pilot its evaluation process for evaluation of DSEN findings when the research is received in 2011/12. In January 2011, DSEN partners held a discussion forum for HC staff to seek input on the development of DSEN, its processes and topic areas. In April 2010, HC completed the contract for the DSEN draft process map to assist in refining the process and procedures of DSEN. In November 2010, the partners presented on DSEN at the Health Canada Science Forum. HC remains an active participant in CIHR lead DSEN activities. The partners continue to engage international partners implementing related initiatives (e.g., EnCepp in EU; Sentinel in U.S) to share best practices and explore opportunities for data sharing. HC continues to facilitate communication with P/Ts where possible.
Health Canada	Health Products	Rapid Response	Existing Resources	Existing Resources		Improved ability to respond with better tools when safety incidents occur	New tools on hold due to delay in new legislation.
Health Canada	Consumer Products	Active Prevention	$41.0	$ 9.3	$6.75	Increased awareness and understanding of product safety obligations by consumer products industry	To increase industry awareness of their product safety obligations, a stakeholder outreach plan for the Canada Consumer Product Safety Act (CCPSA) was initiated, including: regional outreach activities, a public notice campaign and creation of an industry-targeted website. We undertook communications activities such as: Updates to the Health Canada website, specifically a new section about the CCPSA: www.healthcanada.gc.ca/productsafety which includes news releases, backgrounders, Q&A's, speeches, consultation and guidance documents and regulatory proposals Launch of a Public Notice Campaign March 2011 to all national newspapers in Canada to communicate the June 20, 2011 coming-into-force of the CCPSA and key new requirements for industry In preparation for the coming-into-force of the CCPSA, we prepared draft guidance documents for industry on mandatory reporting and document retention requirements, and held targeted consultations with industry representatives to obtain feedback. In addition, preliminary consultation documents were published on the proposed Exemption Regulations and Administrative Monetary Penalties Regulations under the CCPSA. The website for providing information on the CCPSA was redesigned to improve access to guidance and consultation documents, including the creation of a subscription service for industry to receive regular updates. There are currently 1116 English and 163 French subscribers to the listserv. In addition, we updated five industry publications to inform industry of new regulatory requirements and guidelines for certain consumer products: Canadian Requirements for Lighters; Flammability of Textile Products in Canada; Guide to Canadian Consumer Chemical Product Assessment - Second Edition; Industry Guide to Canadian Requirements for Children's Jewellery; Information to Dealers of Second-hand Products (including children's products) Guide to Canadian Requirements for Tents. Ongoing industry compliance promotion activities were delivered across Canada through presentations to consumer product associations, exhibitions at trade show events, and meetings with individual companies. With respect to consumer and clinical radiation protection activities under the Radiation Emitting Devices Act (REDA), presentations were made to MEDEC (the national association for the Canadian medical technology industry) to aid industry in their understanding of the REDA and its regulations.
						Increased awareness and understanding of standards by consumer products industry	To help increase industry awareness of consumer product safety standards: Under the Memorandum of Agreement (MOA) with the Standards Council of Canada (SCC), the SCC analysed the consumer product safety standards development activities world-wide. Focus groups were held for industry on the International Standards Organization (ISO) Product Safety Guidance Standard. Health Canada is also participating in the ISO Recall Guidance Standard. The trilateral (Health Canada - U.S. Consumer Product Safety Commission - European Commission) collaboration on the development of an international standard addressing the hazards of corded window covering products was expanded to include Australia and 2 other products areas (baby slings and booster seats). Health Canada has drafted the following guidelines for industry, on which we will consult with industry and the public in 2011: National Guideline on Turbine Noise Radiation Protection and Quality Standards in Mammography We also published the following information in support of industry awareness: Notice to Stakeholders - Noise from Machinery Intended for the Workplace. http://www.hc-sc.gc.ca/ewh-semt/noise-bruit/machinery-machines-eng.php . Update of human exposure guidelines to radiofrequency electromagnetic energy: "Health Canada's Radiofrequency Exposure Guidelines (http://www.hc-sc.gc.ca/ewh-semt/pubs/radiation/radio_guide-lignes_direct-eng.php#sc6
						Increased awareness and understanding of consumer product safety issues by consumers	To increase consumer awareness of product safety issues, we delivered consumer outreach activities across Canada through exhibitions at consumer events where a high volume of consumers and stakeholders were in attendance. Also, discussions were held with regional public health officials to facilitate knowledge transfer to consumers from health care providers. The number of consumer product complaints/incidents have consistently grown, which demonstrates that consumers have an awareness of Health Canada's consumer products complaint mechanism (FY 2006-07, 567 complaints; FY 2007-08, 672 complaints; FY 2008-09, 944 complaints; FY 2009-10, 1102 complaints; FY 2010-2011, 1359 complaints) Subscriptions to the Consumer Product Safety Recall website increased to over 8000 subscribers in 2010-11. In previous years, the data shows an increase as follows: 2006-07 when the website was launched, 0 to 800 subscriptions; 2007-08 increase from 800 to 5000 subscriptions; 2008-09 increase from 5000 to 6600 subscriptions; 2009-10 increase from 6600 to 7844 subscriptions. The data suggests that the increase in reporting by consumers is linked to the increase in subscriptions to the recall website and is an indicator of increased consumer awareness of risks associated with consumer products. Public opinion research was completed as part of the overall Health Canada public opinion research plan. While the majority of respondents indicated an understanding of industry obligations and Health Canada's post-market role in product safety, a large proportion (83%) indicated that they believed Health Canada already had mandatory recall authority which is now granted under the new Canada Consumer Product Safety Act. In order to more effectively raise consumer awareness of product safety issues via social media, Health Canada: Developed and launched the Recalls and Safety Alerts mobile application and Widget; Encouraged social networking and conversations among consumers through Facebook posts on the Healthy Canadians Fan page; Promoted risks or other consumer related facts via the @HealthCanada Twitter account; Posted a series of YouTube videos including Canada Consumer Product Safety Act, Wi-fi - Health Canada, Drop-side Cribs - Health Canada and Reusable Bags. The following documents were published/updated on the Health Canada website: Safety of Wi-Fi Equipment (http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/prod/wifi-eng.php) Personal Stereo Systems and the Risk of Hearing Loss (http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/life-vie/stereo-baladeur-eng.php); Sunglasses (http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/prod/glasses-lunettes-eng.php) Cell Phone Towers- includes Youtube video (http://www.hc-sc.gc.ca/ewh-semt/radiation/cons/stations/index-eng.ph); Research on Radiofrequency Energy and Health (http://www.hc-sc.gc.ca/ewh-semt/radiation/cons/radiofreq/research-recherche-eng.php); Wi-Fi Equipment- includes Youtube video(http://www.hc-sc.gc.ca/ewh-semt/radiation/cons/wifi/index-eng.php); Frequently Asked Questions About Wi-Fi (http://www.hc-sc.gc.ca/ewh-semt/radiation/cons/wifi/faq-eng.php); Health Canada Statement on Radiofrequency Energy and Wi-Fi Equipment (http://www.hc-sc.gc.ca/ahc-asc/media/ftr-ati/_2010/2010_142-eng.php) To further increase consumer awareness of pesticide product safety issues, Health Canada: Delivered seminars to targeted consumer groups/associations (e.g. immigrant consumer groups). Developed content and processes to improve transparency of compliance activities and decisions via the internet/website. Under the Consumer Information Strategy, activities included outreach programs to increase consumers' awareness and understanding of pesticides; understanding of pesticide regulation and pesticide use and management. Participated as exhibitors at 29 events across Canada to raise consumer awareness of pesticide regulation. Expanded web content and created multilingual pest notes and factsheets (examples include bedbugs, spray drift in residential areas on personal protective equipment) Produced booklet/web content on the safe use of swimming pool and spa chemicals. Developed content on how to effectively control rat/mice infestation. Continued consumer education efforts on Healthy Lawns information. 26 news articles were written and published by News Canada Services to reach local residents across Canada on the importance of proper label use and homemade recipes. (i.e. bedbugs, registered, unregistered, pools, chemical safety etc.).
Health Canada	Consumer Products	Targeted Oversight	$15.7	$ 3.8	$5.43	Improved timeliness and quality of information on consumer product safety	In order to improve the timeliness and quality of information on consumer product safety, we: Developed industry guidance on the CCPSA mandatory incident reporting provisions Established a dedicated division to triage and monitor consumer and industry mandatory incident reports to help identify and analyze emerging trends and hazards with respect to consumer product health and safety Established a dedicated risk assessment division, and related policies and procedures, to conduct risk assessment on high priority consumer product incidents Developed a new business information system (RADAR) to help track and manage information on consumer and industry incident reports
						Improved Cosmetic Regulations under the Food and Drugs Act	Health Canada continued to work on: Proposed amendments to the Cosmetic Regulations under the Food and Drugs Act - the analysis and recommendation for the first phase of amendments was completed and will be consulted on with the public in 2011 Personal Care Product Working Group to classify products at the cosmetic-drug interface. Improving and creating new IT systems for processing Cosmetic Notifications submitted to Health Canada by industry and flagging unacceptable cosmetic products for compliance action We also conducted public consultations on changes to the Cosmetic Ingredient Hotlist, which is a tool used by Health Canada to communicate to industry ingredients or concentrations of ingredients that are considered to be unacceptable for use in cosmetics.
						Increased sharing of information with international regulators	With a view to increased sharing of information with our international regulatory partners to enhance consumer product safety in Canada, we: Continued implementation of the Memorandum of Understanding with China on the safe manufacturing of consumer products. We signed a Canada-China Letter of Intent for an action plan in September 2010. Provided input into the Canada-European Union (EU) Free Trade Agreement (CETA) negotiations. Continued ongoing bilateral discussions with the US and quarterly Canada-US-Mexico teleconferences to share best practices and information on emerging trends or concerns related to consumer products in the respective jurisdictions and to discuss and identify opportunities for joint collaboration. Created the joint PilotAlignment Initiative to explore harmonization of technical requirements on certain consumer products with US, EU and Australia Actively participated on the Organization for Economic Co-operation and Development (OECD) Committee on Consumer Policy's Working Party on Consumer Product Safety. Established dedicated capacity to international affairs for consumer product safety. With respect to radiation emitting devices, we collaborated with the following International regulatory partners: International Standards Organization (ISO) Working Groups to support recommendations for noise declarations with machinery sold in Canada - Noise from Machinery Intended for the Workplace WHO/IARC to develop Monograph 102 on Radiofrequency Fields (includes mobile phones). International Committee for Electromagnetic Safety to develop/revise IEEE standards and to develop standard operation procedures for measurement of Radiofrequency energy. As a member of the International Electrotechnical Commission, Subcommittee 62B, currently reviewing international standards for mammography and dental X-ray equipment.
Health Canada	Consumer Products	Rapid Response	$17.9	$4.6	$6.20	Improved legislative authority and regulatory tools for consumer products	The cornerstone of the FCSAP is improved legislative authority and regulatory tools for consumer products. The Canada Consumer Product Safety Act (CCPSA) gives the Government stronger and more modern legislative powers to help protect Canadians from unreasonably dangerous consumer products. After its third introduction to Parliament, the CCPSA received Royal Assent in December 2010. The Order Fixing June 20, 2011 as the Day on which the CCPSA Comes into Force was published in the Canada Gazette, Part II, and the following regulations were created/amended in order to transfer existing prohibitions and regulations from the Hazardous Products Act (HPA) to the CCPSA: Surface Coating Materials Regulations; Children's Sleepwear Regulations; Restraint Systems and Booster Seats for Motor Vehicles Regulations; Toys Regulations; Candles Regulations; Children's Jewellery Regulations; Face Protectors for Ice Hockey and Box Lacrosse Players Regulations; Ice Hockey Helmet Regulations; Textile Flammability Regulations; Regulations Amending the Asbestos Products Regulations; Regulations Amending the Consumer Chemicals and Containers Regulations, 2001 In addition, new regulations that were published in Canada Gazette, Part II and now fall under the CCPSA: Regulations Amending the Surface Coating Materials Regulation; Consumer Products Containing Lead (Contact with Mouth) Regulations; Cribs, Cradles and Bassinets Regulations; Phthalates Regulations In support of modernizing the Radiation Emitting Devices Act (REDA), policy research and analysis has been completed. It was concluded that while legislative modernization would be beneficial in order to have consistent authorities across Health Canada legislation for similar products (e.g. consumer products and medical devices), legislative changes will not be pursued at this time. Work will focus on enhancing the administration and enforcement of the existing legislation. This will include leveraging other legislation/regulations that govern the health effects of radiation emitting devices (e.g. Canada Consumer Product Safety Act for consumer products and the Medical Devices Regulations under the Food and Drugs Act for medical devices); updating existing regulations and creating new regulations to better utilize the existing authorities under REDA; working in partnership with other federal regulators; and making better use of existing resources to manage radiation emitting devices. We are developing Memorandum of Understanding with other Government departments for REDA assessments: MOU with Industry Canada and Department of National Defence in final review. MOU in progress with Canadian Air Transport Security Authority, Correctional Services Canada and Transport Canada
						Improved monitoring of consumer and cosmetic products	The regulatory regime for the Consumer Product Safety Program is based on post-market surveillance and monitoring. In order to measure industry compliance, requirements are tested according to a planned cycle (the Cyclical Enforcement Plan). The 2010-2011 cycle targeted 13 product categories with identified hazards and baseline data (as identified in previous cycles). Carpets (20 samples- 15% non-compliant ); Carriages and Strollers (9 samples- 100% non-compliant); Cellulose Insulation (10 samples- 20% non-compliant ); Charcoal - warning labels (55 samples- 42% non-compliant ); Children's Sleepwear (9 samples- 33% non-compliant ); Corded Window Coverings (no samples from preliminary survey); Cosmetics: (97 samples- 4% non-compliant ); Cribs and Cradles: (23 samples- 100% non-compliant); Mattresses (futons)- (26 samples: 73% non-compliant ); Teethers (11 samples- 9% non-compliant ); Tents (20 samples- 100% non-compliant); Toys (plush) (27 samples- 41% non-compliant ); Toys (rattles) (29 samples- 10% non-compliant ). Corrective action was taken on 100% of non-compliant cases. Corrective action can include: recalls, industry communication, stop-sales, education and industry commitments. Regional compliance and enforcement activities were delivered in accordance with work plans, including implementation of the cyclical enforcement projects, compliance promotion, inspections of industry in communities outside of major cities, inspections at customs, and monitoring of recalled products. Note: Not all establishments are inspected so this does not give an indication of the compliance rates for the entire market for a given product category. Overall, Health Canada is on track with inspections, sampling and testing for the cyclical enforcement plan. The plan was revised to account for CCPSA implementation and to add new regulations. In addition, an unscheduled survey of hair smoothing products was carried out in response to the introduction of a new type of product on the market and resulting consumer complaints. 22 products were found to contain hazardous levels of formaldehyde and were removed from the market.
Health Canada	Pesticide Regulation	Active Prevention	$6.9	$1.64	$1.37	Increased industry (manufacturers and retailers) awareness of risks and related regulatory requirements	Delivered a consultation program with industry (manufacturers and formulators) regarding pesticide manufacturing quality control and assurance (38 consultations). Assessed industry's level of awareness of regulatory requirements and exchanged information. Delivered first phase of a consultation program with rental property associations (84 consultations) to determine their level of knowledge related to the safe use of pesticide products and associated regulatory requirements. The associations' mechanisms for reporting pesticide related incidents and degree of communication with their membership was also assessed. Delivered ten presentations to pest control operators and their technicians in Alberta and Quebec, providing an overview of the regulatory process and introduction to online tools (e.g. label search). Provided information during inspections to 135 vendors and importers/distributors in order to raise awareness related to regulatory requirements. Participated in the annual F/P/T meeting and the annual Association of American Pesticide Control Officials (AAPCO) meeting. Met with Chinese consumer and vendor associations which facilitated the delivery of seminars to immigrant groups on the safe use of pesticides and associated regulatory requirements. Contributed to ongoing internal discussions related to a policy/regulatory approach for articles treated with pesticides.
Health Canada	Pesticide Regulation	Rapid Response	$8.0	$2.1	$1.75	Improved monitoring of pest management products using a risk management approach	Delivered an inspection program of pool and spa product vendors (110 inspections). Follow-up action on non-compliance included letters to registrants. Delivered an inspection program targeted at vendors suspected to be selling unregistered international pest control products (e.g. insecticidal chalk, mothballs) and importers/distributors (135 inspections), resulting in 63 enforcement actions. Translated (Chinese) fact sheets were developed and distributed. Developed and piloted the use of PMRA compliance risk assessment templates and tools to resolve consumer product safety issues. A risk-based targeting guidance document was drafted to facilitate the planning/prioritization of compliance activities. Initiated a cyclical inspection program to systematically monitor and verify compliance of regulated groups/communities, including those related to consumer pesticides. A new Compliance Results Tracking database for use by compliance officers was implemented, including web reporting capability. Amended Administrative Monetary Penalties (AMPs) Regulations and published in Canada Gazette I and II, enabling Notices of Violations to be issued for a wider range of violations that were part of the new PCPA legislation in 2006, including violations for Sales and Incident Reporting, and significant work on updating AMPs procedures. Participated in a pilot to streamline the interface between the Canadian Border Services Agency (CBSA) and Health Canada related to compliance issues through the use of call centres. Worked with CBSA to strengthen oversight at the border, including drafting of an Annex in support of the Umbrella Memorandum of Understanding between Health Canada and CBSA. As part of the Single Window Initiative, initiated participation in the CBSA Pathfinder Project to enable PMRA to receive pesticide importation data collected by CBSA. Shared compliance and enforcement information with the US EPA and discussed shared issues/concerns related to consumer pesticides. Compliance activities were delivered within Canada as a result of this information sharing (e.g. Health Canada alerted Canadian consumers who had purchased through the internet an unregistered pesticide). Chaired the OECD Expert Group on Compliance, which drafted a final version of the Pesticide Compliance & Enforcement Best Practice Guidance document to be submitted to the OECD Risk Reduction Steering Committee. The document includes guidance on conducting compliance activities related to the distribution, storage, use, and container recycling/disposal of pesticides.
Health Canada	Food Nutrition	Active Prevention	$29.6	$6.7M	$6.5M	Establishment of the appropriate instrument or mix of instruments, including regulatory and non-regulatory measures (standards, policies, etc.) to address immediate areas of concern	Regulation: Regulations related to "Enhancing labelling for food allergens, gluten sources and added sulphites" were published in February 2011 in Canada Gazette, Part II (CGII). Completed a regulatory amendment related to the approval of the additive "micocin", an application aimed to prevent listeria growth in ready-to-use meats. Regulatory amendments enabling 14 food additives were published in CGII, and 11 Interim Marketing Authorizations (IMAs) were published in CGI. Guidance and Policy: New risk communication material on the microbial safety of fresh produce was published (http://www.hc-sc.gc.ca/fn-an/securit/kitchen-cuisine/safety-salubrite/index-eng.php) Health Canada's Policy Direction With Respect To Revising Canada's Gluten-Free Labelling Regulations was published. Guidance on the preparation of powdered infant formula in the home and hospital/care settings was published: (http://www.hc-sc.gc.ca/fn-an/securit/kitchen-cuisine/pif-ppn-eng.php). Completed risk/exposure assessment of the natural toxin Deoxynivalenol (DON) in order to develop a Canadian guideline for the presence of it in Canadian foods
						Increased understanding of food safety risks, alert systems and safety systems	Participated in the evaluation of options for risk profiling tools and exchanged information on the use of such tools with our international counterparts (USDA/USFDA)
						Increased engagement by Canadians in the regulatory system Increased industry knowledge regarding food labelling	Completed the Allergen Regulations consultation on key areas identified under CG1 and posted summary on the HC website. Conducted public consultations on the proposed policy intent for revising Canada's Gluten Free labelling requirements. Conducted consultations on the use of allergen precautionary statements on pre-packaged food labels. Completed public consultations on the proposed definition of dietary fibre. Evaluated more than 200 of Health Canada's consumer-oriented Web pages for plain language and formatting, including Food Branch pages. Improved tracking data through the Public Enquiries Centre. Established a central contact centre for consumer phone and email requests for information on food and product safety issues. Created the inaugural Food Regulatory Advisory Committee (FRAC), with membership across several sectors including Patient/Consumer, Health Professional/Regulatory, Research/Academia, and Industry. Consulted the FRAC on several topics
						Increased industry understanding of and engagement in the development and implementation of food safety risk mitigation processes Improved international collaboration in addressing common import risks	Canadian summary report from the 42nd session of the Codex Committee on Food Additives, at the IDC/Codex meeting. As the e-WG lead, Canada prepared and presented the Melamine Codex Maximum Level (ML) document at 4th session of Codex Committee on Contaminants in Food (CCCF). Continued industry engagement on proposed risk management strategies to reduce exposure of the natural toxin Ochratoxin A (OTA) in food. Developed and presented the Codex discussion paper on the management of DON in the food supply at the 5th session of the Codex Committee on Contaminants in Food. Made use of international chemical liaison groups for food safety for information sharing and issue identification. Established regular forums with like-minded regulators on emerging issues
	Food Nutrition	Rapid Response	$1.3	$0.3	$0.2	Increased public understanding of food safety risks, alert systems and safety systems	Be Food Safe campaign - Provided expertise, financial support, developed new education materials (i.e. food safety wheel, Be Food Safe bilingual video, Food Safety for Family brochure). Launched/continued marketing initiatives for Children's Health and Safety, Safe and Informed Consumers, Hazardcheck and other initiatives. Improved consolidation and tracking data through the Public Enquiries Centre. Established a central contact centre for consumer phone and email requests for information on food and product safety issues. Launched social media platforms, including a new Recalls and Safety Alerts mobile app and a cross-departmental widget for consumers. Developed a 'foodborne illness' section for Healthy Canadians, as well as revision of Web pages and It's Your Health articles on food safety.
Canadian Food Inspection Agency (CFIA)	Food Safety & Nutrition Risks	Active Prevention	$114.2	$25.8	$23.09	Increased understanding of food safety risks by HC, PHAC & CFIA	Enhanced the CFIA's Food Safety Risk Prioritization process through the use of two tools: population of the iRisk Tool, a science-based risk ranking for food/hazard combinations (FHCs), completion of a pilot with 70 FHCs, and collaborative research efforts with PHAC, HC, University of Alberta, and University of Massachusetts Amherst, on the development of a Multi-Factorial Risk Prioritization Framework tool which takes into consideration other factors such as market impact, social sensitivity, and consumers perception. Five (5) risk profiles were developed - Salmonella in fresh Tomatoes; Ochratoxin A in Cereals and Cereal Products; Salmonella in Spices; Melamine in Imported Milk Ingredients; and Escherichia coli 0157:H7 in Baby Spinach. The draft reports, which are a compilation of scientific information on specific food hazard combinations, are at various stages of completion. Development of novel platforms for testing and detection of pathogens such as Listeria, Shigella and Campylobacter. Conducted targeted surveys on microbiological and chemical hazards for which over 25,395 samples were collected resulting in 59,254 different microbiological and chemical tests being performed. The analysis of the results of ten (10) targeted surveys on chemical hazards were completed: Arsenic speciation in rice and pear products; Aflatoxins in dried figs and dried dates ; Undeclared Allergens in baby food; Bisphenol A in infant food and formula; Melamine/Pesticides and Metals in milk based and soy based products; Food colours in manufactured foods; OTA/'DON in selected foods; Pesticide/Metals in fresh fruit and vegetables; Pesticide/Metals in dried tea; Fining agents in wine The analysis of the results of five (5) targeted surveys on microbiological hazards was completed: Bacterial Pathogens and Indicators of Faecal Contamination in Leafy Green Vegetables in the Canadian Market (imported and domestic, conventional and organic, pre-packaged fresh-cut); Bacterial Pathogens and Indicators of Faecal Contamination in Fresh Leafy Herbs in the Canadian Market (imported and domestic); Bacterial Pathogens in Cantaloupes in the Cnidarians Market (imported and domestic whole, imported fresh -cut); Bacterial Pathogens and Indicators of Faecal Contamination in Tomatoes in the Canadian Market (imported and domestic, conventional and organic); Salmonella in Peanuts and Peanut-derived Products in the Canadian Market (imported and domestic)
						Establishment of the appropriate instrument or mix of instruments, including regulatory and non-regulatory measures (standards, policies, etc.) to address immediate areas of concern	Continued development on the submission package for the proposed regulations pertaining to the Imported Foods Products Sector under the Canada Agricultural Products Act. Continued work with Health Canada on the development of legislative amendments to the Food and Drug Act.
						Increased industry understanding of and engagement in the development and implementation of food safety risk mitigation processes Improved international collaboration in addressing common import risks	CFIA published the Guide to Food Safety (GFS) to provide guidance to the food industry on the design, development and implementation of effective preventative food safety control systems. For the Fresh Fruit and Vegetable (FFV) Sector, CFIA implemented changes to food safety monitoring programs focussing its inspection activities on high risk sector of the industry, such as packers and re-packers of fresh leafy vegetables, herbs and green onions. Enhanced engagement with international regulatory counterparts to advance food safety information exchange and inform risk management approaches. Signed MOU to facilitate exploration of approaches for rapid exchange of information and handling of food safety emergencies with the General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China (AQSIQ).
						Increased engagement by Canadians in the regulatory system Increased industry knowledge regarding food labelling	CFIA A public consultation to receive feedback on proposed requirements to enhance the safety of imported foods was conducted. The feedback, received both through on-line submissions and during face to face sessions held in five cities across the country, was constructive. It will be used to inform proposed regulations. 27 labeling investigations related to Product of Canada were conducted. Government of Canada committed to review the "Product of Canada" guidelines to ensure they continue to meet the needs of both consumers and Canadian industries. Consultations ended in September 2010 on the need to exempt imported sugar, salt and vinegar when making a "Product of Canada" claim on foods that contain those ingredients and the possibility to remove qualifiers from the "Made in Canada" claim. The Agency is analyzing the information gathered and will post the results on its website.
Canadian Food Inspection Agency	Food Safety & Nutrition Risks	Targeted Oversight	$77.0	$19.2	$13.19	Increased verification of industry food safety measures	Implementation of the FFV Establishment Inspection Pilot Project - for Packer and Re-packers of Fresh Leafy Vegetables, Green Onions and/or Herbs during which 9 inspections were completed. Delivered the following training to inspection staff: Microbiological Sampling, Introduction to Fresh Produce Safety, Understanding Food Allergens, Food Safety Investigation. Continued the update of existing and development of new training material in support of FSAP activities implementation. In the non-federally registered sector, a total of 803 inspections were conducted, in the four identified priority areas of greatest risk (produce, mycotoxins in cereal, imported ingredients, undeclared allergens): 68 related to Microbial Pathogens in Spices; 15 related to Microbial Pathogens and Patulin in Pasteurized Apple Juice and Cider; 37 related to Pathogens in RTE Fresh Cut Vegetables; 39 related to Pathogens in Sprouts; 90 related to Allergens and Salmonella in Domestic and Imported Chocolate; 46 related to Microbial Pathogens and Patulin in Unpasteurized Apple Juice and Cider; 36 related to Alfatoxin and Salmonella in Imported Nuts, Peanuts and Peanut Butter; 472 related to Allergen Controls at Importers of non-federally registered foods.
						Improved ability to monitor and control importation of food	Increased identification of imported products entering Canada through improvements to the Automated Import Reference System database for tracking of imported products entering Canada through increasing the number of Harmonized System Codes available for classifying traded products. Completion of Phase I of IM/IT enhancements, by implementing foundational elements which will support applications for enhancing importer identification and imported product tracking. 54 Border Blitz inspections, 61 Post-Entry Import Verifications, and 367 import surveillance activities were conducted.
Canadian Food Inspection Agency	Food Safety & Nutrition Risks	Rapid Response	$32.2	$7.4	$5.73	Timely and efficient recall capacity	Expanded microbiology laboratory capacity for recalls through the implementation of a 7-day work week. Increased # of employees working on FSAP by 10% of which 36% are new to the Agency. By the end of 2010-11, the CFIA managed over 200 food recall incidents, and conducted 4668 food safety investigations. In 2010-11, the CFIA efficiently managed 131 public warnings for Class I recalls. All warnings were issued within the 24 hours following the declaration of a warning. Enhanced awareness of the recall process through e-mail notifications of all Class 2 and 3 undeclared allergen recalls are sent directly to subscribers.
						Increased public understanding of food safety risks, alert systems and safety systems	The "Canada's 10 Least Wanted Food borne Pathogens" publication series was completed. This provides a package of information which included a brochure, activity sheet and trading cards to better inform consumers on the nature of the microorganisms which can cause food borne illness. A consumer-friendly booklet - "Common Food Allergies - A Consumer's Guide to Managing the Risks" - was published, containing key information on the most common food allergens. Past food safety issues have highlighted the importance of gathering regular feedback from Canadians on food safety, food recalls and confidence in Canada's food safety system. Results have helped inform outreach initiatives and policies related to food safety. It helps provide the Agency with a better understanding of consumers' awareness, attitudes and behaviours in terms of food safety, and helps ensure communications material is consistent with the needs of Canadians. Targeted POR conducted in February of 2011 revealed that Canadians' confidence in Canada's food safety system noticeably increased since 2007-08. CFIA also launched the Consumer Association Roundtable, which ensures that consumers (target population) have a voice in the food safety continuum. Recent POR findings show that consumers look to a variety of media to obtain their information. Among those preferred: social media, televised and print news. In 2010-11, the CFIA began making information readily available through additional email alert notifications (i.e. Class II and III recalls), Twitter and Facebook. By using social media tools, the CFIA has diminished the need to search for this information on its website. However, traffic to the CFIA website does remain consistent, with a noticeable spike in activity during times of an outbreak (i.e. Listeria). By the end of 2010-11, the CFIA had 47,500 subscribers to the recall and allergy alert email notification service, and over 1,800 Twitter followers. Seven targeted survey reports were posted to the CFIA website. These present information on the findings of CFIA's targeted surveys regarding the occurrence of contaminants in the food supply. Four microbiology: (Bacterial Pathogens and Indicators of Faecal Contamination in Domestic Unpasteurized Apple Cider / Juice; Bacterial Pathogens and Indicators of Faecal Contamination in Leafy Green Vegetables; Bacterial Pathogens and Indicators of Faecal Contamination in Tomatoes and Cantaloupes; Hepatitis A Virus in Green Onions and Strawberries) Three chemistry: (Aflatoxin in Dried Figs and Dried Dates; Bisphenol-A in Infant Food and Formula; Ochratoxin A and Deoxynivalenol in Selected Foods)
Public Health Agency of Canada	Surveillance and Population Health Assessment )/ Disease and Injury Prevention and Mitigation	Active Prevention	$18.3	$4.1	$3.5M	Increased understanding of food safety risks by HC, PHAC, & CFIA Emerging and re-emerging food-borne, environmental and zoonotic infectious diseases outbreaks are responded to and controlled Stakeholders are knowledgeable of research and tools pertaining to food-borne, environmental and zoonotic infectious diseases	Capability to perform the latest generation laboratory fingerprinting method (MLVA) was certified for PulseNet Canada (NML) by US CDC in Atlanta. PulseNet Canada (NML) now offers E. coli MLVA laboratory service to all PulseNet Canada members. Genomics has been used to research and develop a novel laboratory fingerprinting method for Salmonella Enteritidis. Current laboratory methods for this foodborne pathogen do not always help support outbreak investigations and identification of contaminated food sources. CIPARS integrated surveillance of antimicrobial resistance in the foodchain continued sampling in 7 provinces. In addition to the major domestic commodities (beef, chicken, pork), sampling included selected imported meats (e.g. lamb), domestic and imported seafood (e.g. shrimp), and, through an agreement with CFIA, selected imported produce was also tested. The knowledge synthesis and translation approach to prioritizing targets for surveillance of antimicrobial resistance in seafood was completed. Molecular characterization of isolates continued for retail sampling and comparison with isolates from other CIPARS segments (farm, abattoir, human). C-EnterNet integrated surveillance of enteric pathogens continued in the original sentinel site in Ontario and a second site was initiated in British Columbia. In addition to sampling in core domestic commodities (beef, chicken, pork), retail sampling included high risk imported products including leafy greens and berries. Increased sustainable capacity for molecular characterization of foodborne pathogens will allow for rapid and accurate identification of bacteria associated with outbreaks in Canada. An on-going assessment of new molecular characterization methods for differentiation of foodborne pathogens is being carried out in order to improve accuracy and turn around time. Key pathogen serotypes have been prioritized for molecular characterization using a comparison of the LFZ's data for bacteria from non-human sources with the NML's data for human sources. Supported FPT pathogen reduction efforts in addressing food-borne disease associated risks through the application of a risk prioritisation tool within case studies. This approach is unique because it includes considerations of economic, perception, social criteria and human health risks. This tool is targeted for future implementation by CFIA. PHAC continued their dialogue with Provinces and Territories to expand the capacity of the web-based Outbreak Summary Reporting System, which was developed with extensive provincial/territorial input. The system allows standardised dissemination of the results of disease outbreak investigations. An Enteric Module of the application was launched in Prince Edward Island in July 2010 and in Newfoundland and Labrador in October 2010.
Public Health Agency of Canada	Health Promotion/Chronic Disease Prevention and Control	Targeted Oversight	$8.0	$2.0	$1.10	More and better data on accidents, injuries, illnesses and deaths due to consumer products Engagement of risk assessment stakeholders	Databases created/improved against plan: The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database was improved at each stage of surveillance, beginning with data collection through to analysis and dissemination. A new data element was created in CHIRPP to track the proportion of consumer-product related injuries. The most recent CHIRPP data available (all ages) show 48% of CHIRPP cases to be consumer product-related (compared to 45% in the previous cycle). For the target age groups 0-4 years, 0-9 years and 0-18 years the percentages are 55% vs. 53%, 55% vs. 52% and 50% vs. 48%, respectively. The Canadian Coroner and Medical Examiner Database (CCMED) was developed to obtain further details on investigated deaths to build evidence base for prevention. Methodological fine-tuning of the CCMED database to optimize identification of consumer product-related deaths. Assessment of enhanced surveillance of helmet use/compliance in winter sports (in cooperation with HECS). The Canadian Longitudinal Survey on Aging was expanded/improved against the plan CCMED: Coroners' Database development completed, and preliminary analysis of data underway. Established CCMED Working Group Other progress: Initial phases of surveillance system modernization underway to facilitate ease of product-related injury data collection. Winter sport helmet pilot study - Phase 1 of data collection completed, analysis underway. Done in cooperation with HECS. Completion of falls surveillance pilot study in BC. Organized a stakeholder meeting in cooperation with HECS and SafeKids Canada to host: A Dialogue on Poisoning Prevention in Canada. Knowledge translation through presentations at national and regional injury prevention and child health conferences. 5 new reports, briefs and posters on product related injuries. Data/reports to key stakeholders Report from Carbonear General Hospital feasibility study on risk assessment of consumer product related injury Review relevant to falls-related injuries. Risk assessment of activity-limiting injury in the Canadian Population Longitudinal Health Survey 1994-2006. Risk assessment of incidence of injury associated with immigration status and length of immigration in Canada. Risk assessment of risk factors for unintentional injury in Canada. Risk assessment of All-Terrain Vehicle (ATV) related injuries Canadian Longitudinal Survey on Aging (CLSA) Completed: Protocol to Study Consumer Product and Falls Related Injuries in the Canadian Longitudinal Study on Aging. Completed: Literature review relevant to falls-related injuries (narrative review, review of reviews and a systematic environmental scan). Completed: Injury and Consumer Product Related Falls Module developed and approved for implementation. Sentinel Centre Consumer Product Related Injury Risk Assessment (CPRIRA).Meeting held to seek consensus on adapting a current Emergency Room surveillance program to include product-related injury data collection. Memorandum of Agreement established with Kingston General Hospital. Data linkage between National Trauma Registry, National Ambulatory Care Reporting System and Discharge Abstract Database initiated for injury risk assessment analysis. Completion of best practices in injury prevention for seniors in residential centers, including the principles of effective practices; Completion of best practices in injury prevention interventions (snow and ice and other topics).
Canadian Institute of Health Research	Strategic Priority Research	Targeted Oversight	27.1	6.93	$2.13	Increased knowledge of post-market drug safety and effectiveness to inform decisions Increased capacity in Canada to address priority research on post-market drug safety and effectiveness	Also see: DSEN, Health Canada, Health Products, Targeted Oversight The DSEN Steering Committee (DSEN SC) was established by CIHR in September 2010. Membership includes senior executives from federal and provincial governments, national organizations and from the research, health care provider and patient communities. The DSEN SC met twice in 2010-11, establishing their TOR and a first agenda for DSEN research. The DSEN Coordinating Office (DSEN CO) established an interim Science Advisory Committee to identify research projects among the list of questions posed by decision makers (DSEN Queries) since 2009/10 that could be initiated in 2011-12. Eight DSEN Queries were identified as being researchable in 2011-12 by DSEN collaborating researchers identified through funding opportunities launched in 2010-11. CIHR launched the competition to establish the first of three DSEN Collaborating Centres in September 2010. One application was received and deemed meritorious in Jan 2011, allowing DSEN to provide $17.5 M over 5 years to the Canadian Network for Observational Drug Studies (CNODES). CNODES brings together 12 principal investigators and co-investigators and 56 collaborators, representing investigators in eight provinces. In February2011, DSEN launched two additional funding opportunities to create five research teams in two new Collaborating Centres, one for Prospective Studies and a second for Network Meta-Analysis and Innovative RCT Designs. This funding opportunity closed June 1, 2011 and the meritorious applicants will be funded for up to $5.6 M over three years in September 2011. DSEN held two Knowledge translation events in 2010-2011. The DSEN collaborative innovation forum on Research Methodologies in Real World Drug Safety and Comparative Effectiveness was held in November 2010. This event brought together experts in the regulatory, academic, and industry communities in a neutral environment to engage in discussions relating to research methods applicable in the areas of drug safety and comparative effectiveness. In March 2011, DSEN held its inaugural Knowledge Translation Forum on Post-Market Drug Safety and Effectiveness, bringing together researchers and knowledge users to discuss emerging real word safety and effectiveness research on drugs. This forum focussed on sharing of preliminary results from the 14 DSEN Catalyst Grants funded in 2009-2010. Participant feedback showed > 85% of participants rated the events as good to excellent, clearly meeting the stated objectives and having relevant, comprehensive and practical content.

Comments on Variances:

Health Products	The late release of the frozen allotment for "mandatory reporting" did not allow for sufficient time to make significant expenditures. In addition, fewer pre-submission meetings were held than expected and fewer positions were staffed than anticipated in 2010-11. In order to focus strategically on developing the DSEN network of collaborating researchers, CIHR/DSEN focused efforts on the establishment of the key pan-Canadian network of research centres that delivers the core research capacity for the DSEN initiative.  The time and effort required to reach the desired outcome suggested that, to be prudent, DSEN should manage funding between the implementation years to best target the DSEN Grants budget to research that aligns long term with the DSEN mandate and objectives. Thus $4.37 M from 2010-11 and $1.2 M in 2011-12 has been reprofiled within the DSEN budget in equal amounts across 2012 - 2016.
Consumer Products	The CCPSA did not receive Royal Assent until December 2010, after its third introduction into Parliament. A portion of FCSAP funding was frozen pending Royal Assent and as a result many initiatives were delayed until the last quarter of 2010-11
Food Safety	In the third year of implementation of the Food and Consumer Safety Action Plan, the CFIA experienced a delay in the completion and approval of the Effective Project Approval submission for the IM/IT project to support initiatives falling under both Active Prevention and Targeted Oversight. Further contributing to the lapse under Targeted Oversight, is the stage of development of the importer licensing program. Specific details require refinement before training and delivery can commence. Delays in staffing processes at national Headquarters resulted in under spending in activities falling under Rapid Response. Funds lapsed are being carried forward. Due to the delays in staffing and staff turnover, collectively the full salary allocation and associated O&M funding was not expended in full by PHAC.

Results to be achieved by non-federal partners (if applicable): N/A

Contact information:
Hélène Quesnel, Director General
Legislative and Regulatory Policy Directorate
Strategic Policy Branch
Health Canada
Telephone: (613) 952-3484
E-mail: helene.quesnel@hc-sc.gc.ca

Weblinks

• Healthy Canadians
• Consumer Product Safety
• Consumer Product Recalls
• Advisories, Warnings & Recall-Food &Nutrition
• Avis, mises en garde et retraits - Aliments et nutrition
• Allergy Alerts-Food Allergies and Intolerances
• Alertes à l'allergie - Les allergies alimentaires et les intolérances alimentaire
• Produce Safety
• Salubrité des fruits et légumes frais
• Safe Food Handling
• À bas les BACtéries! - Manipulation hygiénique des aliments
• Manipulation hygiénique des aliments
• Food Allergen Labelling - Health Canada
• Étiquetage des allergènes alimentaires - Santé Canada
• Safe Food Handling Guide
• Consumer Safety Portal

Name of Horizontal Initiative:

Federal Tobacco Control Strategy

Name of Lead Department(s):

Health Canada (HC)

Lead Department Program Activity:

Substance Use and Abuse

Start Date of the Horizontal Initiative:

April 1, 2007

End Date of the Horizontal Initiative:

March 31, 2011

Federal Funding Allocation:

$363.3M

Description of the Horizontal Initiative (including funding agreement):

The FTCS establishes a framework for a comprehensive, fully-integrated, and multi-faceted approach to tobacco control. It is driven by the longstanding commitment of the Government of Canada to reduce the serious and adverse health effects of tobacco for Canadians. It focuses on four mutually reinforcing components: prevention, cessation, protection, and product regulation.

Shared Outcome(s):

The goal of the FTCS is to reduce overall smoking prevalence from 19% (2005) to 12% by 2011.

Objectives:

• reduce the prevalence of Canadian youth (15 to 17) who smoke from 15% to 9%;
• increase the number of adult Canadians who quit smoking by 1.5 million;
• reduce the prevalence of Canadians exposed daily to second-hand smoke from 28% to 20%;
• examine the next generation of tobacco policy control in Canada;
• contribute to the global implementation of the World Health Organization's Framework Convention on Tobacco Control; and
• monitor and assess contraband tobacco activities and enhance compliance.

Governance Structure(s):

Health Canada is the lead department in the FTCS and is responsible for the coordination and implementation of the FTCS, including delivering the contribution program component and undertaking activities related to our components and objectives. The role of federal partners will remain to monitor and assess tobacco contraband activities.

The partner departments and agencies are:

• Public Safety Canada - monitors increases in contraband tobacco activity and related crime;
• Office of the Director of Public Prosecutions - monitors federal fines imposed in relation to tobacco and other types of offences in order to enforce and recover outstanding fines;
• The Royal Canadian Mounted Police - works with federal partners to identify criminal activities and to coordinate information on national and international contraband tobacco issues;
• The Canada Revenue Agency - administers the Excise Act 2001, which governs federal taxation of tobacco products and regulates activities involving the manufacture, possession and sale of tobacco products in Canada; and
• The Canada Border Services Agency - increases knowledge of contraband domestically and internationally by liaising with tobacco authorities at all levels and by monitoring and providing regular reports on both national and global contraband tobacco.  The CBSA provides reports, information and guidance to the Department of Finance Canada on matters that will impact the future tax structure of tobacco.

Planning highlights

Implementation of the 'Cracking Down on Tobacco Marketing Aimed at Youth' Act (2009), including compliance measures to ensure no tobacco advertising appears in magazines or newspapers, and that certain flavoured tobacco products (e.g. little cigars and blunt wraps) are no longer used in Canada.

Federal Partners	Federal Partner Program Activity	Names of Programs for Federal Partners	Total Allocation (from Start to End Date)	2010-11 ($ millions)
				Planned Spending	Actual Spending	Expected Results	Results Achieved
HC	Substance Use and Abuse	FTCS	$287.34 M	$42.7M	$50.4M	Reduce overall smoking prevalence from 19% (2007) to 12% by 2011	Latest available data (2010) report a 17% overall smoking prevalence. Federal inspections show that 98% of tobacco retailers in Alberta and Saskatchewan are in compliance on sales to youth. (Note: in 2009 retailer compliances rates of 84.3% were based on the Evaluation of Retailers' Behaviour Towards Certain Youth Access-to-Tobacco Restrictions Survey, which included all Provinces. This survey has been discontinued.) 99% of tobacco products inspected are in compliance with labelling requirements. 95% of samples analysed are in compliance with Cigarette Ignition Propensity regulations. Compliance measures with the implementation of the Cracking Down on Tobacco Marketing Aimed at Youth Act did result in 4 warning letters being sent to manufacturers for packages of little cigar products with less than the minimum 20 units.
PSC	Law Enforcement Strategies	FTCS	$3.0 M	0.61M	0.61M	Enhanced partnership arrangement with Akwesasne Mohawk Police. Leading the Canadian Delegation in preparation and participation in the World Health Organization Framework Convention on Tobacco Controls negotiations for a Protocol in illicit tobacco.	See results achieved by non-federal partners (i.e. Akwesasne Mohawk Police) in section 17 below. PS leads the Canadian Delegation in the preparation and participation to negotiate a global Protocol to reduce illicit tobacco which takes place in Geneva. Canada participated in two intersessional working groups in 2010-11, in support of Protocol negotiations. The next negotiating session is scheduled for March 2012.
RCMP	Criminal Intelligence Operations & Technical Policing Operations	FTCS	$8.6 M	$1.5M	$2.6M	Provide regular reports on the illicit tobacco situation to Finance and Health Canada, including data on seizures, organized crime involvement and trends.  Side bar reports and presentations to other partners and key Ministerial entities upon request, such as the Government of Canada Task Force on Illicit Tobacco, the Senior Revenue Officials Conference and the Interprovincial Investigations Conference.  Attend regular meetings to brief the Department of Finance on the illicit tobacco market. Improve border security through the use of sophisticated technology which permits detection and monitoring of illegal border intrusions, resulting in vital intelligence. Co-host the 2011 Joint U.S./Canada Tobacco Diversion Workshop with American and Canadian agencies to be held in spring 2011.  Participate in information sharing sessions with American Law Enforcement partners.  To give presentations at law enforcement courses/workshops in Canada and the U.S. on the subject of contraband tobacco.	Regular reports on the illicit tobacco situation were provided to Finance and Health Canada. Side bar reports and presentations provided to other key partners and key Ministerial entities upon request, such as the Government of Canada Task Force on Illicit Tobacco, the Senior Revenue Officials Conference and the Interprovincial Investigations Conference. The Tobacco Analysts also regularly brief and attend meetings with the Department of Finance. Continued border security through the use of sophisticated technology which permits detection and monitoring of illegal border intrusions, resulting in the collection of vital intelligence. The RCMP increased and enhanced ability to monitor movements of persons, vehicles, shipping containers and other packages in order to determine patterns of operations of persons involved in smuggling of contraband products. Finally, the RCMP deployed tools and techniques to support criminal operations which provided intelligence, interdiction activities and evidence in criminal investigations. There was an increased level of support provided to the investigation of organized crime groups that are involved in the smuggling of contraband tobacco. There was no Joint U.S. /Canada Tobacco Diversion Workshop in 2010 due to the economic recession, however, American and Canadian authorities are preparing the 2011 Workshop that will be held in Ottawa September 13-15. This event brings together members of Canadian and American law enforcement and regulatory agencies who have a vested interest in the illicit tobacco market whether it pertains to smuggling, counterfeit, stolen or other illegal activities. In recent events, the TDW has also included a number of international guests as participants and speakers also involved in tobacco enforcement efforts. The workshop addresses the growing illicit tobacco market and its cross-border flow through an integrated policing and intelligence sharing approach. The Second Progress Report for the implementation of the Contraband Tobacco Enforcement Strategy will be released soon, and will be made public and available online at the RCMP Customs and Excise website. The FTCS supported criminal intelligence analysts for tobacco have attended several training courses regarding contraband tobacco as both students and presenters; they include: Interprovincial Investigations Conference: The aim is to develop, increase and maintain cooperation among all those who are involved in combating the contraband tobacco market by providing current information and contacts in other jurisdictions. IBET Analyst/Intelligence Officer Workshop: This provided an overview on Crime trends, technology strategy and regional overviews. RCMP Customs and Excise Investigators Workshop: The purpose of the workshop is to ensure that C&E investigators from across Canada are aware of ongoing National issues which impact the program, including contraband tobacco, counter proliferation, firearms smuggling and the national program evaluation. Other Meetings: Facilitated meetings with tobacco analysts as well as meetings between the RCMP, US Alcohol, Tobacco, Firearms and Explosives Agency and United States Border Patrol. In 2010, the RCMP seized approximately 782,000 cartons/unmarked bags of contraband cigarettes. This represented a decrease of approximately 20% compared to the 2009 seizure of approximately 975,000 cartons/unmarked bags. The RCMP also seized approximately 5,300 kilograms of raw leaf tobacco, 43,000 kilograms of fine cut tobacco and 142,000 cigars in 2010.
ODPP	ODPP	FTCS	$10.0M	$2.1M	2.1M	Prioritize recovery for fines ordered under cigarette contraband and tobacco sales to youth convictions. Increase the number of fines satisfied by a minimum of 18 percent. Continue to prioritize the most effective and least costly recovery methods. Prioritize payment of fines over incarceration, but enhance enforcement measures when appropriate. Increase registration of outstanding fines in CRA's Set-off program by 20%. Recover against estates whenever possible.	Due to the substantial increase in policing and border control efforts, the number of convictions for offences related to cigarette contraband and illegal sales of tobacco product related fines have increased and the inventory of tobacco-related fines is now at 1036 files of which 623 are solely contraband. The volume of tobacco related fines has increased dramatically. The recoverable amount for these fines is at $25.2M, an increase of 38%. Emphasis has been to put these fines in set-off when there are no assets to seize. Approximately $5.2M has been recovered for all outstanding fines as of YE 2011, a decrease of 13% over the previous year. Over 1,600 files were settled, a decrease of 3.8%. This concerns all fines, not only tobacco related. The Set-off process with CRA has accounted for almost $900K in recovered fines, an increase of 11 % over the previous year (this amount is included in point # 1. Set-off is one of the most cost-effective methods of recovery. Over 8,000 fine recovery interventions were registered during this period and 151 individuals were incarcerated for failure or refusal to pay their fines during this period, of which 17 opted to pay their fines in lieu of remaining in custody. Our target of increasing by 20.4% the registration of outstanding fines for set-off has been reached. 6,041 fines are registered compared to 4,816 last year, for a recovery potential of almost $22M vs $12M last year, an increase of 45.5%. Our volume is at over 20,000 fines. Of these, over 11,600 are drug related fines for which only 57 are over $10K. Of 2,831 payments received via set-off, an increase of 20% over last year. The majority of fines fully satisfied were in the $1 to $10K range. This inventory comprised of fines dating back to 1996 for which offenders could not be located as well as small fines in the $1.00 to $1000. range. Reduction of this inventory will permit units to concentrate their efforts on larger fines.
CRA		FTCS: Assessment and Benefit services Branch	$4.44M	0.2M	0.2M 0.6M 0.09M	Systems adjustments and maintenance to reflect the legislative changes that affect rates, reporting and refunds as well as program changes to include duty-free shops and ships stores. Verify Export Activity Ensure compliance with legislative requirements imposed on the manufacture, possession and sale of tobacco products in Canada. Support CBSA and RCMP enforcement activity, and work with stakeholders to monitor and assess the effectiveness of measures used to reduce contraband tobacco. Provide the Department of Finance with advice to assist in the development of policy and the determination of the magnitude and timing of future tax increases. Funding formula allocation (Justice Canada, and Public Works and Government Services Canada).	Processed returns and payments to ensure correctness; maintained systems and reporting capabilities to meet program requirements. Inspected and monitored shipments of tobacco to be exported from Canada; maintained recording system. Performed audits and regulatory reviews of tobacco licensees to ensure compliance with legislative requirements. Provided technical information as well as expert testimony and affidavits; participated in a number of committees dealing with the monitoring and control of tobacco products including those dealing with inter-provincial issues. Met with the Department of Finance as required; provided industry and product information..
		FTCS: Legislative Policy and Regulatory Affairs branch Funding formula allocation		0.6M 0.09M
CBSA	1.1 Risk Assessment 2.2 Conventional Border Internal Services Loss of Duty Free Licensing	FTCS	28.4	5.7	4.9M 4.3M	Provide advice to Department of Finance on matters that will impact the future tax structure on tobacco. Monitor and report on the contraband tobacco situation in Canada. Expand cooperation with international and national law enforcement partners. Collection of the tobacco duties imposed on personal importations of returning Canadians.	Attended regular meetings with Department of Finance and partners to discuss and serve as a reference for questions on tobacco enforcement issues. Provided monthly analysis of the national contraband situation by compiling reports received from the Regions.  Partnered with RCMP in a joint annual risk assessment regarding the nature and extent of the tobacco contraband market. Coordinated contraband tobacco intelligence collection and development with the Regions. The capabilities of our officers and analysts to infiltrate the marketplace, gather intelligence, liaise with other agencies and process their files has resulted in: an increase in targets for examination, for both companies and individuals; identification of indicators and modus operandi not previously known; identification of emerging trends and threats and the sharing of same within the regions and our domestic and international partners.  Actively participated in Joint Force Operations with law enforcement partners across the Regions.   Developed and maintained contact with international tobacco enforcement personnel.  In 2010-2011, CBSA front line officers continue to collect duties and taxes on tobacco importations.  Many years previous, personal importations of tobacco were exempted from the payment of duties and taxes.  The exemption no longer applies.  Duties and taxes are collected at Ports of Entry on all personal importations of tobacco.
			21.5	4.3
Grand Total:			$363.3M	$57.8M	$65.8M

Comments on Variances:

The CBSA variance of $0.8M was due to not as much work associated with the initiative as planned, resulting is lower spending than anticipated.

The HC variance of $8.0M is due to two transfers from Controlled Substances and Tobacco Directorate (HECS) to Regions and Programs Branch (RAPB) totalling $4.2M as well as $3.8M in corporate costs being omitted from the planned spending of $42.7M in the RPP for 2010-11. Total actual spending is $50.4M including Controlled Substances and Tobacco Directorate (HECS) transfers to Regions and Programs Branch (RAPB) and corporate costs.

RCMP: The support provided by Technical Operations to the FTCS exceeded the funding and resources provided in the strategy due to an increased demand for investigative support and border monitoring.  This increased demand, and related expenses, occurred in locations that received resources under the FTCS and in locations that have not previously been required to provide resources for these activities. The increase in resources provided to this initiative resulted in a decreased capacity to fulfill other mandated activities.

17. Results to be achieved by non-federal partners (if applicable):

The Akwesasne Mohawk Police (AMP) have been able to increase their surveillance and monitoring of tobacco smuggling. The AMP has reported participating in joint forces operations that have led to charges and seizures, including tobacco. All tobacco seizures made by the AMP are turned over to the RCMP for prosecutions and reported through the RCMP Cornwall Detachment.

The Akwesasne Mohawk Police have enhanced their capacity in intelligence development and specialized criminal investigation techniques through their work with Canadian and U.S. law enforcement partners in the context of the Integrated Border Enforcement Team in the Cornwall area. In addition, they have had an opportunity to lead and participate in Joint Forces Operations related to cross-border criminal activities and organized crime.

An evaluation has been conducted by Consulting and Audit Canada under contract to PS. Annual reports are provided by the Akwesasne Mohawk Police, relating specifically to the Joint Investigation Team. These reports detail ongoing efforts by the Joint Investigation Team to combat illicit tobacco activities in the Akwesasne Community, including breakdowns of significant seizures of contraband tobacco.

20. Contact information:
Cathy A. Sabiston , Director General
Controlled Substance and Tobacco Directorate
Healthy Environments and Consumer Safety Branch
Health Canada
Telephone: (613) 941-1977

1. Has the department established green procurement targets?

Yes

2. Summary of initiatives to incorporate environmental performance considerations in procurement decision-making processes:

Health Canada (HC) supports the objectives of the Policy on Green Procurement, including incorporating environmental performance considerations and value for money into the procurement decision-making process. HC promotes training of materiel managers, procurement personnel and cost centre managers (the contract signing authority) on green procurement by encouraging them to take the Canada School of Public Service on-line course, by broadcasting general awareness messages and by participating in Environment Week. The Acquisition Card Policy has been updated to direct cardholders to ensure their procurement practices stand the test of public scrutiny in matters of prudence, honesty and conflict of interest as well as with the implementation of environmental practices.

The Department's procurement planning process is a component of the Health Canada Integrated Planning approach, which allows HC to identify economies of scale through consolidation of acquisitions, resulting in increased flexibility and avoiding delays through greater use of Standing Offer Agreements. HC is also better able to manage risk due to improved lead times for higher dollar value and/or highly complex requirements. The process also provides the opportunity to incorporate environmental performance considerations as appropriate in any consolidated acquisition vehicle HC develops and implements.

The Department is in the process of reviewing procurement related processes and controls to ensure that they incorporate environmental considerations, when appropriate. Updating the Health Canada Fleet Management Standard was the main focus of greening during the fiscal year. The standard directs managers to consider environmental issues when evaluating and planning transportation options. In particular, HC has implemented a fleet vehicle acquisitions standard, based on standardized national operational requirements and matching those requirements with the most environmentally-friendly models available through Standing Offers.

Health Canada produces an Annual Fleet Report that reports on alternative fuels, alternative fuel vehicles, greenhouse gas and air contaminant emissions and various other performance indicators. This report is used to make decisions regarding fleet management and to track progress against sustainable development strategy targets identified in the Federal Sustainable Development Strategy.

The Department has implemented the practice of capturing green procurement information using a field in the existing enterprise system, SAP. The SAP green procurement field serves a dual purpose of

1. Allowing the Department to identify and report on the environmental friendliness of purchases so that decision-making can be influenced.
   
   
2. Serving as a regular reminder to the individuals entering SAP information that there is a Policy on Green Procurement that should be applied to their purchasing decisions.

3. Contributions to facilitate government-wide implementation of green procurement:

Health Canada is identified in the Federal Sustainable Development Strategy and is an active participant in federal procurement reform initiatives, such as the establishment of mandatory standing offers led by Public Works and Government Services Canada (PWGSC), which incorporate environmental performance and lifecycle analysis. The Department has incorporated green procurement tracking procedures in our existing enterprise system through participation in horizontal SAP initiatives with other SAP departments.

4. Summary of green procurement targets:

Green procurement is a key target area listed in the 2011-14 Federal Sustainable. Development Strategy (FSDS) for "Shrinking the Environmental Footprint" of government. The 2010-2011fiscal-year was a development year and each department was to establish:

• At least 3 SMART green procurement targets to reduce environmental impacts;
• SMART targets for training, employee performance evaluations, and management processes and controls, as they pertain to procurement decision-making.
• A target to reduce greenhouse gas emissions from its operations (from the baseline fiscal year 2005-2006), set on a downward trend, thereby contributing to the economy-wide target of a 17% reduction by 2020.

5. Results achieved:

The Department has set targets recommended by PWGSC in areas that are well supported by existing tools, best practices and supplier capacity and interest. This process was selected to support implementation of the targets, since an important consideration was that no incremental funding would be provided for incremental work under the Federal Sustainable Development Strategy umbrella.

As of April 1, 2011, 100% of employee performance evaluations for PG Group Directors and Managers included clauses relating to greening of government operations.

Health Canada is analyzing procurement decision-making processes and controls to identify those that should include environmental considerations. The Fleet Management Standard was reviewed and updated accordingly through consultation with the Regions and programs.

The Department will continue to work with PWGSC on identifying greening opportunities for procurement. Health Canada will also continue communications to increase awareness of green procurement and the need to enter green procurement information for every transaction. Including green procurement in the enterprise system process itself provides a constant reminder to employees that green procurement is one of HC's objectives.

Acquisition card holder training includes a reminder regarding the implementation of environmental practices within the Department. Green procurement training continues to be mandatory for all new Procurement Officers (PG group) and is strongly encouraged for all employees with a role in procurement.

The purchase of alternative fuels has decreased (compared to 2009-10), attributed in part to the lack of access to alternative fuels in many regions across Canada. In 2010-11, 43% of new vehicle acquisitions were vehicles capable of using alternative fuels (ethanol 85, etc.), however, availability of this type of fuel is an ongoing issue.

Name of Horizontal Initiative:

2010 G8/ G20 Summits

Start Date:

April 1, 2009

End Date:

March 31, 2011

Total Departmental Funding Allocation (from start date to end date):

$6.3M (includes both EBP and accommodation costs)

Description of the Horizontal Initiative (including funding agreement): 

Under customary International Law, the Government of Canada has the legal obligation to ensure the security, protection and inviolability of the Internationally Protected Persons (IPPs) participating in international major events taking place in Canada.  This directly leads to a legal obligation to ensure their health protection. Within Health Canada, the IPP Program of the Emergency Health Planning, Preparedness and Response (EHPPR) has this responsibility and it is done through the development and implementation of health plans which include emergency health services and a comprehensive food surveillance program. The work of the IPP Program is implemented in close collaboration and consultation with the Department of Foreign Affairs and International Trade (DFAIT) and the RCMP.

Under section 4(2)(f) of the Department of Health Act, and the Public Safety and Anti-Terrorism II TB Submission, Health Canada through its Physical Emergency Preparedness and Response Unit (HC-PEPR) is responsible for ensuring the health and safety of federal government employees who must meet the challenges of hazards, such as a terrorist attack or disease outbreak and continue to provide essential services.  PEPR provided advice and guidance to federal clients, as well as monitoring and analytical services, risk assessments, information and advisories, control measures and decontamination strategies for chemical, biological, radiological and/or nuclear (CBRN) agents. PEPR supplemented the resources of on-site emergency responders, and worked under their incident command structure.

Existing Public Security and Anti-Terrorism (PSAT) II funding provides for the availability, on a national scale, of a trained Psycho-Social Emergency Response Team (PSERT).  PSAT II funding allows for some training, however, in the event of a situation resulting in a team deployment, either in part or in whole, the costs of these services must be met through incremental resources.  For this reason, funding was sought to allow for a contingent of the PSERT for the G8/G20 events.

Governance Structure(s):

Shortly after the announcement of the 2010 G-8 Summit, DFAIT established the Summits Management Office (SMO) to manage the planning, hosting and reporting on the Summit.  Later on, the work of the SMO expanded to include the G-20 Summit. Health Canada's IPP Program was invited by the SMO to join the Summits Management Committee (SMC) in which all key partners, including the RCMP, PWGSC, and DND, were represented and where all major decisions regarding the planning of both Summits were discussed and made.  Representatives in the SMC were expected to liaise with senior management in their respective home department.

Similarly, PCO organized a series of meetings to ensure G-8 Summit security.  Later on, PCO's work expanded to include the G-20 Summit. Health Canada's PEPR unit was invited by PCO to join these meetings and formed essential linkages with key partners, including the Ontario Fire Marshal and City of Toronto Fire Hazmat, whom PEPR supported in the field and reported up through during the G8 and G20, respectively. 

The services of Health Canada's Psycho Social Emergency Preparedness and Response Team (PSERT) were included in the Security plans for the G8 and G20 events, as coordinated by DFAIT.  Under mandate, Health Canada responds to the psycho social needs of all federal employees, including RCMP and DND when requested.

Department Program Activity	Total Allocation (from Start to End Date)	2010-11 ($ millions)
		Planned Spending	Actual Spending	Expected Results	Results Achieved
PA 3.3	$6.3M (includes EBP and accommodation costs)	$5.6M	$5.1M (includes EBP and accommodation costs)	Health Canada was expected to meet both the urgent and non-urgent health care needs of the IPPs and requests of partner agencies; dedicate on-site services; assist in the coordination of medical services with other federal partners in an emergency or evacuation situation; resolve as quickly as possible any CBRNE / Hazardous Material incidents which could impact on the summits or surrounding communities and thus result in security concerns; ensure an onsite PSERT presence and that an additional PSERT member was on standby to function as the team wellness coordinator; provide for a  pre-event training for the PSERT in Safety/Function/Action; and involve the members to be deployed in exercise Trillium Guardian HC will provide scientific and technical assets to support the national team in security surveillance and response to CBRN threats during the G8/G20.  HC will conduct radiation surveillance monitoring as part of their activities in support of IPPs.	Health Canada met both the urgent and non-urgent health care needs of the IPPs. This involved treating 164 patients at the on-site clinics.  Also, additional burden to the local and provincial health care systems was avoided by limiting access to only 5 patients for further diagnosis or treatment. During the summits, Health Canada responded with partners to 3 incidents, which facilitated a more timely resolution to these situations. We also carried out training for partners to improve interoperability and response effectiveness. Health Canada also had two PSERT members in both Huntsville and Toronto during the events.  In addition, one member was activated throughout the events to coordinate the wellness of the deployed PSERT members. A one - day training was provided in Safety/Function/Action in May of 2010 for all PSERT members and the same three PSERT members were involved in exercise Trillium Guardian as part of preparations for the G8/G20 events. Health Canada deployed staff that were trained and equipped, placed surge detection equipment, and pre-positioning of scientific and technical resources near events including mobile nuclear labs and emergency vehicles needed for event radiological security surveillance. They also enhanced local consequence management readiness support to federal, provincial and municipal security forces and first responders.

Comments on Variances:

Considering the high risk associated with hosting major international summits such as the G8 /G20, the Health Canada must forecast in the context of a "worst-case" scenario. The original budget estimates included, for example, evacuations of IPPs by air ambulances, which represented massive costs.  As a result of the efficient management of resources, effective collaboration with provincial and federal partners, savings achieved through economies of scale, the sound structuring of on-site services to reduce the number of resources required, and the absence of any major security incident involving IPPs, the IPP Program was able to reduce significantly its costs associated with the Summits. This explains the variance between the original amounts requested in the TB Submissions and the actual costs involved.

PEPR spending for the summits was essentially the same as the budgeted allocations. Spending was very close to the amounts requested; however savings were found by having two PSERT members work from the residence of one member [located proximate to the G20 event].  Moreover, as the G8 transitioned from Huntsville to the G20 in Toronto, members deployed to the Huntsville area transitioned at essentially the same time.  This avoided having an overlap of coverage that had been initially anticipated.

In the Radiation Security Surveillance and RN Emergency Readiness area, some salary was not used due to lower demand on staff (OT) than planned.  Lower operating costs than expected due to last minute changes in a number of different areas including but not limited to, accommodations, equipment movement and deployment,

Contact information:

Anthony Sangster
DG, Emergency Preparedness and Occupational Health Directorate
Regions and Programs Branch
Health Canada
Telephone:  613-957-7669

Beth Pieterson
DG, Environmental and Radiation Health Sciences Directorate
Healthy Environments and Consumer Safety Branch
Health Canada
Telephone: 613-954-3859